Ongoing projects

Prevalence of epilepsy and its potential association with Onchocerca volvulus and Mansonella perstans infection in the Adansi South District of Ghana: A pilot study. 01/04/2024 - 31/03/2025

Abstract

Epilepsy is a common neurological disorder, affecting about 50 million people worldwide with more than 80% of them living in developing countries. Besides the perinatal, traumatic, and metabolic causes of epilepsy, epidemiological associations have been established between epilepsy and several parasitic infections (malaria, neurocysticercosis, onchocerciasis, mansonellosis, etc.). The specific type of epilepsy caused by O. volvulus (known as onchocerciasis-associated epilepsy or OAE) is characterised by sudden seizure onset in previously healthy children between the ages of 3 and 18 years. However, the pathophysiological mechanisms by which O. volvulus can trigger epilepsy are still unclear. We recently discovered a virus inside the O. volvulus parasite, called OVRV1. OVRV1 is closely related to the family of lyssaviruses (e.g.: the rabies virus) and could be involved in the pathogenesis of OAE. So far, few cases of OAE have been reported from West Africa since O. volvulus transmission had been controlled in most of its onchocerciasis foci. However, a persisting hyper-endemic hotspot was identified in the Adansi South District of Ghana, with anecdotal reports of frequent epilepsy in that area. In this pilot project, we seek to determine the epilepsy prevalence in this hyper-endemic Ghanaian area and investigate whether OVRV1 constitutes a risk factor for developing OAE. Another filarial parasite that will be investigated as a potential risk factor for epilepsy is Mansonella perstans, which is also endemic in the target communities. Lastly, we will investigate why onchocerciasis persists in this area despite many years of mass treatment with ivermectin to break the transmission cycle. To achieve this, we will conduct door-to-door epilepsy surveys in the study villages. Epilepsy cases will be identified via questionnaires and clinical examination by trained physicians. All village residents will be questioned about ivermectin intake and reasons for ivermectin refusal documented. Children aged 5-9 years will be tested for onchocerciasis antibodies using a rapid diagnosis test as a measure of ongoing O. volvulus transmission. A nested case-control study will enrol all persons with epilepsy who will be age-and sex-matched with non-epileptic controls, and tested for O. volvulus, M. perstans, and OVRV1 infection. Our findings will be important to make informed decisions for onchocerciasis elimination interventions and epilepsy prevention/management in the study villages. This study also promises to significantly advance research on OAE pathophysiology and disease mechanisms of filarial parasites.

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  • Research Project

Award 'Robert Oppenheimer' - 2023. 01/12/2023 - 31/12/2024

Abstract

Onchocerciasis, caused by the parasite Onchocerca volvulus, is still endemic in Cameroon despite long-term annual community-directed treatment with ivermectin (CDTI). Low CDTI coverage and frequency (once a year) resulted in a high prevalence of onchocerciasis-associated morbidity (skin, eye, and neurological disease). Children infected with O. volvulus between the ages of 5-12 years are at risk of developing onchocerciasis-associated epilepsy. Moreover, O. volvulus infection during pregnancy induces "parasite tolerance" in the neonate and an increased risk to become infected with high parasitic loads, predisposing the child to develop onchocerciasis-associated morbidities. We hypothesize that maternal onchocerciasis has a negative impact on the neuro-cognitive development of the child. This will be investigated by recruiting nursing mothers with different exposures to onchocerciasis during pregnancy, and by monitoring the neurocognitive evolution of their children at 12 and 24 months of age.

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  • Research Project

A platform for equitable global access to whole genome sequencing-guided management and control of drug resistant tuberculosis (MAGMA). 01/05/2023 - 31/12/2024

Abstract

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is the world's most deadly infectious disease with 1.6 million people dying from TB each year. A combination of several antibiotics for 6 to 9 months can cure TB if the infecting Mtb strain is not drug resistant. Every year, there are about 450,000 new cases of rifampicin-resistant TB (RR-TB), which is much more difficult and expensive to treat. To cure RR-TB, it is crucial to have a precise and comprehensive diagnosis of drug resistance for individual patients. To stop the continued global spread of RR-TB, halting the chain of transmission is key. Thanks to the genomic revolution, accurate insights in both drug resistance and transmission events can now be obtained by whole genome sequencing (WGS). At present, WGS of Mtb is done on purified Mtb DNA obtained after one or more lengthy culturing steps. Sequencing Mtb straight from sputum or early positive primary liquid cultures would reduce the sample-to-interpretation timeframe. Analyzing Mtb DNA extracted from these samples is however extremely challenging because of the low amount of Mtb DNA and the high level of human and other micro-organisms contamination in such samples. The TORCH consortium, founded by Prof Van Rie at the University of Antwerp, developed MAGMA (Maximum Accessible Genome for Mtb Analysis), an easy-to-use bioinformatics pipeline specifically created for the analysis of Mtb sequencing data for clinical and public health applications. Even though MAGMA was developed with end-users in mind, the interpretation of resistance profiles and transmission clusters will remain challenging for doctors and public health workers who typically lack bioinformatics expertise. The MAGMA databases and software will also need regular updates and maintenance to remain up-to-date with the rapid scientific developments. To use MAGMA for improved RR-TB care and control, the next steps are valorisation, user-testing, accreditation and endorsement by international organizationssuch as the World Health Organization (WHO). To achieve this, we will work in tandem with Sequentia Biotech, a commercial bioinformatics company with experience in clinical bioinformatics pipelines. Information obtained through surveys with end-users and stakeholders, Sequentia Biotech will be able to create a web platform that generates automated, reliable, and actionable outputs. For doctors, we aim to report and visualize the drug resistance profiles and translate these into the optimal treatment regimen for their patients, thus enabling the use of precision medicine for RR-TB. For regional and national DR-TB reference laboratories, we aim to create a dashboard that monitors resistance to 'old' TB drugs (such as rifampicin, isoniazid, pyrazinamide and fluoroquinolones) and emergence of resistance to new TB drugs (including bedaquiline, linezolid, delanamid and pretonamid). For contact tracing units, we aim to translate the phylogenetic data generated by MAGMA into a dynamic and interactive display of transmission events with identification of superspreading and 'high risk' drug resistance profiles to target public health actions, thus enabling a precision public health approach to RR-TB control.

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  • Research Project

Preparing First Line health care workers in the Flemish health care system for 'virus X', by setting up and validating a training package, using viral hemorrhagic fever as a model (FiLi-Vi-X). 01/05/2023 - 30/04/2024

Abstract

Pandemic preparedness includes many challenges and activities. Healthcare workers in primary care (such as family physicians, emergency room and ambulance workers) play a special role in this. They are the first ones to be confronted with a new threat; missed diagnoses can quickly trigger local outbreaks and further spread, including within the healthcare facility. Effective surveillance therefore requires well-trained staff in the field, who can recognize unusual or high-risk situations, sound the alarm and initiate a proper response. The European Centre for Disease Prevention and Control (ECDC) already recommended our country in 2015 to strengthen the preparedness of first-line healthcare providers. The sudden emergence of COVID-19 in 2020 and of Mpox in Europe in 2022 has demonstrated the variability of how a new threat can emerge. Preparing as generically as possible for a "worst case scenario" is essential; WHO therefore launched the concept of "preparedness for virus X" (2018). The challenge here is to keeping knowledge readily available about rare, impactful pathology, within professionals whose day-to-day expertise lies elsewhere. Viral hemorrhagic fever (VHF) could be used as a proxy for this given its high mortality, high risk for nosocomial infection and permanent risk. VHF often presents itself with small-scale outbreaks, but such high-impact pathogens can spread rapidly if they enter settings that are insufficiently prepared for them. Since 2016, we have procedures and training for VHF in Flanders/Belgium, but these mainly focus on the last part of the response chain. In this project, we want to develop a method and training package that can be used to systematically train first-line healthcare workers at the beginning of the alert and response chain, where alertness, recognition of infectious risk situations and a correct response can be tested and practiced. The package and method will be compiled in consultation with the relevant professional groups and authorities, and will also be tested internationally. To our knowledge, such a didactic program does not yet exist in Belgium, and by extension in Europe, and is therefore a first in its kind. It is therefore the intention within the project to further develop this "ugly" prototype (TRL4) to a TRL6 level (prototype system tested in intended environment close to expected performance). The primary partnership of this project consists of the UAntwerpen (UA), the University Hospital of Antwerpen (UZA) and the Institute of Tropical Medicine (ITG), with Radboudumc as international partner. The three Antwerp institutions already have decades of sustained collaboration in the care of patients with infectious diseases, and in research and training on infectious diseases; they already collaborated intensively in VHF-preparedness and COVID-19 response. Recently, this collaboration was extended to Radboudumc. The project includes four work packages: (1) General coordination and project management; (2) Compilation of didactic package and writing of different exercise scenarios; (3) Organization of a summer course focused on pandemic preparedness within the health system and (4) Performance and analysis of pilot exercises with international validation. During the work, field partners from different disciplines (professional organizations, health authorities, educational experts) will be invited to monitor the content, methodology and improvement cycle within the process. The ultimate goal is that this training package would not only be rolled out within Flanders/Belgium, but could also be further tested and used at the European level to keep front-line workers trained.This partnership will therefore already establish contacts with other European HLIUs during this project in order to further Europeanize this roadmap in a second stage.

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  • Research Project

SEvere MAlaria treatment with Rectal artesunate and Artemisinin-based Combination Therapy [in remote settings] (SEMA ReACT). 01/04/2023 - 31/03/2027

Abstract

Annually, almost 500,000 children under 5 years die from malaria in Africa. Timely access to effective antimalarial therapies is life saving as treatment with pre-referral rectal artesunate (RAS), followed by injectable artesunate and 3 days treatment with ACTs leads to an observed 96% reduction in mortality. Though recommended by the WHO for years, RAS deployment is very limited. The full treatment paradigm is not always feasible when access to primary healthcare facilities is limited due to lack of transport, non-availability of services, and cost. Rollout has recently been paused as outcomes data is incomplete in these contexts making the development of best practice recommendations challenging. Hence the relevance of the proposed study. The proposed project is an observational, non inferiority study in Zambia and DRC. Community Health Care Workers will identify/diagnose, treat and follow up patients with (severe) malaria as part of integrated community case management. We will compare the efficacy of a treatment regimen consisting of pre-referral RAS, then post-referral injectable artesunate, followed by three days of ACT versus a regimen consisting of RAS alone followed by three days of ACT in remote areas. We will compare recurrence rate between the two regimens at Day 28, the number of lives saved, the risk of generating drug resistance. We will assess and mitigate operational and institutional facilitators and barriers in all stakeholders (patients, caregivers, health care providers, regulators, malaria experts) and recommend sustainable policies for this remote context. This generated evidence will support policy development and implementation. The proposed consortium brings together vital experience in the rollout and deployment of rectal artesunate, study design and execution, social science, data collection and management, stakeholder engagement and translation of research results into clinical practice.

