Tuesday, November 13, 2018
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A Test To Save Children 

By Dr. Willis S. Akhwale*

Each year, countless numbers of children in Cameroon and across Africa are brought into clinics and hospitals with fevers. These children could be suffering from deadly diseases ranging from malaria to pneumonia to meningitis. Yet, it is incredibly difficult for doctors to identify the disease causing the fever without the right tools and equipment.

I’ve seen this problem since my early days as a medical student and intern at the Nakuru Provincial General Hospital in Kenya’s Rift Valley province. Because tests to diagnose children were scarce, we had to rely on our best guess to determine what was causing the fever. We oftentimes missed the actual diagnosis and could not provide the right treatment needed to save a child’s life.

Two decades later, doctors still don’t have the tests we need to quickly and accurately diagnose multiple diseases that cause fever. While there has been some progress with tests that diagnose malaria and HIV/AIDS, when these tests come back negative, we have few options to figure out what other illness the child has.

The result is that far too many children in Cameroon and other African countries continue to suffer unnecessarily each year due to the misdiagnosis of fever, which contributes to the deaths of 3 million children less than five years of age from malaria and pneumonia.

We should be far ahead of where we are. The first step to the right treatment is the right test.
Doctors and other health care workers desperately need a test that can quickly and accurately identify and distinguish between the fever-causing diseases. A novel device like this would be revolutionary. It would enable us to provide children with proper drugs, ensure we aren’t wasting resources on inappropriate treatments, and, in many cases, it could be the difference between life and death.

Now, an innovative organization is working to promote the development of such a test. BIO Ventures for Global Health (BVGH) has designed a competition that would award major cash prizes to companies that successfully develop this test. The prize competition, also called the Global Health Innovation Quotient Prize or IQ Prize, requires companies to design a test that is durable enough to work in settings that might not have electricity and clean water.

It would be low-cost, portable and simple to use;and would need to work just as well for a child at a hospital in Yaoundé as a child presenting in a rural clinic in Maroua- in the remote Extreme North Region. There are many reasons to be excited about a test that could reliably diagnose various causes of fever. Most notably, it could save up to 220,000 children’s lives each year in sub-Saharan Africa alone, and up to 350,000 lives worldwide.

This groundbreaking new test would also help doctors avoid giving the wrong medications to children. As a precaution, doctors and health workers often treat patients for malaria even when a child tests negative because of uncertainty around the test result. Doctors without access to diagnostic tests often prescribe antimalarials or antibiotics to children with fever, which I saw all too often when I headed Kenya’s National Malaria Control Program from 2006 to 2008.

Unfortunately, this means many children receive unhelpful and potentially harmful antimalarial and antibiotic drugs. This builds resistance to these medications, which makes the drugs less effective for future patients. This is a growing danger in Africa and around the world. A test that allows doctors and paramedics to accurately and quickly diagnose our children’s fevers is one potential solution.

To make this test a reality, doctors and parents alike need to raise awareness about the need for such tests. If and when this test becomes available, government health officials will have to find ways to train staff and integrate this test into their health systems and guarantee that treatments for the diseases are available once they are diagnosed.

It is critical that prospective donors and governments support financial incentives, like this prize competition, to develop lifesaving diagnostics. Fortunately, Barack Obama’s administration in the United States and other governments are increasingly looking at prizes to stimulate innovation. If this prize is successful, it could be a model for other prizes to develop lifesaving products needed in African countries for emerging and re-emerging infectious diseases.

Every child who suffers or dies because a doctor could not reliably detect the illness is one child too many and, at this age of technological advancement, quite regrettable. We must ensure that doctors have what they need to help protect our vulnerable children and save precious lives.

 *Dr. Willis Akhwale is a malariologist and is the head, Department of Disease Prevention and Control in Kenya’s Ministry of Public Health and Sanitation.

 

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