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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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Advancing a Protein-to-Creatinine Rapid Test for Determining Proteinuria Status as an Onset Indicator of Preeclampsia/Eclampsia

Louis RouxLifeAssay Diagnostics (Pty) LtdCape Town, South Africa
Grand Challenges South Africa
All Children Thriving
1 Jun 2016

Louis Roux from LifeAssay Diagnostics (Pty) Ltd. in South Africa, in collaboration with PATH, will develop an easy-to-use, low-cost, strip test for pregnant women in developing countries to detect the onset of proteinuria, which indicates a highly increased risk of preeclampsia/eclampsia. Preeclampsia/eclampsia is a major cause of maternal death, particularly in developing countries. Onset is rapid, and so early diagnosis is crucial, particularly in remote communities where health care is not immediately available. The test measures the ratio of protein to creatinine, which is more accurate than the current protein-only version, and they will produce a low-cost version that can be locally manufactured. They will evaluate the test's performance in comparison to three similar tools on a minimum of 1100 urine samples collected from the CAP trial in South Africa. The study also includes usability and stability evaluations to inform further prototype improvements and product insert development for downstream validation studies.

Integrating a Package of Home-Based Early Childhood Interventions into Existing Community Health Worker Protocols in South Africa: A Cluster-Randomized Trial

Denise EvansWits Health Consortium (Proprietary) LimitedSouth Africa
Grand Challenges South Africa
All Children Thriving
22 Mar 2016

Denise Evans from the Wits Health Consortium (Pty) Ltd. in South Africa in collaboration with Peter Rockers from Boston University will evaluate the impact and sustainability of a combined health care package for families offered by community health workers in the home to improve child health in South Africa. The package includes methods that are known to be effective on their own but have never been evaluated in combination including cognitive behavioral therapy for maternal depression and teaching parents new ways to engage and stimulate their children to boost their cognitive and emotional development. They will integrate the package into the current community health worker program for ease of delivery direct to people’s homes, and evaluate it using a pilot cluster-randomized trial involving 2000 households and 100 community health workers.

Development and Validation of a Progesterone-Impregnated Cervical Pessary with Strain Gauge Sensors to Detect Cervical Shortening and Dilation to Improve Prevention and Prediction of Preterm Birth

Lineo MatselaSefako Makgatho Health Sciences UniversityPretoria, South Africa
Grand Challenges South Africa
All Children Thriving
1 Mar 2016

Lineo Matsela from Sefako Makgatho University in South Africa together with collaborators at the University of Alabama at Birmingham will develop a progesterone-impregnated cervical pessary with strain gauge sensors to identify cervical shortening and dilation and help prevent preterm labor. Preterm birth is a major cause of infant mortality. One of the best predictors is shortening of the cervix, which is currently detected by ultrasound and can then be treated by either vaginal progesterone or a pessary. However, none of these methods are practical in resource-limited settings. They will test different materials for developing an easy-to-use, and inexpensive cervical pessary that is also impregnated with progesterone for steady release, and test it for usability and performance on 40 non-pregnant women.

Development and Validation of a Sensitive, Specific, One-time Blood Test for Gestational Diabetes

Abram MuseSefako Makgatho Health Sciences UniversityPretoria, South Africa
Grand Challenges South Africa
All Children Thriving
1 Mar 2016

Abram Muse from Sefako Makgatho University in South Africa together with collaborators from the University of Alabama at Birmingham, USA and the University of the North West in South Africa will identify biomarkers that can be used to develop a sensitive and low-cost blood test for diagnosing gestational diabetes. If left untreated, gestational diabetes can have severe consequences for mother and child. It is currently diagnosed by an expensive and time-consuming glucose tolerance test, which involves taking blood multiple times, and is often not available in low-resource settings. They will perform a prospective cohort study of pregnant women at 20-28 weeks gestation who will be screened for gestational diabetes using the standard test. They will use a metabolomics approach to simultaneously measure thousands of analytes, and from these identify a combination of three to five biomarkers that can best diagnose gestational diabetes.

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