EACCR2 Held its 1st Steering committee meeting in March 2019. At this meeting a review of the Terms of Reference (TORs) and gave guidance concerning the university of Khartoum- IEND in Sudan, composition of the steering committee was discussed. The minutes and revised TORs are available.EACCR2 held the Annual scientific meeting on the 7 and 8th March 2019 at UVRI-In Entebbe and the Report is available. At this meeting Node committee meeting were also held.
Two Project Implementation Committee meetings have been held in this period of project implementation, quarterly node meetings and monthly secretariat meetings have been held minutes are available. A meeting for 8 EACCR2 finance managers and budget holders was completed on 31st May 2019 to try explore and train them on the EDCTP finance guidelines.
The structure of EACCR2 was restructured into a smaller and efficient network to constitute 5 nodes (HIV, Malaria, TB, NID and Training) and 17 collaborating institutions in a face to face meeting on the 1st and 2nd July 2016. The newly structured EACCR2 was launched on the 24th January 2017. At this meeting the consortium was activated and detailed workplans and budgets discussed. The Node on Neglected Infectious Diseases (NID) was constituted and its membership and management was agreed upon.
Project Implementation Committee (PIC) meetings were conducted every quarter to assess the progress of project activities in months 2, 6 , and 10 of year 1 of the project implementation plan. In addition, the Nodes (HIV, NID, TB, Malaria, Training) held quarterly meetings to discuss node activities (see attached minutes), and the secretariat held monthly meetings.
The HIV node in collaboration with KCRI-Tanzania are involved in the REMIND_ADR study to be conducted in Nsambya hospital in Uganda and Majengo health centre in Tanzania. This is a pilot M-health study to assess the feasibility and acceptability of using mobile SMS reminders to improve reporting of adverse drug events among HIV infected adults receiving antiretroviral treatment in Uganda and Tanzania. Site initiation activities including protocol training have been done for both sites. Consent forms have been translated to Luganda and Swahili, and the protocol has been reviewed by both IRBs at Nsambya hospital and KCRI and received minor comments. The study team has worked on these comments and resubmitted the protocol for final approval.
The NID node continues to collect and synthesize data on 5 diseases:-Dengue, Schistosomiasis, Leishmaniasis, Cycticercosis and Hydatosis. These data are being used to update existing disease databases in 6 six countries. Data on burden of leishmaniasis in Ethiopia for the period 2015-2018 has been acquired retrospectively by health facility-based reporting system.
This activity is done by 6 MSc students, one from each the 6 Eastern Africa countries. GIS mapping for such diseases is also ongoing. This will provide some background information for the planned epidemiological, entomological and clinical trial studies that we aim to conduct within the region. Three MSc students have been recruited and are conducting studies on leishmaniasias. One student on pharmacovigilance and supply chain health commodities pertained to leishmaniasis; a second student focuses on laboratory based screening of natural products for anti-leishmania activity. Another student has been recruited to conduct a study drug sensitivity of Leishmania parasites to currently available anti-leishmanial drugs so as to monitor drug resistance. We hope to complete this activity in Q1 2020
Two studies are ongoing in IDI in Uganda
- Evaluating the Diagnostic Accuracy of a Centrifugation-Free Stool Processing Method on Xpert MTB/RIF Ultra for the Diagnosis of Pulmonary Tuberculosis in Children
- Influence of SP011 polymorphisms in human macrophage on pulmonary Tuberculosis disease among HIV/TB co-infected Ugandan patients
One study is ongoing in KCRI in Tanzania
- Diabetes mellitus effects on anti-tuberculosis drugs exposure research from Kilimanjaro region
The EACCR 2 through HIV Node together with Karonliska Institute (KI) are supporting 4 PhD Students attached to the PMTCT Weltel trial funded by EACCR2-EDCTP2. The student research work explores the effect of an interactive weekly mobile phone messaging on retention in prevention of mother to child transmission (PMTCT) of HIV program: study protocol for a randomized controlled trial (WELTEL PMTCT). One of the students presented the progress report of her study during the annual scientific project implementation and steering committee meeting in Entebbe Uganda on 7th and 8th March 2019. The Student received feedback on their work and networking with other masters and PhD student which enriched her PhD work. The trial protocol has since been published in the BMC Medical Informatics and Decision Making journal. The first paper from the trial based on baseline data collected at trial enrolment was submitted to a scientific journal (BMC public health) in June 2019, peer-review is on-going. Data was collected by students was completed in June 2019. Database developed and in use. Data entry into database and quality checks is on-going. The student plans to begin data analysis in August 2019.
