Objective: To prepare the Walter Reed Army Institute of Research's first partner site in Navrongo, Ghana, to launch a surveillance study to identify severe infectious disease threats in the surrounding area.

Challenges: 

1. Assess the site’s readiness to conduct a research protocol involving an array of laboratory assays as well as insect, animal, and community surveillance components
2. Equip the site and coordinate logistics and shipping to a remote, rural area
3. Ensure progress of site development despite COVID delays and travel restrictions

Solution: HJFMRI has experience developing multiple clinical research facilities in Africa through decades of previous work with the U.S. Military HIV Research Program. The International Laboratory Program (INLAP) engages early in protocol development to assess sites, bring labs to accreditation standards, procure vendor and services contracts, and train local staff.

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The Walter Reed Army Institute of Research (WRAIR) protocol EID005 is a study to identify and characterize cases of suspected severe infectious disease at five sites in Nigeria, Liberia and Ghana. The protocol has an additional, unique disease surveillance component at its Navrongo, Ghana site. The Navrongo Integrated Surveillance Project (NISP) collects insect, animal and human community information to get a more complete snapshot of potential infectious disease sources and transmission in the area.

While most EID005 sites are clinics in larger towns or urban areas, NISP takes place in more rural Navrongo. The setting provides a diverse ecology for the entomologic and zoonotic components of the study, and Navrongo’s location on Ghana’s northern border means residents are more likely to encounter both people and pathogens from outside its sphere.

Assessing the Site

The amount of work needed to bring a site up to protocol requirements varies greatly. At one EID005 site, staff encountered a lab with no electricity or water, and several agencies collaborated to dig them a well.

Site development in Navrongo began in July 2019. HJFMRI visited the site to conduct an initial assessment of the Navrongo Health Research Center (NHRC), the lab where specimen testing takes place. The assessment spans basic infrastructure and utilities to a checklist of protocol-specific supplies and equipment.

The NHRC was already a well-established with stable infrastructure, so INLAP’s next step was to procure all the supplies necessary to launch NISP, a list ranging from centrifuges and chemical reagents to computers and stools for the lab bench.

Securing Supplies and Equipment

Staff also needed to ensure valuable supplies, including sensitively calibrated instruments and refrigerated products, cleared Ghana customs and reached remote Navrongo intact after a flight from capital city Accra followed by a three-hour drive on rural roads.

HJFMRI also supports the Joint West Africa Research Group, an Army-Navy collaboration that supports the expansion of infectious disease research capabilities in the region. Through JWARG work, the Naval Medical Research Unit Three's Ghana detachment and the Noguchi Medical Research Institute, who helped coordinate logistics and deliveries to NHRC. Then, the lab prep team arranged installation and quality assurance checks to ensure the new equipment met certification standards.

Progress Despite COVID

The COVID pandemic halted site development in Navrongo in early 2020 and delayed the start of NISP. As activity resumed in 2021, HJFMRI relied on video calls and virtual meetings to accomplish the SOP development and protocol training that would normally take place over several visits to the site. Despite a two-year gap in in-person visits, HJF/HJFMRI staff provided a consistent presence, ensuring site development progress throughout the pandemic.

 

Learn more about HJFMRI Focus Area: Capacity Building