PhD Studentship: Development of a Low-Cost, Fast, Accurate and Sensitive Point-of-Care Diagnostic D

Tuberculosis (TB) is a deadly infectious disease, caused by bacteria called Mycobacterium tuberculosis. The disease infects a new person every second in the world. Each year, about 1% of the world’s population is infected and about 9 million people develop the disease, resulting in approximately 2 million deaths per year. According to the World Health Organisation (WHO), India is the country with the highest burden of TB, with an estimated incidence figure of near 2.79 million cases in 2016. Among western European nations, the UK has the second-high rate of TB, and this rate is 5 times higher than that in the US. NHS has committed £ 11.6 million to launch their program to make the UK a TB free country. The NHS TB control program defines some key areas of action – the top most is to improve access to services and ensuring early diagnosis. Also, ensuring comprehensive contact tracing and strengthening surveillance monitoring are among the top 10 highlighted focal areas. However, it is suggested that the actual total amount spent per year on TB including activities and services are highly underestimated. According to a survey this cost only in North Central and North West London exceeds £25 million a year.

Because of ineffective and insufficient infrastructure for TB screening for huge number of international arrivals every day, current influx due to changing global scenario and increasing TB cases in different sets of populations such as homeless households, the pathway to achieve the NHS objectives appears to be very unsmooth. With a persistent trend in numbers, and poor TB awareness in these highly susceptible populations, the chances of contact and catching the disease are expected to persist too, or even rise.

Moreover, the UK and other western countries have become the destination of new waves of migrants, especially from Arab and African countries, which further increased the difficulty in the control and management of TB. Increased frequency of the visits of the Arab residents in the UK (already residing in the UK) to the migrated relatives in the European countries may also result in spread of the disease, which cannot be screened immediately after their arrival, and can potentially have long term effects. Timely and accurate diagnosis of TB remains a great challenge globally. Currently, the conventional methods routinely used to diagnose TB such as smear microscopy and bacterial culture are complex, unreliable, technically challenging and time-consuming at point-of-care settings, and most of them are practically impossible to be carried out at the arrival ports.
The goal of this project is to contribute in reinforcing the implemented national and regional public health strategy in the effective management of tuberculosis among local populations and migrating people in the UK. Through this proposal, we aim to reduce susceptible and resistant tuberculosis transmission, morbidity, and mortality by enabling early TB screening and diagnosis. Thus, we at School of Engineering and School of Biosciences and Institute of Microbiology and Infection, UoB, will develop an accurate, rapid, easy-to-use and cost-effective point-of-care (POC) system for the diagnosis of tuberculosis and related Multi-Drug Resistant (TB-MDR) and hyper-virulent strains. The system concept is based on the use of a miniaturized, multiplexed real-time Isothermal Loop Mediated Isothermal Amplification reaction (multiplex RT-LAMP). The multiplex RT-LAMP assay will have several advantages that are relevant and attractive as a diagnostic platform for resource-poor settings: it is specific, highly sensitive, fast, allows a real-time amplification and it generates a result that can be directly detected by an automated phone camera and remotely transmitted to the clinical centers. The device will provide a portable diagnostic platform with globally tractability.

This project will also allow the University to conduct world leading biomedical research activities to counter the global challenge of TB and its spread. The project will enable future developments of accessible diagnostic devices for early diagnosis of TB (and relation conditions), improve patient care, deliver targeted treatment, decrease number of revisits to the clinic, and effectively reduce healthcare costs. The project findings will also impact emerging industries in point-of-care diagnostics market to grow the economy in this sector and create a positive social impact in improving healthcare systems.

Funding Notes

Global Challenges Scholarships Scheme