Mitsakakis Konstantinos, D'Acremont Valérie, Hin Sebastian, von Stetten Felix, Zengerle Roland
Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
Microelectron Eng. 2018 Dec 5;201:26-59. doi: 10.1016/j.mee.2018.10.001. Epub 2018 Oct 5.
Most patients with acute infectious diseases develop fever, which is frequently a reason to visit health facilities in resource-limited settings. The symptomatic overlap between febrile diseases impedes their diagnosis on clinical grounds. Therefore, the World Health Organization promotes an integrated management of febrile illness. Along this line, we present an overview of endemic and epidemic etiologies of fever and state-of-the-art diagnostic tools used in the field. It becomes evident that there is an urgent need for the development of novel technologies to fulfill end-users' requirements. This need can be met with point-of-care and near-patient diagnostic platforms, as well as e-Health clinical algorithms, which co-assess test results with key clinical elements and biosensors, assisting clinicians in patient triage and management, thus enhancing disease surveillance and outbreak alerts. This review gives an overview of diagnostic technologies featuring a platform based approach: (i) assay (nucleic acid amplification technologies are examined); (ii) cartridge (microfluidic technologies are presented); (iii) instrument (various detection technologies are discussed); and at the end proposes a way that such technologies can be interfaced with electronic clinical decision-making algorithms towards a broad and complete diagnostic ecosystem.
大多数急性传染病患者会发烧,这常常是他们前往资源有限地区的医疗机构就诊的原因。发热性疾病之间的症状重叠阻碍了基于临床症状的诊断。因此,世界卫生组织倡导对发热性疾病进行综合管理。在此背景下,我们概述了发热的地方性和流行性病因以及该领域使用的最新诊断工具。显然,迫切需要开发新技术以满足最终用户的需求。即时检测和近患者诊断平台以及电子健康临床算法能够满足这一需求,它们将检测结果与关键临床要素和生物传感器共同评估,协助临床医生进行患者分类和管理,从而加强疾病监测和疫情预警。本综述概述了以平台为基础的诊断技术:(i)检测方法(研究了核酸扩增技术);(ii)检测盒(介绍了微流控技术);(iii)仪器(讨论了各种检测技术);最后提出了一种方法,使这些技术能够与电子临床决策算法相结合,形成一个广泛而完整的诊断生态系统。