Study finds that simpler diagnostic tools can improve care for chronic Hepatitis B patients

Around 82 million People in Africa are living with Hepatitis B a virus that can lead to two potentially fatal health problems, liver cancer, and extensive liver damage (Cirrhosis). While Hepatitis B is treatable, treatment is subject to evidence of advanced liver damage usually shown by elevated Hepatitis B virus in the blood. In a study published in Nature Communications, a group of researchers have investigated whether the use of a combination of cheap and accessible blood tests in Africa, can improve care of patients with Hepatitis.

Co-author in the study, Dr. Alexander Stockdale a Senior Clinical Lecturer at the University of Liverpool (UoL) and Malawi Liverpool Wellcome Programme (MLW), explained that “Our study aimed to answer the question: can we diagnose advanced liver fibrosis in the Africa region, using routinely available and low-cost blood tests for patients with hepatitis B?”. This question is critical to make decisions about which patients should start antiviral treatment.

The researchers who make up a collaborative network called HEPSANET (Hepatitis B in Africa Collaborative Network) say that while the global hepatitis B elimination strategy developed by the World Health organization (WHO) has now been adopted by most countries worldwide, unfortunately, the African continent has been left behind in the fight against hepatitis B although it carries a high burden of preventable disease and new infections.

The study found that the existing World Health Organisation guidelines from 2015, which recommend a simple biomarker called APRI to assess liver injury, is not adapted for the African population. The authors propose to lower the treatment decision threshold of this biomarker for African patients and call for hepatitis B guidelines to be better adapted to the African setting.

The researchers collected and analyzed data collected from 12 sites in 8 African countries namely: Burkina Faso, Ethiopia, The Gambia, Malawi, Nigeria, Senegal, South Africa, and Zambia.

Co-author Dr Marc Henrion, a Senior Lecturer in biostatistics at the Liverpool School of Tropical Medicine and Malawi Liverpool Wellcome Programme, said: “Our study really illustrates the power in systematically pooling all available data on a given research topic and analysing them together using robust statistical models. In our case, we have comprehensively shown that existing WHO diagnostic guidelines using the APRI biomarker are inadequate for sub-Saharan African populations.”

The study paper can be accessed through this link Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa | Nature Communications

In Malawi which is one of the countries from which data was obtained for this study, Hepatitis B is prevalent in 5% of the adult population according to a recent study from MLW (link : https://academic.oup.com/jid/article/226/5/871/6424415). However, screening and treatment are still very limited and as such Hepatitis B has been characterized as a neglected tropical disease.

 

MLW Honours Outstanding Staff

Lights illuminated the room. Black and silver embellishments invited the patrons in. A step into Room Soche 2 at Sunbird Mount Soche Hotel in Blantyre that night of Friday September 16, 2022, exposed one to a scent of success.

On that night, glamour and splendour coated Mount Soche as MLW took its 25th Anniversary Celebrations to another stage. MLW awarded outstanding employees and teams.  Their remarkable efforts in the past 25 years receiving the well-deserved recognition.

MLW’s Interim Director Professor Henry Mwandumba took to the podium and said: “The award ceremony is in recognition of various achievements that members of staff of MLW have attained over the 25 years. This is one way of the ways of appreciating the contribution of staff to the success of MLW.

“We are an organisation that responds to the health needs Malawi and the region. Our intention is to continue working with the Government of Malawi to ensure that we do research in areas that are a priority to the government so that we may continue to contribute to the policies that improve the health of Malawians,” Professor Mwandumba said.

Tiferanji Fatch Sochera, who was awarded for the exceptional growth, encouraged fellow employees to focus on the bright side of their careers for MLW’s flag of excellence to be raised higher.

Sochera, who has recently been promoted to Clinical Research Quality Manager, said: “I am very happy because I did not expect to get this award; it is a surprise to me, and I thank MLW for recognising my work. I have good experience because I joined MLW as a study coordinator and I progressed to the research governance officer then administrator now I am the quality manager. I am thankful for the recognition and career progression.”

Former Director Professor Stephen Gordon received a Lifetime Achiever Award in the operations category.

Stephen Amos, MLW’s Occupational Health Nurse, bagged the most creative and outstanding achievement (Excellence) awards.

Community Engagement Coordinator Elvis Moyo was decorated with the community service award and Dr. Kondwani Jambo glittered in research.

MLW Recognises Media as Key Partner

Within the catalogue of its 25th Anniversary Celebrations, Malawi Liverpool Wellcome Programme has recognised the media as a key partner in health research. On Friday September 9, 2022, MLW celebrated its fruitful relationship with the Malawi media through what was dubbed Editors’ Day. The event took place at Mount Soche Hotel in Blantyre.

MLW’s researchers interacted with news editors and journalists from different media outlets with the aim of appreciating and deepening the understanding of each other’s work.

