The performance of the current and emerging tuberculosis diagnostic test and the potential of DNA aptamer-based point-of-care biosensor: a review

The potential of DNA aptamer incorporated in a point-of-care (POC) biosensor as an alternative to existing Tuberculosis (TB) diagnostics, particularly in low- and middle-income countries, is uncovered in this paper. Relevant articles over the past two decades were searched from Web of Science, Scopus, PubMed, and Google Scholar using the keywords “Tuberculosis, point-of-care testing, aptamers, and antigen”. Articles that present complete data on aptamer selection and testing, with reports on sensitivity and selectivity, and studies that use aptamer-based POC biosensors with performance comparison with existing TB diagnostics using human samples, were carefully selected. Current and emerging TB POC diagnostics studied in the literature were ranked based on the World Health Organization’s “ASSURED” criteria. Literature has shown that aptamers have been integrated successfully into various detection platforms and proven to improve most available TB bioassays. Among the commercially available TB POC tests, the lateral flow device ranked the highest in the “ASSURED” criteria. Aptamer-based electrochemical biosensors and miniaturized surface plasmon resonance, currently in the research stage, were determined as the most promising. An electrochemical biosensor is a mature technology even in developing countries, thus its application is likely plausible in low- and middle-income countries. There is a noticeable trade-off between affordability and deliverability in the development of TB POC tests.