“Invest to End TB. Save Lives”
The World TB Day
2022 was an opportunity for ISTH-PANDORA to
collaborate with the Department of Community Medicine,
ISTH and the Standing Committee on Public Health (SCOPH) of the Ambrose Alli University Medical Students Association (AAUMSA), Ekpoma, to join the rest of the world to raise a voice for more
commitment to end TB. This year’s event was a special
one because it brought together Public Health Practitioners (Community Health workers, Resident doctors and Consultant Public health physicians) and young Medical Students, driven with purpose, to advocate for an end to the dreaded age-long disease. Against the backdrop of misinformation and stigma associated with TB in the general
population, the need for more awareness and commitment to decimating the scourge is imperative.
Enlightement campaign
Our goal therefore was to target high risk population and carry out mass sensitization and Health awareness campaigns. This started at the General Out-Patient Department (GOPD) of ISTH and taken to Iruekpen community in Esan West Local Governmental Area all in Edo State, Nigeria. Elders of the community were engaged earlier which facilitated entry into the community and also gave their consent for our team to create awareness in the marketplace. In preparation for the campaigns,contact was made through the Local Government Tuberculosis-Leprosy Coordinator with the Tuberculosis treatment centers at the Primary Health Care Centre in the community to prepare them for a possible surge in the number persons accessing the facility for screening, diagnosis and treatment following the enlightement campaign. As a result of the COVID- 19 pandemic there has been a reduction in TB screening, diagnosis and reporting in the area. The campaign provided the opportunity to re-emphasize the need to utilize the free testing and treatment facilities available to reduce the incidence of Tuberculosis. Individuals were urged to visit the nearest Primary Health Care Center whenever they have symptoms such as fever and cough of more than 2 weeks duration and provide sputum for testing. The need to avoid stigmatizing victims of TB was re-echoed as the disease was amenable to treatment if diagnosed early and there is full adherence to treatment regimen.
A medical student advocates for TB patients
During the campaign, one of the Medical Students who has just herself defeated TB, rose to the occasion and stood up to speak for TB patients, all over the world, who had no voice and were experiencing societal stigma and shame. Speaking passionately to the patients and staff in the General Out-Patient Department of ISTH on the World TB Day, she shared her journey of resilience, courage and commitment to goals of the treatment after she was diagnosed with TB. She successfully completed the nine months treatment course through compliance to medication despite adverse reactions experienced during treatment, especially at the initial intensive phase of two months which she described as “really intense” Hers was a motivating successful journey back to health and well-being.
Conclusion
The World TB Day celebration served as a reminder for at risk persons in the community to seek medical help when TB is suspected. Through the planning and implementation, medical students were fully involved thus giving them first hands-on experience in community control of endemic diseases like TB. It further helped to galvanise the existing mentor-mentee relationship between medical students and their teachers. The successful engagement with the community leaders is a partnership to be built upon in the local campaigns to eradicate other prevailing dieases. It is hoped that this collaboration will be harnessed for future World Health Day celebrations and other public health programs in the neighboring communities.
Acknowledgements
We thank PANDORA-ID-NET Consortium for providing technical and financial support for the celebration. We also extend deep appreciation to staff of the Heath Promotion Unit, Department of Community Medicine ISTH and Medical students from Ambrose Alli Univeristy, Ekpoma, for their active participation.
Tuberculosis (TB) remains a top cause of death globally from an infectious disease. World TB Day is celebrated every year on 24 March – the day in 1882 when Professor Robert Koch first announced his discovery of Mycobacterium tuberculosis, the causative agent of TB. To commemorate World TB Day 24 March 2022, Sir Prof Alimuddin Zumla, as he does annually, initiated and led three Lancet journal Comments and a TB themed International journal of Infectious Diseases issue of a series of 18 articles co-authored by the TB fraternity from all continents including our PANDORA-ID-NET (https://www.pandora-id.net/)Africa-Europe partners.
