Low Cost Multiplexed DNA Diagnostic Sensors for Infectious Diseases

Nearly 260m people are infected with schistosomiasis, with >90% of
infections found in sub-Saharan Africa. Worldwide ~3.2b people are
at risk of malaria, many also in Sub-Saharan Africa. Both diseases
are endemic in the same rural locations and there is difficulty in
differentiating symptoms and informing correct diagnosis and
treatment. Incorrect diagnosis is known to lead to unnecessary
dispensation of drugs leading to increased probability of drug
resistance.
Professor Cooper has developed a paper-based multiplexed DNA
malaria diagnostic device that exploits novel hot wax printing to
integrate sample preparation and microfluidic flows. The device can
differentiate between three species of malaria causing plasmodium
and has now been tested using whole patient blood samples in the
laboratory.
The aim of this project is to develop a novel blood-based multiplex
test that can, from a single drop of blood, distinguish between malaria
and schistosomiasis and identify drug resistant microbes. This new
highly sensitive diagnostic device will enable field workers to monitor
treatment outcomes, with the specific aims of
(i) providing correct diagnosis;
(ii) preventing re-emergence of infections following local
treatment;
(iii) reducing resistance by ensuring effective and appropriate
treatment.
Field-testing will be carried out operator double-blind field-testing in
East Africa. The samples will also be characterised using
(i) the paper based test;
(ii) through microscopy in-the-field
(iii) will also be stored (as dried blood spots) for retrospective
laboratory based molecular testing in Glasgow.
Ethics permissions will be obtained.
Additional Information: The schistosoma live in the hepatic portal vein
and shed cells into the blood. Malaria parasites (Plasmodium sp.) live
with red blood cells as part of their lifecycle. We will therefore also
develop a blood based assay, where DNA will be detected from a
fingerpick of blood. The assay will again be configured as a low cost,
paper based assay and will be developed as a duplex, enabling both
malaria and bliharzia (schistosomiasis) to be detected at the same
time. This will guide appropriate treatment for febrile patients
presenting themselves at field clinics.
Benefits:
This project is also aligned with the Health priority of the Global
Challenge Fund, which aims 'to tackle diseases, strengthen health
systems and reach the worlds' most vulnerable'. Indeed, according to
the latest WHO estimates, at least 258 million people have required
treatment for schistosomiasis in 2014, with 61.6 million people
reported to be treated. 90% of those requiring treatment live in Africa.
In children, schistosomiasis causes anaemia, stunted growth and
reduced ability to learn. Treatment usually reverses these effects, but
its efficacy needs to be monitored to establish cure and adapt
therapy. If untreated, chronic disease affects people's ability to work
and can result in death. The disease burden has been estimated to
account for 4.5 million DALYs (disability affected life years).
Mass drug administration of praziquantel has been delivered through
National Control Programmes, e.g. in Uganda for over a decade.
Hotspots of infection have been detected, where prevalence,
intensity and associated morbidity are now higher than they were at
baseline.