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MEDICAL RESEARCH COUNCIL UNIT, THE GAMBIA
TAMA: Wolof. n. a talking drum
VOL 13
ISSUE
03
2014/15
www.mrc.gm/tama
PAGE 03
Success story for Meningitis Vaccine Project
Introduction of the meningococcal A conjugate vaccine 10 short years after development is a public health
success story and is already showing promise of significant impact. Following the end of the Meningitis Vaccine
Project in December 2014, we celebrate MRC Unit, The Gambia’s role in the project, working in partnership with
the Gambian Government and the people of The Gambia.
MVVC2: A truly
South-South
collaboration
PAGE 05
In a truly South-South collaboration,
scientists from MRC Unit, The Gambia
and the University of Dakar, UCAD
Senegal, are conducting a joint trial to
determine the safety and interference
of the malaria vectored vaccines
when given together with EPI vaccines
to young Gambian infants, funded
through the Malaria Vectored Vaccine
Consortium 2 (MVVC2).
CONTENTS
03
11
14
17
18
20
21
24
28
29
30
NEWS
VACCINOLOGY
DISEASE CONTROL & ELIMINATION
CHILD SURVIVAL
NUTRITION
NEWS FROM KENEBA
NEWS FROM BASSE
RECENT UNIT PUBLICATIONS
RECENT UNIT SEMINARS
NEWS FROM QUALITY
STAFF SPOTLIGHT
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
NEWS
Dr Olubukola Idoko, Study Clinician on the initial
trials and Trial Coordinator/Local PI for the
persistence project, and some members of her team
Success story for Meningitis Vaccine Project
CONTINUED FROM PAGE 01
Studies performed at MRC Unit, The Gambia, and other African sites, including CVD-Mali, Navrongo
Health Research Center in Ghana and Institut de Recherche pour le Développement in Senegal, have
resulted in the successful development of a vaccine to the highest scientific, professional, and ethical
standards for the public health of people across Africa.
“This affordable vaccine has been developed and tested in record time to combat meningitis A, one of
the most threatening infectious diseases, which periodically affects people living within the “meningitis
belt”, said Professor Beate Kampmann, Principal Investigator of the trial at MRC Unit, The Gambia.
“When meningitis A comes along, it has a devastating impact on people of all ages and causes death and
disability. It shows that big goals can be achieved when funders, developers and sites pull together.
“We are proud to have played an important role in the study. We are also delighted that this vaccine now
protects people in The Gambia, as it was introduced here swiftly by the Government of The Gambia into
its vaccination program.”
INTRODUCTION OF THE VACCINE
Thanks to the Meningitis Vaccine Project, more than 200 million people have now been vaccinated
with the meningococcal A conjugate vaccine, MenAfriVac, and are protected against meningitis A. The
mass vaccination campaign was launched first in Burkina, and soon after in Mali and Niger, in 2010. The
vaccine was introduced in The Gambia a year ago resulting in almost complete national coverage in a
mass vaccination campaign.
Some initial trials for the vaccine and an antibody persistence trial were held at MRC Unit, The Gambia’s
Basse Field Station. This included two safety and immunogenicity trials in one to 29 year old Gambians
and later a study which investigated antibody persistence up to five years after initial vaccination with
MenAfriVac; this is important in order to know how often the vaccine has to be given.
This affordable
vaccine has been
developed and tested
in record time to
combat meningitis
A, one of the most
threatening infectious
diseases, which
periodically affects
people living within
the “meningitis belt"
Professor Beate
Kampmann
Principal Investigator of
the trial at MRC Unit, The
Gambia.
03
04
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
NEWS
EFFECTIVE AND AFFORDABLE
This vaccine has proven to be both effective and affordable and has the added advantage of being
able to travel outside the cold chain. MenAfriVac induces better immune responses than the previously
available vaccines and achieves antibody persistence at five years post-vaccination. The vaccine offers
herd protection and, although still in the early days, the impact of vaccination has already been observed
within the African meningitis belt.
Dr Olubukola Idoko, Study Clinician on the initial trials and Trial Coordinator/Local PI for the persistence
project at MRC Unit, The Gambia, said: “It was a real joy to be able to see the vaccine introduced into the
region and here in The Gambia in particular. The introduction in The Gambia was accelerated by the fact
that the country participated in the original trials. This is further testimony to the unique role of the Unit.
“The region has suffered these devastating epidemics of meningitis periodically and in the short time
that the vaccine has been introduced there's already significant impact. Another notable highlight for
me was seeing the significant indirect impact our studies can have. Entire communities were educated
on the use of locally available items to prepare healthy weaning meals, in response to a clustering of
malnutrition among study participants. Following this, malnutrition rates in our study population dropped
significantly.”
NEXT STEPS
The definition of success for the Meningitis Vaccine Project is the elimination of epidemic meningitis in
sub-Saharan countries that introduce the meningococcal A conjugate vaccine. MRC Unit, The Gambia is
supporting the evaluation plan by assessing the impact of the introduction of MenAfriVac in The Gambia.
Monitoring is being carried out, in collaboration with the London School of Hygiene and Tropical
Medicine, through a series of carriage studies to evaluate the impact of the vaccine on the transmission
of meningococcal infection. MenAfriCar (the African Meningococcal Carriage Consortium) is a global
research effort to study how meningococcal meningitis is spread in Africa, and to document the impact
of a new meningitis vaccine on meningococcal carriage and meningitis.
Some of the Meningitis Vaccine Project team ready for action during the study
About the
Meningitis
Vaccine Project
The Meningitis Vaccine
Project was born from a
partnership between WHO
and Program for Appropriate
Technology in Health (PATH)
with funding from the Bill and
Melinda Gates Foundation in
2001. The goal of the project
was the elimination of
epidemic meningitis in subSaharan Africa where it was
posing a great public health
crisis. This was to be done
through development, testing
and licensure of a conjugate
meningococcal vaccine.
Find out more at
www.meningvax.org
Read about the Meningitis
Vaccine Project community
feedback event on page 11
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
05
NEWS
MVVC2: A truly South-South collaboration
Dr Muhammed Afolabi and Dr Ebrima K Kanteh
CONTINUED FROM PAGE 01
Malaria remains a leading cause of childhood illness and death,
predominantly in Africa, despite the implementation of extensive control
measures. An effective vaccine is a key complementary strategy to
achieve the Roll Back Malaria initiative and Millennium Development
Goals.
Leading researchers from The Jenner Institute, University of Oxford have
therefore been working to develop an effective malaria vaccine using a
unique heterologous approach involving delivery of a potent liver and
sporozoite stage antigen, called ME-TRAP, through the use of two special
agents that are given sequentially, eight weeks apart.
Under the auspices of the Malaria Vectored Vaccine Consortium, a
number of vaccine trials funded by European and Developing Countries
Clinical Trials Partnership (EDCTP) and coordinated by European Vaccine
Initiative Germany took place in the four partner sites including MRC Unit,
The Gambia, UCAD Senegal, CNRFP Burkina Faso and KEMRI Kilifi. The
Unit successfully conducted the early phase of the vaccine trials in adults,
children and infants while the efficacy trials took place in UCAD, KEMRI
and CNFRP.
Consolidating on the success recorded in the first round of the trials at all
partner sites, the Consortium applied for and won a competitive Strategic
Primer Grant under the operational name Malaria Vectored Vaccine
Consortium 2 (MVVC2).
The grant seeks to conduct a phase 1 trial to establish whether the
candidate malaria vaccines would cause interference when coadministered with routine Expanded Programme on Immunisation (EPI)
vaccines in healthy Gambian infants aged 16 weeks, eight weeks and one
week. The unique aspect of the trial is that scientists from MRC Unit, The
Gambia and UCAD Senegal unanimously agreed to jointly conduct this
important trial. This distinctive collaboration represents a paradigm shift
from the usual North-South collaboration and fulfils the cardinal goal of
the funder, EDCTP.
Like every other human endeavour, the trial is not without challenges,
nevertheless the MRC and UCAD scientists are well motivated to
overcome the challenges and achieve the objectives of the vaccine trial.
At the time of writing this report, the team had successfully completed
the enrolment of the 16 and eight-week-old infants and were preparing
to start the last lap of the study involving one week old babies.
For the Senegalese collaborators who have relocated to live and work
at the MRC Unit in The Gambia it has been an exciting and resourceful
experience working in a multi-cultural world-class research institute in
Africa. They are eager to consolidate their experience in the conduct of
cutting-edge research. The MRC hosts are also making concerted efforts
to nurture the partnership between two sites to develop the capacity of
young West African scientists to lead translational research that saves
lives and improve health across the developing world.
Find out more about the MVVC in this short film produced by the
European Vaccine Initiative, featuring Sukuta Health Centre in
The Gambia: http://bit.ly/MVVCfilm
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NEWS
Inspiring the next generation
Commissioning of School
of Medicine academic
complex
Marie Rose Thorpe
From learning about field research in the communities of the
Gambia, to grilling a panel of doctors, MRC Unit, The Gambia
recently gave 32 final year medical students from the University of
The Gambia a first-hand insight into career options available for
graduates of medicine.
The visit, on 7th October, served to familiarise the students from the University of The
Gambia’s School of Medicine and Allied Health Sciences, with undertaking field research in
the communities of the Gambia. Unit Director, Professor Umberto D’Alessandro, welcomed
the students, outlining the past achievements of the Unit as well as current research
priorities and activities. His talk expanded on the collaborations between the Unit and the
Gambia Government, which led to the introduction of insecticide-treated bed nets and
other important achievements in the arena of public health.
Drs Bully Camara, Julia Mwesigwa, Gibril Ndow and Abdou Sillah and Wellcome Trust Fellow
Modou Jobe, gave first-hand accounts of their journeys from medicine into research and
outlines of the various research projects that they are currently undertaking. The session
concluded with a question and answer session where Dr Kalifa Bojang, Senior Clinical
Scientist and Consultant Paediatrician at the Edward Francis Small Teaching Hospital, also
joined the panel of doctors to answer questions from the eager students.
