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      Point-of-Care Diagnostics in Low Resource Settings: Present Status and Future Role of Microfluidics

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          Abstract

          The inability to diagnose numerous diseases rapidly is a significant cause of the disparity of deaths resulting from both communicable and non-communicable diseases in the developing world in comparison to the developed world. Existing diagnostic instrumentation usually requires sophisticated infrastructure, stable electrical power, expensive reagents, long assay times, and highly trained personnel which is not often available in limited resource settings. This review will critically survey and analyse the current lateral flow-based point-of-care (POC) technologies, which have made a major impact on diagnostic testing in developing countries over the last 50 years. The future of POC technologies including the applications of microfluidics, which allows miniaturisation and integration of complex functions that facilitate their usage in limited resource settings, is discussed The advantages offered by such systems, including low cost, ruggedness and the capacity to generate accurate and reliable results rapidly, are well suited to the clinical and social settings of the developing world.

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          Most cited references53

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          Microfluidic diagnostic technologies for global public health.

          The developing world does not have access to many of the best medical diagnostic technologies; they were designed for air-conditioned laboratories, refrigerated storage of chemicals, a constant supply of calibrators and reagents, stable electrical power, highly trained personnel and rapid transportation of samples. Microfluidic systems allow miniaturization and integration of complex functions, which could move sophisticated diagnostic tools out of the developed-world laboratory. These systems must be inexpensive, but also accurate, reliable, rugged and well suited to the medical and social contexts of the developing world.
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            Lateral flow (immuno)assay: its strengths, weaknesses, opportunities and threats. A literature survey.

            Lateral flow (immuno)assays are currently used for qualitative, semiquantitative and to some extent quantitative monitoring in resource-poor or non-laboratory environments. Applications include tests on pathogens, drugs, hormones and metabolites in biomedical, phytosanitary, veterinary, feed/food and environmental settings. We describe principles of current formats, applications, limitations and perspectives for quantitative monitoring. We illustrate the potentials and limitations of analysis with lateral flow (immuno)assays using a literature survey and a SWOT analysis (acronym for "strengths, weaknesses, opportunities, threats"). Articles referred to in this survey were searched for on MEDLINE, Scopus and in references of reviewed papers. Search terms included "immunochromatography", "sol particle immunoassay", "lateral flow immunoassay" and "dipstick assay".
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              Three-dimensional microfluidic devices fabricated in layered paper and tape.

              This article describes a method for fabricating 3D microfluidic devices by stacking layers of patterned paper and double-sided adhesive tape. Paper-based 3D microfluidic devices have capabilities in microfluidics that are difficult to achieve using conventional open-channel microsystems made from glass or polymers. In particular, 3D paper-based devices wick fluids and distribute microliter volumes of samples from single inlet points into arrays of detection zones (with numbers up to thousands). This capability makes it possible to carry out a range of new analytical protocols simply and inexpensively (all on a piece of paper) without external pumps. We demonstrate a prototype 3D device that tests 4 different samples for up to 4 different analytes and displays the results of the assays in a side-by-side configuration for easy comparison. Three-dimensional paper-based microfluidic devices are especially appropriate for use in distributed healthcare in the developing world and in environmental monitoring and water analysis.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Biosensors (Basel)
                Biosensors (Basel)
                biosensors
                Biosensors
                MDPI
                2079-6374
                13 August 2015
                September 2015
                : 5
                : 3
                : 577-601
                Affiliations
                [1 ]Biomedical Diagnostics Institute (BDI), Dublin City University, Glasnevin, Dublin 9, Ireland; E-Mails: shikha.sharma@ 123456dcu.ie (S.S.); julia.zapatero@ 123456dcu.ie (J.Z.-R.)
                [2 ]School of Biotechnology, Dublin City University, Glasnevin, Dublin 9, Ireland
                [3 ]Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK; E-Mail: P.Estrela@ 123456bath.ac.uk
                Author notes
                [†]

                These authors contributed equally to this work.

                [* ]Author to whom correspondence should be addressed; E-Mail: richard.okennedy@ 123456dcu.ie ; Tel.: +353-1-700-5319; Fax: +353-1-700-5412.
                Article
                biosensors-05-00577
                10.3390/bios5030577
                4600173
                26287254
                e1473dd3-9ad0-4975-b82c-1013761f667c
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 June 2015
                : 07 August 2015
                Categories
                Review

                low-cost biosensors,point-of-care diagnostics,lateral flow immunoassay,microfluidics,global health

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