March 2014

A monthly means to inform and inspire our TEAM

March 2014
Vol. 5, No. 3

Tanzania loses Study Coordinator; Uganda completes pilot control enrollment

Captain Josiah Ogada Magatti (RIP)

Captain Josiah Ogada Magatti (RIP)

The study coordinator for EMBLEM Tanzania, Josiah Ogada Magatti, passed away in his home in Shirati, Tanzania, on March 31st 2014. A rare example of dedication to public service in Africa, Magatti served as a Captain in the Tanzanian Peoples Defense Force and was part of the combatants that liberated Uganda from Dictator Idi Amin’s tyrannical rule. In civilian life, he was devoted to agricultural development and public health, particularly the fight against Burkitt Lymphoma, the most common childhood cancer in Mara Region where he lived. He was instrumental in bringing EMBLEM to Tanzania. His leadership and wise counsel will be sorely missed. May his soul rest in peace.

On February 14th 2014, the EMBLEM team in Uganda completed enrolling pilot controls in 12 study villages, meeting their goal of completing this task in less than two years. Enrolling population controls for a childhood cancer study was last done more than 40 years ago when the West Nile Study was conducted and linked infection with Epstein-Barr virus during infancy to Burkitt lymphoma. Northern Uganda was peaceful at that time and the work was led by international luminaries like Guy de The from the Pasteur Institute, the venerable Williams brothers, who worked tirelessly at Kuluva, and G Kafuko who was a pioneering virologist from the Uganda Virus Research Institute. On October 25th 2012, when we launched out into the population to begin the EMBLEM control enrollment, the historical contrasts were fresh in our minds - Northern Uganda was emerging from a brutal civil war; the population was traumatized; the luminaries from yesteryears were long gone. In short, the success of 40 years ago provided no comfort. Looking back to the success we have achieved, we can draw lessons about our success. The secret, perhaps, can be found in a quote by President Abraham Lincoln “I am a success today because I had a friend who believed in me and I didn’t have the heart to let him down”. For us, the non-assuming PI of EMBLEM, Dr. Sam Mbulaiteye, was such a friend. He believed in us and in the population. This inspired us because we did not have the heart to let EMBLEM down. We took the positive message to the community and they believed in EMBLEM and did not have the heart to let us down.

Dr. Tobias engaging the community about BL in Lira District

Dr. Tobias engaging the community about BL in Lira District

We have learned the important lesson to be faithful to our work. This lesson also is captured in the gospel according to St. Luke (7: 9-10) "The servant does not deserve thanks for obeying orders, does he? It is the same with you, when you have done all you have been told to do, say, 'we are ordinary servants; we have only done our duty." The team believes in this notion and will not rest on its laurels until all EMBLEM fieldwork is completed by 2015 for the benefit of the children of East Africa.

- Dr. Kinyera Tobias MB CHB, MPH, (EMBLEM study coordinator, Uganda)

EMBLEM UGANDA

Juliet Faith Aporomon- Data Manager, Uganda

Juliet Faith Aporomon- Data Manager, Uganda

In Uganda, 488 potential cases (310 males, 178 females) have been spotted. Of these, 276 were eligible and 568 (163 males, 95 females) were enrolled.

Matched Population Controls are being enrolled in 20 villages (9 wet, 11 dry) in North Central Uganda, leaving 68 villages to go.

We continued strengthening health education and outreach about BL in the study region using mobile phone short text messaging (SMS). To achieve this, EMBLEM has partnered with Text to Change to develop an upstream and downstream system to increase BL case spotting, early diagnosis and referral for treatment. Over 500 SMS’s have been sent out and the responses have been heartwarming.

EMBLEM KENYA

In Kenya, 342 potential cases (222 males, 120 females) have been spotted. Of these, 143 were eligible and 126 (91 males, 35 females) were enrolled.

A BL awareness workshop was held at Migori Hospital led by EMBLEM senior technical supervisor, Isaiah Ouro Genga, and EMBLEM Fulbright Scholar, Mr. Josh Biddle, reaching about 90 staff members. At Homa Bay, Dr. Nicodemus Odundo was assigned to work as a clinical liaison with EMBLEM. EMBLEM will facilitate Dr. Odundo’s clinical observation and training in ultra-sound guided biopsy of deep-seated tumors at St. Mary’s Hospital, Lacor.

Mr. Biddle had the rare and pleasant chance of meeting Hon. Raila Odinga, former Prime Minister of Kenya and opposition leader of the Orange Democratic Movement. Hon. Odinga hails from the EMBLEM Study area (Nyanza Province) and he was pleased to hear about EMBLEM’s work fighting cancer in East Africa.

EMBLEM TANZANIA

In Tanzania 343 potential cases (192 males, 150 females) have been spotted. Of these, 78 were eligible and 74 (44 males, 30 females) have been enrolled in the study.

A BL awareness workshop was held at Shirati Hospital on March 7th that was attended by about 60 hospital staff. On March 9th, a planning meeting led by senior EMBLEM staff members was held to discuss future activities, prepare for control enrollment, and to discuss strategies to boost low case accrual relative to the numbers projected from historical numbers.

EMBLEM GOALS

With the completion of pilot control enrollent in Uganda, the next objective is to evaluate the validity of one type of control versus the rest (pilot population, matched population, and health center). Lessons from these analyses will be applied to control enrollment plans in Tanzania and Kenya.

Click to enlarge.


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 – Herry Dhuda