Rapid in-field malaria diagnosis, prognosis and monitoring using a mobile phone

使用手机进行快速现场疟疾诊断、预后和监测

• 批准号: 9393957
• 负责人: Peter B Lillehoj
• 金额: $ 20.89万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-16 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9393957
• 关键词: AIDS/HIV problem; Antibodies; Antigens; Area; Bedside Testings; Biological Assay; Biological Sciences; Biomedical Technology; Biosensing Techniques; Biosensor; Blood specimen; Calibration; Car Phone; Cerebral Malaria; Cessation of life; Child; Clinical; Clinical Data; Coma; Communicable Diseases; Computer software; Consumption; Dengue; Detection; Development; Devices; Diagnosis; Diagnostic tests; Disease; Effectiveness; Elements; Enzyme-Linked Immunosorbent Assay; Epidemiologic Monitoring; Generations; Goals; Gold; HRP-2 protein; Health; Health Personnel; Human; Immunity; Individual; Infection; Liquid substance; Malaria; Malawi; Measurement; Measures; Microfluidic Microchips; Microfluidics; Mission; Modification; Monitor; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; National Institute of Biomedical Imaging and Bioengineering; Outcome; Parasitemia; Patient Triage; Patients; Performance; Plasmodium falciparum; Protocols documentation; Public Health; Reagent; Research; Retinal Diseases; Risk; Rotavirus; Sampling; Scheme; Serum; Specimen; System; Technology; Testing; Time; Translating; Triage; Tuberculosis; Validation; Whole Blood; Wireless Technology; base; chromatin immunoprecipitation; clinical Diagnosis; clinical care; comparative; cost effectiveness; data exchange; follow-up; health care settings; improved; innovation; instrument; light weight; malaria infection; miniaturize; mortality; novel; outcome forecast; physical science; point of care; prognostic; prototype; public health relevance; trend

 DESCRIPTION: Malaria is one of the most deadly infectious diseases in the world. Immunity to malaria illness is acquired gradually and irregularly in malaria-endemic areas and this creates two significant difficulties in its diagnosis and treatment: 1) Individuals who are infected with malaria may be asymptomatic, and conversely, symptomatic individuals with malaria infections may be ill for reasons unrelated to malaria, and 2) A proportion of individuals who present for clinical care with a mild malaria illness will progress to severe disease. At this point in time, i is not possible to predict which patients are at risk of deteriorating, and this greatly complicates clinical care. Recent studies by the applicants and others have demonstrated the utility of quantitative Plasmodium falciparum histidine-rich protein 2 (PfHRP2) measurements for (a) distinguishing parasitemic comatose children with cerebral malaria (CM) from comatose children with incidental parasitemia and a non-malarial cause of coma, and (b) identifying which children with apparently uncomplicated malaria are likely to progress to a more serious illness. Currently, PfHRP2 quantification requires an enzyme-linked immunosorbent assay (ELISA) test which is expensive, laborious and time-consuming. Malaria rapid diagnostic tests for PfHRP2 are available, but these assays only provide qualitative results ("positive" vs. "negative") and are no useful for the indications above. The long-term goal is to improve the clinical diagnosis of CM and the triage of patients with uncomplicated malaria. The primary objective of this project is to develop and validate a field-ready mobile phone platform for rapid, quantitative PfHRP2 measurements. The rationale for the proposed research is supported by the applicants' preliminary clinical data, and the feasibility of integrating a miniaturized detection scheme onto conventional mobile phone for rapid, quantitative PfHRP2 measurements of human serum and blood samples. An optimized second-generation prototype device will be developed and validated by pursuing three specific aims: 1) Develop a field-ready, mobile phone platform for quantitative PfHRP2 detection; 2) Validate and optimize device functionality; 3) Evaluate device effectiveness for determining CM diagnosis in patients with CM in field settings. This approach is innovative because it integrates microfluidics with a rapid, quantitative electrochemical detection scheme onto a compact mobile phone platform, and it is significant because is it will improve cerebral malaria prognosis and treatment, and thus, help to reduce malaria-related morbidity and mortality.

 描述：疟疾是世界上最致命的传染病之一。在疟疾 - 末端区域逐渐和不规则地获得对疟疾疾病的免疫力，这在其诊断和治疗方面造成了两个重大困难：1）感染疟疾的人可能是渐近的，而有症状的人可能患有疟疾感染的症状患者可能因疟疾而与疟疾相关的原因与患者的疾病相关，而对患者的疾病则可能是一个临床疾病，而对疟疾的疾病则是一个临床上的疾病。在这个时间点，我无法预测哪些患者有恶化的风险，这使临床护理变得复杂。申请人和其他人的最新研究表明，富含组氨酸的蛋白2（PFHRP2）测量的定量质质质质质量是（a）（a）区分患有脑疟疾的脑疟疾（CM）的寄生虫昏迷儿童（a），偶然的寄生虫和非伴侣的儿童（可能是友善的儿童），可能是coma和coma的儿童（b），这可能是coma和coma的症状。进展到更严重的疾病。目前，PFHRP2定量需要质量昂贵，实验室且耗时的酶联免疫吸附测定法（ELISA）测试。可以使用PFHRP2的疟疾快速诊断测试，但是这些测定仅提供定性结果（“正”与“负”），并且对上述指示无用。长期目标是改善CM的临床诊断和简单疟疾患者的分流。该项目的主要目的是开发和验证一个可以进行现场的手机平台，以快速，定量的PFHRP2测量。拟议研究的基本原理得到了申请人的初步临床数据的支持，以及将微型检测方案整合到常规手机上，以快速，定量的PFHRP2测量人血清和血液样本的可行性。通过追求三个特定目的，将开发和验证优化的第二代原型设备：1）开发一个现场准备的手机平台，以进行定量PFHRP2检测； 2）验证和优化设备功能； 3）评估用于确定现场设置中CM患者CM诊断的设备有效性。这种方法具有创新性，因为它将微流体与快速定量的电化学检测方案相结合到紧凑的手机平台上，并且这很重要，因为它将改善脑疟疾的预后和治疗，因此有助于降低与疟疾相关的发病率和死亡率。