Several students have recently returned from South Africa, where they worked testing various technologies developed for maternal and neonatal healthcare.
As part of the Global Health program, students from various levels – undergrads as well as graduates – are working on developing appropriate technologies for new mothers and babies. Among the most important of these technologies are instruments designed to aid in kangaroo mother care, a process whereby premature infants are placed against the mother’s chest rather than in incubators.
“We’ve become pretty convinced that it’s the right way to do things,” said Matthew Glucksberg, professor of biomedical engineering at Northwestern’s McCormick School of Engineering. “Incubators are really pretty bad places for babies to be.”
Placing babies on the mother’s chest between the breasts ensures proper temperature regulation for the infant, since this area of the mother’s body automatically adjusts to the child’s needs. Though an ancient and very natural practice, kangaroo mother care does have its drawbacks.
“The problem, among others, is that this isn’t going to spread until there’s instrumentation,” Glucksberg said. In other words, there are problems the mother cannot administer to without the aid of technology.
Premature infants can stop breathing spontaneously, for instance. They need phototherapy for jaundice (the blue light helps bleach out bilirubin, a natural compound that results from the breakdown of blood and can make preemies look yellow). They need CPAP, or continuous positive airway pressure, to ensure proper breathing.
This is where project development comes in.
“We’ve been trying to build devices that essentially are a neonatal ICU all on the mother’s chest,” Glucksberg said.
The idea, he explained, is to bring the incubator to the mother and child, in bits and pieces. Since the mother’s chest is such a better place for the infant to be, administering to various needs – proper breathing, blue light, etc. – should happen without separation.
In response to this need, students have worked on testing various products – a blanket that provides blue light, a breathing apparatus that attaches to the infant’s mouth without producing sores.
As David Kelso explained in a recent video live from Capetown, these projects were designed by previous students and some are in the process of being seriously appraised for their viability and market-readiness.
The program, which has been ongoing for the last six years, encompasses other technologies as well.
“What we do really falls into three general areas,” Kelso said. These areas comprise issues of preventing transmission of HIV from mother to child, saving lives at birth and upskilling healthcare workers.
Kangaroo mother care falls into the second category, but the other two are very important in a country rife with poverty and HIV.
The professors and students who work on these projects hope eventually to pass the results off to people within the healthcare system there. By making sure the devices fit within already-used methods (like breastfeeding or kangaroo mother care), Northwestern’s contributions have a much greater chance of lasting impact.
“We end up building global capacity instead of just coming in and solving people’s problems for them,” said Michael Diamond, adjunct professor in McCormick’s biomedical engineering department.
Diamond, who has been instrumental to the development of student-driven global health efforts at Northwestern, said he believes strongly in the program’s emphasis on self-reliance.
“There is actually a philosophy behind all these initiatives,” he said.
Category: Child Health, Community Health, Global Health Initiative, Healthcare Industry, HIV/Aids, Infectious Diseases, Nutrition, Pediatrics, Product Development, Public Health, South Africa | Tags: David Kelso, instrumentation, kangaroo mother care, Matthew Glucksberg, premature infants, South Africa, technology | Comments (0)
Circumcision is the most effective and promising tool that currently exists to prevent the spread of heterosexually acquired HIV infection in developing countries, an international health consultant and medical researcher said at a global health lecture on campus Wednesday afternoon.
The lecture, entitled “The Cutting Edge of HIV Prevention in Africa,” was the first of the Global Health Lecture Series and was cosponsored by the School of Public Health, Feinberg School of Medicine, International Program Development, and the Center for Civic Engagement.
Though there are several prevention tools such as behavior modification programs to promote using condoms or abstaining from sex, “The only truly evidence-based strategy that we have is male circumcision,” said Robert Bailey, who is also a professor of epidemiology at the University of Illinois at Chicago, a research associate at the Field Museum and co-director of the Chicago Center for AIDS Research. Other methods of prevention either don’t have the research to showcase their efficacy or have been found unsuccessful, he said, and a vaccine will not likely be invented soon.
But with 34 million people worldwide infected with HIV and 68 percent of those in Sub-Saharan Africa, preventive measures must be taken immediately. 5,000 men are newly infected each day in Africa, a number that health care professionals must slow down, Bailey said to the audience of 30 students, professors and community members who gathered in the Program of African Studies building on campus to hear him speak.
“We cannot treat our way out of this epidemic,” he said. “But we must find ways to prevent it from spreading.
One of those ways is clear, he said: The simple, cost-effective surgery of circumcision has been clinically proven to be both consistent and powerful in preventing HIV. According to evidence from three randomized controlled trials undertaken in Kisumu, Kenya, Rakai District, Uganda and Orange Farm, South Africa, uncircumcised men are two and a half times more likely to contract the HIV virus than those who are circumcised. Plus, unlike daily pills or other therapies, “once you’re circumcised you’re circumcised for the rest of your life,” he said, which makes it a one-time, inexpensive treatment (it costs about $50) that has lasting benefits.
