Effective resuscitation could reduce intrapartum related neonatal deaths by 30%, and deaths from prematurity by 10%, creating the potential to save 347,200 babies annually. However, one in five trained healthcare professionals (HCPs) fail to perform the resuscitation technique correctly, and those that do, often experience a rapid decline in proficiency. Our Augmented Infant Resuscitator's advanced training capabilities, instant feedback mechanism, and objective self-audit and retraining abilities will maximize and sustain gains from effective resuscitation. The AIR prototype provides instant feedback to users about effective ventilation. This is measured using inexpensive instrumentation that calculates ventilation rate, air volume and air pressure delivered by the bag-valve-mask (BVM) across the resuscitation face-mask. These parameters correlate with the four most common mistakes that result in ineffective resuscitation: 1) Failed seal at the face-mask interface resulting in failure to inflate the lungs; 2) Blocked airways; and 3) Wrong ventilation frequency 4) Insufficient/shallow lung inflation. Each of these mistakes can cause death or brain damage. AIR also records performance on an internal memory card for future feedback, improving HCPs training by identifying persistent gaps in technique.

We propose to develop a low-cost Nipple Shield Delivery System (NSDS) to administer drugs or nutrients to breastfeeding infants via easily disintegrating tablets within a modified nipple shield. A wide-range of active pharmaceutical ingredients (APIs) could be delivered to infants using the NSDS such as antibiotics, antimalarials, antiretrovirals, vitamins, nutrients, and probiotics. Use of the NSDS would empower a breastfeeding mother during the early postnatal period by allowing her to personally administer medicines in a natural setting. This system can provide a novel method for accurately administering drugs and nutrients to breastfeeding infants.

Guatemala has one of the highest national maternal mortality ratios in Latin America at 149 per 100,000 live births, and up to 260 per 100,000 in some northern departments. Only 31% of deliveries are attended by a skilled birth attendant. We propose to scale up an already tested innovative strategy, combining technology, service delivery, and demand creation approaches. Our collaborative effort integrates: 1) a low cost, simulation-based training program (PRONTO) using a low-tech birth simulator (PartoPants) to teach provider teams emergency management during childbirth, 2) a research-driven social marketing campaign encouraging women in the target communities to give birth in clinics rather than at home, and 3) professional midwife liaisons charged with connecting traditional birth attendants to the formal health care system. We expect that this effort will catalyze critical practice changes in maternity care, increase the proportion of births attended in clinics, improve maternal outcomes, and decrease perinatal death in indigenous Guatemalan communities.

Antonio Fernandes Moron from the Universidade Federal de São Paulo in Brazil will investigate whether the presence of specific bacterial populations in the vagina can predict preterm birth, which could form part of an inexpensive test suitable for low resource settings. Preterm birth leads to major short- and long-term health problems for the child. The causes are largely unknown, making it hard to identify pregnant women at increased risk who need monitoring and might benefit from treatment. They hypothesize that bacterial infections in the vagina during pregnancy can alter the length, elasticity and/or thickness of the cervix, thereby triggering preterm birth. To test this, they will analyze vaginal samples from 400 pregnant women located at four urban care centers throughout Brazil to identify bacteria and selected proteins that associate with specific cervical alterations detectable by ultrasound, and determine their association with preterm birth.

Joao Guilherme Bezerra Alves from the Instituto de Medicina Integral Professor Fernando Figueira in Brazil will perform a randomized controlled trial to assess whether a daily oral supplement of magnesium citrate can prevent placental vascular disease, which can lead to preterm birth. Placental vascular disease restricts the flow of nutrients to the fetus and can cause growth restriction and maternal hypertensive disorders. Magnesium is known to promote placental vascular flow, and magnesium citrate is safe, inexpensive and easily absorbed in the body. They will perform a clinical trial in two large hospitals in Brazil in which 3,000 pregnant women will be offered a daily magnesium supplement or a placebo control starting from up to 20 weeks of gestation and continuing until birth. The effect on various outcomes including placental function, preterm labor, and mother and child health will be evaluated.

