Knitting Thread Devices: Detecting Candida albicans Using Napkins and Tampons

Reproducible and in situ microbial detection, particularly of microbes significant in urinary tract infections (UTIs) such as Candida albicans, provides a unique opportunity to bring equity in the healthcare outcomes of disenfranchised groups like women in low-resource settings. Here, we demonstrate a system to potentially detect vulvovaginal candidiasis by leveraging the properties of multifilament cotton threads in the form of microfluidic-thread-based analytical devices (μTADs) to develop a frugal microbial identification assay. A facile mercerization method using heptane wash to boost reagent absorption and penetration is also performed and is shown to be robust compared to other existing conventional mercerization methods. Furthermore, the twisted mercerized fibers are drop-cast with media consisting of l-proline β-naphthylamide, which undergoes hydrolysis by the enzyme l-proline aminopeptidase secreted by C. albicans, hence signaling the presence of the pathogen via simple color change with a limit of detection of 0.58 × 106 cfu/mL. The flexible and easily disposable thread-based detection device when integrated with menstrual hygiene products showed a detection time of 10 min using spiked vaginal discharge. The developed method boasts a long shelf life and high stability, making it a discreet detection device for testing, which provides new vistas for self-testing multiple diseases that are considered taboo in certain societies.