NB Health Care

Wednesday
June 22
2016

Victoria Enwemadu

A Quick, Simple Malaria Test, and Why It Matters

Fyodor’s UMT provides results within 25 minutes

 

It’s the middle of the night. You develop a fever and don’t know why. You live in or are traveling in a malaria-endemic country. Is it malaria, Zika, even yellow fever – or, best of all, nothing? Would it be better if it were simply malaria? At least then you would know and could act quickly.

If you live in an endemic region this nightmare can easily turn to reality. It’s confusing and frightening. What if there were an easy test which would determine if it was malaria or even typhoid, a test without complicated instructions, a test that is simple to administer and doesn’t involve blood?

Until now, all malaria diagnostic tools have been invasive, requiring blood, some technical expertise and/or complicated instructions. The available options include blood rapid tests which require some level of technical skill, with results available within 15 minutes. Testing for malaria can also be done under a microscope to examine the blood smear of a patient on a microscope slide. This method is considered the gold standard for malaria diagnosis. However, it is highly dependent on the quality of the reagents, a well-calibrated microscope and a well-trained microscopist to accurately read the slides.

In contrast to complicated testing tools that require blood and expertise, Fyodor Biotechnologies’ core mission is to develop simple and noninvasive testing solutions to global diseases. Fyodor, where I am vice president of business development and global head of projects, has developed and commercially launched a new point-of-care diagnostic tool – the Urine Malaria Test (UMT) – that can help you or your health care practitioner easily assess whether or not your fever is due to malaria.

UMT-Diag

A test strip is placed in a test cup containing sample urine, and the results are available within 25 minutes. A display of two lines indicates a positive result for malaria; one line indicates a negative result. If it’s malaria you can make an informed treatment decision quickly. If it’s not malaria you save your resources and time by not presumptively treating for malaria, which is what is done in many cases. A negative test becomes a prompt for further investigation – is it stress, an infection, maybe a 24-hour bug?

What problems does a noninvasive, simple test for malaria solve? It can help curb the issues of inappropriate treatment, over-treatment, self-medication or presumptive treatment of malaria. Why subject patients to the possible side effects of anti-malaria drugs if they don’t need them? Why leave the actual cause of fever untreated? Why waste expensive drugs on someone who doesn’t have malaria? Why spend money on a drug you don’t really need?

Imagine a mother in a remote village in a malaria-endemic country. Her child has a fever. She is unsure if it is due to a respiratory infection, a stomach virus or the common malaria ailment. What choices does she have? Will she walk many miles to the nearest primary health care center with her baby on her back? Will the health facility have a lab or trained technicians to perform the required blood test? Will the health care worker assess the patient’s fever without testing and immediately initiate anti-malaria treatment?

What if this mother has the UMT in her home? Immediately she can collect the child’s urine sample and determine if the child has malaria. Within 24 hours she is able to begin treatment and ensure the well-being of her child. There’s no guesswork. If the test is positive, treat immediately; if it’s negative, investigate further.

In malaria-endemic countries, sad stories of people dying from malaria are a dime a dozen. But I often wonder how many of these deaths are actually due to malaria.

I was made aware of a friend’s relative in a developing country, who was being treated for “chronic malaria” for a month. I pondered, what exactly is chronic malaria that warranted presumptive treatment for a month or so? Eventually the family invited their beloved to the United States for further assessment. Upon evaluation, it was determined that the patient actually had prostate cancer. Sad to say, the patient died a month later.

How many previous symptoms had been ignored and assumed to be malaria? Could this life have been saved by a simple, inexpensive Urine Malaria Test? A son will not celebrate his graduation ceremony with his father, a daughter will be fatherless on her walk down the aisle on her wedding day. A wife will no longer have the second income of her husband to depend on. Can you really quantify the value of a life lost?

The classic symptom for malaria happens to be a fever. Guess what the classic symptom is for any foreign invader in the body? You guessed it. Fever. It’s your body’s response mechanism, your immune system at work doing what it is supposed to. These foreign objects can be viruses, bacteria, fungi or drugs, which can manifest as respiratory infection, influenza, typhoid or stomach virus. Cancers, autoimmune disorders and even teething can cause fevers, too. As a result, the issue of presumptive malaria treatment or malaria self-medication based on symptoms which are common to many ailments is problematic. It’s even more problematic considering that the incidence of malaria has decreased in many countries.

Curbing the overuse of anti-malaria drugs also reduces the threat of drug resistance. A once-effective anti-malaria drug, chloroquine, is essentially ineffective in many regions of the world due to overuse. For the average non-scientist, this may not seem critical. But for scientists, this is a real threat that warrants serious attention. Artemisinin combination therapy, an anti-malaria drug, saved the day by replacing chloroquine when widespread resistance made it ineffective. Ironically, artemisinin is now facing the same resistance phenomena.

An alarming Economist article, “When the drugs don’t work: How to combat the dangerous rise of antibiotic resistance,” chronicles the potential havoc of the rising resistance to antimicrobial agents and the need for coordinated efforts from multilateral agencies to combat this emerging issue. In Nigeria, one in every five children younger than 5 dies from malaria. Imagine a scenario where there was no effective malaria treatment option. The effect would be even more catastrophic, especially to the developing world. Access to a simple testing option like the UMT can curb this overuse of anti-malaria drugs.

The UMT retails for about $2 per test. As a new product, we would like the UMT to be available in many developing countries, especially in remote areas where access to health care is limited. We look to partner with organizations which can subsidize the product to further increase the reach and impact.

With the availability of the UMT, we can now elevate the conversation beyond malaria management, to fever management and the need for appropriate or differential fever diagnosis, in order to save lives.

So what does it mean to have a noninvasive, simple, rapid test for malaria? You tell me.

 

Victoria Enwemadu is vice president of business development and global head of projects at Fyodor Biotechnologies Inc.

Photos courtesy of Fyodor Biotechnologies Inc.

Homepage image of a malaria-infected red blood cell by NIAID via Flickr

 


 

Categories
Health Care
Tags
Base of the Pyramid, business development, global health, health care, malaria, social entrepreneurship