Project to tackle urinary tract infections in low- and middle-income countries refunded for third phase

Urinary tract infections (UTIs) are one of the most common infectious diseases, but many people, particularly women in low- and middle-income countries (LMICs), cannot access appropriate care. 

In addition, the lack of rapid and affordable diagnostic tools means that even when treatment is available, antibiotic prescriptions are often made without a definite diagnosis.  This contributes towards poor outcomes for patients and drives antimicrobial resistance. 

To address this critical need, the University of Edinburgh, in partnership with the University of the Arts London, Assam University, Silchar Medical College and the Indian Institute of Technology Delhi (IIT Delhi), has received further funding for the DOSA project from PACE-AMR that will allow continued development and testing of two low-cost diagnostic tests for UTIs. 

The new tests will be used in conjunction with each other, at the point of care, to reduce inappropriate prescribing. 

The first is a colorimetric paper-based strip test for bacterial infections in urine, which is simple enough to be used in the home by non-specialists.

If this gives a positive result, it is followed up in a primary care setting by a second point-of-care test, which is used on a urine sample to rapidly determine the susceptibility of the bacteria to nitrofurantoin, an antibiotic commonly indicated for UTIs.  These results will inform appropriate prescription, and help reduce antimicrobial resistance.

The earlier phases of the DOSA project focused on identifying and addressing community needs related to urinary tract infections (UTIs) and antibiotic resistance (AMR). 

Crucially the project initially started with a One Health approach with partnerships across animal health (dairy), environment (aquaculture), and human health (urinary tract infections).  Through ethnography and co-creation workshops, the project team worked with communities in India to co-design diagnostic solutions to address AMR challenges.

This collaborative approach resulted in the development of a diagnostic test that was easy to read and environmentally friendly, and that specifically addressed community care-seeking behaviours i the community.

With the new funding and support from PACE, the DOSA project will increase the storage stability and mass-manufacturability of the strip test, develop the susceptibility test so that it is optimal for point-of-care settings, and assess the performance of both tests in the field. 

Success for the project will mean improved access to care, better therapeutic outcomes, and more appropriate use of antibiotics in LMICs, contributing to the fight against antimicrobial resistance. The project will also deliver data that is urgently needed for better policy interventions to tackle UTIs.

PACE is a £30m initiative from Innovate, UK, LifeArc and Medicines Discovery, Catapult, supporting early-stage innovation to tackle antimicrobial resistance.

PACE projects portfolio

Diagnostics for One Health and User Driven Solutions for AMR (DOSA) 

Professor Till Bachmann

Institute of Regeneration and Repair, University of Edinburgh

University of the Arts London

Assam University

Silchar Medical College 

Indian Institute of Technology Delhi