From 22.09. – 11.10. 2020 Andreas Sachse (P3/RKI) held a 3-week laboratory training course on molecular SARS-CoV-2 diagnostics, especially on mobile sequencing using MinION (Oxford Nanopore Technology) at the University Hospital CHU Bouaké in the Ivory Coast in order to provide specific support for Ivorian colleagues in the current pandemic.

During the stay Mr. Sachse sequenced together with the Ivorian scientist Etile Anoh a total of 208 samples, mainly from the national Coronavirus Surveillance. During Mr. Sachse’s stay, 64 sequences have been generated so far and these are the first Ivorian SARS-CoV-2 sequence data made available to the public via GISAID. GISAID is an online platform that allows for the rapid international exchange of genomic data, including SARS-CoV-2. At the same time, 7 SARS-CoV-2 full genomes of patients of the BMBF-funded ANDEMIA study from the Democratic Republic of Congo (report September 2020) could be published on the same platform.

In order to support the Congolese colleagues in the current pandemic, a laboratory training in molecular SARS-CoV-2 diagnostics and serology took place at the INRB in Kinshasa.

During a 3-week stay (05.-28.08.2020), Caroline Röthemeier from RKI, Germany and the Congolese ANDEMIA team examined sample material that had been routinely collected from ANDEMIA participants since December 2019. RNA was extracted from over 600 nasal/pharyngeal swabs from patients with acute respiratory symptoms and tested for SARS-CoV-2. In addition, 480 serum samples were serologically tested for the presence of long-term antibodies (IgG) against SARS-CoV-2. Seropositive samples will now be tested by neutralization test at the RKI.

The local staff trained by Ms. Röthemeier is now also responsible for the analysis within a SARS-CoV-2 antibody study among health care workers and their families in Kinshasa. This study is carried out in cooperation between the RKI, the INRB/Kinshasa, the ITM/Antwerp and the IRD/Montpellier.

This training was financially and organizationally supported by the GHPP project ARGOS and ZIG3/RKI respectively.

SARS-CoV-2 is widely spreading throughout the African continent, and with a focus on also acute respiratory disease, ANDEMIA is highly engaged in supporting our African partner countries in responding to the pandemic.

We therefore included SARS-CoV-2 PCR in our routine testing panel for all ANDEMIA patients (co-funded by BMBF through the sub-project ANCOS), implemented mobile sequencing techniques in order to investigate infection chains, and started a pilot serological survey to draw inference on the level of exposure of local populations to the virus.

Adding COVID-19 to the research program of ANDEMIA will aid to close important knowledge gaps in the understanding of COVID-19 disease dynamics and epidemiology, provides a platform for long-term monitoring of COVID-19 pneumonia, and most importantly practically assists in national COVID-19 control efforts, which is of utmost importance.

From the 24.02. to 08.03.2020 three members of the German ANDEMIA team from RKI spent two weeks at the partner site “Centre Muraz” and “Centre Hospitalier Universitaire Souro Sanou” at Bobo-Dioulasso in Burkina Faso.

As the previous stay in Côte d’Ivoire the main focus of the trip was retraining of enrolment staff and quality assurance in laboratory practices. This included pre-analytics such as proper blood sampling procedures and avoiding contamination in blood culture (training video), as well as individual training and reassessment of laboratory practices in both molecular and bacteriological testing. On the molecular testing side, the validation of results was re-evaluated and focused on. On the bacteriological side, the team from RKI emphasized the use of API galleries for bacteria identification with an introduction to the APIweb system. Lastly, several meetings for the start of enrolment of healthy controls were organized to discuss last organizational questions and to successfully launch enrolment in Burkina Faso.

From the 14th of January to the 13th of February 2020 Essia Belarbi and Paul Pitzinger from the german ANDEMIA team visited all study sites in Côte d’Ivoire to re-train laboratory staff in bacteriological and molecular laboratory processes and to implement the enrolment of healthy controls at the different sites.

Health care workers received a refresher training in aseptic blood sampling in order to reduce contamination rates in blood culture, which was supported by a short training video, provided by ANDEMIA and the ITM Antwerp. This video can be accessed freely on the internet here and should be used by the partners to either train new personnel or to remind established health care workers on the proper techniques.

