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Transforming Diagnostics in Africa: The NIHR GHRG Conference in The Gambia

Updated: Jul 8


A group photo of the NIHR Global Health Research Group on Digital Diagnostics for African Health Systems with Gambian stakeholders at the conclusion of the workshop held on June 5, 2024, in Cape Point, The Gambia. Credits: Muhammed Jobe, Digital Content Officer, MRCG@LSHTM
A group photo of the NIHR GHRG with Gambian stakeholders at the conclusion of the workshop held on June 5, 2024, in Cape Point, The Gambia. Credits: Muhammed Jobe, Digital Content Officer, MRCG@LSHTM

Over the first week of June 2024, the NIHR Global Health Research Group (GHRG) on Digital Diagnostics for African Health Systems held an in-person conference at Cape Point, The Gambia. The event was hosted by the MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine (MRCG@LSHTM, a key partner of the consortium. The organization of the conference involved significant contributions from Dr. Annette Erhart, Malaria Coordinator at MRCG, and Professor Umberto D’Alessandro, Director of the MRC Unit The Gambia, along with collaborators from the MRCG Administration, Communication, and Finance Teams.


Members of NIHR GHRG in visit to Sukuta Health Centre, on June 3, 2024, The Gambia Credits: Muhammed Jobe, Digital Content Officer, MRCG@LSHTM

The event involved NIHR members from partner countries and organizations across Africa, including the University of Ghana, minoHealth AI Labs (Ghana), the University of Khartoum (Sudan), the University of Nairobi, Masinde Muliro University of Science and Technology (Kenya), Imperial College, Canterbury Christ Church University, The Institute of Cancer Research, and the Malaria Consortium (UK).


Participants visited Gambian health centers and engaged with collaborators at MRCG@LSHTM and other consortium members to discuss and refine key aspects of the project.


The Workshop with Stakeholders

The conference also featured a workshop with local stakeholders designed to gather insights on the potential applications of portable digital diagnostics within Gambian health systems. The goal was to understand and facilitate the integration of these tools to enhance healthcare delivery in the region. The workshop included 20 representatives from the community, health sector, and government, encompassing patients, nurses, doctors, laboratory staff, hospital directors, and managers, invited from various regions of The Gambia to provide diverse perspectives and address critical aspects of co-developing digital diagnostics within the Gambian health system.


Following participants introductions, the NIHR GHRG project’s mission and vision was presented to the audience by Professor Halidou Tinto, Co-Lead of the NIHR GHRG and Director of the Clinical Research Unit of Nanoro (CRUN) at the Institute of Sciences de la Santé (IRSS) in Burkina Faso, followed by a first brief discussion with the participants on the potential impact of portable digital diagnostics in the Gambian health system.


Dr Dimbintsoa Rakotomalala Robinson, a Ph.D Student of the consortium conducting research on detection of asymptomatic carriage of malaria parasites in the Gambia and Burkina Faso, and Dr Jesus Rodriguez-Manzano, Senior Lecturer in the Section of Adult Infectious Disease at Imperial College, and co-founder and CSO at ProtonDx, led a live demonstration of “Dragonfly” digital diagnostics, the technology developed at Imperial College in partnership with ProtonDx for the NIHR GHRG.


Dr Dimbintsoa Rakotomalala Robinson and Dr Jesus Rodriguez-Manzano demonstrating the versatile operability of the Dragonfly technology in outdoor settings. Credits: Dr Jethro Herberg, Clinical Reader in Paediatric Infectious Diseases at Imperial College London, and member of the NIHR GHRG.
Dr Dimbintsoa Rakotomalala Robinson and Dr Jesus Rodriguez-Manzano demonstrating the versatile operability of the Dragonfly technology in outdoor settings. Credits: Dr Jethro Herberg, Clinical Reader in Paediatric Infectious Diseases at Imperial College London, and member of the NIHR GHRG.

Following the demonstration, Professor Julie Balen, from Canterbury Christ Church University and Professor Salome Bukachi from the University of Nairobi, respectively Health Systems Lead and CEI Co-Lead in the NIHR GHRG, organized table discussions in which stakeholders shared insights on the needs and barriers to implementing new digital diagnostics in their regions and health systems.

Dr. Talya Porat (User-Interface Co-Development Lead, from the Dyson School of Design Engineering at Imperial College) and Professor Julie Balen (Health Systems Lead from Canterbury Christ Church University) in a group photo with Sally Bojang and Ida Cham and their children.  Credits: Professor Aubrey Cunnington, Co-Lead of the NIHR GHRG
Dr. Talya Porat (User-Interface Co-Development Lead, from the Dyson School of Design Engineering at Imperial College) and Professor Julie Balen (Health Systems Lead from Canterbury Christ Church University) in a group photo with Sally Bojang and Ida Cham and their children. Credits: Professor Aubrey Cunnington, Co-Lead of the NIHR GHRG


The NIHR GHRG discussing with stakeholders in different thematic working groups.  Credits: Dr Annette Erhart, Malaria Coordinator at MRCG@LSHTM, and member of the member of the NIHR GHRG.
The NIHR GHRG discussing with stakeholders in different thematic working groups. Credits: Dr Annette Erhart, Malaria Coordinator at MRCG@LSHTM, and member of the member of the NIHR GHRG.



These discussions covered interdisciplinary aspects, such health systems strengthening, policy for device integration, community engagement, user-interface co-design, and data integration and surveillance, and they were facilitated by the NIHR GHRG's ten Ph.D students.


The workshop was covered by local news channels GTRS and QTV, and participants engaged in media interviews.

