title: A smartphone dongle for diagnosis of infectious diseases at the point of care.
abstract: This work demonstrates that a full laboratory-quality immunoassay can be run on a smartphone accessory. This low-cost dongle replicates all mechanical, optical, and electronic functions of a laboratory-based enzyme-linked immunosorbent assay (ELISA) without requiring any stored energy; all necessary power is drawn from a smartphone. Rwandan health care workers used the dongle to test whole blood obtained via fingerprick from 96 patients enrolling into care at prevention of mother-to-child transmission clinics or voluntary counseling and testing centers. The dongle performed a triplexed immunoassay not currently available in a single test format: HIV antibody, treponemal-specific antibody for syphilis, and nontreponemal antibody for active syphilis infection. In a blinded experiment, health care workers obtained diagnostic results in 15 min from our triplex test that rivaled the gold standard of laboratory-based HIV ELISA and rapid plasma reagin (a screening test for syphilis), with sensitivity of 92 to 100% and specificity of 79 to 100%, consistent with needs of current clinical algorithms. Patient preference for the dongle was 97% compared to laboratory-based tests, with most pointing to the convenience of obtaining quick results with a single fingerprick. This work suggests that coupling microfluidics with recent advances in consumer electronics can make certain laboratory-based diagnostics accessible to almost any population with access to smartphones.
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Tassaneewan
authors: T
authors: Laksanasopin
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Tiffany W
authors: TW
authors: Guo
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Samiksha
authors: S
authors: Nayak
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Archana A
authors: AA
authors: Sridhara
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Shi
authors: S
authors: Xie
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Owolabi O
authors: OO
authors: Olowookere
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Paolo
authors: P
authors: Cadinu
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Fanxing
authors: F
authors: Meng
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Natalie H
authors: NH
authors: Chee
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Jiyoon
authors: J
authors: Kim
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA.
authors: Curtis D
authors: CD
authors: Chin
authors: ICAP-Rwanda, Mailman School of Public Health, Chadel Building 1st Floor, Kigali, Rwanda.
authors: Elisaphane
authors: E
authors: Munyazesa
authors: Institute of HIV Disease Prevention and Control, Rwanda Biomedical Center, Kigali, Rwanda.
authors: Placidie
authors: P
authors: Mugwaneza
authors: Department of Pathology and Cell Biology, Columbia University, 3959 Broadway, CHONY 2C-224, New York, NY 10032, USA.
authors: Alex J
authors: AJ
authors: Rai
authors: ICAP-Rwanda, Mailman School of Public Health, Chadel Building 1st Floor, Kigali, Rwanda.
authors: Veronicah
authors: V
authors: Mugisha
authors: Centers for Disease Control and Prevention-Laboratory Reference and Research Branch, Atlanta, GA 30333, USA.
authors: Arnold R
authors: AR
authors: Castro
authors: OPKO Diagnostics, LLC, 4 Constitution Way, Suite E, Woburn, MA 01801, USA.
authors: David
authors: D
authors: Steinmiller
authors: OPKO Diagnostics, LLC, 4 Constitution Way, Suite E, Woburn, MA 01801, USA.
authors: Vincent
authors: V
authors: Linder
authors: ICAP, Mailman School of Public Health, Columbia University, 722 West 168th Street #14, New York, NY 10032, USA.
authors: Jessica E
authors: JE
authors: Justman
authors: Institute of HIV Disease Prevention and Control, Rwanda Biomedical Center, Kigali, Rwanda.
authors: Sabin
authors: S
authors: Nsanzimana
authors: Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA. ss2735@columbia.edu.
authors: Samuel K
authors: SK
authors: Sia
mesh_terms: D040421:Cell Phone; D003141:Communicable Diseases / Q000175:diagnosis*; D011211:Electric Power Supplies; D004797:Enzyme-Linked Immunosorbent Assay / Q000295:instrumentation*; D004867:Equipment Design; D019538:Health Care Surveys; D006801:Humans; D007118:Immunoassay / Q000295:instrumentation / Q000379:methods; D017060:Patient Satisfaction; D019095:Point-of-Care Systems; D012432:Rwanda; D012680:Sensitivity and Specificity