To further improve the quality of bacteriological results biologists and technicians of the bacteriology labs in Bouaké and Guiglo were trained in the use of the API®(Analytical Profile Index) system.  Lastly, the implementation of healthy control enrolment was presented to all study sites. As this phase is crucial for the further analysis and interpretation of results, the protocol was discussed in detail to make sure that every site is familiar with procedures and can start enrolment.

From 28th to 31st of January 2020 members of the ANDEMIA team attended the “Research Network for Health Innovations in Sub Saharan Africa mid-term meeting” in Accra, Ghana. During several workshops and panel discussions African and German scientists from all of the five networks came together to discuss global health questions and to exchange experiences regarding cross-project topics. Project specific issues were discussed in internal network meetings

The fourth ANDEMIA network meeting took place in Berlin from 18th to 22nd November 2019. Project partners from the four African partner countries met at the Robert Koch Institute to discuss progress, problems and plans for the future of ANDEMIA. Of course, employees of the BMG-funded GHPP projects TRICE and ARGOS, which are closely linked to ANDEMIA, were also invited to exchange information with joint project partners. One of the main objectives of this year’s meeting was to plan targeted data analyses and to develop a publication plan.

In the run-up to our network meeting, three workshops for ANDEMIA Master and PhD students, as well as project staff of ARGOS and TRICE, took place:
A workshop on “Proposal writing”, aimed at enabling students to write structured project proposals. In the workshop “Data reporting”, the participants were instructed in compiling and evaluating data from the ANDEMIA database. In the third workshop the participants gained insight into mobile sequencing using MinION technology, which is to be established in the partner countries as an additional diagnostic tool.

Our third network meeting was held from 19th-23th of November 2018 at the Centre Muraz in Bobo-Dioulasso, Burkina Faso. All partners presented preliminary results and discussed both scientific questions and organizational, logistical and content-related difficulties and possible solutions. Additionally the entire 23 master and Phd-students enrolled in the ANDEMIA training program presented their projects.

Key network target of the meeting was improving enrolment numbers and data quality across all sites and strengthening of the bacterial diagnostic capacities in the partnering countries.

Since 2017 the Centre Hospitalier Regional (CHR) Guiglo in Côte d’Ivoire is better supplied with bacteriological laboratory diagnostics capacities (see report “Laboratory set up Guiglo”). Due to this expansion of lab capacity, further diagnostics can now also be offered in the Centre de Sante Rural (CSR) in Tai, a small rural hospital near the Tai National Park at a distance of ca. 80km from Guiglo.

The CHR Guiglo and the Centre Hospitalier Universitaire (CHU) in Bouaké have been in constant training exchange to establish the necessary methodology and workflows in the laboratory. For this purpose, several training exchanges have been organized since mid-2017, during which laboratory staff from Guiglo was trained for several weeks in Bouaké as well as experienced staff from Bouaké accompanied the work in the bacteroiology lab in Guiglo. In April, May and July 2018 Prof. Chantal Akoua-Koffi and Dr. Abdulaye Diarrasouba (Postdoc) organized several visits to Guiglo and Tai  against the background of establishing work processes in diagnostic stewardship in close cooperation with local personnel. This included the correct sampling of patients, sample storage and diagnostic processing in Guiglo as well as the safe transport of samples for further analysis from Tai to Guiglo and from Guiglo to Bouaké respectively.

Through the project and training activities, conveyed by local expertise, not only the cooperation between the hospitals but also the internal working methods within the hospitals have improved. Medical and laboratory personnel at CHR Guiglo now meet every two weeks to coordinate their activities, discuss innovations and problems concerning the projects as well as the hospital routine. A similar development had already taken place at CHU Bouaké, where representatives from all services meet with laboratory personnel on a monthly basis. It has been shown that within these meetings, in addition to project-relevant topics, a general exchange takes place. Developments of this kind can contribute to a sustainable improvement of communication even after the end of the project and thus to the early detection of problems and their management.

Our second network meeting was successfully held at the University hospital Bouaké in Côte d’Ivoire, the site of the ANDEMIA coordinator Prof. Chantal Akoua-Koffi. For this, all countries’ ANDEMIA teams got together to discuss progress and new research directions of the project.
The next meeting will be held at Burkina Faso in November 2018.