For a neglected tropical disease like T. solium, there is much that goes beyond diagnosis and treatment. As there is barely any data concerning the incidence of the pork tapeworm, it is hard to know which areas are in need of our diagnostic tool. This is why education and the spread of awareness is vital to a project like ours. Only by making people aware of the menace of T. solium, the need of a quick and cheap test is realized by the local population. A step towards this goal was undertaken by us at the European Students’ Conference (ESC) in Berlin.
The ESC is one of the largest biomedical student conferences and hosts about 450 participants. This years topic “Genetic Engineering - When Chance Meets Choise“ was a perfect opportunity for diagnost-x to present the project to the interdisciplinary participants from various cultures. In form a workshop, we were able to teach the attendants about our project, as well as coach them how to form a successful international collaboration.
Tasked with the incredible chance to design a 90 minutes workshop for students from India, Romania, The Netherlands and other countries, it was important for us to go beyond presenting our own project. It had to be shown that besides the idea, the implementation matters. What was important for us to get across is how much personal resources matter, and where the limitations lie. This is why we let the participants come up with their own ideas concerning a partnership with diagnost-x. They were put into groups with members from different nationalities, to get across how difficult communication between different cultures can be. The end-goal was to have the groups mock up a partnership with diagnost-x. For this partnership they used resources and contacts available to them in the real world. The groups were made to work on topics important to a project like funding, acquisition of samples and awareness. As alluded to earlier, the groups individually found out what a key issue awareness is. Without the general public’s knowledge about T. solium, our project cannot succeed. This is where the members of the workshop pleasantly surprised us. Out of their own initiative, they wanted to bring the project to their home countries. Not knowing much about the pork tapeworm earlier, they realized it might be a problem in their home country. Together with diagnost-x they will spread awareness for T. solium in their communities. Once the test is ready for field, these are the communities where we will tackle the tapeworm first.
Participation in Cystinet conference
In the beginning of June we were invited to participate at the conference of the interdisciplinary network of scientists and physicians Cystinet that deals with the global challenge of T.solium infestation in human and animal. One of our team leaders travelled to Riga, Latvia to present our approach to develop affordable field diagnostic for the disease.
It was a great opportunity to get in contact with several specialists on the topic and we made valuable contacts in questions of scientific exchange and possible future collaborations for clinical trials and sample acquisition.
We hope to keep up a good and productive contact to the organisation and are optimistic that together we may come one step closer on finding a solution to the growing amount of T.solium related diseases.
Long Night of the Sciences (LNDW)
What is the Long Night of the Sciences (LNDW)?
More than 70 scientific and technology-oriented institutions opened their doors in the night from the 24th to the 25th of July in Berlin to communicate science in a playful and understandable way to everyone. Visitors got the opportunity to take a nocturnal look at the diverse worlds of science and research, which are normally inaccessible for them.
Diagnost-x contribution to the Long Night of Sciences
Presenting our project not only to scientists, but to everyone who is interested is immensely important to us in order to show that neglected tropical diseases (NTDs) are worth working on and that we have come quite a way already! Since we aim to raise awareness in the public for NTDs, we took the chance to present our project to a broad audience at the LNDW. In this night, around 10.000 people from all over Berlin, including kids, students and adults, were entering the Charité Crossover building in which we were presenting our work. With several attractions for kids as worm gummy bears, ‚catch the worm‘-games and image search games, we could also explain -in an understandable and playful way- to our youngest guests the importance of proper diagnostic tests in the fight of NTDs. Not only kids’ games but also a quiz on Tania solium and NTDs and tapeworm-diagnost-x postcards attracted visitors to our stand. With the help of a pipe cleaner toehold switch model, video sequences of the RNA triggered color change and schematic posters we could transfer our main message and project aims to our older guests.
Lively discussions were not only enriching our visitors but also us! We got new inspirations for our project and lots of new input in terms of our scientific design, ways of financing our project and in communicating it to the public. We could fascinate new people from our project and its importance since almost none of our visitors had ever before heard of tapeworms! All in all we enjoyed the entire event, the lively discussions and could further strengthen our team spirit and even recruit new people to our team!
What is a Science Slam?
The concept of Science Slams was developed in 2006 by German writer Alex Dreppec in Darmstadt. In only ten minutes, young scientists should present their work to a non-scientific audience in an informative and - most importantly - an entertaining way. And how to be entertaining is entirely up to the presenter: giving the most absurd examples? Excellent! You can even make a whole performance out of it - as long as it does not exceed ten minutes.
Diagnost-x takes the stage at the 57th Science Slam in the SO36 in Berlin
To us of course, the concept of "Science for everyone" is really important - after all, we're living proof that anyone, PhD or not, can be part of scientific development! That’s why in March 2017 we took the stage and presented our project to an audience of 500 people through a mixed presentation of acting (the common prejudices of either student projects of failing NTD research projects) and presenting (how we actually perform and build up our project). It was tremendous for us to see how many people and kids enjoyed the event and asked us more specific and detailed questions after our performance on stage!
