Digital Innovations and Diagnostics for Infectious Diseases in Africa

Project Information

DI-DIDA

Grant agreement ID: 101057251

DOI

10.3030/101057251

EC signature date 17 August 2022

Start date 1 October 2022

End date 30 September 2027

Funded under

• Health

Total cost

€ 6 468 604,28

EU contribution

€ 6 468 604,28

Coordinated by

INNOTROPE SAS
France

Periodic Reporting for period 2 - DI-DIDA (Digital Innovations and Diagnostics for Infectious Diseases in Africa)

Reporting period: 2024-04-01 to 2025-09-30

Summary of the context and overall objectives of the project

Infectious diseases cause high mortality and morbidity in Africa. Co-infections exacerbate health outcomes. Additionally, zoonotic infections pose significant health challenges, especially in rural communities. Healthcare in rural and semi-urban sub-Saharan Africa is often delivered through vertical, disease-specific programs. Advances in diagnostics have improved lab-based nucleic acid tests, but these are costly and centralized. Point-of-care diagnostics, commonly using immunological testing, remain limited in accuracy and sensitivity.

Our goal is to combine the simplicity of lateral flow tests with the accuracy of nucleic acid assays using paper-based materials. By employing isothermal amplification, these tests will be sensitive, cost-effective, and suitable for low-resource settings. Integrating test outcomes with digital health tools can facilitate personalized medicine, even in remote areas. Utilizing the widespread mobile payment infrastructure, we propose a mobile health platform to deliver connected diagnostics.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

We have four technical and scientific work packages:
1- Research: we will conduct research on four topics:

• In Uganda: UVRI/MoH (VCD/HISP) will focus on the study about infectious diseases co-morbidities:
o Multiplexed sensors co-endemic malaria and schistosomiasis in blood
o Co-morbidities between malaria and one NCD (e.g. diabetes)
o Co-morbidities between mother and child, exploring infection during pregnancy and infant NCDs
o The role of schistosomiasis as a determinant in immune mediated disease, such as eczema and asthma.

• In Senegal (IPD/Diatropix): will focus on the multiplexing diagnostic tool technology and pilot manufacturing:
o Manufacturing multiplexed sensors – including reagent presentation and stabilisation
o Improving sensitivity – manufacturing better paper substrates
o Powering isothermal amplification in self-contained cassettes (see Figure 1).
o Sample preparation in an integrated cassette using blood, swabs or urine from human or veterinary sources.

• In Tanzania: study about human-livestock interactions:
o Human-Livestock transmission – design of febrile chips for co-morbidity studies
o Livestock multiplexes for Brucellosis, Q Fever and Leptospirosis
o Healthcare Technology Assessment – infectious disease interventions in livestock management.
o Infectious disease in children and the role of animal milk/cooking practice/sterilisation.

• In Kenya: focus on the digital solution implementation through a series of pilot studies:
o Data interfaces for infectious diseases from mobile phone to DHIS2/HISP
o Mobile Health – data collection, validation and assurance
o Mobile Health - Low energy trusted and secure information transmission
o Healthcare Technology Assessment – multiplex cost analysis

• In all countries: socio-economic factors of adoption of health innovations in sub-Saharan Africa.

2- Technology development: we will develop our innovative multiplexed low-cost diagnostic tool seconded by mobile phone reading capacities and two-way data exchange with centralised databases with AI capacities to return diagnostic results to patients.

3- Technology integration : we will work on integrating our new technology into existing African health data exchange infrastructure, especially DIH2

4- Education: we will train early-stage researchers and host 16 PhDs within our project

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

For period 1 report (months 01 to 18):

Objective 1
• The four research topics investigated are ongoing and planned to last until month 50. There are therefore not yet preliminary results to report, but the activities have started and are reported in section 1.2.1.
• Staff exchanges have started and are going on as planned. They allow research staff from both Africa and Europe to visit each other and work together on the four topics. They will continue until month 50.
• We were waiting until the PhD students have all started to plan our first training sessions. They will start in October 2024.
• The consortium has started attending international conferences.
• The consortium has applied to 3 EDCTP calls – results are awaiting. We have also four individual grants awarded to PIs in the consortium that complement greatly the Didida project.
• The work related to this objective will continue until month 60.

Objective 2
• GadX and UoG have successfully developed a “hourglass” device design and successfully tested it.
• UoG has developed the point-of-care sensors. First tests are conclusive but further work is required to enhance its sensitivity and specificity.
• UoG, UMoH and KEMRI are developing the digitalisation technology that allows capturing pictures of the diagnostic test and analysing the results through a secure cloud-based hosted AI technology. The first test results are very promising with high sensitivity and specificity. We are confident that we will achieve this technology.
• The same team has already developed a mobile phone app to facilitate image taking from users and communication with databases. Next steps consist in ensuring the app complies with all regulations.
• PharmAccess is working on automating image interpretation. This work is on-going.
• PharmAccess, KEMRI, and AIGHD have developed a dashboard to visualise multiple test results going through our technology. It has already been tested in Kisumu, Kenya.
• The work related to this objective will continue until month 35.

Objective 3
• Data-related ethical issues: an ethical deliverable was submitted accordingly.
• The work related to integrating the new technology intro digital health infrastructure in Africa will start once objective 2 is achieved in month 35.
• Healthcare economic review: a PhD student has started working on the issue.

Objective 4
• The work related to this objective has not started. It relies on having the technology developed to test it through clinical validation studies (starting date: month 30).

Objective 5
• All our PhD students (including the additional Hop-On one for Réunion Island University) have started between October 2023 and January 2024.
• We have organised meetings with all of them to allow them to know each other and to present their PhD projects.
• We have asked each PhD student to write a progress report after six months of PhD.
• This objective will last until month 60.

Objective 6
• We have an active online presence through our website or social media.
• We have a well-defined exploitation strategy, partly thanks to our participation in Horizon Booster.
• In period 2, we will start our series of events in Africa which are likely to have a significant communication impact.