IVI and Ghana

 

Ghanaian Leadership at IVI

 

From 2014 to 2020, Professor Fred N. Binka served on the IVI Board of Trustees, including as the Chair of the Governance & Nominating Committee. 

 

KNUST-IVI Collaborating Center

 

In 2021, IVI and the Kwame Nkrumah University of Science and Technology (KNUST) opened the KNUST-IVI Collaborating Center. 

 

The KNUST-IVI Collaborating Center will be a research and training site to implement ongoing and new collaborative projects, including disease surveillance, vaccine clinical development, vaccination campaigns, and vaccine effectiveness and health economics studies for infectious diseases prevalent to the region such as typhoid and invasive non-typhoidal Salmonella. The KNUST-IVI Collaborating Center is the first of its kind, initiated by IVI to enable joint research, development, and capacity-building activities to achieve regional health objectives as well as the UN’s global goals.

 

 

Ongoing Collaboration

 

Prospective Surveillance of Shigellosis Burden in Ghanaian Children

This study aims to determine the incidence of Shigella -attributed medically attended diarrhea (SMAD) in young children using the stool/rectal swab culture-based method. It will also assess linear growth faltering in the six months following an episode of SMAD compared with the control group. Additionally, the study will examine the clinical characteristics and complications of SMAD at time of presentation to health care facilities and after illness along with assessing the incidence of SMAD by serotypes, age groups, and seasons. Another objective is to help estimate the prevalence of resistance to commonly used antibiotics among the isolated Shigella strain.

 

In 2024, study documents received approval from the IVI Institutional Review Board and local ethics committees. During a field visit, comprehensive on-site training was conducted, and enrollment for the one-year facility-based surveillance study began. This study is in collaboration with KNUST and is funded by the government of Sweden through the IVI European Regional Office. 

 

Typhoid and Invasive Salmonellosis Surveillance

In 2015, IVI launched a multi-country typhoid burden study in six sub-Saharan African countries: Burkina Faso, the Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria. The study’s aim was to collect standardized data on typhoid fever disease incidence, severity, sequelae, and economic burden, as well as the incidence and severity of invasive salmonellosis. Initially launched as the Severe Typhoid in Africa (SETA, 2015-2019) project, it later transitioned to SETAPlus (2020-2023) and has now evolved into the Surveillance for TCV Impact Assessment in Africa (STIA) project. In 2024, a meeting titled “African Stakeholder Engagement for Combating Invasive Salmonella Infections” convened public health leaders, researchers, and stakeholders from 17 African countries to foster a collaborative and sustainable approach to combating invasive non-typhoidal Salmonella and typhoid in Africa.

 

In Ghana, STIA works with School of Public Health at KNUST.

 

THECA Typhoid Vaccine Development

Planned in conjunction with the SETA Program (see below), THECA came into place after a consortium led by the University of Cambridge Department of Medicine received a 13-million euro grant from the European and Developing Countries Clinical Trials Partnership (EDCTP). THECA includes a mass vaccination campaign in the Democratic Republic of the Congo (DRC) using the Typbar-TCV (Vi-TT) typhoid conjugate vaccine. From 2019-2023, this project will assess the safety, feasibility and cost-effectiveness of Vi-TT and its ability to limit the spread of antimicrobial resistance. In-country collaborators included the Institute National for Biomedical Research and Kisantu Hospital Saint-Luc.

 

The THECA project was initiated in 2019, planned in parallel to the SETA program. THECA includes a cluster-randomized vaccine effectiveness trial in Ghana and a mass vaccination campaign in DRC using the recently licensed typhoid conjugate vaccine Typbar-TCV® (also referred to as Vi-TT). An embedded health economics study will also assess the feasibility and cost-effectiveness of TCV when administered through a mass vaccination campaign. These studies will additionally generate data on the safety and immunogenicity of Vi-TT and measure the impact of vaccination in limiting the spread of antimicrobial resistance. 

 

Previous Collaboration

 

Training

Over 10 Ghanaian scientists and medical professionals have received vaccinology training at IVI’s Annual Vaccinology Course. 

 

Typhoid Vaccine Development

Ghana has played a key role in IVI’s efforts in generating evidence-based typhoid prevention measures. IVI’s disease surveillance research projects in Ghana helped establish a clear understanding of the typhoid disease burden and determine which multidrug resistant typhoid strain is most pervasive in Africa. Upcoming vaccine clinical trials in Ghana will enable IVI to bring an accessible, low-cost typhoid vaccine to the market that will save countless lives. 

 

IVI typhoid disease surveillance in sub-Saharan Africa was conducted during 2010 and 2014 in ten countries across the continent. In Ghana, this typhoid disease burden surveillance study was performed in collaboration with the Kumasi Centre for Collaborative Research in Tropical Medicine and the Agogo Presbyterian Hospital (APH) in Asante Akim North District. Febrile patients visiting this hospital (children under 15 years for Ghana site) were informed of the study and enrolled upon written consent.1 The study results showed high incidence rates of Salmonella Typhi infections among children under 15 years of age (389 per 100,000 persons observed during the surveillance period), and particularly higher in younger children between 2 to 5 years old (over 1,000 per 100,000 person-years of observation)2 Through this study, IVI has further confirmed the high burden of multi-drug resistant typhoid fever in Ghana, with predominant strain of multi-drug resistant S. Typhi circulating within Ghana and across its neighboring countries.3 

 

Following up on this study, IVI launched a Severe Typhoid in Africa (SETA) project in 2016, to further investigate the burden of severe typhoid fever, as well as the long-term immune response, carriage, and economic burden associated with invasive salmonellosis. Operating in 7 countries across sub-Saharan Africa, SETA has continued studies at Agogo Presbyterian Hospital and expanded surveillance to the Komfo Anokye Teaching Hospital in Kumasi. The results of IVI’s surveillance campaign will be shared with policymakers to inform their decisions on including typhoid vaccines in their national immunization programs.