Technology a potential solution for collecting specimens and delivering results to rural hospitals

Figure 2a:e-Juba on launching ramp. b: e-Juba cargo bay cartridge

A speedy and accurate laboratory service is mission critical for managing the twin epidemics of HIV/AIDS and TB.

However, providing a speedy service in some rural parts of the Eastern Cape, Limpopo, KwaZulu-Natal and Mpumalanga provinces is rendered difficult by poor road and technology infrastructure.

In order to address this challenge, the NHLS has developed aerial specimen couriers which are currently undergoing extensive testing and piloting.

UAVs (un-manned aerial vehicles) are aircraft that are navigated by remote control using GPS technology.

e-Juba, Zulu for electronic pigeon, is a prototype that was developed by Denel Dynamics. The prototype can takeoff autonomously from an NHLS lab site and be navigated - using GPS technology – to a remote rural clinic where it can perform a precision autonomous landing at NHLS-defined GPS co-ordinates, as well as autonomously launch its return to base,

This aircraft is also suitable for the delivery of urgently required, lifesaving therapeutic agents such as rabies-immune globulin, NHLS-developed antivenoms, two units of whole blood, or critically needed medications to remote GPS-defined points of delivery anywhere up to 100km away, depending on the payload weight.

e-Juba has already demonstrated a range of 53km, which could be extended if some of the payload capacity could be used for additional batteries.

Further, a smaller, simpler, more robust UAV that will be ideal for the transportation of very small and light payloads (up to 10g), such as paper spots for molecular diagnostics, has also undergone extensive testing.

This micro-UAV, developed by BFA systems – a small company in Somerset West in the Western Cape, has a mass of 800g, a wingspan of 800mm, a cruising speed of 50km/hr and a range of 40km.

Further to extensive testing, it has undergone proof of concept flights for the NHLS application, whereby lab samples were dispatched from a surrogate of the remote clinic site and flown to the nearest hospital-based NHLS laboratory site (Murchison Hospital, KZN) near where they were precision-dropped under computer control at an exact GPS waypoint from 10m above ground level, defined in advance.

The dropoff point can be modified in flight, allowing for remote piloted vehicle (RPV) mode of operation, to allow human personnel at the lab to trigger the drop.

Throughout the test flights, continuously updated real-time flight data are sent via the onboard radio telemeters back to the laptop base station.
 
Under development is a wireless modification whereby real-time flight data are relayed to the 3G/HSDPA/HSUPA cellphone networks, and the progress of each flight can be monitored in real-time anywhere in the world.

Tests have been carried out in the Western Cape, Gauteng and KwaZulu-Natal where specimens for HIV and TB were precision-dropped and recovered at the predefined waypoint, in wind speeds of 45km/hr. Specimen results were then dispatched via SMS to the sender, who thus received molecular PCR results within six hours of collection from a remote rural site.

In summary, it has been shown that the technology exists to use UAVs as transport couriers delivering samples from remote clinics to NHLS laboratories. For this to become a practical enterprise, however, demands more than just having the requisite technology, as formidable non-technical barriers remain.

These include solving the legislative and financial issues. Application has been made to the Civil Aviation Authority (CAA) for assistance with the former, while the latter will remain a challenge until sufficient units are in service to harness the attendant economies of scale.

In the interim, donor funding will probably be needed to initiate a roll out of this service.

Future plans, subject to CAA exemption, include a one-month trial involving the submission of test samples from a real clinic, at Paternoster on the West Coast, to Vredenberg Hospital Laboratory. 

For further information contact Professor B Mendelow on 0828083734.