Grant awarded: £629,655
Lead organisation: University of Westminster, London
Partnering organisations: US Army Medical Research Institute of Infectious Diseases; Kwame Nkrumah University of Science and Technology; Public Health England
Project length: Nov-14 to Nov-15
Study locations: London & Ghana
Principal Investigator: Dr Sterghios A. Moschos FRSC MSB, University of Westminster
Symptomatic patients arriving at Ebola treatment centres in West Africa are triaged by a combination of reviewing their symptoms, assessing Ebola epidemiology in their community, and confirming infection through molecular diagnosis. Beyond acute high fever, symptoms that raise suspicion of Ebola Virus Disease (EVD) include vomiting, diarrhoea and uncontrolled haemorrhage. Importantly, these coincide with high levels of viremia and contagiousness through contact with bodily fluids, and are also symptomatic of other diseases prevalent in West Africa, such as malaria.
It is thus necessary to quickly identify and isolate EVD patients to prevent further transmission. However, until that crucial negative molecular result is returned, patients that might be Ebola-free are cared for side-by-side with confirmed positive cases, at risk of acquiring the disease and death. Minimising the time to molecular diagnosis would therefore greatly improve the chances of controlling the current and future Ebola outbreaks.
The project will deliver EbolaCheck, a point-of-need diagnostic device suitable for simple, rapid and safe patient triage at treatment centres anywhere in West Africa. This approach is based on a combination of a validated, proprietary technology for rapid, direct polymerase chain reaction (PCR) on whole blood samples [ExSyte (EBVK8), based on WO2011157989] and the standard of care RTKPCR laboratory diagnostic assays used worldwide to confirm Ebola infection. This project aims to enhance patient triage and improve healthcare worker safety by deploying a rapid (<40 min) diagnostic device based on these laboratory assays.
Progress and outcomes achieved:
The research team will deploy into Makeni (Sierra Leone) in April, expediting the key objective of validation on the live virus, and a device prototype will be ready for viewing by late April. Testing so far indicates that EbolaCheck can detect very low levels of the Ebola virus (<103 viral particles per ml of blood) – this sensitivity is critical for testing in the early stages of the disease - as well as detecting high levels within 10 minutes. The reduced number of Ebola cases now requires contingency planning for field testing. However it is important to note that EbolaCheck will be useful not just for this and future Ebola outbreaks, but also for other diseases.
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.