{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T02:28:28Z","timestamp":1784687308701,"version":"3.55.0"},"reference-count":55,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2016,2,19]],"date-time":"2016-02-19T00:00:00Z","timestamp":1455840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Micromachines"],"abstract":"<jats:p>The advantages offered by centrifugal microfluidic systems have encouraged its rapid adaptation in the fields of in vitro diagnostics, clinical chemistry, immunoassays, and nucleic acid tests. Centrifugal microfluidic devices are currently used in both clinical and point-of-care settings. Recent studies have shown that this new diagnostic platform could be potentially used in extreme point-of-care settings like remote villages in the Indian subcontinent and in Africa. Several technological inventions have decentralized diagnostics in developing countries; however, very few microfluidic technologies have been successful in meeting the demand. By identifying the finest difference between the point-of-care testing and extreme point-of-care infrastructure, this review captures the evolving diagnostic needs of developing countries paired with infrastructural challenges with technological hurdles to healthcare delivery in extreme point-of-care settings. In particular, the requirements for making centrifugal diagnostic devices viable in developing countries are discussed based on a detailed analysis of the demands in different clinical settings including the distinctive needs of extreme point-of-care settings.<\/jats:p>","DOI":"10.3390\/mi7020032","type":"journal-article","created":{"date-parts":[[2016,2,19]],"date-time":"2016-02-19T11:29:39Z","timestamp":1455881379000},"page":"32","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Challenges and Opportunities of Centrifugal Microfluidics for Extreme Point-of-Care Testing"],"prefix":"10.3390","volume":"7","author":[{"given":"Issac","family":"Michael","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), 100 Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Hyeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), 100 Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Sunkara","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), 100 Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon-Kyoung","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), 100 Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, Korea"},{"name":"Center for Soft and Living Matter, Institute for Basic Science (IBS), UNIST-gil 50, Ulsan 689-798, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s10404-005-0049-4","article-title":"Patterning of flow and mixing in rotating radial microchannels","volume":"2","author":"Haeberle","year":"2006","journal-title":"Microfluid. Nanofluid."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1021\/ac0348322","article-title":"Design of a compact disk-like microfluidic platform for enzyme-linked immunosorbent assay","volume":"76","author":"Lai","year":"2004","journal-title":"Anal. Chem."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Madou, M.J., and Kellogg, G.J. (1998, January 27). Labcd: A centrifuge-based microfluidic platform for diagnostics. SPIE Proceedings of the Systems and Technologies for Clinical Diagnostics and Drug Discovery, San Jose, CA, USA.","DOI":"10.1117\/12.307314"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1758","DOI":"10.1039\/b924109d","article-title":"Centrifugal microfluidics for biomedical applications","volume":"10","author":"Gorkin","year":"2010","journal-title":"Lab Chip"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6187","DOI":"10.1039\/C4CS00371C","article-title":"Centrifugal microfluidic platforms: Advanced unit operations and applications","volume":"44","author":"Strohmeier","year":"2015","journal-title":"Chem. Soc. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Urdea, M., Penny, L.A., Olmsted, S.S., Giovanni, M.Y., Kaspar, P., Shepherd, A., Wilson, P., Dahl, C.A., Buchsbaum, S., and Moeller, G. (2006). Requirements for high impact diagnostics in the developing world. Nature, 73\u201379.","DOI":"10.1038\/nature05448"},{"key":"ref_7","unstructured":"Millipore (2009). Rapid Lateral Flow Test Strips: Consideration for Product Development, Millipore."},{"key":"ref_8","first-page":"155","article-title":"Existing and emerging technologies for point-of-care testing","volume":"35","author":"Price","year":"2014","journal-title":"Clin. Biochem. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.jscs.2014.09.001","article-title":"Designs, formats and applications of lateral flow assay: A literature review","volume":"19","author":"Sajid","year":"2015","journal-title":"J. Saudi Chem. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S0140-6736(15)61042-X","article-title":"Reebov antigen rapid test kit for point-of-care and laboratory-based testing for ebola virus disease: A field validation study","volume":"386","author":"Broadhurst","year":"2015","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"259","DOI":"10.4103\/0970-2113.99112","article-title":"Tuberculosis diagnostics: Challenges and opportunities","volume":"29","author":"Nema","year":"2012","journal-title":"Lung India"},{"key":"ref_12","unstructured":"World Health Organization (WHO) (2006). The Use of Malarial Rapid Diagnostic Test, World Health Organization. [2nd ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1475-2875-7-S1-S5","article-title":"Working without a blindfold: The critical role of diagnostics in malaria control","volume":"7","author":"Perkins","year":"2008","journal-title":"Malar. