August 2007 Report
Summary:
August brought an end to the cooler weather, and by months end, the days were getting quite hot. Despite the warm weather, there was plenty of work done, both inside and outside of the MIAM offices and labs.
The well-digging rig came back for a second attempt in early August, and was successful this time, with a good borehole found near to the Maintenance Building.
Data entry for the Epidemiology Pilot study kept five computers and their operators busy for most of the days in August.
The laboratory remained a place with much activity, not only reading the many malaria slides generated by the Epi study, but also getting some PCR data ready to present, after learning that three abstracts from MIAM were accepted for the American Society for Tropical Medicine and Hygiene (ASTMH) meeting in Philadelphia in November.
The on-going USAID-funded building project moved into the last six months phase, as finishing work was done on the kitchen/dining room, floors were being poured in the dormitory, and brick-laying reached the final stage on the fourth staff house.
I - General Site Development and Maintenance
Several projects kept maintenance and general staff busy. The new borehole, drilled near the maintenance building at a site first chosen several years ago but never used, proved to be a good well with a yield of 2 L/sec on test pumping. During the month, the new submersible pump was placed in the well, and new trenches dug to lay the pipe from this second borehole pump to the existing water storage tank. It is hoped that between the two existing wells, we will have an adequate water supply for the expanded campus in the coming years.
The carefully and exactly laid brick walkway between the MIAM office and molecular biology lab was completed in August by our senior grounds-keeper, and will be a welcome relief from walking in the mud when the rains begin in several months.
II - Construction of Buildings
Most days in August, hammering could be heard coming from the dining room/kitchen and also the dormitory buildings, as many workers continued to work on completion of these buildings. Good progress was made, with the dining room/kitchen having painting nearly completed, with final carpentry work (shelves) and final electrical work being completed at month's end. Orders were placed for tables and chairs for the facility, and quotations for appliances obtained from Lusaka early in the month.
The dormitory had most of its concrete floors poured by month end, with painting beginning in the east part of the building. Plumbing and electrical work continues by the sub-contractors.
Staff House 'D' had the reinforced concrete 'ring beam' completed, and the final phase of the brick-laying was proceeding at month end.
III - Information Technology
Internet access remained available regularly throughout the month, with only a few minor and temporary outages. The extension of the wireless network by LinkNet to include the new MIAM staff houses has not yet been completed, since certain items of necessary hardware have not yet been obtained.
The Service Level Agreement (SLA) between MIAM and LinkNet underwent some further negotiation during the month, with hopes that the agreement will be signed in September.
Some of the funds from the USAID grant will be used to purchase additional hardware and software, to eventually allow for phone connectivity between all MIAM buildings using the wireless network.
IV - Vehicles/Transport
All MIAM vehicles were on the road in August, with the recently repaired Pajero now running well again.
An order was placed for a new Toyota Hilux double-cab through Toyota Gibraltar, to be delivered to Zambia in November. This Toyota agency caters to non-profits, and also upgrades the vehicle with heavy duty suspension, etc. to better tolerate the very rough road conditions present in rural Zambia.
A used Toyota Hilux Surf (4 Runner) was also ordered from Japan to be used for fieldwork in the next malaria transmission season, and is currently in Durban, South Africa, ready for shipment to Zambia. It is hoped that with these two additional vehicles, together with the two existing Toyota Hilux double cabs, the expanded field work planned for next year can continue without disruptions due to lack of vehicles.
With the busy Epidemiology field study team taking a break in late August, there was more time for motorcycle and vehicle maintenance. The Honda 125 had a complete engine overhaul carried out in the MIAM maintenance building, with replacement of piston rings, and was running well again after that process was completed. Our locally trained mechanic continues to carry out these kinds of repairs with guidance from others.
Our locally trained MIAM welder also completed welding a roof-rack in August, which was placed on top of the Ford Everest. This will allow for more space for luggage or supplies on Lusaka trips.
V - Research Activities
Entomology: Our resident entomologist made several field trips with other MIAM staff to Namwala in August, looking for anopheline breeding sites along the Kafue river, as well as setting CDC light traps in that area. While most of the mosquitoes found were culicines, they did manage to find several areas with anopheline larva, indicating that breeding of anophelines continues at a low level, even during the cold and dry months.
