Translational Diagnostics and Therapeutics

Diagnostic tests are essential to guide therapy of infectious diseases and to direct control and elimination programs. Although substantial progress has been made for the treatment of many tropical infectious diseases, the development of inexpensive point-of-care diagnostics is lagging behind. For many infections, the available diagnostics are not sufficient to inform physicians on how to adequately manage the patient or address the evolving needs of disease control and elimination. 

Our group develops and validates novel diagnostic tools from inexpensive point-of-care Rapid diagnostic tests (RDTs) to multi-disease diagnostic surveillance platforms with a focus on characterization of "undifferentiated febrile disease" pathogens. Ongoing projects include the Novel integrated infectious diseases diagnosis and surveillance system (NIIDS) project, where we have developed a urine-based biochemical triage test for assessment of disease severity and are developing a serological microarray test for multiple febrile diseases (Figure 1 below).  

Novel diagnostics to improve migrant and refugee health

Swiss TPH, the Armauer Hansen Research Institute (AHRI) and partners are developing a novel integrated infectious disease diagnosis and surveillance system (NIIDS) To support refugee and migrant health. NIIDS will assess THE health needs of migrants and refugees and establish a platform to support the diagnosis and management of clinically relevant infectious diseases in these vulnerable populations. This will subsequently serve as a ready-to-use diagnostic system for surveillance and disease severity assessment at the primary healthcare level. Read more 

Development of a new saliva-based rapid test to detect COVID-19

The DAVINCI project addresses the current urgent need for validated point-of-care (PoC) diagnostics for use at all levels of the population. We are developing and validating a simple, inexpensive and accurate rapid diagnostic test utilising the easily accessible, non-invasive saliva sample and addressing the urgent need to test at scale and determine the extent of seroprevalence and herd immunity in the population. The design of the home test to diagnose COVID-19 includes an application to digitally capture the test result to quickly collate diagnoses associated with a specific location. Read more

 

New diagnostic and treatment tools for Buruli ulcer

Buruli ulcer (BU) is a chronic, necrotizing skin disease that primarily affects children in West and Central Africa. Most infections occur in remote areas where patients have limited access to adequate medical care. ThE TOOLS4BU project aims to develop a simple diagnostic test and an effective treatment for BU that can be introduced at primary health care level. The overall goal is to prevent or at least minimise the prolonged suffering, stigma and permanent disability of affected children in African countries where Buruli ulcer is endemic. Read more

In the Urine Analysis Digital Dipstick (U-ADD) project, we are continuing the work on our urine sensor development. We are incorporating an additional two analytes (creatinine, and albumin) in the sensor and developing it further for the diagnosis of kidney diseases, which are a largely under appreciated common non-communicable diseases in low- and middle-income countries.
 

We work with partner groups both within Swiss TPH and at external institutes to develop RDTs for diseases of poverty. We have developed a saliva-based test for SARS-CoV-2 detection (completed in 2022) and have two further tests in the pipeline for development; an innovative non-invasive saliva-based influenza RDT and a fingerprick-based Dengue virus RDT, which will distinguish between the four serotypes.

Building on two long-standing tuberculosis (TB) and HIV patient cohorts in Tanzania and collective expertise by Swiss TPH, the University Hospital Basel (USB) and Ifakara Health Institute (IHI) in pathogen genomics, we have established an innovative integrated pathogen-sequencing platform for HIV-, TB-, antimicrobial resistance (AMR)-related issues, and zoonotic disease pathogen discovery. The platform has strengthened integrated care and diagnostics in Tanzania by providing sequence-guided patient treatment and disease surveillance. It has also created capacity for characterizing emerging pathogens and AMR.

Project overview

In the IDSP project we have built an innovative integrated diagnostics and sequencing platform for the characterization and surveillance of emerging and re-emerging pathogens and antimicrobial resistance development in Tanzania. The project has a strong regional capacity development component with network formation and training of local staff on clinically relevant expertise.
Leveraging excellent pre-existing infrastructure and long-standing productive partnerships, we have maximized synergies by establishing a pathogen-sequencing facility, which serves different clinics and research sites in rural and urban Tanzania. Building up networks of expertise within the country and providing training opportunities for young staff are a central feature of this project. Ultimately, this project aids in improving patient care in Tanzania, enabling the health system to respond more effectively to emerging and re-emerging pathogens and evolving drug resistance, and further promotes innovative science and capacity enhancement in the country.

Goal and research objectives

Building on two long-standing tuberculosis (TB) and HIV patient cohorts in Tanzania and collective expertise by the Swiss TPH, the University Hospital Basel (USB) and Ifakara Health Institute (IHI) in pathogen genomics, we have established an innovative integrated pathogen-sequencing platform for HIV-, tuberculosis (TB)- and antimicrobial resistance (AMR)-related issues, as well as pathogen discovery for emerging and reemerging zoonotic diseases. This platform has: 

• strengthened  integrated  care  and  diagnostics  in  Tanzania  by  providing  sequence-guided patient treatment and disease surveillance.
• established capacity for characterizing emerging pathogens and AMR;
• trained  diagnostic  personnel  in  molecular  diagnostics  and  pathogen  sequencing  for  AMR determination and improved patient management; and
• enhanced  collaboration  networks  within  Tanzania  to  build  representative  data  collections supporting  national  health  strategies  (i.e., National AIDS control Program (NACP),  National Tuberculosis and Leprosy Program (NTLP),  Ministry  of  Health  and  other research groups).

Key problems addressed 

• Currently, there are few facilities to detect and characterize emerging pathogens,
• AMR  is  a  highly  relevant  problem  in  the  management  of  HIV,  TB  and  malaria  patients globally,  but  currently  existing  capacity  and  infrastructure  in  Tanzania  do  not  allow  large-scale detection of AMR for these diseases.
• Detecting  transmission  hot-spots  is  crucial  for  the  control  and  surveillance  of  infectious diseases,  such  as  TB  and  HIV,  but  gene  sequencing  facilities  in  Tanzania  are scarce.
• There  is  a  significant  lack  of  teaching  and  training  facilities  in Tanzania  for  young medical staff  and  researchers  in  the  use  of  molecular  tools  for  routine  medical  work  and  clinical research.