Point-of-care EVD diagnostic testing for Ebola treatment centres

Grant awarded: £509,646

Lead organisation: Institut Pasteur de Dakar

Partnering organisations: University of Stirling, Robert Koch Institute, German Primate Center, FP6 framework, GIZ Twist Dx

Project length: Dec-14 to Dec-15

Study locations: Senegal & Guinea

Principal Investigator: Dr Amadou A. Sall

Purpose:

Real‐time RT‐PCR is currently used as the standard method for Ebola virus (EBOV) molecular diagnosis but has some limitations in terms of cost, equipment, and turnaround time. In contrast, isothermal recombinase polymerase amplification (RPA) is six times faster than RT- PCR while yielding the same analytical sensitivity and specificity. In addition, the RPA assay uses smaller equipment and reagents which are cold chain independent, making rapid on-site testing feasible and affordable. This project will investigate the use of RPA for EBOV point-of-care detection in Guinea treatment centres.

Expected outcomes:

This project aims to optimise and evaluate RPA assay methods for EBOV testing and will focus on operationalising the use of RPA from the laboratory to the field. The aim is to develop a 15 minute portable diagnostics test for use in Ebola treatment centres. This solar-powered mobile suitcase laboratory will improve early detection of confirmed Ebola cases, while supporting patient management and clinical trials, potentially reducing transmission and mortality due to EVD.

Progress and outcomes achieved:

Two lab-in-suitcases have been piloted, assembled and deployed to Guinea with trained ETC (Ebola Treatment Centre) teams. They have been testing after death initially, using saliva, with good correlation to full lab testing, taking just 6-10 minutes. This has relived the distress of awaiting Ebola confirmation before burial when this takes 2-3 days. Blood sampling at earlier stages of the virus is still in testing process. Sensitivity is proving good, down to 10 copies of the virus, the same as full lab testing. Optimisation is 90% complete

They have completed the first 6 months milestones already so will aim for an early interim report.

R2HC Funding for Ebola Projects.  A Rapid Response

 In August 2014, the Ebola Outbreak in West Africa was declared an International Health Emergency by WHO and within a couple of weeks ELRHA launched a rapid-response call for research to combat the crisis.  The UK Department for International Development (DFID), the Wellcome Trust and ELRHA opened a special funding window through the Research for Health in Humanitarian Crises (R2HC) programme.

 The aim of this emergency call was both to produce robust research findings that could contribute to the effectiveness of the response to the current outbreak and help to draw lessons for future outbreaks of Ebola and other communicable diseases. The projects funded will strengthen the evidence base for the Ebola response in topics ranging from diagnostics to anthropology, surveillance and disease control.

Elrha is hosted by Save the Children, a registered charity in England and Wales (213890) and Scotland (SC039570).

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