There is still widespread health inequality in Africa but an innovation from University of Pretoria could help bridge the diagnosis aspect of the gap
In March 2018, African scientists and innovators gathered in Kigali, the capital city of Rwanda for the Next Einstein Forum Global Gathering and this year featured several ambitious initiatives by researchers and entrepreneurs across Africa. One of the outstanding ones was presented by South African NEF Fellow Dr. Vinet Coetzee.
Coetzee is a researcher and lecturer at the department of genetics at South Africa’s University of Pretoria. She leads the team that developed a non-invasive malaria test that relies on a portable device whose technology includes an affordable 3D camera and highly sensitive algorithm that leverages on specific facial features associated to detect disease conditions.
While the malaria diagnosis innovation she presented is new, the facial morphology detection technology behind it was a product of years of research, iteration and reiterations involving a peculiar collaboration between researchers and the private sector – all with the major aim of developing a non-invasive technology that could quickly diagnose several human disease conditions.
Non-invasive testing is not new since physicians, for centuries, have employed many simple non-invasive methods based on physical parameters in order to assess body function in health and disease (physical examination and inspection), such as pulse-taking, the auscultation of heart sounds and lung sounds (using the stethoscope), temperature examination (using thermometers), respiratory examination, peripheral vascular examination, oral examination, abdominal examination, external percussion and palpation, blood pressure measurement (using the sphygmomanometer), change in body volumes (using plethysmograph), audiometry, eye examination, and many others.
Human diseases and facial morphology
About 700 disorders have characteristic facial features associated with them which can play crucial roles in the initial diagnosis of disorders, but the major shortcoming on the application of this principle is inter-population variation.
Many of the disorders are more difficult to recognise in African children because so little is known about the specific facial features associated with them in African populations. For example, Down syndrome which is easily recognised in Western infants are often difficult to recognise in Black African infants.
This means that they don’t get the lifesaving medical screening and treatment that they need when they require it. Some of these children likely die from associated conditions such as heart defects, even though these conditions could have been treated if their disorder was diagnosed in time.
In their publication on the genetics of human facial morphology, Cole Joanne and Spritz Richard revealed that human facial morphology broadly encompasses several distinct facial structures that alone and together contain enormous variations which contribute to our physical identities as both individuals and members of families and populations.
“The human face comprises an assemblage of multifactorial complex traits, with clear genetic components and known environmental factors playing key roles in its development and maturation throughout life. Current understanding of the genes and pathways pertaining to normal facial development and morphology comes largely from research on craniofacial malformations in both humans and animal models. Recent advances in methodology for deriving accurate and precise facial traits have allowed for several large genomic studies that have provided new insights into the heritability and genes involved in normal facial variation,” they stated.
They however added that continued research on the genetics of facial morphology will improve quantitative diagnosis, treatment and management of craniofacial syndromes, making it possible to one day model the human face from deoxyribonucleic acid (DNA).
Dr. Coetzee’s team has published several publications regarding various aspects of facial morphology and skin colour in health, diseases and other aspects of human endeavors.
Her most cited article was the 2009 PlosOne published piece which revealed that skin blood perfusion and oxygenation influence perceived health in a way that may be important to mate choice.
Private sector’s interest
Since the works of Dr. Coetzee’s team cuts across several human diseases, the team has been able to attract the interest, support and funds of the private sector including Canon which in 2016 announced it would be assisting Coetzee’s team to help bring to fruition a facial screening project that will assist with the early diagnosis of disorders in South African children, specifically African kids.
Canon South Africa reportedly sponsored ten EOS 1200D cameras that were used to build a 3D camera for Dr. Coetzee-led Facial Morphology Research Group.
When the ten cameras are triggered simultaneously, the images produced are used to build 3D models of faces. These 3D models will then be used to identify specific facial features associated with syndromes in African infants.
“When we heard about this tremendous, forward thinking project, we were excited to be involved in bringing it to fruition. We are pleased to be in a position to sponsor the necessary equipment to facilitate the building of a 3D camera for the facial morphology research project. This initiative has great potential to empower the early diagnoses of syndromes in African children, allowing for timely treatment to be effected and improving prognoses,” said Michelle Janse van Vuuren, Marketing Director at Canon South Africa.
The malaria epiphany
Speaking to healthnews.africa on the sidelines of the NEF Global Gathering, Dr. Coetzee noted that several diseases are associated with peculiar changes in facial appearance and her team aims to test the technology they have developed in several disease conditions.
The device that Dr. Coetzee presented can accurately detect malaria. It measures variations in skin colour to accurately predict whether an individual has malaria or not in a few seconds.
She recounted how the device was tested for the diagnosis of malaria in patients in Ibadan, southwest Nigeria.
According to her, the key points about the innovation is that it is highly sensitive and accurate in the detection of malaria even though research is still ongoing on the identity of the specific target/biomarker the device is picking.
“We have developed a rapid, non-invasive and affordable device that can accurately detect malaria and it can do so in very rural settings so you don’t need to have expensive labs. It is very accurate, it’s up to 77% accurate with a sensitivity of 94-95%. We can be very confident that the people that have malaria are all being detected,” Coetzee told healthnews.africa
Bridging Africa’s health inequality gap
While admitting that there is health inequality in Africa, Dr. Coetzee strongly believes that her research group’s facial morphology innovation could play important roles in closing the diagnostics gap for several diseases in Africa since the long-term aim of the project is to develop a facial screening tool that can help doctors identify a range of conditions more accurately at a largely reduced cost.
“Health inequality is a very dangerous thing in Africa and one way to see health inequality is the fact that there is a class of expertise and a wide distribution of needs. If you want to get a solution to health inequality, you need to connect the expertise to needs in an affordable way. This is what we have done with our innovation,” she told healthnews.africa.