Lancet articles Links:
1). Lancet RMed Comment: Optimising tuberculosis care for refugees affected by armed conflicts. https://pubmed.ncbi.nlm.nih.gov/35338843/
2), Lancet ID Comment: World Tuberculosis Day 2022: aligning COVID-19 and tuberculosis innovations to save lives and to end tuberculosis
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00142-6/fulltext
3). Lancet Global Health Comment: Preventing pellagra during isoniazid preventive treatment
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00163-2/fulltext
In the three Lancet journals’ Comments Sir Zumla and colleagues highlight the how global TB control efforts are confronted with major challenges in lieu of the COVID-19 pandemic and more recently the massive exodus of refugees and displaced populations arising from the Ukraine armed conflict. The invasion of Ukraine by Russia, and the ongoing armed conflict, is having hugely damaging effects on health services, health infrastructure, and personnel, and further diminishes hope of achieving End TB targets for eastern Europe—now a seemingly insurmountable task. Although incidence rates of tuberculosis in Ukraine have gradually decreased over the past decade, Ukraine features in the WHO list of 20 countries with the highest estimated number of people with incident drug-resistant tuberculosis and it has one of the highest rates of HIV–tuberculosis co-infection and latent multidrug-resistant tuberculosis infection in Europe. They suggest several practical steps, using recently updated diagnostics, treatments, patient follow-up, and community care guidelines for tuberculosis and COVID-19, and for care of refugees, to be immediately taken forward to have a synergistic, enhancing, and multiplier effect. They also emphasize that COVID-19 programme innovations and adaptations from within the COVID-19 response should be built upon, to enhance access to integrated, patient-centred tuberculosis services which should be revamped and recalibrated to be more inclusive of all other WHO-declared global emergencies. They conclude that countries endemic with tuberculosis to build goodwill on the current global attention on COVID-19 to better address existing tuberculosis care models, One Health approaches to prevent future zoonotic pandemics and the burgeoning problem of global antimicrobial resistance. The Lancet Global Health Comment highlights the vexed issue of isoniazid therapy for treatment of latent TB infection, its age old side effect of pellagra resurfacing in people living with HIV receiving IPT. They suggest vitamin B complex supplementation in refugee populations and revisiting the debate on using alternative treatment regimens for LTBI excluding INH
The IJID themed series of articles cover a spectrum of TB topics including TB epidemiology, impact of COVID-19 on TB/HIV/Malaria services, incidental undiagnosed TB found at forensic autopsies, MDRTB diagnostics, treatments and genomics, need for ‘blue skies research for controlling the TB, pandemic, amongst others. The articles highlight that the effects of COVID-19 pandemic on global tuberculosis control efforts have been catastrophic setting back by several years any progress being made in achieving the WHO End TB Strategy targets by 2030. COVID-19 disruptions to health services have impeded diagnosing and treating everyone with active tuberculosis, drug-resistant tuberculosis, multidrug-resistant or extensively drug-resistant tuberculosis, latent tuberculosis, and tuberculosis and HIV co-infection, as well as access to tuberculosis medicines, counselling and follow-up, and lowered treatment adherence. This promotes the development of multidrug-resistant strains of tuberculosis and increases treatment failure rates, suffering, and death. Thus, in the foreseeable future, tuberculosis will continue to pose multiple challenges and negatively impact on already fragile health systems in countries with a high burden of tuberculosis.
Pathogenesis, epidemiological and programmatic TB studies from the PANDORA-ID-NET team in Zambia showed that there is a large TB caseload which remains undiagnosed and untreated and this may be generic to all high tb burden countries. This is highlighted by a novel case series study of incidental TB cases seen at forensic autopsy of individuals who died suddenly, unexpectedly, and violently in the community in Lusaka, Zambia. This serves as a pivotal starting point for conversations around future autopsy studies focused on TB pathology, pathogenesis and co-infections. They highlight the need for sequencing data to align to autopsy studies and calls for more investments into TB programs, for more proactive screening, testing and treatment activities, accurate data collection, revamping autopsy studies worldwide would provide more insights into the actual mortality burden.
For further reading and more information:
IJID Special TB Themed Issue selected articles Links:
1). Incidental Tuberculosis in sudden, unexpected, and violent deaths in the community Lusaka, Zambia - A descriptive forensic post-mortem examination study. https://www.ijidonline.com/article/S1201-9712(22)00140-0/fulltext
2). World TB Day 2022: Revamping and Reshaping Global TB Control Programs by Advancing Lessons learnt from the COVID-19 pandemic
https://www.ijidonline.com/article/S1201-9712(22)00138-2/fulltext
3). Blue Skies research is essential for ending the Tuberculosis pandemic and advancing a personalized medicine approach for holistic management of Respiratory Tract infections https://www.ijidonline.com/article/S1201-9712(22)00150-3/fulltext
4). Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis
https://pubmed.ncbi.nlm.nih.gov/35245659/
5). Tuberculosis, HIV/AIDS and Malaria Health Services in sub-Saharan Africa – A Situation Analysis of the Disruptions and Impact of the COVID-19 Pandemic
https://www.ijidonline.com/article/S1201-9712(22)00173-4/fulltext
6). Drug resistant TB – latest developments in epidemiology, diagnostics and management
https://www.ijidonline.com/article/S1201-9712(22)00165-5/fulltext
7). A 10-year Review of TB Notifications and Mortality Trends Using a Joint Point Analysis in Zambia - a High TB burden country
https://www.ijidonline.com/article/S1201-9712(22)00188-6/fulltext
8). Relevance of genomic diversity of Mycobacterium tuberculosis complex in Africa
https://www.ijidonline.com/article/S1201-9712(22)00154-0/fulltext
9). The WHO Global Tuberculosis 2021 Report – not so good news and turning the tide back to End TB
https://www.ijidonline.com/article/S1201-9712(22)00149-7/fulltext
Strengthen
research on multidrug resistant Tuberculosis: a duty for research networks like
PANDORA-ID-Net et CANTAM
The Pan-African Network for Rapid Research, Response, Relief and Preparedness for Infectious Diseases Epidemics (PANDORA ID-NET) is a ‘ONE Human and Animal HEALTH’ multidisciplinary consortium of 22 partner institutions (13 African and 9 European) derived from 9 African and 4 European countries. Namely WEST AFRICA: Sierra Leone, Nigeria, Ghana; CENTRAL AFRICA: Republic of Congo and Gabon; EAST AFRICA: Sudan, Uganda, Tanzania; SOUTHERN AFRICA: Zambia. European countries are United Kingdom, Italy, Germany and France.
