Recent infectious disease outbreaks, such as COVID-19 and Ebola, have highlighted the need for rapid and accurate diagnosis to initiate treatment and curb transmission. Successful diagnostic strategies critically depend on the efficiency of biological sampling and timely analysis. However, current diagnostic techniques are invasive/intrusive and present a severe bottleneck by requiring specialist equipment and trained personnel. Moreover, centralised test facilities are poorly accessible and the requirement to travel may increase disease transmission. Self-administrable, point-of-care (PoC) microneedle diagnostic devices could provide a viable solution to these problems. These miniature needle arrays can detect biomarkers in/from the skin in a minimally invasive manner to provide (near-) real-time diagnosis. Few microneedle devices have been developed specifically for infectious disease diagnosis, though similar technologies are well established in other fields and generally adaptable for infectious disease diagnosis. These include microneedles for biofluid extraction, microneedle sensors and analyte-capturing microneedles, or combinations thereof. Analyte sampling/detection from both blood and dermal interstitial fluid is possible. These technologies are in their early stages of development for infectious disease diagnostics, and there is a vast scope for further development. In this review, we discuss the utility and future outlook of these microneedle technologies in infectious disease diagnosis.
Keywords: AC, alternating current; APCs, antigen-presenting cells; ASSURED, affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free and deliverable to end-users; Biomarker detection; Biosensor; CMOS, complementary metal-oxide semiconductor; COVID, coronavirus disease; COVID-19; CSF, cerebrospinal fluid; CT, computerised tomography; CV, cyclic voltammetry; DC, direct current; DNA, deoxyribonucleic acid; DPV, differential pulse voltammetry; EBV, Epstein–Barr virus; EDC/NHS, 1-ethyl-3-(3-dimethylaminoproply) carbodiimide/N-hydroxysuccinimide; ELISA, enzyme-linked immunosorbent assay; GOx, glucose oxidase; HIV, human immunodeficiency virus; HPLC, high performance liquid chromatography; HRP, horseradish peroxidase; IP, iontophoresis; ISF, interstitial fluid; IgG, immunoglobulin G; Infectious disease; JEV, Japanese encephalitis virus; MN, microneedle; Microneedle; NA, nucleic acid; OBMT, one-touch-activated blood multidiagnostic tool; OPD, o-phenylenediamine; PCB, printed circuit board; PCR, polymerase chain reaction; PDMS, polydimethylsiloxane; PEDOT, poly(3,4-ethylenedioxythiophene); PNA, peptide nucleic acid; PP, polyphenol; PPD, poly(o-phenylenediamine); PoC, point-of-care; Point-of-care diagnostics (PoC); SALT, skin-associated lymphoid tissue; SAM, self-assembled monolayer; SEM, scanning electron microscope; SERS, surface-enhanced Raman spectroscopy; SWV, square wave voltammetry; Skin; TB, tuberculosis; UV, ultraviolet; VEGF, vascular endothelial growth factor; WHO, World Health Organisation; cfDNA, cell-free deoxyribonucleic acid.
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