Even though malaria kills more than 600,000 people every year, it’s often difficult to tell who has got it. For a proper test, you need skilled health care workers and sensitive chemicals. Both are often difficult to obtain in hard-hit regions like sub-Saharan Africa.
Now John Lewandowski, a graduate student in mechanical engineering at the Massachusetts Institute of Technology, thinks he has the answer. He helped invent a battery-powered machine that uses magnets and lasers to identify malaria-infected blood, and cofounded a company, Disease Diagnostic Group (DDG), to develop it.
The small device, called the Rapid Assessment of Malaria (RAM), is portable and easy to use in the field; testers do not need specialized medical training. Each test can be done in about one minute, and cheaply — for about 25 cents. Importantly, it can also detect malarial infections in people who do not yet show symptoms of the disease.
“He could very inexpensively save a lot of lives,” said Elana Fine, managing director of the Dingman Center for Entrepreneurship
“This competition is looking for both an impactful idea but also a strong entrepreneur,” said Fine. “They really saw that in John.”
Lewandowski is working on a doctorate at MIT in mechanical engineering, with a special focus on designing machines that use electronics, rather than chemicals, to diagnose diseases. He founded DDG in Cleveland, where he earned his undergraduate degree at Case Western Reserve University. Lewandowski’s cofounder and former faculty adviser, Brian T. Grimberg, is an assistant professor of international health at the university’s medical school, and a specialist in malaria.
Both Lewandowski and Grimberg realized the world needed a better way to diagnose malaria. Today, it is often done by eyeball. In one method, a medical worker takes a blood sample, and adds a chemical to make the malaria parasite easier to see. The sample then goes under a microscope, and the worker counts the number of parasites.
“That takes about an hour,” said Lewandowski, “and it’s highly dependent on the skill of the clinician, the quality of the microscope.”
In poor countries, where workers often have limited training and poor equipment, “it becomes, really a flip of a coin,” Lewandowski said.
An alternative method is called the “rapid diagnostic test,” and although similar to a drug store pregnancy test, it has drawbacks. Correctly reading the test requires some training. It also requires temperature-sensitive chemicals that must be stored in refrigerators.
Moreover, these tests cannot detect infections in people if they do not show symptoms of the illness.
“Even if you have a small amount in your system and you’re asymptomatic,” Lewandowski said, “you can still spread the infection to others.” For example, if a mildly infected person gets bitten by a mosquito, the insect will infect each subsequent victim it attacks.
Grimberg’s research into malaria revealed a new way to identify the illness. The parasites that cause the disease consume red blood cells, but cannot digest the iron in those cells. Instead, the parasites concentrate the iron into rod-shaped crystals that remain in the infected person’s bloodstream, and so show up on a blood sample.
So the key to their breakthrough is using the iron in the blood as a marker for the disease. That is where the magnets come in. A drop of blood mixed with a little water is inserted into the RAM machine, where magnets create a magnetic field around the sample. Then, the machine shoots a beam from a low-powered laser at the sample.
If the person is infected, the magnetic field will cause the bits of iron in the blood sample to line up in an orderly pattern that partially blocks the laser light. By measuring the amount of light that passes through the sample, RAM can quickly spot infected blood, or confirm that a person is free of the disease.
Disease Diagnostic Group claims its device has an accuracy rate of 93 percent, compared with 87 percent for the rapid diagnostic test method or 50 percent when a microscope is used.
Thomas Teuscher, deputy executive director of the Roll Back Malaria Partnership, said the new machine holds considerable promise.
“It’s a simple test, it’s a quick test, whereas all the other alternatives are costly and can take a lot of time,” said Teuscher, whose United Nations-sponsored organization coordinates worldwide efforts to control malaria.
Teuscher said RAM would be particularly useful in limiting the spread of malaria. For example, Persian Gulf states such as Saudi Arabia attract thousands of temporary workers from high-risk Asian and African countries. RAM testing could provide quick, inexpensive confirmation that incoming workers are free of the disease.
The device has received accolades from throughout the startup community. Lewandowski and Disease Diagnostics have won or placed high in numerous business plan competitions around the country, including a $10,000 award from one at MIT.
The RAM system is being tested in Peru by the US Navy and in India by the German conglomerate Bosch. If the trials pan out, Lewandowski hopes to bring RAM to market later this year, at a cost of $2,000 per device.
DDG ultimately plans to create a wristwatch-like tester that will constantly monitor the wearer for signs of malaria, transmitting the data to a smartphone via Bluetooth. Such a wristband might cost less than $50.
Meanwhile technology being developed by Harvard University is playing another unusual role in fighting malaria. Harvard’s Biorobotics Lab is working with a Maryland biotech company, Sanaria Inc., to build a robot that will fight the disease by dissecting the mosquitoes that carry it.
Sanaria has developed a malaria vaccine made from mosquitoes’ salivary glands. But harvesting these organs by hand is slow, painstaking work. So Sanaria and the Harvard lab are raising funds to build a robot that can do the job.
And next for Lewandowski is identifying other ailments that can be diagnosed entirely by electronics.