Press release: Revolutionary health technology to fight pediatric mortality in low resource settings
Doctors have developed an algorithm enhanced and life saving monitoring system that alarms when the condition of a hospitalized child deteriorates. It is intended for hospitals in low- and middle-income countries that do not have the knowledge, skills or resources to purchase and implement existing monitoring systems. With the support of the EU funded EDCTP program, led by the Amsterdam Institute for Global Health & Development, this system will be developed further by a consortium of Malawian and European research institutes and the Dutch startup GOAL 3.
Principal investigator Job Calis: “If this system is successful it has the potential to save up to one million children’s lives every year. This is what unites and motivates us to work on this project.”
The Challenge
Every year, more than three million children in low-resource settings die due to low quality of care caused by constraints in healthcare systems. Shortage of staff and lack of adequate equipment lead to the needless deaths of millions of children.
In hospitals in low resource settings, subtle but important changes in a child’s health can go unnoticed. As a result, the window of opportunity to intervene and prevent children dying from curable or preventable complications is missed. In high-resource settings monitoring of vital signs like heart rate, blood pressure and respiratory rate is the standard of care to detect these conditions in an early stage. Yet, these monitoring tools are not available in countries like Malawi.
Existing monitoring systems are designed for high-income settings and cost a few thousand euros with disposable sensors that require constant repurchasing. These prices exceed the financial capacity of low-resource hospitals. In addition, these systems are complex to use and interpret and the skills and knowledge needed to operate and maintain these systems are scarce. Therefore, these systems break down, or are not used adequately and thus they prove ineffective in low resource settings.
The project
Therefore the IMPALA project was initiated which is coordinated by the Amsterdam Institute for Global Health and Development (AIGHD). The aim of this interdisciplinary project is to develop an algorithm enhanced monitor for low-resource environments that enables health workers to timely detect critical conditions and perform life saving interventions. The design focuses on a durable and easy to use system that makes it easier to collect vital signs like oxygen saturation, heart rate and breathing rate. One of the innovations is the use of a very sensitive pressure sensor that is put underneath the mattress for measurement of the vital signs. The signals from this and other sensors are processed by algorithms to detect changes in vital signs that may indicate serious illness hours before even highly trained healthcare workers would be able to identify the issue.
Another exciting development within this study are the lab-on-a-chip biomarkers which are being developed by the Imperial College London. These accurate point of care tests that require only a drop of blood are able to differentiate between Malaria, bacterial and viral infection in a matter of minutes. Combining the IMPALA monitoring system and the lab-on-a-chip biomarkers could revolutionize the diagnosing process in these resource constraint settings.
Origin of the project
The idea for the IMPALA project originated from the collaboration between pediatric and intensive care specialist Job Calis (Amsterdam UMC), Bart Bierling (industrial designer) and Niek Versteegde (tropical medicine specialist) from the social enterprise GOAL 3. Their combined clinical and technical experience has led to the new approach of the IMPALA project.
Principal investigator Job Calis experienced the need firsthand while working on the PICU in Malawi: “Timely detection of critical conditions in hospitalized children is essential to save their lives. During my work I have experienced first hand that children died due to the absence or failing of monitoring systems. This is unacceptable.”
To ensure that the system meets local demands and is sustainable, the Dutch medical technology company GOAL 3 will be developing the IMPALA system together with the Polytechnic, the department of biomedical engineering of the Malawi University of Business and Applied Sciences.
Partners and collaborations
This project is a collaboration between Dutch, English and Malawian research institutes. It is part of the official collaboration signed in 2020 between the Emma Children’s Hospital of the Amsterdam University Medical Center and the Kamuzu University of Health Sciences - College of Medicine.
The project is led by the Amsterdam Institute of Global Health and Development (AIGHD). Together with the consortium partners it investigates aspects relating to the future implementation of the monitoring system. This will be examined through increasingly large pilot interventions from a social, behavioral, and economic perspective in addition to the medical evaluations.
The impacts of the IMPALA project will be assessed in two clinical centers in Malawi: Blantyre (Kamuzu University of Health Sciences - College of Medicine) and Zomba (Training Research Unit of Excellence). These are two world class research institutes that work closely with the world health organization.
Last but not least, the English Imperial College of London and the Dutch National eHealth Living Lab are involved and contribute with their extensive experience in AI, data science, biomarkers and digital health.