1. Development of an Antenatal Screening Kit Katherine Paseman Under supervision of: Sean Monagle, Maxim Budyansky, & Kristy Peterson,

2. Impetus Undergraduate CBID Program at Hopkins Jhpiego

3. Problem Each year 6.3 million pregnant women and infants die due to preventable complications of pregnancy In developing countries 32% of women have no access to antenatal screening and when you look into the rural regions of these countries you will find this number to be as high as 80%.

4. Problem Pre-eclampsia and eclampsia cause 576,000 deaths per year Current methods for detection are dipsticks (20-30 cents/ dipstick) Cheap treatments are available

5. The “Key Question” Is there a way to improve the technology which already exists to detect Pre-eclampsia so that it is cheaper, more effective, and can be used as a platform to detect other diseases? (like gestational diabetes, and UTIs, and most other diseases which can be detected by Dipsticks)

6. Quick Appendix Pre-Eclampsia: High blood pressure Indicator: Protein Gestational Diabetes: Diabetes during pregnancy Indicator: Ketones Urinary Tract Infection (UTI): Infection in urinary tract Indicator: Nitrites

7. Current Progress

8. Patent Reading

9. Reagent Design Factors Thermal and Light Stability Moisture Resistance Evaporation Color Uniformity

10. Device Design Paper Pen vs. dropper vs. spray Opaque vs. clear Packaging

11. Ketones Fats not glucose  Ketosis Two methods for detection acetoacetic acid β-Hydroxybutyric Acetone (CH 3 ) 2 CO Acetoacetic acid CH3C(O)CH2CO2H β-Hydroxybutyric acid C4H8O3

12. Ketones Efficacy Comparison

13. Ketone Problems No specific concentration Ketone decay

14. Nitrites Not all UTIs caused by bacteria

15. Nitrites Color Change due to Light

17. Nitrites Efficacy Comparison

18. Nitrite Problems Light exposure Low threshold Stunted Research

19. What I’ve Learned about Research Ask questions, make observations Expertise optional, enthusiasm required

20. Bibliography Dr. Anthony Speroni, Urinalysis Results Interpretation, http://www.drsperoni.com/downloads/articles/Urinalysis_Results_Interpretation.pdf, Jhpiego.org Wilson et. al, Denver Health Medical Center, (April 15, 2004), Laboratory Diagnosis of Urinary Tract Infections in Adult Patients, Medical Microbiology, http://cid.oxfordjournals.org/content/38/8/1150.full.pdf Lillian Mundt, MHS, (2013), Chemical Screening of Urine by Reagent Strip, MediaLab, http://www.medialabinc.net/spg506373/nitrite_test_sensitivity.aspx Gary R. Skankey, MD, FACP, Infectious Disease, Las Vegas, NV, (no date), A Practical Guide to Diagnosis and Treatment of Infection in the Outpatient Setting Diagnosis and Treatment of Urinary Tract Infections, http://www.nevadapublichealthfoundation.org/userfiles/file/Physician%20Antibiotics%20Materi als/Article-Diagnosis_and_Treatment_of_UTIs.pdf Hiren P. Patel, Ohio State University, (2006), The Abnormal Urinalysis, Pediatric Clinics of North America, http://inovapeds.org/library/readings/Proteinuria/The%20Abnormal%20Urinanaylsis.pdf American Diabetes Association, (January 2003) Tests of Glycemia in Diabetes, http://care.diabetesjournals.org/content/26/suppl_1/s106.full.pdf Sacks et. al, Harvard Medical School, (3/02) Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus, Clinical Chemistry, http://www.clinchem.org/content/48/3/436.full.pdf