NEW YORK – A new EU-funded project has commenced that pledges to deliver new rapid tests for poverty-related infectious diseases to Africa, while investing in digital health infrastructure, and training a new cadre of experts to tackle the continent's healthcare needs.
The Digital Innovations and Diagnostics for Infectious Diseases in Africa (DI-DIDA) project kicked off this month and will run through September 2027 with a budget of about €6 million ($5.9 million). The DI-DIDA consortium involves 14 partners from eight countries, including Kenya, Senegal, Tanzania, and Uganda. The University of Glasgow in the UK is the coordinator.
Jonathan Cooper, a professor of engineering at the University of Glasgow and principal investigator on DI-DIDA, said that "diagnostics are at the heart" of the project, and that one goal is to develop rapid, electronic lateral flow tests that can be used in the field for malaria, schistosomiasis, and human papillomavirus screening.
Yet there is more to the project, which envisions strengthening African research capacities and encouraging the adoption of new technologies by sub-Saharan health authorities, including digital health support technology that can be integrated into existing African health infrastructure. Education is also a major component of DI-DIDA, and one aim is to build a graduate school that will produce a new generation of investigators to tackle infectious diseases.
"A large number of Ph.D. studentships will be funded in Africa" as part of DI-DIDA, Cooper noted. "They will be in the field and on the ground implementing these new diagnostic devices."
Cooper was corresponding author on a Nature Electronics paper last year that detailed the design of a smartphone-based platform for point-of-care malaria testing. The approach included a paper-based microfluidic testing strip combined with deep learning algorithms for local decision support, as well as blockchain technology for secure data connectivity and management, and was validated via field tests in rural Uganda.
He was corresponding author on a separate paper published last year in Nature Communications that described the development of a low-cost, pan-genotypic assay based on reverse transcriptase loop mediated isothermal amplification for hepatitis C virus detection. Cooper and colleagues developed a prototype device for point-of-care testing that consists of a LAMP amplification chamber and lateral flow nucleic acid detection strips, the results of which can be read visually.
Cooper said the two papers are "just examples of what we have done so far," but that similar tests could be developed during the DI-DIDA project.
In terms of two diseases of interest, schistosomiasis and human papillomavirus, DI-DIDA could develop low-cost, handheld, smartphone-enabled, nucleic acid-based tests, according to Cooper.
For schistosomiasis, a disease caused by parasitic worms, users could analyze blood samples from patients using a LAMP assay similar to the one Cooper and colleagues developed for hepatitis C, while using their smartphones to collect data and provide decision support for communities where the parasites that cause the disease are endemic.
Cooper noted that rapid HPV testing is a component of World Health Organization recommended programs for preventing and treating cervical cancer, and that low-cost HPV screening devices could reduce barriers to screening and treatment. According to Cooper, an envisioned rapid test could be used on self-collected samples, overcoming the need for additional infrastructure and reducing turnaround times associated with conventional testing approaches.
In terms of digital health, Cooper said that the DI-DIDA project might implement the most recent version of District Health Information Software (DHIS 2), an open source software platform, which is used for reporting, analyzing, and disseminating healthcare data. The department of informatics at the University of Oslo has coordinated the development activities of the DHIS 2 platform.
The PharmAccess Foundation, an Amsterdam-based nonprofit, is also taking part in DI-DIDA, and the project could similarly use the organization's digital tools, Cooper said. In one example, PharmaAccess' platform could help with managing costs related to delivering resources for specific actions or resources.
The Institut Pasteur de Dakar in Senegal is also taking part in DI-DIDA, as is Diatropix, a nonprofit platform for the manufacture of rapid diagnostic tests. Joe Fitchett, senior adviser for biotechnology at the Institut Pasteur de Dakar, said that there are multiple elements that make DI-DIDA an important African project, including geographic representation, as countries from across sub-Saharan Africa are involved.
He added that the digital component of DI-DIDA is particularly necessary. "At Dakar, we are already digitizing our surveillance work with the government of Senegal," said Fitchett, noting that samples are collected from patients presenting with symptoms of infectious diseases at 25 sites and sent to reference labs for testing, as well as pathogen sequencing when necessary.
Institut Pasteur de Dakar is also supporting point-of-care testing for SARS-CoV-2 and malaria and will soon add yellow fever and measles to its multiplexed rapid tests. In 2019, the institute partnered with Mologic to implement the UK firm's next-generational lateral flow testing platform at its sites in Senegal. The company was acquired last year by the Soros Economic Development Fund with support from the Bill & Melinda Gates Foundation, and is now called Global Access Diagnostics.
According to Fitchett, who joined the Institut Pasteur de Dakar from Mologic, the new DI-DIDA project will support Diatropix by funding the creation of new diagnostics, as well as training new specialists, "the next generation of innovators to work on digitizing diagnostics."
He added that it could result in more sophisticated tests, including smartphone-based diagnostics or tests that rely on other low-cost readers, "which would blur the line between a qualitative rapid test and a quantitative laboratory test."
Fitchett also noted that investigators will likely review how they link and store data, to reduce data storage costs and environmental impact of any resulting digital health infrastructure. "We need to make sure the information is genuinely useful and affordable," Fitchett underscored. "Sometimes data storage costs more than running the test itself."
The EU has funded numerous diagnostics projects in recent months to develop new infectious disease diagnostics for Africa, as well as Europe. One project, called Mobilise, also commenced this month, and aims to develop a mobile laboratory that can be used to test emerging pathogens in the field using molecular technologies, such as PCR and next-generation sequencing.