Primary Projects From Ghana: Group 1

Throughout the Spring 2017 semester, our professor, Dr. David Issadore, taught us (a class of eight undergraduates students and one graduate student) about microfluidics and point-of-care diagnostics. The next phase of the course was to come up with a new diagnostic for pediatric tuberculosis. At the end of the semester, our final assignments included submitting an NIH Research Project Grant (R01) proposal and giving a 20-minute presentation for our devices. These assignments greatly prepared us for our trip to Ghana, as we were able to ask questions and get feedback on our proposed devices by speaking to healthcare professionals at Ghanaian hospitals, clinics, and research facilities. The semester course was mainly focused on the technical design of our devices, which enabled us to hone in on the practical and real-world implementation of the devices while in Ghana. This week, the BE Blog will publish our summaries.

Fecal Diagnostics for Pediatric Tuberculosis

Katharine Cocherl ’20, Kathleen Givan ’20, Kaila Helm ’20, Hope McMahon ’18, David Pontoriero ’18

In order to address the numerous diagnostic problems specific to pediatric tuberculosis in low-resource settings, we have designed a device that uses a fecal sample rather than the current method of sputum samples. Because many children cannot produce sputum samples with the required quality and quantity of sputum, we decided to use stool samples. This noninvasive substitute will ideally allow us to collect all the bacteria swallowed by the patient. The bacterium that causes the disease, Mycobacterium tuberculosis (MTB), is very hardy and has been found to appear in fecal matter. However, this method may be difficult because there are many other substances in fecal matter that need to be removed. By filtering out these impurities, the presence of the bacteria can be detected.

The device we designed is essentially a disposable cartridge that separates  virulent TB bacteria from all other fecal material. This collection can be performed with no power and minimal technician input and can be obtained in any desired volume. The total operation time is predicted to be 90 minutes.

ghana group 1
The figure shows an overview of the steps (a-h) for use of the fecal diagnostic for pediatric TB (click to enlarge).

The first aim of our project is to identify a target protein on the surface of the bacteria so that the bacteria can be isolated from the solution. Next, the MTB will be enriched from fecal samples with a single-use filtration device so that a final sample can be provided in a similar form as a sputum sample. This final sample can then be used for smear microscopy, in which technicians look for the presence of the bacteria under a microscope, or for use with the GeneXpert. The GeneXpert is an automated diagnostic test that can identify MTB DNA and resistance to the most potent TB drug, rifampicin. These devices have been distributed to labs and hospitals across Ghana, but they are not yet widely used for general diagnostics.

Because the number of GeneXperts available and the infrastructure supporting them are increasing, we are hopeful that, in the near future, our diagnostic will be able to be used in conjunction with this technology. Upon integration with the GeneXpert system, our device would be able to increase sample specificity for the underserved demographic of pediatric TB patients. In addition, as technology becomes available in smaller, more local clinics, we foresee lower travel burdens for families and lower operational costs for healthcare facilities.

We are beyond grateful for the opportunity to engage with Ghana’s medical system. Before traveling to Ghana, we created a proposal for our fecal diagnostic for pediatric TB. After learning more about the current medical system and infrastructure in place, we were able to revise our ideas in a meaningful way. It is our hope that one day a project of this magnitude can come to fruition.

Bioengineering and BDM Go Together

by Joe Maggiore, Bioengineering ’19

BDM stage
Band Dance Music in performance

I’m a rising junior studying Bioengineering at Penn. I’m also the founder of a music group called Band Dance Music (BDM). The overall premise of the group is to take the same music that a DJ plays at a college party but to play it with an 11-piece live band. The idea for this group started before I got to Penn, but it was something that I was confident in pursuing despite all of the other time commitments during the school year.

Starting a band at Penn was definitely a challenge. There are already so many music groups on Penn’s campus that it’s very easy for a group that is just starting out to get drowned out by other more prominent groups. After really pushing marketing hard for auditions, it actually was pretty easy to find students who were interested in the idea behind the group. Interestingly, of the 11 members that are now in the group, nine of them are actually in the School of Engineering and Applied Science.

While bioengineering and band dance music seem like two totally disparate fields, I was actually able to bridge the gap between these areas while taking ENGR105 with Professor Rizk. At the end of this course, we are asked to create a graphical user interface (GUI) that combines the entire course’s material. This GUI is completely free form – it can be in any area of interest that you like.

