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EDCTP portfolio: Emerging diseases

The MobEBO-DRC project is enabling teams in the Democratic Republic of the Congo to use a mobile ‘laboratory in a suitcase’ successfully deployed in Guinea in the 2014–16 West Africa Ebola outbreak.

Onsite detection of Ebola

Rapid diagnosis of Ebola infection is essential for effective control. However, standard methods of diagnosis require laboratory facilities, and even field-based tent laboratories take time to generate results and are not truly mobile. 

To speed diagnosis, a mobile suitcase laboratory was developed and successfully in Guinea in 2014. It provides the tools for safe on-site extraction of DNA and molecular identification of Ebola virus. It delivered the first on-site detection of Ebola virus in Guinea, and proved able to diagnose infections in less than an hour.

The challenge

The aim of the MobEBO-DRC project is to enable use of the mobile suitcase laboratory, a proven diagnostic technology, in the Democratic Republic of the Congo (DRC).

The team behind the development of the technology will work with groups in the DRC to train teams on field use of the mobile suitcase laboratory in outbreak settings.

The project

The MobEBO-DRC project is ensuring that the DRC can benefit from a proven mobile diagnostic technology. It has brought together the existing development team with the leading Ebola research group in the DRC, strengthening the group’s capacity to respond to outbreaks. A wide international network has also been established to explore use of point-of-care tests. Ultimately, rapid and accurate detection of Ebola infections will be an essential tool in the swift control of potential outbreaks.

Impact


test the safety and efficacy of this new formulation in young children

Bringing antiretroviral drugs to children

The CHAPAS trials have ensured that many more children with HIV have benefited
from life-saving antiretrovirals.

EDCTP portfolio: HIV & HIV-associated infections

The challenge

Rapid diagnosis of Ebola infection is essential for effective control. However, standard methods of diagnosis require laboratory facilities, and even field-based tent laboratories take time to generate results and are not truly mobile. 

To speed diagnosis, a mobile suitcase laboratory was developed and successfully in Guinea in 2014. It provides the tools for safe on-site extraction of DNA and molecular identification of Ebola virus. It delivered the first on-site detection of Ebola virus in Guinea, and proved able to diagnose infections in less than an hour.

The aim of the MobEBO-DRC project is to enable use of the mobile suitcase laboratory, a proven diagnostic technology, in the Democratic Republic of the Congo (DRC).

The team behind the development of the technology will work with groups in the DRC to train teams on field use of the mobile suitcase laboratory in outbreak settings.

The project

The later CHAPAS-3 trial compared the efficacy and safety of three fixed-dose combinations including two without stavudine (found to have some long-term side effects in adults, leading to a recommendation that its use be discontinued in children). The trial the first of its kind in Africa studied nearly 500 children at four sites in two African countries.

The MobEBO-DRC project is ensuring that the DRC can benefit from a proven mobile diagnostic technology. It has brought together the existing development team with the leading Ebola research group in the DRC, strengthening the group’s capacity to respond to outbreaks. A wide international network has also been established to explore use of point-of-care tests. Ultimately, rapid and accurate detection of Ebola infections will be an essential tool in the swift control of potential outbreaks.

ratios forfixed-dose combinations and on appropriatedosage according to weight. 

The CHAPAS-3 trial confirmed the effectiveness of fixed-dose combinations, providing further impetus to the rollout of antiretrovirals to children. Its evidence on abacavir informed the WHO recommendation of abacavir-containing combinations for first-line therapy in children. Trial data have also been used to support applications for regulatory approval for new scored efavirenz tablets.

Impact

L’homme RF et al. Nevirapine, stavudine and lamivudine pharmacokinetics in African children on paediatric fixed-dose combination tablets. AIDS. 2008;22(5):557–65.

Mulenga V et al. Abacavir, zidovudine, or stavudine as paediatric tablets for African HIVinfected children (CHAPAS-3): an open-label, parallel-group, randomised controlled trial. Lancet Infect Dis. 2016;16(2):169–79.

WHO. Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. 2010.

WHO. Consolidated guidelines on the use of antiretroviral drugs
for treating and preventing

HIV infection: Recommendations for a public health approach
(second edition). 2016

Projects: Children with HIV in Africa Pharmacokinetics and Adherence of Simple Antiretroviral Regimens (CHAPAS): CHAPAS-1 and -3

Project lead: Professor Chifumbe Chintu, University Teaching Hospital, Zambia (CHAPAS-1); Dr Veronica Mulenga, University Teaching Hospital, Zambia (CHAPAS-3)

Target population(s): Children with HIV

Sample size: 71 (CHAPAS-1); 480 (CHAPAS-3)

Countries involved: Ireland, the Netherlands, the UK, the USA, Zambia (CHAPAS-1); Uganda, Zambia (CHAPAS-3)

Project duration: 2005–2009 (CHAPAS-1); 2010 –2011 (CHAPAS-3)

EDCTP funding: €1.2M (CHAPAS-1); €4.6M (CHAPAS-3)

Total project funding: €1.2M (CHAPAS-1); €5.0M