Jump-starting innovative new tests for HIV, pregnancy and malaria

A new type of test that could revolutionise the way women and children are checked and treated for some of the world’s most life-threatening diseases and complications is being developed by scientists in South Africa, with support from UNICEF.

Three types of simple-to-use diagnostic tests are being developed to give users quick and clear information on their health status. They work much the same way as existing pregnancy tests with one key difference: they are designed using DNA which can be simply manufactured and used in remote areas as they are not as affected by heat and humidity like traditional tests.

Professor Janice Limson, Director of the Biotechnology Innovation Centre at Rhodes University

“There’s a gap in the developing world for foetal and maternal health diagnostics,” explains Professor Janice Limson, Director of the Biotechnology Innovation Centre at Rhodes University. “A lot of tests currently require you to send samples to labs for results, which takes time and is expensive – especially if you’re in a very remote area. Our work is about access and time, and ultimately should help save lives.”

With support from UNICEF’s Global Innovation Centre, Janice’s team of scientists are currently working on developing tests that are cheap, quick and easy to use.

“A pregnancy test is a good example of a diagnostic test,” explains Dr Ron Fogel, a scientist at the Biotechnology Innovation Centre. “It’s simple to use and it’s easy to interpret the results. This test has been used for 30 or 40 years and it’s usually a yes or no answer. We have found ways to get even more valuable information from similar tests.”

A safer pregnancy

Lauren Shaw, a PhD student at Rhodes University

“What we are imagining is that these little tests can be used where there are no clinics or no structured health care systems. They could be used to identify high risk cases and get those in need of help to clinics to be treated,” says Lauren Shaw, a PhD student who started working on the test strips earlier this year.

This new type of test will indicate whether you are pregnant, and will also serve to indicate a high-risk pregnancy. High risk pregnancies, for example, include ectopic pregnancies and those where twins or triplets might be expected. High-risk births could then be flagged for further attention and definitive diagnoses.

“Right now, to get this kind of information you’d need medical staff to draw blood, perhaps send it off and have it tested on expensive equipment with trained staff,” explains Lauren. “With this kind of urine test it’s really portable and affordable, something everyone can use.”

Around the world expectant mothers from poor and remote communities struggle to get appropriate support when they are pregnant. Distances to hospitals and the costs associated with traveling and health care fees means problems will often be detected too late. This test will bring cheap and easy-to-read results directly into these communities and enable health workers to quickly identify who needs care.

Nurses in a nearby hospital agreed that such a test would be extremely valuable. “There’s a lot of backlog here so it would really speed things up,” said Nurse Mdyogolo Valithuba at Settlers Day Hospital. “There are so many bookings and maybe a pregnancy has gone too far before we realise there’s a problem – it might be too late. This would be very useful here and in the community.”

A clearer picture on HIV status

Anne Loeffler, Ntombezodwa Goje and Nomfundo Thobi from the Raphael Centre in Grahamstown

By counting the number of CD4-positive cells in the blood stream, doctors can identify what type of HIV treatment is required and also monitor the progress of that treatment. Keeping track of this number can literally be a case of life and death and the team at Rhodes University is developing a strip that can indicate your CD4 count.

“Testing of CD4 levels is currently too expensive – the machines are thousands of dollars and HIV-positive patients often only have their levels tested once a year,” explains Professor Limson. “Without knowing your CD4 count you don’t know if your treatment is working effectively.”

Workers in a nearby HIV clinic were enthusiastic about this new test. “If there’s a chance to do CD4 testing it would be great,” said Anne Loeffler, Manager of the Raphael Centre in Grahamstown. “It’d be great because we can monitor patients’ health on a regular basis. Motivating them to stick to treatment is a big challenge for us right now – this would be huge help.”

Taking the sting out of malaria

Dr Ron Fogel, a scientist at the Biotechnology Innovation Centre at Rhodes University

“Malaria is a catch-all term for infections from different species of Plasmodium parasites carried by mosquitoes. These require different treatments,” explains Dr Fogel. “Infections used to be geographically defined but that’s changing. Our work will not only tell you that you have malaria, but also which type you have.”

Children are disproportionately affected by malaria: every two minutes, a child dies of the disease. Currently half the world’s population are at risk of malarial infection and this new test will help quickly identify what type of treatment is required.

“Malaria is a big problem in Africa,” explains Adewoyin Martin Ogunmolasuyi who is currently working with the team in Rhodes University. “I’m from a rural area myself in Nigeria, where there are many poor people. This is why I really want to make this work: it’s really going to be of great benefit to people once it is released.”

Innovation for a better future, for all

UNICEF/2018/NazerPostgraduate student Khanysile Buthelezi working in the Rhodes lab

For Professor Limson, all this work is ultimately about helping people most in need. “As scientists we want to do research that impacts people,” she says.

UNICEF ‘s Global Innovation Centre supported this innovative work because of its potential to impact the lives of vulnerable children and women. The hope is that this support will jump-start cutting-edge academic ideas into real-world, life-saving solutions.

There’s still some way to go before these innovative tests hit the market but with UNICEF’s support the scientists at Rhodes University are getting closer every day. “Here in South Africa, I was exposed to inequalities at a young age and it’s something that’s always driven my work,” says Professor Limson. ‘It’s about making developed health care available to those in rural, poor areas. There’s so much potential here to help so many people.”

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