Mobile Phone Microscopes to Revolutionize Health Diagnostics

 

Mobile phone usage has increased hugely across the global South in the past five years. In Africa, the number of mobile phone subscribers reached 545 million in 2013, while there are 3.5 billion mobile phone users in Asia and the Pacific (ITU). Some 93 million people in Africa and 895 million in Asia and the Pacific have mobile phone Internet access (ITU).

“Every day we are moving closer to having almost as many mobile-cellular subscriptions as people on earth,” Brahima Sanou, Director of the ITU Telecommunication Development Bureau, wrote in its latest report on their growth.

The number of mobile phone subscriptions in the developing world has surpassed 5 billion and the number in the world as a whole reached 6.8 billion in 2013 (ITU), out of a world population of more than 7.1 billion. This compares to considerably lower numbers of people with access to the Internet: 2.7 billion in the world (ITU).

While many people in poorer countries have basic versions of mobile phones, the next generation of smartphones has been growing in number as prices come down (http://en.wikipedia.org/wiki/Smartphone). Examples of these smart phones include the BlackBerry, Apple’s iPhone, the Samsung Galaxy, and the Nokia Lumia. Smartphones tend to have enormous computing power and an ability to run complex ‘apps’ or applications – including public transport options, maps, restaurant and store locators, banking services and market information and resources. They can also access the Internet through Wi-Fi, and have camera and video capability.

What people can do with these feature-packed phones is limited by little other than human imagination. With the ability to store large amounts of data and images, using apps that perform a limitless range of services and tasks, smartphones can be deployed as powerful tools to tackle problems.

Science fiction sagas have long fantasized about people being able to walk around with small electronic devices that can do immensely powerful tasks, including being a medical diagnostic tool. But this science fiction dream is rapidly becoming reality in the global South.

Various initiatives and innovators are using mobile phones and smartphones to conduct medical diagnosis and gather data for medical studies in real time.

Some innovations are even turning smartphones into mobile microscopes.

Developed by the University of California, Berkeley in the lab of Professor Daniel Fletcher (http://cellscope.berkeley.edu/), the CellScope (cellscope.com) is capable of turning the camera on a cell (mobile) phone into a diagnostic microscope with a magnification of 5x to 60x. Fletcher’s lab has also pioneered work on needle-free injection technology.

The CellScope can be used for ocular imaging (technologies for visualizing and assessing a range of diseases of the eye) and for detecting tuberculosis, blood-borne diseases and parasitic worms.

Fletcher is a bioengineer and was impressed with how much mobile phone technology has proliferated across the global South.

“You don’t have to put in these copper wires (for phone lines) anymore; you have the (cell) towers. It’s big business,” Fletcher told The Scientist Magazine.

“It’s leaping over the need for infrastructure.”

Fletcher and his colleagues experimented by attaching extra lenses to smartphones. They then used the phone to image cells that had been stained with fluorescent dyes to make them easier to see. The quality of the image was so good, they were able to diagnose malaria from blood samples and tuberculosis from sputum (spit) samples.

With the addition of image analyzing software, the phone was able to automatically count the number of Mycobacterium tuberculosis bacilli. They were trying to prove you did not need conventional microscopes to do this sort of diagnostic work.

Fletcher and his colleagues are currently trialling the technology in Vietnam, India, Cameroon and Thailand.

“Technology alone doesn’t create effective health care,” Fletcher emphasizes. “It’s got to be part of a context in which the information is captured and validated and is analyzed in the right way, and treatments are then available in response to information.”

Another group from Toronto General Hospital in Canada (http://www.uhn.ca/corporate/AboutUHN/OurHospitals/Pages/TGH.aspx) has ‘hacked’ an iPhone smartphone by placing a 1 millimeter ball lens on the phone’s camera. Isaac Bogoch, an infectious disease specialist, had been investigating parasitic worm infections in children on Pemba Island off the coast of Tanzania. Along with Jason Andrews of Massachusetts General Hospital, they had been inspired by a report about how a team of researchers from the University of California, Davis had created a simple microscope out of an iPhone with a 1 millimeter lens. This makeshift microscope was used to take pictures of blood smears at a 350 times magnification and giving a 1.5 micron resolution.

“We thought that was a great idea,” Bogoch told The Scientist Magazine. Bogoch regularly works as part of an international team around the world, often in remote locations.

“We thought … we could take it to the field and see if it accurately works in a more real-world setting.”

Inspired, Bogoch got together with his colleagues and created a similar microscope with a 3 millimeter ball lens and then got to work using it to identify soil-transmitted helminth eggs in stool samples in Tanzania. When examining the stool samples of 199 children in a clinical trial using the makeshift microscope, they were able to accurately identify helminth infections in 70 per cent of the cases. They also found the iPhone microscope did very well at spotting eggs of particular parasites, such as 80 per cent of Ascaris lumbricoides infections (http://en.wikipedia.org/wiki/Ascaris_lumbricoides). The success rate dropped significantly, however, when trying to detect whipworm parasites (just over half) and hookworm infections (14 per cent).

But this is early days and an experiment: “Obviously the results aren’t perfect and there’s definitely room for improvement,” Bogoch admits.

What stands out is the potential to completely revolutionize health care by continuing to develop the capability of smartphones. With their portability and low cost, they also have the advantage of not needing a trained physician to operate them, according to David Walker, president of the American Society of Tropical Medicine and Hygiene, in The Scientist Magazine.

One of the many advantages of combining a microscope with a digital smartphone is the ability to take a picture and send it straight away to someone to make a diagnosis.

