Innovative Approach to Bedside Urinary Diagnostics: Prospective Study of Diaper-Embedded Test Strips

Abstract

Background: The most often requested test in many developing nations, particularly in lower-level medical facilities, is the dipstick urinalysis. The dipstick test, when used as a diaper insert, holds significant potential in early detection and management of various health conditions such as glucosuria, proteinuria, and ketonuria. By providing a convenient, non-invasive method of monitoring urine composition, it can help identify abnormalities in the urinary system. This could lead to earlier interventions, potentially reducing the number of patients requiring more invasive or complex treatments for these conditions. The integration of this technology into daily life allows for continuous monitoring, improving disease management and preventing complications associated with untreated urinary tract or metabolic disorders.

Methods:  A prospective study was conducted between July 2023 and Deember 2024. The study involved 300 patients attending Yenepoya Medical College, Deralakatte. The samples were subjected to dipstick urinalysis as diaper insert (Protien, ,Glucose, and Ketone bodies) and quantitative laboratory urine analysis method.

Results : In this study, we evaluated the accuracy of diaper insert dipstick urinalysis compared to laboratory spot testing for detecting urinary protein, glucose, and ketone bodies. Laboratory testing identified 133 (44.3%) positive samples for protein, 123 (41%) for glucose, and 66 (22%) for ketone bodies, while diaper insert dipstick testing identified 128 (42.6%), 116 (38.6%), and 73 (24.2%) positive samples for the same parameters, respectively. The sensitivity, specificity, and accuracy of urine dipstick tests in this study were high for glucose (96.2%, 100%, and 98.3%, respectively) and ketone bodies (90.4%, 100%, and 97.7%), indicating excellent diagnostic performance, while protein testing showed good sensitivity (87%), specificity (94.9%), and accuracy (91.7%), making all three reliable tools for screening metabolic and renal abnormalities with slight variation in their false positive and false negative rates.

Conclusions: Urine dipstick tests for glucose, protein, and ketone bodies provide rapid and practical screening tools exhibiting generally high sensitivity, specificity, and accuracy, making them effective for early detection and monitoring of metabolic and renal conditions, though confirmatory testing remains essential to address limitations related to false positives and negatives.