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  • Research Project

Reducing onchocerciasis-associated morbidity in children. 01/11/2022 - 14/11/2025

Abstract

Onchocerciasis, caused by the parasite Onchocerca volvulus, is still endemic in Cameroon despite long-term annual community-directed treatment with ivermectin (CDTI). Low CDTI coverage and frequency (once a year) resulted in a high prevalence of onchocerciasis-associated morbidity (skin, eye, and neurological disease). Children infected with O. volvulus between the ages of 5-12 years are at risk of developing onchocerciasis-associated epilepsy. Moreover, O. volvulus infection during pregnancy induces "parasite tolerance" in the neonate and an increased risk to become infected with high parasitic loads, predisposing the child to develop onchocerciasis-associated morbidities. We hypothesize that maternal onchocerciasis has a negative impact on the neuro-cognitive development of the child. This will be investigated by recruiting nursing mothers with different exposures to onchocerciasis during pregnancy, and by monitoring the neurocognitive evolution of their children at 12 and 24 months of age. We also will evaluate a school-based ivermectin distribution strategy (adding to annual CDTI) to obtain six monthly intake of ivermectin by 5-12 year old children to prevent infection and ensuing morbidity. Understanding the impact of onchocerciasis on neurocognitive development during infancy and the possible benefits of an additional ivermectin dose in older children is expected to lead to interventions to preserve the intellectual capital of children in onchocerciasis-endemic regions.

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  • Research Project

Data-driven implementation of a behavioural Antimicrobial Stewardship approach and expert consultancy for a more appropriate use of antimicrobials in Europe (DRIVE-AMS). 01/11/2022 - 31/10/2025

Abstract

Effective response to AMR entails prudent antimicrobial use (AMU) and improvement of AMU surveillance, which are both key priorities of the EU One Health Action Plan on AMR, suggesting antimicrobial stewardship programmes (ASP) need to be strengthened across the Union. ASP as recognised step towards improving AMU, has 3 core components: a) system prerequisites (BASICs, including AMU measurement); b) WHAT the AMS team wants to improve; and c) HOW the AMS team will achieve these goals. In existing programmes, a lot of emphasis is placed on the 'WHAT' of AMS, and little attention is generally paid on the 'HOW' within an ASP: HOW to make sure professionals comply to these 'WHAT' recommendations. This usually requires behaviour change approach. General objective of DRIVE-AMS is to reduce inappropriate AMU through supporting effective implementation of Antimicrobial Stewardship (AMS) interventions using a step-wise behaviour change approach. This objective will contribute to the European and national targets for reducing inappropriate antimicrobial use and tackling AMR. Combining the 3 key elements (measurement, training and implementation) into one DRIVE-AMS course would enhance the impact of data-driven training and sustainable AMS implementation, through: i) understanding AMS principles (BASICS, the WHAT); ii) identifying gaps in AMU by pre-course Point Prevalence Survey (PPS); iii) providing 4-day course on the HOW of AMS, and developing "My Project" AMS intervention; iv) providing 6-month expert support for "My Project" implementation; v) measuring impact by post-course PPS. DRIVE-AMS project will: a)build capacity of national experts; b)deliver national DRIVE-AMS courses; c)provide expertsupport for "My Project" implementation. To enable accessto DRIVE-AMS in rest of Europe, we foresee: a) continuation of national DRIVE-AMS courses, extending capacity (TTT) to other EU countries, continuing G-PPS support, sustaining expert support to EU and non-EU countries.

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  • Research Project

Infectious Diseases Education Advanced Level Intensive Training for a nEw Reality (IDEALiTER) 01/10/2022 - 30/09/2025

Abstract

IDEALiTER is the continuation of the European projects IDEAL and IDEAL+, financed by Erasmus +, for a period of three years (2022-2025). Partnering institutions include: Università Cattolica del Sacre Cuore (Rome), Ethniko Kai Kapodistriako Panepistimio Athinon (University of Athens), Universiteit Antwerpen (Antwerp), UMC (Utrech Medisch Centrum), Hamburg Eppendorf Universitätsklinikum (Hamburg) and Université Paris Cité as well as the associated partners – NHS Lothian (Edinburgh) and Aston University (Birmingham) and the members of the external committee (UniCamillus of Rome and University of Leeds). IDEALiTER is dedicated to students and teachers and intends to deepen the contents of the training courses initiated by IDEAL and IDEAL+. IDEALiTER is therefore a program that improves the initial courses and allows students to deepen their knowledge of infectious diseases, innovative teaching methods and to consolidate a network of health professionals throughout the European Union. Its activities include a yearly 'train the trainer'-course, the organisation of 2 yearly seminars dedicated to a hot topic in infectious diseases in each partner institution, and the yearly organisation of a Summer School. The participating medical students will be able to participate to advanced courses on infectious diseases taught by professors from the European partner universities and summer schools and to access free online resources. Young teachers will be able to learn new and innovative teaching methods, such as "Teach the trainers". This innovative teaching method allows students to be accompanied on several case studies based on symptoms given during the course and allowing diagnosis. Mentoring for other universities in the European Union will also be set up so that they can develop the "IDEAL method" within their program.

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  • Education Project
  • Research Project

Strengthening national efforts to eliminate malaria in Peru (CeroMalariaPeru) 01/09/2022 - 31/08/2027

Abstract

Malaria is one of the most important infectious disease in Peru but now there is a National Malaria Elimination plan launched by the government. This plan requires from research-based evidence to adapt the strategies 'on the road' to malaria elimination scenario. Therefore, we aim to continue and deepen our efforts to provide relevant evidence for malaria elimination in Peru by promoting and empowering the partnership of Amazonian public universities and local, regional and national public health institutions. We seek to potentiate the multidisciplinary health-related research and outreach skills in these institutions, for them to later contribute to the good health and well-being of the most affected populations (indigenous and children) by malaria in Peru. We will assess multiple multidisciplinary approaches that could be implemented in the malaria elimination plan and provide educational information about malaria to the civil society and the affected population.

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  • Research Project

ICP Connect - Master of Epidemiology 01/09/2022 - 31/08/2027

Abstract

The Master Epidemiology is unique in Flanders. Students gain the knowledge, skills and competences required to design and conduct epidemiological research to address the etiology, prevention, screening, diagnosis, and treatment of disease and to enhance or maintain health of people and populations. Three fields of epidemiology are covered in depth: infectious disease, clinical and environmental epidemiology. During the first year, the focus is on gaining in-depth knowledge in the fields of epidemiology, statistics and research methods. In addition, students become acquainted with the practice of epidemiology by attending seminars and workplace visits. In the second year, students expand their methodological knowledge in the course Advanced Methods in Epidemiology, learn how to convert theory into practice in the course Public Health, Policy and Practice, and focus on their own research for their Master's thesis.

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  • Education Project

Project in the field of Onchocerciasis diagnosis. 01/06/2022 - 31/05/2025

Abstract

Objectives 1. Evaluate Onchocerciasis RDTs under development. 2. Collect, analyse and store blood samples from individuals in onchocerciasis endemic areas. Activities Onchocerciasis results in severe itching, blindness and poor socioeconomic development. It has been targeted for elimination by 2030 by the WHO. Current diagnostics for onchocerciasis, including the skin-snipping microscopy, Ov16 ELISA and Ov16 RDT, are limited in their sensitivities. Improved versions of the Ov16 RDT are in development and need to be evaluated to assess their diagnostic performance. Moving these tests along the development pipeline will greatly enhance the diagnostic needs for onchocerciasis and contribute to its elimination. We propose to advance the development of these tests, and evaluate them against current tools through: • Establishing a diagnostic biorepository for onchocerciasis. The availability of a repository for well characterized samples continues to be a challenge for the development and evaluation of new diagnostics for onchocerciasis • Coordination with existing product development partners to evaluate tools in development. This early coordination among partners and evaluation will help identify the best tool to move further in the development pipeline.

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  • Research Project

Antimicrobial Resistance, Prescribing, and Consumption Data to Inform Country Antibiotic Guidance and Local Action (ADILA). 01/04/2022 - 30/09/2025

Abstract

In 2015, the World Assembly endorsed the Global Action Plan (GAP) on antimicrobial resistance (AMR) encouraging countries to develop of National Action Plans (NAP) to tackle AMR. As of 2022, 148 countries had a NAP with an additional 38 countries in the process of developing their NAP. While improvements in collection of microbiology and antibiotic consumption data have been helpful to inform countries of the scale of the issue, guidance on how best to use these data at a country level to inform prescribing practices and improve clinical outcomes based on local priorities is urgently needed. The goal of the 'Antimicrobial resistance, prescribing, and consumption Data to Inform country antibiotic guidance and Local Action' (ADILA) project, funded by the Wellcome Trust, is to optimise the use of AMR surveillance data by developing tools that can be implemented nationally to inform and support individual country's policies on improving the quality of antibiotic use. The proposal aims to learn from the development of clinical surveillance in other disease areas and provide a conceptual framework for future implementation. This project combines expertise on antimicrobial resistance, usage modelling, and policy development. It aims to model existing datasets to provide a framework for future clinical patient-centred AMR surveillance, that can inform empiric prescribing guidance and support local policy decisions. The proposal has been developed to link closely with current and planned WHO AMR initiatives, including the AWaRe handbook, and the work of other key stakeholders.