Since for a while I’d been having trouble arranging music completely by ear, I thought this would be the perfect opportunity to create a GUI that would help me arrange music for the band. There is rarely free time to spare during the school year, so being able to work on a passionate project of mine while also being able to complete my course work was a win-win situation. The GUI definitely took me longer than expected to create since it involved having to process electronic music into parts that would be easier to arrange, but I eventually was able to finish the interface. It featured a tap metronome, a filtering system, and a visual music player so I could streamline the music writing process. Below is a pictures of the GUI I created.

BDM is always looking for more interesting people to join who have a passion for this unique concept for a band. If any bioengineers reading out there are interested, feel free to reach out to me – I’d love to talk more about it. Thanks for reading!

Ghana Trip to Study Tuberculosis: Day 29

Ghana 29.1
One of our favorite memories was visiting King Otumfuo Nana Osei Tutu II of the Asante region (left to right: Salim, Jason Grosz, David Pontoriero, Kaila Helm, Hope McMahon, Dr. David Issadore, Danielle Tsougarakis, Ethan Zhao, Kathleen Givan, Dr. Miriam Wattenbarger, Katharine Cocherl, Kate Panzer).

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

As we woke up early to prepare for the nine-hour flight ahead of us, we all acknowledged that time really does fly. Arriving at the Accra airport, we had to say goodbye to our Ghanaian friends Salim, Uncle Ebo, and Nana Yaa. The month has come and gone. It feels like the trip went quickly, but we have learned so much and gained many valuable experiences along the way. From our hospital and clinic visits, to our interactions with an herbalist and a fetish priestess, we were exposed to many healthcare settings found in Ghana. We had the opportunity to present our pediatric tuberculosis diagnostic ideas to a room filled with researchers and clinicians, getting invaluable feedback from multiple experts. Along with our academic pursuits, we also got to explore the Ghanaian culture and learn about customs, traditions, food, and much more. We met many friendly people along the way. These aspects are the memories that we will remember for years to come. As we move beyond this course, we are excited to continue pursuing our interests in biomedical diagnostics and problem solving that can be applied globally. We would like to thank everyone who helped make this unforgettable experience possible.

Ghana Trip to Study Tuberculosis: Day 28

Ghana 28.2
Students enjoy their last dinner in Ghana at Buka, a Ghanaian and Nigerian restaurant in Accra (left to right: Jason Grosz, Ethan Zhao, Danielle Tsougarakis, Hope McMahon, Salim, Uncle Ebo, Kaila Helm, Kate Panzer, Katharine Cocherl, Kathleen Givan).

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today marked our last full day in Ghana. In the morning, we set off rather early to start our day in Accra. But first, we had to drop one of our students, Dave, at the airport so he could make his way to Rwanda to visit a college friend. As we traveled to the airport, we had the opportunity to get a better picture of what life is like in Ghana’s capital. It was nice to go back to Accra and see how different it was from Kumasi. It is a much larger city, with various government buildings, people walking about, and large advertising signs every few yards.

Ghana 28.1
Kwame Nkrumah stands with past Vice Provost Roy Nichols in front of the Benjamin Franklin statue on College Green.

Our first stop was the Kwame Nkrumah Memorial Park. Kwame Nkrumah was the first president of Ghana when the country gained independence in 1957. Interestingly, he went to Penn to earn a Master of Arts in philosophy and a Master of Science in education. The mausoleum in Accra contains his and his wife’s bodies. It is surrounded by various water fountains, which are a symbol of life to provide a sense of immortality for Nkrumah. Many Ghanaians want to continue the work that Nkrumah did not get to finish by helping Ghana to continue developing as an independent country. In addition, there is a museum that contains many of his clothes and pictures of him as he met with various world leaders. We even saw a picture of him on Penn’s campus, shaking the hand of then Vice Provost Roy Nichols.

After the tour, we met Dr. Ellis from KCCR for lunch at a nice open-air restaurant, called Buka. Many of us stuck to our favorites of chicken and fried plantains, but some ventured out to try guinea fowl and snails. After lunch, we walked around the area to some nearby vendors, where we were able to shop for last minute gifts. We soon realized how much more expensive Accra was, compared to Kumasi.

We headed back to the hotel to relax a bit before dinner. For our last night in Ghana, we went out to a restaurant that had a live jazz band. We had our last taste of Ghanaian cuisine and had fun dancing to highlife music. Highlife is a genre of music that we only recently learned is popular in both Ghana and Nigeria. To end our last night in Ghana, we headed back to the hotel. After spending some time to prepare, we huddled in the hotel’s lobby for our talent show, and as night turned into morning, we reluctantly headed to our rooms to finish packing for our early departure.

