A urine test that works without a fridge, a portable device that detects bacteria and immune markers in minutes, and a digital system to guide antibiotic prescriptions will be tested across clinics in Sub-Saharan Africa. Urinary tract infections are among the most common bacterial infections worldwide, but in Sub-Saharan Africa, many clinics lack the diagnostics needed to tell a bacterial UTI from other conditions. Without that information, antibiotics are often prescribed unnecessarily, which fuels antimicrobial resistance—a growing threat that makes common infections harder to treat everywhere. If the toolbox works as intended, a patient could give a urine sample at a primary care clinic, get a rapid triage result from a lateral flow test, and if needed, have a more precise analysis done on a compact instrument at a nearby hospital. The digital platform would then recommend whether antibiotics are needed and which ones. The project also includes local manufacturing of the tests and sampling cards that do not require cold-chain transport, which could strengthen supply chains and make diagnostics more accessible in remote areas. If successful, the approach could reduce unnecessary antibiotic use, slow the spread of resistant bacteria, and improve how health systems respond to outbreaks.
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Urinary Tract Infections (UTIs) and antimicrobial resistance (AMR) pose significant global health threats, characterised by high incidence and mortality. However, in Sub-Saharan Africa (SSA), there is often a lack of accessible diagnostics to guide proper treatment and therapy monitoring. Our objectives are as follows: (1) Develop and validate a two-tier diagnostic toolbox: (a) Implement a Lateral Flow Test (LFT) for detecting urinary biomarkers at primary care for triage; (b) Deploy a compact, portable Point-of-Care (POC) instrument for secondary care (hospitals, clinics), integrating pathogen detection via isothermal nucleic acid amplification and host-response biomarker quantification for evidence-based therapy and antibiotic prescription; (c) Introduce novel (self)-sampling cards for transport without the need for a cold chain; (d) Establish a digital health platform for clinical decision support. (2) Evaluate the toolbox's field deployability, acceptance, usability, and integration into clinical practice. (3) Maximise the adoption, implementation, and accessibility of the proposed diagnostic toolbox. (4) Prepare for post-project regulatory approval and market launch. (5) Enhance capacity building and surveillance structures through local manufacturing transfer and improvement of the supply chain and logistics. We will recruit diverse patient groups, including under-represented segments of society, from various African settings to ensure the broad applicability, sustainability, and customisability of our solutions. This project is expected to have a significant impact, improving the quality of UTI/AMR diagnostics, reducing unnecessary antibiotic use, preventing resistance, strengthening health systems and their response to epidemics, and increasing accessibility and quality of diagnostics through interdisciplinary and robust industrial collaboration.
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