Public Health England (PHE) has been awarded a £1.1 million (US$1.7 million) research grant from the Bill & Melinda Gates Foundation to develop an innovative point of care test (POCT) to assess childhood immunity to measles and tetanus, using oral fluid samples. The research could deliver a universal approach for monitoring population immunity and vaccine coverage in the future.
Technology to send digital POCT results, displaying location and sample identity, instantaneously to national immunisation centres to help ensure appropriate programme response will be investigated. The rechargeable portable readers being tested can be used in the field such as in developing countries, where direct access to health services is limited.
Professor David Brown, Director of the Virus Reference Department at PHE said:
Oral fluid is proven as a simple and effective sample to collect and use for surveillance, especially with babies and young children. The grant enables us to explore this new technology for measles and tetanus, both of which have a great impact on individuals, communities and health services around the world.
This research is a part of a global programme to support the vaccine initiative. Advancing data collection on coverage and immunity may help inform vaccine programme delivery in the future. Although we’re currently focusing on measles and tetanus, the technology involved presents opportunities to expand these innovative POCTs into other fields.
The research aims to produce a high volume of these POCTs in a cost effective and accessible way that can be used for vaccine programmes in developing countries and in urban settings where oral fluid can be extracted away from the lab.
The first major field tests will be performed in Uganda in the next 18 months to define performance for monitoring routine vaccine coverage in real settings.
PHE has globally pioneered oral fluid sampling over the past 2 decades and continues to develop this area to establish new and effective ways of increasing vaccine access and coverage to populations.
Notes to editors:
Oral fluid is a non-invasive sample which can be used like blood to test for antibodies to a disease. The new swabs capture half a millilitre of saliva by swiping around the patient’s mouth. It is then placed into a sterile tube which flips into an ‘eye-dropper’ to apply to a POCT cassette, the result can then be read in real-time.
The Gates Foundation’s grant has helped fund the Uganda trial and the redesign of the POCTs which will give researchers insight into how effective the levels of reporting are, as well uncover the need for an alternative and more accessible way to diagnose for measles infection. The research is being undertaken in United Kingdom, Germany, New Zealand, Switzerland and field work taking place in various locations in Uganda.
Measles is an acute viral illness caused by a morbillivirus of the paramyxovirus family. The prodromal stage is characterised by the onset of fever, malaise, coryza, conjunctivitis and cough. Measles is spread by airborne or droplet transmission. The incubation period is about 10 days (ranging between 7 and 18 days). It is a highly communicable infectious disease.
Tetanus is now a rare disease and the small number of cases that occurred prior to 2003, about 10 per year, were generally confined to unimmunised people aged over 64 years (Rushdy AA, White JM , Ramsay ME, Crowcroft NS. Tetanus in England and Wales 1984-2000. Epidemiol Infect 2003; 130: 71-7).
WHO estimates that between 2 and 3 millions child deaths are prevented through vaccination annually. However, many more deaths could be prevented through the optimal use of currently existing vaccines. The identification of populations where vaccination programmes have failed to reach has a critical role to play in this objective. The implementation of routine immunisation programmes has traditionally been measured by vaccine coverage achieved with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) among children aged 12-23 months.
Public Health England’s mission is to protect and improve the nation’s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. PHE is an operationally autonomous executive agency of the Department of Health.
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