EDCTP portfolio: EDCTP/AREF Preparatory Fellowships

Dr Abubakar Shaaban Hoza aims to acquire new technical knowledge and skills in medical microbiology at the University of Leipzig, Germany, and apply these at the Sokhoine University, Tanzania.

Resistance profiling of M.tuberculosis complex and S. aureus

The challenge is to advance research capacity in medical microbiology at the Sokoine University of Agriculture in Tanzania. New technical knowledge and skills will be acquired and then applied in a project while training research staff.

The challenge

A placement at the University of Leipzig will enable Dr Hoza to acquire the skills (including Next Generation Sequencing) and knowledge to isolate M. tuberculosis and S. aureus isolates from presumptive TB patients. Dr Hoza will use biological samples and/or data generated during his PhD study.

At his home institute at the Sokoine University of Agriculture, he will then conduct a study on the utility of whole-genome sequencing in the prediction of drug resistance genotypes of M. tuberculosis and S. aureus. This will give the fellow the opportunity to further train staff in the context of this project.

The project

In line with the scope and objectives of the EDCTP/AREF Preparatory fellowship, the expected impact of the fellowship is the enhancement of the research capacity in medical microbiology of the fellow and his home institution in Tanzania. Moreover, the planned study aims to address the public health impact of multi-drug resistant tuberculosis (MDR-TB) caused by M. tuberculosis, and S. aureus resistance in the resource-limited settings of Tanzania.

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 challenge is to advance research capacity in medical microbiology at the Sokoine University of Agriculture in Tanzania. New technical knowledge and skills will be acquired and then applied in a project while training research staff.

A placement at the University of Leipzig will enable Dr Hoza to acquire the skills (including Next Generation Sequencing) and knowledge to isolate M. tuberculosis and S. aureus isolates from presumptive TB patients. Dr Hoza will use biological samples and/or data generated during his PhD study.

At his home institute at the Sokoine University of Agriculture, he will then conduct a study on the utility of whole-genome sequencing in the prediction of drug resistance genotypes of M. tuberculosis and S. aureus. This will give the fellow the opportunity to further train staff in the context of this project.

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.

In line with the scope and objectives of the EDCTP/AREF Preparatory fellowship, the expected impact of the fellowship is the enhancement of the research capacity in medical microbiology of the fellow and his home institution in Tanzania. Moreover, the planned study aims to address the public health impact of multi-drug resistant tuberculosis (MDR-TB) caused by M. tuberculosis, and S. aureus resistance in the resource-limited settings of Tanzania.

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