Table 3.

Representative commercially available technologies available to diagnose the leading causes of maternal mortality. Notably, many of the listed technologies are lacking robust usability, scalability, and field performance studies.

Condition	Representative Technology	Analyte Measured	Core Technology	Input Sample	Diagnostic Performance	Cost	Power*	Health System Use Level	Advantages	Limitations	Image
HIV Diagnosis	Alere Determine HIV-1/2 Ag/Ab Combo376,377	HIV-1/2 antibodies and free HIV-1 p24 antigen	Lateral Flow	Whole Blood	Sensitivity: 99.9% Specificity: 98.3%–99.9% †376	$18.22	None	Heatlh Post	Results in 20 minutes; approved for fingerstick use; excellent sensitivity	Unsuitable for acute infection and treatment monitoring
HIV Monitoring	Xpert HIV-1 Viral Load24,378,379	HIV RNA	Automated MicrobiologyAnalyzer	Whole Blood	R2=0.92; limit of detection 40 cp/mL †**378	$17,000 instrument $9.98/test	Mod	Reference Lab	Minimal hands-on time; 92-minute run time; high throughput; integrated sample preparation	High cost
Malaria	SD BIOLINE Malaria Ag Pf60,380,381	Plasmodium falciparum histidine-rich protein II (PfHRP-II)	Lateral Flow	Whole Blood	Sensitivity: 95% Specificity: 97.1% † 60	$0.70	None	Health Post	Low-cost; minimal training requirements; results in 30 minutes; excellect sensitivity	Counterfeit tests on market; limit-of-detection unsuitable for submicroscopic infections
Diabetes	LifeScan OneTouch Ultra 298,382	Glucose	Lateral Flow with Reader	Whole Blood	AUC: 0.778 95% CI: 0.726–0.829 † 97	$19.99 instrument $1.45–1.60/test	Low	Health Post	Widely available; integrated sample processing	High per-test cost
Anemia	HemoCue383–385	Hemoglobin	Microfluidics	Whole Blood	R2=0.85–0.995 AUC: 0.96† 383	$449 instrument $1.53–$1.86/test	Low	Health Post	Integrated sample processing	High per-test cost
Hemorrhage	BRASS-V drape146,148,386	Blood Loss	Blood Collection and Volume Measurement	Whole Blood	R=0.928 †† 148	$4/test	None	Health Post	Accurate; minimal training requirements	High per-test cost
Pre-eclampsia	Alere Triage PlGF185,186,387	Placental Growth Factor	Lateral Flow with Reader	Plasma	Sensitivity: 77% Specificity: 95% † 186	$1750 instrument $50/test	Mod	Health Center	Results in 20 minutes	High per test cost; requires plasma separation from whole blood
Bacterial Infection	Blood Culture388–391	Bacterial Load	Laboratory Microbiology	Sterile Whole Blood	Sensitivity: 73% † 388	$28	High	Reference Lab		Prone to contamination and false positives
PROM	Amnisure ROM205,219,392	Placental alpha-microglobulin 1 (PAMG-1)	Lateral Flow	Vaginal Swab	Sensitivity: 96.8% Specificity: 98.3% † 205	$60/test	None	Health Center	Excellent sensitivity, minimal training requirements, results in 10 minutes	High per test cost, blood contamination can give false positives

^*Power can be battery based, with low indicating small, easily replaceable batteries, moderate indicating larger, more expensive batteries, and high indicating dependency on electrical power grid.

^†Reported diagnostic performance is idenpendently verified.

^††Diagnostic performance is manufacturer reported.

^**Reported diagnostic performance was achieved using plasma samples.

HIV Diagnosis image provided courtesy Alere Inc.

HIV Monitoring image provided courtesy of Cepheid.

Malaria image provided courtesy Alere Inc.

Hemorrhage image reproduced from Reference 386 under the terms of Creative Commons Attribution License.

Pre-eclampsia image provided courtesy Alere Inc.

Bacterial Infection image reproduced from Reference 391 under the terms of Creative Commons Attribution License.

PROM image provided courtesy of Qiagen.