Mobile Phone enabled Diagnostics for Infectious Disease Diagnosis: Low Cost Tools for Digital Health in East Africa

传染病仍然是许多低收入和中等收入国家发病和死亡的主要原因，这些国家卫生基础设施有限、贫穷和政治不安全，增加了各种人类和动物传染病的传播。我们对我们网络的愿景是，我们的新型手机支持基于纸微流体的低成本DNA传感器技术，将在未来为东非，包括乌干达和坦桑尼亚，以及撒哈拉以南非洲的其他国家带来健康和经济效益。新的诊断技术将特别加强实验室诊断能力，例如，根据世卫组织乌干达合作战略，这是合作的主要重点。我们已经通过应用程序和云展示了连接，访问安全数据存储和人工智能/机器学习决策支持工具，以帮助医疗保健提供者对同一样本中的多种传染病做出正确诊断。我们现在预测，通过使用这项技术，最终用户将能够使用不同的样品，包括水、牛奶和血液，对人类和牲畜进行传染病诊断。通过这样做，我们将能够定量地确定动物与人类之间的传播途径（无论是通过共享水源还是未经巴氏消毒的牛奶），从而帮助实现以下可持续发展目标，即可持续发展目标2、3、6和15。这将使卫生保健技术人员和流行病学家更好地了解这些疾病对兽医护理的影响，以及在乌干达和坦桑尼亚的特定环境中对人类感染的影响，从而带来经济和健康效益，减少贫困，实现可持续发展目标1。我们的目标是利用这一活动作为案例研究，举例说明移动诊断对数字健康平台的更广泛影响，向政府、非政府组织、慈善机构、大学、行业以及更广泛的患者和公众提供信息，并在移动诊断平台中建立广泛的利益攸关方网络，以确定和克服在乌干达和坦桑尼亚以及其他地区部署数字健康解决方案的障碍。我们的网络将通过开发低成本定量诊断和筛查工具，及时调查导致传染病持续存在的因素，解决坦桑尼亚和乌干达强调的主要卫生挑战之一。除了对增加健康和经济效益产生影响外，该网络的成果还将大大减少传染病对妇女的影响，目前妇女的负担过重。她们不仅为年轻家庭提供主要支持，包括负责照顾和为儿童做饭以及提供教育，而且还为农村农业活动提供80%的劳动力。妇女患病会导致家庭收入的直接损失，而预防疾病可随后带来额外的经济效益（可持续发展目标3、5和10）。同样，如果儿童生病，他们往往会被带离学校，再次造成收入损失和错失教育机会（可持续发展目标4）。在人类疾病方面，截至2017年，疟疾是乌干达和坦桑尼亚的第三大死亡原因。通过使用数字医疗，我们的网络使农村社区能够提供和连接诊断，使当地社区和政府能够提高治疗效率（通过增加决策支持），并制定和实施监测战略，以预防流行病和疾病的再次出现。

Infectious diseases remain a primary cause of morbidity and mortality in many Low and Middle Income Countries, which suffer from limited health infrastructure, poverty and political insecurity, increasing the transmission of a broad range of human and animal infectious diseases.Our vision for our network is that our new mobile phone enabled low cost DNA sensor technology, based upon using paper microfluidics, will bring both health and economic benefit to East Africa, including both Uganda and Tanzania, as well as other countries in Sub-Saharan Africa in future. The new diagnostic technology will I particular strengthen laboratory diagnostic capacity, which is a main focus for cooperation according to the WHO Cooperation Strategy for Uganda for example. We have already demonstrated the connectivity through apps and the cloud, accessing secure data storage and artificial intelligence/machine learning decision support tools to help healthcare providers make the correct diagnosis for multiple infectious diseases from the same sample. We now predict, that by using this technology, end users will be enabled to perform infectious disease diagnosis in humans and livestock using different samples, including water, milk and blood. In doing so we will be able to determine, quantitively, transmission pathways between animals and humans (whether this be through shared water sources or unpasteurised milk) - thereby helping address the following Sustainable Development Goals, SDGs, 2, 3, 6 and 15. This will provide healthcare technologists and epidemiologists better understanding of the impact of these diseases in veterinary care, as well as in human infection in the specific environment in Uganda and Tanzania - with resulting economic and health benefits, reducing poverty - address SDG 1.We aim to use this activity as a case study to both exemplify the broader impact of mobile diagnostics on digital health platforms, to inform Governments, NGOs, Charities, Universities, Industry as well patients and the public more generally, as well as to build a wide network of stakeholders in mobile diagnostics platforms to identify and overcome barriers to deployment of digital health solutions in Uganda and Tanzania, and beyond. Our network will address one of the major health challenges highlighted by both Tanzania and Uganda, through the development of low-cost quantitative diagnostics and screening tools, enabling timely investigations of the factors contributing to the persistence of infectious diseases. In addition to delivering impact on increased health and economic benefits, the outcomes from the network will significantly decrease the impact of infectious diseases on women, who currently have a disproportionate burden. They not only provide the main support for young families, including responsibility around caring and cooking for children, and providing education, but also provide 80% of the labour for rural agricultural activities. Illness in women leads to a direct loss in the family's income, and prevention of disease can subsequently provide additional economic benefit (SDG 3, 5 & 10). Similarly, if children are ill, they are often taken out from school, again resulting in a loss of income as well as missed education opportunities (SDG 4). In the case of human disease, as of 2017, malaria was the 3rd leading cause of death in both Uganda and Tanzania. By enabling delivery and connectivity of diagnosis in rural communities, using digital health, our network will allow local communities and governments to both increase the efficiency of treatment (through increased decision support) as well as build and implement surveillance strategies to prevent epidemics and re-emergence of diseases.