Parikshay

Nearly 23% of the world's population is affected with Tuberculosis. India is the highest contributor to these numbers, accounting for around 2.8 million cases annually. Around 60% of TB cases go undiagnosed due to a myriad of reasons. We aim at making testing more accessible to ensure higher rates of detection of TB.

However, in India, the burden spectrum is slightly different -  sensitive, multi drug, extensive and total drug resistance types of Tuberculosis infections are predominantly seen across the country. Formulating specific diagnostic and clinical management protocols for each type adds pressure on policymakers, healthcare sector and the public to constantly update, execute and monitor policies and protocols at both rural and urban levels to ensure access to appropriate clinical care. Besides, the pandemic delayed the timely detection and notification, and monitoring of TB patients for almost two years, and has thankfully bounced back to its pre pandemic status (as per the National Annual TB Report of 2022).

Rural India is particularly hit by TB, both psychologically and economically due to the lack of medical facility in their immediate neighborhoods. People are forced to travel far and wide to have access to these tests and medications and the lose their daily wages in the process. This furthers the apprehension that people have towards these tests.  Delays in taking these tests further aggravates the problems and makes treatment more expensive.

Parikshay presents an affordable, one-click solution to testing for tuberculosis. It eliminates possibilities for human error and ensures hygiene.The test is designed to be self administered in 3 simple steps.A clicker triggers an internal plunger mechanism that in turn releases the needle which administers the protein for the test. The test can be self diagnosed with the aid of the handy indicator scale included as part of the test package. The simple mechanism and manufacturing and technology enables this device to be affordable even to the most remote and economically deprived societies. At the projected cost of ₹40, Parikshay eliminates the need for travel while providing an accessible and affordable solution to all.

The test allows for the convenience of self administration. This is highly relevant in a rural setting where medical professionals and resources are spread thin, and diseases like TB are highly prevalent. In rural areas, often hospitals are quite a distance away and intradermal injections are a skilled task, and might be difficult for an individual without training to administer. With our device, we remove the skill component by creating a design which can reliably administer the diagnostic test with little to no skill involved. Daily wage labourers are a section of society who exist in large numbers in the urban landscape. They live hand to mouth and every waking hour counts towards putting food on the table; it also happens that they are also part of society which is most prone to TB. Daily wage laborers need not spend a large amount of time going to the Public Health Centers in order to get tested and diagnosed. In a large number of cases, TB goes un-diagnosed due to the time commitment required in the current testing scenario.

Ms. Padmavathy is a final year medical student who has had extensive real world experience in dealing with rural settings which gives her a unique insight to the accessibility issues faced in such areas. Developing the test kit without her medical knowledge would have been far more difficult as we have to administer the test in a specific manner.

As simplicity is a key part in the operation of the device, it was designed keeping in mind that the training required to use the device would be minimal.

We are looking to develop our concept to get it to the manufacturing stage as well as develop a better financial plan so as to remain sustainable in the long term.

Parikshay provides a easy to use one click solution to testing for Tuberculosis using the Mantoux test as a diagnostic tool. Having this test packaged into an integrated kit makes it extremely easy for people with zero to minimal training to administer the test by reading the instructions provided in the manual. As the manual will also be written in regional languages, it will also be far more accessible to rural settings.

In the upcoming year we hope to develop the concept as a product and test it with a small audience after approval from medical council. We will collect feedback on the device and on getting feedback we improve on it. We hope to have a working product ready for manufacturing by the end of the year and from there will work on distribution in partnership with PHCs, government health drives and ASHA workers. An ASHA worker is an accredited social health activist is a community health worker instituted by the Ministry of Health and Family Welfare as a part of India's National Rural Health Mission. Through this we hope to further SGD 3: Good health and well being. 

In the upcoming 5 years we hope to expand this technology to other intradermal and intramuscular tests. The same can also be used for vaccinations. Oftentimes hospitals and volunteer camps are short staffed with experienced doctors and nurses. With a device like this, these issues can be addressed. We hope to explore these avenues while still pursuing our initial goal of providing accessible TB tests throughout the country.

We currently have a concept and a design plan at hand, we hope to complete our prototype and have it reviewed by a medical council. On completion of the prototype we hope to begin testing with a small group of people and collecting feedback. The prototype and tests will be indicators in our progress. SDG 9 focuses on dedicating more resources to R&D and ensuring manufacturing does not plummet. With the mass production stage we hope to ensure the device both reaches the projected cost and upholds the SDG. 

The solution offers accessibility, affordability and awareness in one package. Rural settings are often faced with problems of all three. There is a lack of infrastructure and people are often forced to go out of their way and travel far to have access to these tests. As a result of this, they lose their daily wage and spend a sizable amount of their income on travel. They thus are unwilling to take the test. A late diagnosis often leads to critical conditions and more expensive treatment. Rural settings also have a lack of skilled professionals who are certified to safely carry out such tests. With 'Parikshay' all these concerns are addressed. People can seek out these tests for extremely low prices at the comfort of their homes. It is simple to carry out and requires no skilled labor. It will be available in remote locations as well. It thus addresses the problems of delayed diagnosis and cases going undiagnosed and can work towards a healthier world.

The main innovation in our product is the one click mechanism to administer the test. Having a manufacturing friendly approach towards the parts using either injection molding for later stages or 3d printing during prototyping makes it a friendly solution to have in rural settings where mass manufacturing and transportation may not be feasible but having a portable and inexpensive 3d printing setup will make it possible to have test kits ready in a few hours making it extremely accessible. The solution works on simple compliant mechanisms coupled with conventional spring based systems which have been tried and tested and are used in everyday items like pens, these technologies have been combined to form a robust solution for administering intra-dermal tests.

Our team highly values diversity and equity both in our team and our target audience through our product. A 50% female representation in our team reflects our commitment to inclusivity. Upholding the values of financial equity, our product caters to the financially underpriviliged in both low income urban and and rural settings.

The resources which will be needed will be people necessary at this stage for research and development of the product. Once the product is ready, our costs will mostly be manufacture and scaling, since our product is being made using pre-existing mechanisms this step should not be very difficult and expensive.

Our partners and shareholders will be the community we are serving, doctors and nurses who we shall be consulting at every stage, research and development team.

The company due to large quantities being sold despite slim margins, this
supplemented with additional grants will allow us to be financially
sustainable.

The surplus profits will be invested into scaling and ensuring that the distribution channels reach far and deep into the undeserved communities.

The product is of value to the people who take the test because it removes the pain point of going to PHCs and getting tested and going again for diagnosis.

Revenue percentages:

70% - Profits come from selling of the test kit

20% - From government grants

10% - From social organizations which organise test drives.

We have a Low-income client, with slim margins for our product, as the objective is to make the tests more accessible. We shall rely on government grants such as the BIRAC grant in India which is given via the biotechnology ministry to further development of technologically driven solutions for healthcare, with scale we will be able to sustain the company due to large quantities being sold despite slim margins, this supplemented with additional grants will allow us to be financially sustainable.

We shall also adopt the Free-for-service model and sell to social players and volunteer organizations which can use our product TB testing drives, our product can be further expanded to be used for administration of vaccines.

Since we are still at the conceptual stage on our journey we do not have examples to share. We are currently working off of our own funds and hope to seek funding through government grants and fellowships.