Novel low cost diagnostic tools and their impact in Africa

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Point of care testing is fundamental in delivering health and economic sustainability in the Global South. Our project will enable low cost, effective and accurate diagnosis of, in the first instance, two infectious diseases, namely malaria and schistosomiasis. This will be achieved using a novel very low cost paper diagnostic method that is able to quantify the infectious agent's DNA in a patient sample in a multiplexed assay. The platform will allow the measurement of several diseases at the same time, thereby increasing the efficiency of healthcare provision in often hard to reach settings, as well as establishing the species of the infectious agent (e.g. malaria), which will provide actionable information to healthcare professionals, where drugs have different levels of activity for different species, thus helping in reducing the potential emergence/increase of drug resistance. We have already demonstrated the potential for these low cost assays as being both sensitive and specific and we now wish to develop new engineering approaches to improve their performance (in terms of their speed and ease of use) and evidence their impact so that they can find widespread application in both rural and urban environments in Uganda and Sierra Leone, and other endemic countries. As the assays are sensitive and quantitative, they have the potential to be used not only in the treatment of individuals, but also in eradication programmes, such as those advocated by the London 2020 accord, enabling the surveillance of disease re/emergence. To help communicate the value of repeated treatments, we plan to develop new engagement tools based upon a novel mobile phone imaging platform that enables patients to visualise the infectious agent in a sample, and to see the outcome of interventions (whether these be through drug administration or physical/cultural changes such as access to improved sanitation or bed nets). We also propose to measure the impact of our novel diagnostic and imaging platforms by collection of suitable, realistic, logistically feasible metrics, and the potential impacts (including resources, health outcomes, employment, income) of the interventions. We will also feed these into newly developed and parameterised economic models to predict the long-term benefits specific interventions may have. Finally, integral to the proposed research is an ambitious programme of impact, which includes public engagement over infectious disease diagnosis and STEM and capacity strengthening. We will also explore routes to delivery of the technologies both in the UK, where the provision of low-cost point-of-care diagnostics is of significant interest (through our industrial partners), and in LMICs. Our ambition is to explore whether, through not-for-profit business planning, we can develop the correct interactions with Governments, Hospitals and Charities/NGOs, to test whether we are able to scale the manufacturing of these devices, such that they can be made in Africa, for Africa, by Africans.