MicroRNA-based point-of-care diagnostics for emerging and re-emerging infectious diseases: from biomarker discovery to clinical implementation

INTRODUCTION: MicroRNAs (miRNAs) are increasingly investigated as host-response biomarkers for infectious diseases, but translation from differential-expression studies to clinically deployable diagnostics remains limited. AREAS COVERED: This review evaluates the diagnostic and translational potential of miRNAs across malaria, dengue, chikungunya, Zika virus infection, Crimean-Congo hemorrhagic fever, Japanese encephalitis and Nipah virus disease. Unlike prior reviews focused mainly on biomarker discovery or detection technologies, it provides a cross-disease translational perspective linking miRNA signatures with analytical and clinical validation, point-of-care development, clinical implementation, economic considerations and deployment in resource-limited settings. EXPERT OPINION: The next phase of miRNA diagnostics should prioritize reproducible multi-miRNA signatures, standardized pre-analytical workflows and prospective multicentre validation rather than continued biomarker discovery alone. Clinical adoption will depend on integrating these signatures into affordable sample-to-answer platforms and demonstrating that results improve defined clinical decisions under real-world conditions.