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Profile: Fogarty Fellow Jillian Armstrong studies novel malaria detection device in Cameroon

January / February 2020 | Volume 19, Number 1

In a lab in Cameroon, Jillian Armstrong uses a microscope while another lab worker looks on.
Image courtesy of Jillian Armstrong

By January W. Payne

For self-described “talker” Jillian Armstrong, learning to listen has been a key lesson of her current Fogarty fellowship in Cameroon. Living and working in a French-speaking country with no French background has been rewarding, but challenging. “Although I am learning French, I do not have a firm grasp of the language yet,” she said. “I have to listen incredibly carefully when others speak and choose my words wisely when I respond. This experience has helped me truly engage with the people and world around me.”

Armstrong, a Ph.D. student at Yale University, is working on a research project evaluating photoacoustic flow cytometry (PAFC) for the non-invasive detection of malaria-infected red blood cells in Cameroon. Fogarty’s Global Health Program for Fellows and Scholars provides doctoral and postdoctoral students like Armstrong with a year-long mentored research experience in a low- or middle-income country.

Armstrong and her colleagues believe the project is the first to use this technique to diagnose malaria. It’s funded by Fogarty and NIH’s National Institute of Biomedical Imaging and Bioengineering (NIBIB). Malaria is a significant problem in Cameroon where it accounts for nearly 20% of all deaths, according to the U.S. President’s Malaria Initiative (PMI). Current diagnostic tests lack sufficient sensitivity and specificity, and require a blood specimen. However, PAFC is a novel, non-invasive diagnostic method that can detect hemozoin, an iron-containing pigment that accumulates in malaria parasites.

PAFC has been demonstrated to be highly sensitive in animal studies, and it may offer benefits over other diagnostic tests, Armstrong said. Additionally, the real-time nature of PAFC means that it can also be used to study how drugs used to treat malaria work - especially important in children under 5, who are vulnerable for adverse malaria outcomes and may not receive the proper dose of medicine to fully clear infections.

The PAFC project is still in its implementation stage but Armstrong is optimistic. “We believe the findings will demonstrate that the PAFC device addresses many of the limitations of current diagnostics and provides a cost-effective way to detect malaria in a non-invasive, real-time manner,” Armstrong said. “Our PAFC technology has the potential to improve access to highly-sensitive malaria detection in resource-limited settings.”

The experience has been “extremely influential” in helping Armstrong prepare for her dissertation, she said. It was her first experience in the lead role on a study and allowed her to see firsthand all that entails. “Working on a new project meant that I have been involved in everything - from the first conception of the project idea to the proposed analysis of data, and all of the hurdles in between,” she said. “I have learned how to write (and re-write) project proposals, calculate sample-sizes for study aims, and perform new data analysis and laboratory techniques.”

As she continues her work in Cameroon, Armstrong says she is grateful for lessons learned from facing challenges, such as the language barrier, as well as dealing with the unexpected - like how dust can affect her work. “You would be surprised how many biomedical devices and innovations do not take environmental dirt and dust into consideration, which can quickly affect a device,” she said.

The desire to overcome such difficulties is part of why Armstrong is so passionate about applying engineering innovations to global health problems. Listening to partners at every step of the research process is vital, she said. “I think it’s important to involve local researchers and communities in the research you conduct to make sure that it aligns with both the needs and the priorities of the people you’re trying to help.”

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