Learn more about the projects for each research theme at MRC Unit The Gambia.
Maternal Immunization with MenAfriVac®
Contact: Dr Ed Clarke and Prof Beate Kampmann
Funding: Meningitis Research Foundation (MRF)
This phase 3 trial will assess the potential role of delivering MenAfriVac®, the meningococcal serogroup A conjugate vaccine manufactured by the Serum Institute of India Pvt. Ltd, to expectant mothers to protect their infants. As tetanus toxoid is the conjugated protein, the vaccine could replace one of the routine antenatal doses. MenAfriVac® is currently recommended for infants routinely from 9 months upward. Vaccinating expectant mothers could close the window of susceptibility up to this age.
A randomized, observer-blind, non-inferiority trial to evaluate alternative human papillomavirus (HPV) vaccination schedules in females in West Africa
Contact: Dr Ed Clarke
Funding: Medical Research Council/ Welcome Trust/ DFID Global Health Clinical Trials Scheme
This randomized trial will assess the immunogenicity of one or two doses of a 9-valent HPV vaccine in 9 to 14 year old females and will assess the safety and immunogenicity of one and two doses of the vaccine in 4 to 8 year old females. This project will provide data which could broaden the current licensure of the vaccine for those aged only 9 years and above and could facilitate school age based delivery.
Improving the Diagnostics of Childhood Tuberculosis in High Burden Settings
Contact: Prof Beate Kampmann
Funding: Grand Challenge Canada
In order to establish a fast and accurate detection of TB in children a new point-of-care diagnostic test is needed. Professor Kampmann and Dr. Toyin Togun (McGill University) aim to further validate a novel cytokine-based diagnostic biosignature that was identified in unstimulated plasma supernatants from HIV-negative children in The Gambia as part of the MRC-funded program of research into childhood TB, set up by Prof Kampmann since 2012 (Reach4Kids). Secreted cytokines in supernatants harvested from whole blood assays will be measured using a multiplex bead assay.
Reach4Kids Africa: Improving diagnosis and management of childhood tuberculosis in Africa
Contacts: Prof Beate Kampmann
Funding: Medical Research Council Global Challenge Research Fund - Foundation award
Built on the insights and successes of an MRC Programme Grant awarded to Prof Kampmann to improve the management of Childhood TB in The Gambia, funding has been received to extend our diagnostics studies to three additional sites in Africa: Mali, Nigeria and Tanzania. The project is working with colleagues in academic institutions and partners in the National Leprosy and Tuberculosis Programs (NLTP) at all sites to set up prospective cohorts of children with TB- Find and Treat (FaT)- and implement household contact screening at sentinel sites- Screen and Prevent (SaP).
Reach4Kids: Improving diagnosis and management of childhood tuberculosis in the Gambia
Contacts: Prof Beate Kampmann, Dr Uzoh Egere
Funding: Medical Research Council Programme Grant
The diagnosis of TB in children based on microbiological confirmation remains difficult due to the pauci-bacillary nature of the disease. Childhood TB is therefore underreported and underestimated nationally and internationally and preventive strategies are poorly applied. This program of work aims to evaluate performance of current diagnostics, develop new biosignature-based tools, understand household transmission and implement strategies for contact tracing for TB-exposed children that can be integrated into the community care to be delivered by the NLTP.
TB Biomarker study
Contacts: Prof Beate Kampmann, Dr Saikou Bah, Dr Toyin Togun
Funding: National institutes of Health
This NIH-funded collaborative project (PI: M Levin, Imperial College London) will validate previously described biosignatures for the diagnosis of TB in children in stored samples from larger cohorts including from Gambia, South Africa, Malawi using RNA and protein-signatures and bioinformatics approaches.
GAIA Extension : Global Alignment of Immunization safety assessment in pregnancy
Contact: Dr Ed Clarke
Funding: Brighton Collaboration Foundation
This project will assess how case definitions developed by the Brighton Collaboration and their methods of consensus development will perform in a real world field setting of a clinical trial. The GAIA project was launched to meet the WHO’s call for a global approach to active monitoring of the safety of vaccines and immunization in pregnancy, specifically for low and middle income countries (LMIC). It aims to improve the quality of outcome data from clinical and observational studies related to immunization in pregnancy especially in LMIC. Dr. Ed Clarke’ PROPEL trial will be examining the impact analysis of the GAIA outputs, having used these outputs from the start of the study and generating data to be able to assess usefulness and feasibility of various GAIA outputs in The Gambia, which is a LMIC.
Audio-visual tool to train Primary Health workers to strengthen the Expanded Program on Immunization program in The Gambia
Contact: Prof Beate Kampmann
Funding: Bull City Learning
This project is being carried out in collaboration with the EPI program in the Gambia and will develop an audio-visual tool called ‘Speaking Book’ to strengthen the understanding of EPI vaccines by caregivers and health workers and improve their communication.
The book will be recorded by local speakers in both Wollof and Mandinka and its acceptability and utility will be tested in a number of non-MRC affiliated health centres throughout the country using a mixed-methods approach.
Periscope: Developing improved vaccines against pertussis
Contact: Prof Beate Kampmann, Dr Mike Okoye
Funding: European Union/Innovative Medicines Initiative /Bill & Melinda Gates Foundation
This comprehensive multi-partner project aims to better understand immunity to pertussis in order to improve current acellular pertussis vaccines, which appear to offer imperfect protection. We are leading the multi-site clinical trials recruiting infants and pregnant women with one arm being conducted at the MRC Unit The Gambia- the only site in Africa-, 3 others in the UK, Holland and Finland. The aim of these trials is to evaluate the impact of maternal immunisation on responses to whole cell or acellular pertussis vaccination in infancy and impact on longer-term immunological memory.
Maternal IgG and Neonatal Innate Immune Cells
Contact: Dr. Alansana Darboe
Funding: MRC UK-funded IMPRINT Network Fellowship
This study will examine how maternal antibodies activate innate immune cells in the newborn using flow cytometric methods and cell culture techniques. This subject is important to investigate in the context of naturally occurring antibody but also antibody induced by vaccines given to pregnant women. Several mechanisms could influence neonatal immune responses to vaccination and infection, such as direct interaction of the antibody with the neonatal Fc receptors or mechanisms that can induce “trained immunity”. For his study, Dr. Darboe will be collecting and stimulating cord blood samples from babies whose mothers have been vaccinated in pregnancy with TLR ligands and control antigens.