Ghana 28.3
The APOC program began and ended in Accra, the capital of Ghana.

Ghana Trip to Study Tuberculosis: Day 27

by Ethan Zhao, Bioengineering ’19; and Jason Grosz, Bioengineering ’19

Ghana 27.1
The APOC team poses in front of the rooms at Coconut Grove, resembling huts on the outside and furnished with beds and a bathroom on the inside (left to right: Salim, Ethan Zhao, Jason Grosz, Dr. Ocek Eke, Dr. Miriam Wattenbarger, Hope McMahon, David Pontoriero, Kaila Helm, Kathleen Givan, Kate Panzer, Danielle Tsougarakis, Katharine Cocherl, Nana Yaa).

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today was the second day that we spent in the coastal city of Cape Coast. Many of us woke up earlier than usual to walk along the beach and explore the resort. While walking along the beach, we noticed large rowboats in the distance that were anchored to the shore by ropes. We originally thought that they were fishing boats, but it turned out that they were digging up sand from the ocean floor to restore sand erosion on the beach.

Ghana 27.2
Students (left to right) Kate Panzer, Hope McMahon, Katharine Cocherl, and Danielle Tsougarakis stand along the beachfront of Coconut Grove in Cape Coast, with the Atlantic Ocean in the background.

After breakfast, we traveled outside of Cape Coast to Kakum National Park, which is a dense tropical rainforest on the coast that is home to many wildlife species, including monkeys, leopards, elephants, and antelope. It is also the home of one of Africa’s largest canopy walkways, consisting of rope suspension bridges more than one hundred feet above the forest floor. The views from the bridges were amazing, as we could see for miles across the tops of the rainforest trees. While we were on the bridges, it started drizzling, which was refreshing given the heat. After leaving Kakum National Park, we drove back to Accra, the capital of Ghana, where we will stay for the remainder of our trip.

Ghana 27.3
The APOC students stand on a platform among the treetops of Kakum National Park, 100 feet above the ground (left to right: Salim, David Pontoriero, Kathleen Givan, Kate Panzer, Ethan Zhao, Danielle Tsougarakis, Jason Grosz, Hope McMahon, Katharine Cocherl)

Ghana Trip to Study Tuberculosis: Day 26

by Dave Pontoriero, Biotechnology MS ’18

Ghana 26.1
A Portuguese church found in the center of the Elmina Slave Castle.

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today, we said goodbye to our Kumasi friends and left the Ashanti region for the final leg of our trip. After our bonus night in the new student hostel (dormitory), we boarded the KNUST bus for a six-hour road trip to Cape Coast. The drive was pleasant, and the scenery became more coastal as we continued. Most people slept through it, but once the ocean became visible, everyone woke up in excitement because we knew we were getting close to Elmina, a beach town just west of Cape Coast.

As we drove through the town, we noticed that it resembled many of the beach towns back home. Our driver, Uncle Ebo, then parked in front of an enormous white castle. It was located on the edge of a peninsula, with a narrow beach to its left and crashing waves to its right. It had cannons situated all along its upper levels and a bustling group of locals hanging out in front of its entrance. It was the Elmina Slave Castle, also known as St. George’s Castle, and the team started to prepare for the tour.

Ghana 26.2
Cannons are found on the perimeter of the Elmina Slave Castle, which point out toward the Atlantic Ocean.

As we entered the castle, the mood became somber. A tour guide provided us with a background of the building, which was a Dutch fort used over the years to facilitate the sale and transport of people from Ghana and the surrounding countries during the slave trade. The first portion of the tour followed the path of a slave during their internment, beginning with the female quarters, then the courtyards used for public punishment, the male quarters, punishment cells, and lastly the final exit where people were loaded onto the ships for their journey across the Atlantic. It was a grim tour to take, and the guide shared some incredibly harrowing stories throughout. The second portion of the tour focused more on other aspects of the fort.

Once we loaded back onto the bus, the team reflected on the experience we had at Elmina Castle as we drove away. After a half-hour drive, we soon arrived to our new rooms at a local beachfront resort called Coconut Grove. Its beautiful facility included a private beach, an ocean-facing restaurant/bar, beachfront swings, a golf course, horse stables, and a crocodile pond (with ~10 real crocodiles!). We went out to a local restaurant with live music, danced a bit, then headed home to enjoy the amenities during one of our last nights together as a team.

Ghana 26.3
The breathtaking view of Elmina, a beach town on the coast of Ghana near Cape Coast.

