In 2005, a 23-year-old man went to a rural Burmese hospital complaining of fever. The malaria diagnosis wasn’t surprising. The disease is common in his district, but recent drug therapies have reduced death rates dramatically. The man took the prescribed medicine, artesunate supposedly made by Guilin Pharmaceutical in China. Doctors expected a full recovery.
Three days later, the patient went into a coma. Despite transfers to two other hospitals and injections of intravenous fluids and more artesunate, he died of cerebral malaria.
Analysis of the drug provided by the first hospital showed that it was a fake. Guilin makes authentic medications, but the active ingredient in the hospital’s supply was acetaminophen. A small amount of artesunate was present, about 20 percent of a normal dose, enough to fool a simple test.
By some estimates, a third to half of the artesunate in some countries is counterfeit. The World Health Organization has called for faster, more accurate tests, and now a team of Oregon State University chemists has stepped up with an innovative approach. They have created an inexpensive paper-based assay that detects a range of artesunate concentrations by turning shades of yellow in the presence of the drug. In OSU’s new Linus Pauling Science Center, this international team of scientists and students is also developing an affordable diagnostic device that can work with the paper test to pinpoint the amount of an active ingredient in a sample.
“We’re trying to develop a simple, rapid and inexpensive method to detect these counterfeits,” says Myra Koesdjojo, who received her Ph.D. in chemistry from Oregon State in 2009 and now manages OSU professor Vince Remcho’s lab. The native of Indonesia knows what’s at stake. Members of her family have had malaria, a disease that kills as many as 900,000 people a year, most of them children in Africa and south Asia.
Fake drugs not only allow patients to die, they also promote antibiotic resistance. By exposing pathogens to ineffective doses of pharmaceuticals, counterfeits enable disease-causing germs to survive and spread, hastening the day when they can outwit front-line drugs.
Koesdjojo and her team envision a portable testing device the size of a cell phone. Health professionals would be able to test batches of drugs quickly and cheaply. The OSU researchers have already built a prototype using off-the-shelf electrical components and open-source software. In their plans is development of an iPhone app.
“We tried a color sensor with an existing iPhone app,” says Koesdjojo. “It works pretty well. But it’s not built for this purpose. We want to use the same idea and develop our own app.”
The team has even greater ambitions: inexpensive, portable devices to detect environmental pollutants and blood-borne diseases. Koesdjojo says her brother would have benefitted. When he came down with malaria, doctors also treated him for dengue fever because the symptoms are similar and they were unable to perform a more precise test.
“Having these simple tools,” she says, “will eliminate the guessing and enable doctors to treat for the right disease.”
International Research Team
Koesdjojo’s team includes students from Oregon and Asia
The Schuette fund supports transfer students as they acclimate to OSU and contributes to student success by promoting contacts between advisers at community colleges and Oregon State.