June 2008 Report
Summary:
June was a cool and dry month at Macha, with temperatures dipping to the low 40's (degrees F) some mornings. The frequent wind gusts blew fine dust everywhere, making it imperative to keep computer keyboards covered when not in use.
Both field work and laboratory work continued, but by the end of the month field work was winding down, since the Epidemiology study team activities are at a minimum during the cold season. The molecular biology lab remained busy, with several on-going student projects in addition to the usual work, and the anophelene mosquito colony continued to thrive. Work in the Clinical Research lab was diminished while waiting for special reagents from South Africa to arrive for the medical student tuberculosis project.
The water and electrical systems on the MIAM campus continued to work reliably, with the back-up generator used less frequently toward the end of the month, as the national grid became more reliable. All vehicles were kept running and available when needed for field work and business or buying trips to Choma or Lusaka.
I - General Site Development and Maintenance
The MIAM campus road maintenance and repair project was temporarily suspended while the Manager for Buildings, Maintenance and Vehicles was on his annual leave, but will resume in July when he returns to supervise it. The dry weather and wind raised lots of dust, but the flower beds in various strategic places added patches of color to an otherwise dry landscape.
The two campus borehole wells continued to supply good clean water without any problems, and the water and electrical infrastructure had no major problems during the month. Fortunately the national electricity provider is no longer rationing electricity by black-outs nearly every evening, putting less stress on the MIAM back-up generator.
Minor renovations in the "library" building were completed except for painting, with a new classroom created plus office cubicles for up to six more employees. This should keep pace with the expanding needs for office space. The former "Host House" has become the library, main meeting area and the place for staff tea-time, with the eastern portion of the house now a fully functional flat with its own external door.
II - Information Technology
Internet connectivity was maintained throughout the month, though there were many periods of intermittent access. This lack of ability to connect to the internet, or the loss of connectivity every few minutes while working, is made more stressful now that LinkNet (our ISP) has decided to have all MIAM email only available through the internet. A meeting with LinkNet has been requested to try to sort this issue out and will be hopefully held in July once Mr. van Stam has returned for leave in Holland.
The 30 or so MIAM computers were maintained well by our local IT technician, with prompt replacement of hard drives that "died" or battery back-ups that no longer functioned well.
III - Vehicles/Transport
The use of the MIAM vehicles was less intense in June, as field work was wound down and fewer vehicles were used to go out for studies. All vehicles and motorcycles were maintained and kept on the road by the two MIAM mechanics.
The Hilux double cab pickup that had been damaged in an accident in May had the body work completed, and was ready for collection in Lusaka at the month end.
The insurance company had agreed that it would pay the full replacement cost for the extensively damaged Everest after the roll-over in April, but the promised insurance check had not yet been received by the end of June.
IV - Research Activities
Entomology:
The Anopheles arabiensis colony continues to do well, with plans being put into place to provide a long-term solution to the necessary blood meals for the colony. After consultation with Hopkins faculty, it was agreed that MIAM would establish a local mouse colony that would be used for the blood meals needed by the female mosquitoes. The various applicable standards for maintaining a small animal colony are now being worked on to bring this about. The anticipated visit in July by Dr. George Dimopolous from JHMRI will give us the first chance to actually utilize the colony for several experiments.
Epidemiology and GIS:
The Epidemiology study work kept up with the planned activities, with both the cross-sectional and longitudinal households being evaluated. With better and timely reading of malaria smears by the two locally-trained microscopists, it could be determined that parasite prevalence remained low in all areas. The planned RT-PCR work for quantifying gametocytes had not yet begun by the end of the month, but once a necessary reagent is brought to MIAM in early July from Hopkins, and the details of positive controls are worked out, it should get started.
Data entry for the 2007 season was finally completed and sent to Hopkins for analysis and further cleaning.
The Epidemiology field team plans to take a break from field activities in July, since this is a time period of historically very low malaria prevalence. The team will then resume work again in August/September.
The GIS manager assisted with the mapping of all pediatric admissions so far this year with confirmed malaria. There were only 41 cases (compared to over 1,000 in 2003), but interestingly, most of them were from villages to the west of the hospital. Further work is planned to better understand the distribution of malaria cases, especially as transmission patterns change in Zambia from the various intervention methods put into place.
Molecular Biology:
The PCR lab continued to be busy throughout the month with the Fitness and Transmission project work. Several short term student volunteers assisted in the molecular biology lab on these projects, as well as a master's degree student from Michigan State.
Pharmacokinetic Study:
The SP-PK study continued, with only a few of the 25 participants enrolled in the study still remaining to have their second set of pharmacokinetic studies completed. A shipment of filter paper blood spots was sent in June to the University of Cape Town for analysis of the drug levels.
Tuberculosis Study:
Preparations and final clearances for the Rifaquin study were continued in June, with an anticipated start date of recruitment of adults with pulmonary tuberculosis in August or September. Two med students from Holland continued to work in the TB culture lab on a project to determine local types of mycobacterium and their sensitivity to the usual anti-tuberculosis drugs.
HIV/AIDS Studies:
Nearly 200 children have now been enrolled in this longitudinal observational study, now beginning its second year. For the last two months while Dr van Dijk was on leave, Dr Hanna Stewart, a volunteer physician from UK, has ably kept the project running very well. A visit to Macha by the project PI, Dr Bill Moss and the Hopkins Ph D student working with the project was planned for early July to review data collection.
Hospital Data Collection and Analysis:
The on-going collection of hospital admission data was used to map out the village areas where all confirmed malaria cases came from so far this year. This will also focus efforts on the grids that show the most cases. A map is attached to this report showing the malaria case distribution.
V - Personnel
A visiting medical student from Vanderbilt University agreed to give training sessions for MIAM employees in Microsoft Excel, teaching the use of formulas, charts, etc. This was much appreciated by the staff who participated.
VI - Other
A final report was submitted on the USAID project, together with various completed forms, pictures and other documentation. MIAM benefited greatly from this grant, mainly through the construction of five additional staff houses and a dorm and cafeteria to provide for future training needs and seminars.
The registration process for the new entity, Macha Research Trust (MRT) was begun, working with a lawyer in Lusaka. It is hoped that all the necessary documents for registration can be completed and submitted by August, with plans that the assets of MIAM will then be turned over to this new not-for-profit organization based in Zambia.