Awards

David Anderson of the Macfarlane Burnet Institute for Medical Research in Australia will develop a low-cost, simple to use, sample collection device to improve sample quality and ensure accurate and timely diagnosis in remote, low-resource areas. Obtaining high quality serum samples needed for diagnosing a variety of diseases is challenging in these regions due to the lack of equipment and expertise to process the samples and stabilize them for transport to the diagnostic laboratories. They have developed a device comprising an integrated two-step process based on lateral flow chromatography that separates plasma from other blood cells and dries it on paper so it can be stably transported. The dried plasma samples can also be used directly in the laboratory, which accelerates analysis. They will modify the device to separate and store larger volumes of plasma using 25 healthy volunteers, and test its performance for diagnosing patients with different infections, including Hepatitis B and C, compared with fresh plasma.

Chris de Villiers of Sinapi Biomedical in South Africa will produce an improved sample container that ensures sputum samples are of sufficient quantity and quality to diagnose tuberculosis (TB). South Africa has one of the highest burdens of TB, and has implemented a rapid testing program that diagnoses the disease from sputum. However, over 8% (around 218,000) of sputum samples cannot be tested, largely due to insufficient volumes or leaky sample containers. This causes additional costs and leaves many sufferers undiagnosed. In collaboration with clinical, academic, and commercial partners in South Africa and the U.S, they used an iterative design process to develop a new container. They will finalize this design by testing different versions in the laboratory and clinic, and producing two prototypes along with an instruction manual and other training materials. In collaboration with their clinical partner, they will also produce a protocol ready for a large-scale clinical trial that will evaluate the reliability of sputum collection with their new container and collect user feedback.

Apostolos Alissandratos of the Australian National University in Australia will develop a biotechnology platform for the low-cost production of simple, just-add-water diagnostic tests for the early detection of infectious diseases in resource-limited settings. Diagnosis of infectious diseases generally involves detecting pathogen-specific nucleic acids in human samples, which requires unstable reagents, costly procedures, and skilled workers. They have engineered a safe bacterium that produces the biochemical reagents needed to detect the pathogenic nucleic acids as an extract. They will develop a method to freeze-dry this extract so that it is stable at room temperature, simplifying production and storage, and a protocol for incorporating it into a reaction mixture that only requires the addition of water to an individual tube for a diagnostic polymerase chain reaction. They aim to reduce the cost per test by at least 100-fold, and will evaluate their approach for detecting a malaria-causing pathogen.

Amadou Alpha Sall of Institut Pasteur de Dakar in Senegal will add quantum dots to liquid patient samples for better tracking of results and to store diverse types of information relevant for diagnostics and research that can be retrieved in real-time. They will tag samples using stable semiconductor quantum dots to generate unique signatures that can be read by a mobile-based, lens-free, fluorescence microscope. They will develop algorithms to enhance the efficiency of encoding and decoding the data from the quantum dot signatures, and design a cloud-connected database using commercial infrastructures for sample data storage and retrieval. They will perform a field trial with a local laboratory network and real clinical samples to evaluate sample collection, tracking capability, and ease of use.

Gerard Cangelosi of the University of Washington in the U.S. will develop reagents to visually validate oral swabs and stabilize them for storage and transport to diagnostic laboratories in low-resource settings without the need for a cold chain. Oral swabbing to extract saliva is a non-invasive and effective method for diagnosing tuberculosis, and is faster and safer than traditional sputum collection. However, it is more difficult to review the quality of a swab sample as they are hard to see, and processing currently requires refrigeration. To address these limitations, they will develop a low-cost, quality control test with chemical reagents for detecting human mitochondrial DNA using human oral swabs from U.S. volunteers spiked with an avirulent strain of Mycobacterium tuberculosis. This will be coupled to a visual fluorescent readout that can be used to distinguish adequate from inadequate samples. They will also test different buffers for their ability to stabilize the swab samples at different temperatures for up to six months.

Jan Willem Alffenaar of the University Medical Center Groningen in the Netherlands will develop two simple tests that measure the concentration of anti-tuberculosis drugs in treated patients in low-resource settings in order to optimize dosage and limit the emergence of deadly multi-drug resistant Mycobacterium tuberculosis (MDR-TB). The increased incidence of MDR-TB is due in part to low levels of anti-tuberculosis drugs, thus dosage optimization during treatment is important. However, doing this in low-resource settings is currently challenging. They will develop a method for use in Tanzania to measure the concentration of the anti-TB drug fluoroquinolone in saliva using a battery-operated UV spectrophotometer. They will also modify a high-performance liquid chromatography (HPLC) platform for detecting drug concentrations in dried blood spots, which are collected on filter paper and do not require refrigeration to remain stable. The on-site saliva test will allow detection of patients with too low levels of drug at risk for treatment failure, who can then have their dose optimized following the more detailed dried blood spot analysis at a centralized laboratory.

Jeroen Lammertyn, Jaroslav Belotserkovsky, and Michael Kraft of KU Leuven in Belgium will develop a low-cost device to simplify blood collection and processing for monitoring of HIV viral load in low-resource settings. Most diagnostic assays work on blood, which must be manually collected from the patient, and then processed and stored before analysis. This requires trained health workers and infrastructure, is time-consuming, and can be unsafe. They will develop a simple, integrated device to collect and process blood. This will allow blood collection to be less invasive and safer than conventional methods, and integrating collection and processing in a single device would cut the time needed to produce diagnostic-ready samples. Because of the simplicity of the device, only minimal training is required to operate it. They will optimize their device for the removal and preparation of sufficient volumes of blood for subsequent analysis, and test it in model systems.

William Grover of the University of California, Riverside, in the U.S. will create a medical record that is permanently attached to its human sample using micron-sized microtransponder chips added to the samples during collection. These chips will permanently link the sample to the patient, and provide their contact details, when and where the sample was collected, and the test results. Medical records are generally kept separately from the samples, which means that samples can be mixed up or misplaced, particularly when they are shipped to a central laboratory, or split into smaller samples. Their industry partner has developed silicon microtransponder chips carrying a unique identifier that can be read by an ID reader. They will first develop methods to use the chips for medical samples to ensure they function properly also during sample transport and processing, and that they don't interfere with standard diagnostic assays. They will also develop software to link the chips with existing open-source medical records.

Xing Xie of the Georgia Institute of Technology in the U.S. will test whether super-absorbent polymers in sample tubes can improve the accuracy of diagnostics by absorbing molecules like DNA and viruses from liquid samples such as blood, and protecting them during transport to the laboratory. Normally, blood and urine samples degrade over time, particularly when they are exposed to heat or cold. This makes the subsequent diagnostic result unreliable. They propose that low-cost, super-absorbent polymers can preserve diagnostic target molecules by separating them from contaminating cells and bacteria, which can be poured away from sample tubes, and providing a pH buffer and preservatives to extend their shelf-life. They will optimize synthesis of the beads and test their ability to preserve different analytical targets including a human virus surrogate and an antibody against HIV.

Jacob McKnight and Mike Wilson of the University of Oxford in the United Kingdom will develop a simple application that contains information about the quality, location, and the nature and cost of services provided by the different pathology laboratories in Kenya so that doctors and patients can choose the one that best suits their needs. They will conduct surveys to collect key information on the pathology laboratories in the Nairobi area, and consult with doctors and medical associations to find out how they use those laboratory services and what needs to be improved. They will build the application using these data and in collaboration with users. Ultimately, the system should also help to improve the overall quality of services.