The TB node together with the infectious Disease Institute (IDI) in Uganda is conducting 2 studies on:
1. Evaluating the Diagnostic Accuracy of a Centrifugation-Free Stool Processing Method on Xpert MTB/RIF Ultra for the Diagnosis of Pulmonary Tuberculosis in Children
2. Influence of SP011 polymorphisms in human macrophage on pulmonary Tuberculosis disease among HIV/TB co-infected Ugandan patients.
These studies are on-going and hope to publish 2 papers on the results of the study. Another study on diabetes mellitus effects on anti-tuberculosis drugs exposure research from Kilimanjaro region is ongoing in KCRI in Tanzania.
A protocol for another study to explore the effect of UNAIDS and WHO policies on clinical outcomes among HIV-infected patients co-infected with TB or Cryptococcal infection in Tanzania is under ethical review: This is a cross-sectional with a ten-year nested retrospective cohort study and will take place in Tanzania
The HIV node has written a proposal ‘Active Reporting of Adverse drug reactions of antiretroviral drugs among adults living with HIV in East Africa: a pilot study on using SMS’ the Remind-ADR study, which is going to be conducted in two sites (KCRI in Tanzania and Nsambya hospital in Uganda). The proposal is in the final stages and it is hoped that it will be submitted to the ethics committees for review in the first quarter of 2019.
The EACCR2 TB node with other partners institutions from the 6 EACCR2 countries won a grant from the EDCTP for the EXIT TB project. The project aims to conduct trials needed for early diagnosis and better management and treatment of TB in the region.
The NID node started collecting and synthesizing data on 5 diseases :-Dengue, Schistosomiasis, Leishmaniasis, Cycticercosis and Hydatosis in June 2018. This activity is done by 6 MSc students, one from each the 6 Eastern Africa countries. GIS mapping will follow the completion of the data collection.
Under the malaria node, malaria hospital data was collected using predesigned data collection forms for one facility in Kenya. Other EACCR2 sites are due to collect and send these data. We hope to complete this activity in Q1 2020. This will give us some background information for the planned epidemiological, entomological and clinical trial studies that we aim to conduct within the region. An MSc proposal to look at molecular markers of resistance to anti -malarial drugs in Sudan is under review.
The reciprocal monitoring scheme (RMS) identified 8 studies to be monitored in the EACCR2 region. These studies are not funded by EDCTP, but are being conducted in EACCR2 sites. Each study was assigned one monitor, and memoranda of understanding were signed by principal investigators of 2 studies. Monitoring has been scheduled for the period September to December 2018. (see attachment for studies that have requested for monitoring.
The TB node together with University of London conducted a review of Tuberculosis: Progress and
advances in development of new drugs, treatment regimens and host-directed therapies published in March 2018 in the Lancet. The node is also conducting a study to characterize MTB from retreatment TB patients to quantify cases harboring MDR MTB.
As noted in the third objective of boosting training and mentorship program to train and retain African scientists, total of 93 people have been trained in 8 different short courses across the network. Additionally, 3 post docs, 15 students (1 PhD and 14 MScs) are being supported by the consortium for long term training.
13 new clinical trial monitors were trained and have been paired with experienced monitors to be mentored in clinical trial monitoring.
The EACCR2 in collaboration with the Centre Hospitalier Universitaire Vaudois (CHUV) at the University of Lausanne and Swiss Vaccine Research Institute in vaccinology called for applications for scientists to train in an online MSc Vaccinology course. 7 candiates out of 15 applicants were identified and forward to the university of Laussane for further assessment.
10 monitors from the reciprocal monitoring scheme (from EACCR1) received a refresher training that was conducted by Kenya Aids Vaccine Initiative (KAVI) at University of Nairobi in May 2018. The distribution of the trained monitors was as follows; Kenya 3, Rwanda 1, Sudan 1, Tanzania 2 and Uganda 3.
The EACCR2 Malaria node conducted a refresher laboratory training on molecular techniques for malaria diagnosis (RT-PCR, Microscopy) 4-5th June 2018 for 19 students from the 6 countries in region in Kisumu.
The malaria node is also supporting research studies for three 3 Msc students. The student proposals were reviewed by the node committee to prepare them for ethical approvals. Data collection will start after ethical approvals have been obtained.
The EACCR2 TB node recruited one- (Dr Mbazi Senkoro) of the planned 2 postdoctoral fellows attached to clinico-epidemiological studies developed under disease specific themes.
