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Wellcome is exploring how best to support public health and clinical interventions to improve global health. They are looking forward to what the next 10 years of global health trials might look like and want to hear your biggest and boldest ideas!

Wellcome want to know which health interventions you think have the potential to truly transform the health of people living in low- and middle-income countries (LMICs)? They are looking for large-scale evaluations of interventions that are in development but have not yet been formally evaluated (whether these are a product such as a diagnostic tool, drug, or vaccine, or a behavioural intervention, and whether they are targeted at individuals, communities or a combination of the two).

Wellcome are also interested in understanding how they can support more efficient evaluations that can provide definitive evidence and be much better linked with parallel policy work to allow faster uptake of evidence into practice.

Interventions should:

• be at late stage of development that evaluate efficacy or effectiveness (equivalent to pivotal Phase II or Phase III/IV)
• address the major causes of mortality and morbidity in LMICs
• have clear pathways to changing policy and guidelines
• address the issues of scalability and sustainability
• be evaluated at a large scale (either multi-country or multi-site)

To complete the survey visit: http://bit.ly/wellcome-global-health-survey

If you have any questions about the survey please contact Elena Netsi, Portfolio Manager Population Health at Wellcome, e.netsi@wellcome.ac.uk

Learn more about this new assay developed by Kumasi Center for Collaborative Research at Kwame Nkrumah University of Science and Technology (KCCR), Ghana. Our Fellows Dr Michael Frimpong (TMA2015CDF979) and Dr Richard Phillips (TMA2016SF1509) share their experience from the field - https://www.youtube.com/watch?v=jlW2bnOlxhM 

Background

Access to an accurate diagnostic test for Buruli ulcer (BU) is a research priority according to the World Health Organization. Nucleic acid amplification of insertion sequence IS2404 by polymerase chain reaction (PCR) is the most sensitive and specific method to detect Mycobacterium ulcerans (M. ulcerans), the causative agent of BU. However, PCR is not always available in endemic communities in Africa due to its cost and technological sophistication. Isothermal DNA amplification systems such as the recombinase polymerase amplification (RPA) have emerged as a molecular diagnostic tool with similar accuracy to PCR but having the advantage of amplifying a template DNA at a constant lower temperature in a shorter time. The aim of this study was to develop RPA for the detection of M. ulcerans and evaluate its use in Buruli ulcer disease.

Methodology and principal findings

A specific fragment of IS2404 of M. ulcerans was amplified within 15 minutes at a constant 42°C using RPA method. The detection limit was 45 copies of IS2404 molecular DNA standard per reaction. The assay was highly specific as all 7 strains of M. ulcerans tested were detected, and no cross reactivity was observed to other mycobacteria or clinically relevant bacteria species. The clinical performance of the M. ulcerans (Mu-RPA) assay was evaluated using DNA extracted from fine needle aspirates or swabs taken from 67 patients in whom BU was suspected and 12 patients with clinically confirmed non-BU lesions. All results were compared to a highly sensitive real-time PCR. The clinical specificity of the Mu-RPA assay was 100% (95% CI, 84–100), whiles the sensitivity was 88% (95% CI, 77–95).

Conclusion

The Mu-RPA assay represents an alternative to PCR, especially in areas with limited infrastructure.

EDCTP alumnus - a well- known research clinician, epidemiologist, academic and scientist in multidrug resistance tuberculosis (MDR-TB) was recognised by the South African Medical Research Council (SAMRC) for her research excellence in the management of patients with MDR and XDR TB. Dr Nesri Padayatchi, a scientist and Deputy Director at the Centre for the AIDS Programme of Research in South Africa (CAPRISA), received the SAMRC 2018 Silver Scientific Achievement Award, a medal, at the SAMRC Scientific Merit awards in last year.

“SAMRC recognises and congratulates you as an outstanding South African scientist who has contributed to raising the profile of science in South Africa,” said Dr Mike Sathekge, chairperson of the SAMRC Board.

Professor Nesri Padayatchi, MBChB, DCH(Paediatrics), DTM&H (Tropical Medicine), DPH(Public Health), DHSM (Health Management) MS(Epi), is an honorary Associate Professor in Public Health and Nursing, in the College of Health Sciences at the University of KwaZulu-Natal in Durban, South Africa.

She has more than 30 years clinical and research experience in the management of TB and related problems. Respected as an authority on the treatment of multi-drug resistant tuberculosis, her experience extends to the design and implementation of several self-initiated TB-HIV clinical trials as the Principal and/or co-investigator of the studiesShe serves as the South African Principal Investigator for the Columbia University-Southern African Fogarty AIDS International Training and Research Programme since 2009. She serves on the South African National Advisory Board for MDR –TB since 2010 to date and on the KwaZulu Natal MDR-TB technical advisory committee since 2013.

Her biggest scientific contribution has been as a co-investigator in the SAPiT and STRIDE (A5221) studies which changed not only South African guidelines for the management of patients with TB-HIV coinfection, but also WHO and DHHS guidelines.

She has participated as the Principal Investigator in the Centres for Disease Control and Prevention TB Trials Consortium and was the CAPRISA Principal Investigator for the ACTG studies from 2006-2013. She has published several scientific papers on TB-HIV in high impact journals and is a member of the Academy of Science of South Africa.

Padayatchi serves on several scientific bodies that include, the International Union against TB and Lung Diseases (IUATLD) Ethics Advisory Group, the Board of the South African HIV Clinicians society, the South African National and Provincial Advisory Boards for MDR –TB.

“I am honoured and humbled to be recognised by the South African Research Medical Council and my peers,” said Padayatchi. “TB remains the leading cause of death in South Africa  and MDR-TB, in particular, threatens the gains made in HIV. MDR TB remains a serious global threat particularly in impoverished communities constrained countries.”