The Central Africa clinical research Network was established in 2009 as an EDCTP regional network of excellence for developing health research capacities for clinical trials on tuberculosis, HIV/AIDS, Malaria and neglected Tropical infections. It involves Cameroon, Gabon, Democratic Republic of Congo, Republic of Congo, Zambia, and Germany, United Kingdom and The Netherlands.
The implementation of PANDORA-ID Net and CANTAM activities falls under 3 objectives of the SDGs: The first objective of the SDGs is to reduce poverty in all its forms and tuberculosis is a disease which increases the vulnerability of populations and has an enormous economic impact. Objective 3: well-being and health for all. Goal 17: partnership to achieve the goals.
Today, tuberculosis kills about 1.5 million people per year and only one partially effective vaccine is used to prevent this disease. The theme of World Tuberculosis Day, "Invest to end TB, save lives" echoes PANDORA's action in investing in the surveillance of this disease by describing the level of resistance of MTB strains, improving laboratory infrastructure so that each country can culture MTB and inform national tuberculosis control programs appropriately.
The Lancet: Infectious Diseases have published a very important comment on "World Tuberculosis Day 2022: aligning COVID-19 and tuberculosis innovations to save lives and to end tuberculosis"
Led by PANDORA-ID-NET Professors Francine Ntoumi and Sir Professor Alimuddin Zumla, this is a gender balanced article co-authored with PANDORA-ID NET co-investigator Professor Dorothy Yeboah-Manu, former TB UNION President Professor Jeremiah Chakaya, and other high profile TB contributors from South Africa, USA, Europe, Russia and Pakistan.
The Pan ASEAN Coalition for Epidemic and Outbreak Preparedness (PACE-UP)
derived from 28 partner institutions across Asia-Africa and Europe, with
South-South collaborations (Africa and Asia) together with PANDORA-ID NET, has
successfully completed SARS-CoV-2 genome sequencing training for sites in the
Republic of Congo, Zambia, Gabon, Ghana, Nigeria, Sierra-Leone, and Vietnam.
This capacity is being sustained and a number of sequences are currently being
deposited in the GISAID databases by the representing partner institutes in
Asia and Africa.
The activities are led by Prof. Dr. Thirumalaisamy P.
Velavan, representing the University of Tübingen, the German partner of PANDORA
and PACE-UP, and project coordinator for Germany and Vietnam.
Professor Richard Kock and Dr. Najmul Haider of the Royal Veterinary College, United Kingdom visited Sierra Leone to meet with Professor Rashid Ansumana of Njala University, Sierra Leone to discuss PANDORA’s ongoing research project on Lassa fever during November 20th to December 2nd, 2021.
The team visited two rural field sites located in the village named Sulemata and Lalihan under Kenema District, discussed with the village chief, villagers, farmers and study participants to understand their acceptance and opinion on ongoing research project.
The team is running a number of studies
including i) a case-control study to identify the risk factors for Lassa fever
infection ii) space-time clustering analysis of LFV infection iii)
sero-prevalence of LFV among people with febrile illness iv) role of domestic
(dog, cats) and peri-domestic animal (rodents, and squirrels) in maintenance of
LFV, v) understanding rodents access to food ingredients through infrared cameras.
PANDORA-ID-NET co-director Professor Sir Alimuddin Zumla has been named on Clarivate's annual 'Highly Cited Researchers List' 2021 which recognises authors of the most influential research papers around the world.
Sir Ali also featured in the 2018, 2019 and 2020 lists.
