Format

Send to

Choose Destination
Sci Transl Med. 2018 Apr 25;10(438). pii: eaar6076. doi: 10.1126/scitranslmed.aar6076.

A digital microfluidic system for serological immunoassays in remote settings.

Author information

1
Department of Chemistry, University of Toronto, 80 St. George Street, Toronto, Ontario M5S 3H6, Canada.
2
Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, 160 College Street, Toronto, Ontario M5S 3E1, Canada.
3
Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA.
4
Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada.
5
Centers for Disease Control and Prevention, Kenya Medical Research Institute (KEMRI) Complex, P.O. Box 606-00621, Mbagathi Road Off Mbagathi Way, Village Market, Nairobi, Kenya.
6
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
7
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
8
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
9
Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, P.O. Box 30016-00100, Afya House, Cathedral Road, Nairobi, Kenya.
10
International Rescue Committee, P.O. Box 62727, Galana Plaza, 4th Floor Galana Road, Kilimani, Nairobi, Kenya.
11
Office of the United Nations High Commissioner for Refugees, P.O. Box 43801-00100, Lynwood Court, Off Waiyaki Way, Westland, Nairobi, Kenya.
12
KEMRI, P.O. Box 54840-00200, Off Mbagathi Road, Nairobi, Kenya.
13
Department of Chemistry, University of Toronto, 80 St. George Street, Toronto, Ontario M5S 3H6, Canada. aaron.wheeler@utoronto.ca.

Abstract

Serosurveys are useful for assessing population susceptibility to vaccine-preventable disease outbreaks. Although at-risk populations in remote areas could benefit from this type of information, they face several logistical barriers to implementation, such as lack of access to centralized laboratories, cold storage, and transport of samples. We describe a potential solution: a compact and portable, field-deployable, point-of-care system relying on digital microfluidics that can rapidly test a small volume of capillary blood for disease-specific antibodies. This system uses inexpensive, inkjet-printed digital microfluidic cartridges together with an integrated instrument to perform enzyme-linked immunosorbent assays (ELISAs). We performed a field validation of the system's analytical performance at Kakuma refugee camp, a remote setting in northwestern Kenya, where we tested children aged 9 to 59 months and caregivers for measles and rubella immunoglobulin G (IgG). The IgG assays were determined to have sensitivities of 86% [95% confidence interval (CI), 79 to 91% (measles)] and 81% [95% CI, 73 to 88% (rubella)] and specificities of 80% [95% CI, 49 to 94% (measles)] and 91% [95% CI, 76 to 97% (rubella)] (measles, n = 140; rubella, n = 135) compared with reference tests (measles IgG and rubella IgG ELISAs from Siemens Enzygnost) conducted in a centralized laboratory. These results demonstrate a potential role for this point-of-care system in global serological surveillance, particularly in remote areas with limited access to centralized laboratories.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center