ROLE, RELATIONS WITH THE MoH AND PROGRAMMES

.As one of the technical institutions within the Ministry of Health, CREC acts under the auspices of the Public Health Research unit. Among other commitments, it has responsibility for assisting the National Malaria Control Programme in the design, implementation of programmes and the evaluation of their entomological impact.

Research Programme
Most of the research activities at CREC are conducted in collaboration with local and international institutions. Current research projects are mainly in areas of malaria, with particular focus on entomology and epidemiology. CREC has an Institutional Review Board within the MoH systems which reviews and monitors ethical issues in all research projects.
Links and collaborations with research institutions and Universities from
.West Africa (MRTC, INSP, CNRFP, IRSS)
.Central Africa (OCEAC)
.Northern Institutions (University of Paris XI, University of Roma, LIN, LSTM)

Strong partnership with
LSHTM, IRD, TDR/WHO and RBM/WHO.

AMANI CENTRE HISTORY

The NIMR Amani Centre was established at Ubwari, Muheza, Tanzania by Capt. Dr. Bagster Wilson in 1949 as the former East African Malaria Unit (EAMU) under the Colonial and Welfare Scheme. The unit served British Somaliland, Kenya, Uganda, Tanganyika, and Zanzibar in the control of malaria and other vector-borne diseases.

In 1951 the unit was moved to Amani Hill and renamed ‘East African Malaria Institute’ (EAMI) and became operational under the East African High Commission. Amani Hill did not provide an environment suitable for malaria field activities (mainly due to the lack of malaria vectors, hence a lack of malaria transmission) and the Ubwari site continued to operate as a field station. Research covered malaria, schistosomiasis, and onchocerciasis. The Centre had a strong training component targeting malaria field workers covering basic malariology and control of malaria vectors.

In 1954, the EAMI was renamed the East African Institute of Malaria and Vector Borne Diseases (EAIMVBD); research on schistosomiasis was phased out in 1960. Bancroftian filariasis and plague were introduced as new research areas at the EAIMVBD then operating under the East African Community (EAC) in the 1970’s.

Following the collapse of the EAC in 1977, the EAIMVBD was renamed ‘Amani Medical Research Centre’, which was to operate under the National Institute for Medical Research (NIMR).

The NIMR Amani Centre continued its research activities at both Amani Hill and its three Field Stations, namely Ubwari Field Station (located at the former EAMU premises in Muheza), Bombo Field Station at Bombo Hospital in Tanga City and Gonja Field Station in Same, Kilimanjaro Region. From 1998 research areas at NIMR Amani have increased to include clinical research as well as health systems and policy research.

In 2005 NIMR split the Amani Centre into two, namely Tanga and Amani Medical Research Centres. Amani Centre consists of Amani Hill and Ubwari Station.

The New Amani Medical Research Centre has a vision of being a centre of excellence in vector biology and disease control research. The strategic plan focuses on a wide range of public health issues including research on malaria, plague, lymphatic filariasis, tick-borne relapsing fever, onchocerciasis, health systems and policy, bio-informatics, diagnosis and laboratory sciences, demographic surveillance systems, basic/applied research (genetics and molecular biology) and indigenous knowledge and traditional medicine.

Its mandate covers vector biology and ecology, vector control, surveillance for vector susceptibility to insecticides, basic and applied research on appropriate vector control technologies, operational research on vector interventions, product development & evaluation, health financing and service delivery.

Experimental hut sites are located 15km from KCM College and 800m above sea level in an area between the Masai savannah and 5,896m high Mount Kilimanjaro. The surrounding area is dominated by agriculture and irrigated rice farming is the major activity close to the experimental huts. Japanese aid in this area of semi-arid savannah began in 1978 and has resulted in a system of irrigation canals and agricultural training.Paddy fields cover an area of more than 1,100 hectares. The irrigated fields are a major breeding site for the predominant malaria vector species in the area Anopheles arabiensis.

Fig. 1 Experimental huts located next to irrigated rice fields (with Mt. Kilimanjaro behind) which provide ideal breeding sites for An. arabiensis

The nuisance biting and filariasis vector Culex quinquefasciatus is also present at certain times of the year, breeding mainly in latrines and a sewage disposal plant situated approximately 1km away. Anopheles arabiensis are largely susceptible to most insecticide classes but show pyrethroid tolerance (as defined by WHO 80-100% mortality in susceptibility tests), due to metabolic mechanisms, and resistance to dieldrin. Culex quinquefasciatus in the area show resistance to pyrethroids, carbamates, and dieldrin.

Rainfall is concentrated in March-May accounting for 60% of the annual total 800mm in Moshi town (10km North). The remainder falls during October-December. Between the two rainy seasons are a hot, dry season January-February and a cool, dry season June-September. Rice is grown in 2 cycles with the sowing being done in mid-June, and November. Irrigation of rice fields during the early growing season coincide with peak An. arabiensis populations. Lower Moshi area is hyperendemic for falciparum malaria.

Fig. 2 Seasonal population dynamics of An. arabiensis at Mabogini field site. Showing mean number caught in the untreated control hut p/night.

Fig. 3 Seasonal population dynamics of Cx. quinquefasciatus at Mabogini field site. Showing mean number caught in the untreated control hut p/night.

Community localities for Phase 3 Trials

At present, two localities (Msitu-wa-Tembo & Babati) have been surveyed and prepared for Phase 3 evaluations. They have abundant An.arabiensis and Cx.quinquifasciatus population.