Further information be can found on the UCL website.
Image Credit: Clarivate Web of Science
We are extremely
proud and absolutely delighted to announce that PANDORA-ID-NET Co-Director
Professor Sir Alimuddin Zumla has been honoured with
the prestigious EU-EDCTP PASCOAL MOCUMBI
PRIZE in recognition of his outstanding scientific research,
health services capacity building, training and advocacy achievements in
Africa.
A video profile of Sir Ali and his acceptance speech can be viewed below and on the
EDCTP YouTube page.
On behalf of our entire PANDORA-ID-NET consortium and our partners and collaborators from across the world, we would like to convey our warmest congratulations to Professor ‘Sir’ Alimuddin Zumla for this richly deserved and befitting prestigious accolade.
The full press release can also be read below.
PANDORA-ID-NET partner site Njala University , Sierra Leone has produced a brochure for local schools highlighting how to prevent rabies.
PANDORA-ID-NET coordinator Professor Francine Ntoumi has contributed to a recent article in The Lancet asking " Should global financing be the main priority for pandemic preparedness?"
The full article can be accessed here.
Huge congratulations to PANDORA-ID-NET member Professor Dorothy Yeboah-Manu on her appointment as the first female Director of the Noguchi Memorial Institute for Medical Research in Ghana.
Could there be a link between antimicrobial resistance and COVID-19?
A BSAC funded project collaboration between PANDORA-ID-NET partners UCL (UK), HerpeZ (Zambia) and the Institute of Endemic Diseases (Sudan) is exploring this, with the aim of helping protect staff and patients around the world from both COVID-19 and antibiotic resistant bacteria.
PANDORA-ID-NET research associate Dr Linzy Elton explains more here.
Follow @AmrCovid for further updates and information.
Professor Sir Alimuddin Zumla has been awarded the 2020 Mahathir
Science Award in Tropical Medicine in recognition of his outstanding
contributions to global health, particularly in tropical infectious diseases.
Sir Ali said that the award "reflects the commitment, dedication and hard work of my research teams, collaborators and friends across the world."
This was the first time the ceremony has been broadcast online.
June 2021 - Post Mortem examination of Hospital Inpatient COVID-19 Deaths in Lusaka, Zambia - A Descriptive Whole Body Autopsy Series.
PANDORA Co-Principal Investigator Professor Sir Ali Zumla has contributed to the publication of a novel post mortem autopsy study from University Teaching Hospital Zambia.
This shows the
extensive damage which occurs in the body due to COVID-19. The manuscript can be downloaded here and contains colour photos of
the effects of COVID-19 on the brain, lung, kidneys and liver.
Tuberculosis (TB) remains one of the top causes of death globally from an infectious disease. World TB Day is celebrated every year on 24 March – the day in 1882 when Professor Robert Koch first announced his discovery of Mycobacterium tuberculosis, the causative agent of TB.
To commemorate World TB Day March 24th, 2021, the International Journal of Infectious Diseases (IJID) published a specific TB Theme issue co-guest edited by Professor Sir Ali Zumla (PANDORA-ID=NET Co-Principal Investigator) and dons from Australia, Europe, Asia and Africa. The IJID series of 18 articles is written by a global authorship of over 120 authors from all continents, including many collaborators from the EDCTP funded PANDORA-ID-NET One-Human-animal-Health consortium.
Several articles in the IJID series are co-written by Pandora-ID-NET scientists, Professors Ali Zumla, Francine Ntoumi, Richard Kock, Tim McHugh, Ibrahim Abubakar, Sayoki Mfinanga, Peter Mwaba, Dorothy Yeboah-Manu, Drs. Nathan Kapata and Najmul Haider, and others, focuses on the WHO and STOP TB Partnership theme for World TB Day March 24th, 2021, ‘The Clock is Ticking’. They convey vividly the sense of urgency that the world is running out of time to deliver the commitments to end TB made by global leaders at the United Nations General Assembly high level meeting on TB. This theme is particularly appropriate and critical in light of the diversion of funder and political attention to devastating COVID-19 pandemic, setting back global TB control efforts by several years. They conclude the series by saying:
“World leaders need to urgently address and reverse the negative socio-economic and health services impacts of the COVID pandemic. As COVID vaccines and public health measures start to have an effect on slowing down the COVID outbreak, every effort must be made by to ensure that health services and prevention programs for TB are not compromised.
“The commitment of western governments to the rapid development and rollout of COVID-19 vaccines is commendable, but it is important to ensure that no-one is ‘left behind’.