MLW’s Communications and Public Engagement Manager, Lindiwe Mafuleka said the meeting with editors was highly important and demonstrates the value that MLW places on its relationship with the media. “Most of the time we invite you the media to come listen to us but today we get an opportunity to hear from you and this for us is very important”, said Mafuleka.

 

Media trainer at the Malawi University of Business and Applied Science (MUBAS) Dr. Jolly Maxwell Ntaba said scientists should also invest their time to understand journalism for the relationship to thrive and benefit the country.

News editor at Kulinji.com Chisomo Ngulube thanked MLW for recognising and working with the media in its 25 years of improving health through health research.

Ngulube said; “I appeal to MLW to  consider providing trainings to editors in science and health research reporting as they do to journalists through the JIR platform. This will help in levelling the understanding of health issues between the reporter and news filters.”

During World Press Freedom Day each year, MLW also recognises excellent work in Health Research Reporting through Malawi’s Annual Media Awards organised by the Malawi Chapter of the Media Institute of Southern Africa (MISA Malawi) through its initative called Journalists in Residence.

MLW Celebrates Anniversary with A Majestic Walk

On Monday September 12, 2022, Malawi Liverpool Wellcome Programme premises turned into a hive of attraction as the research organisation began the second week of 25th anniversary celebrations.

The week started with a walkathon (a long-distance walk organised to raise awareness) that caught the attention of many people around the Ginnery Corner side of Blantyre.

The walk was organised to celebrate and inform the public of MLW’s success in research over the past 25 years. The walkers (mostly MLW staff) donned MLW branded attire, carried placards with different messages, thus setting the tone for the celebration.

Speaking after the walkathon, MLW’s Interim Director Professor Henry Mwandumba said the past 25 years have been productive because the organisation has improved health and trained the next generation of scientists and leaders.

“We are doing research that informs a lot of health policies within and outside of Malawi. The Government of Malawi is putting into practice some of our work to improve the health of the nation. We look forward to working with the government, local and international partners as we continue conducting research and training the next generation of scientists and leaders,” said Mwandumba.

Mwandumba said MLW will extend its focus to include other areas posing challenges on health such as climate change.

Kamuzu University of Health Sciences (KUHeS) Vice Chancellor Professor Macpherson Mallewa said the partnership between MLW and KUHeS has tremendously contributed to the nation.

“We have a research agenda that speaks to the National Health Research Agenda, and all along the MLW research has spoken to KUHeS research agenda going we will carry on together doing research, we will carry on together training future scientists, doctors, and nurses for the benefit of the country,” said Professor Mallewa.

The Director of Liverpool School of Tropical Medicine Professor David Lalloo said MLW has been a fantastic partner among its partners in Malawi and the United Kingdom.

Lalloo said he is hoping for MLW’s massive growth of research capacity to conduct high quality research in Malawi and Africa to make a big difference in the region.

Professor in Infectious Diseases and Global Health at the University of Liverpool Neil French who visited MLW during the Anniversary said: “It is a privilege to be here to see the fantastic growth of the organisation and how it has truly converged into a fully-fledged and strong research institute.”

MLW Staff Celebrate 25th Anniversary in Thailand

The MLW Community Engagement and Bioethics (CE & B) Associate Research Group was part of this year’s summer school held in Bangkok, Thailand by The Global Health Bioethics Network (GHBN) which ran from 12-16 September 2022. On the sidelines of the summer school, the CE & B group joined in the MLW 25th anniversary celebrations.

In celebrating MLW, Dr Nicola Desmond said it is wonderful that MLW has reached its 25th anniversary and that she is privileged to have been part of the team for many years.

“I want to particularly congratulate the social science and community engagement teams for their work and look forward to more successes with you all in the future,” said Desmond.

MLW’s Social Scientist Gertrude Banda said: “This is not just an organisation’s anniversary celebration, it’s an anniversary celebration of a family that only grew stronger over the years. As they say, teamwork turns dreams to reality. Thank you MLW!”.

This year’s summer school themes were Ethics & AMR, Ethics & Pandemics, Ethics & Engagement, Vaccines & Ethics and Justice & Equity.

The network also carries out ethics research and builds ethics capacity across the Wellcome Trust’s Programmes in Kenya, Malawi, South Africa, Thailand-Laos, and Viet Nam, as well as other Wellcome Trust centres, such as the Brighton and Suffolk Centre for Global Health Research.

The Global Health Bioethics Network (GHBN) is a collaboration between the five Wellcome Trust funded Africa and Asia Programmes (AAPS) in Kenya, Thailand-Laos, South Africa, Viet Nam, Malawi, and the Ethox Centre at the University of Oxford. The network holds summer schools annually.

MLW Launches New Building in Chikwawa

As MLW turns 25, the excellence in research and stakeholder relations keep growing. This is evident from the  launch of the long-awaited  building in Chikwawa   on 14 September 2022.

Field Sites Manager Chimwemwe Theu said the building will not only host MLW staff, but it will also be a home to other departments from Chikwawa District Hospital.

