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)
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).
- 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.
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.
· Francesco Vairo (Epidemiologist) – Team leader
· Marco Iannetta (Physician)
· Concetta Castilletti (Virologist)
· Patrick Kija Tungu (Entomologist)
RVC, United Kingdom
· Najmul Haider (Animal health/Modelling)
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.