# An Automated Versatile Diagnostic Workflow for Infectious Disease Detection in Low-Resource Settings

## TL;DR

This paper presents an affordable and adaptable automated diagnostic system for infectious diseases using open-source tools and paper-based tests.

## Contribution

The integration of open-source modular automation with adaptable molecular protocols for low-cost infectious disease diagnostics.

## Key findings

- The automated workflow for Neisseria meningitidis detection is faster and cheaper than manual methods.
- Magnetic bead-based DNA isolation and isothermal amplification work effectively with paper-based diagnostics.
- The system is adaptable for various infectious diseases and suitable for low-resource settings.

## Abstract

Laboratory automation effectively increases the throughput in sample analysis, reduces human errors in sample processing, as well as simplifies and accelerates the overall logistics. Automating diagnostic testing workflows in peripheral laboratories and also in near-patient settings -like hospitals, clinics and epidemic control checkpoints- is advantageous for the simultaneous processing of multiple samples to provide rapid results to patients, minimize the possibility of contamination or error during sample handling or transport, and increase efficiency. However, most automation platforms are expensive and are not easily adaptable to new protocols. Here, we address the need for a versatile, easy-to-use, rapid and reliable diagnostic testing workflow by combining open-source modular automation (Opentrons) and automation-compatible molecular biology protocols, easily adaptable to a workflow for infectious diseases diagnosis by detection on paper-based diagnostics. We demonstrated the feasibility of automation of the method with a low-cost Neisseria meningitidis diagnostic test that utilizes magnetic beads for pathogen DNA isolation, isothermal amplification, and detection on a paper-based microarray. In summary, we integrated open-source modular automation with adaptable molecular biology protocols, which was also faster and cheaper to perform in an automated than in a manual way. This enables a versatile diagnostic workflow for infectious diseases and we demonstrated this through a low-cost N. meningitidis test on paper-based microarrays.