Infectious
diseases claim millions of lives each year. Robust and
accurate diagnostics are essential tools for identifying those who
are at risk and in need of treatment in low-resource settings. Inorganic
complexes and metal-based nanomaterials continue to drive the development
of diagnostic platforms and strategies that enable infectious disease
detection in low-resource settings. In this review, we highlight works
from the past 20 years in which inorganic chemistry and nanotechnology
were implemented in each of the core components that make up a diagnostic
test. First, we present how inorganic biomarkers and their properties
are leveraged for infectious disease detection. In the following section,
we detail metal-based technologies that have been employed for sample
preparation and biomarker isolation from sample matrices. We then
describe how inorganic- and nanomaterial-based probes have been utilized
in point-of-care diagnostics for signal generation. The following
section discusses instrumentation for signal readout in resource-limited
settings. Next, we highlight the detection of nucleic acids at the
point of care as an emerging application of inorganic chemistry. Lastly,
we consider the challenges that remain for translation of the aforementioned
diagnostic platforms to low-resource settings.
Abstract.A rapid, on-bead enzyme-linked immunosorbent assay for Plasmodium lactate dehydrogenase (pLDH) and Plasmodium falciparum histidine-rich protein 2 (HRP2) was adapted for use with dried blood spot (DBS) samples. This assay detected both biomarkers from a single DBS sample with only 45 minutes of total incubation time and detection limits of 600 ± 500 pM (pLDH) and 69 ± 30 pM (HRP2), corresponding to 150 and 24 parasites/μL, respectively. This sensitive and reproducible on-bead detection method was used to quantify pLDH and HRP2 in patient DBS samples from rural Zambia collected at multiple time points after treatment. Biomarker clearance patterns relative to parasite clearance were determined; pLDH clearance followed closely with parasite clearance, whereas most patients maintained detectable levels of HRP2 for 35–52 days after treatment. Furthermore, weak-to-moderate correlations between biomarker concentration and parasite densities were found for both biomarkers. This work demonstrates the utility of the developed assay for epidemiological study and surveillance of malaria.
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