“It’s now time for them to invest with equal commitment to ending the TB epidemic. Reality showed us that it can be achieved, if there is serious political will which is translated into measurable, tangible actions resulting in impactful deliverables”
Further Reading: IJID Special Issue articles authored by UCL staff:
PANDORA director Professor Francine Ntoumi has published a World View piece in Nature looking at the effect of Covid19 on disease programmes, and how we can bounce back.
The full publication is available on the Nature website.
The Africa CDC Institute for Workforce Development has developed a COVID-19 Clinical Community of Practice.
Weekly Zoom webinars (1 hour) will be held every Thursday, starting 29th October, and there is an online knowledge hub.
Please see the accompanying flyer for further details and follow this link to register.
Oct 2020 - Laureate Chat: In Conversation with Alimuddin Zumla
On 10 August 2020, Professor Sir Alimuddin Zumla was informed via an official video call that he had won the 2020 Mahathir Science Award.
The MSA Foundation recently caught up with Professor Zumla to learn more about his message for the youth, his work on infectious diseases, and of course, COVID-19.
The full interview can be read on their website.
Oct 2020 - British Society for Microbial Chemistry Grants Call: PANDORA-ID-NET researchers awarded $65,000
PANDORA-ID-NET researchers have just been awarded a $65,000 grant from the British Society for Microbial Chemistry to undertake a project on ‘the impact of COVID-19 infection prevention and control measures on transmission of hospital acquired infections and antimicrobial resistance in Africa’.
The study will be undertaken by Dr Linzy Elton, Professor Tim McHugh, Dr Mags Thomason, Dr Isobel Honeyborne and Mrs Kerry Roulston from UCL (UK), Dr Muzamil Mahdi Abdel Hamid and Dr Hana Elbadawi from the Institute of Endemic Diseases (Sudan) and Dr John Tembo from HerpeZ (Zambia).
Patients who develop serious illness due to COVID-19 are more likely to have bacterial co-infections and the World Health Organization therefore recommends treatment with antibiotics. As a result, many countries are observing a change in antimicrobial stewardship, in addition to changes in infection prevention and control practices such as the use of personal protective equipment, on COVID-19 wards. Few data on COVID-19 and its impact on antimicrobial resistance (AMR) have come from low and middle-income countries (LMICs). As these countries often have higher rates of AMR, and COVID-19 cases are still increasing across many sub-Saharan African countries, it is vital to report on how COVID-19 is affecting antimicrobial stewardship, to direct clinical practice moving forward.
This pilot study, based in hospitals in Sudan and Zambia, will identify infection prevention and control (IPC) guidelines for COVID-19 and non-COVID-19 wards. We will then compare the secondary bacterial infections acquired by patients, as well as from the ward environment, on COVID-19 and non-COVID-19 wards, using microbiological and sequencing methods to identify species, as well as identifying AMR transmission patterns using phylogenetic analysis. This project will enable an Oxford Nanopore Sequencing platform to be set up in Sudan (one has recently been installed in Zambia), with UCL providing sequencing training. These platforms and the training programme will enable the teams in both countries to not only undertake sequencing for this project, but also set up a sequencing pipeline for the identification of multi-drug resistant bacteria in clinical settings.
The results of this study will provide evidence that can inform policy on IPC measures put in place on COVID-19 wards.
PANDORA-ID-NET member Swaib Lule discusses his work with the Entebbe Mother and Baby Study in the Immunomodulation and Vaccines Programme at the MRC/UVRI and LSHTM Uganda Research Unit in Entebbe, Uganda.
Visit the website to read the interview in full.
We are delighted to announce that PANDORA-ID-NET founder member and lead, Professor Sir Alimuddin Zumla has been awarded the 2020 Mahathir Science Award, the
most prestigious international science award in Tropical Sciences which recognises the best scientific work in solving priority
health problems in the tropics.
Sir Ali’s research, capacity development and advocacy work over 30 years has led to breakthroughs in tuberculosis, TB/HIV co-infections and infectious diseases with epidemic potential, and health of disadvantaged populations globally.
The Mahathir Science Award is awarded jointly by the Mahathir Science Award Foundation and Academy of Sciences Malaysia – and Sir Ali will receive $100,000.00, a gold medal, and certificate at a ceremony to be held in Malaysia early 2021.
Nominees for the Mahathir Science Award go through a rigorous selection process modelled on the Nobel Prize (scientific) selection procedures in order to ensure that the award is presented to the best candidate. The evaluation is performed by the Fellows of Academy of Science Malaysia (Akademi Sains Malaysia) and by an International Advisory Panel. This year, the panel consisted of Nobel Laureate Professor Barry Marshall, previous MSA laureates Emeritus Professor John Sheppard Mackenzie and Professor Alan Cowman, and the former Director of the London School of Hygiene & Tropical Medicine Professor Sir Andrew Haines. In deliberating they took into consideration several factors including originality of work, innovation, impact and its significance in solving the health problems of the tropics by improving the quality of life and contributing to the region’s prosperity.
