Malaria screening in resource-poor settings using a simple, power-free, cell phone-friendly device

使用简单、无电源、适合手机使用的设备在资源匮乏的环境中进行疟疾筛查

• 批准号: 8809505
• 负责人: IONITA Calin GHIRAN
• 金额: $ 23.61万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8809505
• 关键词: Acute; Adult; African; Algorithms; Anemia; Antibodies; Area; Artemisinins; Back; Beds; Bite; Blood; Blood Cells; Blood Platelets; Blood capillaries; Blood specimen; Buffers; Burkitt Lymphoma; Cell Separation; Cell physiology; Cellular Phone; Cessation of life; Child; Child Mortality; Chronic; Code; Collaborations; Comorbidity; Complex; Complication; Culicidae; Custom; Data; Detection; Devices; Diagnosis; Diagnostic; Diagnostic Procedure; Diagnostic tests; Disease; Drops; Drug resistance; Emergency treatment; Equipment; Erythrocytes; Fatal Outcome; Fever; Geometry; Glass; Goals; Gold; Health; Health Services; Health system; Heating; Hematology; Hemoglobin; Hospitals; Hour; Human Resources; Image; Image Analysis; Immune; Immunity; Individual; Infection; Insecticides; Ions; Laboratories; Lead; Letters; Leukocytes; Life; Location; Magnetism; Malaria; Malignant Neoplasms; Malnutrition; Measures; Methods; Microscope; Microscopic; Microscopy; Nigeria; Outcome; Parasites; Pathology; Patients; Pharmaceutical Preparations; Plasmodium; Plasmodium falciparum; Plastics; Pregnancy; Prevalence; Process; Property; Provider; Public Health; Reaction; Reagent; Recurrence; Resources; Risk; Role; Sensitivity and Specificity; Shapes; Sickle Cell Anemia; Solutions; Splenomegaly; Staining method; Stains; Structure; Symptoms; System; Technology; Telephone; Temperature; Testing; Time; Training; Universities; Work; Writing; artemisinine; base; capillary; cell type; cloud based; cost; drug testing; early childhood; efficacy testing; feeding; hemozoin; image processing; improved; innovation; interest; lens; light microscopy; light weight; mortality; novel; pathogen; prevent; programs; prototype; research clinical testing; screening; stability testing; tool; vector mosquito

DESCRIPTION (provided by applicant): Malaria is a life-threatening disease caused by one the four species of Plasmodium parasites that are transmitted to people through the bites of infected mosquitoes. In 2012 alone, malaria caused over 625 000 deaths, mostly among African children. Due to its high child mortality and prevalence in Sub-Saharan regions, in 2000 a new program was launched in Nigeria, the Roll Back Malaria (RBM), aiming at reducing the burden of malaria by using presumptive treatment (PT) based, in many cases, only on fever as single sign of malaria infection. This approach, necessary due to limited laboratory support leading to long waiting times for laboratory diagnostic and consequently increased risks associated with delayed anti-malaria treatments, is often the only available option for local health service providers. Although studies have shown a significant decrease in malaria burden since the beginning of the RBM program in areas where the PT approach is employed, continuation of this practice already led to over-diagnosis of the malaria, under-diagnosis of other illness, increased drug wastage, increase adverse anti-malaria drug reactions, increased parasite-drug- resistance, and unnecessary financial burden to local health systems. We propose to develop an antibody- free diagnostic screening device that is based on the principles of magnetic levitation, allowing for separation of infected red blood cells from un-infected red blood cells. Our screening device will be light-weight, disposable, and cheap to manufacture with an indefinite shelf life at room temperature. The prototype system requires less than a drop of fingerprick blood (<1 μ�L) and a small volume of RBC-friendly buffer containing paramagnetic ions. Binary diagnostic results is obtained within a few minutes solely by using a set of permanent magnets immobilized in a plastic structure surrounding a glass/plastic capillary containing the blood. Results are recorded and stored using a standard camera phone. No additional imaging equipment, staining reagents, or consumables are required.

描述（由申请人提供）：疟疾是一种威胁生命的疾病，由四种疟原虫寄生虫之一引起，通过受感染的蚊子叮咬传播给人类。仅在2012年，疟疾就造成62.5万多人死亡，其中大多数是非洲儿童。由于撒哈拉以南地区的儿童死亡率和流行率很高，2000年尼日利亚启动了一个新的方案，即"击退疟疾“方案，目的是通过在许多情况下仅以发烧作为疟疾感染的单一迹象为基础的假定治疗来减轻疟疾负担。由于实验室支持有限，导致实验室诊断等待时间长，从而增加了与抗疟疾治疗延误有关的风险，因此这种方法是必要的，但往往是当地保健服务提供者唯一可用的选择。尽管研究表明，在采用PT方法的地区，自RBM方案开始以来，疟疾负担显著下降，但继续这种做法已经导致疟疾的过度诊断，其他疾病的诊断不足，药物浪费增加，抗疟疾药物不良反应增加，寄生虫抗药性增加，以及当地卫生系统不必要的财政负担。我们提出开发一种基于磁悬浮原理的无抗体诊断筛选装置，其允许将受感染的红细胞与未受感染的红细胞分离。我们的筛选设备将是重量轻，一次性的，廉价的制造与无限期的保质期在室温下。原型系统需要不到一滴手指血（<1 μ L）和少量含有顺磁性离子的RBC友好缓冲液。仅通过使用一组固定在塑料结构中的永磁体，在几分钟内即可获得二元诊断结果，该塑料结构围绕着含有血液的玻璃/塑料毛细管。使用标准的照相手机记录和存储结果。无需额外的成像设备、染色试剂或耗材。