Mobile Phone enabled Diagnostics for Infectious Disease Diagnosis: Low Cost Tools for Digital Health in East Africa

Infectious diseases remain a primary cause of morbidity and mortality in many Low and Middle Income Countries, which suffer from limited health infrastructure, poverty and political insecurity, increasing the transmission of a broad range of human and animal infectious diseases.

Our vision for our network is that our new mobile phone enabled low cost DNA sensor technology, based upon using paper microfluidics, will bring both health and economic benefit to East Africa, including both Uganda and Tanzania, as well as other countries in Sub-Saharan Africa in future. The new diagnostic technology will I particular strengthen laboratory diagnostic capacity, which is a main focus for cooperation according to the WHO Cooperation Strategy for Uganda for example.

We have already demonstrated the connectivity through apps and the cloud, accessing secure data storage and artificial intelligence/machine learning decision support tools to help healthcare providers make the correct diagnosis for multiple infectious diseases from the same sample. We now predict, that by using this technology, end users will be enabled to perform infectious disease diagnosis in humans and livestock using different samples, including water, milk and blood. In doing so we will be able to determine, quantitively, transmission pathways between animals and humans (whether this be through shared water sources or unpasteurised milk) - thereby helping address the following Sustainable Development Goals, SDGs, 2, 3, 6 and 15. This will provide healthcare technologists and epidemiologists better understanding of the impact of these diseases in veterinary care, as well as in human infection in the specific environment in Uganda and Tanzania - with resulting economic and health benefits, reducing poverty - address SDG 1.

We aim to use this activity as a case study to both exemplify the broader impact of mobile diagnostics on digital health platforms, to inform Governments, NGOs, Charities, Universities, Industry as well patients and the public more generally, as well as to build a wide network of stakeholders in mobile diagnostics platforms to identify and overcome barriers to deployment of digital health solutions in Uganda and Tanzania, and beyond.

Our network will address one of the major health challenges highlighted by both Tanzania and Uganda, through the development of low-cost quantitative diagnostics and screening tools, enabling timely investigations of the factors contributing to the persistence of infectious diseases. In addition to delivering impact on increased health and economic benefits, the outcomes from the network will significantly decrease the impact of infectious diseases on women, who currently have a disproportionate burden. They not only provide the main support for young families, including responsibility around caring and cooking for children, and providing education, but also provide 80% of the labour for rural agricultural activities. Illness in women leads to a direct loss in the family's income, and prevention of disease can subsequently provide additional economic benefit (SDG 3, 5 & 10). Similarly, if children are ill, they are often taken out from school, again resulting in a loss of income as well as missed education opportunities (SDG 4). In the case of human disease, as of 2017, malaria was the 3rd leading cause of death in both Uganda and Tanzania. By enabling delivery and connectivity of diagnosis in rural communities, using digital health, our network will allow local communities and governments to both increase the efficiency of treatment (through increased decision support) as well as build and implement surveillance strategies to prevent epidemics and re-emergence of diseases.

We expect the following impacts on the Sustainable Development Goals, SDG, to arise from the funding of this network (achieved through engagement with stakeholders that include charities, academics, Government and Non-Governmental Organisations, industry as well as patient groups and the public more widely), namely: (i) partnerships across Uganda and Tanzania, addressing SDG 17, between healthcare providers and veterinary scientists and ICT experts to not only enhance the health and well-being of patients and animals but to develop a better understanding of clinical diagnosis and disease transmission using digital health platforms; (ii) economic and societal benefits in East Africa more widely, through the development of translational pathways into industry, SDG 1 and 8. Longer term economic benefits may also arise as a consequence of increased commercial activity in ICT as well as in enhanced efficiency in agricultural practice and better diagnosis of human and animal disease, SDG 1, 2, 3, 5, 8, 10, 15; and (iii) capacity strengthening through the creation of cohorts of early career researchers /technologists with a set of multidisciplinary skills in bioengineering, diagnostics, manufacturing and ICT, SDG 4 and 9.

We have also highlighted 5 specific Impact Deliverables, that augment the general outcomes of the network, which also impact upon the SDGs, namely:

Deliverable 1. Following the delivery of co-creation and co-production sessions during the first workshop in Uganda, we will prepare a communication plan during the first 6 months of the project, including defining a web presence, publication, dissemination through social media and broader public engagement, SDG 17.

Deliverable 2. Use of our mobile phone enable platform as a case study to exemplify the broader impact of mobile diagnostics on digital health platforms, providing a report to inform Governments, NGOs, charities, Universities, Industry as well patients and the public more generally, SDG 1, 3, 8, 9, 17;

Deliverable 3. The Ugandan Industrial Research Institute together with the industrial partners will take the lead on the market assessment of the digital health platforms which will feed into our final report, see Deliverable 2 (based upon equitable commercialisation), SDG 8, 9.

Deliverable 4. Development of a generic quality management system/governance structure around the network to guarantee research integrity, standardisation of documentation, transparency and comparability of information between countries and between stakeholders from different disciplines or sectors, SDG 17.

Deliverable 5. Working with Bioengineers, Computer Scientists and Veterinary Scientists in Uganda and Tanzania, we will deliver educational and outreach projects within both Universities and local technical colleges, SDG 4, 5 and 8.