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  • Research Project

Tuberculosis and non-tuberculous mycobacteria research cluster 01/01/2022 - 31/12/2026

Abstract

Mycobacterial diseases constitute a major burden to global public health, with the best known ones including tuberculosis (TB), leprosy and Buruli Ulcer. In Belgium, around 1000 patients are diagnosed with tuberculosis each year. Proportionally, we struggle more with non-tuberculous mycobacteria (NTM). In 2020, 66% of mycobacterial isolates sent to the National Reference Center were NTMs. The clinical significance of all these isolates however, remains hard to determine. The Mycobacterial unit at ITM has been organizing 'TB Cluster' meetings over the past decade. Some partners already collaborate on (FWO funded) projects, such as the DeepMTB study and the Whole Genome Sequencing (WGS) to streamline TB diagnosis pragmatic trial and on shared supervision of PhD students. Some partners are formally linked through honorary appointments at ITM (Conor Meehan, Emmanuel André). The scientific targets that our collaboration aims to facilitate are: (1) To translate our collective findings on drug resistance from TB to NTM-associated diseases, (2) to incorporate and contribute to the quickly developing landscape of diagnostics and research tools based on DNA/RNA such as on large scale phenotypic screening, and expression analysis as tool for measuring drug resistance and elucidating metabolic pathways; (3) to discuss our own findings and new discoveries from other labs and to teach the associated skills among interested researchers within the network or via exchange with external laboratories; (4) to translate results from bedsite to bench and vice versa by profiting from research units closely related to the clinic/ field sites and basic research units; (5) to translate trial observations into hypotheses and research questions and joint proposals. With these targets we aim at advancing the TB/NTM research in Belgium and strengthen the interaction between the involved research units.

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  • Research Project

StatUA. 01/01/2022 - 31/12/2026

Abstract

StatUa was recognized and funded as a core facility of the University of Antwerp in 2009, with the mission to facilitate scientific research at UAntwerp via statistical and methodological support of researchers. Following positive evaluations, this recognition was renewed twice: in 2011 for the period 2012-2016 and in 2016, for the period 2017-2021. In virtually all fields of research, the importance of proper methodological setup and state-of-the-art statistical analysis is increasing. Since its recognition, StatUa has assisted researchers from all faculties from UAntwerp. This resulted in co-autorship of a StatUa collaborator in over 200 internationally peer-reviewed publications. Moreover, these publications only represent a fraction of all research projects to which StatUa has contributed. Apart from direct support to individual researchers, StatUa has a close collaboration with Antwerp Doctoral School for teaching statistics and methodology to doctoral students, through short courses and hands-on practical sessions. Within the UAntwerp, StatUa is an important and well-known point of contact for researchers with statistical and methodological questions. The primary focus of this proposal is to renew the recognition of StatUa as a core facility, to continue our statistical and methodological support of the researchers at UAntwerp.

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  • Research Project

Unraveling the contribution of Plasmodium vivax metapopulation on the persistence of malaria transmission in residual areas. 01/01/2022 - 31/12/2025

Abstract

Despite adequate coverage of malaria intervention strategies in rural, remote areas, the elimination efforts vanished after some months, and residual malaria persists. Malaria importation might be playing a significant role in the maintenance of local transmission. From a fundamental perspective, this scenario reflects the metapopulation dynamics theory, where the parasite population's subdivisions are geographically dispersed but with limited interaction between the components. Events of extinction and recolonization give the maintenance of the metapopulation. For instance, after an adequate intervention, the parasite population might be diminished, but people returning to their villages carrying imported parasites may revert the effect. The present study aims to study the contribution of Plasmodium vivax metapopulation in the burden of residual malaria in villages sharing watersheds in the Amazon. We will unravel human mobility's role in the recolonization event by integrating epidemiological and travel data with the parasite population genetics. Our project is the first study to address P. vivax metapopulations as a significant challenge for elimination and seeks to develop a genomics platform that distinguishes among highly related parasites. The expected findings could provide crucial insights about a better design of intervention strategies.

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  • Research Project

Culture-free approaches including whole genome sequencing in support of diagnostic and transmission studies on Mycobacterium leprae. 01/11/2021 - 31/10/2025

Abstract

Due to the specific characteristics of mycobacteria, diseases such as tuberculosis (TB) and leprosy are associated with numerous challenges in their diagnosis and associated research. Culture of Mycobacterium tuberculosis is a lengthy process, while M. leprae cannot be cultured on artificial medium at all1. Culture-free solutions are thus a necessity for diagnosis and to gain insights in M. leprae diversity. Such analyses are pertinent to better understand why M. leprae remains hyperendemic in the Comoros and other foci worldwide2, by understanding chains of transmission and drug resistance associated polymorphisms. Indeed, developments in the field of direct-on-biopsy whole genome sequencing (WGS) and associated techniques are further advanced for M. leprae compared to M. tuberculosis. Specifically, this study aims to implement recent advances in RNA bait capture of M. leprae DNA that suggest a more sensitive and cheaper approach to WGS3. The expertise and experience gained will in turn be applicable to direct-on-sputum WGS of M. tuberculosis.

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  • Research Project

Intermittent preventive treatment of malaria in school children: from research into policy. 01/10/2021 - 30/09/2025

Abstract

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

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  • Research Project

Statistical methods for the estimation of age- and time-dependent epidemiological malaria parameters and the analysis of social network data as a novel approach to design malaria elimination strategies. 01/10/2020 - 30/09/2024

Abstract

The aim of this research project is the development of new advanced, state-of-the-art methodology for epidemiologists, mathematical modellers and biostatisticians interested in modelling vector-borne infectious disease transmission. More specifically, we focus on the estimation of age- and time-dependent epidemiological malaria parameters, correcting for other attribute data, governing the spread and transmission of malaria. In addition, interest is in the identification of key individuals responsible for sustained malaria transmission in low transmission settings. Based on social network analysis techniques, we aim at gaining insights relevant for the development of malaria elimination strategies. In conclusion, the main objectives in this proposal are (1) the development of novel methodology to integrate mathematical and statistical models to estimate time- and age-varying malaria epidemiological parameters in the presence of unobserved heterogeneity; (2) the development of approaches to deal with doubly interval censored observations in combination with outcome-dependent sampling and heterogeneity; and (3) the study of heterogeneity in household conditions and individual attribute data using social network data. Although special attention is directed to malaria, the methodology developed in this project is more widely applicable in the context of vector-borne infections in both human and animal populations.

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  • Research Project

Stratified host-directed therapy for drug-resistant tuberculosis: a randomized controlled multi-centre trial (DRTB-HDT). 01/01/2020 - 31/12/2025

Abstract

Tuberculosis is a leading cause of morbidity and mortality worldwide. Current TB treatments are inadequate, requiring patients closely adhere to multi-drug regimens that are long, complex, and often poorly tolerated. These concerns are greatly magnified in rifampicin-resistant (RIF-R) TB, an urgent global and EU public health priority. WHO estimates that only 54% of patients who began RIF-R TB treatment in 2016 were cured. In addition to these wellrecognized shortcomings, current TB treatments, particularly those for RIF-R TB, leave a majority of cured patients with permanent, clinically significant lung impairment and radiographic evidence of bronchiectasis and fibrosis. This project will determine if two adjunctive host-directed therapies (HDTs) can prevent these poor outcomes. 330 patients with RIF-R TB and baseline risk factors for poor outcome will be enrolled in a randomized, controlled, 3-armed multi-centre trial, with clinical sites in Germany, Romania, Moldova, Georgia, Mozambique, and South Africa. All patients will receive standard multidrug therapy according to national guidelines. Those patients randomized to the experimental arms will in addition receive either CC-11050 or metformin. These selected HDT candidates represent 2 complementary HDT strategies: reducing inflammation vs inducing host cell anti-microbial activity, respectively. Both candidates are supported by data from preclinical and clinical studies. Co-primary efficacy endpoints will examine effects on lung function (measured by spirometry) and infection (measured as time to stable sputum culture conversion). A sub-study will examine quantitative change in lung radiodensity by CT scan. If successful, this groundbreaking project will increase Europe's capacity to control RIF-R-TB by developing new treatments that increase the likelihood of cure and reduce the risk of life-long disability.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Past projects

Identifying compensatory mutations in XDR-Mtb strains: understanding the dynamics and mechanisms of transmission 01/11/2021 - 31/10/2023

Abstract

Tuberculosis (TB) continues to be a major global public health threat. The development of drug resistance, and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis (Mtb) especially, pose a major problem to TB control. Transmission of XDR-Mtb strains is in conflict with the dogma that XDR-Mtb strains are less transmissible due to a cumulative fitness costs of resistance conferring mutations. For rifampicin resistant strains for example, it has been shown that mycobacteria can acquire compensatory mutations in the rpoC gene to overcome the fitness cost of resistance conferring mutations. Due to the limited access to large sample sets of XDR-Mtb strains, the transmissibility of XDR-Mtb strains and the effect of compensatory mutations to reverse the fitness cost remain poorly studied. The FWO-funded TORCH consortium houses a whole genome sequence database of around 1000 XDR-Mtb strains collected in the Western Cape Province in South Africa over a 14-year period (2006 to 2020). This exceptional dataset of XDR strains allows an in-depth analysis of XDR-TB transmission dynamics and its evolutionary mechanisms. By combining bioinformatics analyses (identifying XDR-Mtb associated genomic convergence) with spatio-temporal analyses of the XDR-Mtb strains by transmission status we expect to identify novel compensatory mutations and their relative importance to the transmission of XDR-Mtb strains.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Evaluation of molecular point-of-care Xpert® Xpress SARS-CoV-2 detection implementation in resource limited settings (EXPERT-CoV2). 01/07/2021 - 30/06/2023

Abstract

Background. Rapid diagnostic tests of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2) is the cornestone to implement early case detection, contact tracing and isolation as part of the containment and controlling the spread of the deadly virus. The current diagnostic strategy recommended to identify COVID-19 suspects is to detect for the presence of viral RNA to SARS–CoV-2 in respiratory tract samples using molecular tests such as SARS–CoV-2 specific real time polymerase chain reaction (RT-PCR). However, in many resource constrained countries, there is a limited diagnostic facilities and access to molecular tests (RT-PCR) has been challenging. Such tests are usually done in centralized laboratories that are also face acute shortage of skilled laboratory staff, unreliable and weak transportartion network for patients and specimens as well as inefficient systems for result delivery. Recent development of the Gene Expert molecular Point-of-Care (POC) (Xpert Xpress SARS-CoV-2 test , Cepheid) for SARS-CoV-2 testing in the clinic with results delivery within hours of sample collection has been vital in resolving the turn around time (TAT).. The assay is an automated POC for qualitative detection of SARS-CoV-2 in nasopharyngeal swab, nasal wash, or aspirate specimens from suspected patients. GeneXpert are widely rolled up within national tuberculosis (TB) and HIV programmes across the continent. However, evaluation of the diagnostic accuracy of the newly introduced Gene Expert molecular POC SARS–CoV-2 assays and the feasibility of its intergration into the TB/HIV programme has not been evaluated in resource-constrained settings. It is anticipated that the presence of the Gene Expert platform and the introduction of SARS-CoV-2 detection will cater for timely detection of COVID-19 cases, avert fatalities, facilitate containment and lower the burden at the national reference labs. Study objective. This study aims to evaluate the diagnostic accuracy and effectiveness of POC VL in improving the availability of SARS-CoV-2 detection for COVID-19 patient management in decentralized healthcare facilities in resource-constrained settings in Africa. Furthermore, we will implement genomics surveillance of SARS-CoV-2 and other respiratory viruses to elucidate transmission, evolution, and geophaphical spread and inform pandemic control efforts and policies makers at local and regional level. Relevance. The rapid spread of SAR-CoV-2 necessitates urgent improvement in testing capacity at decentralized health facilities in the region. The recent advances in in vitro diagnostic (IVD) assays using Xpert Xpress SARS-CoV-2 (Cepheid) assay has potential to scale up and improve diagnostics in the region to support patients management and response strategies to curtail the spread of SARS-CoV-2. Thereferore, a quick evaluation and deployment of this tool will contribute toward controlling the transmission of SARS-CoV-2 in the population.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

