Joanna Marie Esperanza

February 6, 2015

BSN4A0

A smartphone dongle for diagnosis of infectious diseases at the point of care

T. Laksanasopin, T. W. Guo, S. Nayak, A. A. Sridhara, S. Xie, O. O. Olowookere, P.
Cadinu, F. Meng, N. H. Chee, J. Kim, C. D. Chin, E. Munyazesa, P. Mugwaneza, A. J.
Rai, V. Mugisha, A. R. Castro, D. Steinmiller, V. Linder, J. E. Justman, S. Nsanzimana,
S. K. Sia.

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.

A step-by-step demonstration of a smartphone dongle to diagnose sexually

transmitted infections through a fully automated immunoassay.

Reaction

According to WHO more than 1,000,000 people acquire sexually transmitted infections
around the world every day. Syphilis and HIV are among the most common conditions caused
by Sexually Transmitted Infections (STIs). These two are also among the conditions that can be
transmitted from mother to child during pregnancy and childbirth, as well as blood transfusion
and tissue transfer. Mother-to-child transmission of STIs can result in stillbirth, neonatal death,
low-birth-weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital
deformities. Syphilis in pregnancy leads to approximately 305 000 fetal and neonatal deaths
every year and leaves 215 000 infants at increased risk of dying from prematurity, low-birthweight or congenital disease.
Current diagnostic tests for STIs are only widely available and used in high income
countries in contrast to low and middle income countries where it is largely unavailable. Where
testing is available it is often expensive and takes a long time to gain results. This leads to
deferment of care and treatment. The only inexpensive rapid blood test currently available is for
Syphilis where results can be obtained in only 15-20 minutes.
Biomedical engineers from Columbia University were able to develop a device that turns
a smartphone into a mini lab that could test human blood for HIV and Syphilis. This device is a
dongle that attaches to the smartphones audio jack where it will get its power source and
requires no separate batteries. An app on the phone will display the result in only 15 minutes,.
As for my reaction, this is actually by far the best article I have ever found. Given the
information about the number of STI cases around the world, this is progress. Though syphilis is
curable, HIV on the other hand isnt. Therefore the best way to reduce the number of cases is
prevention. Because if this kind of device will be available commercially, then, sexually active
people can buy this and test themselves first to see if one of them has the virus before they
commit into sexual acts since the results that it displays is so simple that it doesnt require
someone to be on the medical field to actually know what it means. This device according to the
researchers shuld cost $34 or about P1500;Each test runs for $1.44 or P66. There are available
HIV testing centers here in the Philippines as well as HIV testing kits which around 500 pesos.
So I think considering the price, accuracy (93-100% of the time) and convenience, it is worth the
deal. Who would choose the risk to be ill of HIV for a lifetime where they can prevent it for just a
small amount of money?

References:

Columbia University School of Engineering and Applied Science. "HIV and syphilis biomarkers:
Smartphone, finger prick, 15 minute diagnosis." ScienceDaily. ScienceDaily, 4 February 2015.
<www.sciencedaily.com/releases/2015/02/150204144517.htm>.
T. Laksanasopin, T. W. Guo, S. Nayak, A. A. Sridhara, S. Xie, O. O. Olowookere, P. Cadinu, F.
Meng, N. H. Chee, J. Kim, C. D. Chin, E. Munyazesa, P. Mugwaneza, A. J. Rai, V. Mugisha, A.
R. Castro, D. Steinmiller, V. Linder, J. E. Justman, S. Nsanzimana, S. K. Sia. A smartphone
dongle for diagnosis of infectious diseases at the point of care. Science Translational
Medicine, 2015; 7 (273): 273re1 DOI: 10.1126/scitranslmed.aaa0056
HIV, Syphilis Tests? Theres an App for That. Malaysia IT Fair: Bringing IT Closer to You
2015. http://malaysiaitfair.com.my/?p=14324#more-14324