Develop low cost medical devices to:
Monitor the severity of HIV infection occurring in adults
Resource limited settings have difficulty performing the needed medical follow up with patients diagnosed as HIV positive. The problem centers around the difficulty in maintaining contact with patients during the long turn around time associated with sending a patient sample to a central laboratory and waiting for results. Often the turn around time can be on the order of a couple of weeks provided the sample is not lost or damaged during transport. This problem can be alleviated if the clinics can perform the necessary diagnostic tests at the point-of-care (POC).
Understanding how severe the level of infection is for an HIV positive patient is vital to effective patient care. The viral load, as it is known, is used to determine whether anti-retroviral therapies are needed or whether to change therapies. In developed countries, this is accomplished using an amplified nucleotide assay (often involving polymerase chain reaction or PCR) to determine the viral load (i.e. the number of viruses per milliliter of blood). Such assays are suited to the central laboratory testing model because they require expensive equipment in a clean and temperature controlled environment. CIGHT is developing an inexpensive point of care viral load assay that provides the same quality of diagnostic testing found in a centralized laboratory but in a format compatible with resource limited settings.
Screen for HIV Infection in children less than 2 years old
Infants and children under the age of 2 years old present an unique problem related to diagnosing HIV. At the point-of-care, the rapid screening assays for HIV can only test for antibodies in the patients’ blood that react to HIV. A child under 2 years old can have HIV reactive antibodies in their blood but still be HIV negative. Antibodies from the child’s mother can be transmitted to the child while the child is in the womb via the placenta or through breast milk. Maternal antibodies can persist in these children for up to two years. Without a definitive HIV screening test, many HIV positive children go untreated at a time when they are highly vulnerable to HIV. As a result, there is significant child mortality in the first year of life due to HIV infection. The interference from maternal antibodies can be avoided by screening either for viral proteins (e.g. HIV p24 core antigen) or for viral nucleic acids (e.g. viral DNA or RNA). The core antigens or viral nucleic acids are specific to HIV and if present in a sample, the patient is considered HIV positive. CIGHT is developing rapid POC tests for both viral core antigen and viral nucleic acids to address this specific need.
Develop a low cost digital alternative to X-ray film
Radiological assessment and diagnosis is necessary for a variety of medical conditions ranging from physical trauma such as broken bones to pulmonary function and infections such as tuberculosis (TB). In the past there has been a concerted effort to place quality X-ray equipment in clinics that serve resource limited settings. However these efforts met with little success for two reasons. First, the cost of X-ray film and the chemicals/equipment needed to process exposed film proved to be cost prohibitive for sustained use. Second, the number of trained radiologists that can properly read and interpret X-ray results is very low for resource limited settings. CIGHT is developing a low cost digital alternative to X-ray film to address both of these problems. Digital capture of X-rays alleviates the need for film processing chemicals and equipment. More importantly, the X-ray images can be transmitted electronically to a facility with radiologists where they can be properly assessed.