International epidemiology, biostatistics and qualitative research models (I-EBQ). 04/03/2021 - 27/11/2021

Abstract

This course offers a profound training of 6 weeks on the basic principles and methods of epidemiology. An in-depth study of medical statistics with appropriate statistical methods will be integrated with the main epidemiological content. Basic principles of qualitative methods will be explained. Introductory lectures on systematic reviews, health economics and cost-effectiveness are programmed. Throughout the whole course, each participant will have the opportunity to work with his/her own data set (or from the organisers if not available) under the guidance of experienced tutors. Each participant will receive a reader including necessary didactic materials (handouts, power point slides, articles, etc.). To offer a profound training of six weeks in research methods - on the basic principles and methods of epidemiology. - An in-depth study of medical statistics with appropriate statistical methods integrated in the main epidemiological content. - Basic principles of qualitatve methods - Introductory lectures on systematic reviews, health economics and cost-efectiveness

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

The assessment of psycho-social and behavioral response and compliance to restriction measures to prevent and control of Covid-19: an series of rapid surveys. 21/01/2021 - 20/01/2024

Abstract

The aim of this project is to conduct series of investigate Psycho-Social and Behavioral Response and Compliance to Restriction Measures to Prevent and Control of Covid-19 and compose sets of recommendation to governments for further manage country crisis management and recovering plans. The study objectives are: 1. To describe the psychosocial burden and coping capabilities, risk of contracting the diseases and level of adherence behaviors, the current measures recommended by governments and during the first 6 months following implementation 2. To describe the determinants of adherence to the measures recommended by governments (baseline covariates and time-varying covariates) 3. To assess the overall effectiveness of adherence to the measures recommended by governments on the incidence of severe COVID-19 disease 4. To identify the most effective measure (or combination of measures) to reduce the incidence of severe COVID-19 disease and NCD risk and NCDs management during post-covid-19 epidemic. 5. Assess knowledge, understanding and acceptability related to Covid-19 vaccine 6. Psycho-social, stress, performance, and other impacts of covid-19 epidemics during, between and post pandemics of each waves among various samples such as health workers.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Laying the foundation for whole genome sequencing of clinical Mycobacterium tuberculosis isolates in the rural Eastern Cape area of South Africa. 01/01/2021 - 31/08/2022

Abstract

Tuberculosis (TB) remains an important global health concern as efforts are likely to fall short in reaching the 2030 End TB Strategy targets of reducing TB deaths by 90% and TB incidence by 80%. Moreover, recent statistics published by the World Health Organization confirmed fears of a growing drug resistant TB (DR-TB) epidemic, which further threaten TB control. South Africa is faced with dual HIV and TB epidemics and is a hotspot for DR-TB, with one of the highest burdens of multidrug resistant TB (MDR-TB) in the world. Within South Africa, the Eastern Cape, Western Cape and KwaZulu-Natal provinces suffer the highest burden of both MDR-TB and the very hard-to-treat, extensively drug resistant TB (XDR-TB). Whole genome sequencing (WGS) allows for the complete analysis of the Mycobacterium tuberculosis (Mtb) genome and identification of all known drug resistance conferring mutations. The rapid advancement of WGS technology and its decreasing cost have made it more accessible for use in research and have opened the possibility of its application in public health, even in low resource settings. The high resolution of WGS also provides the opportunity to study the genomic variants of pathobiology, decipher transmission, detect mixed infections, investigate the emergence of drug resistance, and to discover novel mechanisms of drug resistance, thereby ensuring a better understanding of factors that drive the DR-TB epidemic. Despite the ostensible benefits and decreasing costs, WGS has not yet found its rightful place in research or care of DR-TB patients in high TB burden settings due to the limited local expertise in the extraction of high quality Mtb DNA, a critical requirement for successful WGS, and the lack of personnel with the bioinformatics skills that are required for analysis and interpretation of WGS data. The overall goal of this project is to establish a new collaboration between the Global Health Institute of the University of Antwerp (UAntwerp) (Dr Anzaan Dippenaar) and the Department of Laboratory Medicine and Pathology, Water Sisulu University (WSU), South Africa (Dr Teke Apalata) in order to lay the foundation for successful future collaborative research between these two groups in the area of Mtb WGS. In order to build capacity, advance technology transfer, and plant the seeds for future collaboration, we propose a highly cost effective and innovative blended learning capacity building approach to Mtb culturing, DNA extraction for WGS and bioinformatics analyses of WGS data. In the current pandemic situation and with foreseeable future budget restrictions, novel approaches to North-South capacity building are needed. Due to the COVID-19 global pandemic, higher education has undergone massive migrations from traditional face‐to‐face education to online teaching using diverse digitalization strategies. Current online and blended learning, however, primarily focus on providing knowledge, taking tests, and offering online support. Most university have opted to keep practica on campus and in person. In this project, we aim to expand the current blended learning to hands-on, laboratory-based training by implementing novel approaches such as the "lab-in-the-box", live-streaming online demonstrations of laboratory procedures, and online monitoring of independent implementation of laboratory procedures to ensure that the technical nuances and complexities of Mtb DNA extraction and WGS bioinformatics analyses are taught in a "COVID-proof" and cost-effective manner.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Evaluating the impact of covid-19 pandemic on the malaria burden in indigenous communities in the Peruvian Amazon. 01/01/2021 - 31/08/2022

Abstract

Malaria caused around 229 million infections and 409,000 deaths in 2019. Worldwide efforts to control and eliminate malaria have reduced its morbidity and mortality; however, the progress has stalled in the last four years, remaining a major problem on public health in endemic countries. Since last year, the world has been facing the emergence and spread of COVID-19, which rapidly spread and caused massive global disruption on public health systems, impacting peoples' lives and wellbeing. Therefore, considering that context, malaria epidemics, or resurgence in free-malaria settings can occur, and no reliable data from malaria-endemic areas is available, such as the Peruvian Amazon. In 2020, most malaria cases in Peru were concentrated in Amazonian regions: Loreto (91%) and Amazonas (8%). Cases were distributed across rural communities, featuring frequent asymptomatic and submicroscopic infections. Due to the pandemic, health posts and hospitals and surveillance activities were disrupted, contributing to missed case detections and under-reporting malaria cases in both regions. For instance, until mid-July 2020, no malaria cases were reported by the health authorities of Loreto and Amazonas, highly contrasting with previous years' reports from these regions. Reliable local data is urgently needed from endemic malaria areas to assess the impact of the COVID-19 pandemic and avoid malaria control gains over the past years. Therefore, we propose to measure the impact of the COVID-19 pandemic on the malaria burden and care in remote indigenous malaria-endemic communities of the Peruvian Amazon using mixed research methods, considering the following objectives: 1. To determine the prevalence of malaria (symptomatic and asymptomatic cases) through microscopy and molecular analysis of blood samples. 2. To determine the risk factors associated with malaria in the context of the COVID-19 pandemic through household surveys. 3. To explore indigenous communities' population's insights/perceptions about the pandemic impact on malaria care through semi-structured interviews. The information generated will assist local health authorities to plan opportunistic malaria contingency strategies, improve the intervention programs in indigenous communities during pandemic events, and provide better access to healthcare facilities for indigenous populations. The MALCOVA study will be performed in the Condorcanqui Province, located in the northern jungle of the Amazonas Region of Peru. Condorcanqui is divided into three districts: Nieva, El Cenepa, and Rio Santiago, and it has an extension of 17,892 km2, with an estimated population of 42,470 inhabitants (native and mestizos). Considering the Health Rectorate of Amazonas' communities' census, a simple random sampling method will be performed through door-to-door visits to enrol eligible participants. The participants will be considered in the study only if informed consent/assent is signed. This study will be performed in collaboration with two local Peruvian institutions, Universidad Nacional de Toribio Rodriguez de Mendoza de Amazonas (UNTRM) and the Regional Directorate of Health of Amazonas (DIRESA Amazonas). The local ethical committee at UNTRM has recently approved the study protocol. The study will be funded by the Global Minds Small project grant (2021-2022) awarded to Dr C. Delgado (UAntwerp) and local Peruvian funds.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Identification of compensatory mutations in XDR-Mtb strains: understanding the dynamics and mechanisms of transmission. 01/11/2020 - 31/10/2021

Abstract

Tuberculosis (TB) continues to be a major global public health threat. The development of drug resistance, and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis (Mtb) especially, pose a major problem to TB control. Transmission of XDR-Mtb strains is in conflict with the dogma that XDR-Mtb strains are less transmissible due to a cumulative fitness costs of resistance conferring mutations. For rifampicin resistant strains for example, it has been shown that mycobacteria can acquire compensatory mutations in the rpoC gene to overcome the fitness cost of resistance conferring mutations. Due to the limited access to large sample sets of XDR-Mtb strains, the transmissibility of XDR-Mtb strains and the effect of compensatory mutations to reverse the fitness cost remain poorly studied. The FWO-funded TORCH consortium houses a whole genome sequence database of around 1000 XDR-Mtb strains collected in the Western Cape Province in South Africa over a 14-year period (2006 to 2019). This exceptional dataset of XDR strains allows an in-depth analysis of XDR-TB transmission dynamics and its evolutionary mechanisms. By combining bioinformatics analyses (identifying XDR-Mtb associated genomic convergence) with spatio-temporal analyses of the XDR-Mtb strains by transmission status we expect to identify novel compensatory mutations and their relative importance to the transmission of XDR-Mtb strains.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

International epidemiology, biostatistics and qualitative research models (I-EBQ) 19/10/2020 - 27/11/2021

