Stick, Press, Diagnosis: Rapid Diagnosis on a Global Scale

Changing how we do health care may start in the lab.

Prof. Axel Scherer

When Dartmouth-Hitchcock’s Gregory J. Tsongalis, PhD, received a phone call from Axel Scherer, a professor of Electrical Engineering, Applied Physics and Physics at Caltech, the phone call went something like this: “I’ve been reading “Molecular Diagnostics: For the Clinical Laboratorian” and noticed that you’re the author. Can we meet?” As it turned out, Scherer was teaching just down the street at Thayer School of Engineering as a visiting professor.

What Tsongalis, director of Molecular Pathology, and Scherer, director of the Caltech Global Health Initiative discussed were diagnostics in the developing world. “What the developing world is grappling with is being able to provide rapid diagnostic testing at the same time the patient is seen by the clinic or village health care provider,” explains Tsongalis. Too often, he says, patients do not, or cannot return for their test results because they live too far away. “So a seven or eight hour turnaround and instructions to come back tomorrow, just doesn’t work and we may never see them again.” These patients are “lost to follow up.”

Tsongalis and his team are working to develop an assay—or test—that can produce a quick diagnosis, in collaboration with Scherer and Caltech engineering who is creating the delivery system. To accomplish this in less developed countries, presented opportunities as well as challenges. “It required really unorthodox thinking,” Tsongalis says, “so I told the research and development group in the lab ‘everything you ever learned at school or I ever taught you here in the lab, forget about it. Due to the extensive limitations we have to start from absolute scratch, and think completely outside of the box’.”