Abstract

A decentralized approach to diagnostics can decrease the time to treatment of infectious diseases in resource-limited settings, yet most modern diagnostic tools require stable electricity and are not portable. Here, we describe a portable device for isothermal nucleic acid quantification that can operate with power from electricity, sunlight or a flame, and that can store heat from intermittent energy sources for operation when electrical power is not available or reliable. We deployed the device in two Ugandan health clinics, where it successfully operated through multiple power outages, with equivalent performance when powered via sunlight or electricity. A direct comparison between the portable device and commercial quantitative polymerase chain reaction machines for samples from 71 Ugandan patients (29 of which were tested in Uganda) for the presence of Kaposi’s sarcoma-associated herpesvirus DNA showed 94% agreement, with the four discordant samples having the lowest concentration of the herpesvirus DNA. The device’s flexibility in power supply provides a needed solution for on-field diagnostics.

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All data supporting the findings in this study are available within the Article and its Supplementary Information. Additional data are available from the corresponding authors upon request.

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Acknowledgements

We would like to thank P. Namaganda, M. Laker-Oketta, H. Byakwaga, P. Kyomuhangi, E. Mande and O. Mbabazi for their work at the Infectious Diseases Institute. We also thank O. Imsdahl, J. Gutierrez and J. Sullivan (Cornell University) for assistance in fabrication of the TINY prototypes. Special thanks to M. Kirya for assisting during visits of rural Ugandan health clinics in July 2016. This work was performed in part at the Cornell NanoScale Facility, a member of the National Nanotechnology Coordinated Infrastructure (NNCI), which is supported by the National Science Foundation (grant ECCS-1542081). The authors acknowledge support for this research from the US National Cancer Institute under grant UH2 CA202723. This study is based upon work supported by the National Science Foundation Graduate Research Fellowship under grant no. 1144153.

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Affiliations

  1. Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA

    • Ryan Snodgrass
    • , Varun Lingaiah Kopparthy
    • , Jens Duru
    •  & David Erickson
  2. Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA

    • Andrea Gardner
    •  & Ethel Cesarman
  3. Infectious Diseases Institute, Kampala, Uganda

    • Aggrey Semeere
  4. Department of Dermatology, University of California, San Francisco, CA, USA

    • Toby Maurer
  5. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    • Jeffrey Martin

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Contributions

R.S. and A.G. wrote the manuscript with review from all other authors. R.S., V.K., J.D., E.C. and D.E. developed the TINY device. All authors were responsible for design of experiments. R.S., A.G. and J.D. conducted experiments. A.S. and J.M. coordinated collection of human samples. R.S. and A.G. analysed the data. R.S. generated the figures and tables.

Competing interests

The authors have submitted a patent for the TINY system.

Corresponding authors

Correspondence to Jeffrey Martin or Ethel Cesarman or David Erickson.

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    Supplementary methods, figures and tables

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DOI

https://doi.org/10.1038/s41551-018-0286-y