After seeing the striking results of the clinical trials, The World Health Organization and UNAID threw in their endorsement in 2007, recommending that male circumcision now be recognized as an important intervention to reduce the risk of HIV.
But surgery alone is not the solution and must be performed in conjunction with other preventative treatments, Bailey cautioned. He is currently leading efforts funded by the Bill and Melinda Gates Foundation and the U.S. Government to implement a comprehensive package of HIV prevention services that includes male circumcision along with other tools such as couples counseling and sexually transmitted infection diagnosis in western Kenya.
Not only is circumcision effective in preventing the spread of HIV, it is also helpful in reducing sexually transmitted infections, genital herpes, genital ulcers and cervical cancer in women, among other things. And through implementing this comprehensive circumcision program, health care professionals will also have the opportunity to reach out and educate men and women on HIV and improve the health care infrastructure in Africa.
Bailey and his team have already performed 140,000 circumcisions in Kenya during the last 14 months and hope to perform 900,000 over the next 10 years. “My goal since 1994 when I first got into this was to show that [circumcision] is effective and implement it,” he said. “And now it’s happening.”
For more information on the Global Health Lecture Series, please visit http://globalhealthportal.northwestern.edu/news-and-events/events-archive.
Category: General, HIV/Aids, Kenya, South Africa, Uganda | Tags: blog, Chicago Center for AIDS Research, Circumcision, HIV/Aids, Kenya, One Book One Northwestern, South Africa, Uganda, UNAID, University of Illinois at Chicago, WHO | Comments (0)
As part of NU@AHEAD’s Professional Development Brown Bag series on Thursday, July 1st, Kara Palamountain, Executive Director of the Global Health Initiative (GHI) at the Kellogg School of Management, gave an update on the progress the GHI group has made since it received a $4.9 million grant from the Bill & Melinda Gates foundation in 2006. GHI’s uses an interdisciplinary approach (GHI’s work spreads across various NU schools, including Kellogg, McCormick and Feinberg) to develop and distribute affordable diagnostic devices for infectious diseases to be used in low-resource countries all over the world. GHI initially receives proprietary intellectual properties donated from partner companies, such as Abbott or Invernes, while NU students and faculty then develop that IP into a usable product, test it, and in the end hope to return it to these companies for them to bring the product back to the market.
One of GHI’s products, a handheld portable Early Infant HIV Diagnosis Test (EID), has been developed by NU students and faculty and is currently ready for clinical testing. As is the case with many low-income countries, most births do not take place at healthcare facilities and thus HIV testing of infants is rare, if not non-existent. In Uganda for example, out of the 1.2 million births each year, 100,000 infants are exposed to HIV. Out of these 100,000 infants, an estimated 20,000 babies in fact end-up with an HIV-infection, with only approximately 0.007% of all infants actually getting tested for HIV. GHI has taken students to various low-resource countries, such as Botswana, Mozambique, Namibia, South Africa, Tanzania and Uganda for market research and market entry analysis.
During their market analysis, GHI researchers and developers have identified several problems, which are an intrinsic part of the lack of market structure. One of the problems is the inherent shortage of healthcare workers, especially technicians. Imagine a piece of equipment breaking in a lab in Durban, South Africa. The closest technician who would be able to fix this piece of equipment lives in Nairobi, while the next closest technician lives in Germany. GHI researchers, therefore, identified the need for portable, easy-to-use, rugged and accurate devices. Another problem researchers identified lies within the distribution of lab results. Researchers analyzed how long it takes for test results to be delivered to the patient. In Botswana for example, this could take between 2-16 weeks, in Mozambique at least 3 months, and in Namibia 1-4 weeks. The unpredictable timeframe of delivering tests to the patients results in a backlog of unclaimed results. Most patients can’t afford to return to clinics every week to check in on their test results. This is a major problem that needs to be solved to assure the delivery of lab results to the patient.
While there are many obstacles in bringing a product to an underdeveloped country, there are routes for the development and distribution of diagnostics products that will benefit global health. GHI researchers and developers are optimistic and are looking forward to see the first product clinically tested soon. More updates to follow!
Category: Botswana, Commercialization, Global Health Initiative, HIV/Aids, Infectious Diseases, Mozambique, Namibia, Product Development, South Africa, Tanzania, Uganda | Tags: Africa, Bill & Melinda Gates Foundation, blog, Botswana, GHI, Global Health Initiative, Kara Palamountain, Medical Device, Mozambique, Namibia, South Africa, Tanzania, Uganda | Comments (0)