- Email: [email protected]
Without a drop of blood
Features Interview
Without a drop of blood Malaria is a daily threat for millions of people, one that inspired Brian Gitta to create a test that could change how we treat the disease on a global scale, as he tells Helen Thomson
A
9-YEAR-OLD child is locked between his mother’s legs, refusing to have the blood test that could save his life. That is a regular sight at Brian Gitta’s nearest clinic in Kampala, Uganda, where people wait for hours in long queues to learn if they have malaria, one of the leading causes of death in the country. Worldwide, 219 million people get malaria each year and 435,000 people die of the disease. More than 90 per cent of those deaths are in Africa, according to the World Health Organization. We can treat malaria, but accurate diagnosis is essential: the drugs targeting the mosquito-borne parasite that causes the disease can harm people who don’t have it. Diagnostic tests take time and, worse still, they are invasive. The most widely used method involves analysing a blood sample under a microscope, a process that can take up to an hour. Rapid diagnostic tests are becoming more widespread, but they
46 | New Scientist | 24 August 2019
still require people to give a blood sample. Gitta thought there must be an easier way and when he started studying at Makerere University in Uganda 2012, he set out to find it. Now he and his team are running a clinical trial for a portable, non-invasive device that uses light to identify malaria in the bloodstream in just 2 minutes. He hopes it won’t only save precious time for people with the disease, but also help us to track malaria around the world. Why did you take on such a huge problem? Growing up in Uganda, I went to a traditional primary school and got involved in a computer club. I was 9 years old and I was meant to be learning Microsoft Word, but also ended up playing games. I liked it so much, I kept wanting to come back and complete the next level. I eventually became head of the computing club at high school and then went on to study computer science at university. I was in my first year when I thought, “how can I use all of these software
developments and skills that I’ve learned to solve the problem of malaria?” Why focus on malaria and not another disease? Malaria is something that people where I live are fighting every day. My friends and I all experienced a lot of malaria growing up. How many times have you had it? I can’t even count how many times I had it as a child; at least once a year. It’s tough – you’re hospitalised, you’re throwing up, you’ve got a high temperature, you can’t eat. Is the situation still as bad? Things have improved: we’ve got better medication and free mosquito nets. But we haven’t seen much change in the diagnosis. I asked myself, “Why is it that people are still dying when we have the medication? Why are people still suffering, just to get a simple diagnostic test done?” When I first started looking into it, we didn’t really have an
understanding of how malaria affects the body. We needed to understand the mechanics of malaria, and we needed to understand a lot of things in microbiology and parasitology.
ALL PHOTOS: ROLEX/JOAN BARDELETTI
Tell us more about the problems with the current diagnostic tests. Doctors use a blood test and it takes time to get a diagnosis. People can be queuing for hours. It takes a skilled doctor to do the analysis and they can be sitting there all day staring down a microscope. I wanted to figure out how we can make that process easier, how we can take the patients’ pain away and how to do it quickly. It isn’t just the diagnosis: while people are queuing, they aren’t going to school, they aren’t going to work, they aren’t earning money.
“While people wait for a malaria diagnosis, they aren’t going to school, they aren’t going to work”
A prototype of the diagnostic tool that could help people get treatment more easily
What was your solution? We did lots of research and found that when a person is infected with malaria, the parasite that causes the disease changes the physical and chemical composition of their blood cells. It also creates a crystal-like structure in the bloodstream. Our solution uses the principles of light scattering and magnetism to map out the differences between malaria-infected and normal blood cells. We use this information together with a light beam that is shone onto the finger to detect whether malaria is in the blood or not. Did you have an “aha” moment when you figured it all out? Our device had to go through lots of iterations. The first few prototypes failed completely. There were lots of things that interfered with the light beam, like the temperature of the skin, which changes when you have a fever. There was never really an “aha” moment, more like constant research that gradually moved towards the solution. Once we got there, we started a company called Matibabu, which means “treatment” in Swahili. We are now starting a clinical trial and looking at improving consistency. We’re testing it on 500 people and then, if the outcomes are good, we will start a trial of 10,000 people, so that we can get verification before we roll it out. How expensive will your approach be compared with standard blood tests? We are still working out the costs, but our plan was always for it to be cheaper than a microscope. And in terms of value for the community and the time it takes to get a diagnosis, its worth is more than just the cost of the test itself.
