• Cancer
  • Top healthcare solutions in the Innovation Prize for Africa

    The African Innovation Foundation (AIF) has announced the top ten nominees for its landmark programme, the Innovation Prize for Africa (IPA). Now celebrating its fifth year under the theme Made in Africa, IPA offers a grand share prize of $150 000 to spur growth and prosperity in Africa through home-grown solutions, an article in IT-Online says.

    The IPA has seen considerable growth in applications and increasing interest from both innovators and innovation enablers over the years. IPA 2016 attracted a record of over 3,600 innovators and received 985 successful submissions from 46 African countries. African ingenuity this year showcases new breakthroughs in public health, including malaria, HIV/AIDS and cancer, smart solutions for farmers and dynamic energy initiatives. 

    AIF will host the IPA 2016: Made in Africa awards ceremony on 22 and 23 June 2016 in Gaborone, Botswana. Collaborating partners include the Ministry of Infrastructure, Science and Technology (MIST), and the Botswana Innovation Hub (BIH). 

    The healthcare solutions in the top 10 IPA 2016 nominees include:

    Urine Test for Malaria (UMT)

    Dr Eddy Agbo from Nigeria developed the UMT, a rapid non-blood diagnostic medical device that can diagnose malaria in less than 25 minutes. Africa has the highest number of malaria cases worldwide. The inability to quickly diagnose and commence malaria treatment can lead to various complications including kidney failure, build-up of lung fluid, aplastic anaemia and even death. UMT uses a dip-stick to get accurate results within half an hour. The technology detects malaria parasite proteins in urine of patients with fever due to malaria. UMT’is simple and affordable, and a potential game changer in managing malaria across Africa. 

    Api-Palu

    Valentin Agon from Benin also developed a solution to curb the spread of malaria. Api-Palu is an anti-malaria drug treatment developed out of natural plant extract. It is significantly cheaper than available anti-malarial drugs, and has great inhibitory effects on 3D7 strains of plasmodium falciparum the causative agent of malaria. According to the WHO, Sub-Saharan Africa is home to 88% of malaria cases and 90% of malaria deaths reported globally with some African governments spending up to 40% of their public health budgets on malaria treatment. Api-Palu manifests as a fast rate of malaria parasite clearance from the blood following short term treatment, with relatively lower doses. It is available in tablets, capsules or syrup. The drug has been approved in Benin, Burkina Faso, Tchad, and Central Africa Republic because of its therapeutic and non-toxic effects.

    Exatype

    Dr Imogen Wright, South Africa, solution addresses a different healthcare issue facing many African countries, HIV/AIDS. Exatype’s a software solution that enables healthcare workers to determine HIV positive patients’ responsiveness to Antiretroviral Drugs (ARV) drug treatment. According to WHO, 71% of people living with HIV/AIDS reside in Africa. 

    A growing number of people on ARVs are resistant to drug regimens, leading to treatment failure, further exacerbating the continent’s HIV/AIDS burden. Exatype processes the highly complex data produced by the advanced next generation of DNA sequencing of HIV DNA in patients’ blood. A simple report detects drugs resistant to patients, then highlights the need to avoid these to ensure successful treatment. Exatype has the potential to contribute towards effectively managing HIV/AIDS in Africa, and also holds promise in helping detect drug resistance for other disease burdens such as Tuberculosis (TB) and malaria.

    Aceso

    Dr Kit Vaughan, also from South Africa, created an imaging technology, capable of performing full-field digital mammography and automated breast ultrasound at the same time, dramatically improving breast cancer detection. Annually, there are more than half a million cancer deaths in Africa and these numbers are expected to double in the next three decades. If diagnosed early enough, the chances of treating the cancer successfully increases dramatically. However, because 40% of women have dense tissue, their cancers cannot be seen on X-ray. Furthermore, a false negative finding can have devastating consequences. Aceso is a single device that can acquire dual-modality images, full-field digital mammography and automated breast ultrasound at the same time. This world first system’s protected by international patents and has been successfully tested in two separate clinical trials with 120 women.

    Having four healthcare solutions emerging from the top ten Innovative solutions across the different sectors is very encouraging. All four address critical healthcare issues facing African health systems and have the potential to have a real impact and save lives across the continent.

  • Molecular scissors cut through a leukaemia barrier

    Layla was a healthy baby. Her story's that at after 14 weeks, she was diagnosed with Infant Acute Lymphoblastic Leukaemia (ALL) and admitted to the world-famous Great Ormond Street Hospital (GOSH). She had one of the most aggressive forms of the disease the GOSH’s doctors had seen. Chemotherapy was started without delay, then a bone marrow transplant (BMT) to replace her damaged blood cells. It didn’t work. A second round of treatment wasn’t an option. Neither was an experimental treatment at another hospital. Layla was a year old then.