Jose Simon Camelo Junior from the Universidade Federal de São Paulo in Brazil will test a method for producing a lyophilized human milk concentrate for feeding very low birth weight newborns that can be implemented in developing countries. Very small premature babies of less than 1,500 grams require large quantities of proteins, calories, minerals, micronutrients and electrolytes to survive and thrive. However, breast milk alone is not concentrated enough. Supplements derived from cow’s milk have been used but appear to inhibit particularly the immunological quality of human breast milk, which helps block infection. Human milk additives have now also been tested and show promising results, but they are prohibitively expensive to produce in developing countries. They will use a simple method involving evaporation, centrifugation and lyophilization to produce a concentrated form of human milk that can be implemented in Brazilian milk banks. The milk product will be evaluated for stability and safety and for nutritional content to ensure it contains adequate concentrations of essential nutrients within manageable volumes to support very low weight newborns.

Silvia Regina Dias Medici Saldiva from the Instituto de Saúde in Brazil will determine whether and which physical, social and cultural aspects of urban environments can increase the incidence of preterm birth. Prematurity is a major cause of childhood mortality and disability, and levels are high in Brazil. Preterm birth is likely caused by combinations of factors that, particularly in urban locales, might include environmental factors such as the quality of housing, proximity to health facilities and pollution levels, which then interact with social and cultural factors. They will identify spatial clusters of premature births from 2012 in the city of São Paulo to define suitable regions for performing case-control studies. The studies will involve face-to-face interviews at selected households by trained interviewers to assess environmental and social factors such as income, education, health and sanitation. These data will be supplemented with available or modeled meterological and pollutant data, and data from tree rings, which can provide climate information as well as levels of toxins. They will then perform hierarchical modeling to identify environmental factors associated with preterm births.

Renato Soibelmann Procianoy from the Universidade Federal do Rio Grande do Sul in Brazil will analyze the association between bacterial populations in the vagina and gut of mothers in their third trimester and in the meconium of very preterm newborns, with risk of preterm delivery. It was previously assumed that microbes from the mother are first transferred to the fetus during delivery. However, it was recently shown that this could happen already in the uterus, triggering a possible immune response by the fetus that may lead to premature birth, which is a leading cause of infant morbidity and mortality. They will use 16S rRNA-based bacterial sequencing technology on around 600 samples to compare the types of bacteria present in preterm infants with that in healthy term infants in a neonatal unit in the Clinicas Hospital in Porto Alegre. They will also track the changes in bacterial composition in healthy and sick newborns during their hospital stay, to identify types of bacteria associated with specific diseases such as diarrhea. All samples will be stored in a repository for future case-controlled studies.

José Guilherme Cecatti from the Universidade Estadual de Campinas in Brazil will develop a predictive algorithm to identify early in pregnancy those at increased risk of preterm birth so that if possible they can be treated. There are likely to be many causes of preterm birth, and it is a major cause of both short and long term life-threatening complications for infants. They will use existing data from 6,000 pregnancies that resulted in both term and preterm births, and perform three complementary mass spectrometry-based methods on blood taken early (around 15 weeks) in those pregnancies to identify a panel of biomarkers that can predict preterm birth. This will be combined with sociodemographic and physical data including economic status and age to generate a predictive algorithm. They will then evaluate this algorithm in a cohort of 1,150 low risk pregnant Brazilian women for its ability to identify those that go on to give birth prematurely.

Brian Lilly of Ergo-Tech Inc. in the U.S. will design and build a water irrigation pump from inexpensive and widely available automobile parts to decrease labor and increase production of women smallholder farmers in Africa. Irrigation is one of the most time-consuming and labor-intensive activities of women farmers. Making an irrigation system from automobile parts is useful because the parts are well tested and mass-produced in Africa, and expertise on their repair and maintenance is readily available. Lilly will build an irrigation system from automobile parts using different designs for the pump and battery charger components, and test the interchangeability of different parts. Once the design is finalized, he will build 10 machines and test them in Africa to evaluate performance.

