DAY 3 – Wednesday 4 May – 11:45-13:15
Swiss Tech | Room 1B | Level Garden
ETH Zurich, Switzerland
Walter Karlen is an Assistant Professor in the Department for Health Sciences and Technology heading the Mobile Health Systems Laboratory at ETH Zurich since October 2014. He received an MSc degree in micro engineering and a PhD in Computer, Communication and Information Sciences from the Ecole Polytechnique Fédérale de Lausanne (EPFL), Switzerland. He has worked extensively on mobile phone implementations of biomedical sensors for global health applications and developed novel algorithms for the automated analysis of biomedical signals and diagnosis of infectious diseases.
Parasite born infectious diseases such as malaria cause a large burden on low-resource health care systems. Current in-field diagnostic devices have limited sensitivity and inconsistent performance and preventive technologies have had limited effectiveness. New developments are sought to fight malaria and other infectious diseases. Pre-symptom diagnostic tests that allow for early screening of infections must address apart from improved sensitivity also better specificity. Furthermore, to have impact and allow scalable implementation in low resource settings, novel interventions have to satisfy the ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment free and Delivered) criteria set out by the World Health Organization for rapid diagnostic tests.
While research focuses largely in satisfying sensitivity and specificity, other aspects of ASSURED such as low cost, usability, robustness and implementation strategies are often neglected during the initial development stages. The goal of this session is to bring together researchers and implementers from various fields to discuss common strategies to address challenges that new technologies for infectious diseases eradication must meet.
Nora Engel, Maastricht University, Netherlands, Barriers to Point of Care Testing in India and South Africa
Point of care (POC) testing in communities, home settings and primary healthcare centers has tremendous potential in reducing delays in diagnosing and initiating treatment for diseases such as HIV, tuberculosis, syphilis and malaria. Quick diagnosis and further management decisions completed in the same clinical encounter or at least the same day, while the patient waits, promise to overcome delays associated with conventional laboratory-based testing. However, the availability of cheap, simple and rapid tests that can be conducted outside laboratories does not automatically ensure successful POC testing. In order to understand the new roles and challenges medical devices such as these encounter, we need to study how tests are used at the POC and integrated into workflow and patient pathways. This paper reports on results from a qualitative research project on barriers to point of care testing in India and South Africa. Using semi-structured interviews and focus group discussions we examined diagnostic practices across major diseases and actors in homes, clinics, communities, hospitals and laboratories in South Africa and India. The results reveal diagnostic eco-systems that provide very different conditions for POC testing. The paper concludes by reflecting on how to take such insights into account when designing POC testing programs.
Iveth J. González, FIND, Switzerland, Supporting the Development and Implementation of Improved Diagnostic Solutions for Malaria Control and Elimination [invited speaker] [PDF Extended Abstract]
Malaria is one of the four most burdensome infectious diseases globally and the fifth highest cause of child mortality. The 2014 World Malaria Report estimates that in 2013, there were 198 million cases and 584,000 deaths due to malaria. However, remarkable progress has been made in malaria control during the last decade. For the second time in history, the world is actively fighting toward malaria elimination. Sustaining global gains and accelerating actions toward malaria elimination requires better access to appropriate individual diagnosis and effective surveillance and response tools. FIND is committed to increasing access, even in the remotest areas, to high-quality malaria diagnostic tools that have the confidence of health workers and patients. As progress towards elimination is made, country by country, our ability to accurately identify the remaining malaria infections with effective diagnostic tests will be critical for success. Across all FIND’s activities, collaborating with partners is essential. We work with academia, industry, national malaria control programmes, other international organizations, implementation agencies and global procurement agencies to increase access to effective malaria diagnosis.
Javier Perez-Saez, Ecole Polytechnique Fédérale de Lausanne, Switzerland, Integrating Waterborne Disease Modeling in a Participatory Approach to Tackle Schistosomiasis in Burkina Faso [PDF Full Paper]
The Sustainable Development Goals charge the global community to end poverty, ensure healthy lives and grant access to water and sanitation within 2030. Waterborne diseases, with a global footprint, a significant health burden, and complex transmission cycles, lie at the nexus of these challenges, especially in those areas where the population’s livelihood depends on water resources. Moving beyond our cutting-edge modelling of the ecohydrological controls of schistosomiasis, a neglected waterborne disease, in Burkina Faso, we propose a vision through a participatory approach that includes social aspects in our mathematical model to study the disease in a rural Sahelian village. Our participatory approach aligns our research objectives with local challenges in water resources management including waterborne diseases. We found that though the community depends on a small reservoir for subsistence agriculture, this is the culprit for schistosomiasis infection by causing behavioral changes in addition to providing favorable habitats for the snail intermediate hosts of the parasite. Through our participatory research process, we are laying the foundation for an early warning and surveillance-response tool which will: 1) provide valuable support to public health authorities, 2) enhance capacities of all local stakeholders and 3) be adaptable to other disease settings across sub-Saharan Africa.