April 7 is World Health Day, themed “Small bites; big threat”, highlighting vector-borne diseases. Grand Challenges Canada, which is funded by the Government of Canada, joins other global organizations in commemorating this day by highlighting its projects aimed at raising awareness about the threats posed by insect and arthropod vectors, as well as the protozoa, bacteria, viruses and parasites they carry, collectively known as vector-borne diseases (VBDs)
Bites from insects that result in diseases (such as malaria, dengue, kala-azar, sleeping sickness and elephantiasis) are horrendous but mainly affect the poor and neglected. To mark this day, Grand Challenges Canada wishes to sensitize the public on our efforts to control and prevent vector-borne diseases, especially those that impact maternal and child health, because the effect of these bites is greatest on mothers and children. In most societies, women and children are the most vulnerable due to poverty. Apart from malaria, all these other vector-borne diseases are Neglected Tropical Diseases (NTDs), so called because they generally receive low levels of funding for treatment and research, yet their collective impact on health is significant.
Grand Challenges Canada is supporting a total of 16 innovations that address the global health challenges of these vector-borne neglected tropical diseases. We have committed about $2.55 million to this important cause, through seed grants, transition-to-scale funding or partnerships with other organizations around the world.
Diseases Spread by Mosquitoes
Of all vectors that impact the health of mothers and children, it is mosquitoes that are the greatest culprit. Millions of deaths annually result from mosquito bites that transmit protozoan diseases, such as malaria, and viruses such as dengue and helminthes, including filarial worms. In addition, mosquito bites are very irritating to the skin. Grand Challenges Canada takes this mosquito menace seriously and is thus supporting innovators globally who are working on new ways to prevent, control and treat infections that arise from mosquitoes.
Malaria
According to the World Health Organization (WHO), malaria kills over 1 million people annually. Its devastating effects are greatest in pregnant women, children and immunocompromised individuals. Twenty-five million pregnant women are currently at risk for malaria, and malaria accounts for over 10,000 maternal and 200,000 neonatal deaths annually. Malaria in pregnant women can also result in high rates of miscarriage, intrauterine demise, premature delivery, low-birth-weight neonates and neonatal death, as well as a higher risk for severe anemia and maternal death.
Since April 25th is World Malaria Day, we invite you discover all our innovations that are malaria-related, below.
Dengue
Dengue is the fastest growing vector-borne disease globally. It is a viral disease that is spread by mosquitoes. About half of the world’s population is now at risk. Dengue infection in pregnancy carries the risk of hemorrhage for both the mother and the newborn, as well as premature birth and fetal death.
Controlling the vector
In order to reduce dengue, WHO advocates a strategy of controlling the mosquito vectors or interruption of human–vector contact. Various projects supported by Grand Challenges Canada aim to do this.
Controlling the spread of dengue through an innovative trap built by school children is the focus of the Government Medical College (India). The trap is made of discarded materials and offers the potential to prevent several other diseases. Combining a novel virus-construction method and high-throughput screening, Development Agency National Science and Technology (Thailand) is searching for new dengue vaccine candidates that are attenuated specifically toward an immune pathway relevant to dengue pathogenesis.
Rapid diagnosis
Rapid diagnosis of dengue is important for both patients and clinicians, as it enables early management of the condition. Delayed diagnosis may lead to secondary infection, which is often severe. Various projects supported by Grand Challenges Canada aim to do this.
The University of Victoria is developing a low-cost, hand-held device in Brazil for a field diagnostic of dengue in the form of a plastic strip. This device will allow real-time detection of the disease. Padjadjaran University (Indonesia) is creating a rapid molecular assay for early detection of dengue fever in primary care, to ensure patients receive appropriate monitoring. This tool would empower any field clinics to diagnose dengue promptly.
Lymphatic filariasis (Elephantiasis)
Another mosquito-borne disease is lymphatic filariasis, also known as Elephantiasis. It is a disease that mainly affects the poor and disadvantaged; approximately 120 million people worldwide suffer from the disease, with one-third being disfigured or debilitated. Many of those affected are women who suffer embarrassment and become social outcasts. The WHO has a goal of eliminating lymphatic filariasis as a public health problem by the year 2020. This task is enormous: approximately 1.4 billion people live in endemic areas. Grand Challenges Canada is contributing to this through the following projects.
In India, which has the highest number of cases of Elephantiasis globally, Sensoreal Inc. is developing a self-powered disposable liquid handling microchip as a point-of-care biosensor to expedite the early diagnosis of Elephantiasis. The National Institute for Medical Research (Tanzania) is implementing research to control filariasis vector, Culex quinquefasciatus, using biolarvicides and oviposition attractants in Mafia, Tanzania. Their research will utilize pheromones to attract Culex quinquefasciatus to lay eggs in biolarvicides-treated water bodies to control the vector and accelerates lymphatic filariasis elimination.
Diseases Spread by Sandflies
Biting flies are also responsible for a large number of diseases, especially in the tropics. Of these flies, one of the most common transmitters of disease is the sandfly, which transmits leishmaniasis to humans through the bite of an infected female sandfly.
