AnemiaPhone, a technology developed by a multidisciplinary team of Cornell researchers to accurately, quickly and cheaply assess iron deficiency, has been transferred to the Indian Council of Medical Research of the government of India for integration into its programs for anemia, women's health, and maternal and child health throughout the country.
AnemiaPhone will enable access to rapid screening and diagnosis of iron deficiency at the point of need across the country in India. Iron deficiency is the leading cause of anemia, a condition where the body doesn't have enough healthy red blood cells to carry oxygen. It affects one in four people.
The technology was developed and tested in the laboratories of Dr. Saurabh Mehta, David Erickson and Julia Finkelstein, director and co-directors of the College of Human Ecology's Joan Klein Jacobs Center for Precision Nutrition and Health, and was formally transferred at no cost to India on Nov. 7.
Iron supplementation is an important strategy for prevention and treatment of anemia, which can cause a range of symptoms, from fatigue and shortness of breath to multi-organ failure and death. Detection of lower iron status - even before an individual develops clinical anemia - is important for screening and for timely interventions to improve human health at the population level.
"AnemiaPhone is something Saurabh Mehta, David Erickson and I dreamed of together more than a decade ago," said Finkelstein, associate professor of epidemiology and nutrition and director of the Maternal and Child Nutrition Program in the Division of Nutritional Sciences, whose lab in India validated the accuracy of the technology.
The aim is to be able to determine why an individual has anemia and directly inform differential diagnosis, prevention and treatment at a moment when a patient needs it the most.
The test is similar to COVID-19 home tests and uses some of the same technology, said Erickson, the Sibley College Professor of Mechanical Engineering in Cornell Engineering. A small finger stick, a little drop of blood on a reader that takes a few minutes to assess, and an individual knows if they have anemia because of iron deficiency. Health care workers or providers can interpret the test and be able to provide actionable guidance, triage and referral, or intervention on the spot.
"This project started off with a really good understanding of what the problem was," Erickson said. "Once we established the technology and innovation, it was ready for translation to the population level. It was something we knew that, if we could figure out a way to target the last mile, it would have a major global health impact."
Gold standards for biomarker assessments often have lab-intensive methodologies, Finkelstein said, methodologies that much of the world cannot access or afford.
AnemiaPhone can help to bridge this gap, Finkelstein said, allowing iron deficiency to be quickly and cheaply diagnosed by testing a droplet of blood in a community or clinic setting. Instead of sending blood to a lab and waiting for results, the decision can be made in the community or clinic itself, reducing costs and speeding intervention.
It's empowering across the whole system, said Mehta, enabling clinicians, community health workers and patients themselves to make real-time decisions and course corrections upon screening and diagnosis.
"It's about changing the paradigm and transforming health care," said Mehta, who is the founding director of the Jacobs Center. "We're not trying to replace traditional or reference laboratories, but in places where people don't have access to laboratory and medical settings, this is a way to decentralize health care and extend the reach of central labs."
This is particularly important for pregnant women and their children, Finkelstein said, pointing to the higher cost of anemia and iron deficiency during these life stages.
This vital work can help ensure access to high-quality healthcare for millions of women and children particularly in low resource settings, said Rachel Dunifon, the Rebecca Q. and James C. Morgan dean of the College of Human Ecology.
"AnemiaPhone continues our college's 100-year legacy of improving women's health globally," Dunifon said. "The Joan Klein Jacobs Center for Precision Nutrition and Health enables cutting-edge research like this, empowering the development of innovative solutions for populations around the world."
As a technology-driven device, AnemiaPhone has the potential to address current challenges in screening and diagnosing anemia within India's Anemia Mukt Bharat programme, said Dr. Bharati Kulkarni, the head of the Reproductive, Child Health and Nutrition Division at the Indian Council of Medical Research.
"If scaled to its full capacity, it could play a pivotal role in India's health care landscape where anemia remains a significant concern, particularly among women and children, offering new possibilities in combating this recalcitrant public health problem," Kulkarni said.
The research was initially funded by the National Science Foundation through its INSPIRE program and the National Institutes of Health, including a joint Indo-US NIH-Department of Biotechnology program. It was also supported by the Cornell Atkinson Center for Sustainability's Academic Venture Fund. Balaji Srinivasan, a research associate in Mehta's lab and then at the Jacobs Center, led the key publications establishing the technology, and Antra Ganguly, postdoctoral researcher, contributed.
The project was also supported by five-year funding from the National Institute of Biomedical Imaging and Bioengineering, Fogarty International Center and the National Center for Complementary and Integrative Health to launch the Point of Care Technologies for Nutrition, Infection and Cancer for Global Health (PORTENT), led by Erickson and Mehta.