Dr Ousman Secka then gave the group a tour of the various MRC laboratories. Pa Amadou
Sohna, the University class representative, expressed appreciation on behalf of his fellow
classmates for having been introduced to the work of the Unit and getting first-hand
accounts from doctors that had made the transition from medicine into research.
On 22nd October, Professor Umberto
D’Alessandro attended the opening
ceremony of the new School of Medicine
and Allied Health Sciences academic
building at the Edward Francis Small
Teaching Hospital in Banjul.
Inaugurated by the Vice President and
Women’s Affairs minister, the building
represents a major milestone in the ongoing
development of The University of The
Gambia.
The new building is expected to give
improved learning space for academic and
clinical activities for the Medical and Allied
Sciences students, faculty members and
researchers.
Established in 1999, The University of The
Gambia has been a close partner of the
MRC Unit since the University’s inception.
The Unit currently employs a number of
graduates of the University.
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07
NEWS
Enhancing learning facilities
A ceremony at the Edward Francis Small Teaching Hospital (EFSTH) in Banjul on 20th January celebrated
the opening of refurbished facilities completed by MRC Unit, The Gambia, funded through The West
African Network of Excellence for Tuberculosis (TB), AIDS and Malaria (WANETAM).
As part of MRC Unit, The Gambia and the WANETAM’s
shared commitment to build capacity for West African
scientists, the MRC has renovated the former neonatal
ward of the Paediatric Unit at EFSTH into a conference
room and library. The refurbishments include computers
and an internet connection which will be funded for
one year. The renovated area will be used by medical
students in the department of paediatrics to support
and enhance their studies.
Funded by the European and Developing Countries
Clinical Trials Partnership, WANETAM’s mission is to build
capacity at West African sites for clinical trials in HIV,
TB and malaria. The WANETAM network consists of 20
institutions in 12 countries.
The subsequent WANETAM Plus grant continued to
build on the strategic objective of capacity building for
West African scientists by supporting a number of shortterm training sessions.
Dr Martin Antonio, Senior Scientist and Unit Molecular
Biologist at MRC Unit, The Gambia, leads the TB work
package for the WANETAM consortium and Unit
Director Professor Umberto D’Alessandro is a WANETAM
collaborator.
Unit Director Professor Umberto D’Alessandro and Chief Medical
Director of the EFSTH Dr Muhammed Ammar Al-Jafari at the opening
ceremony
The ceremony also included the official presentation
of equipment donated to the Paediatric Unit by MRC
Unit, The Gambia, including two oxygen concentrators,
a photocopying machine and equipment in the SMAC
lab such as haematology analysers, a colorimeter and
microscopes.
Also present at the ceremony was Dr Kalifa Bojang,
seconded to the EFSTH from the Unit in 2011 as Head
of Paediatrics, who said: “The relationship between MRC
Unit, The Gambia and the EFSTH has proved mutually
beneficial, allowing the MRC to carry out research that
addresses important public problems in The Gambia.
“The hospital benefits from the teaching and clinical
services provided by skilled physicians and highly
qualified nursing staff from the MRC. The renovation
of the former neonatal ward into a meeting room and
library will further enhance teaching and learning in the
department of paediatrics.”
A computer room in the newly refurbished facilities
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NEWS
MRC presents equipment to the Gambian Government
In a ceremony attended by senior representatives of the Gambian Government, MRC Unit, The Gambia handed
over equipment to the Ministry of Health and Social Welfare through the Global Fund Asset Transfer, on 23rd
December 2014.
The Global Fund Nationwide Gambian Survey of TB prevalence
(GAMSTEP) was done in collaboration with the Ministry of Health and
Social Welfare and the MRC, through its agency, the National Leprosy
and TB Programme. The project set out to determine the prevalence of
TB in The Gambia.
WHO estimates of TB prevalence in The Gambia were 490 per 100,000
people but the survey showed overall national prevalence of all forms of
TB to be 128 per 100,000 people, about four times lower than previously
estimated.
100,678 Gambians in 138,857 households were invited, of which 55,831
were eligible to participate in the survey. The project involved symptom
screening of all participants with prolonged cough via chest X-rays, and
sputum testing.
As part of the project documentation and agreement, equipment used
during the recruitment process was handed over to the Ministry of
Health and Social Welfare as required by the Global Fund and Country
Coordinating Mechanisms, for use within the health sector.
In the ceremony, MRC Unit, The Gambia handed over six motorcycles, a
mini truck, three laptops and two sets of X-ray machines to the Ministry
of Health and Social Welfare.
On presenting the equipment, Professor Umberto D’Alessandro said: “This
project is a fantastic example of the collaboration existing between the
Gambian Ministry of Health and MRC Unit, The Gambia. We are together
in fighting diseases of major importance in The Gambia and Africa.
“We provide the Ministry of Health with information to better control
infectious diseases. The TB prevalence project, which included about
50,000 participants aged over 15 years, found that The Gambia has
already reached the Millennium Development Goal for TB.”
In appreciation, the Honourable Omar Sey, Minister of Health and Social
Welfare, thanked the MRC for the continued partnership that exists
between the MRC and the Ministry of Health and Social Welfare. He
also expressed gratitude for MRC Unit, The Gambia’s involvement in the
development of the Strategic Plan and thanked the MRC for providing
Ebola prevention training to the National task force.
The Honourable Omar Sey, Minister of Health and Social
Welfare and Professor Umberto D’Alessandro, Unit
Director at the ceremony.
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09
NEWS
Welcoming global collaboration
On the 2nd and 3rd of September, MRC Unit, The Gambia welcomed a team of seven researchers from the
University of Cambridge to explore potential two-way collaborations in health research across a broad range
of themes. Both the MRC and the University of Cambridge expressed an interest in developing a synergy
using complementary resources. The two day visit was hosted by Professor Tumani Corrah and Dr Peter Dukes,
Director and Assistant Director respectively, of the Africa Research Development Programme and the MRC
Leadership Board.
The discussions included existing common research interests in infectious diseases and meeting the
challenges of emerging and re-emerging diseases – such as respiratory infection and diarrhoea – and
possible research collaborations in the intersection between non-communicable diseases, nutrition
and malaria. The team experienced the Unit’s stimulating research environment first-hand by touring
the MRC laboratories, Clinical Services Department and then onto the Sukuta Health Centre.
The University of Cambridge has a Cambridge-Africa Programme, which was initiated and led by
Professor David Dunne, one of the visitors, that aims “to strengthen research capacity in Africa
through the provision of training and mentorship to African researchers, and also through supporting
Cambridge-Africa research collaborations in a range of disciplines including health.” This nature of
this programme provided an invaluable opportunity to discuss capacity building, as well as a poster
session that included early career scientists Brenda Kwambana, Jorjoh Ndure and Leopold Tientcheu.
The Cambridge delegation included Professor Nabeel Affara, Head of the Division of Cellular
Molecular Pathology at University of Cambridge, the father of the MRC Unit’s own Dr Muna Affara.
Dr Pauline Essah, Coordinator of the Cambridge-Africa Programme and the Wellcome TrustCambridge Centre for Global Health Research, expressed her thanks: “I would like to say a big thank
you to everyone we met, for their hospitality and participation in the discussions. We definitely
found the meeting to be very worthwhile, and are convinced that there are potential opportunities
for collaborations and training in the near future.”
I would like to say
a big thank you to
everyone we met, for
their hospitality and
participation in the
discussions. We definitely
found the meeting to be
very worthwhile, and are
convinced that there are
potential opportunities
for collaborations and
training in the near future
Dr Pauline Essah
Coordinator of the CambridgeAfrica Programme and the
Wellcome Trust-Cambridge
Centre for Global Health Research
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MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
NEWS
Improving community health services
through mutual partnership
Dr Muhammed Afolabi
A community event held last year saw Dr Kalifa Bojang, Senior Scientist and Head of Paediatric
Department at the Edward Francis Small Teaching Hospital, along with Dr Ed Clarke, Head of Infant
Immunology, Vaccinology Theme, donate materials to help the smooth running of medical services and
diagnostics at Sukuta Health Centre.
The event was attended by the representative of the Alkalo of Sukuta, the Village Development Committee, staff of the health centre and of the
MRC Sukuta field site. It served to rekindle the spirit of mutual partnership that has long been entrenched between MRC Unit, The Gambia and
the host community of Sukuta.
“What started in a ‘portacabin’ has grown to become an internationally recognised clinical trial site which has successfully conducted phase I-IV
trials.” He also noted that these outstanding achievements would not have been possible without the understanding, support and co-operation
of the good people of Sukuta and he encouraged them to put the items to good use.
Dr Ed Clarke in his address cherished the excellent relationship existing between the MRC and the Sukuta community. He donated a microscope
to facilitate the diagnosis of common infectious diseases in the health centre.
The Acting Matron-in-charge Ms Mariama Jamba, thanked the team for the generous donations and promised to make good use of the items.
The representative of the Alkalo also echoed the goodwill messages of the Alkalo and the Village Development Committee. He called on the
staff of the MRC Unit and Sukuta to continue working together to improve the health of the people of Sukuta community, and The Gambia.
Dr Kalifa Bojang and Dr Ed Clarke donated office items and a microscope
to Sukuta Health Centre
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
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VACCINOLOGY
MVP thanks the community in Dampha Kunda
Njilan Johnson
Born in 2001, the Meningitis Vaccine Project (MVP) came to a close in December. Earlier in 2014 the MVP team
and partners joined Professor Beate Kampmann, Principal Investigator and Dr Olubukola Idoko, Clinical Trial
Coordinator, to share the results of the vaccine trial and persistence studies with the communities around Basse
who were involved in the trial, and to thank them for their support and participation.
The community feedback event was held in the market square of
Dampha Kunda and attended by village elders, men, women and children,
as well as representatives from the Ministry of Health and sections of
local Government. Many of the women and their children were part of
phase II/III and persistence trials of the MVP and got to know MRC staff
members well during the trial.
Before the event started, a group of women began singing and dancing,
getting the crowd excited as they watched and listened. This prompted
another group of women to respond with their own musical interlude.