Ghana Trip to Study Tuberculosis: Day 25

by Danielle Tsougarakis, Bioengineering ’20; and Kate Panzer, Bioengineering ’18

Ghana 25.1
Our last trip to Icy Cup, a yogurt food truck and shop chain that can be found scattered across campus and in other major commercial areas in Kumasi (left to right: Hope McMahon, David Pontoriero, Ethan Zhao, Martin, Katharine Cocherl, Kate Panzer, Kaila Helm).

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

This morning, we found out that we would be spending our last night in Kumasi in a hostel, which is equivalent to a dormitory at a U.S. college. We packed our belongings and moved into a hostel called “Complex Brunei,” which is an apartment-style dorm for upperclassmen, each room furnished with three beds, a closet, a full bathroom, and a table. We were all excited to get the student experience of staying in a hostel and compare it to the visitor housing at the KCCR guesthouse.

In the afternoon, we had the opportunity to visit the international community school (ICS),  a high school founded on the philosophy of bringing competitive, Western-inspired education to Kumasi. A friend of our team member Dave currently works at ICS and suggested we come speak to the prospective college students at the school. That being said, we gave a presentation on how the college application process works in the United States to a group of 10th and 12th graders. After our brief overview, we split into small groups and answered individual questions students had regarding different types of universities, SAT/ACT scores, the importance of a strong essay, and other application essentials. Speaking with the prospective students here and motivating them to apply to American universities was a great experience. Sharing our own college application processes and stories with the students was a fun and engaging way to fuel their academic aspirations. After our well-received presentation, the whole team left feeling accomplished.

Ghana 25.2
For our last night in Kumasi, we spent quality bonding time with our new friends Seun (Pittsburgh) and Tim (Michigan) and said our goodbyes.

For dinner, we had a special surprise outing to a nearby Chinese restaurant, where we shared many different dishes and passed them around on a rotating glass platform. For some of the Ghanaians, this was their first time trying Chinese food, so it was fun to hear their reviews of all the dishes. Upon returning to campus, we continued our beloved tradition of team bonding by playing the Noun Game and card games.

Ghana Trip to Study Tuberculosis: Day 24

by Kaila Helm, Biological Basis of Behavior ’20;  Kathleen Givan, Bioengineering and Political Science ’20; Katharine Cocherl, Bioengineering ’20; and Hope McMahon, Chemical and Biomolecular Engineering ’18

Ghana 24.1
At a nearby hostel (dormitory), the APOC students gather to watch a big football match between the Ghanaian and the Ethiopian national teams. (Ghana won!)

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

We started our not-so-lazy Sunday with a late start. We enjoyed our last weekend breakfast, provided by the one and only Nana Yaa. A fan favorite is always the avocados and the Milo, which we know we will miss dearly when we get back to the States. Luckily, we all have our personal stashes we plan on bringing back. We all had the much-needed opportunity to do laundry and catch up on life errands. Once mid-afternoon hit, we all decompressed by watching the Ghanaian vs. Ethiopian National Football teams on the television in a nearby dorm. GHANA WON THE FIFA QUALIFIER AND THE CROWD WENT WILD!!!!!

Ghana 24.2
The APOC girls show off their newly made Ghanaian clothing at the Closing Ceremony (left to right: Katharine Cocherl, Kathleen Givan, Kate Panzer, Kaila Helm, Danielle Tsougarakis, Hope McMahon)

The next thing on the agenda was our farewell ceremony and dinner. We were instructed to wear our Ghanaian clothing that had been made for us during the trip, but some of us had not yet received the alterations back from the seamstress. When Nana arrived, clothes in hand, it was exhilarating to see the final products and wear similar colorfully patterned clothes to our Ghanaian counterparts.

The meal was catered by our favorite kebab stand, along with drinks, tilapia, and banku (the classic combination). Many of the people who have contributed immensely to our trip were there, and we enjoyed good conversation and memories into the night. We were put to shame as we watched the children dance their hearts out, using more rhythm and soul than we would know what to do with. It was so nice to see the program come full circle. We all looked back fondly at the welcome ceremony, where all the faces were unfamiliar but kind. Fast forward to the farewell ceremony, and this time, we saw the same faces and smiles, but now we felt connected to the people behind them.

