Development of an Antenatal Screening

Kit

Katherine PasemanUnder supervision of: Sean Monagle, Maxim

Budyansky, & Kristy Peterson,

Impetus

Undergraduate CBID Program at Hopkins

Jhpiego

Problem

Each year 6.3 million pregnant women and infants die due to preventable complications of pregnancy

In developing countries 32% of women have no access to antenatal screening and when you look into the rural regions of these countries you will find this number to be as high as 80%.

Problem

Pre-eclampsia and eclampsia cause 576,000 deaths per year

Current methods for detection are dipsticks (20-30 cents/ dipstick)

Cheap treatments are available

The “Key Question”

Is there a way to improve the technology which already exists to detect Pre-eclampsia so that it is cheaper, more effective, and can be used as a platform to detect other diseases?

(like gestational diabetes, and UTIs, and most other diseases which can be detected by Dipsticks)

Quick Appendix

Pre-Eclampsia: High blood pressure Indicator: Protein

Gestational Diabetes: Diabetes during pregnancy

Indicator: Ketones

Urinary Tract Infection (UTI): Infection in urinary tract

Indicator: Nitrites

Current Progress

Patent Reading

Reagent Design Factors

Thermal and Light Stability

Moisture Resistance

Evaporation

Color Uniformity

Device Design

Paper

Pen vs. dropper vs. spray

Opaque vs. clear

Packaging

Ketones

Fats not glucose Ketosis

Two methods for detection acetoacetic acid β-Hydroxybutyric

Acetone (CH3)2CO

Acetoacetic acid CH3C(O)CH2CO2H

β-Hydroxybutyric acid C4H8O3

KetonesEfficacy Comparison

KetoneProblems

No specific concentration

Ketone decay

Nitrites

Not all UTIs caused by bacteria

NitritesColor Change due to Light

NitritesColor Change due to Light

NitritesEfficacy Comparison

NitriteProblems

Light exposure

Low threshold

Stunted Research

What I’ve Learned about Research

Ask questions, make observations

Expertise optional, enthusiasm required

Bibliography

Dr. Anthony Speroni, Urinalysis Results Interpretation, http://www.drsperoni.com/downloads/articles/Urinalysis_Results_Interpretation.pdf,

Jhpiego.org Wilson et. al, Denver Health Medical Center, (April 15, 2004), Laboratory

Diagnosis of Urinary Tract Infections in Adult Patients, Medical Microbiology, http://cid.oxfordjournals.org/content/38/8/1150.full.pdf

Lillian Mundt, MHS, (2013), Chemical Screening of Urine by Reagent Strip, MediaLab, http://www.medialabinc.net/spg506373/nitrite_test_sensitivity.aspx

Gary R. Skankey, MD, FACP, Infectious Disease, Las Vegas, NV, (no date), A Practical Guide to Diagnosis and Treatment of Infection in the Outpatient Setting Diagnosis and Treatment of Urinary Tract Infections, http://www.nevadapublichealthfoundation.org/userfiles/file/Physician%20Antibiotics%20Materials/Article-Diagnosis_and_Treatment_of_UTIs.pdf

Hiren P. Patel, Ohio State University, (2006), The Abnormal Urinalysis, Pediatric Clinics of North America, http://inovapeds.org/library/readings/Proteinuria/The%20Abnormal%20Urinanaylsis.pdf

American Diabetes Association, (January 2003) Tests of Glycemia in Diabetes, http://care.diabetesjournals.org/content/26/suppl_1/s106.full.pdf

Sacks et. al, Harvard Medical School, (3/02) Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus, Clinical

Chemistry, http://www.clinchem.org/content/48/3/436.full.pdf