# NTDscope: A multi-contrast portable microscope for disease diagnosis

## TL;DR

The NTDscope is a portable diagnostic device that combines microscopy and molecular testing to detect diseases in resource-limited areas.

## Contribution

The NTDscope integrates multiple imaging and molecular diagnostic methods into a single portable device for NTD diagnosis.

## Key findings

- The NTDscope functions as a brightfield, darkfield, and fluorescence microscope for parasite detection.
- It can quantify molecular assays like lateral flow tests and CRISPR-based assays.
- The device improves robustness and expands diagnostic applications in low-resource settings.

## Abstract

Accurate diagnostics are essential for disease control and elimination efforts. However, access to diagnostics for neglected tropical diseases (NTDs) is hindered by limited healthcare infrastructure in many NTD-endemic regions, as well as by reliance on time- and labor-intensive diagnostic methods, such as smear microscopy. New diagnostic tools that are portable, rapid, low-cost, and meet World Health Organization (WHO) sensitivity and specificity targets are urgently needed to accelerate NTD control and elimination programs. Here, we introduce the NTDscope, a portable microscopy platform that enables point-of-care imaging and automated detection of parasites and other pathogens in patient samples. The NTDscope builds on and extends the capabilities of the LoaScope, a device that turned the camera of a mobile phone into a microscope and used on-board image processing to automatically quantify Loa loa microfilariae burden in whole blood samples. The NTDscope replaces the mobile phone of the LoaScope with a system-on-module (SOM) that enables the integration of multiple imaging modalities in a single package designed to improve robustness and expand applications. In this work, we demonstrate the use of the NTDscope as a portable brightfield, darkfield, and fluorescence microscope for samples including microfilariae and helminth eggs. We also show that the device can be used to quantify molecular assays, such as a lateral flow test and a CRISPR-Cas13a-based assay. The ability to combine the diagnostic capabilities of conventional microscopy with molecular assays and machine learning in a single device could expand access to diagnostics for populations in NTD-endemic areas and beyond.