Even more exciting, Sebastian Wachsmann-Hogiu at the University of California, Davis (http://cbst.ucdavis.edu/people/sebastian/) is adapting mobile phones to undertake spectroscopy (http://en.wikipedia.org/wiki/Spectroscopy), using diagnostic test software to analyze samples on the spot. This, when successful, would be akin to the capabilities first mooted in the science fiction television and film series Star Trek (startrek.com). In Star Trek, the doctor is able to use a small handheld digital device to quickly diagnose what ails somebody.

The potential for this technology in the global South is significant. Aydogan Ozcan at the University of California, Los Angeles, who is also working on mobile phone microscopes, believes this is as significant as the dawn of the personal computer: “If you look at the early computers, they were bulky, they were extremely expensive,” he says.

But now computers “are portable … and almost anyone can afford them. The same thing is going on today (with microscopy). We are miniaturizing our micro- and nano-analysis tools. We’re making them more affordable; we’re making them more powerful.”

It looks like this science fiction dream will soon become today’s reality.

By David South, Development Challenges, South-South Solutions

Published: July 2013

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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Southern Innovator Issue 1: https://books.google.co.uk/books?id=Q1O54YSE2BgC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 2: https://books.google.co.uk/books?id=Ty0N969dcssC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 3: https://books.google.co.uk/books?id=AQNt4YmhZagC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 4: https://books.google.co.uk/books?id=9T_n2tA7l4EC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 5: https://books.google.co.uk/books?id=6ILdAgAAQBAJ&dq=southern+innovator&source=gbs_navlinks_s

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A Local Drink Beats Global Competition

For many decades, strong American and multinational food brands have penetrated markets in the South. This is a global business success story for those companies, but the downside has been the marginalizing of local alternatives. This not only reduces wealth-creating opportunities for local entrepreneurs, but also leads to products like sugary soda pops (http://tinyurl.com/yzwal98) pushing aside healthier, local alternatives like tea.

But one company in Indonesia has been pioneering a healthy local drinks empire while also seeing off aggressive foreign rivals. Teh Botol Sosro, a tea drink in Indonesia bottled by family-owned business Sosro, was not only the first bottled tea brand in the country, but also in the world, it claims. The company started bottling the jasmine-flavoured black tea drink in the 1970s.

The Indonesian company has shown that it is possible for local flavours to beat powerful international brands like Coca Cola in the battle for drinkers’ palates. While Coca Cola has tried to sell many bottled tea drinks in the Indonesian market, they have not been able to push aside the local product, The Teh Botol Sosro. Brewed by the Sinar Sosro company, it has captured 70 percent of the non-carbonated drinks market.

It is a drink of cool, black, sweetened tea with a hint of jasmine. Invented by the Indonesian family of Sosrodjojos, Sosro (http://www.sosro.com/) was founded in central Java in the 1940s.

Culturally, Indonesians have either coffee or tea with their meals. The brand’s marketing slogan plays on this: “Whatever you eat, you drink Teh Sosro.”

The company has aggressively fought off competition not only from local rivals, but also from Coca Cola’s Frestea brand and Pepsi Cola’s Tekita. The company stayed sharp in its business strategy, never letting a rival product take hold. Just as a rival would introduce a new product, Sosro would reply with a new drink attuned to Indonesian tastes. This ability to not be complacent about the company’s success, and to use its knowledge of local tastes to always outsmart foreign competition, has kept the company where it is today.

Sosro pioneered bottled drinking tea with its launch in 1970 and started with a dried tea only distributed in Central Java.

The journey to cold, bottled tea is an amusing one. The company first wanted to promote its tea in Jakarta, the capital, by having public tastings. But by brewing the tea on the spot, the too-hot tea took too long to drink for impatient Jakartens. The solution was to not brew the tea on the spot, but instead to brew it off-site and deliver to markets in big pans on trucks. But the bad roads made this a bit of a mistake as well: the tea would spill on the journey.

The ‘aha’ moment came when the idea arose to store the brewed tea in bottles. The bottles were eye-catching and have evolved in design over the years.

The drink now comes in various packages, from a returnable glass bottle (220 ml) to a Tetra Pak (1 litre, 250 ml, and 200 ml) and a 230 ml pouch.

The Botol Sosro (http://www.sosro.com/teh-botol-sosro.php) is not the company’s only product: it also brews Fruit Tea, The Botol Kotak and S-Tee. The economic benefits of these popular brands stay local, as Sosro gets the tea from PT Gunung Slamet, which operates three tea estates covering 1,587 hectares in Indonesia.

By David South, Development Challenges, South-South Solutions

Published: March 2010

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

Follow @SouthSouth1

Google Books: https://books.google.co.uk/books?id=Qx2YBgAAQBAJ&dq=development+challenges+march+2010&source=gbs_navlinks_s

Slideshare: http://www.slideshare.net/DavidSouth1/development-challengessouthsouthsolutionsmarch2010issue

Southern Innovator Issue 1: https://books.google.co.uk/books?id=Q1O54YSE2BgC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 2: https://books.google.co.uk/books?id=Ty0N969dcssC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 3: https://books.google.co.uk/books?id=AQNt4YmhZagC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 4: https://books.google.co.uk/books?id=9T_n2tA7l4EC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 5: https://books.google.co.uk/books?id=6ILdAgAAQBAJ&dq=southern+innovator&source=gbs_navlinks_s

As cited in Export Now: Five Keys to Entering New Markets by Frank Lavin and Peter Cohan (Wiley).

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