    Profs Waseem Qasim and Paul Veys described Layla’s story at the Royal Society of Medicine’s 12th Innovation Summit in April. They were able to offer a very recent and experimental treatment only trialled in mice. Prof Qasim was developing the molecular scissores, and only one vial was available for Prof Veys to use. There were no guarantees. Layla’s parents agreed. GOSH’s ethics committee promptly agreed it was right to try it.

    Treatment used molecular scissors to edit genes and create designer immune cells programmed to seek and kill drug-resistant leukaemia. Leyla was given a small 1ml infusion of genetically engineered cells, Universal Chimeric Antigene Receptor T-cells (UCART19).

    It took a couple of minutes, followed by a five minute flush. She was bouncing around her cot during the process. Leyla’s now cancer-free, and doing well. The breakthrough from GOSH and UCL Institute of Child Health’s (ICH) pioneering research teams supported by the National Institute for Health Research (NIHR) Great Ormond Street Biomedical Research Centre.

    The doctors expected an immune response within a fortnight, usually a rash or a fever. A rash emerged after two weeks. It worsened, then, faded. A second child has now had successful molecular scissor treatment, and didn’t have a rash.

    When doctors were confident that Leyla’s leukaemia cells had been removed, she was given a bone marrow transplant to replace her entire blood and immune system which had been wiped out by the treatment. She returns to GOSH regularly to check that her bone marrow cells are healthy and blood counts continue to normalise.

    Molecular scissors works by adding new genes to healthy donor T-cells, arming them against leukaemia. Molecular tools, TALEN, act like accurate scissors to cut specific genes to make the T-cells behave in two ways. First, cells become invisible to a powerful leukaemia drug that usually kill them. Next, they’re reprogrammed to target and fight leukaemia cells.

  • Smartphones improve cervical cancer screening in Madagascar

    mHealth keeps expanding its potential. A study in Ambanja, a city in Madagascar, published in PLOS One, found that using smartphones for on-site diagnosis offer the same information as off-site diagnosis, and it takes much less time. 

    The team, mostly from Geneva University Hospitals, sought to test the use of smartphones to improve the screening technique of visual inspection of the cervix after applying 5% acetic acid (VIA). It’s a technique used widely in Low and Middle-Income Countries (LMIC). Women were recruited from a screening campaign, 332 in total. Each one completed a human papillomavirus (HPV) self-sample as a primary screen. PV is a group of viruses that affect skin and moist membranes lining bodies, so they can affect the cervix.

    Women testing positive for HPV went on to VIA followed by D-VIA, a cervical biopsy and endocervical curettage, a procedure where the mucous membrane of the cervical canal is scraped with a curette, a spoon-shaped instrument. The D-VIA was emailed to a tertiary care centre for immediate assessment. Results were either D-VIA normal or D-VIA abnormal, requiring immediate therapy or referral to a tertiary centre.

    About 41%, 137 women, were HPV-positive and recalled for VIA triage. About 69%, 95 women, complied. Cervical intraepithelial neoplasia, an indication of premalignant transformation and abnormal growth, was detected in digital images by 18% on-site and 22% off-site physicians. After adjusting for sensitivity, the team concluded that using smartphone images for off-site diagnosis of cervical intraepithelial neoplasia achieves a similar diagnostic performance to on-site diagnosis.

    While smartphone images can improve cervical cancer screening, the study didn’t extend to testing the efficiency of using smartphones in LMICs. While these results are awaited, it’s encouraging to confirm another valuable role for mHealth in Africa.

  • GENOMES and GENIE offer more hope for cancer patients

    Research into health matters is increasingly a global endeavour. Its scale and value’s illustrated by the American Association for Cancer Research (AACR) launch of AACR Project Genomics, Evidence, Neoplasia, Information, Exchange (GENIE). It’s an international collaborative and initiative that aims to now power clinical decision making and advance clinical and translational research. The project will aggregate participants’ clinical-grade sequencing data to improve patient treatment decisions and be a catalyst for clinical and translational research. 

    Phase one’s being conducted in partnership with seven global leaders in genomic sequencing for clinical utility and two informatics partners. The seven founding members of the consortium and phase 1 are:

    The Center for Personalized Cancer Treatment, Utrecht, Netherlands Dana-Farber Cancer Institute, Boston Institut Gustave Roussy, Villejuif, France Johns Hopkins University's Sidney Kimmel Comprehensive Cancer Center, Baltimore Memorial Sloan Kettering Cancer Center, New York Princess Margaret Cancer Centre, Toronto Vanderbilt-Ingram Cancer Center, Nashville, Tennessee. 

    The two informatics partners are:

    Sage Bionetworks, Seattle cBioPortal, New York.

