South Africa's leading cause of death is tuberculosis (TB). The country is inflicted by the world's highest incidence rate of TB. Diagnosing TB is notoriously challenging and requires long testing times, costly equipment or false negatives. Of the currently available diagnostic tests, culture tests of sputum samples are the most sensitive but require at least 10 days prior to results. Sputum is often inaccessible, in children or patients co-infected with HIV. More powerful available techniques are costly, bulky or require specially trained staff, inhibiting their implementation in rural healthcare clinics. Point-of-care (POC) tests have transformed diagnoses of several diseases, including HIV in developed regions, and we aim to create innovative POC tests designed to be implemented in South Africa and are rapid, accurate, and cost-effective for the diagnosis of TB. Our design incorporates nanomaterial-based approaches to enable sensitive and specific detection, while microfluidic engineering will support sample processing and signal amplification to give optimal readouts. We will also incorporate a smartphone-based component with the intention to immediately report results and enable rapid linking with remote healthcare units or global healthcare organisations to improve TB monitoring. We will validate our device by analysing samples deriving from patients in South Africa and Malawi. We will perform validation studies in a small pilot study with the Africa Health Research Institute (AHRI), located in KwaZulu-Natal, a rural region of South Africa that hosts the epicentre of TB and HIV endemics. This Plus Award will directly support and feed into the main goals of the "i-sense2" Interdisciplinary Research Centre (IRC), which aims to exploit research strategies to design and promote smartphone-based biosensing technologies within resource-constrained settings, for (re)emerging infectious diseases, influenza-like illnesses, sexually transmitted infections and antimicrobial resistance.
