Rice bioengineers aim for one-cent jaundice test

Rice bioengineers aim for one-cent jaundice test

Rice University senior design team BiliQuant has wasted no time collecting awards for its low-cost method of diagnosing jaundice.

Team members Stephanie Tzouanas and Melody Tan took first place last week in the poster competition at the University of Minnesota’s Design of Medical Devices Conference International Student Showcase. Add that to BiliQuant’s second-place finish at this spring’s Rice Undergraduate Venture Challenge and its Most Impactful Award from the Houston Global Health Collaborative’s Connect Conference, and the five-member team can already count 2014 as a banner year.

But there’s more to BiliQuant than a shelf full of awards for the team, which consists of Brown College’s Tan, Jones College’s Tzouanas, Rohan Shah and Monica Barrera and Wiess College’s Jacinta Leyden.

“This team was tasked with solving a hard problem, and they’ve definitely risen to the challenge,” said BiliQuant faculty adviser Maria Oden, professor in the practice of bioengineering and director of Rice’s Oshman Engineering Design Kitchen. “For me, the most exciting part of this will happen later, when the technology is field-tested. If this works in a clinical setting, it could impact many lives.”

BiliQuant team members (from left) Monica Barrera, Stephanie Tzouanas, Melody Tan, Rohan Shah and Jacinta Leyden.

Jaundice is characterized by the yellowing of the skin and affects about 60 percent of infants worldwide. The condition is caused by elevated levels of bilirubin, a byproduct of the body’s constant replenishment of red blood cells. For some infants, including about 2.5 million each year in sub-Saharan Africa, bilirubin can build up to levels that can cause permanent brain damage.

It’s easy to treat jaundiced babies with phototherapy units that deliver a type of blue light that breaks down bilirubin. The lights are available in many developing-world hospitals — and Rice’s global-health students have even tackled the problem of lowering the cost for them — but diagnosing which babies to treat is still a big problem.

“You can appropriately diagnose jaundice using a number of tests that are completely unsuitable for the developing world,” Tzouanas said. “It can be diagnosed from blood samples, but the tests typically require a centrifuge, which most developing-world hospitals do not have. There are also devices that shine light on the infant’s skin, but these are expensive, and they don’t work well on infants who are dark-skinned.”

As a result, most physicians in the developing world diagnose jaundice simply by looking for signs of yellowing skin. Because it is difficult to accurately gauge the severity of jaundice by sight, there’s a dual risk of both undertreatment and overtreatment.

BiliQuant prototype

“We knew that our solution would need to be inexpensive, and one thing that often drives up costs is disposables — the things like plastic cuvettes that we think nothing of using once and throwing away,” Tzouanas said.

Building on point-of-care hemoglobin-testing concepts developed by bioengineering graduate student Meaghan Bond and her faculty adviser, Department of Bioengineering Chair Rebecca Richards-Kortum, the team created a test system that uses paper strips. Their test involves pricking the baby’s heel and collecting a tiny spot of blood on the paper. The paper is then inserted into a slot in a small machine, where inexpensive LED lights shine through the paper. An onboard microprocessor converts the acquired signal into the concentration of bilirubin present, and the value obtained is read out on a small LCD screen. Estimated cost per test: one penny.

Though the idea is simple, the implementation hasn’t been, particularly given the problems associated with separating blood components and achieving the target accuracy, plus or minus five milligrams of bilirubin per deciliter of blood.

“Hemoglobin has a very high optical density, and its signal actually masks that of bilirubin, so you typically need to separate the blood components to get a clear signal,” Tan said. “People usually use a centrifuge to do that, and performing the separation on paper has been a challenge.”

The team hopes to have a complete working prototype assembled for this Thursday’s Engineering Design Showcase, and they are still compiling results about the accuracy of the tests. They’ll also go for another award later this month in Washington, D.C., as one of 10 finalists selected to compete in this year’s American Society of Mechanical Engineers Innovation Showcase, or IShow.