Brian Gitta is co-founder with Joshua Businge Muleesi, Josiah Kavuma and Simon Lubambo of Matibabu, a Uganda-based company that aims to develop new technology to improve community health. He is a 2019 recipient of the Rolex Awards for Enterprise, which recognise entrepreneurs whose work addresses major global challenges
You have a bigger vision for how it can be used, though, right? Yes. The device also collects data in real time, and we can use this to look at the geographical distribution and evolution of malaria cases. This data is passed on to organisations involved in malaria control programmes. We’re also looking at letting pharmaceutical companies use the data so they can provide the right medications to the communities that need it most. Have you come across any unexpected challenges during development? When we did some test cases, a mother came in to have a diagnosis for her child who had a high fever. Her kid was malaria negative. The mother wasn’t convinced, so she went next door and had the blood drawn as well. This made us understand that we also have to change the way that people think about new technologies. You’re 27, but you have already created this potentially game-changing technology. What will you do next? I want to grow the company in order to close the gaps between communities and their rightful access to healthcare. I would like to build more technologies that offer better diagnoses. This definitely won’t be the last device we develop. ❚ Helen Thomson is a consultant for New Scientist and author of Unthinkable: An extraordinary journey through the world’s strangest brains 24 August 2019 | New Scientist | 47
Without a drop of blood Malaria is a daily threat for millions of people, one that inspired Brian Gitta to create a test that could change how we treat the disease on a global scale, as he tells Helen Thomson
A
9-YEAR-OLD child is locked between his mother’s legs, refusing to have the blood test that could save his life. That is a regular sight at Brian Gitta’s nearest clinic in Kampala, Uganda, where people wait for hours in long queues to learn if they have malaria, one of the leading causes of death in the country. Worldwide, 219 million people get malaria each year and 435,000 people die of the disease. More than 90 per cent of those deaths are in Africa, according to the World Health Organization. We can treat malaria, but accurate diagnosis is essential: the drugs targeting the mosquito-borne parasite that causes the disease can harm people who don’t have it. Diagnostic tests take time and, worse still, they are invasive. The most widely used method involves analysing a blood sample under a microscope, a process that can take up to an hour. Rapid diagnostic tests are becoming more widespread, but they
46 | New Scientist | 24 August 2019
still require people to give a blood sample. Gitta thought there must be an easier way and when he started studying at Makerere University in Uganda 2012, he set out to find it. Now he and his team are running a clinical trial for a portable, non-invasive device that uses light to identify malaria in the bloodstream in just 2 minutes. He hopes it won’t only save precious time for people with the disease, but also help us to track malaria around the world. Why did you take on such a huge problem? Growing up in Uganda, I went to a traditional primary school and got involved in a computer club. I was 9 years old and I was meant to be learning Microsoft Word, but also ended up playing games. I liked it so much, I kept wanting to come back and complete the next level. I eventually became head of the computing club at high school and then went on to study computer science at university. I was in my first year when I thought, “how can I use all of these software
developments and skills that I’ve learned to solve the problem of malaria?” Why focus on malaria and not another disease? Malaria is something that people where I live are fighting every day. My friends and I all experienced a lot of malaria growing up. How many times have you had it? I can’t even count how many times I had it as a child; at least once a year. It’s tough – you’re hospitalised, you’re throwing up, you’ve got a high temperature, you can’t eat. Is the situation still as bad? Things have improved: we’ve got better medication and free mosquito nets. But we haven’t seen much change in the diagnosis. I asked myself, “Why is it that people are still dying when we have the medication? Why are people still suffering, just to get a simple diagnostic test done?” When I first started looking into it, we didn’t really have an
understanding of how malaria affects the body. We needed to understand the mechanics of malaria, and we needed to understand a lot of things in microbiology and parasitology.
ALL PHOTOS: ROLEX/JOAN BARDELETTI
Tell us more about the problems with the current diagnostic tests. Doctors use a blood test and it takes time to get a diagnosis. People can be queuing for hours. It takes a skilled doctor to do the analysis and they can be sitting there all day staring down a microscope. I wanted to figure out how we can make that process easier, how we can take the patients’ pain away and how to do it quickly. It isn’t just the diagnosis: while people are queuing, they aren’t going to school, they aren’t going to work, they aren’t earning money.
“While people wait for a malaria diagnosis, they aren’t going to school, they aren’t going to work”
A prototype of the diagnostic tool that could help people get treatment more easily
What was your solution? We did lots of research and found that when a person is infected with malaria, the parasite that causes the disease changes the physical and chemical composition of their blood cells. It also creates a crystal-like structure in the bloodstream. Our solution uses the principles of light scattering and magnetism to map out the differences between malaria-infected and normal blood cells. We use this information together with a light beam that is shone onto the finger to detect whether malaria is in the blood or not. Did you have an “aha” moment when you figured it all out? Our device had to go through lots of iterations. The first few prototypes failed completely. There were lots of things that interfered with the light beam, like the temperature of the skin, which changes when you have a fever. There was never really an “aha” moment, more like constant research that gradually moved towards the solution. Once we got there, we started a company called Matibabu, which means “treatment” in Swahili. We are now starting a clinical trial and looking at improving consistency. We’re testing it on 500 people and then, if the outcomes are good, we will start a trial of 10,000 people, so that we can get verification before we roll it out. How expensive will your approach be compared with standard blood tests? We are still working out the costs, but our plan was always for it to be cheaper than a microscope. And in terms of value for the community and the time it takes to get a diagnosis, its worth is more than just the cost of the test itself.
Brian Gitta is co-founder with Joshua Businge Muleesi, Josiah Kavuma and Simon Lubambo of Matibabu, a Uganda-based company that aims to develop new technology to improve community health. He is a 2019 recipient of the Rolex Awards for Enterprise, which recognise entrepreneurs whose work addresses major global challenges
You have a bigger vision for how it can be used, though, right? Yes. The device also collects data in real time, and we can use this to look at the geographical distribution and evolution of malaria cases. This data is passed on to organisations involved in malaria control programmes. We’re also looking at letting pharmaceutical companies use the data so they can provide the right medications to the communities that need it most. Have you come across any unexpected challenges during development? When we did some test cases, a mother came in to have a diagnosis for her child who had a high fever. Her kid was malaria negative. The mother wasn’t convinced, so she went next door and had the blood drawn as well. This made us understand that we also have to change the way that people think about new technologies. You’re 27, but you have already created this potentially game-changing technology. What will you do next? I want to grow the company in order to close the gaps between communities and their rightful access to healthcare. I would like to build more technologies that offer better diagnoses. This definitely won’t be the last device we develop. ❚ Helen Thomson is a consultant for New Scientist and author of Unthinkable: An extraordinary journey through the world’s strangest brains 24 August 2019 | New Scientist | 47