BIMA PROJECT

I am a physician from Mérida-Venezuela, co-founder and manager of BIMA (Biotechnology & Medical Applications). We conduct a small group of professionals dedicated to design innovation in health sciences.

My team recently released the Histology Classifier App, a machine learning resource that helps students identify histological structures seen in laboratory practice, and we are now creating new implementations for Microbiology and Medical Entomology.

In addition to offering new learning resources, we are strongly driven by the concept of creating tools to benefit society, by promoting innovation to face health threats that affect our communities.

1. Triatomines are blood-sucking insects that transmit the causative agent of Chagas disease, Trypanosoma cruzi. Despite being recognized as a difficult task, the correct taxonomic identification of triatomine species is crucial for vector control in Latin America, where the disease is endemic.
2. We are developing a mobile tool based on automated image recognition to help healthcare technicians to overcome the difficulties to identify triatomine vectors when the technical expertise is missing. Geographic coordinates together with date and time information will be used in order to assist the epidemiological surveillance to map the Chagas disease vectors distribution. Future works may include other arthropods of medical importance.
3. In the long term, we expect our products to transmit the same spirit of innovation that has driven us, and inspire our users in the search for novel solutions against deadly infectious diseases.

Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite Trypanosoma cruzi.

An estimated 6 to 7 million people worldwide are  infected with T. cruzi. The global cost of Chagas disease was estimated to be about US$ 7 billion per year in 2013, including lost productivity. Chagas disease is found mainly in endemic areas of 21 continental Latin American countries, where it is mostly transmitted when humans come into contact with faeces of infected blood-sucking triatomine bugs (vector-borne transmission). 

Currently more than 140 species of triatomines have been recognized throughout Latin America. The correct taxonomic identification, performed by trained technician staff have a major role for the development and improvement of vector control and surveillance strategies.

However, correct identification requires training and technical expertise that is not always available in many countries, which consequently leads to a lack of specialists to perform the correct identification, resulting in entomological surveillance impairment.

This is an interactive and easy-to-use mobile application that integrates automated image recognition to identify Chagas disease insect vectors. It can be used by professionals and non-professionals when the necessary training is missing.

This tool will include a feature that allows users to report and send geographic coordinates to local institutions that will validate this information. Finally, these data will serve to monitor the distribution of triatomines and thus support the country's entomological surveillance system.

Since we launched our first mobile app in February 2020, we have received over 700 downloads. The majority of our users are students from all over the world who have given us good reviews. Many of the students in our faculty taking the histology course have shared their experience with us, describing this tool as a useful resource for doing reviews during quarantine.

This experience with medical students encourages us to launch new implementations such as the one we are proposing for the Elevate Prize. We believe that our application will have two kinds of beneficiaries:

• Direct beneficiaries: they will be the citizens and medical personnel who download and use the App to identify a possible vector insect in an endemic area.
• Indirect beneficiaries: these are members of a family or a community. The number of indirect beneficiaries will depend on the ability of the main user to establish preventive measures in their home or local community.

We want our projects to generate confidence, accomplishing scientific support in everything we do, we believe that in order to create important innovations in health, trust is everything.

Living in a digital era, where many things are possible, the current COVID-19 pandemic is reminding us that there's still a lot to improve in our health systems. We should be able to implement new technologies in this field, and that is the path that we want to take.

The current economic and social crisis in Venezuela has generated a massive migration of human talent that includes outstanding professors from our faculties. This often results in a decrease in academic quality in our institutions.

I was an Histology teaching assistant from 2013 to 2015 and, at some point, it occurred to me that by introducing an innovative tool in laboratory practices, perhaps it could generate some motivation in our students. I kept working on it until the Histology Classifier App was finished.

Months later, a friend told me about a medical consultation he had during his experience as a rural doctor, a patient had brought an insect to his office and nobody knew for sure if it was a triatomine. Where he was, the phone signal was poor, so Internet access was limited. Days later, he realized that indeed the species they had found was a possible vector. Later they followed the protocol to deliver the insect to an institution.

With my previous experience I knew that it was totally possible to create a useful tool for this type of situation.

