Low Cost Blood Test

A centrifuge is a device that fractionates blood. Blood fractionation separates blood into plasma, white blood cells, and red blood cells. Fractionated blood is easier for researchers to analyze. Unfortunately, centrifuges can be pricey and bulky. They also require electricity. As a result developing countries and field-hospitals can’t utilize them. Recently, however, scientists at Stanford have developed an inexpensive alternative.

Inspired by a Children’s Toy

Manu Prakash is a bioengineering professor at Stanford University. He and his team traveled to Uganda and spoke with healthcare workers. The team discovered that the workers had a centrifuge, but they were using it as a doorstop. With no electricity, the device was useless to them. Prakash returned home and decided to explore children toys for inspiration. He eventually found a toy called a whirligig or buzzer. It spins much faster than a yo-yo, so it made sense to explore it as an option.

The Paperfuge

The paperfuge works just like a whirligig. A string runs through the middle of the paper disc. Handles are attached to either end of the string. When a person pulls on the handles, the disc in the middle rotates quickly. Prakash and his team found that their device makes 125,000 revolutions per minute. That number is one of the fastest rotational speeds ever recorded for a human powered device.

While the device’s disc is made out of paper, it is coated with polymer to make it less likely to break. Healthcare workers can attach blood samples to the disc and then pull on the strings to separate the blood. Prakash and his team traveled to Madagascar to test the device. It worked just as they planned.

Inexpensive Tool

One of the most important aspects of the paperfuge is its cost. It can be produced for as low as 20 cents per device. The disc itself can even be created with a 3D printer, so it’s easy to produce a large number of the devices. So far the device has only been used to detect malaria. Since it’s shown success Prakash and his team plan to test the device with other diseases. To learn more about Manu Prakash visit his Stanford profile.

The World Needs an Essential Diagnostics List: Here’s Why

Heart CareIn the medical field, vaccines and drugs receive a huge amount of attention while diagnostics hide in the shadows. This is unfair to say the least, since diagnostics are at the basis of medicine. Without diagnostics, doctors would not know how to treat people. In a number of low-income areas throughout the world, serious health issues go undiagnosed. Even when diagnostic testing is done in these areas, it is not always of good quality. But what are we to do about the extremely high number of people suffering and dying due to lack of a diagnosis?

A recent article in NEJM suggests that to improve access to critical diagnostics, we should make a list. The World Health Organization started a Model List of Essential Medicines (EML) in 1977, and the list has since improved access to medicines. So why don’t we do the same with diagnostics? We could create a Model List of Essential Diagnostics, or an EDL. Here are a few ways that such a list would make an impact:

1) More affordable diagnostics

When it comes to vaccines and drugs, volume discounts, bulk and advanced purchasing, and pooling mechanisms are widely used. While TB can be detected using the Xpert MTB/RIF test, affordability is limited. A list of essential diagnostics could encourage group purchasing by international organizations. With larger and more predictable volumes, manufacturers would be able to lower the costs of diagnostics tests. Countries can use the list to waive import duties and impose price controls in order to ensure affordability.

2) Better detection of emerging infectious threats

The epidemics of both Ebola and Zika have emphasized the need for surveillance. While there are a number of countries with reference laboratories, laboratory capacity at lower health system tiers tends to be weak. An EDL could increase laboratory capacity at every tier, thus helping countries to prepare for epidemics and implement international health regulations.

3) Better patient care and clinical outcomes

Patients will consistently receive access to quality essential diagnostics that will be always available as well as affordable. Governments, funders and manufacturers can make sure that a diagnostic is available and accessible once it is added to an EDL.

4) Better quality and regulation of diagnostics

While developed countries have regulatory agencies that determine the accuracy of diagnostic devices, resource-poor settings either do not have these agencies, or they are weak. An EDL could allow these agencies to focus on priority tests. It could also help to identify sub-standard diagnostics, as is already being done for malaria rapid tests.

5) Improved laboratory infrastructure and supply chain

In many low income settings, laboratory devices are unusable due to poor infrastructure and inconsistent supply chains. With an EDL in place, ministries of health could strengthen key infrastructures and create targeted supply chains for the important tests.

Our world does not have an equal distribution of healthcare. While we often focus on giving struggling people access to vaccines and drugs, there is not enough focus on diagnostics. Without diagnostics, we cannot know which drugs and treatments to give patients. We need to start treating diagnostics with the same importance at vaccines and drugs, and the first step to achieving this globally could be to create a Model List of Essential Diagnostics.

