The Future of Global Health
Unprecedented
efforts are being directed at overcoming the challenges of delivering
healthcare in low income countries globally. Previous, though well-intentioned,
attempts to implement technologies to improve healthcare have largely failed.
“Known, effective, and cheap” are necessary but insufficient criteria for
successful Global Health technologies. However, much has been learned. The
CIMIT Global Health Initiative Forum on January 8th seeks to highlight some of
the challenges and opportunities in this field. Two CIMIT funded researchers
will highlight their current work in the realm of diagnostic testing utilizing
microfluidic technology directed at conditions ranging from Avian Flu through
HIV. Microfluidics holds significant promise to allow rapid, accurate, and
inexpensive diagnostic testing in settings without supportive laboratory
infrastructure or personnel. Please come and join in the discussion!
4:00PM Introduction
Moderator: Kristian Olson, MD, MPH, Clinical Educator Svc, Department of Medicine,
Massachusetts General Hospital; CIMIT Global Health Initiative Leader; MGH
Center for Global Health Senior Advisor; Instructor, Harvard Medical School, krolson@partners.org
4:15PM Disposable Molecular
Diagnostics: Microfluidic Laboratories for the Field
Catherine Klapperich, PhD, Assistant Professor of
Manufacturing and Biomedical Engineering, Boston University, catherin@bu.edu
The
impact of infectious disease on resource poor areas of the world is devastating.
It is unlikely that the financial climate surrounding drug development for
diseases prevalent in third world countries will soon change. Our best approach
at dealing with some of these diseases will be prevention efforts assisted by
the widespread availability of inexpensive and accurate diagnostics. Probes to
amplify and identify microbial or viral nucleic acids are available for almost
every well known disease vector. Assays for serum antibodies to many organisms
are also well documented. Dedicated engineering of test protocols (patient
sample
preparation, dilutions, washing, blocking, and detection) and devices is
required to move these technologies out of the research laboratory and into the
field where they can have a more immediate impact on world health. Catherine
Klapperich’s team is focused on designing and prototyping disposable
microfluidic platforms to enable molecular diagnostic testing using patient
samples in locations far from a full service laboratory. Device design goals
are low production costs, long shelf lives and relative ease of use. This talk
will cover the formulation, fabrication and testing of microfluidic solid phase
extraction columns based on polymer monoliths impregnated with nanoparticulate
inclusions for protein and nucleic acid isolation from patient samples. Mammalian
and bacterial cell lysis in microfluidic chips will be covered in addition to a
discussion of strategies for micro and nanoscale enzyme linked immunosorbent
assays. Practical concerns about the direct use of patient samples (blood,
urine, saliva, and stool) will also be addressed.
5:00PM Disposable, Point-of-care Microchips
for CD4 Counts in Resource Limited Settings
Utkan Demirci, PhD, Instructor of Medicine and
Health Sciences and Technology, Harvard Medical School, Brigham & Women's
Hospital, Harvard-MIT Health Sciences and
Technology
Bio-Acoustic-MEMS in Medicine: BAMM Labs, udemirci@rics.bwh.harvard.edu
More than 35 million HIV-infected people live in
the developing world, yet it is estimated that only one in ten persons infected
with HIV has been tested and knows his/her HIV status. The U.S National Intelligence Council (NIC) predicted
that the number of HIV-infected individuals in the developing world would rise
to 80 million by 2010[1]. Effective antiretroviral therapy (ART) for HIV has
been available in developed countries for more than a decade. However,
worldwide, less than 10% (1.3 million) of all the infected individuals are
currently receiving treatment, since most affected persons live in developing
countries. Part of the problem associated with existing ART delivery systems
are the limitations of conventional methods to diagnose and monitor infected
individuals living in rural poor communities. In order to increase access to
HIV care and to improve treatment outcomes requires an urgent development of
low-cost diagnostic tools for developing countries[2-5].
Utkan Demirci’s team’s objective
is to develop novel point-of-care low cost diagnostics to bridge emerging
engineering nano- and micro-scale solutions to HIV infected patients at
resource limited. This laboratory at the interface of Harvard and MIT
specializes in applying micro- and nano-scale techniques to problems in
medicine. The Lab’s target is a point-of-care, low-cost (<$1), disposable,
microfluidic device which uses a fingerstick blood sample (<10 µl) and
produces a CD4 count rapidly (<1 min) with on-chip sample handling and will
greatly accelerate CD4 counting in resource-limited settings.
Discussion: view
video