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Battle against TB overseas going digital

It only takes an inexpensive digital X-ray detector to help stamp out a disease that is killing millions of people in developing countries, an award-winning University of Waterloo researcher says.

WATERLOO, Ont. — It only takes an inexpensive digital X-ray detector to help stamp out a disease that is killing millions of people in developing countries, an award-winning University of Waterloo researcher says.

Karim S. Karim is developing a $1,000 digital X-ray device to screen for tuberculosis, a killer disease that affects a third of the world’s population and claims 1.8 million lives annually, most of them in Asia and Africa.

Karim, who was born in Pakistan, has seen the devastation that tuberculosis can do.

He vividly recalls being a child in Pakistan and seeing patients with tuberculosis cough up blood. Both of his parents were doctors, he says, and he heard about the disease a lot at home.

“Tuberculosis is something that I have seen, and it’s bad. ... It was a big thing there. In fact, I’d say it’s more prevalent than heart disease. It’s in all ages, but the worst segment that’s affected is the young ones. It’s the biggest tragedy there.”

As a scientist, Karim made a key discovery that led him to challenge the disease.

You don’t need to come up with the best advancement, the highest-performing technology or the most-talked-about solution in order to make a difference in the world, he says.

The associate professor in the UW department of electrical and computer engineering was recently named one of 15 “rising star” researchers by Grand Challenges Canada.

Grand Challenges is an independent not-for-profit organization funded through a federal government program that urges the best minds to find solutions to the world’s health problems.

Karim received a $100,000 seed grant to develop his digital X-ray detector further. He’ll get another $1 million to continue the work if his innovation is judged to have the highest potential of the proposals.

Other winners include a scientist who is using chicken feathers as a filter to remove arsenic in water supplies and a researcher who is developing a medical records system for use in the worst slum in Nairobi.

Digital X-ray detectors currently cost about $100,000 and are produced for general use in hospitals in developing countries, Karim says.

But because there are too few hospitals, they aren’t very accessible, he says.

So Karim is developing a low-cost digital X-ray detector that will screen for tuberculosis only. He’s using existing detectors and modifying them so that they’re smaller — since the detector will only be used to examine the lungs, not the full chest.

Then they can be used in tuberculosis screening clinics in developing countries, he says.

“The technology is out there,” he says. “The larger the panel, the larger the cost. You cut the area in half and you’ve taken half the cost out.”

Karim is working with Aga Khan University in Pakistan, which is providing him with images of patients with tuberculosis in order to help him build a prototype.

“I want to build a system that I can now ship to Aga Khan University in Pakistan for them to test,” he says. “The ultimate vision would be a network of low-cost health-care clinics in developing countries.”

Screening would help detect the disease so people can be cured. Besides saving lives, the diagnostic tool has the potential to help change a country’s prosperity, he says.

“Right now, the problem that grips a lot of developing countries is their workforce gets decimated by preventable diseases like tuberculosis.”

“If you can find a way to screen and knock out tuberculosis, now you’ve got a massive improvement in the workforce, therefore the economy and positive change comes about.”

During his research career, Karim says, he experienced a series of eureka moments that made him realize that aiming for the ultimate in scientific discovery isn’t always the most useful approach.

But that’s a different way of thinking for many researchers, whose culture it is to continue to raise the bar by developing faster, newer, better technology than anything that exists, says Karim, adding that he’s “not knocking fundamental science.”

He had to give his own head a shake before he accepted his own conclusions, he says.

“I think it’s a bizarre thing for a researcher to say ... but I actually think this is a key point,” Karim says.

“I’ve been developing all this wonderful technology that is an inch better or an ounce better or a per cent better. We’re constantly pushing that envelope of performance, but what does it really mean to get it out there?”

Karim says he learned this lesson after trying to commercialize technology he developed while working on his PhD in Waterloo, then at Simon Fraser University in Vancouver where he taught from 2003 to 2007.

One project he developed was a low-dose, real-time X-ray camera.

“I had developed something improved, but not necessarily what was needed.”

He decided that he needed to learn from businesspeople.

They “always have the end use in mind because if you don’t have the end use in mind, you’re going to fail in business,” he says.

He applied for a Science to Business fellowship that was offered by a federal health research funding agency and would pay the cost for him to obtain a master of business administration degree.

He got the funding and was on the road, twice a week, for 7 a.m. classes at the Rotman School of Management at the University of Toronto.

With full teaching responsibilities at UW and two young daughters, he couldn’t have managed the work and study load without the help of his wife, Tasreen Charania, who is also working on her PhD, he says. He planned to finish the MBA program this month.

Karim has learned to think of the consumer, rather than taking “the deep dive into technology.”

As a result, he says, he took old technology and low-cost materials and made them perform better to produce a fast, low-dose X-ray camera with good image quality.

A Canadian company is now interested in the results of that research, he says.

What he learned at business school also led him to enter the Grand Challenges Canada competition with his idea for a revised screening technology for tuberculosis.

If his idea is used, “it’s huge,” he says. “We’d be giving people a chance at a better life ... or at life, period.”

He says he views the research as a fulfilling way to give back to the community. “It tends to meet the needs of the spirit.”

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