Diagnostic Devices for Diseases in Low-Income Areas: A Compilation of Seven Cost-Effective Solutions

Every year, malaria claims the lives of 1 million individuals, while respiratory infections lead to the demise of over 4 million, intestinal infections cause 3 million deaths, and AIDS and tuberculosis together contribute to 5 million fatalities. Furthermore, various sexually transmitted and parasitic infections prevalent in tropical regions result in hundreds of thousands of deaths. Developing countries bear the brunt of over 95% of these fatalities, as highlighted in the scientific paper “Diagnostics for the Developing World,” published in Nature Reviews in 2004. The authors of the publication emphasized the crucial need for straightforward, precise, and durable diagnostic tools to combat these diseases. Unfortunately, such diagnostic solutions are typically unavailable to those who need them the most.

Addressing the significant health challenges posed by diseases like malaria, respiratory infections, intestinal infections, AIDS, and tuberculosis requires accessible and effective diagnostic solutions. In resource-limited settings, where the majority of these health threats are concentrated, the lack of access to reliable diagnostic tools compounds the severity of the problem.

To bridge this gap, there has been a growing focus on developing low-cost devices specifically tailored for diagnosing diseases in impoverished regions. These devices aim to provide simple, accurate, and stable diagnostic capabilities that can be deployed in challenging environments with limited resources.

Several innovative solutions have emerged to tackle this issue. These low-cost diagnostic devices leverage advancements in technology, often incorporating portable and user-friendly features. They play a crucial role in enabling early detection, timely intervention, and effective management of diseases that disproportionately affect vulnerable populations in developing countries.

One notable example is the use of rapid diagnostic tests (RDTs) for malaria, allowing for quick detection of the parasite in a cost-effective manner. Additionally, low-cost point-of-care devices for respiratory and intestinal infections have been developed, providing essential diagnostic support in regions where laboratory infrastructure is minimal.

In the realm of sexually transmitted and parasitic infections, efforts have been made to create affordable diagnostic tools that can be readily deployed in tropical areas. These innovations contribute to reducing the burden of diseases and improving health outcomes in underserved communities.

Despite these advancements, ongoing research and collaboration are crucial to further enhance the accessibility and effectiveness of low-cost diagnostic devices. Continued investment in innovation, coupled with strategic partnerships, holds the potential to save millions of lives by ensuring that diagnostic solutions reach those who need them the most in resource-constrained settings.

Conventionally, the proper diagnosis and treatment of diseases necessitate substantial infrastructure, often in the form of hospitals or laboratories. However, recent years have witnessed the emergence of novel techniques designed to expedite the treatment of diseases prevalent in developing countries, eliminating the dependency on extensive health infrastructure.

This shift has given rise to Point-of-Care Tests (POCT), economical medical tests delivering nearly instantaneous results. They are deemed “the best way to reach places where access to the health network is challenging,” as elucidated in the scholarly article titled “Point-of-Care testing for infectious diseases: diversity, complexity and barriers in low and middle income countries,” published in Plos One in 2012.

POCTs empower healthcare professionals to swiftly acquire test results from patients, facilitating the initiation of diagnosis or intervention during the initial clinical encounter. Adhering to the ASSURED criteria—affordable, sensitive, specific, user-friendly, rapid, robust, equipment-free, and delivered—is recommended by the scientific community.

The spectrum of POCTs is diverse, manifested through various devices categorized into first, second, and third generations. First-generation devices, termed Rapid Diagnostic Tests (RDT), are highly cost-effective, with most meeting the ASSURED criteria and costing up to a dollar per test. Second-generation devices facilitate nucleic acid amplification tests (NAAT) to detect the genetic material of viruses or infecting organisms. Third-generation devices incorporate mobile technology, including those connectable to low-end mobile phones (2G technology) for data transmission to other sources.

Outlined below are some of the latest POCTs, many of which are still in the preliminary study phase and have not been launched yet.

