Using Mobile Technology For Disease Early-warning Systems
10 November 2017
The recent Ebola and Zika virus outbreaks have highlighted the pressing need for early warning systems to prevent the spread of infectious diseases. i-sense is a 5-year EPSRC-funded research programme, combining self-reported symptoms on the web with mobile phone-connected diagnostic tests for rapid detection of disease outbreaks. Following an initial focus on influenza, HIV and bacterial infections in the UK, the team has discovered the impact their technologies can have on HIV and Ebola in Africa.
Diagnosis and treatment of HIV/AIDS and Ebola in Africa
“We are just beginning to see the power of harnessing telecommunications for health” says Professor Rachel McKendry, Director of i-sense. “In the UK smart phones are ubiquitous and even where we work in South Africa, in excess of 96% of households have access to a mobile phone. Our research aims to harness the power of smartphones to detect the early onset of disease when symptoms first appear.”
A new collaboration on HIV with the Africa Centre for Population Health (South Africa) began when Prof Deenan Pillay, the Deputy Director at i-sense, moved to work there. Researchers from i-sense and the UCL Bartlett Centre for Advanced Spatial Analysis (CASA) created a digital dashboard that shows, in real-time, whether HIV-infected participants’ are linked to antiretroviral therapy services. The dashboard masks the location of individual participants on the map to safeguard their identity but still enables the identification of areas where further support is needed. Following a trial of 24,000 patients with the Africa Centre, the ideas are now being used to build the first online NHS HIV self-testing patient pathway, an example of ‘reverse innovation’.
The team have also repurposed their influenza technology to Ebola using paper microfluidic tests (similar to pregnancy tests) and a mobile phone app linked to a smartphone camera. This project was initiated by PhD student Polina Brangel in Prof Molly Stevens team at Imperial College London, and in collaboration with Prof Rachel McKendry’s team at UCL. A paper is currently being written up.
Building public trust in the technologies and having strong data security is vital. The team are working with computer scientists, behavioural scientists, ethicists and a wide range of potential users at the beginning of technology development to address these challenges.
These projects are at an early-stage but demonstrate the potential of the technologies to be rapidly adapted and transferred to combat new diseases anywhere in the world.
For the Director of i-sense, Prof Rachel McKendry, the project has had a lasting personal impact. Having never worked in global development before, her first trip to the Africa Centre was an eureka moment:
“I came back [from South Africa] inspired to focus my future research on global health needs. I stopped worrying about publishing Nature papers, and started thinking about how my research could be translated to deliver impact in some of the poorest countries in the world, who suffer the greatest burden from infectious diseases. [I saw how] being able to develop technologies that could improve the lives of wellbeing of people in developing countries would be personally rewarding. ”
Lessons, challenges and learning
Promoting transdisciplinary research The i-sense team is extremely interdisciplinary ranging from physicists to philosophers across five universities, industry, clinical and public health partners. To help the team ‘speak the same language’ and work well together they created an Education Alliance which regularly arranges lectures and workshops to grow the skills of their students and researchers. Prof McKendry is keen to see future dedicated ‘themed’ fellowships or Chairs that support these transdisciplinary approaches to tackle infectious diseases.
Cross country learning and partnerships The flexible funding from EPSRC was really important, enabling the team to deliver core projects, exploratory research and to build long term partnerships. This has enabled them to fund joint positions with the Africa Centre and they plan to create short-term Mobility Fellowships to build an international network of excellence. They hope to build on these partnerships to conduct more work on neglected tropical diseases.
Having the right blueprint The i-sense team includes Rosanna Peeling, from the London School for Hygiene and Tropical Medicine, who is creating a blueprint of what an ideal early warning technology would look like, to set the goalposts for the engineers and physical scientists. This is enabling the team to select or reject technologies much more rapidly.