Carmine Bozzi of Akeso Associates in the U.S., along with Maurice Masoda of Heal Africa in the Democratic Republic of Congo, will test the effect of treating hookworm infections in women smallholder farmers in the Democratic Republic of Congo on disease prevalence, iron status, and capacity for labor over a 12-month period. Hookworm infections are endemic in many regions, and infection rates can reach 50% of the population. Hookworms reside in the intestinal wall where they mediate blood loss causing iron deficiency and anemia, which is exacerbated in women due to menstrual blood loss and iron demands during pregnancy. This anemia in turn leads to reduced aerobic work capacity, therefore successful treatment of these infections could result in significant gains in labor productivity.

John McGiven of the Animal Health Veterinary Laboratories Agency in the United Kingdom, along with David Bundle of the University of Alberta in Canada, will evaluate a glycoconjugate vaccine for brucellosis that is safe, stable, inexpensive, and efficacious. Complementary diagnostics will allow for the differentiation of vaccinated and infected subjects and assist in the control of this insidious zoonotic disease. They will test both the vaccine and the diagnostic in a standardized mouse model.

Judy Sakanari of the University of California, San Francisco, and Manu Prakash from Stanford University in the U.S. will develop a cheap electromagnetic detection device to non-invasively assess the viability of parasitic nematode worms in infected patients to guide treatment duration. Current methods of detecting viable worms in nodules or the lymphatic system are invasive or expensive. Using animal infection models, they will develop an easy-to-use electronic bandage enabling ultrasensitive detection of capacitance changes caused by movement or physical changes in the adult worms following drug treatment. This could greatly improve the ability to perform in vivo drug studies in animals by being able to non-invasively monitor worm viability over the course of drug treatment and dosing. The bandages will ultimately be tested on humans and could be designed to transfer data remotely for real-time monitoring of the effects of drug treatments in the field.

George Warimwe of the Jenner Institute at the University of Oxford in the United Kingdom will develop a vaccine to protect a variety of species, including humans, sheep and cattle, against Rift Valley fever, which can cause serious illness. Current vaccines that are in development have safety concerns for use in humans. They have developed a Rift Valley fever vaccine using a replication-deficient simian adenovirus as a safe vector that is easy and inexpensive to manufacture, and have tested its safety and immunogenicity in mice, and begun field-testing in sheep in Kenya. They will test safety and immunogenicity of the vaccine and the effect of an adjuvant in calves and goats, and compare this with the data from mice and sheep.

Peter Rabinowitz of the University of Washington in the U.S., along with colleagues at Washington State University and CDC Kenya, will test whether unhealthy gut microbes in livestock that co-reside with humans in smallholder households can negatively influence the gut microbes in the humans, and whether this can be exploited to improve human health. The microbial community (microbiota) living in the gut is important for childhood health, growth and development. They will analyze the gut microbiotas of healthy and unhealthy children and co-residing companion and domestic animals in selected households in western Kenya to determine whether they are related. If they are, they will reset the animal microbiota using established fecal transplant methods and determine whether there is a corresponding positive effect on the microbiotas of the rest of the household.

Simon Parrish of Development Initiatives in the United Kingdom will create a toolkit for the generation of a single interoperable dataset from diverse databases to help more users better assess the impact of resource spending in developing countries. Accurately assessing the impact of spending in areas such as health and education in specific locations, and the ability to directly compare different locations, is necessary to effectively eradicate poverty. However, the relevant datasets are currently incompatible or difficult to access by the appropriate communities. Parrish will partner with a Ugandan organization and community leaders in two districts to identify relevant datasets and the pertinent information they contain. This will be used to generate a merged dataset along with a web-based tool for local users, which will then be evaluated for interoperability and usability.

Derek Dunn-Rankin of the University of California, Irvine in the U.S. will refine the design of an energy storage device that collects and stores solar energy to enable indoor or evening cooking in developing countries. Traditional stoves use wood or animal dung as an energy source, which are labor-intensive methods, environmentally unfriendly, and potentially deleterious to health. The storage device consists of an insulated box containing potassium nitrite and sodium nitrite, which undergo a solid-to-liquid phase transition at a certain temperature. During re-solidification, the stored energy is slowly released to provide a stable heat source that can be used to cook foods such as bread and rice. They will work to optimize the design to improve performance and reduce the cost of the device, in order to move towards mass production.

