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Innovative Interdisciplinary Approaches to Sustainable Airborne Infection Control

A three-tiered approach to airborne infection control:

1) Research capacity-building through innovative engineering approaches:

a. Further develop and test at least two novel approaches to upper room UV air disinfection that have resulted from the past year of intensive Fogarty-funded research: “eggcrate upper room UV” and “LED UV sources”.

b. Develop a quantitative smoke clearance test (QSCT) as a method for measuring the clearance time of cough-generated aerosols in rooms.

c. Transfer product designs developed in the first two years at Harvard for adaptation and further testing under local conditions in South Africa.

d. Field-test prototypes of both novel germicidal UV concepts and the QSCT in the Airborne Infections Research (AIR) facility in South Africa.

2) Research capacity-building through innovative architectural approaches:

a. Develop and test indicators or quantitative indices of effective building designs for preventing airborne infection through interdisciplinary (architecture, engineering, computer science, medicine, behavioral science, and epidemiology) assessment of existing hospitals and clinics in South Africa and at Partners In Health (PIH) sites around the world.

b. As a specific indicator of effective building design, evaluate the quantitative smoke clearance test developed at Harvard and in South Africa to estimate the clearance rate of a simulated infectious cough aerosol within rooms and buildings. This test may also be useful in determining the need for ceiling mixing fans in rooms where upper room germicidal UV is contemplated.

3) Research capacity-building through innovative medical approaches:

a. Conduct operational field research to measure the impact of active cough surveillance followed by sputum analysis by new rapid molecular methods (Xpert TB) on transmission of TB to health care workers in a busy urban hospital in Lima, Peru.

b. Two other medically-related projects may be available for fellow participation:

i. If validated by year 3 of this research program, screen coughing patients first with a new, on-site breath analysis (developed by Menssana Research, Inc) for TB-associated volatile organic compounds (VOCs).

ii. If a NIH-funded AIR facility clinical trial of an inhaled dry-powder antibiotic (colistin) to reduce TB transmission shows promising results, incorporate additional development and testing of this new local treatment approach in South Africa.

Innovation:

Through regular consultation with innovation specialists at the Harvard School of Engineering and Applied Sciences (SEAS), fellow/mentor teams in all three sites will learn how to create an environment where new ideas are stimulated, supported, prototyped, and tested.