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Issue The number of people with diabetes worldwide has risen from 108 million in 1980 to 422 million in 2014, with the global prevalence in adults having risen from 4.7% in 1980 to 8.5% in 2014. Diabetes prevalence has been rising more rapidly in low- and middle-income countries, and is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Regular glucose monitoring with blood glucose test strips is seen as an essential tool for diabetes management, but affordability and availability are a challenge for those in many countries, including India. In the Indian state of Tamil Nadu, one in three adults…weaving, which is usually done at home. As a pilot, pre-coated yarns were transported to Kanchipuram, Tamil Nadu, from Achira Labs in Bengaluru, Karnataka. Members of women's groups wove these pre-coated yarn kits on their home looms without any additional training. Dried reagent chemistry allows for storage at room temperature and improved shelf-life. Concurrently Achira…

Issue Measles and rubella are major contributors to childhood mortality and disability, representing a significant global economic and social cost. In keeping with the Measles and Rubella Initiative, the World Health Organization has developed a five-pronged strategic plan for the global elimination of these diseases by 2020. Surveillance tools capable of diagnosing infection and determining immunity coverage from vaccination are a key component for elimination, but…

…population is aging and the incidence of dementia is increasing, with an estimated 4.6 million new cases annually. In Bolivia, the response by various levels of government to the challenge of the growing number of patients with dementia has been minimal, with mental health services accessible to fewer than one percent of the population. Specialized care for patients with dementia is limited and, in communities, there is little capacity to cope with dementia cases, with ignorance and stigma leading to mistreatment and abandonment. Solution…

Issue Lack of access to adequate sanitation is a global problem, with nearly 40% of the world’s population living in unsanitary conditions. In humanitarian emergencies, the problem is further compounded by crowded and unhygienic conditions, and the spread of diarrheal diseases is one of the major contributors to the overall morbidity and mortality rates following…available (composting and biogas systems) are feasible in acute emergency contexts. Solution The overall objective of the project was to develop a portable and easy-to-operate treatment system for human waste, for deployment in emergency situations. The specific aim of this study was to test the performance of several aeration devices using venturi injectors and to…could be inferred that the venturi aeration system would be more cost-efficient than its conventional counterparts. Based on the encouraging initial results, a 200L pilot-scale system was designed and commissioned for proof-of-concept testing of the device. This system was tested with domestic wastewater over a range of loading rates and operational conditions. The most significant challenge encountered during this phase was establishing steady-state conditions following the system start-up, as time was needed for the active bacterial consortia to establish themselves and thrive. Under the conditions tested, steady-state was not achieved, suggesting the venturi aeration device…

Issue Tuberculosis (TB) causes millions of deaths annually, worldwide. In 2011, there were 8.7 million new TB cases and 1.4 million TB deaths. The current gold standard for diagnosis by cell culture is slow and may result in further progression; molecular diagnostic techniques are promising but not widely used. There is a need for a rapid and effective diagnostic tool that is suitable for use in low-income settings. Solution The project team proposed to develop a rapid, sensitive and specific diagnostic test (lipid antigen detection kit) for pulmonary and extra-pulmonary tuberculosis. The project involved a number of steps: ·         identification of sero-reactive lipid…

Issue Maternal mortality remains a major issue in Uganda, where many women still die during and following childbirth from severe bleeding, infection and obstructed labour. Similar to other marginalized and powerless communities, rural pregnant women in Uganda have lacked visibility and a meaningful voice in discussing how to address their own high rates of mortality.…healthcare, and to provide platforms to share their powerful stories with peers and policymakers. The approach was based on previous research showing that, while data are critical for presenting scientific facts, individual stories are more effective in changing the way people make decisions and in generating social action. This approach placed rural Ugandan women in…– are viable and desired messengers for antenatal care information, compared to the preferred but least scalable approach of in-person visits from a health professional. This finding supports the hypothesis that targeting hearts with powerful, relatable and personal stories, told by mothers through existing popular media channels, is a more effective, desired, cost-effective and scalable…health messages – group information sessions led by already overburdened health centre staff, foreign educators, and outdated posters taped to the walls. The current study was not designed to assess how effective Maama Story videos were in reducing maternal mortality, as this would have required a much longer and more complex evaluation. Information about the…

Issue Dengue is a major threat to public health in most tropical and subtropical countries, with an estimated 100 million infections annually. Despite intensive work, there is still no vaccine to provide protection against dengue infection, which is caused by one of four dengue virus serotypes. The development of a dengue vaccine has unique challenges…vaccine recipient to severe disease. Conventional virus-construction techniques can produce only a small number of virus mutants at a time and, with a small mutant pool available for analysis, the chance of finding target vaccine candidates is low. Solution The project team hoped to combine a novel virus-construction tool with existing high-throughput assays to effectively…in obtaining DENV mutants that were sensitized specifically toward the over-expression of STAT2 (and not of other anti- dengue genes). Several technical difficulties were encountered in setting up all the components used in the screening system, and in dealing with cost and resourcing issues. The project team was able to set up the reporter virus…

Issue Hypertension is a major health issue in Africa, with retention of salt and water for hereditary reasons being more common. Two particular causes of resistant hypertension are more common in the region: renal sodium channel mutations (variants of Liddle’s syndrome) and primary aldosteronism, due to bilateral adrenocortical hyperplasia. Current approaches to management of hypertension assume that all patients are the same, yet patients with mutations of the renal epithelial sodium channel account…eplerenone is not available).Solution This project tested the hypothesis that using individualized treatment based on the patient’s physiology (assessed by measuring plasma renin and aldosterone) would be superior to usual care. The project involved patients with resistant hypertension in three countries – Kenya, Nigeria and South Africa. A total of 101 patients with resistant hypertension…were treated with diuretics (amiloride where available) and amlodipine; those with high renin and high aldosterone were treated primarily with angiotensin receptor blockers, thiazide and amlodipine. Individualized therapy significantly improved blood pressure control. Systolic blood pressure was reduced to the target (<140 mmHg) in 75% of patients randomized to individualized therapy versus 25% of those randomized to…

According to the WHO, nearly 1.7 billion cases of diarrhoeal disease occur worldwide every year, illnesses that kill about 760,000 children under five years old. Other profound health consequences for children include physical and cognitive stunting, and severe malnutrition. Diagnostic tests are essential, but useless without properly collected specimens. The objective of this Botswana-based collaboration led by Dr. David Goldfarb was to design and evaluate a user-friendly flocked swab specimen collection system for the identification of enteric infections. This would have immediate impact in much of the world were diarrheal…undiagnosed.Using an inexpensive innovation in specimen collection, the Canadian-led team diagnosed previously unrecognized pathogens that had caused the severe diarrhoea of over one-third of children in a group of southern African hospitals. McMaster University researchers designed and tested in Botswana a specially-designed “flocked swab” for collecting samples from children admitted to hospitals with severe diarrhoeal…