MLW’s Infectious Disease Epidemiology lead Dr Anja Terlouw said: “I cannot overstate the impact which people from Chikwawa have contributed to MLW’s research. The new facility is a symbol of the good relationship between MLW and the community and a promise of good collaborations to come. By launching this new building, the community is assured that moving out of Chikwawa is not an option.”

Terlouw also extended her sincere heartfelt appreciation to the people of Chikwawa because of participating in MLW research such as the EPIMAL study which is a Malaria Vaccine Surveillance Study. Terlouw stressed that without them, MLW research would not exist at all.

Traditional Authority Kasisi from Chikwawa expressed his gratitude to MLW for its positive impact in Chikwawa.

“MLW has  broken-down walls of myths surrounding health research. Importantly, by opening this facility, we anticipate more research studies which will benefit the nation at large,” said T/A Kasisi.

The Chikwawa Building was funded by The Wellcome and constructed by DEC Contractors.

 

Women In Science Celebrate and Inspire Each Other

To mark the beginning of the 25th Anniversary celebrations, MLW hosted a Women in Science event on 5 September 2022 to recognise the achievements of women who have taken up science careers, to help address the crucial challenges faced by women in science careers and to address the most asked question regarding women scientists.

Speaking during the event, one of the guest speakers the Principal at Malawi University of Business and Applied Sciences (MUBAS) Dr Nancy Chitera shared her personal journey to becoming the first female University Chancellor in Malawi.  Dr. Chitera said  having passion for her work and  pursuing excellence in all aspects of life was important in her journey.

Another speaker at the event was Angeziwa Chunga who encouraged the women to not set boundaries for their dreams.

“Women should always be proactive and look for opportunities because no one is going to be given an opportunity just because she is a female. Everyone needs to believe and fight for what they want in life. I was first a laboratory technician and then I did my bachelor’s degree and now I am a postdoctoral researcher. If I had set a limit for myself, I would not have made it to where I am today. I got here because of mentors like Professor Melita Gordon and the great support system which I find here at MLW”

Some of the guest speakers at the event were CEO of ETHCOL Lusubilo Chakaniza, the first orthopedic surgeon in Malawi Dr. Linda Chokotho and Dr. Nancy Chitera.

One of the attendees of the meeting was Data Manager of MLW Debora Phiri. She said before the meeting, it did not cross her mind to pursue a PhD because she had set a limit for herself.

“I have been challenged, if all these amazing women are able to achieve great things, so can I,” Debora said.

 

Deputy Minister Launches Construction of MK8bn MLW Complex

Malawi’s Deputy Minister of Health Enoch Phale officially launched the construction of MLW’s Clinical Research Excellence and Open Resource (CREATOR). Phale launched the construction in Blantyre at the climax of MLW 25th Anniversary, September 15, 2022.

The CREATOR, which is estimated to cost over K8 billion, will house MLW’s laboratories, conference rooms and offices to sustain and drive health research works in Africa.

He applauded MLW for responding to the country’s health needs and challenges through research.

“MLW has helped the Ministry of Health in reshaping its policies and treatment guidelines for various diseases including malaria, HIV and TB, meningitis and pneumonia,” said Phale.

On the CREATOR Building, the deputy minister said the building will provide space for conducting high-profile research activities to solve Malawi’s health problems.

Deputy Minister of Education Monica Chang’anamuno and Principal Secretary for Administration in the Ministry of Health Benson Chisamile were also among the government officials who patronised the CREATOR’s ground- breaking ceremony.

Interim Director of Malawi Liverpool Wellcome Research Programme awarded 2022 Weber-Parkes Prize by Royal College of Physicians (RCP)

Professor Henry Mwandumba, Interim Director of the Malawi Liverpool Research Programme, is receiving a prestigious award for his ground-breaking work in unlocking understanding of the pathonegenis of tuberculosis.

Professor Mwandumba will receive the 2022 Weber-Parkes Prize, from the Royal College of Physicians (RCP), during the Harveian Oration Lecture, at RCP in London on the evening of 19th October 2022.

The award is traditionally given to somebody who has demonstrated excellent work in the field of tuberculosis, both in this country or abroad. Historically, the recipient was given a prize of 150 guineas and a silver medal, which they received at ceremony during the Harveian Oration.

On hearing his work had been recognised with the award, Professor Mwandumba said: “I am proud to have been recognised as part of an illustrious list of scientists who have contributed to research into and treatment of tuberculosis, which still carries a heavy cost across the world. Increasingly, multi-drug resistance can be harder to treat effectively, which is why continued research and funding in this area of treatment are so important.”

The Harveian Oration first took place at RCP in 1656 and was set up by William Harvey, an English physician who contributed substantially to knowledge about anatomy and physiology. Each year a leading doctor or scientist is invited to speak on issues relating to their field of work.

The Weber-Parkes Prize and medal are awarded once every three years for major contributions to the prevention and cure of TB.