    Charles L. Sawyers, MD, AACR is the chair of the Project GENIE Steering Committee. He says that despite an increase in the amount of genomic data available for analysis, “These data are typically insufficient in number or lack the necessary clinical outcomes data to be clinically meaningful. Thus, to effectively benefit patients, the genomic and clinical outcomes data from as many institutions as is practical should be combined through a data-sharing initiative, such as AACR Project GENIE.”

    GENIE will achieve its goals by pooling Clinical Laboratory Improvement Amendments (CLIA) and International Organization for Standardization (ISO)-certified sequencing data from the members’ institutions into a single registry and linking these data with selected longitudinal clinical outcomes. All project data will be made open-access following defined periods of project exclusivity, and the initial genomic data set will be publicly available on Nov. 6, 2016.

    There are already over 17,000 genomic records in GENIE’s registry, which is unique in that it’s enriched in late-stage cancers and contains only clinical-grade sequencing data used for clinical decisions. The number of genomic records in GENIE’s registry will continue to grow as new patients are seen at each institution are added. Each of the seven members can keep working how it sees fit, while simultaneously contributing its data to the project. This will ensure that future participants can easily be added after the pilot phase project is completed.

    The GENIE registry is a tool that can be used to solve many clinical and research challenges. There are numerous ways that it can benefit patients. They include:

    Validating gene signatures of drug response or prognosis Identifying new patient populations for previously US. Food and Drug Administration (FDA)-approved drugs Expanding patient populations that benefit from existing drugs Identifying new drug targets and biomarkers.

    It’s a project that Africa’s health systems should follow closely. They should also invest in the eHealth that enables them to participate and thrive from the benefits GENIE offers to patients and communities.

  • e-Driver algorithm can detect protein changes in genes

    DNA carries genetic information. It’s the chemical instructions that tell our cells what to do. When DNA’s damaged and cells mutate, it can cause cancer. Exploring and learning more about the relationships between genes and cancers are high-priority research activities. Many people want to know more about the genetic risks they’re facing. In 2005, Eduard Porta-Pardo and Adam Godzik from Sanford-Burnham Medical Research Institute, California, described their e-Driver algorithm in e-Driver: A novel method to identify protein regions driving cancer. It can analyse the effect of proteins on different parts of a gene they affect. It added to the approach that focuses on a gene as an entire entity.

    Porta-Pardo and Godzik are part of the team that used e-Driver to produce A Pan-Cancer Catalogue of Cancer Driver Protein Interaction Interfaces. It’s published by PLOS Computational Biology. It starts from the position that some ten years after their e-Driver paper, the role of mutations on Protein-Protein Interaction (PPI) interfaces as cancer drivers hasn’t been studied systematically. 

    The team included Luz Garcia-Alonso from the European Bioinformatics Institute in Cambridge, UK and Thomas Hrabe, Joaquin Dopazo from Computational Genomics Department, Centro de Investigación Príncipe Felipe (CIPF) in Valenica, Spain. They used e-Driver to analyse the mutation patterns of the PPI interfaces from 10,028 proteins in a pan-cancer cohort of 5,989 tumours from 23 projects of The Cancer Genome Atlas (TCGA) to find interfaces enriched in missense mutations which can inhibit a protein’s function. The result was 103 PPI interfaces enriched in somatic cancer mutations, with 32 of them found in proteins coded by known cancer driver genes. The other 71 interfaces are found in proteins that weren’t identified as cancer drivers even though in most cases there’s extensive literature, suggesting they play an important role in cancer. 

    The study shows that algorithms and the considerable skills and knowledge to develop and use them can have an enormous impact in advancing healthcare’s knowledge research. Africa’s health systems should find a place for these activities as part their eHealth strategies. While it may only be a small part to begin with, it’ll increase in scale and importance.

  • BreastIT pour combattre le cancer du sein en Ouganda

    Moris Atwine, étudiant en troisième année informatique à l'Université de Makerere avec deux autres étudiants, Alvin Kabwama, quatrième année en génie électrique et David Mwesigwa, troisième année en informatique ont développé une solution mHealth qui détecte le cancer du sein. Ils ont décidé de venir avec la technologie pour faciliter le diagnostic du cancer, surtout chez les personnes ayant des antécédents familiaux de la maladie. Cela survient après qu’Atwine ait perdu son propre grand-père au cancer du sein en 2012. Deux ans plus tard, BreastIT a été développé.

     

    La technologie est en train d’être testé actuellement aux essais cliniques à travers le pays selon un article paru dans allAfrica. Un essai est en cours à l'Institut du cancer d'Ouganda. La technologie a enregistré 55% d'efficacité et il y a un espoir d'atteindre au moins 70% d'ici la fin de l'année.

