Aug 17, 2020

New saliva test can detect malaria before symptoms show

saliva test
malaria
early detection
rapid test
Leila Hawkins
3 min
New saliva test can detect malaria before symptoms show
It's the world's first saliva-based rapid diagnostic test for the disease...

A new startup company is aiming to eliminate malaria with a rapid, early detection test that can identify the virus in saliva. 

The SALVA! test works like blood-based malaria tests, with a test strip inside a plastic cassette, a little like a pregnancy test. The patient spits into a tube and the results are available within 5-20 minutes, without having to send the sample off to a lab. 

It’s an easy test to administer as there’s no need for needles, therefore it doesn’t require trained clinicians and eliminates the fear children and adults may have of injections. 

It can also detect the disease before symptoms appear which is crucial to treatment, as it can sometimes take up to two weeks for someone to show signs of the infection. 

The test is the brainchild of Dr Benji Pretorius and Dr Richard Schmidt, two practicing doctors in South Africa who co-founded ERADA Technology Alliance in 2018, to put the test into production. They developed the SALVA! kit in collaboration with the Dinglasan Malaria Laboratory and John Hopkins University.

So far sample trials have been carried out on 364 children in Cameroon and Zambia. From these trials the doctors were able to produce a prototype that can detect the parasite responsible for causing malaria. 

The test can also detect the proteins the parasite needs to survive. This would help the test remain effective long term as it will detect potential mutations of the virus. Further trials are currently on hold because of Covid-19. 

There are around 228 million cases of malaria around the world, according to the most recent figures from the WHO. An estimated 405,000 people died from the disease in 2018, and the health body has warned that almost half the world's population is at risk of contracting malaria. This warning is especially prescient now that most efforts are concentrated on controlling the Covid-19 pandemic. 

Dr Pretorius recently wrote a blog post urging that work to combat malaria doesn’t stop because of the pandemic. “2020 was heralded as the year the global community stepped up its fight to eradicate malaria once and for all” he wrote. “Slowing death rates and mortality, coupled with advancements in detection and research, painted an encouraging picture. Now Covid-19 threatens to derail the significant progress we have made.

“Malaria still takes the lives of 400 000 people each year. Halting prevention programmes in order to concentrate efforts on Covid-19 will see that number almost double in the worst-case scenario, with sub-Saharan Africa being the hardest hit. 

Additionally, many countries in the south of the country are approaching their rainy season, when we see the majority of malaria cases. All the components for a devastating spike in cases and mortality rates are aligning perilously close. Experts predict that, in the worst case scenario, we’ll see levels of cases and mortality rates last seen twenty years ago.

“It is imperative that the framework for malaria protection is in place and that it aligns with the latest Covid-19 guidance. This is not about choosing one disease to prevent over the other – it is about ensuring communities are prepared for both.”

Dr. Pretorius has specialised in treating malaria for most of his medical career. Recognising the harm it causes to education prospects as well as health, along with his own near-death experience from the disease, are what led him to co-founding ERADA. 

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Jun 15, 2021

 NHS trials test that predicts sepsis 3 days in advance 

sepsis
MachineLearning
clinicaltrial
blooddisorder
2 min
Queen Alexandra Hospital is trialling a new sepsis test by Presymptom Health that uses machine learning to detect the onset of the disease

A new test that can predict sepsis before the patient develops symptoms is being trialled at a National Health Service (NHS) hospital in the south of England. 

Clinicians at Portsmouth’s Queen Alexandra Hospital are leading medical trials of the blood test, which they hope will help them save thousands of lives a year. 

The test is being developed by government spin-out company Presymptom Health, but the research began over 10 years ago at the Defence Science and Technology Laboratory (Dstl). This included a study of 4,385 patients and more than 70,000 samples, the largest study of its kind at the time. 

From the samples taken, a clinical biobank and database were generated and then mined using machine learning to identify biomarker signatures that could predict the onset of sepsis. The researchers found they were able to provide an early warning of sepsis up to three days ahead of illness with an accuracy of up to 90%.

Unlike most other tests, Presymptom Health identifies the patient’s response to the disease as opposed to detecting the pathogen. This is an important differentiator, as sepsis occurs as a result of the patient's immune system’s overreaction to an infection or injury, which can then cause life-threatening organ dysfunction. 

Worldwide, an estimated 49 million people a year contract sepsis, while in the UK almost two million patients admitted to hospital each year are thought to be at risk of developing the condition. If Presymptom's test is effective, it could save billions of pounds globally and improve clinical outcomes for millions of sepsis patients.

The initial trials at Queen Alexandra Hospital will last 12 months, with two other sites planned to go live this summer. Up to 600 patients admitted to hospital with respiratory tract infections will be given the option to participate in the trial. The data collected will be independently assessed and used to refine and validate the test, which could be available for broader NHS use within two years. 

If successful, this test could also identify sepsis arising from other infections before symptoms appear, which could potentially include future waves of COVID-19 and other pandemics.

Dr Roman Lukaszewski, the lead Dstl scientist behind the innovation, said: “It is incredible to see this test, which we had originally begun to develop to help service personnel survive injury and infection on the front line, is now being used for the wider UK population, including those fighting COVID-19.”

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