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CRISPR-Based Point-of-Care Diagnostics for Enteric Pathogens in Low-Resource Settings: A Narrative Review
Subject area: Biological & Medical Sciences · Area of research: Molecular Diagnosis
DOI: https://doi.org/10.64388/IREV9I10-1715972
Abstract
Enteric infections caused over 500,000 deaths annually, yet culture and PCR diagnostics were largely inaccessible in rural healthcare settings. CRISPR-based diagnostics (CRISPR-Dx) offered amplification-free detection at ambient temperature within 30 minutes. This narrative review synthesized evidence on the analytical and field performance of CRISPR-Dx for detecting Salmonella, Shigella, Campylobacter, diarrhoeagenic Escherichia coli, and Vibrio species in low-resource settings. Systematic searches of PubMed, Web of Science, medRxiv, and bioRxiv (January 2018–December 2023) identified 18 studies: eight laboratory validation studies, six clinical cohorts, and four field pilots. Pooled sensitivity for Shigella spp. across five studies was 93.2% (95% CI: 88.4–96.1%) and specificity 97.7% (95% CI: 95.4–99.1%). Detection limits ranged from 10¹–10² CFU per reaction. Field pilots used lyophilised CRISPR reagents and smartphone-based fluorescence readers, achieving door-to-result times of 90–120 minutes. Where comparable diagnostic accuracy data were available, pooled sensitivity and specificity estimates were calculated using a random-effects mode. Key barriers included cold-chain requirements for guide RNAs and lack of multiplex panels. CRISPR-Dx demonstrated diagnostic accuracy comparable to qPCR and superior to rapid antigen tests, but development of multiplex lyophilised assays and streamlined WHO prequalification remain priorities for widespread adoption, with implications for diagnostic stewardship and antimicrobial resistance mitigation in low-resource settings.
Keywords
CRISPR Diagnostics; CRISPR-Cas12; CRISPR-Cas13; Enteric Pathogens; Point-Of-Care Diagnostics; Low-Resource Settings; Molecular Diagnostics.
References
[1] World Health Organization. Diarrhoeal disease fact sheet. 2023.
[2] Liu J, et al. Global aetiology of diarrhoeal disease. Lancet Glob Health. 2020;8:e1051-61.
[3] Crump JA, et al. Rapid diagnostic tests for enteric fever. Cochrane Database Syst Rev. 2019;5:CD008892.
[4] Gootenberg JS, et al. Nucleic acid detection with CRISPR-Cas13a. Science. 2017;356:438-42.
[5] Li Y, et al. CRISPR-based diagnostics for infectious diseases. Nat Rev Microbiol. 2022;20:415-31.
[6] Auma A, et al. Field validation of CRISPR-Cas12 assay for Shigella in Kenya. J Clin Microbiol. 2022;60:e00521-22.
[7] Rahman F, et al. Lyophilised SHERLOCK for cholera surveillance in Bangladesh. medRxiv. 2023. doi:10.1101/2023.08.12.23293938.
[8] Patel P, et al. Paper-based multiplex CRISPR chip for enteric pathogens. Biosens Bioelectron. 2023;220:114887.
[9] Glasgow RE, et al. RE-AIM planning and evaluation framework. Ethn Dis. 2019;29:343-50.
[10] Zhou Y, et al. CRISPR-LAMP for cholera in Uganda. PLoS Negl Trop Dis. 2021;15:e0009788.
[11] Curren EJ, et al. Advancing diagnostic stewardship for healthcare-associated infections, antibiotic resistance, and sepsis. Clin Infect Dis. 2022;74(4):723-8. doi:10.1093/cid/ciab672.
[12] Bhardwaj T, et al. Current advancements and future road map to develop ASSURED microfluidic biosensors for infectious and non-infectious diseases. Biosensors. 2022;12(5):357. doi:10.3390/bios12050357.
How to cite this paper
@article{1715972,
author = {Ahmad Abdullah, Aisha Hameed, Badmus Adirulah},
title = {CRISPR-Based Point-of-Care Diagnostics for Enteric Pathogens in Low-Resource Settings: A Narrative Review},
journal = {Iconic Research And Engineering Journals},
year = {2026},
volume = {9},
number = {10},
pages = {355-361},
issn = {2456-8880},
url = {https://www.irejournals.com/formatedpaper/1715972.pdf},
abstract = {Enteric infections caused over 500,000 deaths annually, yet culture and PCR diagnostics were largely inaccessible in rural healthcare settings. CRISPR-based diagnostics (CRISPR-Dx) offered amplification-free detection at ambient temperature within 30 minutes. This narrative review synthesized evidence on the analytical and field performance of CRISPR-Dx for detecting Salmonella, Shigella, Campylobacter, diarrhoeagenic Escherichia coli, and Vibrio species in low-resource settings. Systematic searches of PubMed, Web of Science, medRxiv, and bioRxiv (January 2018–December 2023) identified 18 studies: eight laboratory validation studies, six clinical cohorts, and four field pilots. Pooled sensitivity for Shigella spp. across five studies was 93.2% (95% CI: 88.4–96.1%) and specificity 97.7% (95% CI: 95.4–99.1%). Detection limits ranged from 10¹–10² CFU per reaction. Field pilots used lyophilised CRISPR reagents and smartphone-based fluorescence readers, achieving door-to-result times of 90–120 minutes. Where comparable diagnostic accuracy data were available, pooled sensitivity and specificity estimates were calculated using a random-effects mode. Key barriers included cold-chain requirements for guide RNAs and lack of multiplex panels. CRISPR-Dx demonstrated diagnostic accuracy comparable to qPCR and superior to rapid antigen tests, but development of multiplex lyophilised assays and streamlined WHO prequalification remain priorities for widespread adoption, with implications for diagnostic stewardship and antimicrobial resistance mitigation in low-resource settings.},
keywords = {CRISPR Diagnostics; CRISPR-Cas12; CRISPR-Cas13; Enteric Pathogens; Point-Of-Care Diagnostics; Low-Resource Settings; Molecular Diagnostics.},
month = {April},
doi = {https://doi.org/10.64388/IREV9I10-1715972}
}