Low Cost Multiplexed DNA Diagnostic Sensors for Infectious Diseases

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Nearly 260m people are infected with schistosomiasis, with >90% ofinfections found in sub-Saharan Africa. Worldwide ~3.2b people areat risk of malaria, many also in Sub-Saharan Africa. Both diseasesare endemic in the same rural locations and there is difficulty indifferentiating symptoms and informing correct diagnosis andtreatment. Incorrect diagnosis is known to lead to unnecessarydispensation of drugs leading to increased probability of drugresistance.Professor Cooper has developed a paper-based multiplexed DNAmalaria diagnostic device that exploits novel hot wax printing tointegrate sample preparation and microfluidic flows. The device candifferentiate between three species of malaria causing plasmodiumand has now been tested using whole patient blood samples in thelaboratory.The aim of this project is to develop a novel blood-based multiplextest that can, from a single drop of blood, distinguish between malariaand schistosomiasis and identify drug resistant microbes. This newhighly sensitive diagnostic device will enable field workers to monitortreatment outcomes, with the specific aims of(i) providing correct diagnosis;(ii) preventing re-emergence of infections following localtreatment;(iii) reducing resistance by ensuring effective and appropriatetreatment.Field-testing will be carried out operator double-blind field-testing inEast Africa. The samples will also be characterised using(i) the paper based test;(ii) through microscopy in-the-field(iii) will also be stored (as dried blood spots) for retrospectivelaboratory based molecular testing in Glasgow.Ethics permissions will be obtained.Additional Information: The schistosoma live in the hepatic portal veinand shed cells into the blood. Malaria parasites (Plasmodium sp.) livewith red blood cells as part of their lifecycle. We will therefore alsodevelop a blood based assay, where DNA will be detected from afingerpick of blood. The assay will again be configured as a low cost,paper based assay and will be developed as a duplex, enabling bothmalaria and bliharzia (schistosomiasis) to be detected at the sametime. This will guide appropriate treatment for febrile patientspresenting themselves at field clinics.Benefits:This project is also aligned with the Health priority of the GlobalChallenge Fund, which aims 'to tackle diseases, strengthen healthsystems and reach the worlds' most vulnerable'. Indeed, according tothe latest WHO estimates, at least 258 million people have requiredtreatment for schistosomiasis in 2014, with 61.6 million peoplereported to be treated. 90% of those requiring treatment live in Africa.In children, schistosomiasis causes anaemia, stunted growth andreduced ability to learn. Treatment usually reverses these effects, butits efficacy needs to be monitored to establish cure and adapttherapy. If untreated, chronic disease affects people's ability to workand can result in death. The disease burden has been estimated toaccount for 4.5 million DALYs (disability affected life years).Mass drug administration of praziquantel has been delivered throughNational Control Programmes, e.g. in Uganda for over a decade.Hotspots of infection have been detected, where prevalence,intensity and associated morbidity are now higher than they were atbaseline.