The growing demand for smartphones opens a possibility to reach many people, and finding practical solutions with this technology that can translate into a public health impact in my community is something that has really interested me.

I am very passionate about these projects and I believe in the benefit that it can generate for society, I will hardly stop persevering and I have demonstrated it by achieving things in my country. 

Furthermore, I believe that this experience can open a path for us to combine automated diagnosis with the use of IoT devices.

The main reason I apply for the Elevate Prize, is because it is a perfect opportunity to achieve this dream, the support and advice of Solve MIT would be the ideal both technically and strategically to achieve great things.

Thanks to the Histology Classifier App, I have the support of the University of Los Andes (ULA) through the Department of Infectious and Parasitic Diseases. In previous meetings, they have also expressed their interest in developing a similar tool for Microbiology practices, although at this time they do not have enough resources to support us.

As a team, we are well positioned to obtain support from other international institutions, such as the London School of Hygiene & Tropical Disease, through Dr. Juan Carlos Gabaldón, who is an outstanding scientist in the area of parasitology and currently part of of our team. We also have recruited very talented software engineers. 

Furthermore, I am part of the most recent promotion of the ULA medical school, graduated in February, which means that most of my colleagues (220), including me, we are in our year of rural medicine, which would be a good strategy to start this project with them as the first users.

In the last 3 years that I have worked with the application, there have been multiple obstacles: constant blackouts, finding experienced programmers, lack of resources, and during this time I was still a medical student. 

Venezuela is going through a complex situation, and we started this project without any institutional nor financial support. I had to work as a pizza delivery guy to buy my computer. And although the educational projects haven't given any revenue still, I feel very compromised with the effect it's having.

But even with these difficulties, I have realized that wherever you are, you are going to find obstacles in front of you, and that each one can potentially mean not achieving the goal if it's not overcome. We have faced all these problems with a lot of perseverance.

During my 6 years in the medical school, I participated as a histology teaching assistant for two years, I was a first aid volunteer during the 2017 protests, I founded Bima Project as a proposal to modernize laboratory practices in my country and worldwide. Today I am working in Venezuela as a rural doctor in the first line of defense against the current pandemic by COVID-19 amid a humanitarian crisis.

Despite all adversity, I think I have done a good job managing my team, I am someone who will always prefer to be optimistic about the future. I believe every crisis means an opportunity to start a new way.

We propose this new implementation with the aim of opening the way for new diagnostic and monitoring tools for infectious diseases. 

This project offers a renewed focus, combining automation techniques and geographical data acquisition, to scale up the approach of integrated global vector control and response.

1. Activities: development of an interactive and easy-to-use mobile application that allow automated identification of Chagas disease vectors.
2. Short Term Outcomes: real-time data as geographical information of captured species will be used for risk stratification of communities and to further optimize planning and implementation of interventions.
3. Long Term Outcomes: Improvement of vector control and surveillance strategies in Latin America.

• In one year we expect to reach >100.000 users
• In five years, if we expand our identification tool so it could recognize other arthropods of medical importance, I'm confident it should reach >1 million users

I believe that this experience can open a path for us to combine automated diagnosis with the use of IoT devices. The information obtained in this project and the implementation of remote sensing could be useful to design future models in faster response against new outbreaks. My goal in five years is to work on molecular level, noninvasive and marker free diagnosis with portable devices. A combination of all should help prevent future pandemics.

I think the most important barrier is the financial one, basically, all of the expenses of this project has come out from my pocket. 

There are few tools that help the identification of arthropods of clinical importance, and even fewer that allow automated identification in addition to showing the most relevant details of the recognized species.

We are offering a practical solution to problems that anyone in an endemic country could face.

The application market will make it very easy to distribute this tool. The applications we are creating are still new and even unique. It is a market that we are still getting to know and we're excited about it.

Our financial strategy consists in offering our Apps as a Freemium model. We could charge for using some of the identification functions that we will offer.

I think this is a great opportunity to propose a new approach to tackle vector-borne diseases. The financial and technical advisory offered by The Elevate Prize will be fundamental to make a great impact.