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"192","DOI":"10.4269\/ajtmh.2012.11-0619","article-title":"How do we best diagnose malaria in africa?","volume":"86","author":"Rosenthal","year":"2012","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0003676","article-title":"Enabling the development and deployment of next generation point-of-care diagnostics","volume":"9","author":"Derda","year":"2015","journal-title":"PLoS Negl. Trop. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1021\/ac9013989","article-title":"Diagnostics for the developing world: Microfluidic paper-based analytical devices","volume":"82","author":"Martinez","year":"2010","journal-title":"Anal. Chem."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4574","DOI":"10.1021\/ac300689s","article-title":"Two-dimensional paper network format that enables simple multistep assays for use in low-resource settings in the context of malaria antigen detection","volume":"84","author":"Fu","year":"2012","journal-title":"Anal. Chem."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/srep13368","article-title":"Malaria diagnosis using a mobile phone polarized microscope","volume":"5","author":"Pirnstill","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3263","DOI":"10.1007\/s00216-013-7473-1","article-title":"Cellphone-based devices for bioanalytical sciences","volume":"406","author":"Vashist","year":"2014","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1039\/c3lc41360h","article-title":"Lab-on-dvd: Standard dvd drives as a novel laser scanning microscope for image based point of care diagnostics","volume":"13","author":"Ramachandraiah","year":"2013","journal-title":"Lab Chip"},{"key":"ref_21","first-page":"179","article-title":"Rapid, low-cost prototyping of centrifugal microfluidic devices for effective implementation of various microfluidic components","volume":"26","author":"Smith","year":"2015","journal-title":"S. Afr. J. Ind. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/srep16145","article-title":"Quantification of NS1 dengue biomarker in serum via optomagnetic nanocluster detection","volume":"5","author":"Antunes","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_23","unstructured":"Humphreys, M., and Varshney, A. Violent conflict and the millennium development goals: Diagnosis and recommendations. Available online: http:\/\/www.columbia.edu\/~mh2245\/papers1\/HV.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S0140-6736(14)60925-9","article-title":"Countdown to 2015 and beyond: Fulfilling the health agenda for women and children","volume":"385","author":"Requejo","year":"2015","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(14)60844-8","article-title":"Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990\u20132013: A systematic analysis for the global burden of disease study","volume":"384","author":"Murray","year":"2013","journal-title":"Lancet"},{"key":"ref_26","unstructured":"Institute for Health Metrics and Evaluation (IHME) (2014). Life Expectancy & Probability of Death, IHME."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mbonye, A.K., Magnussen, P., Lal, S., Hansen, K.S., Cundill, B., Chandler, C., and Clarke, S.E. (2015). A cluster randomised trial introducing rapid diagnostic tests into registered drug shops in Uganda: Impact on appropriate treatment of malaria. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0129545"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Davids, M., Dheda, K., Pant Pai, N., Cogill, D., Pai, M., and Engel, N. (2015). A survey on use of rapid tests and tuberculosis diagnostic practices by primary health care providers in south Africa: Implications for the development of new point-of-care tests. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0141453"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1099\/jmm.0.000144","article-title":"Combined therapy for multi-drug-resistant acinetobacter baumannii infection\u2014Is there evidence outside the laboratory?","volume":"64","author":"Tuon","year":"2015","journal-title":"J. Med. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1586\/14737159.2015.1081802","article-title":"Bringing diagnostics to developing countries: An interview with Rosanna Peeling","volume":"15","author":"Peeling","year":"2015","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_31","unstructured":"United Nations (UN) (2015). Goal 3: Ensure Healthy Lives and Promote Well-Being for All at All Ages, UN."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Girosi, F., Olmsted, S.S., Keeler, E., Hay Burgess, D.C., Lim, Y.-W., Aledort, J.E., Rafael, M.E., Ricci, K.A., Boer, R., and Hilborne, L. (2006). Developing and interpreting models to improve diagnostics in developing countries. Nature, 3\u20138.","DOI":"10.1038\/nature05441"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1473-3099(13)70250-0","article-title":"Diagnostic point-of-care tests in resource-limited settings","volume":"14","author":"Drain","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1039\/B611455E","article-title":"Lab-on-a-chip devices for global health: Past studies and future opportunities","volume":"7","author":"Chin","year":"2007","journal-title":"Lab Chip"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1186\/1756-0500-7-873","article-title":"Risk factors associated with hepatitis B exposure and the reliability of five rapid kits commonly used for screening blood donors in Ghana","volume":"7","author":"Mutocheluh","year":"2014","journal-title":"BMC Res. Notes"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1136\/bmj.39496.444271.80","article-title":"Funding for primary health care in developing countries","volume":"336","author":"Maeseneer","year":"2008","journal-title":"BMJ Br. Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/nrmicro841","article-title":"Tropical infectious diseases: Diagnostics for the developing world","volume":"2","author":"Mabey","year":"2004","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_38","unstructured":"World Health Organisation (2015). Who List of Prequalified in Vitro Diagnostic Products, World Health Organization."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3377","DOI":"10.1128\/JCM.00593-14","article-title":"SAMBA HIV semiquantitative test, a new point-of-care viral-load-monitoring assay for resource-limited settings","volume":"52","author":"Ritchie","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1038\/nrmicro1568","article-title":"A guide for diagnostic evaluations","volume":"12","author":"Peeling","year":"2006","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_41","unstructured":"World Health Organization (2015). In Vitro Diagnostics and Laboratory Technology, World Health Organization."},{"key":"ref_42","unstructured":"Kettler, H., White, K., and Hawkes, S. (2004). Mapping the Landscape of Diagnostics for Sexually Transmitted Infections: Key Findings and Recommendations, World Health Organization."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/s12936-015-0615-5","article-title":"Comparison of rapid diagnostic test Plasmotec Malaria-3, microscopy, and quantitative real-time PCR for diagnoses of Plasmodium falciparum and Plasmodium vivax infections in Mimika Regency, Papua, Indonesia","volume":"14","author":"Fransisca","year":"2015","journal-title":"Malar. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1097\/01.aids.0000366081.91192.1c","article-title":"Who starts antiretroviral therapy in Durban, South Africa?\u2026 not everyone who should","volume":"24","author":"Bassett","year":"2010","journal-title":"AIDS"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1038\/nprot.2015.051","article-title":"Inexpensive, rapid prototyping of microfluidic devices using overhead transparencies and a laser print, cut and laminate fabrication method","volume":"10","author":"Thompson","year":"2015","journal-title":"Nat. Protoc."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1039\/c001195a","article-title":"Lab-on-a-foil: Microfluidics on thin and flexible films","volume":"10","author":"Focke","year":"2010","journal-title":"Lab Chip"},{"key":"ref_47","unstructured":"Espira Inc.. Available online: https:\/\/www.espirainc.com."},{"key":"ref_48","unstructured":"GenePOC. Available online: http:\/\/www.genepoc-diagnostics.com."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"22046","DOI":"10.1039\/c3ra44482a","article-title":"Rapid and highly sensitive luciferase reporter assay for the automated detection of botulinum toxin in the centrifugal microfluidic labdisk platform","volume":"3","author":"Stevens","year":"2013","journal-title":"RSC Adv."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1039\/C0LC00205D","article-title":"Fully integrated lab-on-a-disc for simultaneous analysis of biochemistry and immunoassay from whole blood","volume":"11","author":"Lee","year":"2011","journal-title":"Lab Chip"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2954","DOI":"10.1021\/ac3036734","article-title":"Lab-on-a-disc for simultaneous determination of nutrients in water","volume":"85","author":"Hwang","year":"2013","journal-title":"Anal. Chem."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1021\/ac203163u","article-title":"Lab-on-a-disc for fully integrated multiplex immunoassays","volume":"84","author":"Park","year":"2012","journal-title":"Anal. Chem."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"5069","DOI":"10.1039\/c2lc40781g","article-title":"Optical sensing system based on wireless paired emitter detector diode device and ionogels for lab-on-a-disc water quality analysis","volume":"12","author":"Czugala","year":"2012","journal-title":"Lab Chip"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1039\/c2lc21204h","article-title":"Commercialization of microfluidic point-of-care diagnostic devices","volume":"12","author":"Chin","year":"2012","journal-title":"Lab Chip"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"914","DOI":"10.2471\/BLT.12.102780","article-title":"Low-cost tools for diagnosing and monitoring HIV infection in low-resource settings","volume":"90","author":"Wu","year":"2012","journal-title":"Bull. World Health Organ."}],"container-title":["Micromachines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-666X\/7\/2\/32\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:19:23Z","timestamp":1760210363000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-666X\/7\/2\/32"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,19]]},"references-count":55,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2016,2]]}},"alternative-id":["mi7020032"],"URL":"https:\/\/doi.org\/10.3390\/mi7020032","relation":{},"ISSN":["2072-666X"],"issn-type":[{"value":"2072-666X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,19]]}}}