Jean-Pierre Scheerlinck of the University of Melbourne in Australia will develop an effective vaccine against the parasite Theileria parva, which causes East Coast Fever in cattle, by conjugating parasite lysates to nanobeads, which act as an adjuvant to induce a strong immune response. Upon infection, the parasite enters cells of the immune system making classical vaccination strategies that induce antibody responses ineffective. Protecting these animals against infection instead requires a cytotoxic T cell immune response. Nanobeads are inexpensive, inert, 40nm diameter beads that, when covered with antigens, can induce a cytotoxic T cell response in humans. Scheerlinck will generate parasite lysates from infected lymphocytes grown in the laboratory as a source of antigens, conjugate it covalently to nanobeads, and inject them into cattle to test for a robust cytotoxic T cell response and protection against Theileria parva infection.

Ndadilnasiya Endie Waziri of the the African Field Epidemiology Network in Nigeria will determine whether combining child and animal vaccination programs can reduce the incidence of vaccine preventable diseases in Nigeria. Current programs often fail to reach highly mobile rural communities who raise livestock. This dependency on livestock may make them more agreeable to vaccination programs that offer protection for both their animals and themselves, which would also optimize the use of limited health care resources. They will use GPS-enabled smart phones to map these nomadic communities and their movements. A vaccination strategy will be designed, and key workers in the human and animal health sector will be trained to educate the communities and deliver vaccinations against a variety of diseases including polio for humans and anthrax for livestock. Coverage and cost-effectiveness of the strategy will be evaluated.

Kaveh Ashrafi of the University of California, San Francisco in the U.S. will use the free-living model nematode worm Caenorhabditis elegans as a molecular platform to identify new drugs capable of killing adult filarial parasitic worms, which cause serious infections. C. elegans is a non-parasitic model organism that can be easily grown and manipulated in the lab, unlike related parasitic Roundworms. Ashrafi will genetically engineer C. elegans to carry the parasitic version of the gene encoding phosphodiesterase-4, inhibition of which is known to kill the parasites. This mutant, as well as one carrying the human version of the same gene, will be used in screens to identify drug candidates that can selectively kill adult parasites.

Mateus Marrafon and colleagues from Instituto Kairós in Brazil will produce a new system for planting seeds using biodegradable strips of paper to increase productivity and decrease time and labor costs for smallholder farmers in Africa. The seeds are attached to the tape at regular intervals, which improves growth, and the tape physically protects them from pests and high temperatures. They will generate tape prototypes for both manual and animal sowing, and test their performance in the laboratory and in the field. They will also teach individuals how to manufacture and use the seed tape.

Ricardo Capúcio de Resende of Universidade Federal de Viçosa in Brazil will design and test a new machine to enable women smallholder farmers in sub-Saharan Africa to more efficiently and effectively plant seeds. He has designed a new seeder concept using only two rotating parts, which is light, easy to use and maintain, and can simultaneously plant two crops. He will query local manufacturers and users to further develop the design, and then produce prototypes that will be bench- and field-tested for manufacturability and performance. The results will be used to produce the final seeder design, and this design concept could be applied to other agricultural machines.

Thumbi Mwangi of Washington State University in the U.S. will work at the Kenya Medical Research Institute in Kenya to test whether treatment of parasitic helminth infections reduces the severity of the co-occurring parasitic diseases malaria and East Coast Fever (ECF) in humans and cattle respectively, which are more difficult to treat. In many developing countries, humans carry more than one parasitic disease, but if and how they interact to affect disease impact, for example by modifying the immune response, is not well understood. Mwangi will perform a controlled field trial in Western Kenya to test the effect of anthelmintic drugs on the incidence and severity of malaria and ECF, and will also analyze the presence of specific cytokines, which are immune signalling molecules, to help understand how pathogen interactions occur.

