Diagnostics For All is developing a nucleic acid amplification tests (NAATs) platform that can perform sample preparation, amplification, and detection in a disposable, self-contained, cartridge without any additional instrumentation. We propose adapting this platform to deliver a qualitative HIV early infant diagnosis (EID) test that can truly be used at the point-of-care, reducing the turnaround time from over a month to under an hour. Since it can be performed before the mother and child leave the clinic, the proposed technology can result in immediate initiation of antiretroviral therapy (ART) and eliminate loss to follow-up. Through this 2-year seed grant, we will produce a completely equipment-free, fully-integrated device that can receive and process a whole blood sample, perform isothermal amplification, and provide visual result readout with a clinically appropriate sensitivity for HIV EID.

Monash is seeking to develop an affordable heat-stable, self-contained, simple to administer inhaled delivery system for oxytocin. Such a product removes the challenges associated with access and use of the current oxytocin product and has the potential to ensure that a high-quality oxytocin product is accessible to women with greatest need. The project is innovative as it would, for the first time, provide an effective oxytocin product that does not rely on cold chain supply and storage to maintain quality or the presence of healthcare workers trained to safely administer injections. Current uterotonic products are presented either as injections susceptible to degradation in ambient conditions or, in the case of misoprostol tablets, do not provide the level of efficacy possible with oxytocin. The proposed inhaled oxytocin product presents the potential of delivering the gold standard therapy in a robust form that simplifies administration at a cost equivalent to current products. As such, this innovative product has the potential to significantly expand access to oxytocin across low- and middle-income countries by creating efficiencies within busy facilities, administration to lower tier healthcare workers and birth attendants.

Our idea is to develop BreathAlert, a $25 battery-powered monitor that detects and automatically corrects apnea. BreathAlert is a stretchy band placed around a baby's chest to detect if breathing has stopped; if apnea occurs, coin-sized vibrating motors in the strap are activated and the vibration automatically stimulates the baby to resume breathing.

Our objective is to develop a low-cost Smartphone attachment and application to diagnose and treat bacterial neonatal pneumonia in Pakistan. Currently, serious bacterial infection - pneumonia, sepsis and meningitis - results in preventable deaths of 700,000 neonates every year, 99% dying in resource limited settings such as Pakistan. Signs of serious infection in young babies are difficult to recognize. Diagnostic tests and chest X-rays are rarely available outside tertiary care hospitals. The proposed device has the potential to identify and treat bacterial pneumonia quickly and decrease mortality. Our technology is an attachment that snaps on to a Smartphone and acquires, then displays a thermal image of a neonate's lungs. An application (app) will calculate the chance a neonate has bacterial pneumonia, based on the presence of "hot spots" or temperature differences which represent the increased blood flow/inflammation that occurs with bacterial pneumonia. The app will produce a read-out recommending treatment with antibiotics if the thermal image is consistent with bacterial pneumonia. The attachment and app will work with most Smartphones that are increasingly available globally and will be powered by the Smartphone's battery. It will take minutes to acquire and process the images. No specialized equipment or technical expertise by the user will be needed. The device is non-invasive, low risk, easy to use and incurs a one-time (not per test) expense which is minimal compared to X-rays.

This project aims to reduce human Zinc deficiency through biofortification by foliar zinc application. It aims to prove that this traditional and efficient strategy of agronomic biofortification, can be a rapid solution for improving zinc concentration in grain to address the ongoing human zinc deficiency.

This project aims to utilize ultrasound to move and settle human waste collected in a specifically designed latrine. This redesigned latrine uses less water and therefore provides a more sustainable solution to collect human waste.

Krishna Swamy and team are building a comprehensive tuberculosis (TB) mobile application to improve TB detection, treatment, and adherence. The team will build upon its open-source, mobile health (mHealth) platform CommCare and predeployed CommCare mobile applications for TB in India to develop a comprehensive, SMS-enabled mobile application for TB detection, treatment, and adherence. Dimagi will work with the International Union against Tuberculosis and Lung Diseases, South-East Asia (USEA) in the Khunti District, Jharkhand in India to design, test, evaluate, and scale the proposed mDOTS application, which will be designed around the World Health Organization's recommended directly observed treatment, short-course (DOTS) protocol for TB.

