Desiree LaBeaud & Seema Handu discussed Sustainable Global Health Initiatives for Children in the Developing World at bio2devicegroup.org on February 7, 2012.

Seema Handu, PhD, Managing Director of CGHI (Children’s Global Health Initiative, http://www.cghi.info/) shared the organization’s mission to address health issues identified by the UN with respect to children and maternal health.  Every year, 10.6 million children under the age of 5 die and many of these deaths could be prevented with better healthcare and nutrition.  CGHI only goes to a country when invited and collaborates with local in-country clinics to devise sustainable programs in clinical services, translational research, and capacity funding for infrastructure, medical supplies, and medicines.

Dr. Desiree LaBeaud is assistant scientist at CHORI (Children’s Hospital Oakland Research Institute, http://www.chori.org/) and a clinician at the Children’s Hospital in the Pediatric Infectious Diseases.  LaBeaud leads efforts in research, containment, and cure of arboviral infections and their long-term health consequences.  Arboviral infections are caused from arthropod or mosquito-borne viruses.  While previously these outbreaks were more contained to smaller geographical areas, they now spread easily and can lead quickly to major worldwide epidemics due to such influences of modern life, like urbanization, land reclamation, deforestation, military activities, war, natural calamities, climate change, and increased mobility.  Many of these infectious diseases are highly debilitating, often with long lasting effects.  For instance, Chikungunya causes fever and debilitating arthritis that can last for months and sometimes years.  Dengue is the #1 mosquito borne viral infection in the world and causes an illness of sudden onset with headaches, fever, sever joint and muscle pain and recovery takes several weeks.  Dr. LaBeaud specifically investigates Rift Valley fever virus in Kenya, with outbreaks causing debilitating diseases like hemorrhagic fever, retinitis, and encephalitis.  Many of these diseases are also accompanied by long lasting cognitive impairment, confusion, somatic problems, extreme fatigue, concentration problems, memory loss, and psychosis.

Currently there exist no vaccines for most of these mosquito borne diseases (with the exception of yellow fever), and there aren’t many treatment options until the virus runs its course.  But the sad part is that there aren’t many rapid, low cost diagnostic tools and there is often misclassification, while the virus continues to spread, when there is an epidemic.   Diagnostic tests are needed that are rapid, sensitive, specific, easy to use, portable, random access, cost effective, adaptable, multiplexed and can test many things, and are broad based so can test for etiologies that one may not necessarily be looking for.   Routinely used Elisa assays do not get real time info and have limited sensitivity and lack specificity.  DNA based panviral microarray or virochips are good for broad based diagnosis but are very expensive and analysis is labor intensive. Loopmediated iso-thermal amplification or LAMP is single tube assay for nucleic acid detection and is simple, cheap, and fast but is not broad based and one should be certain what one is looking for.  Wicking assays are point of care, rapid, can be easily adapted, are filed deployable, but are difficult to multiplex and not broad based.  Microfluidic devices are Point of Care tests that are rapid, flexible, portable, can have many different channels and very likely are the wave of the future.  In the end, better diagnosis will save children, said LaBeaud.  Besides, no longer can these diseases of the developing world be ignored, as they easily travel and there is always a fear of major worldwide outbreaks that can infect people and animals globally.