Publications

Funding for clinical research |drugs, vaccines, microbicides, diagnostics | HIV/AIDS, tuberculosis, malaria, other infectious diseases |sub-Saharan Africa

EDCTP portfolio: Emerging diseases

The EPIRISK-Ebov project is supporting Ebola preparedness in the Republic of Congo, a neighbour of the Democratic Republic of the Congo that is at risk of importing Ebola infection.

Enhancing Ebola preparedness

The Republic of Congo shares a border with the Democratic Republic of the Congo (DRC), marked by the River Congo. In 2018, Ebola infections were detected along the River Congo, as well as in the major outbreak in the north of the DRC.

Recognising the risk of spillover, the Republic of the Congo adopted a preparedness approach and formally requested international assistance.

The challenge

The EPIRISK-Ebov project is carrying out a range of activities to support preparedness in the Republic of the Congo. Its main aim is to provide additional epidemiological information of exposure to Ebola virus along the border with the DRC, by identifying individuals carrying antibodies to Ebola and comparing the numbers with a control population in Brazzaville.

The project will also investigate the properties of Ebola-specific antibodies and cell-based immune responses, and explore risk factors for Ebola infection among the local population.

An additional strand of work will focus on identifying the most common viral and bacterial infections in the local population, using state-of-the-art diagnostic technologies.

The project

The EPIRISK-Ebov project will provide important benchmark data on past exposures to Ebola virus and on current patterns of infection in the Republic of the Congo. Importantly, it will be involved in training of staff from key national research and public health institutions in the Republic of the Congo, building capacity in diagnostics, biosafety, immunological and other laboratory procedures, and social science. The project will maintain regular communication with the Ministry of Public Health, involve key ministry staff and integrate activities fully into national surveillance activities.

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

The Republic of Congo shares a border with the Democratic Republic of the Congo (DRC), marked by the River Congo. In 2018, Ebola infections were detected along the River Congo, as well as in the major outbreak in the north of the DRC.

Recognising the risk of spillover, the Republic of the Congo adopted a preparedness approach and formally requested international assistance.

The EPIRISK-Ebov project is carrying out a range of activities to support preparedness in the Republic of the Congo. Its main aim is to provide additional epidemiological information of exposure to Ebola virus along the border with the DRC, by identifying individuals carrying antibodies to Ebola and comparing the numbers with a control population in Brazzaville.

The project will also investigate the properties of Ebola-specific antibodies and cell-based immune responses, and explore risk factors for Ebola infection among the local population.

An additional strand of work will focus on identifying the most common viral and bacterial infections in the local population, using state-of-the-art diagnostic technologies.

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 EPIRISK-Ebov project will provide important benchmark data on past exposures to Ebola virus and on current patterns of infection in the Republic of the Congo. Importantly, it will be involved in training of staff from key national research and public health institutions in the Republic of the Congo, building capacity in diagnostics, biosafety, immunological and other laboratory procedures, and social science. The project will maintain regular communication with the Ministry of Public Health, involve key ministry staff and integrate activities fully into national surveillance activities.

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