Abstract

UC Leuven This course offers a profound training of 6 weeks on the basic principles and methods of epidemiology. An in-depth study of medical statistics with appropriate statistical methods will be integrated with the main epidemiological content. Basic principles of qualitative methods will be explained. Introductory lectures on systematic reviews, health economics and cost-effectiveness are programmed. Throughout the whole course, each participant will have the opportunity to work with his/her own data set (or from the organisers if not available) under the guidance of experienced tutors. Each participant will receive a reader including necessary didactic materials (handouts, power point slides, articles, etc.). To offer a profound training of six weeks in research methods - on the basic principles and methods of epidemiology. - An in-depth study of medical statistics with appropriate statistical methods integrated in the main epidemiological content. - Basic principles of qualitatve methods - Introductory lectures on systematic reviews, health economics and cost-efectiveness

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Perform a systematic review of the published literature and unpublished data from ongoing clinical trial on diagnostic accuracy on commercially available hybridization-based technology for pyrazinamide resistance detection. 01/10/2020 - 31/12/2020

Abstract

The goal of the systematic literature review and meta-analysis is to estimate the diagnostic accuracy of the PZA LPA assay for detection of PZA resistance in cultured MTB isolates and sputum samples from patients diagnosed with pulmonary TB with or without rifampicin resistance using three different reference standards: phenotypic DST (pDST), genotypic DST (gDST) and a composite reference standard (CRS). The goal is to, if the data allows, to estimate the diagnostic accuracy of the PZA LPA overall and stratified by sputum smear microscopy status, rifampicin resistance status and treatment outcome.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Realistic forecasting, control and preparedness for coming COVID-19 waves (RESTORE). 22/05/2020 - 21/05/2021

Abstract

Over the following months Belgian society will be asked to adapt its behavior in order to keep the COVID-19 outbreak under control and not to jeopardise our healthcare system. This calls for an expertbased policy that is supported by accurate medium-term model forecasts on the further COVID-19 progression to assess the impacts of possible control and containment measures. For that purpose, we will start from established population-based SEIR-models and extend these to account for age- and space-dependent disease dynamics, the stochasticity intrinsic to disease spread and hospital bed capacity. These extended models will be complemented with a socioeconomic model to quantify the effects of measures on consumption, labor supply and economic activity. Finally, a controller will be developed that interacts with the aforementioned models to identify the optimal set of control and mitigation measures. The extended and holistic SEIR modeling framework offers a solid basis for providing Belgian healthcare institutions and policy makers with more accurate predictions. Currently, the consortium already provides short-term forecasts to policy makers, and hence it has all connections and simple models in place to guarantee a swift delivery of improved tools.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Heteroresistance: an occult threat to the treatment success of resistant tuberculosis Acronym "DeepMTB". 01/01/2020 - 31/12/2023

Abstract

Rifampicin-resistant (RR) tuberculosis (TB) is an especially lethal form of TB, with less than 50% of over 0.5 million patients affected each year reaching successful treatment outcomes. Due to difficulties in defining the full drug resistance profile in each individual patient, there is a tremendous risk of losing key classic- (fluoroquinolones) and new drugs (bedaquiline (BDQ)) at a faster pace than novel drugs can be developed. The Mycobacteriology Unit at ITM is uniquely placed due to its key role as central microbiological laboratory for the largest RR-TB trials conducted to date. The two STREAM and two endTB trials, enrolling over 2000 patients, allow to robustly assess the impact of heteroresistance on treatment outcomes. In collaboration with the University of Antwe , we will use innovative, state-of-the-art methods to test the hypothesis that heteroresistance at RR-TB treatment initiation is associated with microbiological failure. We will be the first to apply targeted deep sequencing to clinical samples of RR-TB clinical trial participants and to quantify culture bias in the detection of heteroresistance. In addition, we aim to quantify the effect of treatment interruption on acquisition of resistance to BDQ, which poses a threat to the durability of new RR-TB regimens. The results will provide a leap forward in our knowledge and provide evidence required for defining the most appropriate diagnostic and management strategies for patients afflicted by RR-TB.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Phase Out of Institutional University Cooperation. 01/01/2020 - 31/12/2021

Abstract

The phase out progamme is the period provided by VLIR-UOS to summarize and document all the accomplishments and lessons learned from the IUC Partner Programme. In this case the IUC-LIMPOPO that lasted for10 years

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Nodding syndrome and Onchocerciasis associated epilepsy (OAE). 01/12/2019 - 30/09/2020

Abstract

Background Epidemiological evidence suggests a strong association between onchocerciasis and epilepsy. A recent cohort study investigating the temporality of this association reported an increased risk to develop epilepsy following childhood infection with Onchocerca volvulus, with a strong dependence on the initial parasite load. Communities with high transmission of onchocerciasis are often confronted with a high burden of debilitating seizure disorders mainly affecting children and adolescents aged 3–18 years. These clinical conditions fit into the spectrum of onchocerciasis-associated epilepsy (OAE), which regroups generalized/focal epilepsy, nodding syndrome (NS), and Nakalanga features. The natural history of OAE is still poorly understood. However, follow-up data of persons with NS in Uganda suggests that the disease begins with an initial debilitating phase, which evolves towards the more conspicuous convulsive manifestations. This is confirmed by surveys in Cameroon where several persons with epilepsy (PWE) often showed signs of cognitive impairment reported to have started during their childhood or early adolescence. While seizure-related mechanisms can lead to cognitive deficits in PWE, it remains unclear if in the case of OAE, cognitive decline precedes the onset of seizures or is rather a consequence of the enduring epileptogenic state. A plausible hypothesis could be that an insidious deterioration of the cognitive function may occur before the onset of full-blown motor seizures observed in persons with OAE. Objectives and Methods The general objective of the proposed research is to identify early neurocognitive symptoms of OAE which could prompt rapid treatment, thus optimising patient prognosis. Specific objectives and methods include: • Neurocognitive assessment in children without epilepsy aged 5–15 years in onchocerciasis-endemic settings using validated tools • Investigating exposure to O. volvulus in these children by testing for Ov16 IgG antibodies testing by ELISA (as recommended by the World Health Organisation) • Case-control study comparing neurocognitive outcomes in onchocerciasis-exposed children (cases) and unexposed children (controls) • Community follow-up of all enrolled children to monitor signs of epilepsy onset Relevance Our findings would improve our understanding of the natural history of OAE, and thus inform policy makers regarding required interventions in affected communities. Our study addresses a real global health problem as it focuses on a neglected disease of poverty (onchocerciasis) and its interaction with a non-communicable condition (epilepsy). This project could result in strategies for early detection and management of OAE, but could also motivate stakeholders to strengthen onchocerciasis elimination efforts in epilepsy hotspots which are hyper-endemic for onchocerciasis.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

International training on epidemiology, biostatistics and qualitative research methods (I-EBQ). 20/10/2019 - 30/11/2019

Abstract

UC Leuven This course offers a profound training of 6 weeks on the basic principles and methods of epidemiology. An in-depth study of medical statistics with appropriate statistical methods will be integrated with the main epidemiological content. Basic principles of qualitative methods will be explained. Introductory lectures on systematic reviews, health economics and cost-effectiveness are programmed. Throughout the whole course, each participant will have the opportunity to work with his/her own data set (or from the organisers if not available) under the guidance of experienced tutors. Each participant will receive a reader including necessary didactic materials (handouts, power point slides, articles, etc.). To offer a profound training of six weeks in research methods - on the basic principles and methods of epidemiology. - An in-depth study of medical statistics with appropriate statistical methods integrated in the main epidemiological content. - Basic principles of qualitatve methods - Introductory lectures on systematic reviews, health economics and cost-efectiveness

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

IDEAL+ Ifectious DisEases Learning 01/09/2019 - 31/08/2022

Abstract

The overal aim of this project is: to combat antimicrobial resistance (AMR) and health care associated infection in Uganda through improved education and training of health care professionals. We aim to reach this overall objective through 4 broad specific objectives: Objective 1. To have an actualized and locally relevant undergraduate curriculum for all health care professionals in the fields of AMR, antibiotic stewardship (ABS) and health care based infection prevention and control (IPC).

Researcher(s)

Research team(s)

Project type(s)

  • Education Project

Development of novel methods to predict the drug resistance phenotype of Mycobacterium tuberculosis variants. 01/01/2019 - 31/12/2022

Abstract

Every year, ten million people develop tuberculosis (TB) and 1,7 million people die from TB. About 600,000 people are diagnosed with TB resistant to rifampicin, a key first-line TB drug. Drug resistant TB thus poses a global public health problem and threatens global TB control. Whole Genome Sequencing (WGS) is an innovative method to detect drug resistance, but current drug resistance tools can only predict the resistance profile for a small proportion of the over 2000 genetic variants that may be associated with resistance. Furthermore, in late 2018, the WHO will prioritize fluoroquinolones (FQ) and bedaquiline (BDQ) as two of the three core drugs for treatment of rifampicin resistant TB. While FQs are a well-studied class of antibiotics, BDQ is a new drug. Consequently, genotype-phenotype data is limited, and no mutations have been statistically associated with BDQ resistance. New tools to predict resistance are needed to make optimal clinical use of WGS. In this project, I will develop two different methods for prediction of drug resistance in Mycobacterium tuberculosis. In the first method, I will apply pattern mining methods to assess alteration of the drug binding site as a resistance mechanism, by modelling the drug-drug target interaction. In the second method, I will assess regulatory resistance mechanisms, such as upregulation of efflux pumps, by modelling transcriptional changes caused by genetic mutations.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

A personalized recommendation system for whole genome sequencing based and individualized tuberculosis treatment. 01/01/2019 - 31/12/2022

Abstract

Tuberculosis (TB) continues to be a global public health problem with 10.4 million new cases and 1.4 million TB deaths annually. About 600 000 of these new TB cases are resistant to rifampicin, the most important first line drug. In this PhD project I aim to bring Whole Genome Sequencing (WGS) as a diagnostic method, currently mostly used in research, to the patient. Interpretation of WGS data requires expertise which is unavailable in high burden countries, I will bridge this gap by developing a software suite which automatically interprets the WGS data and recommends the optimal individualized treatment regimen for each patient, also taking clinical patient information into account. Additionally, the software will also be able to, dependent on the region and based on the prevalence of drug resistance in that region, detect unexpected drug resistance patterns in patients. For these patients, additional drug susceptibility tests (DSTs) will be recommended. The software will have an easy to use interface where health care workers can enter the clinical patient data. The WGS results will be combined with the clinical information and the results will be made available to the health care worker. Depending on the expertise of the health care worker, additional details describing the decision process towards the optimal regimen and DST recommendation can be made available. This all-inclusive software suite will allow for easier diagnosis and treatment of drug resistant TB.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Improved infectious diseases control in Peru through sustainable capacity building for bioinformatics and genome sequencing. 01/01/2019 - 31/08/2022

