Accurate and Inexpensive Point-of-Care Diagnosis
of Sickle Cell Anemia
Agency: Doris Duke Charitable Foundation
Collaborators: Rebecca Richards-Kortum (Rice), Russell Ware (Cincinnati Children’s Hospital)
The World Health Organization (WHO) recognizes sickle cell disease (SCD) as a significant health problem and recommends that countries in sub-Saharan Africa develop screening and treatment programs. Newborn screening programs are emerging in a few African countries, but the vast majority of affected children receive no testing, and they develop morbidity and mortality without the correct diagnosis.
Although affordable therapies are now available for SCD, these therapies cannot be implemented effectively in low-resource settings, because of a lack of tools to monitor for complications of therapy. Current techniques for detecting SCD include hemoglobin electrophoresis, isoelectric focusing, high performance liquid chromatography, and DNA analysis. Each requires collection of blood followed by analysis using specialized equipment. Transport issues, the need for electricity, and costs all limit the widespread use of these techniques to screen for SCD.
Our lab recently developed an accurate test to assess hemoglobin concentration at the point-of-care in low-resource settings. Leveraging advances in paper microfluidics and micro-fabricated optics, we reduced the cost of consumables required for each test from $1 to less than 1 penny without reducing accuracy.
Building on this work, we propose to create and validate an accurate, affordable lateral flow test for SCD that can be implemented in sub-Saharan Africa. We will also develop tools to monitor elements of the complete blood count, the most critical laboratory test to monitor therapy for children with SCD. The ability to diagnose SCD quickly and accurately and to safely monitor therapy would represent a substantial improvement in our diagnosis and management of this lethal disorder.