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Pictures of the Future
The Magazine for Research and Innovation
 

Health and Well-being

European Inventor Award 2017: Rapid Blood Test for Malaria

The Dutch-Austrian inventor duo developed a computer-based test for malaria infections - a major step forward in fighting a disease that affects over 200 million people worldwide.

The European Patent Office has honored Dutch product manager Jan van den Boogaart, 57, from Siemens Healthineers, and his Austrian research colleague Prof. Oliver Hayden, 45, with the 2017 European Inventor Award. The two Siemens Healthineers employees have invented an automated method for detecting the life-threatening disease malaria.

On the basis of their own research, they jointly developed a method for the Siemens Healthineers Advia 2120i hematology system. Until now, diagnosis had involved relatively time-consuming, complicated, and expensive procedure. But with this method, the Advia 2120i hematology system can run malaria tests automatically as part of a full blood panel. The great advantage is the high throughput at lower cost than with other methods, such as microscopic examination.

According to the World Health Organization (WHO), almost half the world’s population was at risk of malaria in 2015. The tropical disease claimed 429,000 human lives that year – two-thirds of them children under the age of five. Diagnosis is complicated by the disease’s non-specific symptoms: high fever, chills, headache and a general feeling of weakness. The disease is especially rampant in sub-Saharan Africa: 90 percent of malaria cases and 92 percent of malaria fatalities occur in this region.

Jan van den Boogaart and Oliver Hayden, winners of the European Inventor Award 2017 in the category Industry, at the award ceremony in Venice on 15 June.

And this is also where the idea for an automated testing method was born. There, Jan van den Boogaart conducted user training courses for the Advia 2120i hematology system – a device that performs Complete Blood Count (CBC) tests, counting and analyzing blood cells, their changes and identifying abnormalities in size and volume to aid in the detection of anemia, infections, blood cancers and immune system disorders. Then, he was alerted by a South African colleague about an odd phenomenon: “in evaluating the test results from our hematology system, she noticed some correspondences in the blood values of malaria patients. But she couldn’t find an unequivocal pattern,” van den Boogaart says.

Impressive Knowledge of Blood Tests

Van den Boogaart has been working in hematology for 36 years – initially as a lab technician in a hospital laboratory, later as a field service officer, and finally as a product manager at Siemens Healthineers. He has an impressive knowledge of blood tests and the diseases they can detect. Van den Boogaart recognized the potential of his colleague’s observation. He started working with the problem, and caught himself up on the latest research. Then he started gathering data of his own. He compared blood samples from non-infected blood specimens with malaria-infected specimens from South Africa. He compiled the data in a big Excel file and also listed the measurement data put out by the Advia 2120i hematology system. The system can cover 500 parameters, including red and white cell counts. A malaria infection leaves traces in specific parameters performed as part of CBC. For example, it lowers the number of platelets – the smallest blood cells, which support coagulation in an injury. But many of the signs can apply to other diseases as well.

The problem was to find values that could be uniquely traced to malaria. Van den Boogaart contacted Prof. Dr. Oliver Hayden, so far the head of In Vitro Diagnostics and Bioscience for Germany at Siemens Healthineers. The biochemist habilitated in analytical chemistry at the University of Vienna in 2005, and has been working at Siemens Healthineers for ten years, including at its Technology Center, the company’s innovation factory. Together, the two investigators identified a combination of parameters that define whether a patient has malaria – and from those, they developed the method for the Advia 2120i hematology system. The system’s automated test doesn’t look for the parasites that cause malaria, but rather for the changes the disease causes in the blood platelets and immune cells. “The pathogen hides from the immune system in the red blood cells, and the infection can’t be detected directly in an automated blood panel. But, we found a combination of different malaria-induced changes in the blood cells – a kind of fingerprint of the attempt to defend against the parasite. From those we developed the method that can detect malaria fast, reliably, and amid a large volume of tests, using the Advia 2120i hematology systems,” Hayden says.

"Jan and I are driven by the idea of developing affordable technologies that can influence the improvement of health conditions for billions of people."

The Idea of Affordable Technologies

Until now, the most reliable method has been a microscopic examination of the blood for plasmodia – the parasites that are transmitted to humans by the female anopheles mosquito. This method calls for experienced, trained personnel, because it’s not easy to recognize plasmodia under the microscope. The process is also very time-consuming – it can take up to an hour for just one specimen. In recent years, malaria has also been diagnosed more and more often with fast tests that involve no microscopic examination: a test strip that detects parasite-specific antigens. But if used improperly, that test is unreliable, and it’s also expensive.

Jan van den Boogaart (left) and Dr. Oliver Hayden.

Once a mosquito bites someone, the blood stream soon carries the parasites to the liver. There, they proliferate, but are initially inactive and sometimes go into a dormant phase. In some kinds of malaria, it can take years for them to become active. Once the pathogens enter the circulatory system, they attack red corpuscles, so as to hide in them from the immune system and proliferate further. The infected corpuscles explode, releasing the pathogen to go on and infect more blood cells. This repeated process robs oxygen from the body and causes intermittent high fever and chills. It takes decades to develop a natural resistance to malaria that alleviates the infection’s symptoms. But children under the age of five still have a rather undeveloped immune system – the reason why child mortality from malaria is especially high. A fast diagnostic method that can be used en masse could save thousands of lives.

“Jan and I are driven by the idea of developing affordable technologies that can influence the improvement of health conditions for billions of people. Infection diagnostics from blood panels prepared by automation has great potential for routine clinical use,” Hayden says.

As is normal with medical products, the development phase will now be followed by comprehensive clinical studies. Even that doesn't mean the end of the research process. "We are currently gathering more samples to investigate whether this method could be applied to other pathogens in principle," adds van den Boogaart. Automated malaria detection offers an insight into what might still be possible. The Inventor Award and the people's choice award are the EPO's way of recognizing committed individuals who drive technological progress forward with their new ideas and dedication.

Julia Donhauser