Reboud, J. , Xu, G., Garrett, A. , Adriko, M., Yang, Z. , Tukahebwa, E., Rowel, C. and Cooper, J. M. (2019) Paper-based microfluidics for DNA diagnostics of malaria in low resource underserved rural communities. Proceedings of the National Academy of Sciences of the United States of America, 116(11), pp. 4834-4842. (doi: 10.1073/pnas.1812296116) (PMID:30782834) (PMCID:PMC6421471)
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Abstract
Rapid, low-cost, species-specific diagnosis, based upon DNA testing, is becoming important in the treatment of patients with infectious diseases. Here, we demonstrate an innovation that uses origami to enable multiplexed, sensitive assays that rival polymerase chain reactions (PCR) laboratory assays and provide high-quality, fast precision diagnostics for malaria. The paper-based microfluidic technology proposed here combines vertical flow sample-processing steps, including paper folding for whole-blood sample preparation, with an isothermal amplification and a lateral flow detection, incorporating a simple visualization system. Studies were performed in village schools in Uganda with individual diagnoses being completed in <50 min (faster than the standard laboratory-based PCR). The tests, which enabled the diagnosis of malaria species in patients from a finger prick of whole blood, were both highly sensitive and specific, detecting malaria in 98% of infected individuals in a double-blind first-in-human study. Our method was more sensitive than other field-based, benchmark techniques, including optical microscopy and industry standard rapid immunodiagnostic tests, both performed by experienced local healthcare teams (which detected malaria in 86% and 83% of cases, respectively). All assays were independently validated using a real-time double-blinded reference PCR assay. We not only demonstrate that advanced, low-cost DNA-based sensors can be implemented in underserved communities at the point of need but also highlight the challenges associated with developing and implementing new diagnostic technologies in the field, without access to laboratories or infrastructure.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Garrett, Miss Alice and Cooper, Professor Jonathan and Reboud, Professor Julien and Xu, Mr Gaolian and Yang, Dr Zhugen |
| Authors: | Reboud, J., Xu, G., Garrett, A., Adriko, M., Yang, Z., Tukahebwa, E., Rowel, C., and Cooper, J. M. |
| College/School: | College of Science and Engineering > School of Engineering College of Science and Engineering > School of Engineering > Biomedical Engineering College of Science and Engineering > School of Engineering > Infrastructure and Environment |
| Journal Name: | Proceedings of the National Academy of Sciences of the United States of America |
| Publisher: | National Academy of Sciences |
| ISSN: | 0027-8424 |
| ISSN (Online): | 1091-6490 |
| Published Online: | 19 February 2019 |
| Copyright Holders: | Copyright © 2019 The Authors |
| First Published: | First published in Proceedings of the National Academy of Sciences of the United States of America 116(11): 4834-4842 |
| Publisher Policy: | Reproduced under a Creative Commons License |
| Data DOI: | 10.5525/gla.researchdata.722 |
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