Meeting capacity-building and scaling-up challenges to sustainably prevent and control dengue in Machala, Ecuador:
This project aims to evaluate the effectiveness, cost and acceptability of an Eco-Bio-Social approach to controlling and preventing Dengue in Ecuador, in comparison to traditional insecticide-based control programs. Dengue is a neglected mosquito-borne viral disease, for which there is no vaccine. The Eco-Bio-Social approach includes a school-based anti-dengue education campaign, a safe water storage and clean patio community campaign and anti-dengue community workshops. Universidad Andina de Simon Bolivar will collaborate with UBC, BCCDC and the Universidad Tecnica de Machala to undertake this project funded by the WHO TDR Special Programme for Research on Diseases of Poverty. Kendra Foster, a UBC PhD student has received a 3 year Best & Banting graduate scholarship from the Canadian Institutes of Health Research to work on the project for her dissertation.
To enhance systems biology studies in the areas of host pathogen interactions and innate immunity, we developed InnateDB (www.innatebd.com), a open-source, publicly available database and systems biology analysis platform of the genes, proteins, interactions and signalling responses involved in the human & mouse innate immune responses.
InnateDB is becoming an important tool in immunology as evidenced by the >1,500,000 hits per year. While all known human and mouse pathways (>3,000) and molecular interactions (>115,000) are present, the emphasis on innate immunity has been achieved through our contextual review, curation and annotation of >12,000 molecular interactions and pathways involved in innate immunity.
We have demonstrated the usefulness of this tool in systems analyses of host responses to a variety of important pathogens including human clinical datasets: typhoid and malaria in Vietnam, non typhoidal Salmonella infections in AIDS patients in Malawi, helminth infections in children in Ecuador, and mouse models of Cerebral Malaria and M. tuberculosis.
Mapping Outcomes for Mothers (MOM):
MOM is a mobile health (mHealth) application for mapping and predicting community specific risk of pregnancy related illness and death: MOM is a mHealth application that uses geographic mapping methods to create an integrated picture of maternal health in the context of local social and physical environments. It is unique because it looks at pregnancy risk in 4 dimensions:
1) social environment
2) physical environment
3) health care system and
4) the woman’s individual characteristics.
The use of geo-spatial mapping is novel: this is the first time it is being used for identifying maternal health risk. By overlaying health with the local social and environmental contexts, MOM identifies the positive and negative influences and how they interact to create risk. It is a point of care diagnostic tool that aids real-time decision making by the frontline health worker. By breaking down a complex phenomenon into its root causes, MOM will ultimately put solutions in the hands of communities.
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Development of Fixed Drug Dosing Bands:
The purpose of this project is to simplify assessment and treatment decision making, as well as communication between health providers, thru the development of weight or proxy for weight bands. In Phase I the validity of drug dosing decisions based upon weight bands and proxies were tested and validated using existing data sets from Uganda and Bangladesh. In Phase II these bands will be color coded and tested for accuracy, validity and feasibility under more-or-less ideal conditions (efficacy) within both countries. In Phase III a similar exercise will be carried out, but under actual conditions (effectiveness) in rural health centres. Weight band proxies to be tested include age, height, and long bone measurements (tibia and ulna).
Low-Cost Malaria Diagnostic:
Accurate, sensitive, and cost-effective diagnostic tests are central to the global campaign to control and eradicate malaria. Inaccurate diagnosis not only results in patient mortality and morbidity, but also leads to ineffective use of treatment resources and could potentially accelerate the emergence of drug-resistant strains.
Malaria is caused by a protozoan parasite that invades human red blood cells. Currently, the gold standard detection method is the microscopic examination of Giemsa-stained blood smears to determine the density of infected red blood cells. This detection technique is sensitive and quantitative, but requires expertise and equipment often not available in low-resource regions. Rapid diagnostic tests based on immune-capture of antigens specific to the malaria parasite are a promising low-cost alternative. However, these tests are not as sensitive as microscopy, they do not provide a quantitative measure of parasite density, and they can produce a positive result even when parasites are no longer viable. We are developing a low-cost and portable device for detection of malaria infection that can quantitatively determine parasite density and discriminate viable and non-viable parasites. Such a device could be used to direct treatment until the clearance of all viable parasites, as well as to evaluate the effectiveness of new drugs and vaccines in clinical trials.
Eradicating Disease through Democratic Models of Public Engagement
In the case of dengue and malaria, we will be using basic social sciences tools to better understand key actors and networks in disease management and control, while mapping those networks. This allows us to define disease in line with the perspectives of affected communities and to therefore design socially inclusive and effective tools for prevention, management and eradication in Mexico and Central America.
Through a multidisciplinary approach, we engage different players and stakeholders in order to be able to develop more inclusive and effective health policies and programs that can be managed through low cost, devolution and participatory models. This is the backbone for the 3
projects described below.
- Plant Extracts as Malaria & Dengue Solutions: Working in a multidisciplinary team to develop natural extracts from indigenous plants to produce insect repellants and very low toxicity insecticides for developing communities.
- “Getting Rid of Disease” Board Game for kids in order to disease awareness and develop basic participatory strategies and tactics for disease
prevention and management in poor communities. The focus is malaria, dengue and HIV.
- Low Cost Cellular Phone Health Education models through a collaboration scheme with IT, design and visual arts students in Latin & North America, focusing on dengue, malaria, HIV.
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