The event covered on QTV news channels


GRTS local news channel reporting on the NIHR GHRG



Professor Cunnington interviewed by the local media


Professor Aubrey Cunnington, Co-Lead of the NIHR GHRG and Head of Paediatric Infectious Disease Section at Imperial College, highlighted the alarming gap in Africa, where more than 50% of the population lacks access to diagnostic tests, hindering effective disease diagnosis and treatment.




"If we don’t have diagnostics tests, we don’t know what is causing someone’s illness, and then we don’t know what’s the best treatment to give them, so it is almost like the nurses and doctors wearing a blindfold when they are trying to work out what’s wrong with their patients",Professor Aubrey Cunnington, Co-Lead of the NIHR GHRG.



Dr. Mustapha Bittaye, Chief Medical Director of Edward Francis Small Teaching Hospital in Banjul, emphasized the potential of the NIHR GHRG's technology to simplify difficult diagnoses at the point-of-care. He also noted that the collaboration with NIHR-funded researchers could enhance local capacity and encourage Gambian early-career researchers to develop skills in new diagnostics.



Flavia Kaduni Bawa, Ph.D Student at University of Ghana whose research is focused on evaluating digital diagnostics to distinguish between viral and bacterial causes of childhood febrile illness, explained the structure and interplay of the different disciplines comprising the NIHR GHRG project.



The NIHR GHRG gathered valuable feedback on feasibility, usability, and potential improvements to inform the next stage of prototype evaluation and development, planned over the next two years of the project, making this workshop a success and an invaluable opportunity of learning and sharing against the beautiful backdrop of The Gambia.





 




About the NIHR GHRG on Digital Diagnostics for African Health Systems

Established in August 2022, the NIHR Global Health Research Group on Digital Diagnostics for African Health Systems aims to develop an evidence-base to support the development, implementation, and impact of digital diagnostics technology in African health systems, and training a cohort of African Digital Diagnostics Fellows who will evaluate the impact of and develop further digital diagnostics technology.

The NIHR GHRG brings together a large international and interdisciplinary group of researchers and experts, from 16 different organizations based in 8 countries, between Africa, the UK and Netherlands, and it is led by Professor Aubrey Cunnington, Head of Section and Professor of Paediatric Infectious Disease at Imperial College London, and Professor Halidou Tinto, Regional Director of the Clinical Research Unit of Nanoro (CRUN) at the Institut de Recherche en Sciences de la Santé (IRSS) in Burkina Faso.

 

About the Digital Diagnostic Technologies

As part of the NIHR GHRG programme, Dr Jesus Rodriguez-Manzano and Professor Pantelis Georgiou’s Imperial College and ProtonDx teams, are working on the development of portable, rapid diagnostic solutions, including Dragonfly and Lacewing, for the detection of asymptomatic malaria infections and associated plasmodium species. These solutions provide high level analytical performance equivalent to Nucleic Acid Amplification Tests (NAATS), in a simple to use, cloud connected solution that can be performed without skilled staff, laboratory infrastructure or cold chain requirements.


Dragonfly

Dragonfly, led by Dr Rodriguez-Manzano, incorporates power-free, magnetic nanoparticle-based nucleic acid purification and lyophilized colorimetric Loop Mediated Isothermal Amplification (RT-LAMP) technology, providing sample-to-result outcomes in less than 30 minutes. In contrast to conventional molecular diagnostics, Dragonfly is easy to perform, requiring only a small battery-powered, portable heat block. The operational and analytical performance of Dragonfly for malaria detection in fingerprick blood has been recently evaluated as part of two studies involving over 600 patients in collaboration with teams in The Gambia and Burkina Faso.


The “Dragonfly” digital diagnostics platform set up with kits and panel  Credits: ProtonDX Team, partner of the NIHR GHRG
The “Dragonfly” digital diagnostics platform set up with kits and panel Credits: ProtonDX Team, partner of the NIHR GHRG

Lacewing

Led by Professor Pantelis Georgiou and Dr Nicolas Moser, Lacewing is an automated, portable, state-of-the-art Lab-on-Chip electrochemical sensing technology, which integrates LAMP based molecular approaches and cloud-based surveillance. The platform uniquely allows for high analytical performance and high speed without the need for bulky equipment and centralised laboratory infrastructure. The Lacewing technology is envisioned to be targeted to untrained users, and compatible with remote areas of low-resource settings. Lacewing has already been demonstrated for a range of targets including SARS-CoV2, dengue, colistin resistance and transcriptomic signatures to detect bacterial and viral infections, and it has now been adapted for malaria detection.

 

Credits
The event was organized by Francesca Piffer, Project Manager at Imperial College London of the NIHR Global Health Research Group on Digital Diagnostics for African Health Systems, in collaboration with MRCG@LSHTM Administration, Communication and Finance teams–including Lucene Ahadzie, Isatou Foon, Amat Cham, Dr Shiloe Marie Mokay-Rinke, Alhassan Drammeh, and Mohammed Jobe– with the involvement of Dr Annette Erhart, MRCG@LSHTM Malaria Coordinator, and Professor Umberto D’Alessandro, Director of the MRC Unit The Gambia. The meeting with stakeholders was led and supervised by Professor Julie Balen, Professor of Health Systems and Global Change at Canterbury Christ Church University.

Funding
The workshop was funded by the Research England International Science Partnership Fund (ISPF) 2023/2024 Global Development Hub ODA Project Accelerator through Imperial College London (G28643).
The NIHR GHRG on Digital Diagnostics for African Health Systems is funded by the NIHR (134694) using UK aid from the UK Government to support global health research. The views expressed in this blog are those of the author(s) and not necessarily those of the NIHR or the UK.



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