During his Master thesis project Ludo de Goeije explored the development of a context-specific strip reader for an innovative lateral flow test detecting schistosomiasis. Ludo will continue to work on this project the coming year as a researcher within the INSPiRED project.
This document reports the exploration of the development of a context-specific strip reader for an innovative lateral flow test detecting schistosomiasis. Schistosomiasis is a common poverty-related parasitic disease in many Sub-Saharan African countries. Transmission happens in infested water, putting especially children at risk. Schistosomiasis can be effectively treated. In order to do that, accurate diagnostics are needed at the point of care to target communities at risk. Leiden University Medical Center is developing a lateral flow test that detects the antigen CAA with high accuracy, using upconverting particles. The test has great potential in terms of accuracy, but a dedicated reader is needed to interpret the test result. A reader typically limits the accessibility of a test in low-resource settings, because of its size, high costs, and limited user-friendliness and robustness. On the other hand, one could benefit from the opportunities that come with such a device, such as reducing human error, quantifying results, and real-time data collection. The starting point was to explore the possibilities of developing a context-specific strip reader dedicated to the new test. The approach of this project was based on systemic design methodologies. It deals with complexity by creating interventions that move the system to a more desired state in incremental steps. Transitions towards desired states were described on four different levels of abstraction. On a global level, we aim towards leaving no one behind, making healthcare accessible for everyone. Big forces, like climate change and COVID-19, and smaller forces, like stigmas and technological challenges, are risk factors that could steer change away from the desired direction Meanwhile, opportunities arise, such as the rapid digitization of Sub-Saharan Africa. From a systemic viewpoint, it became clear that new frames are needed to create a strong and attractive narrative for the role of strip readers in diagnostics. Based on the insights, an intervention strategy was proposed to accelerate the development of a context-specific strip reader by early involvement of stakeholders. The strategy consists of two elements. 1) Three new narratives are proposed as an alternative to the current, negative frame of the use of readers in low-resource settings. These narratives were used to formulate multiple development paths of different technical concepts. 2) The Block Reader was developed to support the narrative with evidence and as a means for collaborative prototyping. It enables to gain and share insights, and to communicate with stakeholders. The device is fully modular, allowing the user (developers) to iterate on the technology and user-interaction quickly. Lastly, an outline of the next steps is discussed.