April 2009 Report
Summary:
In April the rainy period waned off and temperatures started to decrease. Mosquitoes continued to be captured, albeit increasingly non-vector species. Health centre surveillance sms data continued to be received, showing similar malaria RDT positivity to the previous month.
There was bustling laboratory and field research activity. Laboratory Scientist Jodi Chondoka ran EPI study RT-PCR for gametocyte detection. Meanwhile Dr. Tamaki Kobayashi, who runs the EPI study with Dr. Moss, arrived to troubleshoot ELISA assays for the same study with Sandra Chishimba. Mwiche Siame led a team of field surveys following up pre- and post-treatment Plasmodium falciparum positivity by RDT and PCR in blood and saliva samples. Genotyping of P. falciparum for drug resistance mutations was in progress, with a special comparison of thick film-positive and thick-film negative infections. The mosquito colony became fully adapted to mouse feeding, leading to considerable egg production.Two abstracts from TB/HIV research were accepted for presentation at local and international conferences.
In line with MIAM's goal to provide technical capacity for the malaria control programme, two technicians from the NMCC underwent attachment at MIAM labs, learning how to rear a mosquito colony. They subsequently left with a donation of eggs to help them start a colony for the NMCC in Lusaka, for subsequent use in national vector control quality check bioassays. In addition, an MSc student from UNZA in the company of his supervisor, Dr. Katongo, spent time learning PCR for An. gambiae sl sibling species identification.
A government delegation, including the Honorable Minister of Home Affairs, Dr. Kalombo Mwansa, other officials and Chief Macha toured Macha Hospital and MIAM facilities
I - General Site Development and Maintenance
Thankfully, there were relatively few ZESCO power outages during the month. The Maintenance team diligently filled out eroded sections of roads around the campus and labs. Following re-painting of the outside for the Lion house, the team performed both internal and external repairs to the Gobelo house, taking the opportunity when Dr. and Mrs. Thuma were away in the USA.
II - Information Technology
Internet accessibility was largely reliable, although a few brief spells of instability were experienced. In lieu of the login system, a new browser filter system was introduced. This still needs tweaking however as it tends to block many genuine searches.
III - Vehicles/Transport
Following replacement of ball joints, the Toyota Hilux Surf was running well during the month. The Toyota Landcruiser Prado was back from repairs in Lusaka and in excellent condition. The relatively old Toyota Hilux 3.0 was assigned to a lower mileage fee scheme, including special mileage rate for MIAM staff as part of their benefits. The 3.0 replaced the old Toyota Hilux 2.8, which used to be on this scheme before it was sold.
IV - Research Activities
Entomology:
The Anopheles arabiensis colony was well adapted to mouse feeding by the end of April, feeding relatively quickly and laying good numbers of eggs. Two technicians were seconded from the NMCC to MIAM labs, where they spent time learning mosquito colony rearing with Mr. Mulenga Musapa. On their departure, a batch of eggs was officially donated, and a material transfer agreement (MTA) signed between MIAM and NMCC, so that the NMCC could start their own colony in Lusaka using Macha lines. Empowered with a colony, NMCC would be able to conduct quality control bioassays in the national malaria vector intervention programme.
An MSc student from UNZA, Mr. Osbert Namafente, in the company of his supervisor, Dr. Katongo, spent a short time during the month learning Anopheles gambiae sl sibling species identification PCR.
Epidemiology:
Longitudinal household field surveys were running well, with preparations under way to resume cross-sectional data collections in May. Plans were made to work on streamlining data entry and minimize errors on the system.
Lab scientist Jodi Chondoka continued to diligently run RT-PCR assays for the EPI study, while microscopy on field samples were also running smoothly.
Dr. Tamaki Kobayashi arrived with new reagents and positive controls to work with Lab Scientist Sandra Chishimba and troubleshoot OD readings for the ELISA assays.
Genotyping, Drug Resistance and Diagnostics:
Field and laboratory data collection activities proceeded apace during the month. Mwiche Siame led a team on field surveys collecting pre- and post-treatment follow-up samples to examine trends in PCR, and RDT P. falciparum detection sensitivity using saliva samples compared to blood specimens. P. falciparum genotyping for drug resistance was running concurrently, comparing submicroscopic infections against thick film-positive samples. It was increasingly evident that P. falciparum resistance genotypes widely reported to be rare/absent in Africa are prevalent among low-grade infections, confirming earlier findings from mosquito infection assays.
Tuberculosis Study:
By April at least 4 patients had been enrolled. The slow pace was attributable to stringent inclusion/exclusion criteria. Discussions were in progress to widen enrolment area to include Choma.
HIV/AIDS Study:
This PART study had enrolled 300 children by the end of April. Two abstracts were accepted for presentation at the forthcoming HIV/TB Transmission and Prevention Conference to be held in Lusaka. An MPH student from Amsterdam University, Jolande Zijlstra, arrived to assist on this project for her dissertation.
Hospital Data Collection and Analysis:
April malaria case load was also much lower than previously seen during the years before advent of ACTs. There was no malaria death during the month.
Rural Health Centre Malaria Surveillance:
Malaria RDT data continued to be received from the rural health centre SMS submission system. Positivity rates for April appeared similar to the previous month. A meeting was held to plan for follow-up screening on the RDT index cases and their respective households.
V - Other
A large delegation including the Honorable Minister of Home Affairs, Dr. Kalombo Mwansa, government officials, Chief Macha and headmen, toured Macha Hospital and MIAM facilities. They left with positive impressions of Macha and they were briefed of general road access challenges faced in the area.
MIAM was officially registered with Workers Compensation Fund in Zambia.
Jodi Chondoka resigned from MIAM to accept a place in the UNZA Medical School.