March 2008 Report
Summary:
The weather remained mostly dry in March, and nights became cool, resulting in a rapid decline in mosquito populations in the surrounding area. By the end of the month, it was clear that the rainy season for this year was essentially over.
March saw the end of the USAID project, which has been running for the last two years, and resulted in construction of five new much-needed staff houses, a dormitory and a cafeteria. Various commodities including computer equipment for MIAM offices were also purchased from this grant.
A significant milestone was reached in early March, with the establishment of a reproducing anopheline colony in the insectary for the first time. This colony continued to do well through-out the month, under the watchful and loving care of our resident entomologist.
The Scientific Director was away for much of the month, as were several of the lab scientists, resulting in less activity in the molecular biology research lab, but more manuscripts and grant applications being worked on. Entomological field work continued unabated throughout the month, while enrollment on the Epidemiology study was stopped in mid-March by the Hopkins IRB, pending a revised consent form being approved.
The SP-PK study continued without problems, with the anticipated visit in April of the PI, Dr. Myaing Nyunt. The clinical research lab provided service for this study, and continued to prepare the TB culture facilities for the TB Rifaquin study, which has finally received all relevant ethical approvals at all of the multi-country sites.
The PART study continued to enroll and follow children with HIV/AIDS exposure. Funding for the study has yet to be released, though slow progress in processing all the paper work is being made.
I - General Site Development and Maintenance
The MIAM campus remained attractive with colorful flower beds scattered between buildings, and the green grass throughout the campus neatly trimmed. Work on the internal roads was carried out with hauling of gravel to re-establish road beds after the heavy rains earlier this year, as well as digging out of drainage ditches. Additional electrical poles and wire were purchased with USAID funds to install additional lighting on the campus for better security, and an additional security guard was hired for the night patrols.
Frequent electrical outages continued, usually for several hours on three or more evenings per week, as part of the national electrical "load-shedding" exercise to ration the limited amount of electrical power in the country. This results in the back-up generator running frequently to maintain electrical power on the campus and in the lab. With diesel fuel prices now at approximately $6.50 per gallon, the frequent running of the generator puts an unexpected drain on the operating budget.
Hospitality services remained busy throughout March, with one Hopkins post-doc, two Hopkins Ph D students, two Hopkins medical students and many other students and visitors occupying the flats and dormitory.
II - Construction of Buildings
The last staff house to be built with USAID funds (House "D") was completed in good time in March, with the final architectural inspection and completion certificate issued. The MIAM Construction Manager returned to the USA, having completed his contract.
With two MIAM staff members recently or soon to be married and moving into larger quarters on campus, and the recruitment of several new lab and clinical staff members, we once again will have all available housing utilized. Various options are being looked at, as we also continue to seek funding to construct additional staff housing.
III - Information Technology
Overall internet access was stable throughout the month, though the new mesh network had some outages, and one of the many wireless boxes in the network appeared to be acting as a server, giving out incorrect Internet Protocol (IP) addresses. This resulted in computers not being able to connect to the internet through the wireless area network.
Using USAID funds, several new office computers were purchased as well as more back-up UPS's, to replace the aging computer hardware in the MIAM offices. An additional data entry computer was installed in the molecular biology lab, and linked to the printer that was previously purchased.
A new air conditioning unit was purchased and installed for the IT equipment room, since the old one was deemed not repairable.
IV - Vehicles/Transport
All MIAM vehicles remained on the road through-out March, with as many as three at a time being used for field work on any given day. Roads in the area, including the main road to Choma, remained in very bad repair, causing damage to tires, shock absorbers and springs on the vehicles being used.
The Mitsubishi Pajero that was originally purchased for field work several years ago, and now replaced with the Toyota Surf, was sold during the month of March. The Toyota Hilux 2.8 double cab and the old Fuso lorry are still for sale as well.
Quotations for a new Honda motorcycle were received in March, with plans to purchase a motorbike in April to be used with the field work.
V - Research Activities
Entomology:
Early in the month our resident entomologist announced that he had successfully managed to get insectary-born Anopheline arabiensis to mate and lay eggs, thus beginning the second generation of a line of anophelines at the MIAM insectary for the first time. By month end, the colony was now on the F3 generation, and it appears that we have finally been successful in establishing a viable and reproducing local colony of anophelines. Now that this has been accomplished, there should hopefully be an ample supply of anophelines for various experiments.