Simon Reid and colleagues at the University of Queensland in Australia will develop a combined metric using Multi-Criteria Decision Analysis to integrate divergent values on impacts of disease interventions from the agricultural, animal husbandry, and human health sectors. These sectors are involved in addressing similar issues such as disease control, but they each have different priorities. They will focus on the impact of interventions to reduce the incidence of two diseases in Bangladesh, and use existing data and consultation with stakeholders to identify priorities for intervention, including livelihood impact and livestock productivity, that are then ranked by each sector. This will be used to develop a measurement framework that preserves the priorities for each sector, but provides a means of comparing them and achieving consensus.

Vijay Modi and colleagues of Columbia University in the U.S. will create a universal database to centralize the mapping of social infrastructures, such as schools, clinics, and water points, to improve data accuracy and help to better coordinate aid efforts. Currently, data collection of physical points occurs across multiple platforms, and is inefficient and difficult to update. They will build and host a web service providing a simple database that is easy to access and edit to promote widespread adoption and thereby sharing and integration of important datasets.

Wayan Vota of Development Gateway in the U.S. will combine data generated by citizens and governments into an interactive interface that can be easily accessed and used by average citizens in order to improve their communities. They will focus on education in three Nairobi slums, and engage the local community and government. An application interface will be designed using relevant datasets, such as school performance statistics, community reports, and geographic data, and used to build an interface that can be accessed over the internet or distributed in print form or via messages sent to mobile phones. They will conduct local workshops to test their approach.

Mostafa Zamanian of Iowa State University in the U.S. will take schistosomes, which are parasitic worms that cause a range of infectious diseases, make them sterile, and genetically modify them to deliver anti-parasitic (anthelmintic) agents into humans to protect them against subsequent infections. They will use genome editing, guided by RNA in the worms, to disrupt individual genes required for laying eggs in order to make the worms sterile and thereby non-pathogenic. They will also introduce transgenes that encode for anthelmintic molecules to inhibit parasitic species, including filarial nematodes and juvenile schistosomes, and test their efficacy using animal models. This biological vector system is advantageous as it will specifically target the relevant site in the body and could provide long lasting protection against a variety of parasitic infections.

Willem van Rensburg of Kimbranox Ltd. in South Africa will test a condom applicator, the Rapidom, that is designed for easy, technique-free application of male condoms. Manual application of condoms takes time, which can lead to incorrect positioning as it interrupts the sexual act, and current applicators require good technique. Kimbranox has designed an applicator with an easy, fail-safe design that is applied with one motion, thereby minimizing interruption. An eight-week, randomized, cross-over study will compare ease of application and customer satisfaction between Rapidom and conventionally-packed condoms.

Linda Stewart and Irene Grant of Queen's University, Belfast in the United Kingdom have developed an immunoassay to help determine the incidence of Mycobacterium bovis, which causes tuberculosis in humans and cattle at currently unknown levels. Tuberculosis caused by M.bovis is resistant to a drug commonly used to treat tuberculosis caused by the more prevalent M. tuberculosis, but the diseases are indistinguishable. They have developed a quick and simple test to assay for the presence of M.bovis-specific antigens, which they identified by irradiating a virulent strain to render it inviable while maintaining critical cell surface protein structures. By collaborating with an African institute, they will refine their assay and evaluate its ability to detect M.bovis in human sputum or urine samples.

Floriano Silva of Fiocruz in Brazil will develop a drug screening assay using automated microscopy to test new drug candidates for toxicity towards adult helminth parasites, which cause a range of diseases. Current screening approaches cannot easily identify drugs that specifically target adult parasites, which is the most disease-relevant life cycle stage. He will develop and validate imaging and computational methods to automatically monitor physical characteristics of the parasites, and perform proof-of-principle drug screens using an FDA approved and an annotated compound library. This approach could be expanded to other parasites and used for screening larger drug libraries to identify new classes of drugs.