7. A DIAGNOSTIC TEST FOR HIV AND HEPATITIS C

MedMira, a Canadian firm, asserts its unique adherence to prevailing regulations in Canada, the US, China, and the European Union, enabling the sale of its instant diagnostic tests for HIV and hepatitis C worldwide. Offering rapid results, the company supplies its devices to diverse settings, including hospitals, laboratories, clinics, and individual users. Recently, MedMira inked a 1 million Canadian-dollar agreement with a US holding company, signaling its commitment to expanding business operations in the US.

6. COMBATING TUBERCULOSIS

A widely utilized tool for identifying tuberculosis and assessing resistance to rifampicin (a commonly prescribed antibiotic for tuberculosis) is the GeneXpert MTB/RIF, a collaborative effort between the University of Medicine of New Jersey, Cepheid, and the US National Institute of Health. Endorsed by the WHO in late 2010 for tuberculosis detection in endemic regions, the device yields results within two hours, albeit at a higher cost compared to previously mentioned devices. Despite its higher price, its adoption has expanded, notably in South Africa, where a recent approval granted the shipment of 10 million cartridges in late March.

5. GENETIC ANALYSIS

QuantuMDx, a UK-based firm, has developed a portable tool called the Qpoc Handled Laboratory, offering rapid results for diseases such as Ebola, gonorrhea, HIV, tuberculosis, and malaria within 10 minutes. Priced at $1,000 USD, with analysis cartridges costing up to $100 USD each, the device is currently pending approval, with its creators anticipating a market launch later this year.

4. AFFORDABLE DETECTION FOR DENGUE, YELLOW FEVER, OR EBOLA

MIT is in the process of creating an economical device, costing only $5, that aims to detect Ebola, Dengue, and Yellow Fever within a mere 10 minutes. Using molecular biology techniques, a single blood drop is sufficient to confirm infection. The device is currently undergoing initial studies with animals.

3. RAPID EBOLA DIAGNOSIS IN 15 MINUTES

The WHO recently endorsed a new tool, the Reebov Antigen Rapid Test, developed by Corgenix, which can identify Ebola cases within a mere 15 minutes, as reported by NPR. Functioning akin to a pregnancy test, this device has faced reluctance from Médecins Sans Frontières, who expressed concerns about its reliability due to false positives. Additionally, it awaits approval from the US Food and Drug Administration for testing outside the USA. Simultaneously, the WHO anticipates validation of other devices to enhance Ebola detection.

2. DETECTING SICKLE-CELL DISEASE FOR UNDER $1

A student affiliated with the Whitesides work group at Harvard recently introduced a cost-effective method for diagnosing Sickle-cell disease—an abnormal red blood cell growth prevalent in developing countries. In the US, 1% of children diagnosed with this disease succumb before reaching five years old, while in Africa, this figure rises to an alarming 70%.

The Harvard researcher devised a technique involving blood centrifugation using a compact and easily transportable kit. Results are discernible within 10 minutes, contingent upon the blood sample’s flotation level. Each test incurs a mere 50 cents in expenses, and the entire apparatus conveniently fits into a backpack.

1. ONE DROP OF BLOOD, DETECTING UP TO 6 DISEASES

Researchers from the Whitesides research group at Harvard have designed a $25 device—which could witness cost reduction through mass production, as indicated by the researchers—to analyze blood samples or assess water supplies. The device is crafted to identify cases of diabetes and malaria, alongside detecting water pollutants. In a subsequent phase, studies could encompass HIV, Ebola, E. coli, hepatitis, influenza, or dengue.

A solitary drop of blood (or water) on a paper strip—subsequently inserted into the device—is adequate for a diagnosis within minutes. The device connects via cable to a mobile phone—no requirement for the latest generation, as 2G suffices—allowing servers to upload the data. This setup enables healthcare professionals globally to oversee the diagnosis and treatment of patients from any location.

The scientific community has demonstrated its ability to integrate top-notch detection methods into affordable devices. Nevertheless, the eradication of these diseases in developing countries necessitates “continuous investment, political commitment, collaboration between the public and private sectors, innovative financing models, and a focus on medical requirements,” as emphasized in the academic publication “Diagnostics for the Developing World,” featured in Nature Reviews in 2004.

References:

BBVA Group

PubMed
WebMD

Dr.Sono
Healthline Network
CDC.Gov