The programme began with introductions from the master of
ceremonies, Pa Cheboh Saine, research project manager for Child
Survival at MRC Basse, and Mustapha Darboe, data/ field coordinator for
the MVP. The Imam of Dampha Kunda offered the prayers and the Alkalo
of Dampha Kunda then welcomed everyone to the event.
Professor Beate Kampmann, theme leader for Vaccinology at MRC
Unit, The Gambia, shared information about MVP with the community,
while Dr. Olubukola Idoko, Clinical Trial Coordinator, elaborated on the
role of the community in licensing MenAfriVac. Their talks covered the
devastation caused by meningococcal epidemics, the amazing success
story of getting the vaccine developed and introduced in 10 short years,
and the impact already noted within the African meningitis belt.
Abdoulie Juum of the Regional Health Team discussed the importance
of the relationship between the MRC and the Ministry of Health
and the almost complete coverage attained during the introduction
of MenAfriVac the previous year. The Chief of Tumana and the
representative of the URR Governor made a few remarks commending
the MRC teams and stressing the importance of collaboration.
The MRC Drama group put on a phenomenal performance to emphasise
the devastating effect that meningococcal A meningitis has had
on families and the roles that the WHO, the MRC and other health
organisations played to come up with this affordable vaccine that saved
lives and built healthier and happier communities.
A question and answer session gave community members an opportunity
to ask questions and voice their opinions. Key among the questions
asked were the mode of spread of meningitis and how often MenAfriVac
needed to be given. Dr Olubukola Idoko then delivered a vote of thanks
and the day ended with the singing of the national anthem.
Community members expressed appreciation for the community
feedback event, giving them an opportunity to hear about the results of
the research and ask questions. For staff who had worked on the project
it was an opportunity to show the members of the community that the
visits to the MRC Basse Field Station and subsequent home visits were
for an important purpose. The MVP has helped save lives and bring hope
to many communities.
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VACCINOLOGY
Highlights of a productive year
for the MDV team
Dr Olubukolo Idoko
Following successful kick-off of the 13-valent
Pneumococcal Conjugate Vaccine Multidose
vial trial in January 2014, our team has recorded
multiple accomplishments, including the adoption of
electronic data collection methods – a first for a trial
undertaken at the Unit – producing excellent results.
The trial aims to test the safety and immunogenicity of the 13-valent
Pneumococcal Conjugate Vaccine (PCV13) Multidose vial preparation
(MDV) which contains four doses of PCV13, compared to the single dose
format which is currently routinely used as part of the immunisation
program in The Gambia.
The single dose pneumococcal vaccine has proven efficacy in protecting
children from pneumococcal pneumonia and other pneumococcal
presentations such as meningitis and ear infections. It is provided in The
Gambia and other African countries with the support from the Global
Alliance for Vaccine Initiative (GAVI).
The major difference between the two formulations is the addition
of a preservative in the MDV preparation. The advantage of having
four doses in the same vial instead of single vials (or syringes) means
a reduction in the cold chain costs and overall delivery costs for an
otherwise expensive vaccine. Reducing these costs may have significant
implications for sustaining the supply of PCV13, particularly beyond the
period of GAVI funding.
If the immunological response induced by the MDV formulation is
not inferior to the current format for the 13 pneumococcal serotypes
included in the two vaccines in our trial in The Gambia, the licensing
process could start for the MDV formulation.
In terms of recruitment for the study, as has happened previously in
other Unit trials, the 500 required participants were recruited into the
study two weeks ahead of schedule. Vaccination visits were completed
on 25th July and the last subject attended the last study visit on 1st
September.
In a first for a trial at the Unit, electronic diaries for collecting participant
follow up information were introduced. The new data collection method
was implemented with great enthusiasm by the study team in spite of
some network challenges that were quickly resolved with the support
of our sponsor, Pfizer. The trial was intensively monitored (100%) and
audited with excellent reports at all time-points. Study close-out is
expected in January 2015 as a few out-of-study procedures continue to
be carried out by the team.
At our recent end-of-study dinner, the team had a chance to unwind
after what has been a truly busy year. The significant additional talents of
the members of the trial team made the evening a very happy gathering.
Highlights of the event included a skit put on by the field team comically
entitled ‘On your own’, which included a farewell poem written by
the poets within the group, as well as presentation of certificates and
speeches from key members of the team.
We are grateful to have received praise from Pfizer for the conduct of
the trial. We look forward to early results due in the first quarter of2015.
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
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VACCINOLOGY
Improving community care
of mothers and infants
Kirsty Le Doare, MRCPCH, Dip PID Oxon, Wellcome
Trust Clinical Research Training Fellow
The Infant Immunology Theme were delighted to host
the first joint training course for midwives and nurses
at MRC Fajara in August 2014.
The course, designed to help improve care of mothers and infants in our
community, was the second in a series of regular ‘helping babies breathe’
newborn care clinical skills courses, established by the team, for MRC
study staff and government health workers.
During the two day course, of intensive practical training in midwifery
and neonatal emergencies and resuscitation skills, Professor Beate
Kampmann, Dr Anna Battersby and Dr Kirsty Le Doare were joined by
midwifery specialists Dr Beverley Donaldson and Mrs Maggie Welch from
Imperial College London, and Dr Patrick Oboye, Obstetrician from Edward
Francis Small Teaching Hospital (EFSTH). They were supported by Dr
Kalifa Bojang, Senior Clinical Scientist and Consultant Paediatrician at the
EFSTH.
Over 30 participants from government clinics and MRC field sites joined
in the training. Midwifery skills run by midwifery trainers Dr Donaldson
and Mrs Welch included the management of shoulder dystocia and
postpartum haemorrhage. Neonatal skills run by Dr Battersby and Dr Le
Doare included bag and mask ventilation and respiratory support.
The course is accredited by the American Society for Emergency
Care and all participants passed the examination on the final day with
flying colours. The training team are looking forward to running more
successful courses in the future. The next course will be held in March
2015.
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DISEASE CONTROL & ELIMINATION
Strengthening capacity across West Africa
Marie Rose Thorpe and Malick J Bah
As part of the West African Nodes of Excellence for TB, AIDS and Malaria (WANETAM) Plus project coordinated
by the MRC, the Unit hosted 18 West African researchers for the fourth and final TB workshop on ‘Data Analysis
and Write-up’ from 4th–8th August.
This latest workshop created the opportunity
for senior researchers from Burkina Faso,
Ghana, Guinea Bissau, Mali, Nigeria, Senegal,
Togo and The Gambia (National Public Health
Laboratories) to analyse data generated from
the TB isolates and begin the initial stages of
writing up results.
The workshop was led by Dr Martin Antonio,
MRC Principal Investigator of the TB Nodes
of Excellence. His team of facilitators was
Florian Gehre, Jacob Otu, Kodjovi Mlaga and
the TB team in this French-English, bilingual
workshop. Dr Bouke de Jong, collaborator in
the WANETAM Plus grant from the Institute of
Tropical Medicine, Belgium, also facilitated the
course.
In his welcoming address, Professor Umberto
D’Alessandro, Unit Director, gave an overview
of the MRC’s achievements across the subregion and emphasised that the Unit will
continue to lead research and collaboration in
this area. He congratulated participants for the
high quality of their contributions during the
course of the workshop.
WHO representative, Dr Charles Sagoe,
said: “WANETAM, which is funded by the
European and Developing Countries Clinical
Trials Partnership, has done a great job in
coordinating research activities according to
local and regional priorities in the field of TB,
HIV and Malaria.”
He noted the importance of capacity building
through training junior and senior West African
scientists, as well as linking seven research
institutions in West Africa (The Gambia,
Senegal, Burkina Faso, Nigeria, Mali, Guinea
Bissau and Ghana) through collaborative
training packages and strengthening
communication.
Dr Sagoe also cited the positive results of a
recent survey on TB prevalence conducted by
MOH, the MRC, WHO and GFATM showing that
the overall prevalence of all forms of TB in The
Gambia is 128 per 100,000 of the population,
3.8 times lower than the 490 per 100,000
estimates in the 2013 Global TB Report.
Mr Ignatius Baldeh, Director of National Public
Health laboratories at the Ministry of Health
and Social Welfare, welcomed all visiting
scientists from the sub-region to The Gambia,
noting how the workshop will ensure excellence
and quality research in data analysis. On behalf
of the Gambian Government and Ministry of
Health he congratulated the MRC for their
training of local junior scientists.
Professor Tumani Corrah, Director of the
Africa Research Development Programme,
described the gathering as “a massive success”.
He promised that the Unit will continue to
support capacity development over the next
three years, thanks to continued funding for
WANETAM.
Dr Martin Antonio, MRC Principal
Investigator of the TB Nodes of
Excellence
About WANETAM
The WANETAM grant, funded by the European and Developing Countries Clinical Trials
Partnership (EDCTP), aimed to develop technical skills that will enable scientists in the West
Africa sub-region to conduct clinical trials to international GCP standards.
The WANETAM network consists of 20 institutions in 12 countries.
During the five years of the WANETAM grant, TB isolates have been collected at the ‘sister’
Consortium sites with TB laboratory facilities.
The subsequent WANETAM Plus grant has continued to build on the strategic objective of
capacity building for West African scientists by supporting a number of short-term training
sessions.
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
15
DISEASE CONTROL & ELIMINATION
Team Gambia at EDCTP Forum
Dr Muhammed Afolabi
A team of scientists represented MRC Unit, The Gambia in the international arena at the 2014 Seventh
Forum of European and Developing Countries Clinical Trials Partnership (EDCTP).
Held at a prestigious hotel in the heart of Berlin in Germany, the
meeting came at a perfect time to share the partnership story, being
at the interface between the tail end of the first EDCTP programme
and commencement of the second programme.
perform better in the next phase of EDCTP, which was officially
launched on 2nd December 2014.
The Forum hosted 359 participants from more than 43 countries;
120 oral presentations were delivered, of which 90% were from
EDCTP-funded projects.
