New India-UK Research To Trial Easy-To-Use Test To Cut Antibiotic Resistance

A new India-U.K. research project is trialling an easy-to-use test to determine if a urinary tract infection (UTI) is present to help establish a suitable course of action and help fight against the global threat of antimicrobial resistance (AMR), according to a British medical research charity.

LifeArc said the project is named Diagnostics for One Health and User Driven Solutions for Antimicrobial Resistance (DOSA) and brings together five leading academic institutions to create innovative and rapid diagnostic technologies to reduce AMR.

DOSA2, as the latest phase is known, is coordinated by the University of Edinburgh and includes partners at the University of the Arts London, Silchar Medical College, Assam University and the Indian Institute of Technology (IIT) Delhi.

"Through our work, we hope to help slow the emergence of drug-resistant infections and improve the ability to diagnose and treat them,” said Dr Mike Strange, Head of Global Health, LifeArc.

The new project is a continuation of the successful DOSA1 project, funded by UK Research and Innovation (UKRI), Economic Social Science Research Council, Newton Fund, and the Government of India’s Department of Biotechnology, which has developed a low-cost, easy-to-use diagnostic strip.

Once dipped in a urine sample, it tells in minutes if an infection is present which can inform the best course of action.

The field study of DOSA2 is attempting to tackle the global issue of AMR at the community level by working with healthcare professionals at primary healthcare centres, volunteers and accredited social health activists (ASHAs), employed by the Ministry of Health and Family Welfare in India.

They will collect urine samples from communities in India to help assess the accuracy of the DOSA UTI test strip and work with ASHAs to establish an understanding of the knowledge and practises around UTIs.

“UTIs are the second leading cause of human antibiotic consumption worldwide, with antibiotics often bought over the counter and taken without medical supervision, creating a vicious cycle of antimicrobial resistance,” said Professor Till Bachmann, Personal Chair of Molecular Diagnostics and Infection at the University of Edinburgh.

"UTIs can cause lasting, sometimes life-threatening, problems if appropriate medical care is not provided. This project has the potential to transform lives through a cost-effective and simple-to-use diagnostic test,” he said.

Prof. Bachmann hailed LifeArc’s investment in the field trial to ultimately enable policymakers to collect and analyse reliable data in the community in an unprecedented way.

“We hope to show the project’s viability to deliver meaningful change across India which could then lead to widespread adoption across other low-and middle-income countries and for other conditions,” he added.

The test uses two specific indicators in urine to detect the presence of bacteria and an infection. According to experts, it is designed to be used at home and is a fraction of the cost of commercially available alternatives, at less than 10 pence per strip, with an easier readout, and better environmental impact.

A crucial part of the new project is to help overcome stigma and engage rural communities across India to build trust and show the benefit of this kind of testing.

According to Dr Amitabha Bhattacharjee of Assam University, the DOSA project and current field study were presented at the 4th International Conference on Contemporary Antimicrobial Research hosted at the university as part of the World Antibiotic Awareness Week 2023. It received "'huge appreciation" from the clinical, academic and policy audience and was highlighted as a prime case for AMR intervention with high impact potential, he claimed.

AMR is one of the World Health Organisation’s (WHO) top 10 threats to global health which, if unchecked, could lead to 10 million deaths per year by 2050. This is because the antibiotics relied upon every day to deal with minor infections or after surgery could simply stop working.

India has the highest human antibiotic use in the world and, if successful, the DOSA Project could significantly help in the prevention and treatment of UTIs and the appropriate use of antibiotics in the country.

The research is part of a broader effort to shift the UTI treatment landscape in low- and middle-income countries, by addressing health, behaviours and systems and the interactions between them.

In this context, the goal of the new India-UK field trial is to see how the test performs and how easy it is to use.