Female researchers from the Council for Scientific and Industrial Research (CSIR) are at the forefront of medical innovation, especially in improving the diagnostic process for patients throughout South Africa.
Dr Patience Mthunzi-Kufa, who leads the CSIR’s biophotonics research team, where optical light is used to study biological materials, is taking her work out of the lab and into the hands of the people. “We asked what we can do to make life easier for poor people and living in settings where getting diagnostics is not easy. From this point, we came up with an idea of making diagnostics readily available.”
Smartphones as diagnostic tools
Mthunzi-Kufa started by describing a cellphone as a tool to advance diagnostics.
“We’ve made cellphone-based diagnostics. It is a photonics space with novel software and hardware built on a phone. A patient can take any of their bodily fluids and put them on this phone to get an image of what the results look like. We’ve built an app that will send the results into a cloud, which will then diagnose and tell the patient what to do further,” said Mthunzi-Kufa.
Photonics refers to the science of light. In this instance, cellphone technology is concerned with transmitting light properties.
This particular device they have developed is multi-screening, which means that it can test for multiple diseases like HIV, TB, and COVID-19, as well as non-communicable diseases.
When Dr Mthunzi-Kufa, Dr Thwala, Dr Lugongolo & Dr Tjale talk about shedding light on disease they are not only referring to increasing their understanding. These women in the CSIR’s biophotonics team literally shine a light on disease: https://t.co/Pg8kQeIlgE #WomensMonth2022
— CSIR 🇿🇦 (@CSIR) August 31, 2022
From the lab to a phone
Mthunzi-Kufa continued to explain how the smartphone was designed. “We’ve miniaturised the lab from a big laboratory with equipment, water and everything to just a smartphone device. We are busy preparing it for commercialisation, and it should be ready in the coming few months.”
She added that another problem they identified was counterfeit medications in Africa. The concern is in the quality of this medication.
Substandard products
According to the World Health Organisation (WHO), one in 10 medical products in developing countries is substandard or falsified.
Mthunzi-Kufa noted: “This is a problem because patients are taking medication, but they’re not getting healed. In most African countries, when the medication comes into the country as an import, it doesn’t get quarantined and screened to check if there’s an active pharmaceutical ingredient in them. And this is what gets despatched”.
Researchers are currently building a tool using photonics to screen drugs at entry ports.
“As an example, we screened different types of Disprins. We just bought different Disprins off of the shelves and rescreened them. I can tell you exactly what the composition of the tablet is using this. We’ve tested the concept, and it works,” she said.
Access and affordability
In 2020, WHO reported that diabetes was the ninth among the top 10 killer diseases on a global scale. Breast cancer, meanwhile, is the leading cause of cancer mortality in women globally and the country. In SA, diabetes has surpassed HIV as the second highest killer in the country.
Senior researcher, Dr Bathabile Ramalapa, referred to the above statistics to describe the burden of these diseases. She said that the two major reasons people are not on medication or treatment for these diseases are because of challenges of access and affordability.
“In SA, you get patient compliance of less than 50% on insulin, which is the most successful diabetes treatment. There is a very high risk of amputation due to wound infection because we also see a lot of bacterial infection,” said Ramalapa.
She explained that we have people who will get even the slightest infection when they have diabetes, which can lead to amputation because they can’t find any cure for that infection.
Breast cancer challenges
Ramalapa continued: “If you look at the statistics for breast cancer, the three-year survival rate in SA is just 50%, as opposed to 90% in high-income countries. We are disadvantaged, and affordability is one of our major challenges.”
Cancer treatment is also known to be expensive and not easily accessible. Ramalapa said that the average cost of breast cancer treatment per patient is R60 000 yearly in both the private and public sectors.
Ramalapa noted that some patients decide not to take chemotherapy as a treatment option because it is not an easy route to recovery. The severe side effects can leave the body feeling very sick. These include nausea, vomiting, hair loss, and extreme fatigue.
Low patient compliance
Ramalapa described the difficulties in storing medication for patients who are living with diabetes,
“The insulin administration mode is that it’s an injectable, and you must take it daily. For some patients, it’s twice or three times a day. Some patients don’t even know how to use injections but are given the insulin to take home and inject themselves,” she added.
Ramalapa added that one of the other challenges that underserved communities face is the “cold chain logistics” of these two treatments. This refers to refrigerated production, storage, and distribution activities of goods sensitive to temperature, like medication.
“Insulin and Trastuzumab, the antibody for breast cancer treatment, are biotherapies. And like the COVID-19 vaccine we were using, they require outer coating logistics to be transported and kept in the fridge,” said Ramalapa.
She further noted that patients, who use insulin, would have to take it home. It would have to be transported and kept in a suitable environment which is sometimes impossible because people don’t have a fridge.
Importing medication
Importing medication with low temperatures, where there is a lack of quality checks, will not be effective for people.
“So, we have been working on advanced drug delivery systems based on polymeric systems. This is for infectious diseases like TB, malaria and HIV. It’s mainly to enhance the drug efficacy through personalised medicine developed for Africans and shortening the dose and frequency of the medication,” she added.
Polymeric systems can be understood as a drug protective coating on a pill that works like a capsule. This protects the drug from environmental factors that may interact with it, such as sunlight and water.
Ramalapa emphasised that they aim to reduce the overall treatment costs to make it affordable for developing countries.
Managing bacterial infections
Researchers aim to better manage bacterial infections in diabetic patients to avoid amputation due to wound infections at all costs.
“Currently, when a person has a bacterial infection, they go to the doctor and receive antibiotics. Over the last few years, many people have become resistant to these antibiotics. Diabetic patients, especially, become resistant to antibiotics much faster,” she said.
Ramalapa explained that reasons for the bacteria to learn how to survive in the body, even with antibiotics, include patients not finishing the entire course of medication and taking the antibiotics when they are not supposed to.
“We are trying to develop materials that have the same properties as an antibiotic. The difference is that the body doesn’t develop resistance to this material as quickly as it would to antibiotics,” she explained.
By focusing on patient-centred experiences within innovative delivery systems, African patients can look forward to treatments becoming affordable and accessible. – Health-e News