Fig 4 & 5. Peak Anopheles arabiensis breeding season with early stage transplanted rice.Early morning mosquito collections from experimental hut window traps.

Laboratory facilities

Specialized spray equipment for WHO phase 1 laboratory & Phase 2 small-scale field trials of IRS.

Spray apparatus includes;

1-Potter Tower

2-Spinning disc conveyor sprayer

3-Hudson sprayer

Fig. 6 Potter tower insecticide sprayer

Laboratory equipped for mosquito bloodmeal analysis, speciation by PCR, resistance mechanism assays icluding kdr & enzyme ELISA.

Benin trial site
Laboratories

1) For Whopes phase I testing of new chemicals and impregnated materials

2) For advanced research work at molecular level on vectors (PCR-species, PCR-forms, PCR-Kdr-Ace-1)

3) For morphological identification of vector species and dissection of their ovaries and salivary glands, backed up by Elisa for vector infectivity

Fig. 1 & 2. Selection of larvae for pyrethroid resistance & Larval rearing.

Whopes phase 2 field evaluation of insecticides

An intense period of rainfall in the South and North part of the country begins in March-April and lasts for 5 months and moderate rainfall occurs September through November. Between the two rainy seasons are a hot, dry season January-February and a cool, dry season June-September. In the north, rice is grown in 2 cycles with the sowing beginning mid April, and May each year. Irrigation of rice fields during the early growing season coincide with peak An.gambiae populations. Both sites are hyper-endemic and intense transmission zones for falciparum malaria.

CREC has two contrasting field sites;

LADJI
In the South of Benin, is a large village on the outskirts of Cotonou, capital of Benin. The village floods during the rainy season. The An. gambiae comprise of the Mopti (M) cytotype and shows resistance to pyrethroids and DDT with kdr present at high frequency. The nuisance mosquito Cx. quinquefasciatus is also present year round and shows resistance to pyrethroids, carbamates and organophosphate insecticides. Suites of experimental huts are situated along a lake at the edge of the village and are used primarily for evaluation of novel insecticides.

MALANVILLE
Situated in the north of Benin, 800 km from Cotonou, in an irrigated rice-growing valley this irrigated field constitues the major breeding site for the predominant malaria vector species An.gambiae in the area. An.gambiae is essentially of the Mopti cytotype but the kdr gene is almost absent and mosquitoes are susceptible to pyrethroids. Twelve experimental huts are present at this site.

Potential field sites for Whopes phase 3 trials
In South and North Benin, there are identified localities with baseline data already gathered on the entomology and epidemiology of malaria, suitable for community intervention.

Key Grants 2001-2008

1 GMP (Investigation of new chemicals/tools to manage pyrethroid resistance among malaria vectors, 2001-2006); Collaboration with Dow, BASF, Bayer, Dupont
2 Pal+ Programme (Acceptability of ITNs and LLINs, 2004-2006)
3 WHO/MIM (Impact of net washing practices under field conditions: 2005-2008 network)
4 Benin Government (Quality control of LLINs & ITNs, malaria vector resistance in Benin, 2005-2006)

- Over 60 years experience with malaria research
- Over 20 years experience with testing insecticides for use in IRS and other mosquito control tools (ITNs and LLINs)
- Country wide insecticide resistance monitoring
- Substantial experience in malaria epidemiology and transmission studies
- An African pioneer centre for ITN and LLIN studies

Trial site area

- Coastal climate (28ºC – 34ºC and RH 60 – 80%)
- Muheza district, north-east Tanzania
- 5°13′S and 38°39′E,
- Altitude 20 – 1000 metres above sea level
- Holoendemic malaria transmission (EIR 150-600)

Vectors include
- Anopheles gambiae ss
- Anopheles funestus
- Anopheles merus
- Culex quinquefasciatus

- Rural population living as subsistence farmers in village settlements of 1000 – 2000 people.

Research Facilities

Experimental Huts

-Suite of 12 experimental huts

Measuring efficacy of
- Insecticides for IRS
- Insecticide treated nets (ITNs and LLINs)
- Insecticide treated blankets and sheets
- Repellents

Mosquito spheres

- Suite of 3 mosquito spheres
- Provide semi-field conditions
Suitable for testing efficacy of; – traps
- repellents
- lures
- attractants
- & mosquito behaviour studies

Experimental Platforms

- Suitable for testing materials for mosquito control in complex emergency situations

- Insecticide treated sheets
- Treated tents
- Blankets

Community based malaria control studies

- Field studies on efficacy, acceptability and ITN /LLIN user practices

- Field studies on efficacy, acceptability, and cost effectiveness of IRS

- Durability of net fabric and endurance of insecticide on ITN/LLIN in the field

Laboratory

- ELISA for malaria sporozoites and bloodmeal source analysis
- Studies on mosquito resistance to insecticides
- Dissection for sporozoite detection and mosquito ageing
- Taxonomic identification of mosquitoes

Insectary

Colonies of mosquitoes in stock

An gambiae (KISUMU, R70 & IFAKARA)
An arabiensis (Dondotha)
Cx quinquefasciatus (MUHEZA, BANDARI & TPRI)

What we have done recently

- Carried out experimental hut trials for WHOPES and Industry

- 7 products tested and reported for WHOPES

- 5 products tested for industry and research

Community field trials
- 1 product under trial for WHOPES
– 4 products under trial for industry