Inkwell: Design and Validation of a Low-Cost Open Electricity-Free 3D Printed Device for Automated Thin Smearing of Whole Blood

Abstract

Microscopy plays a crucial role in hematology and diagnosis of infectious diseases worldwide. For malaria alone, more than 200 million slides are read by manual microscopists every year. High quality thin blood smears are essential for subsequent microscopy examinations including malaria microscopy, but are hard to make in field settings. Current manual smearing methods lack consistency and often do not provide a uniformly dense mono-layer of red blood cells, even when prepared by trained experts. Existing devices for assisting in making thin smears are available but are limited by cost or complexity for wider use. Here we present Inkwell, a portable mechanical device capable of making high quality thin blood smears in field settings.

Inkwell is simple, low-cost, does not use electricity, and requires minimal training prior to use. By utilizing passive dissipative dynamics of a spiral spring coupled to an air dashpot with a tunable valve - we demonstrate a highly tunable mechanism for constant velocity smears at prescribed angle. Inkwell is capable of producing high quality blood smears of tunable cell density with more than 12 million individually distinguishable red blood cells on a single slide. The current design, which exploits precision manufacturing of a 17 cents plastic syringe and a spring, can be printed on a standard 3D printer with overall unit cost of less than a few dollars in large quantities. We further present usability tests to confirm performance over 10,000 unit cycle operations with no degradation in quality of the smear and demonstrate ease of use with minimal training. Inkwell enhances the broader toolbox of open innovations in diagnostics for providing high quality medical care in low and medium resource settings. Combined with rise of 3D printing, Inkwell presents an alternative to traditional centralized manufacturing and opens up distributed manufacturing of medical diagnostics in global context.