I’ve written a number of postings about handheld diagnostic devices as there is great international interest in developing these devices and I’ve also written about protection against malaria. A Sept. 24, 2012 news item on ScienceDaily combines these two topics,
Around 800,000 people die from malaria each year after being bitten by mosquitoes infected with malaria parasites. Signs that the parasite is developing resistance to the most powerful anti-malarial drugs in south-east Asia and sub-Saharan Africa mean scientists are working to prevent the drugs becoming ineffective.
The €5.2million (£4million) Nanomal project — launched September 26– is planning to provide an affordable hand-held diagnostic device to swiftly detect malaria infection and parasites’ drug resistance. It will allow healthcare workers in remote rural areas to deliver effective drug treatments to counter resistance more quickly, potentially saving lives.
Currently for malaria diagnosis, blood samples are sent to a central referral laboratory for drug resistance analysis, requiring time as well as specialised and expensive tests by skilled scientists. Additionally, confirmation of malaria is often not available where patients present with fever. Very often, drug treatments are prescribed before the diagnosis and drug resistance are confirmed, and may not be effective. Being able to treat effectively and immediately will prevent severe illness and save lives.
Contrast the standard process with the proposed diagnostic device (from the news release),
The device – the size and shape of a mobile phone – will use a range of latest proven nanotechnologies to rapidly analyse the parasite DNA from a blood sample. It will then provide a malaria diagnosis and comprehensive screening for drug susceptibility in less than 20 minutes, while the patient waits. With immediately available information about the species of parasite and its potential for drug resistance, a course of treatment personally tailored to counter resistance can be given.
Here’s how they expect it to work (from the news release),
The handheld device will take a finger prick of blood, extract the malarial DNA and then detect and sequence the specific mutations linked to drug resistance, using a nanowire biosensor. The chip electrically detects the DNA sequences and converts them directly into binary code, the universal language of computers. The binary code can then be readily analysed and even shared, via wireless or mobile networks, with scientists for real-time monitoring of disease patterns.
The device should provide the same quality of result as a referral laboratory, at a fraction of the time and cost. Each device could cost about the price of a smart phone initially, but may be issued for free in developing countries. A single-test cartridge will be around !13 (£10) initially, but the aim is to reduce this cost to ensure affordability in resource-limited settings.
In addition to improving immediate patient outcomes, the project will allow the researchers to build a better picture of levels of drug resistance in stricken areas. It will also give them information on population impacts of anti-malarial interventions.
There are more details about the device (and an image of it) in the ScienceDaily news item. The Nanomal team is expecting to begin field trials in the next three years preparatory to bringing the device to market.
I found more information about Nanomal on the European Commission’s Cordis website,
Development of a handheld antimalarial drug resistance diagnostic device using nanowire technology
Organization name:ST GEORGE”S HOSPITAL MEDICAL SCHOOL Administrative contact Address Name:Jane BOLAND (Ms.) Cranmer TerraceLONDON
Region:SOUTH EAST (UK) GREATER LONDON
Tel:+44-2082666818 Fax: E-mail:Contact URL:http://www.sghms.ac.uk Organization Type:Education
Objective: Malaria is a global health priority that has been targeted for elimination in recent years. Attaining the goals that define elimination of malaria in different countries depends critically on provision of effective antimalarials and further that these antimalarials are used appropriately in individual patients. Drug resistance is a major threat to malaria control and has important global public health implications. Over the past decades the genetic bases for resistance to most of the antimalarial classes currently in use has become defined. For some drugs and combinations, these mutations are the most important predictors of treatment failure. This proposal will innovate new technologies to confirm malaria diagnosis and detect drug resistance in malaria parasites by analysis of mutations in nucleic acids, using nanowire technology, and will result in the development of a simple, rapid and affordable point-of-care handheld diagnostic device. The device will be useful at many levels in malarial control by:
1. Optimising individual treatments for patients;
2. Assessing the epidemiology of drug resistance in malaria endemic areas;
3. Assessing population impacts of antimalarial interventions;
The development programme capitalises on highly original and proprietary advances made by QuantuMDx in the field of point-of-care diagnostics. This is complemented by academic expertise that has made major contributions to the understanding of antimalarial drug resistance mechanisms in laboratory models, as well as parasites obtained directly from patients. The impact of this proposal can be extended rapidly to other established and emerging infectious diseases.
I was particularly interested to note the UK is the lead on this project in light of an earlier handheld diagnostic device developed in the UK and tested on the country’s Olympic athletes prior to the 2012 Olympics (my Feb. 15, 2011 posting on Argento).
The Nanomal project is multinational as per the news item on ScienceDaily,
The Nanomal consortium is being led by St George’s, University of London, which is working with UK handheld diagnostics and DNA sequencing specialist QuantuMDx Group and teams at the University of Tuebingen in Germany and the Karolinska Institute in Sweden. It was set up in response to increasing signs that the malaria parasite is mutating to resist the most powerful class of anti-malaria drugs, artemisinins. The European Commission has awarded €4million (£3.1million) to the project.
Nanomal lead Professor Sanjeev Krishna, from St George’s, said: “Recent research suggests there’s a real danger that artemisinins could eventually become obsolete, in the same way as other anti-malarials. New drug treatments take many years to develop, so the quickest and cheapest alternative is to optimise the use of current drugs. The huge advances in technology are now giving us a tremendous opportunity to do that and to avoid people falling seriously ill or dying unnecessarily.”
QuantuMDx’s CEO Elaine Warburton said: “Placing a full malaria screen with drug resistance status in the palm of a health professional’s hand will allow instant prescribing of the most effective anti-malaria medication for that patient. Nanomal’s rapid, low-cost test will further support the global health challenge to eradicate malaria.”