Finger-Actuated STEerable microfluidics CHip (FASTECH) integrating recombinase polymerase amplification and lateral-flow assay for multiple point-of-care testing of childhood diarrhea viruses.

Acute viral diarrhea is a common childhood illness and a major cause of morbidity and mortality worldwide, particularly in low-income countries. Nucleic acid testing is critical for clinical management because it enables accurate identification of the causative virus and supports targeted treatment. However, conventional nucleic acid detection methods rely on sophisticated instruments and trained personnel, limiting their use in home testing and primary care settings. Therefore, a user-friendly, miniaturized, and portable platform integrating extraction-free nucleic acid release, amplification, and result readout is urgently needed. In this study, a Finger-Actuated STEerable microfluidic CHip (FASTECH) integrating recombinase polymerase amplification and lateral-flow analysis was developed. This platform enabled simultaneous detection of three major diarrhea-associated viruses in children, including rotavirus A, norovirus, and adenovirus, with sensitivities of 1 copy/μL, 1 copy/μL, and 5 copies/μL, respectively. Combined with a self-developed disposable lysis tube, FASTECH completed sample processing and nucleic acid release at room temperature within 5 min and achieved sample-in-result-out detection in under 25 min. Validation using 90 clinical samples demonstrated high concordance with gold-standard qPCR. In summary, FASTECH is expected to provide a reliable platform for point-of-care diagnosis of pediatric infectious diseases in resource-limited settings and offer strong support for public health efforts.