Andrew Jackson of the University of Liverpool in the United Kingdom will develop a diagnostic tool for Animal African Trypanosomiasis (Nagana), which is caused by unicellular parasites known as trypanosomes and threatens up to 50 million cattle in sub-Saharan countries. To avoid immune detection, the causative trypanosomes change their DNA sequences (genomes), particularly in genes encoding for cell surface glycoproteins, which also affects the symptoms the parasites cause. They will sequence these trypanosome genes from forty parasites spanning diverse countries and hosts to quantify their variation. By associating the variation with disease factors, such as virulence and severity, this profile of variation can be developed as a diagnostic marker to improve disease management and treatment.

Cecilia Bouzat of the Instituto de Investigaciones Bioquímicas de Bahía Blanca in Argentina will develop a drug screening platform to identify new antiparasitic drugs using the model nematode Caenorhabditis elegans. There are limited numbers of effective anthelmintic drugs and resistance to these drugs is emerging in the field. However, parasitic nematodes are unsuitable for large-scale drug screens mainly because they generally require host animals to survive. She will use the related free-living C. elegans to screen extracts of medicinal plants from South America and isolate bioactive compounds from any extracts demonstrated to be toxic for nematodes. The protein targets of these compounds will then be identified and the corresponding DNA from the clinically-relevant nematodes will be incorporated into C. elegans by genetic engineering to validate the compound's anthelmintic activity and enable the testing of derivatives that may be more effective.

Nils Pilotte and Steven Williams of Smith College in the U.S. along with Lisa Reimer at the Liverpool School of Tropical Medicine in the United Kingdom are developing a simple and inexpensive approach to monitor diseases caused by parasites that thrive in mosquitos based on detection in mosquito feces. Current approaches for disease surveillance are expensive, insensitive, or labor intensive, and are generally unsuitable for the areas in which they are needed most, including where disease incidence has decreased. This proposed so-called molecular xenomonitoring approach overcomes these hurdles, in part by avoiding the need for human sampling, and because it can be adapted to increase throughput. In Phase I, they demonstrated proof-of-principle that very low levels of parasitic DNA could indeed be extracted from mosquito fecal samples and then detected by PCR, and also adapted a simple test-strip detection method that could be used in low-resource field settings. They also developed a mosquito trap from a two-liter soda bottle containing a simple carbon dioxide-producing solution and sugar, and demonstrated its ability to attract mosquitos and isolate their feces in a field setting in Trinidad, albeit with modest yields. In Phase II, they will further optimize their detection method and the traps, and perform preliminary field tests in malarial and filarial endemic locations in the Philippines, Ghana, and Haiti.

Milosz Faber of Thomas Jefferson University in the U.S. will develop a combined contraceptive rabies vaccine that both protects dogs against rabies and reduces their population levels in order to control the incidence of human rabies. Human rabies causes 70,000 deaths annually and is mostly spread by dogs. Current therapeutic approaches to control dog rabies require multiple doses and have had limited success. Faber has designed a safe dog rabies variant that can induce a strong and long-lasting immune response when introduced in mice. He will combine this vaccine with gonadotropin-releasing hormone (GnRH), which causes infertility. Three different carrier proteins will be conjugated to GnRH and tested in combination with the vaccine for safety and for inducing immune responses upon a single dose in mice.

Fidelis Cho-Ngwa of the University of Buea in Cameroon will develop a small animal model to test the safety of candidate drugs for treating the parasitic disease onchocerciasis in people who are coinfected with the Loa loa parasite. Ivermectin, which is used in mass drug administration efforts to treat onchocerciasis, causes severe adverse effects, including death, in people who carry high levels of Loa loa. They will purify early-stage Loa loa from infected human blood and test the ability of a variety of small animal models, including mice, to sustain the parasites over 30 days, which would be enough time to perform an in vivo drug screen. Once a suitable small animal model has been identified and validated, it will be possible to screen large numbers of compounds to identify effective and safer treatments.

Mumbi Kimathi and a team from Farm Concern International in Kenya will promote farming-related trade between and around villages in rural Africa with their "e-Women Dial-up Initiative." They will develop a mobile phone platform for communications, and for ordering and paying for farming-related materials, products, and services. They will test their approach in 10 villages in Kenya, consisting of 5,000 farmers, and establish a rural distribution network by recruiting vehicle owners to reduce the need for individuals to be mobile. They will also set up a supply network of accredited materials, services, and business development service providers. Their approach will be evaluated in terms of volumes traded, income, cost- and time-savings, and the level of individual participation.