The Malaysia Academy of Sciences President, Professor Datuk Dr Asma Ismail said in her press release that “Sir Alimuddin has proved time and time again that his mission is to serve the world through his research and global collaborative efforts. His work focuses on improving global health, with an emphasis on assisting poorer and disadvantaged peoples of the world. Our decision to award Sir Alimuddin the award was unanimous. We could not think of a better recipient for this year’s Mahathir Science Award.”
Commenting on his award, Sir Ali said: “I feel extremely honoured and truly humbled to have been recognised by such an illustrious selection committee as the recipient of the prestigious 2020 Mahathir Science Award. “This award is a reflection of the commitment, dedication and hard work of my research groups at UCL the UNZA-UCLMS and Pandora-EDI-NET teams and collaborators from across all continents who have dedicated their time and efforts on our joint collaborative program on killer infectious diseases.
“I strongly believe that as scientists, we need to be intimately involved in research, aligned with training, capacity development and advocacy efforts, so that we can have an impact for generations to come, and sustain the progress we make. We need to look beyond the normal and be involved in innovative and impactful research projects that will be beneficial for the future.”
On the right you can watch a report by the Zambia National Broadcasting Corporation.
Mar 2020- COVID-19 preparedness workshop
On 11-13 March 2020, PANDORA and Africa CDC jointly conducted a COVID-19 workshop hosted by a Zambia-based PANDORA member which was attended by a total of 33 participants from 20 countries. The workshop focussed on risk assessment at points of entry and further management of clinical cases (confirmed and suspected). The lectures and accompanying presentations from the workshop are openly available on the PANDORA YouTube channel.
Relative risk of importing at least one novel coronavirus (2019-nCoV) case by country as of 31/01/2020. Najmul Haider, Alexei Yavlinsky, David Simons, Abdinasir Yusuf Osman, Francine Ntoumi, Alimuddin Zumla, Richard Kock.
In press, Epidemiology and Infection, DOI: 10.1017/S0950268820000424
For full text click here. Also like through interactive map.
PANDORA PIs, Prof Francine Ntoumi (FCRM) and Prof Alimuddin Zumla (UCL) were in Geneva today with EDCTP's Jean-Marie Habagirura, to contribute to discussion on the way forward for a comprehensive global response to the nCoV threat to global public health.
PANDORA partners across Africa are working with national governments to strengthen preparedness and response capacity in the wake of the emergence of a novel coronavirus outbreak from Wuhan in China. The Global Health Network have put together a fantastic Knowledge Hub and you can also keep abreast of developments through the World Health Organisation's nCoV situation reports.
UCL have put together a useful instructional video on nCoV diagnostics. You can also access a PDF with full protocol. French and Portuguese versions in press.
PANDORA partners attended telecall with Africa CDC to liaise and coordinate response to nCoV outbreak in Africa, to ensure health systems are ready to detect and isolate suspected cases and prevent onward transmission.
The African Congress for Clinical Trials (ACCT) is being held at the Centre de Recherches Médicales de Lambaréné (CERMEL) in Lambaréné, Gabon from 10th-14th November 2019. The congress is hosted by CERMEL PANDORA partners Professor Ayôla Akim Adegnika and Dr Selidji Todagbe Maxim Agnandji.
The focus of the ACCT is to share ideas to accelerate the development of research in sub-Saharan Africa in emerging and re-emerging infectious diseases.
PANDORA ID-NET was represented during a workshop on the role of social sciences in health interventions by Sarah Edwards (Professor of Bioethics, University College London, UCL), Pierre Chetel (anthropologist from Fondation Congolaise pour la Recherche Médicale, FCRM), Steve Diafkietela (FCRM PANDORA project manager) and Mags Thomason (UCL PANDORA Project Manager).
Professor Edwards gave an overview of the evolution, since the Ebola outbreak in West Africa, of conducting rapid and rigorous social sciences in relation to emerging epidemics to help response efforts. Monsieur Chetel led discussions on ongoing PANDORA projects in Congo Brazzaville on the socio-anthropological determinants of exposure and risk of Ebola infection in rural and refugee communities along the Congo river.
Interactive sessions between 80 participants from Africa (Gabon, Cameroon, Congo, Benin, Senegal) , Europe (Germany, Austria, Italy, Spain, UK) and USA are covering clinical trials, epidemiology, entomology, molecular biology, data analysis and bioinformatics with workshops and symposia on controlled human infections, the development of malaria vaccines and the evaluation of treatments against infectious diseases. Steve Diafkietela introduced one of the feedback sessions.
