DR Congo

Abstract

Malaria remains a major public health threat despite considerable progress on control in the past decade. We, and others, demonstrated that the burden of malaria in school aged children is substantial with significant consequences later on in life. Recent decreases in the malaria burden puts school-aged children increasingly more at risk for malaria. The mainstay for malaria control includes use of insecticide-treated nets (ITNs), indoor residual spraying (IRS), prompt diagnosis and treatment with an effective antimalarial drug . Malaria control interventions often target vulnerable populations, pregnant women and children under-fives or targets the population at large. Yet, these interventions have a weak coverage in school aged children and no malaria control interventions specifically target in school-aged children. In 2012, we started field work on this theme in DR Congo, a high malaria endemic setting, and proved that Intermittent preventive treatment in school children (IPTsc) is an efficacious and feasible intervention. These findings are confirmed by others and at present, we're conducting similar research in different sociocultural and epidemiological settings in Ethiopia and North East Tanzania. This PhD proposal will provide required additional information to translate evidence gathered in previous research into policy. We will identify models of within-host dynamics of Plasmodium falciparum that have been fitted to parasite density profiles from malaria therapy patients, and simulations of P. falciparum epidemiology fitted to field malariologic datasets from a large ensemble of settings across Africa. We will use this models to assess the relative and absolute contribution of schoolchildren (6-12 yrs) on malaria transmission in different malaria endemic settings taking into account the (effectiveness of) other interventions. We hypothese that school aged children, who represent 26.8% of the population though over 40% of both the malaria reservoir and burden, are a main driver of malaria transmission. Further, will the selected integrated mathematical models be used for predicting the epidemiologic and economic effects of IPTsc both at the individual and population level. The models will provide a unique platform for predicting both the short- and long-term effects of IPTsc on the burden of disease, allowing for the temporal dynamics of effects on immunity and transmission. We'll perform a sensitivity analyses taking into account adherence, school attendance rates, drug resistance rated and thus assess the impact of IPTsc on the malaria burden and transmission at population (i.c. impact on population level R0-rates). It should be mentioned that in the last decades school attendance rates have raised to over 95% in most LMICs (though drop-out rates are still substantial). Finally, the chosen model will obtain robust cost-effectiveness estimates for IPTsc delivery strategies in different eco-epidemiologic settings. We will be able to rank IPTsc amongst other health interventions and stipulate its contributing role to attain several Sustainable Development Goals' (SDGs). In parallel, this PhD-program will be involved in 4 case studies in 4 different settings (Ethiopia, Tanzania, DR Congo and Burkina Faso) in which we will assess the possible institutional implementation modalities. This health (and educational) system analysis is a key element. Many evidence based policy recommendations have suboptimal coverage or are, in practice not implemented as it is not clear which department or control program should take up this additional intervention, determine the possible supply channels, reporting, training programs and resources needed. We will also at least explore how an IPTsc could be the nucleus, together with existing helminth control programs, for a comprehensive (institutionalized) school health program (i.e. including immunization activities, oral health, vision screening, health education, etc…).

Researcher(s)

• Promotor: Van geertruyden Jean-Pierre
• PhD student: Manda Geoffrey

Period

01/10/2021 - 30/09/2025

Summary

The EBOVAC3 project aims to assess, through clinical trials in children and adults in Africa, the safety and effectiveness of an Ebola vaccine regimen. As such it will help to improve the world’s preparedness to deal with an Ebola outbreak. The project focuses on the ‘prime-boost’ Ebola vaccine regimen (Ad26.ZEBOV and MVA-BN-Filo) prime-boost’ Ebola vaccine regimen, in which patients are first given a dose to prime the immune system, and then a boost dose which is intended to enhance the immune response over time. Building on work carried out under the EBOVAC1 and 2 projects, EBOVAC3 will run clinical trials in children in Sierra Leone, Guinea and the Democratic Republic of Congo. It will also follow up people who participated in earlier clinical trials in Sierra Leone, to assess the safety and efficacy of the vaccine in the longer term. Finally, the project aims to characterize the outbreak preparedness of Sierra Leone, Guinea and the Democratic Republic of Congo.