Geraldine Taylor and colleagues at The Pirbright Institute in the United Kingdom will develop a thermo-tolerant vaccine based on human adenovirus 5 (Ad5) against peste des petits ruminants (PPR), a highly contagious disease found in goats and sheep, that enables the distinction between infected and vaccinated animals (known as DIVA vaccines). Current live attenuated vaccines require cold storage, which is unavailable in many developing countries, and vaccinated animals cannot be differentiated from infected animals, complicating disease control efforts. Ad5–vectored vaccines are safe and effective in humans, inducing both antibody and cytotoxic T cell responses from the immune system. They will extend their preliminary work showing that Ad5-conjugated with surface glycoproteins from the PPR virus provides complete protection in goats by vaccinating local breeds of goats in Africa. They will also determine the minimum vaccine dose and the effect of adding a specific cytokine to enhance immunity.

Edward Mitre and colleagues at the Henry M. Jackson Foundation for the Advancement of Military Medicine in the U.S. will develop a short course therapy for clearing adult filarial worms, which cause substantial morbidity and mortality, to enhance eradication efforts. Current antifilarial medications target only larval forms of the worms, requiring repeated administration until the natural death of the adults. Filarial infections are known to induce immune cells to release histamine, which can regulate the immune response. Using mouse models of filarial infections, they will evaluate whether a short course of standard antifilarial treatment combined with an antihistamine can clear adult worms and thereby more quickly cure the disease.

Ali Mokdad and a team at the University of Washington in the U.S. will integrate data on animal health and its determinants to better understand and monitor human health and opportunity in the developing world. Animal health, which itself is influenced by environmental factors, has a direct impact on human health. Although data on all these areas exist, there has been no attempt to amalgamate them to measure the overall impact on human health. They will assess data from Zambia on environmental factors such as temperature and rainfall, and the condition and sales of animals and crops, to identify indicators of animal health. These will be integrated with data on human disease burden and mortality to generate an enhanced human health metric that incorporates the effects of animal health. They will also make recommendations for improved data collection.

Vandana Patravale of the Institute of Chemical Technology in India will develop a sub-unit nanovaccine using green technology against brucellosis, a zoonotic disease which is endemic in sub-Saharan West Africa. The vaccine will be developed for non-invasive intranasal administration and the investigators will study vaccine delivery and its ability to induce a strong protective immune response against Brucella in mice, with a view to future clinical testing in humans.

Aravind Vijayaraghavan and a team from the University of Manchester in the United Kingdom propose to develop new elastic composite materials for condoms containing nanomaterials like graphene. This composite material will be tailored to enhance the natural sensation during intercourse while using a condom, which should encourage condom use.

Louise Kelly-Hope of the Liverpool School of Tropical Medicine in the United Kingdom and Thomas Unnasch of the University of South Florida in the U.S., along with their research teams, will develop high resolution tools to map the locations and chart the habitats of vectors of several parasitic worm infections to promote safer and more effective control strategies. Some of the drugs that can successfully treat parasite infections become harmful in the presence of other parasites, but predicting where these co-infections are most likely to occur is difficult. Using the fly vectors for the parasitic nematode Loa loa, they will develop a remote sensing model for predicting its presence by identifying environmental factors that the flies favor using satellite technology and geographic information systems, and validate the model by performing ground-based studies in several African countries.

Ron Frezieres of the California Family Health Council in the U.S. along with Max Abadi of Unique International in Colombia and I.MAXX Inc. in the U.S. are developing a stronger and thinner male condom made of polyethylene to promote condom use. Polyethylene is a non-toxic and hypoallergenic material that wraps and clings rather than squeezes, thereby enhancing sensation and enabling easier application. In Phase I, in collaboration with the polyethylene condom inventor/manufacturer in Colombia, the team optimized the material, tested compatibility with different lubricants, designed discreet packaging, and manufactured two prototypes with either a pull-tab applicator or a flanged base.These were compared with traditional latex condoms for performance and usability by 34 couples that overall preferred the pull-tab condom. In Phase II, they will further optimize the condom by improving the lubrication and application, and develop more economical packaging for developing countries. They will also perform a larger clinical study of the modified product using 300 couples.

