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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

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Challenges: Pneumonia
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A Low-Cost Ultrasound System for Detection of Malnutrition

Mirko Zimic, Universidad Peruana Cayetano Heredia (Lima, Peru)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Mirko Zimic of Universidad Peruana Cayetano Heredia in Peru will develop a simple, low-cost lung ultrasound device that can automatically diagnose bacterial pneumonia and measure nutritional status in children in low-resource settings. They have developed an algorithm to detect lung infiltrates from digital ultrasound images as evidence of pneumonia in children, and have built a prototype device, which comprises an ultrasound probe connected to a laptop or smartphone for realtime analysis of the images. Visible and audio alerts are used to notify the technician of suspect regions. They will develop an additional algorithm to automatically measure anatomical parameters including rib diameter and skin thickness for predicting levels of malnutrition, and test it in a hospital in Peru. Ultimately, this will be incorporated into the ultrasound device so that both pneumonia and malnutrition can be easily diagnosed together by non-specialized health care workers.

A Point-of-Care Instrument for Rapid Diagnosis of Pneumonia

Bastiaan Hoogendoorn, Cardiff University (Cardiff, United Kingdom)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Bastiaan Hoogendoorn at Cardiff University in the United Kingdom will develop a simple, inexpensive breath-testing device to measure the type and levels of bacteria in the lungs for rapid diagnosis of pneumonia in children in low-resource settings. Rather than condensing the exhaled breath, which can cause variation, the device directly captures respiratory fluid droplets containing non-volatile pathogen markers. These markers can then be identified using low-cost commercially available bioassay kits. They will analyze biomarker levels in the breath of sick and healthy children, and test and refine the design of their prototype.

Affordable and Accurate Malnutrition Diagnostic Device

Pavan Dadlani, Philips Research (Eindhoven, Netherlands)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Pavan Dadlani of Phillips Research in The Netherlands will create a handheld three-dimensional scanner that can automatically analyze body shape and assess malnutrition in young children, which is a strong risk factor for mortality associated with a variety of common diseases. Current physical measurements of children to assess nutritional status are time-consuming, uncomfortable for the child, and difficult to take accurately, particularly in low-resource settings. They will develop and test an algorithm for measuring height, upper arm length, and circumference of the head, belly and upper arm from a three dimensional image, by collecting data from children between 0 and 5 years old. They will also produce a user-friendly design for health workers by conducting a field analysis in low-resource settings.

Assessing Malnutrition in Pneumonia using BIVA

Carina King, Institute for Global Health (London, United Kingdom)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Carina King of the Institute for Global Health in the United Kingdom will use bioelectric impedance vector analysis (BIVA) to measure nutritional status in children with pneumonia in Malawi in order to improve treatment. Malnutrition is strongly associated with poor prognosis in pneumonia but is difficult to accurately assess. BIVA measures bioelectric properties to predict physiological parameters such as hydration and body mass of specific body regions. They will develop a protocol and evaluate BIVA for assessing nutritional status in children with pneumonia compared to current assessment methods. They will also lead focal discussion groups to evaluate related knowledge and likely acceptance of the protocol by health workers and care staff. Finally they will conduct a pilot training program on the technology for health care workers.

BIOTOPE - Biomarkers to Diagnose Pneumonia

Joe Gallagher, University College Dublin (Dublin, Ireland)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Joe Gallagher together with Chris Watson of University College Dublin in Ireland will develop a method to quickly and accurately diagnose bacterial pneumonia in children with acute respiratory infections so that the correct treatments can be given. Physical symptoms of bacterial pneumonia are similar to many other diseases including malaria but they require vastly different treatments. They will use a screening approach to identify protein, metabolite or miRNA biomarkers of bacterial pneumonia in blood and urine samples from 500 children in Malawi clinics with a known diagnosis of pneumonia. The most specific biomarker panel will be combined with a selected panel of symptoms such as heart and breathing rate to generate a highly sensitive clinical prediction model that specifically diagnoses bacterial pneumonia and can be used in low- to middle-income countries.

