Point-of-care telemedicine units for surveillance of infectious diseases

Nielsen, Karin

Abstract

Infectious diseases comprise the leading cause of morbidity and mortality in low to middle income countries. Malaria, tuberculosis, HIV disease and gastrointestinal illnesses pose 2/3 of the world population at risk. Investigators at UCLA from the Schools of Medicine, Public Health and Engineering (Karin Nielsen, MD, MPH;Risa Hoffman, MD, MPH;Yvonne Bryson, MD;Pamina Gorbach, MHS, DrPH;Roger Detels, MD, MPH;and Aydogan Ozcan, PhD) propose to train a new generation of scientists from these disciplines in the conduct of supervised problem-oriented multi-disciplinary global health research which implements innovative point of care technology for surveillance, diagnosis and treatment of infectious diseases in resource-limited settings. MD;Pamina Gorbach, MHS, DrPH;Roger Detels, MD, MPH;and Aydogan Ozcan, PhD) propose to The proposal evaluates a new methodology for screening of cells or micro-organisms developed by Dr. Ozcan in the UCLA School of Engineering: Lenseless Ultra-iuide-field Cell monitoring Array platform based on Shadow imaging"""""""" (LUCAS). This technology incorporates the use of digital holography (lenseless microscopes which generate signature images from the shadow of cells) into portable handheld devices such as wireless phones, thus enabling highly sensitive and specific images of cells and micro-organisms to be beamed across the globe to computer software programs that can interpret such images based on specific holographic diffraction properties. The LUCAS platform is applicable to diagnosis of malaria, tuberculosis, measurement of CD4 cells, performance of complete blood cell counts (CBC) and surveillance of water supplies for bacterial pathogens, among others. During the award period, 6 postdoctoral students enrolled in established UCLA postdoctoral training programs with academic curricula in infectious diseases, epidemiology or engineering will be mentored in global health projects by a multidisciplinary core faculty expert team. Scholars in engineering will have mentored projects fine- tuning the lens free holographic imaging platforms for infectious disease projects worldwide including evaluation of new device prototypes and further validation of the methodology against a wide array of pathogens. Infectious disease and epidemiology postdoctoral scholars will be mentored in projects evaluating malaria and tuberculosis surveillance and diagnosis comparing standard methodology and the LUCAS platform, as well as performance of the technology in CBC analysis, CD4 cell monitoring and evaluation of water supplies. Training programs will be multidisciplinary and interaction between scholars and mentors from the 3 schools will be emphasized in research projects. Research activities will be conducted within the 3 schools at UCLA and also at international sites with a strong history of successful collaboration with UCLA, including the UCLA Clinical Trials Units in Brazil (Conceicao/Tropical Institute), the UCLA clinic in Lilongwe, Malawi, and the Dream program in Mozambique.

Public Health Relevance

""""""""LUCAS"""""""" is highly innovative and can be used at extremely low cost by unskilled personnel for point-of-care testing of blood, urine, saliva, sputum or water by searching for unique holographic signatures of organisms. It can also perform cytometry with data transfer in seconds to remote computer software. Its telemedicine and rapid diagnosis capabilities are revolutionary for infectious diseases. This proposal allows training in innovative global health approaches and advancement of technology.