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.
Abhijit Das of Arogya Medtech Pvt. Ltd. in India will develop a device - CEREBROS - that is a modular unit combining electroencephalography (EEG) and near infrared spectroscopy (NIRS) together with an Internet of Things (IoT) component incorporating a telemonitoring platform. This system enables continuous remote monitoring of cerebral hypoxia and seizures and early detection and management of hypoxic ischemic encephalopathy (HIE) at point-of-care. The device is in the form of a wearable cap for neonates. It will also include a multivariate classifier incorporating quantitative EEG metrics and cerebral oximetry metrics, which will identify disease-specific patterns that can be presented remotely by a neonatologist simultaneously in voice, text, pictures, or video or animations. The device could be provided, through both public and private care providers, under an affordable rental or pay-per-use model. The device provides an easy-to-use alternative to structural imaging (CT or MRI) that has better sensitivity and specificity, especially for neonates or infants less than 2 years old.
Gautam V. Soni from Raman Research Institute in India will develop a Resistive Pulse Technique (RPT) for malaria detection based on the established fact that the Plasmodium falciparum-infected red blood cells (RBCs) are about 3 to 10 times stiffer than the normal RBCs, depending on the stage of parasite growth. Therefore, flow velocities of stiffer (infected) and softer (normal) RBCs can be easily distinguished in a simple fluidic channel using RPT. In this project, the difference in these flow velocities would be electrically measured across a spatial constriction to accurately determine the infected stage of individual RBCs. Various aspects of the device would be optimized for high throughput detection, ultimately yielding a portable electrical device capable of high sensitivity detection of one infected RBC per microliter of blood. They will also identify a clinical partner to work with infected blood samples from patients.
Taslimarif Saiyed from Centre for Cellular and Molecular Platforms (C-CAMP) in India will develop microfluidics-based pH sensors for antimicrobial resistance (AMR) detection. AMR is big healthcare challenge worldwide and particularly in India. Susceptibility assays are vital to study the emergence of new AMR strains in a community or geography, especially during epidemics. The proposed system - Rapid Personalized Antibiotic Susceptibility Assay (r-PASA) - is a DNA-based assay with pH sensors on a microfluidics platform. Microfluidic channels were chosen due to their suitability for rapid bacterial growth, and the reaction mechanism involves the accumulation of organic acids as a function of bacterial growth that changes the pH of the growth medium. Since testing pH at microliter (<5 μl) or nanoliter volumes is challenging, the device includes a DNA sensor based on a mismatched duplex such that acidic pH brings two flourophores' close together for a Fluorescence Resonance Energy Transfer (FRET) reaction that can be monitored by fluorescence imaging using a reader integrated into the device. The microfluidic channels use various classes of commonly used antibiotics in different concentrations to ascertain and quantify resistance at the same time.
Balaji Teegala from BRUN Health Pvt. Ltd. in India will develop a Doppler stethoscope - Acousta - that acts both as a standard annular Y-shaped stethoscope and as a Doppler stethoscope. The problem in auscultating the fetal heart to identify birth asphyxia among other fetal morbidities is the difficulty, skill, and training needed while using a regular stethoscope. This is mitigated by active sensing systems like the fetal Doppler systems or cardiotocographs. However, these systems are burdensome to carry in addition to a stethoscope. Alternatively, electronic stethoscopes give clarity during auscultation but are predominantly targeted at specialties like cardiology, while still being passive systems in their approach to sensing physiology. Acousta is a combinatorial approach using both these systems.
Pratap Mukhopadhyaya from Wobble Base Bioresearch Pvt. Ltd. in India will develop a glucometer to detect HIV RNA. The existing major methodologies for viral load quantitation require sophisticated infrastructure and reagents that generate high priced tests (>50 USD per test) that are often not feasible for use in resource limited settings. The new assay involves making an HIV cDNA-DNA-invertase complex, which is added to sucrose solution to generate glucose through hydrolysis by the invertase enzyme that is detected using the glucometer. The amount of glucose detected is a function of HIV copy number.
The project intends to identify challenges to accelerate linear growth among infants/children in low-income settings and strategies to overcome them. The study proposes delivery of an integrated package of interventions (nutritional, environmental, WASH and care) during pregnancy and early childhood in a community-based model. Using stratified randomization, the proposal has been designed in a manner that permits the assessment of the impact of these intervention packages when delivered synergistically or independently on the growth and development of the young child.
Asif Mohammed from the International Centre for Genetic Engineering and Biotechnology in India will identify miRNA patterns as potential biomarkers as per Receiver Operating Characteristics, to identify quantitative patterns of circulating human miRNAs which can be used as early biomarkers to predict outcome of the anti-TB drug therapy. They will follow-up patients during their course of treatment with first line anti-TB drugs, and will isolate, sequence, identify and quantitate circulating miRNAs in sputum and plasma of these individuals at one month, two month and 6/9 months of treatment.
Sudeshna Adak from OmiX Research and Diagnostics Laboratories Pvt Ltd. In India will develop a point-of-care AMR test and polymer card combined with a phone based surveillance system to detect and track AMR molecular signatures in primary care settings or in settings where access to AMR testing is currently unavailable. They will demonstrate a proof-of-concept for detection of AMR in urinary tract infections (UTI), establish and validate a 5-gene AMR signature assay in the proposed AMR test.
The project study proposes the development of nutrient rich genotypes in rice possessing the key nutraceuticals and therapeutic clues through which required nutrients such as iron and zinc for pregnant women and infants of rural households will be supplemented sustainably. Any improved line of rice will be compared with the traditional parents and other popularly eaten white rice varieties for its nutritional content and therapeutic values. The improved lines of rice having nutritive, anti-diabetic and therapeutic characters may be registered.
The study intends to develop an inter-generational intervention to ameliorate neonatal gut microbiota. It is based on the hypothesis that consuming prebiotic starches such as high amylose maize starch (HAMS) by mothers during the third trimester of pregnancy will modify their fecal microbiota and will subsequently lead to a beneficial variation in the fecal microbiota of the newborn infant. This will consequently guide favorable intestinal activity, thus enhancing growth, and intellectual competence of the infant in the intermediate and long term.