Innovative TB Screening: Antonia Morita Saktiawati’s Drive for Accessibility and Equity

Breaking the Wall of Tuberculosis Screening in Indonesia

Winner Interview 2024: Women's Impact Award

Antonia Morita Saktiawati is revolutionizing tuberculosis (TB) screening with her innovative research aimed at providing accurate, inclusive, and cost-effective tools, particularly for remote areas of Indonesia. Her work addresses critical challenges in TB diagnosis, developing an Indonesian-made eNose to screen patients' breath for TB. This device is portable, easy to use, and affordable, making it suitable for underserved populations. Saktiawati’s project also emphasizes improving women's access to TB screening and creating sustainable solutions through interdisciplinary collaboration. Her groundbreaking efforts are promoting social equity and transforming healthcare delivery in the fight against TB.

Which wall does your research or project break?

Tuberculosis (TB) is a deadly global infectious disease. While TB is curable, approximately every 20 seconds, a person dies from it, often due to late diagnosis or unsuccessful treatment. Additionally, women have less access to TB diagnosis compared to men. The earlier someone is diagnosed, the greater their chances of recovery. Current screening methods face challenges such as low sensitivity, radiation exposure, and impracticality in remote areas. Given the significant social and economic impact of TB, there is an urgent need for accurate, inclusive, and cost-effective screening tools, particularly in remote regions. Our research aims to develop such tools for use in remote areas of Indonesia.

Moreover, the sustainability and long-term effectiveness of a screening test diminish if it is not tailored to local conditions. To address this, the Indonesian-made eNose was developed and adapted to meet local needs, ensuring not only the sustainability of our technology but also contributing to the growth of the local economy and industry. By reducing inequality within the country, we aim to provide equal access to TB screening for all individuals, regardless of socio-economic status or geographic location, thereby promoting inclusivity and social equity.

What are the three main goals of your research or project?

The three main goals of our project are:

First, to develop a screening tool that is accurate, inclusive, and cost-effective, particularly for use in remote regions. To achieve this, we are investigating the potential of an electronic nose (eNose) for TB screening by analyzing patients' breath. This device is easy to use, requires minimal infrastructure, is potentially cheaper than current screening tools like Xrays, and is portable, making it suitable for door-to-door screening in remote areas.

Second, we aim to explore the barriers to access, particularly those faced by women. Our TB screening project in Indonesia, which includes the use of the eNose and AI reader for digital Xrays, seeks to overcome these barriers and promote the use of technology to empower women by improving their access to TB screening.

Third, we aim to develop sustainable solutions that address the needs of all stakeholders, from advancing scientific research to improving healthcare delivery and empowering local communities. Our project embraces an interdisciplinary approach and follows the principles of penta-helix collaboration, uniting academia, industry, stakeholders, health facilities, and communities. By fostering partnerships across these sectors, we leverage collective expertise, resources, and networks to drive meaningful change in TB screening. 

What advice would you give to young scientists or students interested in pursuing a career in research, or to your younger self starting in science?

There are several guiding principles that have strengthened me over the years, and I believe they may also resonate with the young scientists. 

First, approach your work with passion and love. These qualities will serve as your foundation during the toughest moments of your career. Passion fuels resilience, allowing you to push through challenges and emerge stronger. As Friedrich Nietzsche stated, 'What does not kill me makes me stronger.'

Second, many of the limitations we face are often those we impose upon ourselves. These mental barriers often arise from doubt or fear, preventing us from realizing our full potential. It’s important to break free from these constraints and push beyond the boundaries of what we think is possible. In science, where the unknown is vast, the only true boundary is often your imagination. Dream big, aim even higher, and refuse to let self-doubt stand in your way. The key is to give your absolute best effort, and instead of declaring 'I can’t,' simply take the first step and try. Only through trying will you uncover what is truly possible, and the results may surprise you.

Third, make the best of what you have. Coming from a country with limited resources and infrastructure for research, I’ve learned the value of adaptability and resourcefulness. Instead of focusing on what is lacking, focus on how to maximize what is available. The research most needed in my country may not be the type that earns a Nobel Prize, but it’s the kind that directly improves the welfare of the people. Science, at its core, is about solving problems, and often, the greatest impact comes from addressing the challenges closest to home.

What inspired you to be in the profession you are today?

Having witnessed how TB devastates the most vulnerable members of society, I am driven to conduct research aimed at alleviating their suffering.

What impact does your research or project have on society?

Society could benefit from a TB screening method that is easy to access, user-friendly, affordable, accurate, and adapted to local conditions, while being sustainable and inclusive.

What is one surprising fact about your research or project that people might not know?

All data collectors at the remote study site are local women, many of whom initially lacked computer skills and had never used a laptop. Despite this, they quickly learned and adapted to support the research.

What’s the most exciting moment you've experienced over the course of your research or project?

To meet with patients, understand their struggles, and share hope with them.