November 2008 Report
Summary:
The month of November passed swiftly as both laboratory and field activities gathered momentum, while the searing heat since the previous months eventually culminated in the first downpour of rains for the forthcoming 2009 season.
Drs Bill Moss and Tamaki Kobayashi conducted on-site training of laboratory scientists and set up automated ELISA assays, while also consolidating RT-PCR methodology at Macha, using standard positive and negative controls.
The newly established mouse colony continued to thrive, as did the lab insectary, and preparations were put in place to start adapting the Macha mosquito colony to blood-feeding on mice.
After a series of brainstorming, critique and rehearsal sessions in laboratory meetings combining both molecular and clinical research lab staff, presentations for the New Orleans ASTMH conference were finalized and posters were printed in Lusaka.
I - General Site Development and Maintenance
Construction of the new sheltered car-park was in progress, with only roofing remaining. Following timely maintenance and compacting, MIAM campus gravel roads remained in good state upon the advent of rains. The notorious Choma-Namwala road was graded all the way from Choma to where tarmac begins towards Niko area, making travel a little easier on the vehicle fleet. It seems that this road may eventually be paved in the new year, which would tremendously facilitate MIAM operations and bring more development to the general Macha area.
Unlike October, the electrical grid "load shedding" resumed in earnest during the month, leading to significantly increased fuel consumption as the generator was running longer hours.
II - Information Technology
The IT system functioned well for the better part of the November. However, at the end of the month, connectivity was temporarily lost for days due to a malfunctioning hub. This was to be subsequently restored the following month.
III - Vehicles/Transport
All the MIAM vehicles continued to run well as field-related wear and tear were promptly fixed as always by the maintenance team. Plans were under way to register the newly procured Landcruiser Prado.
IV - Research Activities
Entomology:
The colonized genetic lines of the Anopheline vector mosquitoes reached the 12th filial generation. The mouse colony that was seeded in preparation for adapting mosquito blood-feeding to animals continued to burgeon such that the water bottles were soon running short. More were kindly brought by Dr. Moss, and plans were made for possible acquisition of more cages. Preparations were made to begin capturing more wild mosquitoes to further increase mosquito numbers before commencing mouse-feeding adaption.
Epidemiology:
Field data collection and entry continued on the on-going Epi study. Drs Bill Moss and Tamaki Kobayashi conducted hands-on training of Laboratory scientists Jodi Chondoka and Sandra Chishimba on RT-PCR assays and ELISA for immune responses to malarial infection using dry blood spots (BDS). An ELISA plate reader and ELISA plate washer were installed in MIAM labs. Automated data capture for ELISA was set up on the same computer coupled to the Kodak gel documentation system.
Genotyping, Drug Resistance and Diagnostics:
Work was started looking at changes in drug P. falciparum resistance genotypes over time and between human and mosquito phases.
After laboratory meeting-based critiquing and brainstorming sessions, two poster presentations on drug resistance were finalized and printed for dissemination at the ASTMH conference, titled: "The prevalence of the Pfcrt-76 point mutation in Plasmodium falciparum point mutations of Lusaka urban district, Zambia"; and "Status of the artemisinin resistance-associated ATPase6 S769N mutation in Plasmodium falciparum infections of Lusaka urban district, Zambia". These emanated from research by UNZA MSc staff development fellow Enesia Chaponda, with laboratory aspects conducted under MIAM supervision at Macha, through the MoU between JHMRI and UNZA Ridgeway campus.
One oral presentation was also completed on the immunochromatographic detection of P. falciparum infection using non-invasive human saliva samples.
Pharmacokinetic Study of SP:
A presentation was finalized of results for an abstract accepted for the American Society of Tropical Medicine and Hygiene meeting in readiness for dissemination in New Orleans.
Tuberculosis Study:
The Site Initiation Visit (SIV) for Macha for the multi-centre TB drug trial took place from Nov 10-13th. Ms. Heather Clouting, the trial manager and monitor of MRC Clinical Trial Unit UK, came out to Macha to do the training and document review. All CRL staff members, Rifaquin trial staff members, and the hospital pharmacist attended sessions relevant to their involvement.
During the month of November we were able to enroll our first patient in the study, which has a target enrollment of 100 patients over a 2 year period.
The support from the lab consultants from Erasmus Medical Center Rotterdam has been instrumental in preparing the clinical research laboratory for this trial.
HIV/AIDS Study:
The pediatric HIV study continued to enroll HIV infected children from the HIV clinic into the cohort (currently 250 enrollments). Study samples for Viral Load determinations were sent to UTH and analyses of baseline characteristics are being done.
Hospital Data Collection and Analysis:
Pediatric malaria admissions prospective data capture continued smoothly during the month, again still indicative of much lower case numbers than previously typical of Macha.
Rural Health Centre Malaria Surveillance:
The GIS manager, Aniset Kamanga, continued to implement the health centre-based surveillance study. However, Mr. Kamanga and his wife unfortunately lost their baby during this month. Naturally the flow of data was briefly affected, but senior fieldworker Petros Moono was assigned to be assistant for Mr. Kamanga on this project.