Researchers have developed a small cartridge that can identify harmful microbes in a newborn or the mother. It is extremely easy to use and does not require much clinical microbiological expertise.
The health worker simply adds a sample from the baby, mother, or both, and waits ten to fifteen minutes for the result. This simple, cheap and rapid test gives health care professionals useful data so that they can decide quickly what treatments to recommend.
When a baby is born, they move from the protection of the womb to an environment with literally trillions of microscopic organisms.
Douglas Weibel, biochemistry professor at the University of Wisconsin-Madison, said "While that microbial environment in the gut is still developing, the introduction of one of many of the wrong kinds of bacteria may cause a severe immune response. In an infant, the immune system could just ravage the intestines."
In remote parts of Africa, the risk of the infant's immune system ravaging the intestines is even greater. The Bill & Melinda Gates Foundation awarded Wiebel and team a Grand Challenges Explorations grant to get a simple bacterial test out on the field; one that could detect necrotizing enterocolitis - a common and often fatal infection in Uganda, Rwanda and Kenya.
Weibel said "We get many of the beneficial microbes that take up residence in our bodies from our mothers at birth. But if there are pathogens that are transmitted from mother to baby as well, they can be identified and treated."
Treating those pathogens often means administering an antibiotic after the infant has developed vague symptoms. As the mother nears labor, she may be given antibiotics as a preventive measure - the problem is that the antibiotic itself causes the very problem it was designed to prevent.
Weibel said "An approach like that can indiscriminately destroy almost all of the bacteria in a baby's intestines - including the helpful types -leaving harmful bacteria the space and resources to flourish. And you're back where you don't want to be, working against a high mortality rate."
By knowing whether harmful bacteria are present before or after birth, antibiotic usage can be narrowed down to just those who really need it. However, verifying who the needy ones are has meant, until now, using complex and expensive genome sequencing equipment that only exists in well funded laboratories.
Wiebel's group configured the cartridge system and managed to keep the cost per unit below one dollar.
Wiebel said "Nate Cira, a really smart undergrad who worked in our lab, developed a small cartridge that we have adapted to carry almost everything needed to identify harmful microbes. It is extraordinarily simple. It doesn't require someone that has a lot of clinical microbiology expertise."
The team plans to adapt the technology so that it can be used with smartphones and the results may be processed and shared through a wireless connection. The analysis data could be shared with health care providers nearby and centers that monitor disease globally. Weibel said "The doctor gets information on the specific organism that could cause very serious health problems for a baby, and disease centers can use it for epidemiological research."
The Grand Challenges Explorations has funded over 80 projects, at $100,000 each for one year's research. They all have to option of then submitting their work for further funding, which may be up to $1 million.
Chris Wilson, director of the Global Health Discovery and Translational Sciences program at the Gates Foundation, said "Investments in innovative global health research are already paying off. We continue to be impressed by the novelty and innovative spirit of Grand Challenges Explorations projects and are enthusiastic about this exciting research. These investments hold real potential to yield new solutions to improve the health of millions of people in the developing world, and ensure that everyone has the chance to live a healthy, productive life."
Weibel will visit Uganda with James Ntambi, a fellow biochemistry professor, as well as a group of UW-Madison students. They will set up a lab where they can test the cartridges.