The Unit was well represented by leading scientists who made
excellent presentations of their study findings. These ranged from
research support, novel TB diagnostic methods and TB molecular
studies to bioethics.
The Forum also benefitted from the leadership skills of Professor
Tumani Corrah and Professor Beate Kampmann who expertly
chaired many plenary and parallel sessions.
Overall, the team gave an outstanding performance at the meeting,
putting the Unit in a favourable position to attract more grants and
Visit the Seventh EDCTP Forum website to access
the exciting presentations at:
www.edctpforum.org/2014/index.php/programme-2/
presentations
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DISEASE CONTROL & ELIMINATION
A new malaria team member
Kalilu Dibba
Dr Jane Achan joins the Disease Control and Elimination Theme as a
Clinical Epidemiologist. While at MRC Unit, The Gambia, she will be
involved in some of the already ongoing research activities within
the malaria team and in development of additional areas of research
targeting new approaches to achieve further reductions in malaria
transmission.
What is your professional
background?
I am a medical doctor with a PhD in
Biomedical Sciences from the University
of Antwerp Belgium, a Master’s degree in
Paediatrics and Child Health from Makerere
University, Kampala, Uganda and Master’s
training in clinical trials from the University of
London, UK.
I have been actively involved in malaria and
HIV clinical and operational research for the
past 12 years with the Makerere UniversityUniversity of California San Francisco (MUUCSF) Research Collaboration.
My professional interests and
experience mainly include evaluations of
chemotherapeutic interventions to guide
policy, evaluation of health-related impact
of interventions as well operational health
systems research. I have also provided
technical support for clinical research, public
health and epidemiological strategies to health
organisations focused on operational and
clinical research activities.
I have been actively involved in the
epidemiological surveillance of malaria
morbidity and mortality trends as well as
a provider of technical advice on case
management policy issues in Uganda. I am a
practicing paediatrician and was previously a
lecturer at the Department of Paediatrics and
Child Health at Makerere University College of
Health Sciences.
Why medicine as a profession?
I think medicine is a call to service and a
really noble profession whose sole aim is to
save lives. I was drawn to medicine mainly
because of the burden of diseases we observe
in resource-limited settings like Uganda and
the need to contribute towards alleviating this
suffering.
I hoped to contribute positively towards
achieving improved quality of health care
provided in these settings. The interest in
research was generally driven by the need
to provide evidence-based practices that
feed back into improvements in better
interventions that target disease prevention
and treatment.
What is your research focus?
The focus of my prior research work was
generally driven by the need to provide
evidence to guide policy and improve clinical
practice. I have been involved in several
antimalarial drug therapeutic trials in Uganda
that have informed malaria case management
practices in the country. We provided evidence
of poor effectiveness of oral quinine for
uncomplicated malaria and this led to a policy
change of second-line therapy from oral
quinine to dihydroartemisinin-piperaquine. In
addition, we also documented sub-optimal
treatment practices for severe malaria across
health facilities in the country and used this
information to guide training and support
supervision approaches to improve on the
quality of care provided.
I have also been involved in several studies
evaluating the interactions between HIV and
malaria, two diseases that cause significant
morbidity and mortality in sub-Saharan
Africa. Through this work we have been able
to provide evidence of significant drug-drug
interactions that have also led to policy
changes at the international level. Our work
on interactions between Lopinavir/ritonavir
and artemether-lumefantrine led to a revision
in the 2013 WHO treatment guidelines for
HIV with a preference for Lopinavir/ritonavir
based regimens for treatment of HIV-infected
children in areas of high malaria transmission.
Why MRC Unit, The Gambia?
What attracted me to MRC Unit, The Gambia
was its amazing track record of research and
the public health impact this research has had
internationally. Another attraction was the
glaringly different epidemiology of malaria
in The Gambia compared to Uganda which
presented an opportunity for involvement in
a completely scope and spectrum of research
activities.
Do you have plans for a particular
line of research in the Disease
Control and Elimination Theme?
I would like to pursue new approaches
to achieve further reductions in malaria
transmission especially in areas with relatively
high transmission. My interest in this area
stems from a few observations thus far that
show opportunities for additional interventions
over and above what the current guidelines
provide for.
Impressions of the Unit and The
Gambia so far?
My early impression of the Unit is that it is
an academically rich environment with very
talented scientists and amazing research
teams. I think the Gambia is a beautiful and
calm country. I look forward to a fruitful stay
and experience in the Unit and The Gambia.
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17
CHILD SURVIVAL
Strengthening Hib surveillance
Dr Akram Zaman
Is the burden of invasive Haemophilus influenzae type b (Hib) disease increasing in the Western Region of The
Gambia? To help find out, the Hib Surveillance Project team ran a full day workshop on 19th November to train
new medical graduates and lab scientists from eight major health centres and hospitals in the Western Region on
the importance and methods of disease surveillance.
Hib is a bacteria responsible for causing severe pneumonia, meningitis
and other invasive diseases in children, most of which occur in developing
countries. It is transmitted through the respiratory tract from infected to
susceptible individuals.
Hib meningitis surveillance in the Western region, measure incidence
of Hib disease, identify any emerging hyper-invasive clones and detect
potential reservoirs for increased transmission by undertaking a carriage
study.
A successful trial of Hib conjugate vaccine was carried out in 42,848
infants in The Gambia by joint efforts between the Government of The
Gambia and the MRC from 1993–1995. The Gambia was subsequently
the first country in Africa to routinely vaccinate its children with
conjugate Hib vaccine, beginning in 1997, using a primary series of three
doses; these were scheduled for two, three, and four months of age,
and no booster dose. We reported the virtual disappearance of invasive
Hib disease from The Gambia by 2002, and its presence at a very low
incidence thereafter.
The workshop provided training on the clinical and laboratory surveillance
procedures necessary to carry out high quality surveillance, strengthen
Paediatric Bacterial Meningitis Surveillance lead by the Public Health
Laboratories, and also to train new medical graduates in clinical research.
However we are concerned that Hib vaccine effectiveness is waning in
the second decade after introduction in the first African country to use
the vaccine, and a key question is whether a booster is needed.
Between January 2011 and November 2013 formal surveillance of
invasive Hib disease in Eastern Gambia – associated with pneumococcal
conjugate vaccine introduction (August 2009) – detected 18
cases, having detected just one in the previous two years. This was
accompanied by incidentally detected hospital cases in the Western
Region where formal surveillance had stopped in 2010. Around half of the
detected cases had received two or more doses of vaccine and half were
over 12 months of age. Also, in 2011 a Hib antibody survey undertaken
in the Eastern part of The Gambia, in a group of fully vaccinated older
children and adults, showed that a substantial proportion had nonprotective levels of Hib antibody.
We are now re-establishing Hib
surveillance to answer the crucial
question as to whether the
burden of invasive Hib disease is
increasing in the Western Region.
This will allow the indications of
a recent resurgence in Eastern
Gambia to be understood better
and the implications for vaccine
policy to be assessed. We also
plan to do a carriage study in
selected age strata to detect
potential reservoirs for increased
transmission.
The specific aims and objectives of
our workshop were to re-establish
Dr Samba Ceesay, Acting Director of Public Health at the Ministry of
Health and Social Welfare, attended the workshop and in his inauguration
remarks thanked the MRC for taking up the challenge. Representatives
from the MRC and Mr Ignatius Baldeh, Director of the National Public
Health Laboratories, were among the workshop presenters.
Dr Akram Zaman, Acting Theme Leader of Child Survival gave a talk
on Public Health Surveillance, and Dr Steve Howie, presented on the
past and present epidemiology of Hib diseases in The Gambia. With
a remit to ensure quality management, Mr Ignatius Baldeh, spoke on
the importance of Total Quality Management in research – a means of
strengthening health systems. Dr Magnus Ochoge, Research Clinician
from the Child Survival Theme, explained the new Hib Surveillance system
and gave an overview of clinical procedures, and Dr Ousman Secka,
Manager of Microbiology Laboratory Services, provided an overview of
lab procedures at the MRC for the benefit of clinicians and lab scientists.
The workshop also served as a means of bringing together the expertise
of clinicians and lab scientists to emphasise the importance of joint
working to improve Hib disease surveillance and reduce child mortality.
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NUTRITION
Keneba research prominent at 10th
GCGH Symposium
The Bill and Melinda Gates Foundation’s “Grand Challenges in Global Health”
(GCGH) program aims to foster scientific and technological innovation to solve
key health problems in the developing world.
Among other highlights, at the 10th GCGH Symposium in Seattle in 2014, Mr Bill
Gates showed keen interest in Clare Elwell’s poster describing collaborative work
with MRC Unit, The Gambia to validate functional near infra-red spectroscopy
(fNIRS) to assess cognitive function in Gambian children. This work has now
received Phase II funding.
Find out more at: http://gcgh.grandchallenges.org/Pages/Default.aspx
Tony Fulford seeks new pastures
After 15 years as the leader of databases and statistics at MRC Keneba Field
Station, Tony Fulford has opted for early retirement in order to concentrate on
his ornithological research. We owe a huge debt to Tony and wish him many
discoveries and much satisfaction in his new career.
Congratulations to Sophie Moore
After sterling service as our Head of Station in Keneba we congratulate Sophie
on her appointment as Group Leader in Maternal and Child Nutrition at our
sister unit MRC Human Nutrition Research in Cambridge. Sophie will continue
to lead our sub-theme on Early Growth and Development until we recruit her
replacement and will be an integral part of MRC Unit, The Gambia’s work into
the foreseeable future.
Neonatal Society’s Annual Lecture
The Neonatal Society’s Elsie Widdowson Annual Lecture was given by Professor Andrew Prentice
Nutrition Theme Leader at the Institute of Child Health, London on 18th November. His topic was:
Conceptions, pregnancies and neonates: Lessons from rural Africa.
Read more at: www.neonatalsociety.ac.uk/about/widdowsonlecture.shtml
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
19
NUTRITION
The Four Horsemen of the Apocalypse
The Royal Society of Medicine hosted a one day meeting on ‘The Four Horsemen of
the Apocalypse’: Death, War, Pestilence and Famine. The meeting examined the roles of
coroners and the pathology laboratory, a century of pathological activities within military
services, global pandemics and the impact of famine on human health.
