September 2013

A monthly means to inform and inspire our TEAM

September 2013
Vol. 4, No. 9

Capacity Building

"Give a man a fish and you feed him for a day, teach him how to fish and you feed him for a lifetime"

Benjamin Emmanuel, joined University of Maryland PhD programa

Benjamin Emmanuel, joined University
of Maryland PhD program

The improvement in handling and shipping research samples is one example of how capacity is being built in the EMBLEM study. The first such shipment was received in poor condition, with slides dislodged from the holders and many of them broken. The next shipment was received in excellent condition, having been well packed. Lesson learned!

Recently, Benjamin Emmanuel, who had spent the last three years as the overall Study Coordinator for EMBLEM, was accepted to pursue a doctoral degree in epidemiology at the University of Maryland in Baltimore, Maryland, US. This is an example of personal capacity being built in the EMBLEM staff as they expand and upgrade their knowledge and credentials in medical research.

Capacity is also built by building up the library/reference collection at the EMBLEM sites. Recently, Canadian friends of EMBLEM donated reference books that will soon be shipped to EMBLEM sites in East Africa. As the EMBLEM Study continues to build capacity in all areas, it will not only benefit the present study but will also lay the groundwork to improve the capacity for doing future medical research.

Dr. Esther Kawira, editor


Flooded road in Uganda

As of September, EMBLEM Uganda has spotted and screened a total of 406 potential cases (259 males and 147 females). Of those, 207 (129 males and 78 females) were found to be eligible and were enrolled.

Matched control enrollment is underway in six wet villages in Lango sub region with 82 controls remaining to be enrolled. Field work in the “wet” season is challenging. The roads are flooded and usually almost impassable (see photo).

During the month, three clinical staff (one doctor, one nurse, and one technician) from Kuluva received hands-on training on the BL ward from Lacor Hospital’s Dr. Valeria Calbi. This training continues the locally established approach for interregional training of staff between EMBLEM sites in order to harmonize clinical treatment of BL in EMBLEM across sites.


A total of 225 potential cases (89 females and 136 males) had been spotted and screened. From the number screened, 77 cases (26 females and 51 males) had been confirmed eligible and enrolled in the study.

A site visit was made to Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) to plan for EMBLEM work at the hospital. Ms. Pamela Omollo was formally introduced as the local site coordinator and introductory meetings were held with various departments. A local office has been identified at JOOTRH for EMBLEM work. This office will be prepared to support EMBLEM work at JOOTRH and the nearby communities.

The EMBLEM Team held planning meetings with the AMPATH Reference laboratory to prepare for local sample processing and storage, in-country sample transport, and long-term sample storage. In addition, the possibility of collecting and storing flash-frozen BL tumor tissues at MTRH was discussed. Plans for this work will be completed in October and implemented by November.


A section of clinicians and nurses at Geita District Hospital following a presentation on BL Diagnosis by Dr. Esther

A section of clinicians and nurses at
Geita District Hospital following a presentation
on BL Diagnosis by Dr. Esther

Herry Dhudha presenting on the EMBLEM study to Kibara hospital clinicians.

Herry Dhudha presenting on the EMBLEM
study to Kibara hospital clinicians

Ten new potential cases have been spotted since the last report bringing the total number of potential cases screened and spotted to 287 (158 males and 129 females). 55 eligible cases have been enrolled (31 males and 24 females).

During the first half of September, a team of EMBLEM staff visited all hospitals, district medical offices, and regional medical offices in the two regions of our study area. The team updated clinicians, nurses, and district and regional medical officers on the EMBLEM Study, as well as reviewed signs and symptoms of BL, its diagnosis, and treatment. Posters and brochures were also distributed in an effort to increase case spotting.

In addition, a radio interview was given by EMBLEM staff to a major radio station in our study area in order to alert the public about BL and encourage them to bring affected children for medical care.

The PI of EMBLEM visited the Shirati and Bugando offices, and also visited the National Institute of Medical Research (NIMR) in Mwanza, the Mwanza Intervention Trials Unit (MITU), and Baylor University’s center for children with HIV. Also visiting were Prof. Nelson Chao and Prof. Sandeep Dave of Duke University, who were exploring possible research collaborations with EMBLEM in Tanzania.

EMBLEM Study Monitors, Dr. Moses Joloba and Mr. Samuel Kirimunda conducted a three day monitoring visit at EMBLEM Tanzania, visiting the Shirati and Bugando offices.


Touch prep from flash-frozen BL tumor tissue

Touch prep from flash-
frozen BL tumor tissue

EMBLEM is collecting flash-frozen tumor tissues as part of its collaboration with the NCI-led BL Genome Sequencing Project. In September, EMBLEM reached its goal of collecting 30 tissues from patients. The tissues will be shipped to NCI for study.

EMBLEM Newsletter is a monthly on-line publication based on contributions of the EMBLEM Study staff.
Editor: Dr. Esther Kawira
Reporters: EMBLEM Uganda – Esther Birungi; EMBLEM Kenya – Pam Akinyi Were; EMBLEM Tanzania – Josiah Magatti