Funding

The EBOVAC3 project has received funding from the IMI2 Joint Undertaking. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme, European Federation of Pharmaceutical Industries and Associations (EFPIA) and the Coalition for Epidemic Preparedness Innovations (CEPI). For this trial, the Contract Research Organisation and part of the FANG ELISA analyses are funded by the CEPI. All other trial activities are funded by the IMI2 Joint Undertaking grant. All vaccines and neutralizing antibody level analyses against Ad26 at the first visit are provided by Janssen Vaccines & Prevention B.V. .​

Partner(s)

• University of Kinshasa, Janssen Vaccines & Prevention B.V., ACE Research and DFNet Research
• External partners: The London School of Hygiene and Tropical Medicine (LSHTM), the Institut National de la Santé et de la Recherche Médicale (INSERM), and the College of Medicine and Allied Health Sciences (COMAHS)

Period

01/06/2018 - 30/09/2024

more information on EBOVAC3 website and IMI project portal

Abstract:

Nodding syndrome (NS) is a neurological, incurable syndrome, currently affecting mainly children between 5 and 15 years of age in South Sudan, Uganda and Tanzania. Since 1950, when NS was first described, its cause has remained a mystery. NS is characterized by head-nodding (an atonic form of epilepsy), often followed by clonic - tonic seizures, developmental retardation and faltering growth. In the affected regions, NS is a major public health problem associated with severe socio-economic consequences. After exploratory missions to South Sudan, Uganda and the Democratic Republic of the Congo (DRC), we gathered epidemiological evidence that supports the hypothesis that NS is a disease caused by a pathogen transmitted by blackflies, the vectors that transmit the parasitic worm that causes onchocerciasis. We hypothesise that the same disease is also endemic in other onchocerciasis hyper-endemic regions e.g. in the Mbam valley, Cameroon and the Orientale Province, DRC (where it is referred to as “river epilepsy”). In this project we aim to investigate our hypotheses in South Sudan, Uganda, Tanzania, Cameroon and the DRC with a trans-disciplinary approach including clinical-epidemiological, post-mortem, eco-entomological, and metagenomic studies. We will study the effect of vector control methods and ivermectin distribution on the incidence of river epilepsy. So far a multi-country study on NS was never done and nearly all previous studies were cross-sectional, carried out during short country visits. With this long term research plan we hope to finally discover the cause of NS and detect effective control strategies to decrease the incidence of epilepsy in onchocerciasis endemic areas.

Funding

EU, Horizon 2020

Budget

€ 241.7000

Investigator:

Prof. Robert Colebunders

Partners:

Universitaetsklinikum Bonn, Germany

San Diego State University Foundation, United States

Period

1/10/2015 - 30/09/2020

Website

Abstract

La RD Congo et l' l'Université de Lubumbashi (UNILU) souffrent d'une grave carence du personnel compétent en recherche scientifique clinique de qualité internationale et en relève académique; surtout en pathologies infectieuses. Ce projet initial vise à créer une unité de recherche clinique à la Faculté de médecine de l'UNILU. Pour s'y faire, ce projet permettra la formation du personnel académique dans la conduite des recherches cliniques mais aussi en épidémiologie et statistiques. La formation du personnel scientifique se concrétisera par la réalisation de 7 projets de recherches sélectionnés de manière compétitive avec un sup-port adéquat de laboratoire. Les récipiendaires bénéficieront des cours ad hoc et d'un encadrement des professeurs de l'UA, de l'UNIKIN et de l'UNILU afin de pouvoir continuer avec leur projet de recherche jusqu'au niveau doctoral.

Funding(s)

VLIR-UOS

Researcher(s)

Principal investigator: Jean-Pierre Van geertruyden

Partner:

Abdon Mukalay, Université de Lubumbashi

Period

13/03/16 - 31/12/2017

Abstract

L’épilepsie des rivières observé dans des régions hyperendémique pour l’onchocercose  est un syndrome neurologique inexpliqué. Notre hypothèse est que cette forme d’épilepsie, qui inclus le syndrome de hochement de tête (Nodding Syndrome), est causé par un pathogène encore inconnu transmis par les Simulii (l’insecte qui également transmet la cécité des rivières). Avec  notre projet nous voulons tester cette hypothèse et évaluer dans la Province Orientale de la RDC, des interventions qui puissent réduire l’incidence de cette épilepsie.

Funding

VLIR-UOS (South Initiative)

Researcher(s)

Principal investigator: Colebunders Robert
Investigator: Jean-Pierre Van geertruyden

Partner:

Prof. B. AgassaUniversité de Kisangani, RD Congo