Abstract

The Peruvian population is adversly affected by infectious diseases and current govermental efforts are not sufficient to reduce the burden. While bioinformatics and genomics are relatively new approaches in molecular epidemiology, they have already made important contributions to the health of patients and populations. Bioinformatics and genome sequencing capacity in Peru is still extremely limited. Public universities like UNSA in Arequipa and UNAP in Loreto could play a major role in regional and national level infectious disease control by providing further insights in the molecular epidemiology of the infectious diseases in Peru. We propose to develop sustainable capacity in bioinformatics and sequencing through the development of a academic network between 3 universities in Peru and 2 institutions in Belgium. We selected topics of local public health importance: malaria, tuberculosis and antibiotic resistance. For these diseases, next generation sequencing can significantly improve diagnostics, surveillance and control, thus contributing to better health of the population of Peru.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

African network to study, treat and prevent onchocerciasis associated epilepsy (OAE-Africa). 01/01/2019 - 31/08/2022

Abstract

Recently, the consortium involved in this project collected strong clinical and epidemiological evidence that nodding syndrome is one of the clinical presentations of onchocerciasis (river blindness)-associated epilepsy (OAE) and that this form of epilepsy is preventable by strengthening onchocerciasis elimination programs. Despite this evidence there is still little awareness about the important public health problem caused by OAE and a complete lack of interventions to address the problem. Eight African partners of the Democratic Republic Congo, Uganda and Tanzania, all with complementary OAE expertise, will be involved in the project. By increas-ing their research capacity and through multi-country studies we hope to solve the remaining OAE research questions. Moreover, by joining forces, including the organisation of a high profile international workshop on OAE, we aim to put OAE on the international development agenda. This project will increase OAE awareness among affected communities, local health care workers, health policymakers and hopefully funders in order to take appropriate actions.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Mycobacterium Tuberculosis transmission dynamics among university students in Ethiopia: a whole genome sequencing study. 01/01/2019 - 28/01/2022

Abstract

Where TB occurs in high incidence settings like Ethiopia its transmission is not well studied, as traditional research methods struggle to distinguish the large number of transmission chains in these settings due to insufficient resolution. Whole genome sequencing (WGS) is a new powerful technology for characterisation of bacterial genomes and has been successfully used to investigate M. tuberculosis isolates associated with TB outbreaks and to establish the transmission link between the index and contact cases. WGS also has the potential to identify and characterise source cases that are particularly effective in generating secondary cases. We will use WGS sequencing methods and novel phylogenetic approaches to study the dynamic and location of TB transmission in the Ethiopian university environment. We will also characterise the identified transmission clusters in terms of correlated social and demographic factors. A better understanding of hotspot transmission locations, and methods to identify and characterise source cases therein, are urgently required to improve tuberculosis control in the Ethiopian university setting.

Researcher(s)

Research team(s)

Project website

Project type(s)

  • Research Project

Hyperendemic M. tuberculosis from a hypertemporal genomic perspective (HyperMTB). 01/05/2018 - 30/04/2019

Abstract

The Karonga Prevention Study has collected, cultured and genome sequenced more than 2000 sputum samples from 1995 to 2014. We will apply a range of phylodynamic methods to investigate the evolution of Mycobacterium tuberculosis over this period. This study will investigate factors involved in strain success, outbreak likelihood of strains and the impact of interventions on strain diversity.

Researcher(s)

Research team(s)

Project website

Project type(s)

  • Research Project

Multi-disciplinary approach to control onchocersiasis-associated epilepsy in the Mahenge area in Morogoro region, Tanzania. 01/01/2018 - 31/08/2022

Abstract

Despite the use of ivermectin (IVM) once annually for control of onchocerciasis (oncho) (= river blindness) in Mahenge Tanzania, the prevalence of oncho and epilepsy remains high. There is increasing evidence that epilepsy is a complication of oncho and that treatment of oncho can not only eliminate blindness but also reduce epilepsy. Our proposed project aims to: 1) strengthen the multi-disciplinary research capacity for the prevention of oncho and epilepsy in Tanzania. We will establish an oncho-associated epilepsy (OAE) research group to support a master and a PhD-level student in the development of research protocols addressing OAE in the Mahenge region; 2) reduce the prevalence of oncho and the incidence of epilepsy in the Mahenge area by: a) establishing a surveillance system for early diagnosis of epilepsy; b) strengthening and implementing an effective community distribution of IVM; 3) Implement evidence-based guidelines to treat OAE by training local health care workers; 4) introduce community advocacy on epilepsy, epilepsy-associated stigma and discrimination.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Joint efforts for the elimination of Malaria in the Peruvian Amazon. 01/01/2018 - 31/08/2022

Abstract

Malaria burden severely affects the population living in the Peruvian Amazon, which is also affected by low-living conditions. Currently, the Peruvian government has launched the Malaria Elimination program in the Amazon and requires evidence-based research to improve its program. UNAP is the main university in the Peruvian Amazon and is looking to become a key role player on the development of the region by supporting this elimination initiative. The first steps of supporting UNAP becoming more active on research were initiated through a triangular collaboration between UNAP, UPCH and UAntwerp in 2016 (VLIR SI). Here by, we intend to continue and strengthen this collaboration by actively developing educational and research capacities on epidemiology, data analysis and population genetics at UNAP. Constant training through students/professors exchange, courses given by UAntwerp/UPCH professors at UNAP and joint research related to malaria elimi-nation tools encircle the strategy proposed on this VLIR TEAM project.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Improved infectious diseases research and surveillance in Ethiopia through capacity building in bioinformatics and sequencing. 01/01/2018 - 31/08/2022

Abstract

Even though bioinformatics and genomics are relatively new biomedical disciplines, they have already made important contributions to the health of patients and populations. Bioinformatics and genome sequencing ca-pacity in Ethiopia is however extremely limited. African scientists are well positioned to play an important role in sequencing-based surveillance and research because the cost of sequencing technologies has dropped dra-matically, internet connectivity is constantly improving, and bioinformatics software tools are often freely availa-ble. We propose to develop sustainable capacity in bioinformatics and sequencing surveillance and research through an academic collaboration between Ethiopia, South Africa and Belgium. We selected topics of local public health importance: hospital acquired infections, vector borne diseases and tuberculosis. For these dis-eases, sequencing can significantly improve diagnostics, surveillance and control, thus contributing to better health of the population of Ethiopia.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Development of a policy to stop the suffering caused by Nodding Syndrome and Onchocerciasis associated epilepsy (NSstop). 01/09/2017 - 28/02/2019

Abstract

Nodding syndrome (NS) is a form of epilepsy, characterized by head-nodding, often associated with severe intellectual disability, psychiatric problems, and early death. Initially, NS was reported only in onchocerciasis-endemic regions in Tanzania, Uganda and South Sudan. Until recently, the cause of the syndrome was unknown. Therefore, no strategy for prevention and cure was possible. Our ERC project (NSETHIO) discovered that NS is only one of the clinical presentations of onchocerciasis associated epilepsy (OAE) and that this form of epilepsy is probably present in all onchocerciasis endemic regions where onchocerciasis is insufficiently controlled. We estimate that the number of excess cases of epilepsy due to onchocerciasis could be as much as 100,000. Based on NSETHIO findings we will develop an innovative comprehensive OAE policy plan that will prevent children from developing OAE and that will reduce the negative consequences of OAE for the economy and society. This plan includes the following components: strengthening community directed ivermectin (IVM) treatment programs (IVM will stop OAE), establishing an SMS based epilepsy surveillance system by epilepsy trained community-directed IVM distributors, developing a community-based care system using evidence based OAE treatment algorithms, and a community-awareness program. We will fine tune the plan during 2 OAE stakeholder workshops, field test it in a high OAE prevalence health zone and calculate its cost. We will create an international OAE alliance including scientists and health care workers, representatives of communities and advocacy groups, WHO, Ministries of Health, non-governmental organizations, the pharmaceutical industry and donors to scale up the implementation of these interventions after the end of the NSstop project. Reducing the burden of disease caused by OAE will have great positive cultural, societal and economic impacts on affected families and villages in many parts of Africa.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

The impact of intermittent preventive treatment strategies in reducing malaria and improving cognitive ability in school-aged children: a neglected control domain with an considerable develompent impact. 01/01/2017 - 31/08/2022

Abstract

Despite the recent gains, malaria still remains the major cause for mortality and morbidity among children. Further, recent advancements in malaria control is associated with an increased burden of malaria in school children due to delayed in acquisition of protective immunity. Co-morbidities with soil transmitted helminths (STH) and i.e malnutrition compounds the problem even further. Intermittent preventive treatment in school children (IPTc) in school children may be an efficient and effective control strategy. However, today Sulfadoxine-pyrimethamine monotherapy is the only recommended drug to be used as IPT despite the widespread of SP resistant strains. Therefore, there is an urgent need to evaluate alternative drugs to be used for IPTc. Therefore, we'll conduct a clinical trial to compare the efficacy and safety of IPTc using dihydroartemisinin plus piperaquine (DHA-PQ), SP-PQ, SP alone and control group in high SP-resistance setting. Further, using a mixed design methods, we will assess the acceptability, (cost-)effectiveness and feasibility of this strategy as part of a more comprehensive school health package. In combination other proven school health control activities (i.e. addressing chronic and acute malnutrition, optimizing strategies for interrupting geo-helminths).

