Hidden in the deep interior of the Brong Ahafo Region of Ghana, the Kintampo Health Research Centre (KHRC) established in 1994 and provides a base for Health and Demographic Surveillance, clinical, and field epidemiological research in the forest-savannah ecological and cultural transition zone of Ghana. The health research centre is one of eight sites in Africa conducting the Phase II stage of the malaria vaccine, RTS,S research.

The vision of the centre is to develop and sustain a local and internationally competitive health research and development resource centre capable of generating new knowledge and relevant information addressing priority problems in health systems at the district, national, and international levels. This will be achieved through effective scientific research, training, and services delivery aimed at better health and community development.

The centre is a well-established, African-led, research centre. The African identity of KHRC is important as it emphasizes African solutions to African health challenges. KHRC is one of three field research centres of the Health Research Unit of Ghana Health Service.

With over 13 years of accumulated experience in health research in Ghana, KHRC has over 500 employees. The team is multidisciplinary comprising of biological and social scientists and highly skilled support personnel in laboratory and field operations, data management and financial management

Over the years, KHRC has developed one of the largest Health and Demographic Surveillance System (HDSS) and study population cohorts that have made KHRC an award wining institution for quality health research globally.

In September 2006, KHRC embarked on a malaria vaccine trial among children 5 to 17 months of age in the Kintampo North and South Districts of the Brong Ahafo Region of Ghana. The aim of the study was to evaluate the safety and immunogenicity of the vaccine when given at different times. About 540 children are involved in the trial in Ghana. KHRC recruited half while the other half has been recruited in Agogo in the Ashanti Region of Ghana under the coordination of the Kumasi Centre for Collaborative Research/School of Medical Sciences (KCCR/SMS). Vaccination of the 270 recruited participants started on September 30, 2006. The children were successfully followed up the active phase of the study, which spanned over 10 months after the first vaccination.

Following the successful completion of the active phase of the study, a second trial is being conducted among infants, 6 to 10 weeks old. The aim of this trial is to evaluate the safety and immunogenicity of the malaria vaccine when given alongside the routine EPI vaccines. The study is being carried out in two other African countries, namely Gabon and Tanzania. The results are expected in late 2008

A snapshot of some MCTA SITES…

By Clare Banoeng-Yakubo

KUMASI/AGOGO, GHANA
The Agogo site has wide research scope including malaria. Activities for the phase II trial of RTS’S have been completed and site is preparing for the phase III. The Agogo site has adequate laboratory space with adequate equipment to support field study of vaccines, However workspace in Agogo needs urgent extension to house investigators, clinical monitors and the data management unit if it is to take up and optimally execute a large trial. The main drawback is the inability to attract senior researchers to reside in Agogo.

The Kumasi Center for Collaborative Research Laboratory on the other hand has excellent facilities for basic research (virology, microbiology, entomology and molecular biology). However it does not have a position for clinical research coordinator. The site however has the potential to bring academia and research together for its effective development if leadership and additional resources are available. It has the advantage of being part of a medical school that is ideal for identification and development of clinical research leaders with guidance.

KOROGWE/TANGA, TANZANIA
Malaria is the main research interest in Korogwe. A phase malaria vaccine, RTS’S study is ongoing. The site is in the preparatory phase for the phase III RTS’S study. The site is also involved in a phase 1 study of another malaria vaccine, MSP3 in children 12-24 months sponsored by AMANET.

BAGAMOYO, TANZANIA
The site research portfolio is diverse and malaria is a key research area. A phase II malaria vaccine, RTS’S study is ongoing and the site is preparing to conduct other studies on malaria vaccines and drugs.
Clinical and laboratory facilities as well as human capacity are considerable well developed. The site is located at the Bagamoyo District hospital with limited room for expansion. The site relies on peripheral health centers for the recruitment and follow ups of trial participants, and these will require some upgrading to support the planned trials. A data management unit has also been established and a radio communication system to link up the field sites and the base.

NANORO, BURKINA FASO
Nanoro is one of the three new sites that joined the MCTA network recently to participate in the malaria vaccine, RTS’S phase III study. Nanoro is a satellite field station of the Institut de Recherche en Sciences de la Sante (IRSS) in Burkina Faso. The IRSS team is housed at the Nanoro District Hospital which is jointly run by the Ministry of Health of Burkina Faso and Italian Missionaries. Malaria is the main research agenda of the IRSS team.

KILIFI, KENYA
 The site has conducted a number of malaria drug and vaccine trials in the past. The site has core funding from the Wellcome Trust as well as from several funded projects from the same foundation. The site has a large HDSS supporting several clinical, epidemiological surveillance and anthropological studies. It has a strong link with Universities in the UK with Oxford being the main partner. It has recently established a clinical trials unit to coordinate the numerous clinical trials going on in the unit in keeping with GCP principles.

MANHICA, MOZAMBIQUE
The site has been conducting a long-term follow up of a phase 11 of the RTS’S malaria vaccine and currently conducting a second phase II vaccine study in younger children. The site is also involved in several malaria drug studies in children.

The site infrastructure and human resources are adequate for the conduct of GCP standard clinical trials. The site  is getting ready to take part in the phase III RTS,S malaria vaccine study and to ensure optimal recruitment, they are expanding the HDSS.

LILONGWE, MALAWI
This site is mainly involved in HIV/AIDS research and is for the first time getting into malaria research. Its headquarters is housed within the Kamuzu referral hospital in a stand alone facility. The site proposes to work closely with the department of pediatrics at the hospital in the phase III RTS’S study. The pediatrics department has a new intensive care unit of six beds for acute clinical care and three general pediatric wards.

UCAD, SENEGAL

At the UCAD site in Senegal, the department of Parasitological is part of the Faculty of Medicine of UCAD and is located within the Faculty of Medicine. Malaria is their main research agenda, although the site has interest in other parasitic diseases. Currently the site is conducting a pilot study of Intermittent Presumptive Treatment in children (IPTc). A large IPTc effectiveness study which will involve more than 50,000 children is also about to start. Other ongoing research activities are; a pharmacovigilance study of co-Arsucam versus Coartem and a study of artesunate/pyronaridine versus artemether/lumefantrine.