IVI and Burkina Faso

 

Ongoing Collaboration

 

Vaccine against Schistosomiasis for Africa (VASA)

With funding from the EU Horizons 2020, IVI launched VASA in 2019 to conduct a Phase I clinical study of the SchistoShield® anti-schistosomiasis vaccine in Burkina Faso and Madagascar. This project includes disease surveillance and cost-effectiveness studies, the formation of a global consortium to advance schistosomiasis vaccine research, and an Integrated Product Development Plan (IPDP) for development of the vaccine backed by the Bill and Melinda Gates Foundation. In addition, VASA contributed towards a human challenge model for the vaccine which was developed in partnership with the University of Leiden.

 

IVI’s primary activities for the VASA project are: 1) A seroprevalence and disease burden study in Madagascar and Burkina Faso to understand the current disease burden and evaluate the age of exposure to schistosoma. This information will help inform vaccine development and guide control measures; 2) A cost-of-illness study to comprehend the financial burden of schistosomiasis on local populations and estimate the cost-effectiveness of a vaccine; 3) A phase Ib clinical trial to assess the safety and reactogenicity of the SchistoShield® vaccine, one of the leading schistosomiasis vaccine candidates.

 

For the Phase Ib trial, the First Participant First Visit took place in November 2023 in Madagascar.

 

In 2023, data analysis suggests a heavy burden of schistosomiasis in rural settings in Madagascar, including in children under five years of age.

 

The disease burden is much lower in Burkina Faso, in line with a successful national helminth control program.

 

In Burkina Faso, the lead VASA collaborators are the University of Ouagadougou and the Group de Rechereche Action en Santé.

 

Severe Typhoid in Africa Plus / Surveillance for TCV Impact Assessment in Africa (SETA+/STIA)

IVI launched the SETA program in 2015 in six countries: Burkina Faso, the Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria to collect standardized data on typhoid fever disease incidence, severity, sequelae, and economic burden in addition to invasive salmonellosis incidence and severity. The program was successfully completed at the end of 2019 and transitioned to SETA Plus (except Ethiopia) in 2020 following further funding. Surveillance was completed at the end of 2022.

 

To date, the largest case numbers have been identified in the DRC and Nigeria, including severe typhoid and intestinal perforation cases. Further characterization of disease severity, the extent of carriage of pathogens in stool, patterns of antibiotic consumption, prevalence of resistance, and cost-of-illness data are underway.

 

SETA Plus surveillance has provided valuable evidence to support national decision-making processes for TCV roll-out. In Burkina Faso, a typhoid stakeholder meeting concluded with the decision to introduce typhoid vaccination, and Malagasy officials from the newly established National Immunization Technical Advisory Group (NITAG) are reviewing typhoid burden data in the country.

 

In December 2022, IVI hosted the first Africa Regional Meeting on Typhoid and Typhoid Conjugate Vaccine in Cape Town, South Africa to accelerate vaccine introduction in typhoid-endemic countries.

 

From 2024, the project continues as STIA until the end of 2025.

 

In Burkina Faso, the Institut Supérieur des Sciences de la Population (ISSP) at the Joseph Ki-Zerbo University of Ouagadougou is the lead collaboration partner.

 

International Vaccinology Course

Since 2012, three individuals from Burkina Faso have participated in IVI’s International Vaccinology Course.

 

Previous Collaboration

 

Typhoid Conjugate Vaccine Introduction in Africa program (THECA)

THECA was a consortium led by the University of Cambridge Department of Medicine and funded by a €13 million Euro grant from the European and Developing Countries Clinical Trials Partnership (EDCTP). From 2019-2023, this project assessed the safety, feasibility and cost-effectiveness of typhoid vaccine and its ability to limit the spread of antimicrobial resistance.

 

THECA encompassed five projects: a Phase IV cluster-randomized trial of Typbar-TCV® involving children aged nine months to 16 years in Ghana; a Typbar-TCV® mass vaccination campaign with a prospective cohort evaluation of vaccine effectiveness in the Democratic Republic of Congo; a vaccination campaign with effectiveness evaluation of the TYPHIBEV® vaccine in Madagascar; and advocacy support for the introduction of TCV in Burkina Faso.