(left to right) Steve Diafkietela (FCRM), Jolivet Mayela (FCRM CANTAM project manager), Mags Thomason (UCL), Akim Adegnika (CERMEL), Sarah Edwards (UCL), Pierre Chetel (FCRM).
The Centre for Clinical Microbiology at University College London ran a MinION training workshop with experts from Oxford Nanopore Technologies, Great Ormond Street, LCG and the Quadram Institute delivering practical and theoretical sessions over three days at the Royal Free Hospital in London. Fourteen delegates from across PANDORA and partner institutions attended, learning how to use the rapid barcoding kit, the rapid PCR barcoding kit, flow cell preparation and analysis of their results using real clinical samples. The knowledge gained from this training session should enable participants to set up Nanopore sequencing in their own laboratories, with on-going support from this new network.
In 2008 a novel arenavirus was discovered in Zambia that killed 4/5 people infected (Simulundu et al... 2015). Despite two previous surveillance studies the animal reservoir for Lujo virus (LUJV) has yet to be established, but we assume like for all other mammarenaviruses, the reservoir species is probably a rodent.
The PANDORA-Zambia veterinary team from the University of Zambia and HerpeZ visited Livingstone in July 2019 to capture and sample rodents. Analysis will then be undertaken in the BSL-3 facilities at the University of Zambia School of Veterinary Medicine.
July 2019 - Training on viral diagnostics at the Uganda Virus Research Institute (UVRI)
This training was aimed at strengthening the capacity of sub-Saharan African countries to respond to epidemics and to carry out research in the event of an epidemic. At the end of this training, with a completed certificate, participants gained advanced knowledge of virus capture and concentration on ApoH magnetic beads, as well as purification of DNA or RNA, qPCR and RT-qPCR.
A joint team from BNITM (Bernhard Nocht Institute for Tropical Medicine), Hamburg, Germany and FCRM (Congolese Foundation for Medical Research, Brazzaville, RoC) made their first exploratory mission to Bomassa in the Kabo District, Sangha Department in the north of the Republic of Congo as part of the implementation of the activities of the PANDORA network, prelude to the start of the study on "Research the presence of antibodies against the Ebola virus and risk factors for Ebola infection in the river corridor in the Republic of Congo ".
This mission, which coincided with the schedule of the WCS Field Team Immunization Campaign, was part of the "One Health" and aimed to provide expertise on the state of Bomassa and explore other sites for possible missions to accompany the PANDORA project in the northern part of the Congo (Ouesso, Makoua, Kabo, etc.). At the end of this mission, a restitution took place respectively with the Departmental Directors of Health and Livestock of the region of Sangha, Republic of Congo on the necessity of conducting a possible study on zoonoses.
The BNITM / FCRM / WCS joint team that took part in this mission consisted of Dr. Béatriz ESCUDERO-PEREZ, Virologist (BNITM-Germany), Mr. PEKO Simon Marie (Molecular biologist, PhD student FCRM), Miss. Linne LOBALOBA INGOBO (FCRM student) and Miss. Eeva Kuisma (WCS)
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Organized by Irrua Specialist Teaching Hospital (ISTH), member institution of the PANDORA-ID-NET Consortium in Nigeria, under the leadership of Prof. Sylvanus Okogbenin and Dr Danny Asogun, this workshop which had the theme: "PANDORA's role in the response to infectious disease epidemics in Africa" was attended by teachers, researchers and students (MsC and PhD) from Nigeria, Benin, Ghana, Liberia, Togo, Sierra Leone and Congo (Coordination).
Activities included:
- Opening ceremony with the participation of the Deputy Governor of Edo State, the Ministry of Health, the WHO, the EU Commission, the CDC Nigeria, local authorities, customary chiefs, officials and faculty from the University of Irrua, members of the Advisory Committee, PANDORA Coordination, PANDORA Principal Investigator in Nigeria, and ISTH (High Ceremony) authorities.
- Theoretical training at ISTH on mobile laboratory deployment.
- Practical training with the deployment of mobile laboratories in two (2) teams.
- Evaluation, discussion and validation of the results obtained by each group.
- Visit the Lassa Fever Institute of Irrua Specialist Teaching Hospital.
- Ceremony of handing over certificates of participation and closing of the workshop.
During this workshop, participants learned how to quickly deploy and manage a mobile laboratory in an emergency situation. This training thus supports one of PANDORA's objectives to take leadership in Africa in terms of response operations on emerging and re-emerging epidemic infectious diseases and One Health. This contributes to the achievement of a big challenge for Work Package 2 (Capacity Building and Training).
