Evaluation of new diagnostic tests
A major area of focus for the Clinical Research Department is the evaluation or fine-tuning of new tests or diagnostic algorithms and new techniques for monitoring treatment efficacy. Efforts are aimed both at the three major diseases – HIV infection, tuberculosis, and malaria – as well as at some neglected tropical diseases.
Projects concerning HIV infection in adults, children and newborns involve verifying the sensitivity and specificity of various rapid diagnostic tests or new techniques for measuring CD4 counts at the patient point of care or point of contact with peripheral health facilities (“point-of-care” tests).
In an effort to improve TB diagnosis for adults and children (HIV co-infected or not) in peripheral health centers, a series of studies was launched in Homa Bay, Kenya and at the Mbarara field research base in Uganda using the Biosafety Level 3 (BSL-3) mycobacteriology laboratory. The goal is to improve the yield from samples of mycobacteria cultures, and to introduce molecular techniques in the near future.
Neglected tropical diseases
Buruli ulcer, a skin infection caused by a mycobacterium, is still rife in humid tropical regions. In Cameroon, Epicentre and its partners have launched a research effort to establish a diagnostic algorithm for skin sores, to help differentiate Buruli ulcer from other skin ulcers requiring different treatment.
The two-year follow-up needed to conclude that the treatment for second stage human African trypanosomiasis has been effective is a burden on patients and an obstacle to the development of new treatments. By analyzing the data from twelve MSF programs, Epicentre has validated a treatment efficacy indicator that shortens this follow-up period to six or twelve months.