 

Within these studies, post vaccination enhanced surveillance was integrated into the SETA+ hospital-based surveillance area, enhancing case detection and supporting the calculation of vaccine impact at both individual and population levels.

 

Following a 2022 consultative meeting co-organized by IVI and PATH, Burkina Faso’s National Immunization Technical Advisory Group (NITAG) issue favorable recommendations for 1) the introduction of TCVs in the expanded immunization program and 2) a mass national vaccination campaign with children between the ages of 1 and 15.

 

In Burkina Faso, the University of Ouagadougou was the lead collaboration partner.

 

COVID-19 Research in African Settings (COVIA)

With funding from Sweden’s Sida, IVI launched COVIA, a program which supports local institutions in Burkina Faso in alignment with national authorities. COVIA aims to improve the collection of disease burden data by implementing COVID-19 surveillance tailored to health care centers, as well as testing and tracing the household contacts of infected patients.

 

Severe Typhoid in Africa (SETA)

The Severe Typhoid Fever in Africa (SETA) program, a multicountry surveillance study, aimed to understand the burden of severe typohid fever and the associated case fatalities, clinical characteristics, and potential host risk factors that may be related to the disease severity. The SETA program also aimed to investigate the host immune response and bacterial shedding patterns associated with invasive salmonellosis.

 

SETA conducted prospective healthcare facility–based surveillance with active screening of enteric fever and clinically suspected severe typhoid fever with complications was performed using a standardized protocol across the study sites in Burkina Faso, the Democratic Republic of Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria.

 

In Burkina Faso, SETA conducted surveillance from 2016 to 2019 in the capital Ouagadougou and Balé Province in collaboration with the Schiphra Hospital Laboratory.

 

The data generated by SETA will be essential in developing adequate immunization strategies and typhoid and iNTS disease control and prevention policies. The SETA study results will have a direct impact, particularly in countries eligible for support from Gavi, the Vaccine Alliance, on potential uptake of TCV in the next 10 years.

 

Typhoid Surveillance in sub-Saharan Africa Program (TSAP)

From 2010 to 2014, IVI’s The Typhoid Fever Surveillance in Africa Program (TSAP) obtained comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania).

 

With initial funding from the Bill and Melinda Gates Foundation in 2010, a field site was established in Burkina Faso to conduct surveillance on the invasive Salmonella infections largely impacting children and rural populations. In 2013, data analyses from this program showed a high incidence of typhoid fever burden in Burkina Faso, following which IVI obtained additional funding from the Else Kroner-Fresenius-Stiftung of Germany to carry out capacity-building activities in the country.

 

Each TSAP site conducted passive surveillance for bloodstream infections among febrile patients to isolate and identify aerobic bacteria from the patients’ blood. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. The results of TSAP indicated that enteric fever caused by Salmonella Typhi and non-typhoidal Salmonella are significant problems in Africa and that the prevalence of multi-drug resistance may limit appropriate treatment options.

 

Along with its new disease burden discoveries, TSAP and its collaborators strengthened local surveillance capacities at multiple sites across sub-Saharan Africa, creating a system that has improved bacterial disease diagnostics, disease surveillance, reporting, and analysis systems in the region.

 

Dengue Vaccine Initiative (DVI)

After its establishment in 2011, DVI research was expanded to Burkina Faso in 2014. IVI’s Policy and Economic Research (PER) team kickstarted a health economics study to evaluate a cost estimation tool and transmission model to estimate the global impact of a new oral cholera vaccine. In response to the Ebola outbreak in 2014, the DVI assisted in the launch of a mobile-based system using PDA devices and conducted data management training using internet applications at a field site in Burkina Faso.

 

Meningitis in Niger Program

After WHO approval in 2010, IVI helped to carry out the mass roll-out of MenAfriVac in 2011, which was initially introduced in Niger and subsequently expanded into select regions of Burkina Faso.