October 2008 Report
Summary:
As typical of this month, October marked the veritable peak of dry heat and dusty whirlwinds as the rainy season was drawing closer.
Preparations were under way for commencement of numerous project field data collections, while some were already on-going. Concurrently, laboratory assays continued apace. Following training of Laboratory technologist Jay Sikalima in Professor Kumar's lab at Hopkins, RT-PCR assays were established for the first time at MIAM labs, for detection P. falciparum gametocytaemia on field dry blood spot samples. The first mouse colony, to boost blood-feeds for mosquito rearing in the insectary, was also established by resident entomologist Mulenga Musapa, and dozens of new mouse offspring were produced in the same month. Groundwork for the pediatric anti-retroviral therapy (PART) study was in progress.
Laboratory meetings during the month were focusing on brainstorming, critiques and rehearsals for scientific presentations of a number of abstracts accepted for the forthcoming ASTMH conference due for December in New Orleans.
A new MIAM 4WD vehicle (Landcruiser Prado) arrived from Dar Es Salaam to replace the accidented Ford Everest, which was traded in by the MIAM vehicle insurance company, as it was considered a write-off.
Dr. van Dijk arrived back from attending the World Union Health Conference held in Paris, from October 16-20. Dr. and Mrs. Thuma departed for the USA on October 16.
I - General Site Development and Maintenance
Final touches to the MIAM campus gravel roads were made, with some compacting, to reinforce them before onset of the rains. Happily, the notoriously pot-holed Choma-Namwala gravel road, which connects MIAM to the nearest town, was also being worked on by the government. Plans were under way to improve the badly deteriorated dirt-road connecting MIAM to the Choma-Namwala route.
Fortunately, there was relatively minimal electrical grid "load shedding" in October. This coincided with the build-up to by-elections scheduled for October 31, which was also a free day to allow people to exercise their voting rights. However, it remained to be seen if the power outages would increase back in frequency the following month (November).
II - Information Technology
With few instances of unstable connectivity, the IT system was functioning very well during the month.
III - Vehicles/Transport
All MIAM vehicles were running well as the maintenance team continued their diligent work to keep them in good condition. Following removal of the accidented Ford Everest by the insurance company, the replacement Toyota Landcruiser Prado (photo below) was finally brought to Macha from Dar Es Salaam by the Transport Manager, Mr. Douglas Haadinke (caught in picture just riding past on Honda) and his assistant, Mr. Stembridge Mweetwa. The replacement vehicle appeared to be in excellent condition.
IV - Research Activities
Entomology:
The five distinct genetic lines of the Anopheline vector mosquito colony remained healthy, the oldest reaching the 10th filial generation. In preparation to work on boosting blood-feeding and hence larger mosquito numbers for forthcoming research by various Hopkins faculty, the colony will be adapted to feed on mice, as is routinely done in South African labs rearing the same sibling species. During the month of October, the first mouse colony was commenced at MIAM labs, seeded from the University of Zambia School of Veterinary Medicine stock. Three cages, each with one male and five females started out and by the end of the month, dozens of new mouse offspring were produced. Preparations were made to move the mouse colony from its current location in the lab to a new dedicated animal house, adapted from a room loaned by the hospital.
Epidemiology:
Field data collection for the on-going Epi study, focusing on malaria transmission dynamics, was in progress. After a training attachment, under supervision of Godfree Mlambo in Professor Kumar's lab at Hopkins, Laboratory technologist Jay Sikalima was working with the newly recruited Lab Scientist, Jodi Chondoka, to set up RT-PCR assays for P. falciparum gametocyte detection. Using a gametocyte-positive (by microscopy) filter paper dry blood spot sample, shared from the drug resistance study by Mharakurwa et al, and appropriate negative controls, Jay and Jodi managed to run the first RT-PCR assay at MIAM, thus establishing the technique in Macha labs. Positive controls from laboratory lines were expected to arrive in early November.
Genotyping, Drug Resistance and Diagnostics:
Following extensive field and laboratory data collection, data analysis for studies on the population structure of P. falciparum using MSP1 and MSP2 polymorphic markers was under way, in collaboration with University of Michigan.
Plans were under way to run further assays on changes in P. falciparum drug resistance genotypes over time and between human and mosquito hosts.
Data analysis was also being finalized for field studies on immunochromatographic detection of P. falciparum infection using human saliva samples. This work, which compared saliva-based detection to regular blood-based assays, using microscopy and PCR reference standards, suggests the non-invasive saliva samples may afford similar or better sensitivity than blood samples.
Concurrently, laboratory meetings were being held focusing on brainstorming and critique sessions on scientific presentations for a number of abstracts accepted for the forthcoming American Society of Tropical Medicine and Hygiene conference, scheduled for December in New Orleans. An UNZA MSc student, Enesia Chaponda, whose research was supervised at MIAM, was due to arrive in early November for further refinement and rehearsal of presentations for her accepted abstracts. These sessions, jointly attended by molecular and clinical research lab staff, were increasingly stimulating, with active feedback for the presenters.
Pharmacokinetic Study of SP:
Data analysis and preparation, for presentation of results for an abstract accepted for the American Society of Tropical Medicine and Hygiene meeting, were under way for this study that was completed.
Tuberculosis Study:
Ongoing preparations continued for the upcoming Rifaquin trial during the month. The Site Initiation Visit (SIV) for Macha for this multi-centre drug trial is scheduled from Nov 10-13th. Mr. Francis Hamangaba (CO), our new trial coordinator has taken up his job very well, and assists in SIV preparations. Ms. Heather Clouting, the trial manager and monitor of MRC Clinical Trial Unit UK, will come out to Macha to do the training. 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 continues to enroll HIV infected children from the HIV clinic into the cohort (currently 230 enrolled). Katie Sutcliffe (ScM. JHBSPH Department of Epidemiology) visited Macha to assist with data check and cleaning. Study samples for Viral Load determinations will be sent to UTH and analyses of baseline characteristics are being done.
Hospital Data Collection and Analysis:
On-going prospective collection and entry of data on malaria pediatric admissions to the hospital continued during the month.
Rural Health Centre Malaria Surveillance:
The health centre-based surveillance study, run by GIS manager, Aniset Kamanga, continued to implement smoothly, with weekly cell phone sms text-based reception of malaria case data from the clinic staff. After initial detection at Mapanza rural health centre, it was evident that a few more clinics were also starting to find malaria RDT-positive cases as transmission started to build up. The clinics finding positives included, Mapanza itself, Habulile and Chilala.
I - Personnel
One new employee joined MIAM during the month of October. Miss Mwiche Siame, an UNZA graduate with laboratory experience, joined as a Lab scientist to replace appointment left vacant after Mtawa Mkulama departed to take up another position at a government agricultural research station.
VI - Other
Dr. Janneke van Dijk attended the 39th Union World Conference on Lung Health, held in Paris from October 16-20. A poster was presented on data originating from a student research project at Macha on TB (title: "The feasibility of implementing a modern tuberculosis laboratory in rural Zambia"; abstract no: PS 82149-20)
Dr. and Mrs. Thuma departed for the USA on October 16 and are due to return in the new year.