Worm RNA from India
Flying our ideas to reality – Two team-members travelled to India in order to learn about the environment our test needs to function in and to built up a network that helped us being the first to decode the transcriptome of T. solium eggs and to launch a clinical study for our sensor
T. solium is endemic in India
Data from the WHO indicate that infections with the pork tapeworm is endemic in India. When performing a literature review, we found only few small studies examining the prevalence of T. solium in India. So we were full of uncertainty, when we sent two team members to India in order to explore the context in which our diagnostic test might be used.
Meeting the People's Vigilance Committee on Human Rights
Upon our arrival we met Dr. Lenin from the Human Rights organization PVCHR (People's Vigilance Committee on Human Rights ), who gave us the chance to accompany social workers to Musahar communities, small collections of huts where poor and discriminated people live. PVCHR suspected a high chance that people in these villages are infected with the pork tapeworm.
Standard of T. solium diagnosis in India
At this point we learnt how important it is to develop a rapid field test: Currently diagnosis is made by microscopy but it is impossible to bring a microscope and a trained physician to these areas. At the same time driving to the next hospital takes over two hours and the villagers are working a lot to gain enough money for their families. Many of them never went to a hospital and many of them are superstitious, which makes us believe it would be best, if the social workers they trust could handle our test on site in the village.
Next, we went to a government hospital, a private hospital and several clinical laboratories to meet physicians and to discuss our idea and their thoughts on T. solium. These physicians, particularly Dr. Dilip Mishra (picture), were very interested in a rapid diagnostic test and a joint research project. While we were still on site, we analyzed the research facilities and planned how to isolate RNA from T. solium in this environment. Our plan was to disrupt the eggs using QIAzol and a homogenizer.
Subsequently we wanted to ship the RNA in QIAzol to Germany for further purification and analysis. However, we realized it might be difficult to export such a shipment containing biological compounds and a phenolic agent. For this reason, we went to Delhi to meet iGEM IIT Delhi. Together with the Delhi-Team we established an RNA isolation pipeline, which was a challenge because RNA isolation kits are not developed for temperatures above 40°C. After RNA-Isolation, RNA is dissolved in water and for this reason easy to ship.
Simultaneously we were writing an application to the institutional review boards to gain ethical consent for a clinical study. We received ethical consent from both boards. To our knowledge we are the first iGEM team to write a full (40 pages) application for ethical approval of a clinical study. Throughout this study we will accompany social workers, that provide tapeworm-chemoprophylaxis to villages and ask people receiving chemoprophylaxis (as part of a preventive program supported by the Indian Ministry of Health), for a stool sample. The stool sample will be analyzed by Dr. Mishra using light microscopy as the golden standard for diagnosis of T. solium.
With the remaining sample we will examine how will our test and other novel tests for rapid diagnosis of T. solium are working in an Indian diagnostic laboratory. In addition to collecting more molecular data on T. solium and validating our test, this study will also allow us to add data to the epidemiology of the disease in India: Once completed it will be the third largest clinical study examining the prevalence of T. solium in India.
Our Approach to NTDs
The aim of our project, facilitating diagnosis of T. solium infection, is a topic set within the field of synthetic biology, but with connections to many other domains. The targeted infection is listed as one of the 20 communicable diseases that are mostly affecting poor populations – a neglected tropical disease (NTDs). Stopping the spread of such diseases is thus not only a matter of medical progress, but also of an improved education, higher hygiene and sanitation standards as well as of more equitable communities. This also means that the challenge of NTDs is not only taken on by biologists and physicians! Politicians, health workers and NGOs as well as the private sector have for a long time made efforts to eliminate these diseases. With the NTD lab, our team aimed to bring all these players together to discuss how innovation in the field of these poverty-associated diseases could look like.
On the 17th of May 2017, we thus invited more than 100 participants to the premises of the Humboldt Graduate School. The event was split into two main parts: in an interactive “project fair”, our team presented its work to the participants next to projects of NGOs such as the Christoffel Blindenmission (CBM) or of other scientific institutes such as HTW Berlin. After a reception, a panel discussion with eminent speakers ensued. We were happy to welcome Dr. Georg Kippels (member of the parliament), Prof. Dr. KH Martin Kollmann (member of the advisory board of DNTDs and scientific advisor to the CBM Kenya), Dr. Joachim Klein (German Ministry for Research and Education), Dr. Maria-Luisa Rodriguez (Global Program Head Nifurtimox, Bayer AG) as well as our team leader Henrik on the podium. In an insightful discussion, we were discussing not only the scientific requirements for tackling the problem of NTDs but even how science might be a driving force in reaching the sustainable development goals.
Organizing an event involving almost 150 people was no small endeavor to our team – so what was the goal we aimed to reach with the symposium? Early in our project we realized that neglected tropical disease not only warranted our attention, but needed more general awareness. A broader public should know about these diseases to make a joint action against NTDs possible. We are happy to report that we reached our goals in two different ways: On the one hand, the many students in the audience very visibly curious to find out more about these poorly understood diseases and we even gained new team members. On the other hand, our invited speakers were impressed at the many questions and informed statements from the audience and realized that the topic of NTDs is also interesting to non-experts. Our partners, NGOs as well as scientific groups, expressed interest in organizing a second NTD lab next year – our plans on making this event involve an even larger audience were favorably met, and the planning phase has already started!