2013 Scale-Ups Fellow
A simple, low-cost, electricity-free typhoid & paratyphoid diagnostic system.
Pilot Market: Nepal
Partners: Patan Hospital, Nepal; Massachusetts General Hospital, Boston, Mass.
Meet Scale-Ups Fellow, Shawn Wen
Shawn graduated MIT in 2013, earning an SB in Brain and Cognitive Sciences with a concentration in Science, Technology and Society. An aspiring physician, Shawn has a particular interest in global health and the use of innovative, simple, low-cost technologies to improve patient outcomes in rural, resource-limited settings. Her background includes a wide range of experiences including lab research at Brigham and Women’s Hospital and University of California, San Francisco; user interface design and testing at MIT's Computer Science and Artificial Intelligence Laboratory and Mitsubishi Electrics Research Labs; health policy analysis at Ascension Health; and customer profiling and market research in New Delhi, India. Working on PortaTherm over the past year has been the perfect opportunity to combine her interests in global health, technology, and social impact.
The Issue: Tens of millions of rural patients in need of early, accurate typhoid and paratyphoid diagnostics
Typhoid and paratyphoid are major global health problems, with 27 million confirmed cases and over 200,000 deaths every year. The inability to maintain stable and reliable electricity supply in rural health facilities prohibits them from performing blood cultures, the current gold standard for typhoid and paratyphoid diagnosis.
In Nepal, typhoid and paratyphoid are the second leading cause of hospitalization and the fourth leading cause of outpatient morbidity. However, access to blood cultures is limited to the well-equipped private hospitals located in the urban areas. Over 86% of the total population, receives free, but inadequate health services from local health facilities sponsored by Nepal’s Ministry of Health and Population. None of the government-sponsored facilities has the reliable electricity, specialized microbiology equipment, and skilled personnel required for culture-confirmed diagnoses.The inability to perform point-of-care diagnosis has led to poor health outcomes, indiscriminate antibiotic use, and increasing drug resistance or reduced susceptibility. It has also made targeted, cost-effective vaccination strategies impossible to implement.
The Solution: A simple, low-cost, electricity-free typhoid and paratyphoid diagnostic system
By enabling safe and accurate typhoid and paratyphoid diagnostics, PortaTherm benefits all levels of the health value chain. It gives rural health workers a critically useful tool for knowing what to prescribe patients presenting with undifferentiated fevers. For patients it provides early and accurate typhoid and paratyphoid diagnostics resulting in appropriate treatment, better health outcomes, reduced mortalities, and reduced indiscriminate antibiotic use. From the government perspective, PortaTherm is valuable because it enables disease surveillance and identification of high-burden areas within countries, which can facilitate targeted, cost-effective typhoid vaccination and public health education campaigns.
PortaTherm leverages a low-cost, electricity-free incubator, invented by MIT D-Lab founder Amy Smith, and a simple-to-read, blood culture-based diagnostic test developed by Dr. Jason Andrews of Massachusetts General Hospital to diagnose typhoid and paratyphoid in patients with undifferentiated fevers. A clinical trial conducted June-October 2012 at Patan Hospital (Kathmandu, Nepal) demonstrated that this novel approach features 94.4% overall percent agreement with the gold standard method of blood cultures (publication in PLoS Neglected Tropical Diseases in press).