Addressed by experts within their fields, including Andrew Prentice who spoke about
Famine, the meeting offered those attending a chance to hear presentations focusing
on an exciting range of medical topics which brought together current and historical
perspectives on death, war, pestilence and famine - from the battlefield to the
laboratory.
Find out more at www.rsm.ac.uk/events/ptf01.aspx
Science Museum LATES
On the evening of the last Wednesday of each month London’s Science Museum holds a series of ‘LATES’ events for the public. At one such
evening Andrew Prentice described the team’s breakthroughs in epigenetic research to the title of ‘Are you what your mother ate?‘
Find out more at: www.sciencemuseum.org.uk/visitmuseum_old/events/events_for_adults/lates.aspx
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NEWS FROM KENEBA
A fresh face for Keneba Clinical Services
MRC Keneba Field Station has recently welcomed a new Head of Clinical Services, Dr Ian Head. Here, he discusses
his experience, the qualities required of a good doctor and his goals for the clinic with Yaya Minteh.
Tell me about yourself.
I’m originally from a small seaside town in the South of England. Since
graduating from Medicine at Sheffield University in 2008, I have been
working all around the UK. Outside of work I enjoy swimming, playing
squash, and relaxing with a good book.
How did you get to the MRC Unit, The Gambia?
I was working with infectious diseases in the UK and it has been an
ambition of mine to work in an African country for some time; to
experience the life here and to learn more about tropical medicine. A
colleague put me in touch with the MRC team in Fajara, who told me
about the job opportunity in Keneba, and here I am!
What do you feel are the most important qualities in
being a medical doctor?
Alongside good medical knowledge, the most important qualities in a
good doctor are those which allow him or her to build a trusting and
open relationship with the patient. Good medical doctors all share
excellent communication skills, empathy and honesty.
Discuss your clinical experiences
Since qualification, I have worked in a variety of adult medicine
specialities including cardiology, renal and emergency medicine. My
main interest now is in infection and infectious diseases and I have
been working both in the hospital ward and in the microbiology
laboratory.
What are your major goals and priorities for the MRC
Keneba Clinical Services?
I want to continue the excellent work of my predecessor, Dr Helen
Nabwera, in the MRC Keneba Clinic. The redevelopment of the whole
clinic is underway, and this will be an exciting change for the site. I
would like to take some of our diagnostic services forward to enable
the clinical team to provide even better care for our patients. Ongoing
training of the clinical team is a priority to ensure that we maintain our
excellent care standards. The current Ebola threat has been a focus
here for some months; one of my priorities is to ensure that we here
are as prepared and safe as possible.
Recruiting talented faculty (clinicians and researchers)
is a key part of your job. What do you see as the keys
to success in this area?
To ensure that we recruit the best talent to our team, we need to
advertise widely and to take advice from those who have many years’
experience here in Keneba. Their expertise will be a great guide in
recruiting the right person for the right job.
In what ways will your involvement in both the
clinical and research areas benefit you in your role as
Head of Clinical Services?
One of the great things that I have seen in my short time so far here
in Keneba is the way in which the clinical and research teams work
alongside each other. We can learn so much from each other. I hope to
continue to encourage this collaboration between the two areas.
What are your strengths?
Oh dear! I’m organised at work, and love working within a team.
How do you feel about your stay in Keneba?
A little nervous at first, but since arriving in Keneba everyone has been
very welcoming. I’m slowly getting to know the village and I’m enjoying
the peace and quiet of this beautiful place.
Do you have anything to tell your colleagues and
friends?
Thank you to everyone for giving both Helen (my partner) and I such a
warm welcome since we arrived. We’re both so impressed by the hardworking staff here, and are excited to be a part of the team.
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21
NEWS FROM BASSE
A visit from the US Charge d’Affaires
MRC Basse Field Station was delighted to host Mr Richard T. Yoneoka, Charge d’Affaires of the Embassy of
the United States of America in Banjul, in July 2014.
Mr Yoneoka and his delegation were accompanied by the Unit Head of Operations, Joan Vives Tomas. He had the opportunity to visit the
Demographic Surveillance System (DSS) office, the lab and the insectary.
At the DSS, Mr Salifou Sambou and Golam Sarwar gave a brief outline of the activities of the DSS. At the main lab, Rasheed Salaudeen,
deputising for Basse Lab Manager, gave a vivid account of the various activities of the lab, while Mr Camara gave an account of the works at
the malaria lab and insectary.
The visit served as a first-hand insight for Mr Yoneoka into some of the operations of the field station, demonstrating the excellent facilities
available at Basse Field Station to enable clinical trials, and the opportunity to measure the long-term impact of interventions in a meaningful
way.
Accelerating
translational science
Basse Field Station recently welcomed Professor Andrew
Prentice, Nutrition Theme Leader and Professor of
International Nutrition at the London School of Hygiene
and Tropical Medicine.
With a view to accelerate the Unit’s translational science
building upon synergies between the four themes and
MRC field stations, Andrew’s stay included a visit to the
Demographic Surveillance System (DSS) office, the lab
facilities and the new site at Mansajang. Andrew was
accompanied on his visit by Pa Chebo Saine, Mr Felix Badji
and clinicians based at Basse.
22
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NEWS FROM BASSE
Investing in communities
As part of the process of giving back to the communities of the Upper River Region and Central River
Region, Basse Field Station has donated six computers to three schools in Basse.
The beneficiary schools are St George’s Senior Secondary School, Nasir Ahmadiyya Senior Secondary School and St Mulumba’s Upper Basic
School, and more donations are to follow in the not too distant future.
In her address to all present at the event, Gyasiwaa Amofa, previous Operations Manager of Basse Field Station, noted: “This donation is part
of the MRC Unit’s overall efforts to give back to a very supportive community that has always been a part of the parcel of the MRC’s research
initiatives. It is important for students to be computer literate as this is an aspect of any research initiative; the computer is a necessary
prerequisite in any meaningful research activity.”
On a similar note she informed the students that there is an opportunity to work at the MRC as part of an attachment scheme to deserving
students, again an effort to give back to the community. The opportunity will give the students a chance to gain work experience in various
areas of interest including IT, science, administration and finance.
Since mid-October a group of six high performing students from the beneficiary schools have taken up roles in the areas of finance,
administration, laboratory science and IT/data.
The head teachers of all of the schools seized the opportunity to the thank the MRC for what they all see as an appropriate gesture and
promised to ensure that the computers will be put to good use for the benefit of the students.
Nashir Ahmadiyya Senior Secondary School
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23
NEWS FROM BASSE
LEFT: St George’s Upper Basic and Senior Secondary Schools. RIGHT: St Mulumba’s Upper Basic School
From Basse to Fajara: the
Odyssey of an administrator
To gain big, one has to start small. And that is precisely what
Gyasiwaa Amofa has done, leaving her role as Operations Manager
of Basse Field Station to pick up a new and challenging role as
coordinator of Africa Research Development at MRC Fajara.
When she arrived in Basse over two years ago, people may have wondered who this
small lady was, stepping into a leadership role as the new Head of Operations. Calm and
focused, Gyasiwaa came to Basse with a determination to change the Field Station for
the better.
Gyasiwaa made it clear that the old ways cannot endure if there has to be meaningful
and progressive change in Basse. And in many respects she succeeded in streamlining the
administration of Basse Field Station, although she concedes that there is still a lot to be
done. As the world is a stage where every individual must play a role, she has played her
role here and must now move on. We wish her all the best in her new role.
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RECENT UNIT PUBLICATIONS
Antibodies against Haemophilus influenzae type b in The Gambia:
investigating the extent of protection across age groups.
Following a landmark clinical trial, the vaccine against Haemophilus influenzae type b (Hib) was introduced
in The Gambia in 1997. Whilst the immunogenicity of this vaccine is well established subsequent to the
doses administered under the EPI schedule, little data exists assessing longevity of protection, using
serology. Such data are needed however to predict the susceptibility to Hib at the population level.
To determine antibody persistence in 5-6 year old fully vaccinated Gambian children compared with
older children, adolescents and young adults, 427 serum samples from healthy 5-37 year old participants
were tested for Hib antibodies using VaccZyme Human Anti-Hib ELISA kits. 86% of the children who had
received 3 doses of Hib vaccine in infancy had Hib antibody concentrations ≥0.15 mg/l at the age of 5-6
years. This proportion was 76% for adolescents who had also largely been vaccinated and 90% for adults
who had never received Hib vaccine.
Olubukola Idoko
Although most participants had anti-Hib antibody above concentrations putatively defined as protective,
significantly fewer had concentrations thought to confer long-term protection. This suggests a population
with insufficient or waning antibody that may be susceptible to breakthrough disease and transmission.
Idoko OT, Roberts E, Cox M, Jafali J, Njie-Jobe J, Mackenzie G, Ota MO, Kampmann B. Vaccine.
2014;32(36):4620-4
Coverage and timing of children’s vaccination: an evaluation of the
Expanded Programme on 1 Immunisation in The Gambia
The investigators aimed to evaluate the coverage and timeliness of the Expanded Programme on
Immunisation (EPI) in The Gambia. Vaccination data were obtained between January 2005 and December
2012 from the Farafenni Health and Demographic Surveillance System (FHDSS), the Basse Health and
Demographic Surveillance System (BHDSS), the Kiang West Demographic surveillance system (KWDSS), a
cluster survey in the more urban Western Health Region (WR) and a cross sectional study in four clinics in
the semi-urban Greater Banjul area of WR.
BCG vaccine uptake was over 95% in all regions. Coverage of DPT1 ranged from 93.2% in BHDSS to 99.8%
in the WR. Coverage decreased with increasing number of DPT doses; DPT3 coverage ranged from 81.7%
in BHDSS to 99.0% in WR. Measles vaccination coverage ranged from 83.3% in BHDSS to 97.0% in WR.
