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How bloodless test will reduce time in diagnosis of malaria

Tuesday July 17 2018
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Brian Gitta and Shafik Sekitto work on the malaria-testing kit. PHOTO | COURTESY OF JAMES OATWAY

By EVELYN LIRRI

As undergraduate students at Makerere University, Brian Gitta and his classmates regularly missed classes because of malaria.

Even when they went to a health facility, the diagnosis wasn’t always as fast as they had expected because malaria was sometimes misdiagnosed.

It was such experiences that made the group of six friends —four pursuing degrees in Computer Science, one studying Information Technology and another doing Electrical Engineering — to think of the idea of developing a low cost and reusable device that could be used to test for malaria instantly.

“We became determined to turn what was a health challenge for us into a solution,” said Brian Gitta, one of the innovators.

The device known as Matibabu, a name derived from the Swahili word “treatment,” is unique in many ways.

Unlike current testing methods that require a person’s blood to be drawn first and put under a microscope or through a rapid diagnostic test (RDT) to establish if they have the malaria parasite, Matibabu tests for malaria without drawing blood.

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Instead, the device is clipped onto the finger of a person and using light and magnetism, a red beam of light scans the finger to detect changes in colour, shape and concentration of the red blood cells — all of which are often affected when the malaria parasite is present in the body.

The result is then produced within a minute and sent to a mobile phone which is linked to the device. Another unique feature of the device is that it does not require specialised training for a person to operate it.

For these reasons, Mr Gitta and his team believe Matibabu is the answer to addressing late diagnosis of malaria in low-income settings like Uganda.

“Matibabu offers prompt, accurate diagnosis and reduces challenges of power blackouts, the need for trained personnel and time spent on diagnosis,” said Moris Atwine, a co-innovator of the device.

Matibabu won first place $29,000 at this year’s Africa Prize for Engineering Innovation — an award dedicated to engineering innovation on the continent, which was announced last month.

“It is a perfect example of how engineering can unlock development — in this case by improving healthcare. Matibabu is simply a game changer,” said Rebecca Enonchong, the Africa Prize judge while announcing the winners.

For the team behind Matibabu, innovations like these are important for countries such as Uganda and the continent at large as they struggle to address their high malaria burden.

Over the years, malaria has had a huge economic, health and social burden on Africa, with a 2018 report from the UN Children’s Fund-Unicef showing that the disease costs the continent 1.3 per cent of its GDP.

An estimated 216 million cases of malaria were registered in 2016 alone, according to the most recent data from the World Health Organisation (WHO).

These cases resulted in about 445,000 deaths, with sub Saharan Africa contributing at least 90 per cent of people who die of malaria globally.

Children under the age of five and pregnant women disproportionately carry the biggest burden of malaria deaths on the continent.

Caused by parasites that are transmitted to people through bites of infected female anopheles mosquitoes, malaria can also be easily prevented and cured with timely interventions.

Health experts say prompt diagnosis and treatment of malaria patients is the most cost effective way to ensure that mild cases of the disease do not become severe and lead to death.

Early diagnosis also helps to reduce the rate of transmission from one person to another through bites of infected mosquitoes.

Across sub Saharan Africa, there are several prevention interventions being promoted to reduce the burden of malaria, including the use of Long Lasting Insecticide Treated Nets, indoor residual spraying with insecticides and the use of preventive medicines.

However, coverage of some of these interventions is still low across the region.

According to WHO, in 2016, just about 54 per cent of people at risk of malaria in sub Saharan Africa were sleeping under a mosquito net — the primary method of prevention.

“This level of coverage represents a considerable increase since 2010 but is far from the goal of universal access,” WHO said in its 2017 state of Malaria report.
Uganda is one of the countries that have undertaken mass mosquito net distribution campaign aimed at ensuring universal access. Under the chase malaria campaign, so far 23 million nets have been distributed since 2009.

The target is to distribute at least 25 million nets — two nets per household by the end of 2018.

Health Minister, Dr Ruth Aceng said earlier this year at the launch of the mass net distribution campaign that mosquito nets are being promoted because they are considered low-cost intervention to prevent malaria and are user-friendly.

She said currently 95 per cent of households own a mosquito net compared to 47 per cent in 2009.

The first ever malaria vaccine is also currently being tested under a pilot programme in Kenya, Ghana and Malawi.

It is targeting children aged five to 17 months old. Experts say interventions such as a vaccine would have the potential to save thousands of lives in Africa and contribute in meeting the 2030 global targets of reducing case incidence and mortality rates by at least 90 per cent by 2030.

But to achieve this goal, WHO says a minimum global investment of $6.5billion will be required annually by 2020.

“The $2.7billion invested in 2016 represents less than half of that amount,” said WHO.

Just like Matibabu, there has been a number of promising innovations emerging from the continent — all aimed at finding a lasting solution to the malaria problem.

In 2013 for instance, two students from Burkina Faso and Burundi won the Global Social Venture Competition Award for developing a low cost mosquito repellant solution called Faso Soap.

Developed from natural herbal ingredients sourced from Burkina Faso, the solution can be added to locally manufactured soap, which when used can repel the malaria-causing mosquitoes.

In 2015, a Nigerian innovator also developed a urine malaria test, which uses a dipstick technology similar to the one used for a manual pregnancy test.

The dipstick is dipped in urine and within 20 minutes, it can give a diagnosis. The Matibabu team hopes to have the device on the market within the next two years. They hope to sell it to hospitals across the continent for between $100 and $200.

But this price will depend on a market survey they will undertake before the product hits the market.

For now, they are working with Mulago National Referral Hospital to test and validate the reliability of the device if used against the current microscopy and rapid diagnostic test methods among malaria patients.

“We want to obtain information that will be used to improve the device and eventually roll it out to the market,” said Mr Atwine.

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