Leishmaniasis (Kala-azar)
Leishmaniasis affects the poorest people on the planet, and is associated with malnutrition, population displacement, poor housing, a weak immune system and lack of resources. It occurs predominantly in two forms: a visceral type, otherwise known as kala-azar, that invades the spleen and leads to death over a period of time if untreated, and a cutaneous form that develops as a defined and often disfiguring sore on the skin. An estimated 1.3 million new cases and 20,000 to 30,000 deaths occur annually. Although the burden of leishmaniasis is not significantly higher in women, the effects are greater as women usually are poorer and have less access to medication. Grand Challenges Canada, through its innovators, is dedicated to reducing morbidity and mortality due to leishmaniasis. These efforts focus on early diagnosis and effective treatment.
Rapid diagnosis
Early diagnosis of leishmaniasis enables prompt treatment. McGill University has several projects working on the threat of leishmaniasis:
A unique non-invasive test for visceral leishmaniasis is being designed for implementation in Nepal. This addresses key gaps in current diagnostic capabilities and has the potential to be scaled-up using an electricity-free platform. McGill University is also developing a rapid diagnostic test for India that could detect leishmania in the blood, ensuring treatment is provided to those in need. In Senegal, innovators are building another affordable, rapid diagnostic test for leishmaniasis and other infectious diseases, based on thread and yarn.
Treatment
Another novel approach engineered by McGill University uses a tattoo device to target intra-dermal administration of an anti-cutaneous leishmaniasis therapy, this time in Ethiopia. Rajendra Memorial Research Institute of Medical Sciences (India) has carried out active case-finding in Bihar province in India through the use of social workers (ASHAs), providing them with treatment. Bihar has the highest number if leishmania cases globally. Results so far have been very promising, with over 200 ASHAs trained and 38 new cases identified by the ASHAs. This represents 38 potential lives saved.
Diseases Spread by TseTse Flies
Tsetse flies are large, biting insects that inhabit large swathes of sub-Saharan Africa and are responsible for transmitting sleeping sickness in humans and animal trypanosomiasis, also called nagana, in cattle.
Trypanosomiasis (Sleeping Sickness)
Trypanosomiasis, or sleeping sickness, occurs only in 36 sub-Saharan African countries (mostly in rural areas) where there are tsetse flies that transmit the disease. Diagnosis and treatment of this neglected tropical disease is complex and requires specifically skilled staff. Grand Challenges Canada is supporting innovators tackling this menace.
Rapid diagnosis
Innovators from Makerere University are working on a simple, fast and accurate test to improve the number of sleeping sickness patients that are detected and thus increase the case management rate. Tests are being conducted in the Democratic Republic of Congo and Uganda. Meru University College of Science and Technology is developing a low-cost nucleic acid detection test that will enable rapid detection of pathogens that cause sleeping sickness in Africa and Chagas disease in South America, both in animals and in humans (Argentina, Kenya, Tanzania, Uganda).
Vaccine development
Makerere University (Uganda) has identified proteins (using web-based genome mining tools) that will be evaluated for vaccine potential against Trypanosomiasis using laboratory assays. Currently, there is no vaccine available.
Diseases Spread by Snails
In addition to biting insects, there are other vectors responsible for transmission of diseases. Snails are responsible for transmitting sicknesses that can cause extreme pain, disfigurement and death. The most common disease spread by snails is Schistosomiasis.
Schistosomiasis (Bilharzia)
Schistosomiasis, or bilharzia, is a parasitic disease affecting about 790 million people worldwide, the majority of whom are in Africa. It mainly affects the poor, and women and children are most vulnerable. Women suffer considerably from female genital schistosomiasis that causes infertility, preterm labor, anemia, menstrual disorder, and dyspareunia. Grand Challenges Canada is supporting innovators who aim to reduce the debilitating effects that this disease is causing through eradication of the snail population, as well as rapid detection and treatment.
Eradication of snails
Projet-Crevette
The bold idea of Espoir pour la Santé (Senegal) is to stop schistosomiasis using a combination of chemotherapy and restoring indigenous freshwater prawns to rural waterways in endemic regions of Africa. These prawns are natural predators of aquatic snails that harbor schistosomiasis. This project has already shown promising results, with an estimated 80% reduction in cases of schistosomiasis in test areas, resulting in 2,300 lives improved and 900 lives touched. This shows the great potential of this project in impacting lives.
Detection and treatment
Kenyatta University (Kenya) is proposing a rapid and portable nano-immunosensor using a novel technique that will allow for automated, rapid point-of-care detection of bilharzia. It can be distributed to endemic areas in Kenya for early screening and treatment.
The Government of Canada has committed to improve the health and saving the lives of women and children in developing countries, through the Muskoka Initiative on Maternal, Newborn and Child Health (MNCH). The fight against the impact of vector-borne diseases is crucial to reaching the Muskoka goals. Through Grand Challenges Canada, our Government is showing it is determined to improve the lives of women and children in developing nations through innovation.
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