A key tool in the fight against the covid-19 pandemic is robust testing. The gold standard has been polymerase chain reaction, or PCR, testing, which enables the testing of genes (of humans or of infectious pathogens) from patient samples and can help detect multiple diseases, including covid-19. But a big hindrance has been the cost and complexity of testing platforms. Some PCR tests can cost as much as ₹3,500.
That is changing. The development and large-scale deployment of TrueNat, an innovative point-of-care, or on-site, testing platform for PCR-based medical diagnostics, won Chandrasekhar Nair, chief technology officer of Molbio Diagnostics in Bengaluru, the prize in the engineering and computer science category at the recently announced Infosys Prize, which highlight scientific and research work on some of the most pressing challenges. Nair has created a rugged, real-time, battery-operated PCR device that needs minimal training and can be used at scale in any setting; it got regulatory approval for covid-19 testing in April 2020.
But TrueNat, which includes a portable machine and disposable cartridges, can test for more than 30 diseases and give results in under an hour. A single test, across diseases, costs less than ₹1,000 at point-of-care. It has got regulatory approval for tests for diseases such as tuberculosis, dengue, chikungunya, malaria, typhoid and scrub typhus, which are very common in parts of central and west India. The platform’s tuberculosis test, in fact, is approved by the World Health Organization and is being implemented in national health programmes across 10 countries.
“We developed TrueNat to be a point- of-care system for use in resource-limited settings. That was the goal. When we designed the system, we said we want to use this system independent of any infrastructure or aggressive training needs and make it affordable,” Nair says in a video call. It’s a platform that has been almost 20 years in the making, for it involved significant research and work in the areas of micro electro mechanical systems and mass-scale production.
The end product is a battery-operated, field-usable platform. As Nair explains, PCR is a process that requires a lot of power. For TrueNat, Nair and his team engineered a microchip to use very little energy for the rapid thermal cycling required for PCR. “It gives you patient-specific or test-specific data and tells you whether the result is positive or negative, including data on viral or bacterial load. We have been able to deploy the system wherever required across the country, even in remote places like Kargil,” adds Nair. The platform’s ability to turn over results in less than an hour, he says, allows clinicians to diagnose and treat in a single visit, rather than wait for weeks, and, in some cases, months.
In recent weeks, the emergence of the omicron variant of the coronavirus has driven home the need for more testing and low-cost test platforms. With covid-19 cases on the rise again around the world, systems such as TrueNat could play a key role.
“Viruses will continue to mutate. Our job, as people in the diagnostics field, is to ensure that these tests we have pick up any new variant that comes up, and, if required, develop tests that specifically target new variants. We will have to continuously evolve, along with the virus,” says Nair.