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Development of a Centre for Whole Genome Sequencing studies of Mycobacterium. 01/10/2016 - 30/09/2021

Abstract

Tuberculosis (TB) is a global problem, with > 9 million cases annually and rising numbers of multi-drug resistant TB (MDR-TB). In the 1990's, IS6110 DNA fingerprinting revolutionized the study of Mycobacterium tuberculosis (MTB). Using this technique, I performed groundbreaking studies that proved exogenous reinfection, challenged the dogma that most TB cases are due to re-activation of latent infection, opposed the belief that most MDR-TB is acquired, and demonstrated mixed infection (NEJM 1999, JID 1999, Lancet 2000, AJCCRM 2005). The recent development of high-throughput, relatively low-cost whole genome sequencing (WGS) raises again the promise of significant gains in molecular epidemiology of MTB. Arriving at new paradigms however demands that inferences of WGS data on phylogeny, transmissibility, virulence and resistance are contextualized and integrated with clinical and demographic meta-data in large-scale studies to test the hypotheses generated by small-scale studies on isolates collected in low TB burden countries. As a clinical and molecular epidemiologist, I propose to establish and direct a multidisciplinary Centre for WGS studies of MTB at the University of Antwerp. The Centre will embed itself in the molecular microbiology laboratory of Prof Herman Goossens, who has substantial expertise in WGS research of pathogens other than MTB. The Centre will work in close collaboration with Prof Robin Warren of the South African Centre of Excellence for Biomedical Tuberculosis Research (CEBTR), Stellenbosch University. Access to the ~50,000 MTB strains in the CEBTR biobank will provide a unique opportunity for the Centre to perform molecular epidemiological MTB studies that address ground-breaking basic science and molecular epidemiological questions. To maximize the public health gains of WGS, we will focus on studies of MTB transmission dynamics in a high TB burden setting, the role of epistatis in emergence of drug resistance, MTB adaptation to drug pressure, and within-host MTB diversity.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Nodding Syndrome: a trans-disciplinary approach to identify the cause and decrease the incidence of river epilepsy (NSETHIO). 01/10/2015 - 30/11/2021

Abstract

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

Researcher(s)

Research team(s)

Project website

Project type(s)

  • Research Project

Phase II partner programme (2015-2019) for the Institutional University Cooperation between the University of Limpopo and the Flemish universities. 01/04/2015 - 31/12/2019

Abstract

This project represents a formal research agreement between UA and on the other hand VLIR. UA provides VLIR research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

The relevance of the family in adressing food, health and environment insecurity. 01/04/2013 - 31/03/2019

Abstract

This project represents a formal research agreement between UA and on the other hand VLIR. UA provides VLIR research results mentioned in the title of the project under the conditions as stipulated in this contract.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Below you can find the current projects of the academic staff members that act as promoter, copromoter or grant holder (FWO/IWT). It concerns only those research projects and mandates that were acquired after an external or internal competition.

Strengthening national efforts to eliminate malaria in Peru (CeroMalariaPeru)


Improving diagnostics and care for childhood onset epilepsies and its common neurological co-morbidities in Tanzania (Joint-COE)

Abstract

Childhood onset epilepsies (COE) are important causes of childhood morbidity in Sub-Saharan Africa (SSA), and are frequently accompanied by neurodevelopmental disabilities such as intellectual disability (ID). The treatment gap in SSA amounts to 80%, and stigma associated with both epilepsy and ID further increase disease burden for children and caregivers. Genetic factors are assumed to play a major role in COE, but access to genetic testing is non-existing in Tanzania. In this project we will 1) strengthen the research capacity on COE in Tanzania by establishing a research group supporting resident neurologists and PhD students in the development of research protocols addressing COE in Tanzania, and 2) improve quality of life of children with epilepsy (CWE) in Tanzania by a) improving diagnosis and care for CWE, by strengthen-ing medical education and local implementation of genetic testing; b) reducing the treatment gap by educa-tion of caregivers of CWE, c) improving access and quality of community-based rehabilitation programs

Funding(s)

VLIR-UOS

Researcher(s)

Period

01/01/2020 - 31/12/2021

An international academic Family Medicine Network on interprofessional collaboration

Abstract

The aim of the project is to create an international platform for the participating universities to exchange case-driven experiences and proven solutions at two levels: 1. train FM/PHC professionals in the competencies of interprofessional team working in the participating countries by exchanging working experiences via an interactive web-based platform and 2. increase knowledge, skills and expertise about early recognition and self-management of type 2 diabetes mellitus (T2DM) ) through interprofessional learning at community health centres (CHCs) and private clinics in urban and rural areas.

Though the focus of the case-based experiences will be on T2DM early detection and self-management, the main purpose of this project will be on exchanging needs and experiences for working interprofessionally by the participating academic centres via a web-based platform. There will be a yearly live meeting and regular (bimonthly) webinars or digital meetings (zoom, skype, …) of the leading teams in the different countries, and monthly meetings of the national network of (urban, rural, remote,…) participating CHCs and private clinics within each country.

Funding(s)

Researcher(s)

  • Johan Wens
  • Minh Tam Nguyen

Period

01/01/2020 - 31/12/2021

EBOVAC3: Open-label, Randomized, Clinical Trial to Evaluate the Immunogenicity and Safety of a Prophylactic Vaccination of Health Care Providers by Administration of a Heterologous Vaccine Regimen Against Ebola in the Democratic Republic of the Congo

Summary

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

Funding

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

Role of GHI

UA coordinator: Pierre Van Damme

UA Co-coordintor: Jean-Pierre Van geertruyden

Researchers: Antea Paviotti and Kanchana Withanage

Doctoral students: Gwen Lemey, Ynke Larivière, Irene Garcia-Fogeda and Maha Saloum

Co-project managers: Gwen Lemey and Ynke Larivière

Administrative and financial coordinator: Paul Peter Vermeiren

Data Manager: Bernard Osang'ir

Personal assistant co-sponser: Nele Brusselaers

Partner(s)

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

Period

01/06/2018 - 31/05/2023

more information on EBOVAC3 website and IMI project portal

Improved infectious diseases control in Peru through sustainable capacity building for bioinformatics and genome sequencing

Abstract

The Peruvian population is adversly affected by infectious diseases and current govermental efforts are not sufficient to reduce the burden. While bioinformatics and genomics are relatively new approaches in molecular epidemiology, they have already made important contributions to the health of patients and populations. Bioinformatics and genome sequencing capacity in Peru is still extremely limited. Public universities like UNSA in Arequipa and UNAP in Loreto could play a major role in regional and national level infectious disease control by providing further insights in the molecular epidemiology of the infectious diseases in Peru. We propose to develop sustainable capacity in bioinformatics and sequencing through the development of a academic network between 3 universities in Peru and 2 institutions in Belgium. We selected topics of local public health importance: malaria, tuberculosis and antibiotic resistance. For these diseases, next generation sequencing can significantly improve diagnostics, surveillance and control, thus contributing to better health of the population of Peru.

Funding(s)

VLIR-UOS

Researcher(s)

Promotor: Van Rie Annelies

Co-promotor: Delgado Ratto Chris

Period:

01/01/2019 -31/12/2021

Joint efforts for the Elimination of Malaria in the Peruvian Amazon

Abstract

Malaria burden severely affects the population living in the Peruvian Amazon, which is also affected by low-living conditions. Currently, the Peruvian government has launched the Malaria Elimination program in the Amazon and requires evidence-based research to improve its program. UNAP is the main university in the Peruvian Amazon and is looking to become a key role player on the development of the region by supporting this elimination initiative. The first steps of supporting UNAP becoming more active on research were initiated through a triangular collaboration between UNAP, UPCH and UAntwerp in 2016 (VLIR SI). Here by, we intend to continue and strengthen this collaboration by actively developing educational and research capacities on epidemiology, data analysis and population genetics at UNAP. Constant training through students/professors exchange, courses given by UAntwerp/UPCH professors at UNAP and joint research related to malaria elimination tools encircle the strategy proposed on this VLIR TEAM project.

Funding(s)

VLIR UOS, TEAM programme, 279.994€

Researcher(s)

Flemish promoter: Jean-Pierre Van geertruyden (University of Antwerp)
Local promoter: Dr. Dionicia Gamboa Vilela (Universidad Peruana Cayetano Heredia, Peru)

Period

01/01/2018 - 01/12/2021

Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research (SPICES)

Abstract

The overall research objective of the SPICES project is to implement and evaluate a comprehensive CVD prevention and control program in five settings: a rural & semi-urban community in a low-income country (Uganda), middle income (South Africa) and vulnerable groups in three high-income countries (Belgium, France and United Kingdom) as well as to identify and compare the barriers and facilitators across study contexts. The project will be evaluated using a mix of qualitative and quantitative methods. At the beginning of the project, we will conduct baseline assessments including literature reviews, formative studies, household surveys (where feasible) and learn lessons from other projects to understand healthcare and lifestyle practices, barriers, and facilitators. A costeffectiveness and cost benefit analysis will be included. In addition, the teams will conduct site exchanges visits to learn from each other and organise policy dialogues to ensure sustainability and maximise impact of the interventions.

Funding(s)

Researcher(s)

  • Principal investigator: Bastiaens Hilde
  • Co-principal investigator: Anthierens Sibyl
  • Co-principal investigator: Van geertruyden Jean-Pierre
  • Co-principal investigator: Van Royen Paul

Research team(s)

Primary and interdisciplinary care Antwerp (ELIZA)

Period

01/01/2017 -31/12/2021

Website

www.spicesproject.eu

Multi-disciplinary approach to control onchocersiasis-associated epilepsy in the Mahenge area in Morogoro region, Tanzania.

Abstract

Despite the use of ivermectin (IVM) once annually for control of onchocerciasis (oncho) (= river blindness) in Mahenge Tanzania, the prevalence of oncho and epilepsy remains high. There is increasing evidence that epilepsy is a complication of oncho and that treatment of oncho can not only eliminate blindness but also reduce epilepsy. Our proposed project aims to: 1) strengthen the multi-disciplinary research capacity for the prevention of oncho and epilepsy in Tanzania. We will establish an oncho-associated epilepsy (OAE) research group to support a master and a PhD-level student in the development of research protocols addressing OAE in the Mahenge region; 2) reduce the prevalence of oncho and the incidence of epilepsy in the Mahenge area by: a) establishing a surveillance system for early diagnosis of epilepsy; b) strengthening and implementing an effective community distribution of IVM; 3) Implement evidence-based guidelines to treat OAE by training local health care workers; 4) introduce community advocacy on epilepsy, epilepsy-associated stigma and discrimination.

Funding(s)

VLIR UOS TEAM programme: 300.000€

Researcher(s)

Promotor: Colebunders Robert

Co-promotor: Weckhuysen Sarah

Period

01/01/2018 - 31/12/2021

Development of a Centre for Whole Genome Sequencing studies of Mycobacterium.

