Tag: tuberculosis

by Kaila Helm, Biological Basis of Behavior ’20; and Hope McMahon, Chemical and Biomolecular Engineering ’18

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 ended our three-day trip to Mole National Park. For breakfast, we had omelets and toast with some spread for bread and jam paired with our usual combination of coffee, tea, or Milo (Australian chocolate milk). After packing up the bus with water in hand, we set out for another long car ride (but not before seeing some elephants swimming in the lake and baboons leisurely walking around the property). On the way back to Kumasi, we stopped at a rest stop to use the washroom and have another delicious Ghanaian meal. Some ate jollof rice and chicken; others were more adventurous with goat and fufu with peanut soup. After our long journey, we arrived back to KNUST, pleasantly surprised by the petrichor and rainbows after a brief burst of rain.

A few of us decided to take a walk around campus, stopping by a convenience store and walking around the Guss Hostel. When we arrived back at KCCR, we soon learned we would be joining Dr. Ellis for the evening. After greeting Dr. Ocek Eke, we all ran to our rooms to quickly change. We headed to dinner. There we tried different combinations of smoothies, with a fútbol game projected on a screen in the background. We ate a lot: chicken kebabs, gizzard, liver, joloff rice, fish, and even some French fries. To end our jam-packed day, we headed back to KCCR, greeted at the door by a praying mantis.

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

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 set out on a 7 a.m. morning safari drive in Mole National Park.  We rode on seats built on the roofs of Jeeps and drove along dirt roads dodging trees and spotting animals, such as cobs and wart hogs.  A safari guide accompanied us on the roof to give directions to the driver, and the guide carried a large rifle in case an encounter with an animal went south.  The highlight of the safari was running into two elephants right outside a building complex in the park. We saw two young males, one of which visited so often that park employees had named it Nash, and they were feeding on the wild mint plants that grew in the park.  The guides told us that there were many such frequent visitors and that many of the elephants were named, a testament to how cordial the relationship between the park and the elephants was.  They suspected that the elephants were just as curious of us as we were of them — as soon as we left, the elephants left the building complex as well.  By the time the safari was over, it was around 11, and after lunch, we jumped into the pool as a reprieve from the blistering 100°F weather.

After lunch we visited a traditional African village named Bmognorie near Mole National Park. The village had a population of around 420 people who all lived in mud huts. Polygamy is practiced in the village, although monogamy is more common, and most families have around ten children. Our tour guide told us about life in the village and demonstrated how the villagers make shea butter, which can be used as a skin cream. He also said that sick villagers must travel on the back of a motorbike or bicycle for 30 km to reach the nearest clinic. The nearest hospital was 40 km away. After the shea butter demonstration, we watched and participated in traditional Ghanaian celebratory dances. Most of the dances featured everyone arranged in a rotating circle with complicated foot movements.

After the dances, we played with some of the children in the village. The children’s favorite game was to quickly roll bicycle tires with sticks for as long as possible. Although we tried to play with them, we were not nearly as talented and could not roll the tires for as long as the children could.

by Danielle Tsougarakis, Bioengineering ’20; Jason Grosz, Bioengineering ’19; Ethan Zhao, Bioengineering ’19; and Kate Panzer, Bioengineering ’18

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 is a holiday, Africa Day! That being said, we were unable to go to any hospitals, clinics, or schools today. Instead, after breakfast we continued our morning with a tour of Kumasi Center for Collaborative Research in Tropical Medicine (KCCR). KCCR specializes in tuberculosis diagnosis among other diseases – they are partnered with 40 hospitals and clinics throughout the country. Hospitals will send sputum and blood samples to KCCR for further diagnostics. One of the scientists at the center explained the procedure for testing for multidrug resistant (MDR) tuberculosis. When patients are diagnosed with mycobacterium tuberculosis, they are given first line of defense drugs, which include rifampin, isoniazid, pyrazinamide, ethambutol, and streptomycin with the first two drugs being the most potent. When no improvement shows from theses antibiotics, the patient will provide a sample to be tested in the GeneXpert for resistance to rifampin and isoniazid. After the samples are decontaminated, the sample is run through the GeneXpert to test for resistance to rifampin as well as the amount of MTB present in the sample (low, intermediate, high). If the sample expresses rifampin resistance then it is MDR TB. In addition to our comprehensive information session, we were also able to go into various laboratories throughout the facilities and view much of the equipment used in TB diagnostics such as the GeneXpert, thermocyclers, and PCR machines. We also had the opportunity to view gram-negative strains of tuberculosis up close under a microscope.

