Fondation Botnar supports researchers from Unisanté to integrate dynamic clinical algorithms into frontline healthcare for child and adolescent health in Tanzania
Today Fondation Botnar is proud to announce a new partnership with Unisanté, awarding CHF 7 million to support the implementation of clinical algorithms to improve the health of febrile children and reduce unnecessary antibiotic prescriptions in Tanzania. The project is led by Unisanté and the École Polytechnique Fédérale de Lausanne (EPFL), in collaboration with the Swiss Tropical and Public Health Institute (Swiss TPH), and two research institutes in Tanzania: Ifakara Health Institute (IHI) and National Institute for Medical Research (NIMR).
Each year, 3.3 million children die from an acute febrile episode. Children are a vulnerable population that suffers most from acute illnesses. The management of sick children at primary care remains inadequate: health professionals have limited skills and tools, clinically validated diagnostic tests are sometimes missing, and practice guidelines are often defined for an entire country and not well adapted for local epidemiological situations.
The DYNAMIC project, led by Prof. Valérie D'Acremont aims to improve the quality of care for children (0-12 years) first, and then eventually adolescents in low-resource settings by implementing novel dynamic clinical algorithms and point-of-care tests that help to guide and train health workers in the management of sick children. In Tanzania, the ever-increasing use of antibiotics, where 9 in 10 times an antibiotic is not necessary has been associated with bacterial resistance and ineffectiveness. The health risk remains a high priority for the World Health Organization. The DYNAMIC project could avoid 1 million treatment failures and 28 million unnecessary antibiotic prescriptions each year in Tanzania.
“Both the global shortage of health workers, and the lack of upskilling and training has a severe impact on the health and wellbeing of children and adolescents, especially in low-resource settings,” said Dr. Aline Cossy-Gantner, Chief Learning Officer of Fondation Botnar. “Fondation Botnar is excited to work together with Unisanté, Prof. Valérie D'Acremont and their partners on this important opportunity to address some of the most pressing child health needs. The DYNAMIC project will also provide valuable insights for the foundation as we look to generate evidence on the application and use of digital technologies to improve and personalise health in other low-resource settings.”
At a public health level, computerised surveillance will improve the early identification of localised epidemics and will support both the modification of the patient care algorithm, and the implementation of appropriate interventions, such as vaccination campaigns and other preventative measures.
“The DYNAMIC project illustrates the value of reverse innovation. Because the Tanzanian health system is new, it is more flexible than the Swiss system. It is more connected and integrated and less governed by silos than Switzerland. What we are doing in Tanzania will have the secondary effect of providing experience which could be of benefit in Switzerland.” said Professor D’Acremont.
The platform established by the DYNAMIC project, which will be set-up in 70 health facilities across Tanzania will also offer the opportunity to validate new diagnostics from other initiatives which could strengthen the uptake and integration of future digital tools that can have efficiency gains in health system.
The DYNAMIC project will start on 1 April 2019. The tools and algorithms will be developed in Switzerland and deployed in Tanzania, over a five-year period
The origins of the DYNAMIC project
The DYNAMIC project is based on earlier work by Professor D’Acremont (Unisanté and Swiss TPH) and her research group, who have conducted large-scale research studies with children and adults living in Tanzania. The identification of the causes of fevers in Tanzania enabled the development and implementation of a first generation of electronic algorithms using tablets, as a basis for personalised diagnosis and treatment of patients (ALMANACH). The second generation of this mobile tool, connected to biosensors and rapid point of care tests (ePOCT), works to guide health professionals throughout the consultation - helping them identify the patient’s personal characteristics and assesses whether the prescription of an antibiotic is necessary for each patient. The use of this second-generation electronic tool has proved highly effective in the treatment of children suffering from fever and has enabled a drastic reduction in the misuse of antibiotics, from 95% to 11%. Their work led to the award of the Pfizer Prize in 2015 and 2019.
The DYNAMIC project is part of the development of algorithms for clinical decision support and other electronic health care tools (eHealth), in which Unisanté has been carrying out research and implementation for the last 15 years. Unisanté is the new University Centre for Primary Care and Public Health, established in January 2019. The centre brings together the Policlinique Médicale Universitaire, the Institute of Social and Preventive Medicine, the Institut Universitaire Romand de Santé au Travail and the association Promotion Santé Vaud.
About Fondation Botnar
Fondation Botnar is a Swiss foundation established with the core purpose of improving the health and wellbeing of children and young people in growing secondary cities around the world. To achieve this, Fondation Botnar acts as a catalyst, connecting diverse partners and investing in solutions that leverage artificial intelligence (AI) and digital innovation.
The press release can also be found in French on Unisanté's website here: https://www.pmu-lausanne.ch/a-
Professor Valérie D’Acremont
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