DPT4 booster coverage was low and ranged from 43.9% in the WR to 82.8% in KWDSS.
Susana Scott
The investigators found that The Gambia health system achieves high vaccine coverage in the first year
of life. However, there continues to be a delay to vaccination which may impact on the introduction of
new vaccines. Examples of effectively functioning EPI programmes such as The Gambia one may well be
important models for other low income countries struggling to achieve high routine vaccination coverage.
Scott S, Odutola A, Mackenzie G, Fulford T, Afolabi MO, Jallow YL, Jasseh M, Jeffries D, Dondeh BL, Howie
SRC, D'Alessandro U. PLOS ONE. 2014 September 18. doi: 10.1371/journal.pone.0107280
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
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RECENT UNIT PUBLICATIONS
Targeting regulatory T cells to improve vaccine immunogenicity in early life
Human newborns and infants are bombarded with multiple pathogens on leaving the sterile intra-uterine
environment, and yet have suboptimal innate immunity and limited immunological memory, thus leading
to increased susceptibility to infections in early life.
They are thus the target age group for a host of vaccines against common bacterial and viral pathogens.
However, neonatal and infant responses to many vaccines are suboptimal, and in the case of the
polysaccharide vaccines, it has been necessary to develop the alternative conjugated formulations in order
to induce immunity in early life. Immunoregulatory factors are an intrinsic component of natural immunity
necessary to dampen or control immune responses, with the caveat that they may also decrease immunity
to infections or lead to chronic infection.
Jojo Ndure
This review explores the key immunoregulatory factors at play in early life, with a particular emphasis
on regulatory T cells (Tregs). A deeper understanding of the role that Tregs play in limiting or controlling
vaccine induced immunity would provide strategies to improve vaccine immunogenicity in this critical age
group. New adjuvants and drugs are being developed that can transiently suppress Treg function, and their
use as part of human vaccination strategies against infections is becoming a real prospect for the future.
Ndure J and Flanagan KL. Frontiers Microbiol. 2014;11;5:477.
Heterologous and sex differential effects of administering vitamin A
supplementation with vaccines: a literature review
WHO recommends high-dose vitamin A supplementation (VAS) to children from 6 months to 5 years of
age in low-income countries, in order to prevent and treat vitamin A deficiency-associated morbidity and
mortality. The current policy does not discriminate this recommendation either by sex or vaccination
status of the child.
There is accumulating evidence that the effects of VAS on morbidity, mortality and immunological
parameters depend on concomitant vaccination status. Moreover, these interactions may manifest
differently in males and females. Certain vaccines administered through the Expanded Program on
Immunization (EPI) have been shown to alter all-cause mortality from infections other than the vaccinetargeted disease.
This review summarises the evidence from observational studies and randomized-controlled trials of
the effects of VAS on these-so-called heterologous or non-specific effects of vaccines, with a focus
on sex differences. In general, VAS seems to enhance the heterologous effects of vaccines, particularly
for diphtheria-tetanus-pertussis (DTP) and live measles vaccines, where some studies, although not
unanimously, show a stronger interaction between VAS and vaccination in females. The investigators
suggest that vaccination status and sex should be considered when evaluating the effects of VAS in early
life.
Jensen KJ and Ndure J, Plebanski M, Flanagan KL. Trans R Soc of Trop Med Hyg. 2014 December 3.
doi: 10.1093/trstmh/tru184.
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RECENT UNIT PUBLICATIONS
Early Phase Clinical Trials with Human Immunodeficiency Virus-1 and
Malaria Vectored Vaccines in The Gambia: Frontline Challenges in Study
Design and Implementation
Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and malaria are among
the most important infectious diseases in developing countries. Existing control strategies are unlikely
to curtail these diseases in the absence of efficacious vaccines. Testing of HIV and malaria vaccines
candidates start with early phase trials that are increasingly being conducted in developing countries
where the burden of the diseases is high. Unique challenges, which affect planning and implementation of
vaccine trials according to internationally accepted standards have thus been identified.
In this review, the investigators highlight specific challenges encountered during two early phase trials of
novel HIV-1 and malaria vectored vaccine candidates conducted in The Gambia and how some of these
issues were pragmatically addressed. They hope their experience will be useful for key study personnel
involved in day-to-day running of similar clinical trials. It may also guide future design and implementation
of vaccine trials in resource constrained settings.
Muhammed Afolabi
Afolabi MO, Adetifa JU, Imoukhuede EB, Viebig NK, Kampmann B, Bojang K. Am. J. Trop. Med. Hyg.
2014;90(5):908–914.
Correlates of protection against human rotavirus disease and the factors
influencing protection in low income settings
Rotaviruses (RV) are the leading cause of gastroenteritis in infants and children worldwide and are
associated with high mortality predominately in low-income settings. The virus is classified into G and P
serotypes and further into P genotypes based on differences in the surface-exposed proteins VP7 and VP4,
respectively.
Infection results in a variable level of protection from subsequent reinfection and disease. This protection
is predominantly homotypic in some settings, whereas broader heterotypic protection is reported in other
cohorts. Two antigenically distinct oral RV vaccines are licensed and are being rolled out widely, including
in resource-poor setting, with funding provided by the GAVI alliance. The first is a monovalent vaccine
derived from a live-attenuated human RV strain, whereas the second is a pentavalent bovine-human
reassortment vaccine. Both vaccines are highly efficacious in high-income settings, but greatly reduced
levels of protection are reported in low-income countries.
Ed Clarke
The authors consider the current challenges facing mucosal immunologists and vaccinologists aiming to
define immunological correlates and to understand the variable levels of protection conferred by these
vaccines in humans. Such understanding is critical to maximize the public health impact of the current
vaccines and also to the development of the next generation of RV vaccines, which are needed.
ET Clarke, U Desselberger. Mucosal Immunol. 2014 December 3. doi:10.1038/mi.2014.114
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RECENT UNIT PUBLICATIONS
Efficacy of indoor residual spraying with ichlorodiphenyltrichloroethane
against malaria in Gambian communities with high usage of long-lasting
insecticidal mosquito nets: a cluster-randomised controlled trial
Background
The investigators aimed to assess whether the addition of indoor residual spraying to long-lasting
insecticidal nets (LLINs) provided a significantly different level of protection against clinical malaria in
children or against house entry by vector mosquitoes.
Methods
In this two-arm cluster, randomised, controlled efficacy trial the investigators randomly allocated clusters
of Gambian villages using a computerised algorithm to LLINs alone (n=35) or indoor residual spraying with
dichlorodiphenyltrichloroethane plus LLINs (n=35).
Margaret Pinder
In each cluster, 65–213 children, aged 6 months to 14 years, were surveyed at the start of the 2010
transmission season and followed in 2010 and 2011 by passive case detection for clinical malaria.
Exposure to parasite transmission was assessed by collection of vector mosquitoes with both light and exit
traps indoors. Primary endpoints were the incidence of clinical malaria assessed by passive case detection
and number of Anopheles gambiae sensu lato mosquitoes collected per light trap per night.
Findings
Incidence of clinical malaria was 0.047 per child-month at risk in the LLIN group and 0.044 per child-month
at risk in the indoor residual spraying plus LLIN group in 2010, and 0.032 per child-month at risk in the
LLIN group and 0·034 per child-month at risk in the indoor residual spraying plus LLIN group in 2011. The
incident rate ratio was 1.08 (95% CI 0.80–1.46) controlling for confounders and cluster by mixed-effect
negative binomial regression on all malaria attacks for both years.
No significant difference was recorded in the density of vector mosquitoes caught in light traps in houses
over the two transmission seasons; the mean number of A gambiae sensu lato mosquitoes per trap per
night was 6.7 (4.0–10.1) in the LLIN group and 4.5 (2.4–7.4) in the indoor residual spraying plus LLIN group
(p=0.281 in the random-effects linear regression model).
Interpretation
The investigators identified no significant difference in clinical malaria or vector density between study
groups. In this area with high LLIN coverage, moderate seasonal transmission, and susceptible vectors,
indoor residual spraying did not provide additional benefit.
Pinder M, Jawara M, Jarju LBS, Salami K, Jeffries D, Adiamoh M, Bojang K, Correa S, Kandeh B, Kaur
H, Conway DJ, D'Alessandro U, Lindsay SW. The Lancet. 2014 December 9. doi:10.1016/S01406736(14)61007-2
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MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
RECENT UNIT SEMINARS
TITLE: Share and Share Alike: Why Open Access Matters
NAME: Caroline Lloyd, Head of Library & Archives Service, London School of Hygiene & Tropical Medicine
Caroline Lloyd visited the MRC Unit in The Gambia to discuss current practice in open access. Caroline’s presentation,
based on the work of Gareth Knight, explored the barriers to data sharing in public health and practical steps that can
be taken to address these issues. In particular, she identified the need to: Establish personal and professional benefits
that can be gained by data sharing; Ensure study participants are aware of any intent to make data available and
provide their consent; Perform a risk assessment to determine the likelihood that information will directly or indirectly
identify a participant and take action to resolve problems; Identify a digital repository through which data can be made
available and make key decisions on when, where and how access will be provided.
Following Caroline’s presentation, she invited the audience to discuss how the community could build data sharing
capacity in The Gambia. This discussion highlighted the need for national and international collaboration, among other
factors. The LSHTM’s library has been selected to contribute to the UK Medical Heritage Library digitisation project,
joint funded by the Wellcome Library and JISC. The project aims to create high quality digital scans of 19th century
medical books and pamphlets which will be available for everyone to use under a creative commons license.
Find out more here: http://blogs.lshtm.ac.uk/library/2014/06/25/wellcome-digitise-librarys-19th-century-literature
TITLE: Mycobacterium tuberculosis complex lineages diversity: Does it have an impact on anti-TB treatment response?
NAME: Dr Leopold D. Tientcheu, Senior Scientific Officer, Vaccinology Theme
The likely impact of Mycobacterium tuberculosis (Mtb) complex (MTBC) lineages on anti-tuberculosis (TB) treatment
response is still understudied despite evidence of epidemiological differences in their virulence.
