MRC The Gambia Projects

Learn more about the projects for each research theme at MRC Unit The Gambia.

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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.

Making every baby count: a facility-based audit and review of stillbirths and neonatal deaths in The Gambia

Contact: Dr. Uduak Okomo
Funding: Wellcome Trust-ISSF scheme

Dr Okomo won a pump priming grant to do an audit and review of stillbirths and neonatal deaths in a number of sites in The Gambia. The study will take place at government health centres in the Western Region Division, in collaboration with the Ministry of Health and UNICEF. The data will be collected at the labour wards of six major health centres that provide obstetric care in the region. The resulting report will detail the annually births and the total of stillbirths and neonatal death per facility per year in order to better understand the issues relating to maternal and neonatal mortality and prepare for more substantial funding to address them.