Guest post by Dr. Saurabh Mehta, Associate Professor of Global Health, Epidemiology, and Nutrition Division of Nutritional Sciences at Cornell University
Dr. Saurabh Mehta and his colleagues have been developing the NutriPhone – a mobile device-based diagnostic platform that can determine micronutrient concentrations by testing a blood sample from a finger prick, the results of which are then displayed on an app within a few minutes. When the NutriPhone is ready for market, it is envisioned to be an important tool for health care facilities and community health workers all over the world, including the most remote regions. Availability of this easy to use technology will enable accurate and inexpensive assessment of nutritional status at point-of-care in both home and field settings.
Nutrition International is supporting this development through its Innovation Agenda: an internal process whereby staff can submit new and innovative ideas to address malnutrition that may be sponsored by the organization. One of the funded proposals was from Kim Harding, Technical Advisor, Maternal and Neonatal Health and Nutrition, who suggested extending Nutriphone’s capabilities to vitamin A and iron after learning about this exciting initiative from Dr. Mehta. The Innovation Agenda has many projects like this – both large and small – where a simple pitch from a staff member might potentially end up making a huge impact.
Conventional definitions of medicine and public health have often distinguished them by their focus on the individual and the population, respectively. Those of us who work in nutrition are acutely aware of the need to enable convergence of these approaches as there are not many universally applicable silver bullets or one-size-fits-all strategies for optimizing nutritional status and health. This ‘individualizing of public health’ or ‘precision nutrition’ encompasses prevention and treatment strategies for improving health that consider individual variability in diet, lifestyle, environment and genes. Therefore, technology that can enable the characterization of the nutritional status of an individual as a first step without involvement of intensive resources or infrastructure is critically needed. This is particularly significant as malnutrition now affects a third of the global population, and most of those affected as well as their care providers have limited means of determining their nutritional status.
Similarly, those involved in program design and implementation often have no rapid and affordable way of determining the need for nutrition interventions or the impact or success of their interventions on different indicators of nutrition status, thus hindering program design and scale-up. Nutritional screening in traditional lab settings is expensive, time-consuming, and requires cold-chain and skilled technicians to perform the tests.
The Mehta and Erickson groups at Cornell University have developed the NutriPhone technology, a point-of-care diagnostics platform coupled with a mobile device (smartphone or tablet) to provide improved access to nutritional status assessment. NutriPhone is a first step towards enabling precision nutrition and tailored interventions at both the individual and community levels. NutriPhone is comprised of a low-cost reusable accessory that interfaces with a mobile device, an app, and a test strip to enable colorimetric quantification of different biomarkers.
Nutrition International provided partial support to extend the application of this technology to the measurement of vitamin A (serum retinol-binding protein) and iron (serum ferritin and transferrin receptor), along with C-reactive protein (an indicator of inflammation that helps interpret the vitamin A and iron results) to better inform public health interventions. Currently, there is very limited country-level information on iron and vitamin A status. Where it does exist, it is often old or only representative of small population groups within countries – which limits its use to inform policies and programs.
NutriPhone requires minimal training, no storage or transportation of test samples, uses a minimally invasive finger prick blood sample, and could be easily deployed in a variety of settings including at-home use, research, surveillance, monitoring and evaluation, and health care including primary health care settings in remote areas. Similar to other mobile device-based diagnostic systems, NutriPhone has the capabilities to track health-related changes over time, and to communicate results via e-mail or text messaging.
Many nutritional deficiencies can be overcome by changes in diet, intake of supplements or other behavior modification, particularly if detected early on in their course. At the population level, technology such as NutriPhone can be a critical tool for international nutritional surveillance programs and monitoring of intervention programs. At-home, Nutriphone can help monitor adherence to interventions and track response. The World Health Organization has estimated that there is a global shortage of approximately 4.3 million doctors and nurses, which makes telemedicine and personalized point-of-care testing such as NutriPhone critical. We believe that NutriPhone can potentially bridge a major healthcare, research, monitoring, and implementation gap by making testing for nutritional status accessible to a large proportion of the global population.
For its great potential in advancing the way we address malnutrition internationally, we are looking forward to collaborating with partners to take the NutriPhone forward.