In The Gambia, TB patients infected with Mycobacterium africanum (Maf) are more likely to be older, HIV co-infected
and/or severely malnourished. In addition, Maf-exposed contacts progress slower to active disease compared to
Mtbexposed contact, suggesting that Maf might be the less virulent of the two prevalent strains. The complex
interaction between the bacilli and their host requires an integrated approach that investigates both arms to better
understand the response to treatment in TB patients.
We have shown that the proportions of activated MTBC-specific T-cells are similar between Maf- and Mtb-infected
patients before treatment, but significantly higher post-treatment in Maf- compared to Mtb-infected patients.
Post-treatment Mtb-infected patients recovered better than Maf-infected patients, despite similar degree of disease
severity in both groups before treatment. Furthermore, analysis of sputum isolates from these patients revealed a
drug tolerance phenotype for Maf that could not be detected using conventional drug susceptibility testing methods.
Taken together, our results suggest differences in response to standard anti-TB drug treatment between Maf- and
Mtbinfected patients and warrant further investigation of MTBC strain-specific treatment.
TITLE: A New Diagnostic Toolbox: Immuno-epidemiological approach to the Diagnosis of Tuberculosis in Children
NAME: Dr Toyin Togun, MRC Clinical Research Training Fellow, Vaccinology Theme
Despite the considerable morbidity and mortality caused by Tuberculosis (TB) in children in developing
countries, there is very limited research and routine surveillance data on paediatric TB, principally due to the
difficulties in making a diagnosis of TB in children. Our main objective is to improve diagnosis of childhood
TB by developing a new diagnostic toolbox using an integrated approach that combines epidemiological data
with host and pathogen signature among TB-exposed symptomatic children.
Our results so far confirm the poor specificity of the classical symptoms of TB in children and that interferongamma release does not add discriminatory value to our clinical prediction model. Importantly, the
combination of ‘age <5yrs’ and ‘presence of lymphadenopathy’ on clinical examination, reliably classified at
least 77% of active TB in the target population. We have identified candidate host-specific biomarkers with
reasonable discriminatory accuracy for active TB which we will be exploring further, towards coming up with a
unique bio signature for paediatric TB.
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
29
NEWS FROM QUALITY
Quality for All
Nana Tawiah, Yai Louise Ndure-Bensouda and William Dei-Alorse
In November, the Quality Department of MRC Unit, The Gambia joined the Global Quality Community yet again
to celebrate World Quality Month, a platform for acknowledging the efforts and accomplishments of quality and
all who work to make it happen. Here they provide an update on their ambitious plans.
Since 2012, the department has been working hard to keep quality at the
forefront of the Unit’s work, in striving towards ISO 15189 accreditation.
The Unit’s Quality Management System (QMS) has adopted a processbased approach, in accordance with the requirements of ISO 9001 – and
in alignment with the ultimate goal: ISO 15189 (Medical Laboratories –
Requirements for quality and compliance).
The Quality Management department wishes to thank everyone who
joined them in celebrating Quality. They also want to thank those
who took the annual WQM quiz. Congratulations to this year’s WQM
winners: Fatou Lette-Jallow, Adam Drammeh, and Alpha Jawo. They were
presented with their gifts at the Director’s Awards ceremony.
The ISO 15189 international standard recognises the significant
role customers play in every QMS. In fact one of the metrics used
in determining the success of any business/institution is measuring
customer satisfaction based on their requirements. As a result, the
process-based model aims to enhance customer satisfaction by meeting
the customer requirements.
ISO 15189 standard is a combination of the requirements of ISO 9001
and 17025. Therefore it promotes the process approach by enabling
organisations to effectively improve their quality management systems.
This model efficiently allows interactions of the numerous linked
activities between customers’ requirements or ‘inputs’, managing these
through the organisation’s resources, and transforming the inputs into
outputs. This transformation is considered as a process.
At the simplest level, our QMS process is based on a continual
improvement cycle. We need to heed feedback from customers/clients
and findings through audits or monitoring visits. To remain competitive,
we need to feed back the output, results achieved, including mistakes
learned, back into the way of working.
The concept behind this game was to use the principles of Plan Do Study
Act (PDSA) to demonstrate:
‚‚
‚‚
‚‚
how to approach improving or changing a process,
how to test the changes and build on knowledge gained to design
subsequent changes
how having an objective and performing multiple testing cycles lead
to improvement
After playing the game, the participants understood the concept and
were able to relate this to their process improvements.
World quality month (WQM) provided an opportunity to draw attention
to the continual improvement process, encouraging everyone to work
together to improve their working environments and enable high quality
science with worldwide recognition. The highlight of the celebrations
was the Tennis Ball game that participants played.
The Quality Management team with Alpha Jawo, one of the
World Quality Month winners
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MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
STAFF SPOTLIGHTQUALITY
Workers Credit Union: “People Helping
People”
Mr Abdoulie Cham, Community Relations Officer at MRC Unit, The Gambia,
was elected Chairman of the MRC Worker’s Credit Union in 2014. On 20th
November, he joined all cooperate credit unions and rural branches in The
Gambia to represent the MRC Workers Credit Union at the International
Credit Union day celebrations.
The National Association of Co-operative Credit Unions of The Gambia (NACCUG) commemorated
International Credit Union day at the July 22nd Square in Banjul. NACCUG was established in Banjul in
1991 to act as the national trade association representing approximately 70 affiliated micro-financing
member credit unions in the country.
At the celebrations the Board Chairman of NACCUG, wished all attendees a happy International Credit
Union 2014 and outlined the importance of the celebration. This year’s theme was "Local Service,
Global Good" which promotes the positive impact of credit unions in their communities and around
the world. There is a powerful global network of 57,000 credit unions, with nearly 208 million members
in 103 countries worldwide. Sharing challenges, experiences and solutions with one another can bring
advantages to better serve members.
The MRC Workers Credit Union exists to help staff and complement the efforts of MRC Unit, The
Gambia in staff development. It aims to help staff by offering loans at reduced interest rates when it
can be difficult to get a loan from the bank and interest rates can be high.
The MRC Workers
Credit Union exists
to help staff and
complement the
efforts of MRC Unit,
The Gambia in staff
development.
Unlike banks, the credit union is owned and managed by its members. Members make decisions and
have the final say as to how they want it to be run, including interest rates and dividends to be paid on
returns. The credit union has helped many staff members, for example enabling payment of education
for their children or themselves, or the purchase of land.
Abdoulie, who has served in different executive positions of NACCUG, said, “The aims of the
commemoration were numerous as it brought together all cooperate credit unions and rural branches
in The Gambia. The aim is to promote more advocacy and remind people of the important service
credit union offers to it members.
“The MRC Workers Credit Union has a close relationship with the National Association of Co-operative
Credit Unions which is the parent body of all credit unions in the country. I would like to call on Unit
staff to come on board and join the union which is an initiative of cooperate helping co-operatives;
the credit union interest rate is just 1% per month and 12% per year compared to up to 30% offered by
banks.”
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
31
STAFF SPOTLIGHT
2014 Director’s Awards
The 2014 MRC Unit, The Gambia Director’s Awards were presented at a reception in December. We would like to
congratulate the winners, thank everyone who nominated staff for the awards and give a special thank you to the
judges, Yai-Louise Ndure Bensouda (Quality Management Department), Dr Helen Nabwera (Nutrition Theme) and
Dr Magnus Ochoge (Child Survival Theme). They had the unenviable job of sifting through the entries and coming
to a consensus on the winners.
Category
Inspirational Leader
Research Leader of Tomorrow
Science Support
G.E.M. Award (Going the Extra Mile)
Outstanding Team
Winner
Dr Sarah Burr
Dr Alfred Ngwa
Ms Isatou Foon
Mr Abdou Gibba
Sukuta Platform Team
Runner-up
Professor Beate Kampmann
Dr Olubukola Idoko
Mr Simon Donkor
Mrs Kathy Hill
Trachoma Research Team
The Recognition Award
We were pleased to present two teams from the
Unit with this award.
The Honourable Minister of Health, Dr Omar Sey, kindly
attended the evening and presented the first award to the
Ebola Virus Disease (EVD) Preparedness Team, Clinical Services
Department, in recognition and great appreciation of their
contribution in Clinical Services in EVD preparedness.
We would like to recognise the hard work, dedication and
bravery of all members of the team: Ed Green, Suzanne
Anderson, Amie Bah, Binta Fatty, Fatou Sanneh, Nyima Ceesay,
Fatou (Matty) Camara, Fatou Jatta, Ngendeh Touray, Isatou
Trewally, Gibril Bass, Sheila Jarret, Mamina Bojang.
There are another 25 clinical services team members who are
trained and ready to respond, as well as the Business Continuity
team, Mr Ebrima Cambi, the Research Support Office, and
Nana Tawiah and Aminatta Houma-Colin from the Quality
Management Department, who have been working tirelessly in
the efforts towards EVD preparedness.
The MRC’s Worker’s Union was also presented the Recognition
Award, by Professor Umberto D’Alessandro, Unit Director, in
recognition of the collaboration and contribution of the MRC
Worker’s Union to the overall success of the Unit.
Nominations also received for:
Dr Anna Roca, Kalilu Dibba, Serign Jawo Ceesay
Fatoumatta Darboe
Ebrima Bah, Lamin Manneh, Njilan Johnson
Ebrima Cambi
Facilities, Keneba Lab and Admin Team, Research Support Office,
Transport, TBCC Team, MDV team, PregnAnzi team, PRINOGAM
team.
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MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
STAFF SPOTLIGHTQUALITY
MRC CEO Award: Driving change
We would like to congratulate Dr Muhammed Afolabi, Principal Investigator at MRC Unit, The Gambia,
who received a runner-up award in the MRC CEO Awards in the category of ‘Driving Change’.
The MRC CEO Award Scheme recognises contributions from employees for outstanding effort
and commitment to both their work and the MRC as an organisation. For the third year running, a
tremendous number of nominations were received from across the MRC.