The ‘DxBox’ And Other Upcoming Low-Cost Diagnostics

HealthWhile some of us have access to advanced technology that can diagnose serious illnesses, not everyone in the world is so lucky. A lot of advancements have been made in the past year with regard to low-cost diagnostics, including a revolutionary new device called the DxBox.

The DxBox is a wallet-sized card made of Mylar that is able to differentiate between six pathogens that are likely causes of fever in the developing world. This Mylar card contained dehydrated reagents are able to withstand warm temperatures for months. There is no electricity or refrigeration necessary. DxBox was developed by a team led by Paul Yager. Yager is a professor of bioengineering at the University of Washington. Funding for this endeavor was provided by the Gates Foundation’s Grand Challenges in Global Health Initiative.

This is just one of the many new products used to create portable, easy-to-use, and inexpensive diagnostics that can be used in low-resource settings all around the world. This device and many others are increasing access to healthcare in the developing world because they are simple enough to be used by almost anyone and robust enough to withstand use in the field.

There are a number of promising new tests for global health problems in the works. Scientists, biotech companies, public health professionals, and nonprofits are all working together to develop these solutions. Some represent scientific breakthroughs, while others utilize established technologies, like the home pregnancy test.

The DxBox processes results using microfluidics, which is the manipulation of liquids at very small scales. In order use the DxBox, clinicians only need a drop of the patient’s blood. The blood then travels via the device’s tiny channels to an area that contains dried antibodies. When infected blood binds to the appropriate antibody, the pattern of colored spots indicates the cause of the fever to clinicians. This can be tested within minutes.

Yager and his University of Washington colleague Patrick Stayton have also developed a reagent system that can be used in other types of diagnostic tests, such as paper-based lateral flow tests. Lateral flow tests, like the home pregnancy test, can often be limited in sensitivity but are very robust.

Stayton and Yager created systems in order to purify and enrich targets. The developed these systems out of samples such as blood and then captured them so that they could be directly placed on existing lateral flow tests. This led to increased sensitivity of lateral flow tests for malaria.

According to Yager, the team’s goal is to create diagnostics that are disposable, cheap, more sensitive than existing tests, and able to be stored at room temperature for as long as a year. The researchers are currently zeroing in on influenza and other respiratory viruses, in addition to urinary and blood-borne pathogens such as Dengue virus.

Yager says that the papers for the DxBox can be manufactured in bulk, making them inexpensive. Yager felt that there is a lot of incredible technology in the United States that we take for granted. He and Stayton are motivated to transport these technologies to people who do not have access to 21st-century medical technology and to make them affordable.

New Tech for Low Cost Health Diagnostics

HealthcareContracting a disease in a developing country used to be, essentially, a death sentence. Scientists, researchers, and engineers alike are working to change that. Low cost health diagnostic tests have become a focal point for health research for several reasons. One such reason is the desire to lower the cost of diagnostic tests for everyone in every country. Blood panels are routine to test for and monitor health issues, but they are too expensive for everyone who needs help. This is especially a problem in developing countries where most citizens do not have access to adequate healthcare solutions, much less the funds for expensive diagnostic tests. Thankfully, there are several institutions, such as the EFPL, who are making headway in the low cost health diagnostics field.

The EFPL has recently developed a device that can diagnose and monitor health issues, and is small and portable, at a very low cost. It is a microfluidic device that has already been tested on Ebola cases, and is predicted to be able to be used for many other diseases. The little contraption is battery powered and very accurate, using inexpensive microscopes to analyze small blood samples. It concentrates on biomarkers such as enzymes and proteins to accurately inform a patient about the state of his or her health.

One of the more unique features of this microfluidic device is that it has analog and digital detection mechanisms. Most low-cost health diagnostic devices are only composed of one or the other. Having both lessens the amount of time it takes to analyze a single blood sample, and makes the analysis more accurate. This could result in the ability to catch diseases early, and take preventative measures accordingly.

Another wonderful feature of this new device is that blood samples that it tests do not have to be pre-treated. Rather, they can be inserted directly into the device without separation. This cuts down on a large amount of processing time by doctors, and makes it so that more equipment, such as a centrifuge, is not necessary.

In terms of monitoring disease outbreaks in developing countries and taking action, inventions such as this one are invaluable. They are crucial to catching and treating conditions in patients early at a reasonable cost. We are slowly revolutionizing the way health is handled financially, and I look forward to seeing how this particular device develops.