    L'équipe BreastIT travaille avec la commission communication d’Uganda à veiller à ce qu'ils répondent aux normes après avoir remporté une subvention de 5 000 $ cette année au « Annual Communication Innovation Awards (ACIA »), tenue à Kampala. "Nous avons gagné le prix TIC de la catégorie développement et nous prévoyons d'avoir des cabines de village où nous pouvons avoir de nombreuses personnes dépistées et testées pour le cancer du sein dans un court délai», dit Atwine.

    Les innovateurs travaillent avec l'Institut Ougandais de Recherche Industrielle (UIRI) à concevoir la technologie BreastIT en un produit de diagnostic médical final et amélioré.

    BreastIT est composé d’une application de téléphone mobile et le matériel qui joue le rôle de dépistage du cancer. Le matériel est un gant sur mesure. Il longe au-dessus de la poitrine pour détecter des masses ou des tumeurs. La technologie Bluetooth transmet ces images sur un téléphone mobile. "Après que les résultats sont prêts, ils peuvent être consultés et utilisés par un radiothérapeute ou un spécialiste du cancer pour déterminer la prochaine étape après les interprétations», d’après Atwine.

    Pour délivrer un diagnostic, les développeurs BreastIT veulent que la technologie aide à réduire le temps d’attente des résultats pour les patients et à réduire les coûts de transport encourus, tout en cherchant le traitement du cancer et les soins. En plus du dépistage, l'application fournit des illustrations visuelles sur la façon de procéder à son propre examen des seins et les informations sur les facteurs de risque du cancer et comment les éviter.

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    See article in english 

     

  • A web site screens for lung cancer

    In the USA, doctors recommend a screening test to find a disease early, when treatment may work better. The only recommended screening test for lung cancer is Low-Dose Computed Tomography (LDCT). Now, a web site might help to inform decision making. A before and after study by a team from Michigan, and reported in the American Journal of Preventive Medicine (AJPM) assess the efficacy of shouldiscreen, a web-based patient decision aid for lung cancer screening. It follows on from a study in 2014 and now in the US National Library of Medicine National Institutes of Health. 

    In the 2014 study, 60 participants navigated a web-based decision aid that provided information about LDCT lung cancer screening. An established prediction model set the decision aid computed baseline lung cancer risk for each person and their chances of benefiting from, and risk of being harmed by, screening. Measures included knowledge of lung cancer risk factors and lung cancer screening, decisional conflict, concordance, and acceptability of the decision aid. The 60 participants included current and former smokers, had no history of lung cancer, and had not received a chest CT scan in the previous year.

    Participants’ preference to screen and the US Preventive Services Task Force recommendation improved after seeing the decision aid. Risk perceptions among the 49 screen-ineligible group changed compared to the eleven who were eligible. Ninety-seven percent of the participants reported that the decision aid was likely useful for lung cancer screening decision making.

    shouldiscreen should help people considering lung cancer screening and healthcare professionals and health systems with lung cancer screening programmes. For African countries, it’s an example of using simple eHealth technology with sophisticated analytics to fight lung cancer. It may offer an efficient and effective way of meeting needs in overstretched health systems.

  • BreastIT to combat breast cancer in Uganda

    Moris Atwine, a third year Computer Science student at Makerere University together with two other students, Alvin Kabwama, a fourth year electric engineering student and David Mwesigwa, a third year computer science student have developed an mHealth solution that detects breast cancer. They decided to come up with the technology to ease cancer diagnosis, mostly in people with a family history of the disease. This comes after Atwine lost his own grandfather to breast cancer in 2012. Two years later BreastIT was developed.

     

    The technology’s currently being tested to clinical trials across the country says an article in allAfrica. One trial‘s underway at Uganda Cancer Institute. The technology has registered 55% efficacy and there are hopes of achieving at least 70% by the end of year.

    The BreastIT team is working with the Uganda Communications Commission to ensure that they meet the standards after winning a grant worth $5,000 at this years Annual Communication Innovation Awards (ACIA) held in Kampala. "We won the ICT for development category award and we are planning to have village booths where we can have very many people screened and tested for breast cancer in a short time," says Atwine.

    The innovators are working with the Uganda Industrial Research Institute to (UIRI) design the Breast IT technology into a final and improved medical diagnostic product.

    BreastIT‘s a mobile phone app and hardware which performs the cancer screening role. The hardware is a custom glove. It hovers over the breast to detect lumps or tumours. Bluetooth technology transmits these images to a mobile phone. "After the results are ready, they can be viewed and used by a radiotherapist or cancer specialist to determine the next move after interpreting them” says Atwine.

    For delivering diagnosis, the BreastIT developers want the technology to help reduce the time patients spend waiting for results and cut on transport costs incurred while seeking cancer treatment and care. In addition to screening, the app provides visual illustrations on how to conduct a self-breast examination and information on the risk factors for cancer and how to avoid them.