The awards are a great achievement and recognition of the contribution made by staff to the overall
success of the MRC. The award ceremony was held on 7th October at the London Head Office, where
Professor Sir John Savill announced the category results and presented prizes to the winners and
runners up.
The award recognises the significant contributions of Muhammed’s PhD study which focused
on development and evaluation of a locally appropriate multimedia tool for delivery of consent
information to low and non-literate research participants.
Muhammed also developed an audio digitised questionnaire to measure participant comprehension
of informed consent. The tools have been shown to improve participant understanding of informed
consent and consequently the ethical conduct of clinical trials in The Gambia.
Congratulating Muhammed on the receipt of his award, Professor Umberto D’Alessandro, Director
of MRC Unit, The Gambia said: “Muhammed certainly deserves this recognition thanks to his
commitment to research and his ability to overcome obstacles. I would like to congratulate him for
this fantastic achievement and I wish him well for new exciting research projects.”
Muhammed certainly
deserves this
recognition thanks
to his commitment
to research and his
ability to overcome
obstacles. I would
like to congratulate
him for this fantastic
achievement and
I wish him well
for new exciting
research projects.
Professor Umberto
D’Alessandro
Dr Muhammed
Afolabi was presented
his award by MRC
CEO, Professor Sir John
Savill in London.
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
33
STAFF SPOTLIGHT
Leaving behind a legacy of good
clinical practice
After almost a decade of service, during which she pioneered the
implementation of high good clinical practice standards for the conduct of
clinical trials, Dr Jenny Mueller retired from her role of Clinical Trials Support
Manager at the Unit in August. Malick J Bah reports.
What has been the formula to your
success?
I think there are two main factors. Firstly I
brought in the relevant experience to build up
the Clinical Trials Support office, which I started
when I arrived in January 2006. Secondly I had the
support of management behind me and of course
the willingness of staff to employ high standards
of conduct in clinical trials. I think this has been a
two-sided success story.
How do you feel about leaving the
Unit?
As usual you have a crying and a laughing eye. The
crying eye is definitely to leave a job that I like and
that I enjoy doing. And of course to leave behind
many lovely people; it was a great experience for
me.
Be committed and
be honest. Honesty
is very important,
particularly in
research.
supporting other research projects. There was
always willingness and respect from everyone
involved, without which it would have been
difficult. There were many changes in the last
two years, which if you get a little bit older can
be difficult to deal with – that was one reason to
retire.
I go into such a different life now. However I will
say I am proud of what I have achieved and even
though I am retiring I would still like to collaborate
and offer my services to the Unit as a consultant.
What are some of the challenges you
have encountered during the course
of your work?
The laughing eye is that I can now do what I want
whenever I want, and get up in the morning when
I want to. I don’t know exactly what this future will
bring but that is how I see it.
The main challenge was definitely last year. In
the absence of a Senior Data Manager for the
inactivated poliovirus vaccine trial we took all
that additional responsibility as a sponsor. It was
challenging but I am proud that when the second
audit was conducted during the trial, there were
no critical findings and we managed it well.
What has been the impact of your
work at the Unit?
What has been your most enjoyable
moment?
We succeeded in setting a standard that is
comparable to international standards. We were
confirmed by monitors and auditors verifying that
we really have set an internationally competitive
standard. This means the assurance that all clinical
trials conducted here at MRC Unit, The Gambia,
will follow the international quality standards of
good clinical practice.
I also succeeded in building up a strong team.
I started the Clinical Trials Support office alone
in the first one and half years but I recruited
one new member and expanded the team with
another member later; we worked really well
together as a team.
If you could take something with
you from the MRC, what would it be?
Probably the wonderful working environment.
I worked mainly on clinical trials but was also
I can’t say there was really one moment but it was
rewarding to get the work we did here recognised.
For example there were no major findings when
trials were monitored or audited that could not be
solved easily. To see the fruit of our work and how
new researchers have progressed, some becoming
principal investigators for example, was great.
What will be your final message to
the Unit and the young scientists in
particular?
Be committed and be honest. Honesty is very
important, particularly in research. If you make
any mistakes in your research, which is normal,
admit them and apply correcting measures. It has
been a real pleasure to work with everyone here.
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MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
STAFF SPOTLIGHT
Driving the Transport Department
forward
Here we meet Mr Martin Sabin, who started coming to The Gambia as a tourist
13 years ago and fell in love with the country and its people. He joined the Unit
in August as Fleet Technical Services Manager.
Tell us about yourself
I decided to emigrate to The Gambia in April 2007, initially working with Euromotor Services as a Garage
Manager. After a while I moved on to work as Garage Manager with ‘AB Rent A Car’, maintaining a small
fleet of rental vehicles, and initiating third party repair work, thus mitigating the cost of rental fleet
maintenance.
I later worked at the British Embassy as Estates and Transport Manager. Unfortunately with British
Government cut backs, my job was made redundant. I am now married here to Veronica and have a
beautiful daughter Emily, who has just celebrated her third birthday.
Why MRC Unit, The Gambia?
The redundancy at the British Embassy coincided with the day that the vacancy for Fleet Technical
Services Manager was advertised locally. I applied for the post, partly because of the redundancy, but
also because of the excellent reputation that the MRC has locally – both for services provided to the local
population and their reputation as a fair and ethical employer.
Initial impressions?
The range and
quality of the
work carried out
is very good, and
the facilities are
excellent.
The Unit has lived up to all my expectations. All staff are friendly and always willing to share a greeting.
The Transport Department in particular is staffed by knowledgeable and competent mechanics and
managers. The range and quality of the work carried out is very good, and the facilities are excellent.
What are your plans to move the workshop forward?
I plan to build on the good work already evident in the Transport Department. I would like to build a
stronger team ethic, and to introduce systems to effectively monitor the progress of repairs from initial
report to final sign-off.
I would also like to give all mechanics experience on all of the equipment we are responsible for, thus
building a more capable and flexible team, and increasing job satisfaction. I am also trying to update
vehicle and service records.
Final words?
I have now been here for a few months and believe I am getting my ‘feet under the table’. I can see
that this role is important to the Unit as a whole, ensuring that transport issues never interfere with the
important work and research that is done here.
I have always run an ‘open door’ policy, so if any members of staff want to pop in for a chat they are
more than welcome! I am always open to suggestions as to where we can improve our services, and I’m
always ready to discuss them. After all, I probably don’t have ALL the answers!
MRC TAMA | VOL: 13 | ISSUE: 03 | 2014/15
35
Meet the TAMA Editorial Board
Isabel Baker is Interim Head
of Communications, Chair of
the Tama Editorial Board and
a Science Writer at MRC Head
Office, UK. Seconded from
the MRC (UK), she joined MRC
Unit, The Gambia in August
2014 and has been splitting
her time between The Gambia
and the MRC (UK). With a first
class degree in Biology and
experience in the medical
communications industry she
enjoys writing about science
for non-specialist audiences
and is proud to be helping
communicate the Unit’s worldclass research.
Kalilu Dibba joined MRC Unit,
The Gambia’s HR Department
in 2003. Currently he is the
Senior Human Resources
Advisor. Kalilu worked in
Cooperative Development for
over 8 years under the Ministry
of Agriculture and received
Cooperative training at the
now Moshi University College
of Cooperative and Business
Studies in the United Republic
of Tanzania. He currently holds
a graduate membership of the
Chartered Institute of Personnel
and Development (UK)
Muhammed Afolabi is a
Clinical Scientist with a
medical degree from the
University of Ibadan, Nigeria.
He also has a Masters degree
in Public Health from another
leading university in Nigeria.
Muhammed is a Fellow of
the West African College of
Physicians. He joined the
MRC in 2009 as a Clinician
and has coordinated the field
and clinical aspects of HIV
and malaria vaccine trials. He
is the Principal Investigator
on a malaria vaccine trial and
successfully defended his
PhD from the London School
of Hygiene and Tropical
Medicine, UK, in January
Yai Louise Ndure-Bensouda
is a Quality Assurance Auditor
working in the Quality
Management Department at
MRC. She became a member
of the Tama editorial board in
2010 and has contributed to
the Quality section since.
Tisbeh Faye-Joof is the
Serology Laboratory
Services Manager at MRC
Unit, The Gambia. She has
twelve years of hands-on
laboratory experience. Tisbeh
is graduated with a first
class degree in Biomedical
Sciences from the University
of Westminster, London. She is
married and blessed with two
sets of twin daughters.
Sulayman Janneh is the
Theme Project Manager for
Child Survival. He joined the
Unit in 2011 as a PA/Project
Support Officer. He has been a
member of the TAMA Editorial
Board for 3 years and takes
particular interest in covering
the Social Science Research as
well as Child Survival activities.
Sulayman has served in many
groups but none is more
gratifying than being a part
of the TAMA Editorial Board
family where stories are told
of ordinary people doing
extraordinary things at the
MRC.
Joan Vives Tomas is the Unit
Director of Operations, MRC
Unit, The Gambia. Joan has a
special interest in the history
of medicine and the social
impact of medical research
in Africa. He has been living
in The Gambia for the last 4
years, but as he says “ I feel as
if I just arrived yesterday…”
Fanding P Njie joined the
Unit’s Communications Team
in 2006 as Digital and Print
Communications Manager.
He manages the Unit’s print
production facility and
pre-press requirements. A
significant part of his job
involves developing and
maintaining the website
and web applications. He is
currently doing his MSc in IT
by distance learning. He is a
Certified Web Professional
(CIW), Certified Ethical Hacker
(CEH) and an active member
of the British Computer
Society.
Your Feedback Please!
Tama – the Newsletter of MRC Unit, The
Gambia – is for everyone who is interested
in our work and our community.
We are keen to receive feedback and
suggestions for new features from our
readers. So if you have any comments,
please let us know.
Email: [email protected]
Medical Research Council Unit, The Gambia
Atlantic Road, Fajara
P. O. Box 273 Banjul
The Gambia
Communications
Tel: 4495 442 Ext. 2306
Email: [email protected]
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© Medical Research Council 2015