Clinical Management of Accidents Caused by Venomous and Poisonous Animals
The Section Clinical Tropical Medicine provides consultation regarding accidents caused by venomous and poisonous animals. In Europe, this is a task fulfilled by both toxicology information centres and tropical institutes.
Our section is one of the few European institutions to maintain this expert knowledge and research into this field.
DAAD PhD Programme
Ghanaian-German Centre for Development Studies and Health Research
ACBRIDGE – bridging academic institutions -
Funding: German Academic Exchange Service (DAAD, Deutscher Akademischer Austauschdienst)
Time frame: 2008-2013
Scientists (Section Clinical Tropical Medicine): T. Junghanss, J. Kaur
● School of Public Health, University of Ghana, Accra, Ghana (F. Binka, R. Adanu)
● Swiss Tropical and Public Health Institute, Department of Medical Parasitology and
Infection Biology, Basel, Switzerland (G. Pluschke)
● Department of Epidemiology and Public Health, University of Bielefeld, Germany (O. Razum)
The Ghanaian-German Centre for Development Studies and Health Research is one of five Centres of Excellence established under the funding scheme “Action Africa” of the Federal Foreign Office (Auswärtiges Amt) and facilitated by the “Centres of Excellence for Promoting Future Leaders in Africa” programme of the DAAD.
Our section coordinates the “Health Research” pilar of the Centre. The Health Research division offers an interdisciplinary PhD programme for African and German students to strengthen research capacities in the West African region and contributes to networking in health research.
An important feature of our PhD programme are “tandems” of students; this involves students from northern and students from southern universities working closely together and approaching their research topics of regional relevance from different angles (clinical sciences; biosciences and public health/epidemiology). Our research and teaching activities are predominantly based at the University of Ghana, School of Public Health.
Meningococcal meningitis in sub-Saharan Africa: from the understanding of the dynamics of colonization and disease patterns to improved control
Funding: Volkswagen Foundation (VolkswagenStiftung)
Time frame: 2005–2008; 2008–2013
Scientists (Section Clinical Tropical Medicine): T. Junghanss, A. Kapaun, J. Kaur, K. Rosenberger
· A. Sié, CRSN, Burkina Faso
· A. Zoungrana, CRSN, Burkina Faso
· A. Hodgson, Navrongo, Ghana
· G. Pluschke, Swiss Tropical and Public Health Institute, Basel, Switzerland
The "meningitis belt" of sub-Saharan Africa records the highest incidence of meningococcal meningitis in the world. The disease occurs in epidemic cycles with devastating consequences. The mechanisms leading to the spread of clonal complexes of Neisseria meningitidis and to epidemics of disease are still unclear. Since colonisation is the entry point to meningococcal meningitis, our proposed study focuses on systematic long-term analysis of the relationship between meningococcal colonisation and disease.
In recent years, an increasing incidence of pneumococcal meningitis has been observed in some regions of the meningitis belt. This trend, which is raising major concern since mortality is about tenfold higher for pneumococcal than for meningococcal meningitis, will be followed up very carefully.
The basic design is to analyse in two districts (one in Ghana and one in Burkina Faso) of the African meningitis belt (1) the dynamics of meningococcal nasopharyngeal colonisation, (2) the cerebrospinal fluids of all suspected meningitis patients attending the district health services and (3) the clinical pattern of disease.
The expected outcomes of the study are (1) improved prediction and control of epidemics of bacterial meningitis, (2) improved management of patients with bacterial meningitis, (3) improved understanding of the dynamics of colonisation and disease and (4) clarification of features relevant for the development of improved vaccines.
Clinical research at the district hospital Nouna in cooperation with the Nouna Health Research Center (CRSN) and clinical support for the SFB 544 (central Z3 project)
Funding: German Research Foundation (DFG, Deutsche Forschungsgemeinschaft)
Time frame: 2005–2011
Scientists (Section Clinical Tropical Medicine): A. Kapaun, T. Junghanss, J. Kaur, J. Leimkugel, M. Stojkovic
Scientists (delegated to Nouna from Heidelberg): A. Ries (2006–2007), M. Fritsche (2007–2008), R. Zamoryn (2009–2011)
● A. Sié, Nouna district hospital, CRSN
● SFB 544 working groups cooperating with the CRSN
The main goal of the Z3 project is to support the development of the Nouna district hospital and the CRSN into a qualified clinical trial site and support SFB 544 research projects.
Specific goals are to improve clinical standards in the Nouna district hospital and ensure clinical care for patients participating in trials. The monitoring and treatment of patients (active/passive case finding) are scientifically essential study endpoints and components ethically indispensable in SFB 544 projects in Nouna.
From 2006 to 2008, we focused on two departments within the district hospital: the CRSN/district hospital laboratory and paediatrics. The development of these two areas was coordinated by ‘tandems’ of scientists/physicians from Nouna and Heidelberg; at the CRSN/district hospital laboratory by Dr. A. Sié, Dr. B. Coulibaly and Dr. J. Leimkugel, in paediatrics by Dr. M. Bountogo and Dr. M. Fritsche.
The second period of cooperative quality development in clinical research at the CRSN and the district hospital was covered by Dr. R. Zamoryn (surgeon), who stayed in Nouna for two years from 2009–2011.
Observational clinical study “Cerebral malaria versus bacterial meningitis in children with impaired consciousness”
In sub-Saharan Africa, bacterial meningitis and cerebral malaria are important causes of impaired consciousness in children. Bacterial meningitis in West Africa occurs with a seasonal peak during the dry season. The average lethality is 45%, while the rate of neurological sequelae is as high as 40–50%.
The two main aims of this study are 1) the investigation of a regionally very important problem, with results contributing to the improvement of existing structures and quality assurance in the district hospital along with improved patient care; 2) the extension of the SFB 544, which already has a focus on malaria research, into clinical research.
Standardised clinical and laboratory data extraction sheets and SOPs (standard operating procedures) were developed and piloted. In synergy with the project ‘Meningococcal meningitis in sub-Saharan Africa: from the understanding of the dynamics of colonization and disease patterns to improved control’, the necessary laboratory techniques were developed, in particular typing and culture of microorganisms in Nouna. The molecular-biological workup is done in the Swiss Tropical Institute in Basel. The observational study runs continuously in the Nouna district hospital. Cases included in the study are reviewed on a regular basis, allowing to adjust clinical procedures directly at the district hospital, which again has a direct impact on patient care.