SOUTH-SOUTH CASE STUDY
To tackle diseases in the developing world, the most important first step is diagnosis. Without effective diagnosis, it is difficult to go to the next steps of either treatment or cure. While much attention is given to the high costs involved in treating and curing ailments, screening for diagnosis is also expensive, especially if it involves lots of people. Anything that can reduce the cost of diagnosis will free up resources to expand the number of people who can be checked, and help eradicate contagious diseases.
One innovation is an inexpensive microscope that could allow diagnosing diseases such as malaria to be done on a much larger scale. Called the Foldscope (foldscope.com), it is made from paper, comes in a variety of bright colors and resembles the cardboard, three-dimensional cut-and-keep models regularly found in children’s books and magazines.
Foldscope’s designs are developed on a computer and then printed. Foldscopes are made from thick paper, glue, a switch, a battery and a light-emitting diode (LED) (http://en.wikipedia.org/wiki/Light-emitting_diode).
Inspired by the ancient Japanese paper-folding craft of Origami (http://en.wikipedia.org/wiki/Origami), Foldscope’s makers at the Prakash Lab at Stanford University (http://www.stanford.edu/~manup/) are trying to create “scientific tools that can scale up to match problems in global health and science education”, according to their website.
The Foldscope can be put together in less than 10 minutes (http://www.youtube.com/watch?v=rphTSmb-Ux4) using a pair of scissors, packing tape and tweezers.
Once assembled, a user places a standard glass microscope slide in the Foldscope, turns on the LED light and uses their thumbs to guide the lens to view the slide.
Each Foldscope can magnify up to 2000 times with a sub-micron resolution of 800 nm. The battery can last up to 50 hours on a single button-cell battery and requires no further external power. Its makers claim it can survive being stepped on or dropped from a three-storey building.
It can perform a wide variety of microscopy techniques.
Its makers hope to manufacture billions of Foldscopes a year by exploiting the cheapness of the material and the simplicity of construction.
A beta test called “Ten Thousand Microscopes” will enlist 10,000 people to test the Foldscope in the field. Participants will contribute to helping write a field manual for the Foldscope prior to mass manufacturing. The Foldscope costs just US $0.50 to make for the basic model and US $1 for a higher-magnification version.
Field tests are taking place in the United States, Uganda and India.
Foldscope is designed to be used where more sophisticated lab analysis is not possible or affordable. It can also be an educational tool to give students experience in hands-on microscopy, or build awareness in the general population of how infectious diseases are spread by unseen lifeforms.
Foldscope’s makers hope their creation will help diagnose common but devastating diseases including Plasmodium falciparum (malaria), Trypanosome cruzi (Chagas disease), Giradia lamblia (giardiasis), Leishmania donovani (leishmaniasis), Dirofilaria immitis (filariasis), Human Sickle Cell (sickle-cell anaemia), E. Coli and Bacillus and Pine strobilus.
The quantity of people that need to be checked for diseases is vast and means, in countries where incomes and resources are low, it just isn’t possible to undertake diagnostic services using conventional methods.
“There is definitely a huge gap between where we are and where we want to be,” Stanford School of Medicine Assistant Professor for Bioengineering Manu Prakash explained on the university’s website.
“When you do get it (malaria), there is this simple-minded thing ‘forget diagnostics, let’s just get that tablet’ – and that’s what happens in most of the world. But the problem is there is many different strains, there are many different medications, you could potentially make the problem even worse by not realizing that you have malaria. And at the same time, the people who get a severe case – they are not detected at all.
“What is that one thing that you could almost distribute for free that starts to match the specificity of what detection requires? For malaria, the standard is to be able to image, and sit on a microscope and essentially go through slides.
“What we found as a challenge, if you truly want to scale, you should be really testing more than a billion people every year: that’s a billion tests a year. Any platform that you can imagine needs to scale to those numbers to make an impact.
“One of these things that have been shown over and over again – if you can put (in place) an infrastructure to fight malaria that is scalable and sustainable, then you get retraction of malaria in different regions.”
1) World Health Organization: Facts on malaria from the WHO. Website: http://www.who.int/topics/malaria/en/
2) WHO: Ten Facts on Malaria: About 3.4 billion people – half of the world’s population – are at risk of malaria. In 2012, there were about 207 million malaria cases (with an uncertainty range of 135 million to 287 million) and an estimated 627,000 malaria deaths (with an uncertainty range of 473,000 to 789,000). Website: http://www.who.int/features/factfiles/malaria/en/
3) Instructables: How to build a US $10 stand to turn a smartphone into a digital microsope. Website: http://www.instructables.com/id/10-Smartphone-to-digital-microscope-conversion/
4) Microscope adapter app for smartphones: iPhone, Android, Blackberry or any Smartphone, with an attachment and an app, can be turned into a microscope. Website: http://internetmedicine.com/iphone-microscope/
5) Stanford University: Stanford University, located between San Francisco and San Jose in the heart of California’s Silicon Valley, is one of the world’s leading teaching and research universities. Website: stanford.edu
6) MaRS: Located in Toronto, Canada, MaRS is where science, technology and social entrepreneurs get the help they need. Where all kinds of people meet to spark new ideas. And where a global reputation for innovation is being earned, one success story at a time. Website: marsdd.com
7) Universal smartphone to microscope and telescope adapter/mount: The SkyLight is a universal smartphone-to-microscope adapter. Website: http://www.amazon.com/Universal-Smart-Microscope-Telescope-Adapter/dp/B00GF3Q3CK
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