David Sands of Montana State University in the U.S. will work with Kenyan women farmers to evaluate the performance of a biological control method for eliminating the parasitic weed Striga (witchweed), which can cause up to 80% loss of maize, millet, and sorghum yield in smallholder African farms. Striga is a problem in 43 African countries, and manual weeding is highly time- and labor-intensive. They have previously developed a virulent fungal strain to inhibit weed growth, and shown that it can be easily transported on toothpicks for safe and effective distribution. Preliminary field-tests in one village showed that this fungus could effectively control Striga, and in some instances double crop yield. Sands will expand this testing phase to women maize farmers in 50 villages and evaluate crop yield, weed reduction, and farmer satisfaction over 12 months.

Paula Ribeiro of McGill University in Canada will develop a simple diagnostic test for schistosomiasis, which is caused by parasitic worms, based on microRNAs. Current diagnostics suffer from lack of sensitivity or an inability to distinguish current from past infections. They will evaluate parasite microRNAs contained within small extracellular vesicles (exosomes) as infection biomarkers by first isolating and sequencing them from infected mice. Using this information, they will develop a simple, inexpensive test to amplify the microRNAs from human blood using sera from infected patients in West Africa and Egypt. Their approach could ultimately be used to distinguish between different stages of infection and be broadened to other helminth infections.

Robert Greenberg of the University of Pennsylvania in the U.S., along with Bernadette Ardelli of Brandon University in Canada, will test whether anthelmintics, which are drugs used to treat diseases caused by parasitic worms, can be improved by combining them with inhibitors of ATP-binding cassette (ABC) multidrug transporters. Of the few anthelmintics available, many are of limited use or become ineffective due to the emergence of drug resistance. ABC multidrug transporters regulate the transport of molecules, including drugs, into and out of the cell and have been linked with anthelmintic resistance. ABC transporter inhibitors, which have been approved for use in humans, enhance the activity of anti-parasitic drugs in vitro and may bypass the development of drug resistance. The investigators will use in vivo mouse models of helminth infections to test whether co-administering ABC transporter inhibitors enhances anthelmintic activity, with a view to carrying out clinical trials in humans.

Yanping Chen of the University of California, Riverside in the U.S. will develop an inexpensive and robust sensor to directly measure the real-time density of insect vectors that transmit parasitic diseases to help plan intervention and treatment programs. Preliminary results indicate that insects can be classified based on the frequency of their wingbeats, which also varies depending on the time of day. Chen will develop an accurate detection system by investigating combining wingbeat frequency with circadian rhythms and other behaviors. A software system will also be produced that can translate the data into real-time counts of insect numbers and produce density maps of their distribution. The sensors will be field tested in Cameroon and Cambodia/Thailand.

Tobias Oker and a team from the National Agricultural Research Organization in Uganda will develop a simple plucking tool to more efficiently remove the pods from groundnuts, which is currently done by hand and is labor-intensive and time-consuming for women. They will query farming communities on current harvesting methods to refine their design, and evaluate performance, labor cost, and perceptions in the field using prototypes compared to traditional methods. They will also train users and local manufacturers to fabricate the tools and encourage their use.

William Kisaalita of the University of Georgia in the U.S. will redesign a milk churner to make it suitable for women in order to reduce the time and labor needed to make ghee. In many sub-Saharan countries, the morning milk harvested from cattle can be sold in markets, but the milk harvested in the evening needs to be processed into longer-lasting products such as ghee to prevent it from perishing. The current method for churning milk to make ghee is time and labor intensive. He will recruit women in Uganda to test and refine the milk churner design, which is cheap and can be locally manufactured and repaired, to make it more ergonomic and culturally appropriate for women users and thereby promote its widespread adoption.