Hilmi Quraishi and team are building a system to enable adherence to TB treatment. The proposed solution is sliced from ZMQ's Fully-Technology Linked Model (F-TLM) for TB treatment and management called the Open and Universal Technology based TB (OUT-TB) Management and Treatment Framework. The framework was developed by ZMQ under its Freedom TB initiative. The proposed solution empowers the patients with active compliance reporting, gamification, and effective self-management of TB treatment using mobile-based tools integrated with miniature DOTS Center Systems and DOTS Provider Toolkit. The solution is based on a bottom-up technology model, which empowers patients to take control of treatment with reminder systems, compliance reporting, dosage tracking, test scheduling, and provider connection for need-based supervision. The solution will help in creating networks of treated patients as new knowledge providers, who will serve as peer educators to provide assistive support to patients in their communities. The approach will make the treatment a community-lead model.

Nakul Pasricha and team are working to develop special cards, called myTBdoc cards, with unique alphanumeric identifiers printed on them to be given to medical representatives (MRs). TB medicines manufactured by Lupin will also have unique identifiers printed on them. MRs will give myTBdoc cards to private doctors that see TB patients, educating them on correct TB prescription methods. Doctors will then give these cards to new TB patients, instructing them to SMS the unique code on the card (enrolling them in our program) and to SMS the unique codes printed on their TB drugs as they take them. PharmaSecure will then deliver phone interventions, such as reminders to take medicines, follow up calls, and TB health tips via SMS and voice calls. Lupin holds a major market share in the Indian TB drug market, and hence the solution will reach out to a larger affected population easily.

Shashank Garg and team will develop a mobile solution that addresses problems in adherence to TB treatment through the key technologies of mobile phone-based electronic forms, workflow management, identity management, and electronic health records. The objective is to achieve automated tracking and monitoring of individual TB patients for adherence to the TB treatment protocol. ASHA workers will use the mobile application for collection of dosage intake data in the field. A workflow system will provide a closed loop through SMS alerts in case a patient defaults. Along with identity management and a TB treatment record, the system will ensure patients are able to seek treatment even on migration, thus maintaining continuity of treatment. This mobile solution is novel because it will use a form-based mobile application capable of running in disconnected or offline mode, with data connectivity being required only for the duration of data upload to the server.

Shweta Roy and team are developing a small, electronic, tablet strip holder that enables real-time tracking of patient treatment adherence and inventory. The tablet strip holder will be small in size, embedded with a weighing scale to monitor change in weight of tablet strips and thereby monitor treatment adherence. Any change in the weight of the strip will be recorded on a server via SMS using a telemetric SIM within the holder. If the change in weight is not detected within a given time period, the device will trigger a non-compliance alert through SMS to the patient and caregiver DOTS observer. The holder will also have an inbuilt alarm to alert the patient in case of missed dosages. The final product will be light weight and sleek in design and the patient will be able carry the tablet strip holder like a mobile phone. Minimal patient input is expected, making this device user friendly, and alerts can be customized as per regional language. The cost of the final device is expected to be $10 - 12 USD per piece.

Johnjoe McFadden of the University of Surrey in the United Kingdom will modify the BCG vaccine currently used against bovine and human tuberculosis, and develop a complementary diagnostic test that can distinguish between tuberculosis infection and vaccination. BCG is the only effective tuberculosis vaccine, however it interferes with diagnostic tests, preventing the distinction between infection and vaccination, which is important for control efforts in developing countries. They will identify genes in the BCG vaccine that can be removed without affecting its activity in cattle and determine which of those genes are potentially strongly immunogenic and therefore easy to detect. Selected genes will be used to develop a complementary diagnostic skin test that would not cross-react with the modified vaccine. Next steps would be developing and evaluating the vaccine and skin test in cattle and subsequently in humans.