Much time - and even overtime - was spent during March on the identification of the mosquitoes brought in from the various landing catches, CDC traps and spray catches from the various on-going projects. In addition, the electric grids produced a fair number of mosquitoes which also needed to be identified. One of the field workers, S. Habbanti, has shown interest in learning to do mosquito ID, and has been tutored in this by the Ph D student from Hopkins.
A lead article appeared in the magazine Nature (28 Feb edition) about malaria in Zambia and the research work at Macha, and included a photo showing two MIAM field workers engaged in mosquito landing catches.
Epidemiology and GIS:
The Epidemiology study continued to go well, but in mid-March we received word that the Hopkins IRB had determined at the last minute (just days before the scheduled renewal), that the consent form should be revised to include side effects of any anti-malarial drugs that would be given to those participants found to be positive for malaria. As a result of this, the study had to temporarily closed, and the recruitment of all participants had to stop, until a meeting of the IRB late in the month. By month end, we once again had permission to resume the study for those who had already signed a consent form earlier for the longitudinal study. But due to a new requirement for a small addition in the consent form and a new translation of that form, no new cross-sectional study participants can be recruited until re-authorized.
The lab technologist for the Epi study spent most of the month in Baltimore undergoing training in Dr Kumar's lab on the RT-PCR technique. Once he returns to MIAM in April he will set up RT-PCR at the MIAM lab, in an effort to determine the carriage of gametocytes in the study population.
Of the two microscopists trained for this study, one was due to leave at month end for university, and the other was offered a full time appointment to MIAM staff as a microscopist assigned to the Epi study. It was agreed with the study PI that an additional person will be trained to help with microscopy, to replace the one going to university.
The GIS work continued with the Hopkins post- doc working together with the MIAM GIS Manager, mapping areas and establishing correlations with satellite imagery and local conditions. It is hoped that this study will lead to a better ability to predict mosquito breeding sites based on interpretation of satellite imagery. The GIS Manager also assisted the Epi Study team in mapping and locating the randomly selected households for the longitudinal and cross-sectional components of that study, before going on leave at month's end to get married.
Molecular Biology:
The project looking at changes in molecular resistance markers in the Macha area over the past number of years continued, though with less activity than in February, due to the absence of the lab scientist while he was away on urgent leave for part of the month.
A poster presentation was given at the biannual Hopkins Malaria conference by Dr. Mharakurwa on the various molecular resistance patterns found to be present in the human versus mosquito phase of the malaria parasite. In addition two grant applications were submitted by the scientific director, and another manuscript was finalized for submission during the month.
An abstract on the use of human saliva for diagnosing malaria by PCR was accepted for presentation by Dr. Mharakurwa at the 7th European Symposium on Saliva to be held in May in the Netherlands.
Pharmacokinetic Study:
The 25 women studied during pregnancy have mostly delivered and are now coming for the return visit for the repeat PK study carried out post-partum. The study PI from Hopkins is due to visit in April for data monitoring and evaluation.
Tuberculosis Study:
The EDCTP-sponsored multi-country Rifaquin drug study finally received approval in South Africa in late February, and an investigator's meeting will take place in Maputo, Mozambique in April, with plans to begin the study after that. With the departure of the clinical research lab supervisor, Dr Sue Penno, to return to the USA with her husband, a volunteer lab technologist was sent from Erasmus University in Holland to assist in the TB lab, until more permanent staff could be recruited. A lab technologist recently graduated from Evelyn Hone College in Lusaka was recruited late in March, and plans to join the MIAM staff in early April. Her primary assignment will be to work with the lab scientist in the clinical research lab.
HIV/AIDS Studies:
The CDC/JHPIEGO funded Pediatric Anti-Retroviral Treatment (PART) study continues to keep staff busy, with over 150 children now enrolled and being followed and tracked on a regular basis. Regular viral load samples are collected from each participant, and are being stored pending available funding to carry out the assays. Data entry for the study is being done on an on-going basis. Funding for the study is approved but has yet to be received by MIAM.
Hospital Data Collection and Analysis:
On-going collection of hospital data continues, as does annual data collection from the local rural health centers. As of the end of March, data from the children's ward showed the lowest number of malaria cases for a 1st quarter of a year, since 1984 when data was first collected in this way.
VI - Personnel
The Director attended the Operational Research Working Group meeting at the Zambia National Malaria Control Centre in March and presented to the group the various projects that are on-going at Macha.
The Scientific Director returned to MIAM from Hopkins in March, after attending the malaria meeting there and working on grant applications.
Two lab assistants resigned from MIAM to go to university, while offers of employment were made to a lab technologist, an accounts assistant, and a clinical officer - the latter to assist with the TB and PART studies. All three of the job offers have been accepted.