Africa and the world at large will soon be presented with QuantuMDx, which is a handheld DNA sequencer that will diagnose disease and identify drug resistance in under 20 minutes. Presently, most African countries do not have the equipment to conduct DNA tests and blood and other samples are sent to Europe, US and often Asia for examination and confirmation and the results take weeks and months. The same applies to diagnosis of diseases which are fraught with mysteries and doubtful results.
But with the new scientific product developed in the United Kingdom, the tests can be safely done in Africa and the results received within 20 minutes. Jonathan O’Halloran, chief scientific officer of QuantuMDx Group Ltd in the UK, says that Q-POC is due for commercialisation in 2016/17, the device will be rolled out to healthcare professionals initially and potentially the public after that. However, this will be a little way down the road.
“I think at this point it is important to differentiate our technology from other technologies that are claiming to perform disease detection using sequencing in the field. Our device takes raw, clinical samples, such as whole blood, swabs, tissue, etc, and provides a DNA sequence answer to a clinical question in a clinically actionable timeframe, 20 minutes.
“The device performs lysis, DNA extraction, PCR (because generally pathogens are found in low copy numbers and we need to use PCR to make lots of copies of DNA sequences so that we can effectively read them) and targeted sequencing, with no need for complex library preparation or a computer and electricity. No other technology out there presently, or in development, can get close to that. It is important to note that we do not perform whole genome sequencing, sequencing the entire genome of a pathogen is rather redundant. We answer clinical questions fast and while the patient waits,’’ he said in an interview conducted through the email after the National Women in Engineering Day held in the UK last month.
Speaking on how the device will be marketed, O’Halloran said: “We are marketing our device as a true solution to complex DNA diagnostics in the field, where ease of use, handheld and robust for portability, speed and battery operation are imperative. The device simply does what no other device can do and as such there is huge demand to work with us to take complex assays like drug resistance testing for TB or HIV to the patient. Our handheld laboratory will deliver a significant and positive impact on global health challenges and more importantly, to individuals.’’
He explained that after spending years in Africa observing the fight against disease and the emerging threat of drug resistance, he came up with the vision for a better diagnostic tool for both monitoring and preventing disease outbreak and spread.
“I began developing Q-POC™, an affordable complex molecular diagnostic and DNA sequencing device that could be used to test patients in the field, and provide comprehensive analyses enabling the clinician to prescribe the right drug at the right time and save millions of lives.
“I wanted the device to do so much more than diagnosing diseases. By networking our devices and creating a global network, called The Internet of Life, Q-POC™ will act as a Bio-API by interfacing the genetic code with binary code. Using this data we will then be able to identify natural and manmade bio-threats in real-time and mobilise resources to contain these threats before they spread and cause epidemics and pandemics.”
On how affordable the device will be to Africa nations, he said: “These health economic questions are of course critical in these resource limited settings. In many countries people pay out of pocket privately for their initial diagnosis and then enter into public funded treatment programmes. Tests run in community settings are usually unreliable and follow up clinical and more complex diagnosis is then recommended at centralised referral facilities. The patient then has to travel back and forth from these facilities a number of times to receive a diagnosis that enables them to enter into the treatment programme. Further expense to the patient and the public healthcare system occurs should the treatment fail due to drug resistance in the disease, or in a situation called ‘loss to follow-up’ which increases the prevalence of disease in the population due to increased transmission because the patient hasn’t received their diagnosis or treatment (an understandably situation when the central referral centre is hundreds of miles away from their home). So it is clear that costs are more complex than simply the affordability of the actual test to the patient and costs need to be thought of holistically within the context of a healthcare system.
“We have begun modelling entire healthcare systems in Africa (for TB) to better understand this. We believe that the diagnostic test is the gateway to the healthcare system to manage its resources better and positioning referral standard tests at the community level will actually cost less than what is presently done. This is because the patient won’t need to travel, there will be no loss to follow up and therefore disease transmission rates will drop and prevalence will drop because of it. Moreover, with using complex tests that can determine what treatment a patient goes on, we avoid wasting drugs that won’t work and can monitor the emergence of novel resistance mutations and pathogens, mobilising resources quickly to contain them.
“That said, we still believe in cost effectiveness and have, right from the start, had affordability as one of our main goals during the development of Q-POC™. By doing this we have ensured that quality molecular diagnostics can be accessed by every man, women and child on this planet. Our devices and tests will cost a fraction of those presently on the market and will readily be taken up by the healthcare programmes in all countries.’’
Speaking on how soon the device is expected to arrive in Africa, the scientist said: “I took our prototype to South Africa in May for a bit of a spin, however, we won’t be running trials there until next year. Africa will be one of the first places to benefit from the commercial release of Q-POC™, and we hope the device will reach Africa in 2016/17. Our first tests will be a revolutionary companion diagnostic test for TB that will diagnose a patient and determine the drug resistance status, so the treating doctor can stratify the patients into different treatments regimens.’’
In the same vein, Dr. Jennifer Hannant, senior Biosensor Research Scientist and a member of the team, explained that current molecular testing is long, expensive and extremely complex.
According to her, resource limited countries have been unable to benefit from the power of DNA analysis as they have simply been unable to invest in the necessary infrastructure and skills required to provide this service to its population.
“At QuantuMDx we are passionate about the fact that early diagnosis and effective treatment of disease can lead to prevention and cure if run alongside humanitarian programmes for training and education in new skills and infrastructure.
“This is why we have worked hard to ensure that our device, Q-POC™, is easy to use, affordable and quick. Ensuring patients receive precise results in the same visit reduces the risk of them infecting further individuals and ensures they receive the right treatment the first time,’’ she said.
Speaking on research grants, Hannant said: “The funding we receive comes from a range of sources and supports a number of our ongoing projects. The EU has funded our ongoing Nanomal project – the aim of which is to develop a test to detect malaria infection and drug resistance in under 20 minutes using Q-POC™. Q-POC™ itself has also been supported by funding from Private Investors and Newcastle University based in the UK.”
On future research programmes by Hannant and her team, she said: “Current tumour profiling, carried out in centralised laboratories, is expensive for many economies around the world and dangerously slow for patients with aggressive cancers. Results can take weeks or even months, which cause anxiety and distress for the patients and their loved ones. To ensure effective treatment we are developing Q-Cancer, the first fully integrated tumour profiler for the small histopathology laboratory. The low cost device will help histopathologists or laboratory technicians to rapidly and accurately perform multiplex genotyping of tumours, allowing the fast initiation of the patient’s treatment,’’
This invention will no doubt improve healthcare delivery in Africa and reduce millions of dollars spent annually on health tourism by Nigeria and the other African and less developed countries of the world.
Zebulon Agomuo
