October 2014

A monthly means to inform and inspire our TEAM

October 2014
Vol. 5, No. 10


Dr. James Makorere takes an ultra-sound guided core needle biopsy.

Dr. James Makorere takes an ultra-sound guided
core needle biopsy.

Scientific analysis can involve core sampling of many types, depending on the field of study and the substance being sampled. In the arctic, scientists take core samples of glaciers that can tell much about the earth’s atmosphere through thousands of previous years. A core of a tree trunk can tell of growth patterns reflecting climate patterns. In medicine, core samples of body tissue are usually obtained to facilitate diagnosis of cancer. An accurate diagnosis of cancer is needed to ensure the right treatment is given to the patient and to reduce the dangers of giving unnecessary treatment to patients having a less threatening illness. The use of core biopsies in medicine has reduced reliance on surgical excision as the primary method to obtain diagnostic tissue and reduced the time required to obtain a biopsy, while increasing patient safety.

The EMBLEM Study has supported five doctors (2 each from Tanzania and Kenya, 1 from Uganda) to undergo specialized training in taking core needle biopsies of suspected cancers, including Burkitt Lymphoma (BL). This procedure uses a large bore needle (G18 or 16) inserted through the skin targeting the tumor under ultrasound guidance. Tumor tissue is obtained that can be made into imprints, formalin fixed specimens, and snap frozen tissue specimens. All of these are used for definitive confirmation of the diagnosis of BL. If the biopsy proves to be a tumor other than BL, ascertaining the correct diagnosis can lead to an alternate appropriate treatment for the patient.

In October, Dr. James Makorere of Shirati Hospital in Tanzania went to the Uganda EMBLEM site in Lacor to be trained in taking core needle biopsies with ultrasound guidance. The photo shows him subsequently taking his first such biopsy at the Shirati EMBLEM Unit. This represents a significant step in improving the accuracy of BL diagnosis at the Shirati site.

- Dr. Esther Kawira - Editor


Dr. Tobias training Community Research Assistants

Dr. Tobias training Community
Research Assistants

Currently case enrollment in EMBLEM Uganda stands at a total 567 (362 males, 205 females) screened/spotted and 296 (189 males, 107 females) eligible/enrolled.

On the 29th-31st of October the EMBLEM Uganda team trained 20 community research assistants for matched control enrollment in the last 20 villages in North Central Uganda. Staff continued BL awareness training in the region.


During the month of October, 13 (11 males and 5 females) were spotted out of which 11 (9 males and 2 females) were enrolled giving a cumulative total of 472 spotted and 179 enrolled.

The team continues with BL awareness activities at the hospitals where EMBLEM is enrolling cases and using short-message services to maintain awareness of BL symptoms. The team is also completing their plans for matched control enrollment, which is scheduled to start early in 2015.


Dr. Esther Kawira receives a plaque

Dr. Esther Kawira receives a plaque

A total of 418 (230 males, 88 females) potential cases have been spotted. Of these, 98 were eligible and 91 (54 males, 37 females) were enrolled.   

Plans to recruit a new study coordinator were approved and the job advertised in local newspapers and departmental bulletin boards at medical institutions in the region. EMBLEM has entrusted the responsibility to short list, interview qualified candidates and recommend the best candidates to a search committee chaired by Dr. John Changalucha, Director of the National Institute for Medical Research (NIMR) at Mwanza.

In early October Dr. Esther Kawira, EMBLEM PI for Tanzania, was honored as Goshen College Alumna of the Year for 2014 in her home town of Goshen, Indiana, USA. During Homecoming Weekend, she and the other honoree’s lives were highlighted as fulfilling the college’s motto of "Culture for Service". Among things especially noted were her participation in medical research and teaching of medical students. She also gave a talk at their Science Speakers series, entitled "The Burkitt’s Lymphoma Story", attended by premedical and other science students.



Kishor Bhatia at ASH

EMBLEM made its debut at the 56th American Society of Hematology (ASH) Annual Meeting held from December 6th to December 9th in San Francisco. ASH brings together over 15,000 investigators from North America and elsewhere who are interested in hematological diseases. EMBLEM investigators (Kishor Bhatia, at right, and Sam M. Mbulaiteye) presented two abstracts on preliminary data about sequence diversity of EBV isolated from African and Latin American BL tumors and preliminary data about the association between blood-stage malaria infection and BL using EMBLEM data. Besides the EMBLEM abstracts, only two other abstracts featured BL data from African patients, highlighting the important contribution EMBLEM is making to the research on BL.

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