Finally, at the end of this workshop the participants benefited from the certificates after evaluation. They were satisfied with the training conditions, the quality of the modules developed, the simulations and practical cases applied, as well as the competence of the trainers and are able to deploy a mobile laboratory in the event of an epidemic (Lassa Fever, Crazy, Ebola, etc.). They also expressed a wish to organize this training for the benefit of the other sub-regions of East, Central and South Africa, still under the leadership of ISTH-Nigeria. It should also be noted that one of the highlights of this training was the creation of an already operational WhatsApp group to share information and experiences between the different participants and trainers in terms of research and in case of responses. epidemics in the different countries that participated in this workshop.
From 20th February to the 7th March 2019, in the context of the preparation and response to the EBOLA epidemic in case of emergency and Chikungunya in the Republic of Congo, the PANDORA network, through the FCRM, organized in collaboration with the Institute of Tropical Medicine, Hamburg, a training course on "Diagnosis and immunology of emerging and re-emerging pathogens".
This training provided by Professor Cesar MUNOZ-Fontela, Dr. Beatriz ESCUDERO, Dr. Perez Emily NELSON and Dr. Sergio Gomez MEDINA of the Bernhard Nocht Institute of Tropical Medicine (BNITM) Hamburg, Germany had the general objective of transferring knowledge based on techniques of molecular detection of EBOLA Virus and Chikungunya.
Training objectives :
- To strengthen the capacity of health personnel by providing them with the necessary and adequate tools for an outbreak response in the event of an EBOLA outbreak;
- To transfer knowledge based on molecular biology techniques for the detection of EBOLA virus and chickungunya in blood samples ".
The training involved theoretical training with some sessions of lectures followed by discussions, as well as hands-on sessions with group work and experience sharing. This training was attended by fifteen people including eight from the National Public Health Laboratory (LNSP) of Brazzaville and seven from the Center for Research on Infectious Diseases (CeRMI) of the Congolese Foundation for Medical Research. At the end of this training, participants gained in-depth knowledge of "the diagnosis and immunology of emerging and re-emerging pathogens.
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PANDORA partners from The Tanzanian National Institute of Medical Research, University College London, The Royal Veterinary College and the Istituto Nazionale per le Malattie Infettive L. Spallanzani joined Congolese partners from the Fondtion Congolese pour le Recherche Médicale, to conduct field surveillance during the current Chikungunya outbreak in Republic of Congo.
Personnel
INMI, Italy
· Francesco Vairo (Epidemiologist) – Team leader
· Marco Iannetta (Physician)
· Concetta Castilletti (Virologist)
NIMR, Tanzania
· Patrick Kija Tungu (Entomologist)
RVC, United Kingdom
· Najmul Haider (Animal health/Modelling)
Objectives
1) Strengthen the surveillance system
2) Case management
3) Evaluating the entomological aspects
4) The sylvatic cycle in a ONE Health perspective
5) Modelling the epidemic
The Irrua Specialist Teaching Hospital, Nigeria is a partner institution in PANDORA-ID-NET consortium and brings in the expertise for mobile lab deployment during outbreak of infectious diseases in any part of West Africa. In the wake of an outbreak of Lassa fever(LF) in January 2019 in communities neighbouring Federal Medical Centre Owo, Ondo State in South – West Nigeria, the mobile laboratory domiciled at Irrua Specialist Teaching Hospital was deployed on February 12th, 2019 to support the onsite clinical diagnosis of Lassa fever in that hospital. Prior to the deployment, suspected samples of LF were sent to Irrua for confirmation resulting in delays in clinical decisions. The deployment also provided opportunity for training of local laboratory staff in the use of PCR in the diagnosis of Viral haemorrhagic fevers like Lassa fever.
Lassa fever, caused by Lassa virus (LASV) is endemic in the West African countries of Benin, Ghana, Guinea, Liberia, Mali, Nigeria, and Sierra Leone. An annual case estimates of 100,000 to 300,000 LASV infections with 5,000 to 10,000 deaths are often cited by public health officials. However, more recent surveillance reports have noted substantial increases in the number and geographic spread of cases. Nigeria for example, recorded the worst Lassa fever outbreak in 2018 with a total of 3498 suspected cases, of which 633 were confirmed. There were 171 deaths in confirmed cases, giving a case fatality rate of 27%. From 1st January to 31st March, 2019, a total of 2034 suspected cases have been reported from 21 states with 526 cases, 121 deaths in confirmed cases and Case fatality rate of 23.0%. With the few stationary laboratories in West Africa that have capacity to confirm clinical suspicions of VHFs especially LF, the mobile laboratory becomes very useful in endemic foci in onsite case identification, clinical management, surveillance and outbreak control.