Title: Enabling and translating advances in diagnostic and communication technologies to reduce the burden of STIs
Funder: Medical Research Council

Abstract: eSTI2 (electronic self testing instruments for sexually transmitted infections) is a multi-disciplinary consortium that aims to reduce the burden of STIs by building translational capacity to develop, improve, evaluate, adopt and facilitate the use of simple to use, rapid, accurate, polymicrobial and affordable point-of-care (PoC) and self-test mobile-phone networked micro-diagnostics. These ?eSTI2 technologies? will provide high-risk populations with easy and immediate access to STI diagnosis and treatment and make STI surveillance comprehensive and responsive. Implementation is currently hindered by: technological bottlenecks; lack of capacity to translate advances into validated commercial products; absence of single tests for multiple STI organisms; and little knowledge about the regulatory constraints, ethical challenges and health impacts of using telecommunications to personalise STI diagnosis and management. eSTI2 uniquely combines academic and industrial expertise to address these challenges through cross-disciplinary translational research and by creating trials capacity. There are 5 workstreams: 1. Translational microbiology: provides pathogen genomics and microarray expertise to evaluate DNA reporters for detecting multiple STI pathogens and antibiotic resistance markers and to incorporate these onto varied biosensor devices, with industry partners to deliver prototype PoC devices for clinical evaluation. 2. Microfluidics: will research barriers to developing microsystems and evaluate prototype devices for genital sample processing as a ?front-end? system for novel bio-sensing technologies. 3. Diagnostic Evaluation: will link the HPA?s network of GUM clinics and associated local microbiological laboratories in England, used for surveillance of HIV/STIs (GUMNet), directly to central microbiology laboratories to create sustainable capacity for clinical trials of novel diagnostics. 4. Public health impact of diagnostic interventions: will extensively assess the regulatory, clinical, governance and health-economic constraints of eSTI2 community testing and develop a wireless-web-based system for managing remote STI diagnosis. It will conduct a community-based proof-of-concept study of eSTI2 deployment in preparation for community-based trials of mobile-interfacing self-testing diagnostics. 5. Knowledge transfer and Networking: will promote: dissemination of research findings, inform on strategic challenges and sustain collaboration with industry in order to test novel diagnostic devices using the eSTI2 evaluation pipeline. Career development in translation infection research will be provided to six interdisciplinary PhD studentships and two Academic Clinical Fellowships. Bidirectional collaboration with industry will provide financial sustainability beyond the 5 years of UKCRC funding. Impact: Significant enhancement in capacity for translational research into novel diagnostics aimed at improving treatment, reducing STI transmission and improving sexual health of high-risk groups.


Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES;7.3 MANAGEMENT AND DECISION MAKING;4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: INFECTION