Smartphone Image Processing to Assess Childhood Malnutrition

Heba Khamis, University of New South Wales (Sydney, New South Wales, Australia)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Heba Khamis of the University of New South Wales in Australia will use smartphone technology to more accurately measure malnutrition in children from developing countries, which puts them at increased risk of death from diseases such as pneumonia. They will develop an image-processing algorithm for calculating three key growth parameters (height, and arm and head circumference) and thereby assessing nutritional status from a photograph of a child taken by a smartphone. They will recruit twenty children to help refine the algorithm and the protocol for taking the photograph, which will then be validated on an independent set of children.

Thermal Images of the Lung on a Smart Phone to Differentiate Bacterial from Non-bacterial Causes of Pneumonia

Patricia Hibberd, Massachusetts General Hospital (Boston, Massachusetts, United States)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Patricia Hibberd of Massachusetts General Hospital in the U.S. will develop a low-cost thermal imaging system for a smart phone to diagnose bacterial pneumonia in children from developing countries where the standard chest X-ray is often unavailable. They predict that children with pneumonia specifically caused by bacteria will have asymmetric "hot spots" of high temperatures in the lungs caused by localized inflammation. They will perform a proof-of-concept study in children under age 5 with chest infections in a large hospital in Malawi using the FLIR One Thermal Imaging System attached to a smartphone. At least 10 thermal images will be taken, and two short videos to record breathing rate, and the data will be used to develop statistical approaches for the required analytics. They will evaluate performance for diagnosing pneumonia by comparing it to the standard chest X-ray.

Tissue Oxygen Saturation in Malnutrition and Pneumonia

Mark Ansermino, University of British Columbia (Vancouver, British Columbia, Canada)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Mark Ansermino of The University of British Columbia in Canada will adapt near-infrared spectroscopy (NIRS) for the simple diagnosis and monitoring of children at increased risk of mortality from pneumonia. Children with moderate to severe malnutrition who develop pneumonia are far more likely to die than more nourished children, but diagnosing pneumonia in these individuals is problematic, likely due in part to muscle wasting that masks the classic symptoms of fast breathing and chest indrawing. NIRS is non-invasive and portable, and can rapidly measure tissue oxygenation levels, which will be reduced by oxidative stress in children with malnutrition. They will collect arm muscle saturation data using NIRS on 200 children under five years old admitted for lung infections at a clinic in Uganda, and use the data to design a prototype device and protocols for identifying at risk children.

Ultrasound Strain and Time-of-Flight for Diagnosing Pneumonia

Jonathan Rubin, University of Michigan (Ann Arbor, Michigan, United States)
Nov 1, 2015
Grand Challenges Explorations> Pneumonia

Jonathan Rubin of the University of Michigan in the U.S. will develop a simple, low-cost ultrasound device with cell phone display that can diagnose children with co-existing pneumonia and malnutrition. Over two million children per year die from pneumonia, and many of these deaths are caused by coexisting malnutrition. They will design an ultrasound stethoscope device to automatically measure lung expansion and contraction during breathing to detect ventilation problems caused by pneumonia as well as the levels of subcutaneous fat on the chest wall to detect malnutrition. The device will be tailored for use by a minimally-trained health worker and the results reported on the display by a numeric readout. They will test the adapted ultrasound device in the laboratory, and gather population data to determine the normal distribution of fat thickness in the chest wall for estimating nutritional status.

A Low-Pressure Oxygen Storage System

Roger Rassool, University of Melbourne (Melbourne, Victoria, Australia)
May 1, 2015
Grand Challenges Explorations> Pneumonia

Roger Rassool of the University of Melbourne in Australia will build a device that stably stores oxygen ready for treating children with pneumonia particularly in low- resource settings with unreliable electricity supplies. They will develop a safe, low-pressure oxygen storage device comprising two coupled storage chambers and utilizing water to provide pressure for delivery. The volumes and pressure required will be tested, and the device will be fillable from existing oxygen concentrators. Once built, the device will be tested by training staff and assessed for usability in the field.

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