February 2009 Report
Summary:
The rainy season continued in February, with a total rainfall amount of 123 mm, which was 43% below the expected amount for the month when compared to a 16 year monthly average from 1950 - 66. Despite the decrease in rain for the month, the mosquito trapping field teams continued to find plenty of Anopheles arabiensis in local villages.
Malaria case load at the hospital remained low compared to previous years, with no malaria related mortalities to date for this "malaria season".
Entomology research projects continued throughout February, with two Hopkins Ph D students here for the whole month. Lab research on malaria parasite molecular markers also continued daily, in order to obtain more data for abstracts that were being prepared for submission to the MIM Malaria conference to be held in Kenya in November.
A trip to Zambia by the JHMRI Director Dr. Peter Agre, was accompanied by various public events held in Lusaka, as well as a helpful visit by him to MIAM.
I - General Site Development and Maintenance
Despite the on-going rains in February, the maintenance team kept up with road repairs and the slashing of the grass, keeping the research campus looking like a well-groomed park.
Use of the back-up generator in February remained low for most of the month, for a total of only 20 hours of use (mostly in the last week of the month), as the national electricity grid proved steady and reliable for the most part.
Plans were made during the month to begin re-painting some of the original houses on campus. Other minor repairs will be done to the houses, now occupied for over five years, so as to maintain them in good condition.
II - Information Technology
Internet access remained available for most of the month, with only a few minor outages. Erratic wireless access in the newly renovated office section of Lusumpuko House (the original library/office building), continued to create connectivity problems for those in the new office cubicles. Various measures were being considered at month-end to alleviate the problem.
Our ISP, (LinkNet), has received notice that satellite connectivity charges are expected to go up significantly in the coming months. This may impact our internet accessibility since we may need to decrease our bandwidth purchase in order to operate within our fixed IT budget.
III - Vehicles/Transport
The oldest Toyota Hilux double cab was sold during the month, with plans to buy a replacement vehicle in the near future. Unfortunately, the MIAM reserve fund for vehicle replacement, which is held in Zambian Kwacha, has seen its purchasing power value decrease in recent months, as the Kwacha has depreciated significantly against the US dollar.
After repairing the air conditioning system last month on the Toyota Landcruiser Prado, it subsequently developed a loud engine knock on a trip back from Lusaka in February, requiring it to be taken to Lusaka late in the month for major engine repairs.
Other vehicles, including the two Toyota double-cab pickups and the Toyota Surf continued to be used heavily every day for the many field activities during this time of the year.
IV - Research Activities
Entomology:
The Anopheles arabiensis colony at MIAM continued to reproduce under the watchful care of Mulenga Musapa and his assistants. Feeding of the mosquitoes by mice was increased, after working through various anesthesia methods and then devising a restraint with which the mice could be held in the mosquito cage for longer time periods, allowing for improved blood feeding by the mosquitoes.
Various studies were carried out on the mosquitoes in the colony, including some preliminary insecticide resistance studies by L. Norris, a Ph. D student from Dr. Norris' lab at Hopkins.
Entomology field work continued throughout the month, with CDC light traps and landing catches being carried out three or more times per week.
Epidemiology:
This study continues to screen 24 randomly selected households per month, keeping the field team busy in both the longitudinal and cross-sectional components of the study. So far this year, the yield of positive Rapid Diagnostic tests (RDTs) done in the villages, has been extremely low. The two full time microscopists have done well in keeping up with the workload this year, and are also finding only rare blood smears positive and rare gametocyte carriers.
The RT-PCR work to determine the presence of gametocytes has shown some positives, implying that this technique may be more sensitive than microscopy, in our hands. Antibody work on the study samples was also carried out, with some preliminary data presented to Dr. Agre during his visit to MIAM in February.
Genotyping, Drug Resistance and Diagnostics:
The molecular biology lab continued to be busy with on-going studies on drug resistance allele markers and also on optimizing the best method to find P falciparum DNA in saliva. Further refinement of a technique using "tertiary nested PCR" was carried out, with some preliminary data indicating that perhaps as high as 85% of asymptomatic individuals may be carrying small amounts of parasite DNA in their blood.
A fair amount of work in the lab was being done during the month in anticipation of submitting an abstract for the MIM Malaria conference to be held in Nairobi in Nov '09.
A methodology has also been developed in the molecular biology lab to do nested PCR using a "one tube" method. This will be important for any future micro-fluidics method to diagnose malaria from saliva.
The one PCR machine that had been in the USA for repairs was returned to MIAM in February.
Tuberculosis Study:
The multi-site Rifaquin TB clinical trial continued with no new patients enrolled for February. The TB lab continued to function well, with TB cultures being done, and typing of the isolates by genetic means.
HIV/AIDS Study:
The pediatric AIDS (PART) study continued with enrollment and following of the children on the study. A draft paper was worked on detailing the baseline characteristics of the children and the results of the first year of follow up.
Hospital Data Collection and Analysis:
The on-going prospective data entry of all cases of hospitalized children continued. Malaria cases remained low in February with only eight hospital discharges on the children's ward for malaria, with no malaria-related deaths. Malnutrition (PEM) remained the major cause of death and hospitalization, with about one third of those cases also infected with HIV and/or Tuberculosis.
Rural Health Centre Malaria Surveillance:
Data from the local Rural Health Centers (RHCs) continued to be collected using cell phones and messaging, with the number of positive Rapid Diagnostic Tests (RDTs) for malaria decreasing a bit in late February. The one RHC in Namwala district that was not sending in data was visited in person, and after clearing up some mis-understandings the data is now being received.
Plans are being made to begin the next phase of the project in April, which is to screen local households from which a person with a positive RDT has come from, and compare the results of that screening to households from which a negative RDT has come from.
V - Other
The MIAM Scientific Director, Dr. Mharakurwa, returned in February after spending several weeks in the USA, including collaborative work at New York University School of Dentistry (on saliva diagnostics), time at JHMRI, and also attending a Gordon Research Conference in Texas.
A visit to MIAM in February by the JHMRI director, Dr. Peter Agre allowed for an opportunity of presenting to him various findings from the on-going research projects, and also a chance for him to interact with MIAM staff. He gave a well-received speech to the community on "A Life In Science" - a repeat of the speech he gave earlier at the University of Zambia in Lusaka.
Dr. Norris spent time at MIAM during the month, working with his two graduate students and discussing long term plans for the insectary.
Dr. George Dimopoulos' post-doc completed his project at MIAM in Feb and returned to Baltimore.
Ms. Winnie Muleya, a recipient of a research award from Zambia National AIDS Network (ZNAN) spent time at Macha in February, getting advice on how to analyze her data collected from a survey on attitudes and practices relating to HIV / AIDS.
The Lab Scientist from the Clinical Research Lab, Mr. Pisgah Sikwangala arrived back in Zambia after spending two months of training in the microbiology labs at Erasmus University, Holland.