Digital Diagnostics for Africa Network

在非洲，可预防和可治疗的疾病导致大量疾病和大量死亡。像疟疾这样的传染病是最大的杀手之一。这些疾病不仅给感染者造成重大健康问题，也是个人和社区的重大经济负担，并阻碍整个国家的经济和社会发展。最贫穷和最边缘化的社区通常受影响最严重，因此这些疾病加剧了与地理、性别和种族有关的不平等。目前在最贫穷的环境中应对传染病的战略依赖于基本的诊断和治疗方法，例如依赖一些临床特征(如发烧、呼吸困难或面色苍白)，以及很少有简单的测试来决定一个人应该接受什么治疗。这种方法是必要的，因为附近很少有提供全面检测的诊断实验室，即使有，他们的服务往往也过于昂贵。不幸的是，简单的诊断方法经常导致错误的诊断，并且提供的数据很少，可以学习如何改进。错误的诊断可能意味着给予错误的治疗，导致长期疾病或死亡，同时鼓励过度使用一些治疗方法，如抗生素或抗疟疾药物，这可能会导致对这些药物的耐药性。解决这个问题的革命性解决方案是开发新一代数字诊断测试，即使在最难到达的社区，也可以在护理点使用。这些诊断测试不仅比目前的替代方法更准确、更快，而且有可能节省成本。通过将先进实验室的精确度与现代智能手机提供的便携性、连接性、分析和支持联系起来，数字诊断具有改变这种情况的潜力。这意味着，只需最少的培训，医疗工作者就可以随时随地进行检测。例如，社区卫生工作者从儿童的指尖采集一滴血，可以应用到由手机电池供电的微小芯片上，15-20分钟内就可以做出诊断结果。结果通过蓝牙从微芯片传输到智能手机，因此不需要连接互联网。如果检测到“疟疾”，该设备可以通知医护人员疟疾的类型和正确的治疗。智能手机还可以通过移动网络将结果和位置数据发送到远程计算机系统，该系统可以确定该地区是否存在异常高水平的疟疾，如果是，就通知国家疟疾控制计划，在疫情恶化之前需要额外的资源来应对。因此，儿童受益于正确的治疗，社区受益于干预，卫生当局受益于能够将可用的资源分配到最需要或将发挥最佳作用的地方。实时数据还使国际组织能够制定更有效的政策来应对疟疾并分配资金。在我们的提议中，我们正在发展一个拥有不同技能和专业知识的科学家网络，将他们与制造诊断的商业公司以及直接在非洲国家工作的组织联系起来，将新的疾病控制工具和战略付诸实践。该网络将计划如何最好地开发新的数字诊断设备来解决非洲的健康问题。该网络将测试其战略，具体规划开发一种新的疟疾数字诊断测试设备，并制定其实施路线图。

Preventable and treatable diseases cause a huge amount of illness and a huge number of deaths in Africa. Infectious diseases, like malaria, are some of the biggest killers. Not only do these diseases cause major health problems for those infected, they are also a major financial burden to individuals and communities, and they hinder economic and societal development for whole countries. The poorest and most marginalized communities are usually the worst affected, and so these diseases exacerbate inequalities associated with geography, gender and ethnicity. Current strategies to tackle infectious diseases in the poorest settings rely on rudimentary approaches to diagnosis and treatment, such as reliance on a few clinical features (like fever, difficulty breathing or pallor) and very few simple tests to decide the treatment someone should receive. This approach is necessary because there are rarely diagnostic laboratories nearby to provide comprehensive testing, and even if there are, their services are often too expensive. Unfortunately, the simple methods of diagnosis often result in incorrect diagnosis, and provide little data from which to learn how to improve. A wrong diagnosis can mean the wrong treatment is given, resulting in prolonged illness or death, whilst at the same time encouraging overuse of some treatments like antibiotics or anti-malaria drugs, which can drive resistance to these drugs.A revolutionary solution to this problem is to develop a new generation of digital diagnostic tests which can be used at the point-of-care in even the hardest-to-reach communities. These diagnostic tests are not only more accurate and faster than current alternatives but potentially cost saving. Digital diagnostics have the potential to transform the situation by linking the precision typical of an advanced laboratory with the portability, connectivity, analysis and support that can be provided through a modern smart phone. This means tests can be administered anywhere and anytime by a wide range of healthcare workers with minimal training.For example, a drop of blood collected from the tip of the finger of child by a health worker in their community, could be applied to a tiny microchip powered by a mobile phone battery, and within 15-20 minutes a result could be available to make a diagnosis. The results are transmitted from the microchip to a smartphone via Bluetooth so no internet connection is required. If "Malaria" is detected, the device can notify the healthcare worker of the type of malaria and the correct treatment. The smartphone could also send the result and location data via the mobile network to a remote computer system, which could determine whether there is an unusually high level of malaria in that area and, if so, notify the national Malaria control program that extra resources are required to tackle an outbreak before it gets worse. Thus the child benefits from the right treatment, the community benefits from the intervention, and the health authorities benefit from being able to allocate the resources available to where they are most needed or will work best. The real-time data also allows international organizations to make more effective policies to tackle malaria and allocate funding.In our proposal we are developing a network of scientists with diverse skills and expertise, joining them together with commercial companies that manufacture diagnostics, and organizations who work directly in African countries putting new disease control tools and strategies into practice. This network will plan how best to develop new digital diagnostic devices to tackle health problems in Africa. The network will test its strategies by specifically planning the development of a new digital diagnostic test device for malaria and drawing out a roadmap to its implementation.