Advances in point of care testing technologies

Abstract

Available rapid diagnostic tests (such as immunoassays) are qualitative, have limited sensitivity and generally cannot provide subtype information. Molecular methods are quantitative and can give the high specificity, sensitivity and speed required, but existing efforts using fluorescence techniques are too expensive, require labelling, suffer from inherent noise, and cannot be miniaturized into a small form factor device. There is an urgent need for connected, rapid, portable, ultra-sensitive platforms to be developed for infectious diseases and antimicrobial resistance (AMR) at the point of care (POC) that can be deployed in the community, in homes and in doctors’ offices. The importance of diagnostics in the battle against AMR has been recognised in the challenge set by the £10 M Longitude Prize and the $20 M Prize proposed by the US’ National Institutes of Health and the Biomedical Advanced Research and Development Authority. Both aiming to develop a new rapid, POC diagnostic test which would allow clinicians to make better informed decisions, thereby conserving antibiotics and limiting their use to those cases where they would be efficacious. The Centre for Bio-Inspired Technology at Imperial College London has pioneered the use of microhip technology as molecular biosensors for lab-on-a-chip diagnostics technology, which represents an effective and affordable alternative to conventional optical-based sensors. This microchip technology provides the capability for nucleic acid detection through pH changes produced during amplification reactions such as LAMP and PCR below 30 min, and have already been demonstrated in full genome sequencing and label free point-of-care diagnostics. Our aim now is to evolve this technology into a portable and connected diagnostic test which will tackle the challenge of infectious diseases and AMR.