Abstract

Tuberculosis (TB) is a global problem, with > 9 million cases annually and rising numbers of multi-drug resistant TB (MDR-TB). In the 1990's, IS6110 DNA fingerprinting revolutionized the study of Mycobacterium tuberculosis (MTB). Using this technique, I performed groundbreaking studies that proved exogenous reinfection, challenged the dogma that most TB cases are due to re-activation of latent infection, opposed the belief that most MDR-TB is acquired, and demonstrated mixed infection (NEJM 1999, JID 1999, Lancet 2000, AJCCRM 2005). The recent development of high-throughput, relatively low-cost whole genome sequencing (WGS) raises again the promise of significant gains in molecular epidemiology of MTB. Arriving at new paradigms however demands that inferences of WGS data on phylogeny, transmissibility, virulence and resistance are contextualized and integrated with clinical and demographic meta-data in large-scale studies to test the hypotheses generated by small-scale studies on isolates collected in low TB burden countries. As a clinical and molecular epidemiologist, I propose to establish and direct a multidisciplinary Centre for WGS studies of MTB at the University of Antwerp. The Centre will embed itself in the molecular microbiology laboratory of Prof Herman Goossens, who has substantial expertise in WGS research of pathogens other than MTB. The Centre will work in close collaboration with Prof Robin Warren of the South African Centre of Excellence for Biomedical Tuberculosis Research (CEBTR), Stellenbosch University. Access to the ~50,000 MTB strains in the CEBTR biobank will provide a unique opportunity for the Centre to perform molecular epidemiological MTB studies that address ground-breaking basic science and molecular epidemiological questions. To maximize the public health gains of WGS, we will focus on studies of MTB transmission dynamics in a high TB burden setting, the role of epistatis in emergence of drug resistance, MTB adaptation to drug pressure, and within-host MTB diversity.

Funding(s)

FWO

Researcher(s)

Principal investigator: Van Rie Annelies

Period

01/10/2016 - 30/09/2021

Improved infectious diseases research and surveillance in Ethiopia through capacity building in bioinformatics and sequencing.

Abstract

Even though bioinformatics and genomics are relatively new biomedical disciplines, they have already made important contributions to the health of patients and populations. Bioinformatics and genome sequencing ca-pacity in Ethiopia is however extremely limited. African scientists are well positioned to play an important role in sequencing-based surveillance and research because the cost of sequencing technologies has dropped dra-matically, internet connectivity is constantly improving, and bioinformatics software tools are often freely availa-ble. We propose to develop sustainable capacity in bioinformatics and sequencing surveillance and research through an academic collaboration between Ethiopia, South Africa and Belgium. We selected topics of local public health importance: hospital acquired infections, vector borne diseases and tuberculosis. For these dis-eases, sequencing can significantly improve diagnostics, surveillance and control, thus contributing to better health of the population of Ethiopia.

Funding(s)

VLIR UOS Joint project, 150.000€

Researcher(s)

Promotor: Van Rie Annelies

Period

1/01/2018 - 31/12/2020

Epidemiology and social medicine (ESOC)

The cognitive, psychomotorical and physical impact of malaria and other (infectious) diseases in school aged children

Abstract

Malaria and anaemia are major causes of morbidity and mortality in children. Declining malaria has changed the shifted the burden of malaria to school children. Chemoprevention strategies using sulfadoxine-pyrimethamine (SP) was shown to prevent the incidence of malaria and anaemia in infants and school children in an area with low SP resistance. However, it is not clear whether this observation can be generalised to areas with high SP resistance. High levels of SP resistance are recorded in Eastern and Southern Africa and therefore alternative options needs evaluation as SP resistance continue to spread in the continent. There is, therefore, an urgent need to identify alternative drugs that could be used for IPTsc instead of SP. In addition , soil transmitted helminths co-morbidities continues to be unacceptably high in school-aged children, thus strategies for interrupting transmission needs to be optimized . We propose a randomized clinical trial to comparing the efficacy and safety of IPTc using dihydroartemisinin plus piperaquine and SP with piperaquine versus SP in high SP-resistance area.

Funding(s)

VLIR UOS, TEAM programme, 300000€

Researcher(s)

Flemish promoter: Jean-Pierre Van geertruyden (University of Antwerp)
Local promoter: John LUsingu (National Institute for Medical Research)

Period

01/01/2017-01/12/2020

The relevance of the family in adressing food, health and environment insecurity.

Abstract

This project represents a formal research agreement between UA and on the other hand VLIR. UA provides VLIR research results mentioned in the title of the project under the conditions as stipulated in this contract.

Funding(s)

FED. INST.

Researcher(s)

Principal investigator: Van geertruyden Jean-Pierre

Period

01/04/2013-31/03/2019

Website

www.vlirugandaresearchplatform.com/

Optimal dosing of 1st line antituberculosis and antiretroviral drugs in children- a pharmacokinetic study

Description:

This study will evaluate the 2010 WHO dosing recommendations for first line antituberculosis drugs in HIV-infected and uninfected children in South Africa and Malawi.

Funding source:

US National Institute of Health

Total ammount of funding:

+/- € 1.9 million

Funding period:

2011 - 2016

Role of EfGHI:

Prof Annelies Van Rie is a co-investigator

Partner:

University of Cape Town (Helen McIlleron, PI)

South Sudan Nodding Syndrome Study. A study into the epidemiology, aetiology and outcome of nodding syndrome in South Sudan

Abstract:

It is proposed to conduct an integrate program combining a case- control design with a detailed descriptive study using a phased approach. In the first phase a pathogen discovery programme will be applied on a limited number of NS patients and a group of controls using state of the art next generation sequencing and microarray-based methods on samples obtained from children and black flies. The focus of the second phase of the study will depend, in part, on the outcome of first phase: If a possible pathogen is identified the focus in the second phase will be on further identification of this pathogen. If no pathogen is identified, a detailed descriptive aetiology studies will be started using a case- control design and investigating all possible aetiologies previously indicated. Irrespective of the outcome of phase 1, in the second phase a surveillance study will also be started of all NS cases in the four most affected counties of South Sudan, next to a long term follow up of a selected group of NS cases and controls. This 3 years program will be conducted in close collaboration with South Sudanese, Dutch and Belgium NS and paediatric research experts and will be built on existing NS research and support activities already in place in South Sudan. Expected outcome: There is a significant chance that the true aetiology and the risk factors for NS will be identified and that the NS epidemiology in South Sudan will be clarified with respect to incidence, prevalence and disease progression. In addition, the study will create a platform for treatment intervention studies and will inform local health authorities how to improve their disease management and prevention strategies.

Funding:

Amsterdam Institute for Global Health and Development (AIGHD)
Academic Medical Centre
University of Amsterdam

Co-Applicant:

Prof. Robert Colebunders

Period:

01/01/2015 - 31/12/2017

Réduire d'épilepsie des rivières en République Démocratique du Congo

Abstract

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

Funding

VLIR-UOS (South Initiative)

Researcher(s)

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

Partner:

Prof. B. AgassaUniversité de Kisangani, RD Congo

Joint project to strengthen research skills on molecular epidemiology and to uncover malaria transmission features relevant for its control in the Peruvian Amazon

Abstract

The present project seeks to fulfil the academic capabilities of UNAP by improving quality of research and education. The project relies in the formation of a triangular structure of academic and educational collaboration between the UNAP (public university, academically weak but with high potential as key player in the development of Amazon population), UPCH (well-stablished university will lead UNAP on the project) and UA (supporting the capacity building). The VLIR Sl project will strengthen the academic and operational capacities on molecular epidemiology through active coaching and training in epidemiology, biostatistics and population genetics. From the start of the project UA will provide support to the Peruvian partners on population genetics analysis for which a computer cluster and the respective training will be provided in Peru.

Funding(s)

VLIR-UOS, South Initiative

Researcher(s)

Principal investigator: Jean-Pierre Van geertruyden and Christopher Delgado Ratto

Partners:

Universidad Peruana Cayetano Heredia
Universidad Nacional de la Amazonía Peruana

Period

13/03/16 - 31/12/2017

An investigation into the geographical distribution, host species, burden of disease and optimal diagnosis and treatment of Emmonsia hoerikwaggiana infections.

Abstract

Our group has discovered a new species of dimorphic fungal infection in South Africa. This is the first new species of dimorphic fungus that infects humans to be found for over 50 years. We have named the organism Emmonsia hoerikwaggiana. It causes severe disease and, if untreated, death in persons with poor immune function such as those infected with HIV. We know very little about this fungus. We will investigate its ecological niches, its geographical range, which organisms it usually infects, what the prevalence is of human infections and how these infections manifest. In addition we want to do further investigations into the risk factors for human infection and the optimal diagnostic and therapeutic strategies.

Funding(s)

FWO

Researcher(s)

Principal investigator: Colebunders Robert

Period

01/01/2014-31/12/2017

#emmonsia #southafrica

Joining efforts to detect and control Plasmodium falciparum resistance in East and Central Africa.

Abstract

This project represents a formal research agreement between UA and on the other hand VLIR. UA provides VLIR research results mentioned in the title of the project under the conditions as stipulated in this contract.

Funding(s)

VLIR

Researcher(s)

Principal investigator: Van geertruyden Jean-Pierre

Period

01/07/2014-30/06/2016

Improving maternal and child health in the South Ethiopian Rift Valley

Flemish project leader: Jean-Pierre Van geertuyden (University of Antwerp)
Local project leader: Wanzahun Godana

Project within the Institutional cooperation with Arba Minch University (AMU), Ethiopia

Flemish programme coordinator: Roel Merckx (KU Leuven)
Local programme coordinator: Guchie Gulie Sulla

Phase I started on 1 January 2017.

More information on the VLIR UOS website
 

Création d'une unité interdépartementale de recherche clinique à la Faculté de médecine de l'Université de Lubumbashi (UNILU)

Abstract

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

Funding(s)

VLIR-UOS

Researcher(s)

Principal investigator: Jean-Pierre Van geertruyden

Partner:

Abdon Mukalay, Université de Lubumbashi

Period

13/03/16 - 31/12/2017

Nodding Syndrome: a trans-disciplinary approach to identify the cause and decrease the incidence of river epilepsy (NSETHIO)

Abstract:

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

Funding

EU, Horizon 2020

Budget

€ 241.7000

Investigator:

Prof. Robert Colebunders

Partners:

Universitaetsklinikum Bonn, Germany

San Diego State University Foundation, United States

Period

1/10/2015 - 30/09/2020

Website

Infectious Diseases

Flemish project leader: Annelies Van Rie (University of Antwerp)
Local project leader: Delenasaw Yewhalaw

project within the Network cooperation in Ethiopia

Coordinating university: Jimma University (JU)

Other partner universities:

Ambo University
Hawassa University
Debre Zeit College of Veterinary Medicine and Agriculture

Flemish programme coordinator: Luc Duchateau (Ghent University)
Local programme coordinator: Kora Tushune (Jimma University)

 

Phase 1 started on 1 January 2017.

More information on the VLIR UOS website