The Epi study also generated many mosquito samples that needed to be identified, labeled and stored for future reference. An abstract on PCR methodology that is thought to be more practical for work in resource-poor settings to identify mosquito species, was accepted for presentation at the upcoming ASTMH meeting in Philadelphia.
Epidemiology and GIS: The Epidemiology Pilot study completed all of the longitudinal study sites planned by this time period, as well as all but two of the cross-sectional study sites. This has generated an enormous amount of data, which was being double-entered into the local computer database by four or five MIAM workers on most days of the month. The many blood smears collected on this study requiring microscopy by two different lab techs has also kept our microscopists busy in August.
Molecular Biology: Lab work remained a full time effort for several of MIAM's lab scientists, helping Dr. Mharakurwa generate data for the other abstract that was accepted for the ASTMH meeting. This study on the genetic "fitness" of malaria parasites, has shown some rather novel and interesting results, when comparing the malaria parasites found in mosquitoes to the parasites found in human blood.
There was still no update on thermal block from the ThermoElectron PCR system that was in the US undergoing repairs.
Pharmacokinetic Study: Final approvals were pending from the Zambian Ethics Committee for this study to look at the pharmacokinetics of sulfadoxine/pyrimethamine (Fansidar) in pregnant mothers, with current plans to begin this study in October. Logistics for the study were being worked on in August, including documents for the data collection, and arrangements being made to hire part time nurses and a study assistant to help with the study.
Tuberculosis Studies: The TB lab continued to work on finding ways to decrease possible contamination levels of TB cultures, with some headway made during the month. The current plan is to start the Rifaquin study in November, with funding committed for a four year period. A lab technologist was interviewed late in August for the position of full time lab tech for the MIAM Clinical Research / TB culture lab.
Schistosomiasis Studies: With such successful snail breeding by the MIAM lab scientist assigned to this project, there have been more snails than expected. The planned collection of urine samples from school children with schistosomiasis was delayed until after the school term starts again in September.
HIV/AIDS Studies: Final plans were being made for the Pediatric Anti Retroviral Treatment (PART) study, due to start enrolling patients soon. Funding for the study is now committed for two years, and the study will also help fund the effort to diagnose HIV earlier in infancy using PCR technology.
On-going Hospital Data Collection and Analysis: The effort to capture more hospital data and carry out epidemiological assessment of it continues. An abstract was accepted for the ASTMH meeting showing that tracking pediatric blood transfusions given at a hospital can be a good indicator of the degree of malaria control in a community.
VI - Personnel
Late in the month, five people were called for interviews for various open staff positions at MIAM. It is hoped that from these interviewees, a new Human Resources officer can be hired, who will also help with purchasing. In addition, we hope to replace the accounts officer that resigned in June, and also hire an accounts assistant to help with the burgeoning recordkeeping required for the many projects now being carried out at MIAM.
Drs. Thuma and Mharakurwa had a meeting with the recently appointed Coordinator for the Zambia National Malaria Control Centre (NMCC) in August. Her commitment to malaria control in Zambia is impressive, and she appears to have excellent organizational abilities, which will give a boost to the already active national malaria control program. Discussion on how MIAM can best fit into the national program was fruitful.
VII - Other
Funds budgeted for core operations for the year were finally received from Hopkins, allowing for better planning of expenditures, and also to proceed with ordering a new vehicle that will be needed for the expanding field work.
During August, Dr. Thuma was appointed to the Choma District Health Management Team (DHMT) Malaria Task Force, and subsequently MIAM was asked to assist the government in distributing 80,000 insecticide treated bednets in the Choma District. MIAM used its truck to deliver 20,000 of the bednets to the seven rural health centers that refer patients to Macha Hospital, for further community distribution. This government effort to provide free bednets (up to three to every household), should lead to an additional decrease in malaria transmission in the area around Macha. An additional 5,000 free bednets were donated to MIAM from a World Vision-related organization (RAPIDS), and these nets are being distributed to people attending the HIV/AIDS Antiretroviral Treatment (ART) clinic at Macha Hospital.
Curtis Chong, a medical student from Hopkins spent part of August at Macha, helping in the hospital with patient care, and also assisting with sample shipment to the USA. At months end, a dry shipper with samples from the Epi Study and the Immune Response study was sent to Hopkins, and arrived safely after an initial five day delay in Lusaka waiting for clearance from the shipping company in the USA before dispatch.