Ghana Trip to Study Tuberculosis: Day 23

by Ethan Zhao, Bioengineering ’19; and Jason Grosz, Bioengineering ’19

Ghana 23.2
Penn students watch with amazement as a professional weaver demonstrates the process of Kente cloth weaving (left to right: David Pontoriero, Kaila Helm, Katharine Cocherl, Kathleen Givan)

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Ghana 23.4
Wooden Kente cloth looms can be found throughout the Kente factory, where weavers produce intricate Kente cloth throughout the day.
Ghana 23.1
Penn student Jason Grosz attempting to spool cotton thread for future Kente cloth weaving.

Today, we went to see how Kente cloth is made.  Kente is a special ceremonial cloth, often woven with a story or message in the pattern.  Our tour guide showed us several different kinds of fabric they use, including wool, polyester, and cotton, and demonstrated how they are threaded from the original material with a wooden, hand-operated machine.  Next, he brought us to see the Kente cloth weavers at work.  It was incredible to see the speed and skill with which the weavers passed the shuttles back and forth between the strands of fabric to create a pattern, while Ghanaian (and sometimes American) pop blared from their handheld radios.  Finally, he showed us the land where plants like cacao trees and cotton plants grow.  After the tour, we bought a colorful assortment of Kente cloths, bow ties, and wallets.

Ghana 23.3
Penn student David Pontoriero tries to weave Kente cloth using a wooden Kente loom.

Next, we went to a series of wood shops to buy various carved wooden souvenirs and to practice our bargaining skills.  As we stepped outside the bus, we were immediately surrounded by dozens of shopkeepers, not-so-gently coercing us to check out their own shops.  Since there were no listed prices, the prices for everything bought were the result of bargaining.  Shopkeepers would often present us with relatively high initial prices, only to offer us “discounts” since we were students or “friends” to make us feel like we were getting a great deal. Overall, it was an overwhelming but exhilarating experience to fight for a price on every good we bought.

Ghana Trip to Study Tuberculosis: Day 22

by Kaila Helm, Biological Basis of Behavior ’20;  Kathleen Givan, Bioengineering and Political Science ’20; Katharine Cocherl, Bioengineering ’20; Hope McMahon, Chemical and Biomolecular Engineering ’18; and Dave Pontoriero, Biotechnology MS ’18

Ghana 2.1
The APOC team following our presentations to KCCR researchers and clinicians (left to right: Dr. Miriam Wattenbarger, Jason Grosz, Katharine Cocherl, Hope McMahon, Danielle Tsougarakis, Kaila Helm, Kathleen Givan, Kate Panzer, Ethan Zhao, David Pontoriero, Dr. Yar)

David Issadore, a faculty member in the Department of Bioengineering at the University of Pennsylvania teaches an engineering course ENGR566 – Appropriate Point of Care Diagnostics. As part of this course, he and Miriam Wattenberger from CBE, have taken nine Penn students, most of them majoring in Bioengineering, to Kumasi, Ghana, to study the diagnosis of pediatric tuberculosis. While in Ghana, these students are blogging daily on their experiences.

Today was the day we had been anticipating since the start of our trip: Presentation Day! We presented our final projects to a room full of people from KCCR. Scientists and research assistants attended to hear more about the designs we had been working on all semester.

Our presentations were in the afternoon, so we used the morning to work out any last-minute details. Each group presented on its pediatric tuberculosis diagnostic, with each trying to come up with innovative devices that could be implemented in the future. Even more exciting, we had an opportunity to present our more short-term ideas for problems that undergraduate students could address themselves. Our prompt was to create a project idea that could be completed in one year by one to five undergraduates with low funding requirements. The question-and-answer session that followed our presentations provided a wonderful opportunity to be critical of our ideas and contemplate the limitations of our designs, while still posing new questions regarding what could or could not work in our proposed plans for implementation.

Ghana 22.2
Students pose on the KCCR balcony after giving presentations to KCCR staff (left to right: Benjamin, Kate Panzer, David Pontoriero, Ethan Zhao, Danielle Tsougarakis, Salim, Kaila Helm, Hope McMahon, Kathleen Givan, Katharine Cocherl, Jason Grosz)

After a busy start to our day, we were eager to spend some time relaxing and reflecting on our academic experiences. We were amazed by the progress we made in the construction of our proposals. As engineers and individuals pursuing the STEM field we planned to create technology that could positively impact Ghana. Yet our presentations and the feedback we received were another source of evidence that we must continue to work on the ways in which our devices can be integrated into the Ghana’s current medical system. Nevertheless, we were proud to present all that we learned to such an insightful audience.

After a successful afternoon of presentations, we headed out to dinner to celebrate. We went to the same restaurant we went to two weeks previously. There was live music, dancing, and our new team favorite: grilled tilapia.