Abstract
Resource-poor countries and regions require effective, low-cost diagnostic devices for accurate identification and diagnosis of health conditions. Optical detection technologies used for many types of biological and clinical analysis can play a significant role in addressing this need, but must be sufficiently affordable and portable for use in global health settings. Most current clinical optical imaging technologies are accurate and sensitive, but also expensive and difficult to adapt for use in these settings. These challenges can be mitigated by taking advantage of affordable consumer electronics mobile devices such as webcams, mobile phones, charge-coupled device (CCD) cameras, lasers, and LEDs. Low-cost, portable multi-wavelength fluorescence plate readers have been developed for many applications including detection of microbial toxins such as C. Botulinum A neurotoxin, Shiga toxin, and S. aureus enterotoxin B (SEB), and flow cytometry has been used to detect very low cell concentrations. However, the relatively low sensitivities of these devices limit their clinical utility. We have developed several approaches to improve their sensitivity presented here for webcam based fluorescence detectors, including (1) image stacking to improve signal-to-noise ratios; (2) lasers to enable fluorescence excitation for flow cytometry; and (3) streak imaging to capture the trajectory of a single cell, enabling imaging sensors with high noise levels to detect rare cell events. These approaches can also help to overcome some of the limitations of other low-cost optical detection technologies such as CCD or phone-based detectors (like high noise levels or low sensitivities), and provide for their use in low-cost medical diagnostics in resource-poor settings.
Highlights
Over 80% of the world population lives in low and middle income countries (LMICs) [1]
Single frame Fluorescein detection: A generic complementary metal–oxide–semiconductor (CMOS)-based webcam used as a plate reader (Figure 1) equipped with the original 5 mm f3.8 lens was used for detecting Fluorescein
To similar a conventional plate reader. These results suggest that image stacking improves the sensitivity of inexpensive webcams, and. These results suggest that image stacking improves the sensitivity of inexpensive webcams, and that it may be practical to develop a low-cost fluorescence plate reader for around $100 with the that it may be practical to develop a low-cost fluorescence plate reader for around $100 with the sensitivity and capability to detect multiple analytes
Summary
Over 80% of the world population lives in low and middle income countries (LMICs) [1]. The development of low-cost detection/diagnostic technologies for global health has, not surprisingly, maintained this focus [2]. These include heart disease, stroke, cancer, chronic respiratory diseases, and diabetes. These are the leading cause of death and disability in LMICs, but attract less than 2 percent of global health aid [3]. Despite the efforts to develop medical detection technologies for NCDs for global heath [4], current detection technologies are often too complex, expensive, and unsustainable to address the needs of LMICs. Resource-poor countries and regions require effective, low-cost diagnostic devices for accurate identification and diagnosis of health conditions [2]. Testing (POCT), which is medical diagnostic testing performed on-site
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