A Material Roadmap for Translational and Sustainable Point-of-Care Diagnostics Through Bacterial Cellulose: A Comprehensive Review

Point-of-care diagnostics are reshaping healthcare worldwide by enabling rapid, decentralized testing across clinical and non-clinical settings, particularly in regions with limited laboratory infrastructure. These technologies are transforming telemedicine and disease surveillance by providing timely results. However, the performance and accuracy of these devices heavily rely on the choice of the substrate material. In point-of-care diagnostics, the substrate is the base material of a device that supports sensing components and facilitates interaction between the biological sample and the detection system, as in lateral flow assays for pregnancy testing, electrochemical biosensor strips for glucose monitoring, and reagent dipsticks for urine analysis. Conventional polymeric materials are commercialized as substrates due to their low cost and ease of processing. Nevertheless, their limited biocompatibility, non-degradability, and potential to generate toxic medical waste have raised growing concerns regarding their single-time use. This push for greener materials has turned attention toward biopolymers. Biopolymers derived from plants, animals, marine sources, and microbes are increasingly being explored as point-of-care substrates. Among these, bacterial cellulose stands out as a promising candidate due to its environmentally friendly production route and interconnected nanofibrillar network with high porosity, hydrophilicity, and water-retention capacity while maintaining superior mechanical strength. The abundance of hydroxyl groups allows diverse surface functionalization, while its tunable optical characteristics and biodegradability make it suitable for scientific integration and environmentally responsible disposal. Although notable progress has been made, comprehensive studies linking the structural features of bacterial cellulose to its performance in healthcare testing remain scarce. This review bridges this gap by systematically compiling recent research, examining modification approaches, and outlining how material-driven routes can be implemented to improve the reliability of disease diagnostics. This review also discusses emerging directions where bacterial cellulose may play a broader role in future diagnostic technologies.