U of T Test Could Mean Difference Between Life and Death
In Canada, each year thousands of people with an infection visit the hospital, but only a small percentage of them will become critically ill. Researchers from the University of Toronto are developing a quick and affordable blood test that identifies at-risk patients, allowing doctors to save lives with targeted treatment.
Professor Kevin Kain is currently developing this test for malaria patients in Africa. But it may apply to many serious and potentially fatal infections ranging from Ebola to dengue fever and sepsis. With one prick of the finger, this point-of-care test could identify biological markers that show that a patient’s blood vessels are becoming leaky — a key sign a patient is becoming critically ill and needs urgent care.
“When people are really sick it’s obvious, but when they’re in the grey zone it’s not always clear,” said Kain, a professor in the Faculty of Medicine’s Department of Laboratory Medicine and Pathobiology. “We need better tools and this quick, accurate and affordable test will allow doctors to make objective decisions and focus resources on those most likely to benefit.”
After working in low-resource settings for 35 years, Kain understands the value of a 10-minute test that costs one dollar. “If I’m a patient in Northern Ontario, I need to know whether I need a helicopter to fly me to a hospital. If I’m in rural Africa, I need to know whether I should make the 10-kilometre journey to a clinic.”
Kain identified these biological markers in several studies conducted on children and adults in Thailand, Uganda and Malawi. The results were highly accurate with sensitivity and specificity over 90 per cent.
While the test works in low-resource settings, Kain believes that it could easily translate to North American health care.
“When resources are tight, you need to maximize impact, and that conversation has already happened in countries with limited resources,” said Kain. “We need to have that same conversation in the West — health-care workers are overwhelmed everywhere and they need objective evidence to make difficult and expensive decisions rapidly and accurately.”
Not only could this test save lives but it could also save money — and the savings could be huge. “Based on economic analysis, if you apply our test to 100 children with fever in Africa you could save 17 lives and $2,500,” said Kain. “If you take the same test and apply it to a North American health context, for every 100 children with fever you save almost half a million dollars by avoiding unnecessary admission and hospital-acquired infections.”
In the future, Kain plans to incorporate the biological markers into a pre-existing rapid test for malaria or dengue fever. His team is also conducting randomized clinical trials in Mozambique and Uganda with new therapeutics that stabilize leaky blood vessels. These studies will determine if these therapeutics can improve survival and prevent brain injury in survivors.
“It’s a fascinating time in global health, because innovative things are happening in low-resource settings that can be retrofitted into and have great impact on the West,” said Kain. “In the West we have a model of $1-million machines that help one person at a time. This is tough to economically sustain. It would be exciting to transform this approach to one-dollar tests that help millions of people at a time.”
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