Arboviral Infection Study
The MRC-University of Glasgow CVR and the Ugandan Virus Research Institute (UVRI) are jointly working on the Arboviral Infection Study (AVI). This study, funded by Wellcome and the MRC, will provide information on the epidemiology of novel and emerging insect-borne viruses responsible for acute febrile illness in three Ugandan districts (Arua, Kasese and Kampala).
The study intends to facilitate the development of serological and molecular diagnostics, and provide insights into vector and reservoir populations. The overall impact will be to improve the design of disease control strategies.
As a sub-study, we have added a survey of healthcare workers and farmers/butchers/abattoir workers (funded by the UK-RST). This will involve testing subjects for exposure to a) viruses detected in the Acute Febrile Illness (AFI) study, and b) viruses of consequence (e.g. viral haemorrhagic fevers).
In order to identify the carriers and reservoir species of the target viruses and also examine the wider ecology, we are sampling arthropod and vertebrate species from the ecosystem close to patients’ homes:
- Mosquito collections from homes and the surrounding environment
- Ticks from livestock, dogs and small mammals
- Blood from domestic animals, bats and small mammals (rodents and shrews) trapped in and around homes
AVI study sample analysis - Stella Atim (MUII veterinary PhD fellow)
From these samples we will classify viruses identified by next generation sequencing onsite at the Uganda Virus Research Institute.
This holistic approach to pathogen discovery and surveillance will provide insights into the viruses causing acute febrile illness in Uganda and assist in both the identification of ecological reservoirs and the mechanisms of viral emergence.
Progress report: January 2021
The occupational health substudy of the AVI study, funded by the UK Public Health Rapid Support Team, is underway at Kagando Mission Hospital and Bwera General Hospital in Kasese district, Uganda. This study aims to investigate levels of exposure of healthcare workers to viruses of consequence, including viral haemorrhagic fever viruses such as Ebola. Due to the COVID-19 outbreak, testing for SARS-CoV-2 has been added to virus screening in the study.
The first remote training was conducted on the 4th December 2020 at Kagando Hospital. We had 3 great training sessions.
Training session via Zoom
The team is directed by Dr Mary Munyagwa and consists of Laheri Kabugho the team leader, Mercy Musoki and Joshua Muhindo as study nurses, Bettress Happy as HIV counselor and Edson Masereka in the laboratory. Training sessions involved Marina Kugler joining via Zoom, sessions involved sharing of materials using PowerPoint presentations, documents and training videos.
The team has mobilized their colleagues at the hospital, and the first participant in the Health care worker study group was recruited on the 11th December 2020. Around 30 participants were recruited each day for five consecutive days.
Joshua Muhindo Taking informed consent
Every study parcipant receives a specific study ID preprinted on sticky labels for labelling the blood samples.
Joshua Muhindo and Laheri Kabugho entering questionnaire data into RedCap via mobile phone
Edson Masereka taking blood from a participant
Blood samples are taken from participants. The blood will be tested for antibodies to various viral infections.
The blood samples are then heat inactivated and stored in the freezer.
Heat block for inactivation of samples
Stella Atim arrived in Kagando on the 14th December 2020, to support the team mainly with the recruitment of community members.
Joshua, Laheri, Stella and Hassan (driver) in Kagando.
The chart below shows participant recruitment at Kagando Hospital. 150 participants were expected to be recruited over 5 days.
The second study group were the community members matched to the Kagando Health care workers. Stella Atim and Laheri Kabugho organized a meeting with a member of the village health team and the village leader to introduce the study. They organized mobilizations in their villages and the study team could come to the villages and recruit participants previously mobilized.
Participant recruitment in Rwesorora village, the first place to collect participants in the community member study group.
Participant recruitment in Kiburara
Participant recruitment for community members in villages around Kagando is shown in the graph below. Every day 45 participants were recruited with a plan to match the health care worker in sex and age. In total 225 participants were recruited.
Progress report: June 2020
All collections have been completed except for human samples in Kasese district (this was due to the presence of Ebola virus in the area). Sequencing has been completed for the human, mosquito, rat and bat samples collected and analysis of these sequences is underway. Sampling for the sub-study of healthcare and livestock workers has been completed in Arua district and work in Kasese district has been delayed by the Covid response until later in the year.
Bat sampling in Arua, Uganda