IVI and the Democratic Republic of the Congo

Ongoing Collaboration

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 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.

In D.R. Congo, the team completed a household enumeration census in 2020 in addition to ongoing clinical surveillance. The team is currently finalizing both the main vaccination study and the health economic study protocols with mass vaccination planned across the Kisantu health zone in early 2021.

In D.R. Congo, THECA works in cooperation with the Institute National for Biomedical Research, with funding from the Melinda Gates Foundation and the Second European and Developing Countries Clinical Trials Partnership Programme

Hepatitis E Epidemiology in Africa (HEVA)

In late 2020, IVI received a $500,000 grant from the Bill and Melinda Gates Foundation to conduct seroepidemiology of HEV in Africa. In 2021, IVI will form a consortium with the Institute Pasteur in Dakar, Senegal; the University of Ibadan in Ibadan, Nigeria; and the Institute Nationale de Recherche Biomédicale in Kinshasa, Democratic Republic of the Congo (DRC) to screen approximately 18,000 blood samples from 19 countries to determine the prevalence of HEV across different demographics, groups, and regions in Africa.

Severe Typhoid in Africa (SETA), SETA Plus, and Surveillance for TCV Impact Assessment in Africa (STIA)

After its launch in 2015, the SETA program began surveillance activities in Democratic Republic of the Congo in 2017, expanding its efforts to determine the severe disease study and economic burden of Salmonella infections in sub-Saharan Africa. This two-year project resulted in first incidence estimations of data, following which the Bill and Melinda Gates Foundation extended additional funding for typhoid surveillance in Democratic Republic of Congo and four other SETA countries. Since 2020, SETA Plus has continued the research and monitoring of typhoid in Democratic Republic of the Congo.

In 2017, IVI began conducting epidemiologic and socio-economic research on Typhoid in D.R. Congo through its Severe Typhoid in Africa (SETA) study. The Bill and Melinda Gates Foundation granted additional funding for further typhoid surveillance in D.R. Congo as a part of SETA Plus (+), an initiative intended to commence at the beginning of 2020.

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 D.R. Congo, the Kisantu Health Zone hosts STIA enhance surveillance activities including population census, community engagement & the health center referral system.

Implementing a Health and Demographic Surveillance System (HDSS) 

HDSS seeks to collect accurate longitudinal demographic, socio-economic, health related data and geolocation information from the population living in the surveillance catchment area in D.R. Congo and Madagascar. HDSS runs from 2022 through 2026 with funding from the IVI European Regional Office, in collaboration with the Heidelberg Institute of Global Health, The Hong Kong Jockey Club Global Health Institute, the Ghana FDA, and the Madagascar Institute for Vaccine Research.

The HDSS in Kisantu, D.R. Congo consists of establishing a dynamic cohort of around 50,000 individuals living in three health areas (Gare, Nkandu, Nzeza Landu) within the Kisantu Health Zone through a baseline census and census updates at regular intervals. This activity is done in collaboration with the Institut National de Recherche Biomédicale (INRB).

Implementing an HDSS in Kisantu will be helpful for a better understanding of the basic demographic and health characteristics underlying the population within the study area. It will provide reliable up-to-date denominators calculating vital rates and analyses requiring ‘at risk’ populations, demographically characterized sampling frame for epidemiological studies. HDSS will also serve as a real platform for conducting surveys, demonstration projects, implementing and evaluating interventions, carrying out effectiveness studies and investigational trials with potential public health value.