Dr. Kikaire joined participants from the EDCTP funded NOEs in a one week course on ISO-15189 with emphasis on laboratory quality management and laboratory auditing in Johannesburg South Africa in June 2018.
The training node conducted a research management skills and good financial practice for 31 finance and grant managers in April 2018, at KCRI Tanzania. Of the participants 17 were Tanzanians, 2 Rwandese, 5 Ugandan, 5 Kenyan, 1 Sudanese and 1 Ethiopian.
The HIV Node conducted a basic epidemiology and biostatistics course for 24 participants from the 6 consortium countries in August 2018.
A training in molecular diagnosis was conducted by the NID node in collaboration with the training node in Moshi. 19 participants from the 6 countries were trained.
As noted in objective one, a number of infrastructure upgrades have been supported by the network.
The HIV node site at the Masaka regional Referral Hospital received a computer and printer for their Research Ethics Office (REC). The UVRI clinic set-up a patient waiting area and shelves to hold patient files. Procurement processes are ongoing for the improvement of the Masaka hospital REC office and construction of shelves to increase storage space for the laboratory at Nsambya hospital. University of Rwanda received funds from the HIV node to buy a hematology analyzer for their research clinic.
Infrastructure upgrades for Mananyamala hospital, Majengo and Kibongoto health centres in Tanzania, and Tabitha clinic in Kenya are ongoing under the HIV node.
Two laboratories KEMRI laboratory in Kenya and Central Tuberculosis Reference Laboratory in Tanzania have received accreditation. KCRI laboratory in Tanzania accreditation process is ongoing.
The Malaria node purchased laboratory consumables for Siaya district hospital. The sites are equipped in preparation for to conduct research.
The 5 NID node partner countries received the funds for their infrastructure upgrades and these are ongoing.
The HIV node conducted 9 out of the 17 infrastructure assessements to implement prioritized infrastructural upgrades in sites (3 Nsambya hospital ,UVRI clinic and Masaka hospital in Uganda, 2 in KCRI (Majengo and Pasua), 2 in Kisumu, (Jaramogi hospital and Tabitha clinic in Nairobi) and 2 in Dar-es-salaam (Mwananyamala and Kyela hosptials) .Equipping the sites will follow in Year 2 quarter 2
The malaria node conducted site asessement at Bondo site in Tanzania and bought computers. More quotations were received from BNNICD, the node is awaiting quotations for laboratory consumables from Jimma University, Gondar University ,Siaya County hospital and Taveta.
The TB Node conducted site assessment of their sister sites and upgrades will be done in Q2 year 2.In year one, the TB clinic at Mwananyamala regional referral hospital was revonated with cofunding from the EACCR and the regional medical officer’s office. Also at KCRI, the TB node renovated 17 laboratory doors replacing the wooden doors with aluminium ones as part of the preparation for accreditation.
In preparation for site upgrade/accreditation, KCRI is going on with a one-year mentorship on the accreditation processes to be completed in May to ready for assessment and accreditation.
The EACCR2 revised and updated the brochure and produced 500 copies in preparation for the annual meeting in March 2019. These have been shared with the other nodes and partner institutions. The network also produced more communication and advocacy materials that were shared during the EDCTP forum in Lisbon in September 2018. These included Pens, brochures and information leaflets.
EACCR2 has an active website and social media (Twitter and Facebook) platforms @eaccr which are updated regularly..
The network is also working with The global health trials network (TGNH) at oxford university to finalise the updating of the EACCR2 miniwebsite that is hosted at the TGHN knowledge hub (tghn.org). The domain of the EACCR2 miniwebsite is www.eaccr.tghn.org
We have also developed a google drive based shared portal space. In this portal, network documents are shared with the members of the network and can be edited jointly through this space.
The network communication plan has been updated to reflect the current communication strategies of the network
The EACCR2 revised and updated the existing communication plan and brochure by month 8 of the project implementation in 2017. The communication plan and revised brochure (500 copies) were circulated to nodes and sites, the documents are available on the EACCR2 website for information of stakeholders.
EACCR2 hosted a launch and kick-off meeting to evaluate progress and to give Node committees a clear understanding of the activities of the network. The stakeholdes agreed to have the annual scientific and networking EACCR2 consortium meetings involving its African & northern partners in year 2 quarter 2. This will also give be a platform in which the students supported by the EDCTP to present their work and progress reports.
An up-to date interactive website (www.eaccr.org) and social media platforms (twitter and facebook) @eaccr are used to communicate information and network activities to the wider community and general public.