Later, one of the Ghanaian students drove us around to see his house and the area where he grew up.  Distance-wise, his home isn’t far, about 4-5 miles away.  However, driving took more than half an hour, not because of traffic, but because there were so many holes on the road that it was necessary to drive slowly over them at less than walking speed.  We first visited the market where his mother owned a store.  There, a large group of kids gathered and stared at us.  Unable to communicate with those who only spoke Twi, we took out our deck of cards and managed to set up a game.  Everything seems to be given more freedom, as children and chickens alike are allowed to roam the market freely, trusted to return to their respective homes at the end of the day.  We then visited his grandmother’s house.  His grandmother was originally from Northern Ghana, and she only spoke Hawza, a language spoken primarily by the Nigerian Muslim community, and not Twi, in contrast with the majority of the population.  Overall, it was a great experience to go off campus to see the environment in which everyday Ghanaians work and live.

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

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.

Our day started early. We woke up for a 7:00 a.m. breakfast of our usual combination of rolls with jam, sausages, omelets, and a beverage. After breakfast, we headed for the bus, where Uncle Ebo (our bus driver) was waiting to take us to a rural hospital about an hour away. We soon arrived at the Agogo Presbyterian Hospital. We were amazed by the organization and structure. At our previous hospital visit, we only saw a TB clinic. Today, we got to see a hospital that served a very different community. After spending some time in an old Presbyterian church, an administrator greeted us to begin our tour. We entered the main atrium, a large waiting room filled with more than a hundred people. We even saw a sheet used to characterize patients’ symptoms — a comprehensive list of numerous traits and experiences. We then continued our tour by entering the various wings and sections affiliated with TB treatment. This provided a wonderful opportunity to see a different side of the hospital’s operations.

Initially, we were allowed to peek into the diagnosing wing. The first room was small and was purposed for smear microscopy tests. It had a few light microscopes and many technicians. Adjacent to this room was the GeneXpert room. Tucked away in the back corner was a small box (the GeneXpert), maybe 18 inches high. We were surprised at how small and streamlined it was — finally seeing the machine we have talked about for a solid semester was an almost surreal experience. It seems that they value it highly and therefore keep it well maintained and protected. We learned more about how they use the GeneXpert and the limitations they face, such as a limited number of cartridges, problems with overuse, and slow maintenance.

We then went into the X-ray room. As per our past lectures, this is the preferred initial screening methodology, so it was exciting to see how well established their systems are. There were two X-ray machines that were donated and used by the entire facility. The nurse also showed us how they store all the scans and showed us a scan of a pneumonia patient’s lung. They hope to introduce digital X-rays in the future, which will be better for analyzing and diagnosing. She taught us what to look for on the scans, saying that pneumonia is differentiated from TB because it is localized at the bottom lobes of the lung, whereas TB is more widespread and present in the top lobes as well. The tour concluded with a trip to the isolation room for TB patients, but time was limited, so we didn’t spend much time there.

Once we took the bus back to KCCR, we attended a lecture by Dr. David Issadore, who spoke about his research to a packed room filled with Ghanaian clinicians and researchers. They were very interested in his work, especially in how microfluidic chips could be used as a diagnostic for TB. Interestingly, the room was filled with clinicians and research scientists, but engineers were poorly represented. Dr. Issadore definitely made us proud!

After the presentation, our group scattered. Some of us took control and hand-washed our clothes. A few numb fingers made for a very nice reminder about the little things we take for granted back in the States. After we worked up an appetite, we introduced the American classic of peanut butter and banana sandwiches to the Ghanaian students and Nana. We received some mixed responses, and we won’t be getting many returning customers, but it was nice to have a little bit of role reversal. Considering how much we have learned about Ghanaian culture through their food, it was nice to help them see a little bit of what America has to offer.