Update (March 2009):
- Opening Ceremony: On 26 February 2009 the new MARIB Laboratory and Clinic were officially opened by the Civil Surgeon of Bandarban. More than 100 invited guests attended the openeing ceremony and the following lunch. The new clinic and laboratory will allow for better diagnsotic support for the Bandarban Sadar Hospital, easier access for the patients, more waiting room, expanded laboratory space, and better reseach facilities for ongoing projects.
- It has been a major focus of our work in the last year to provide technical support to the Bandarban Sadar Hospital with an emphasis on diagnosis and lab support. Fund raising efforts in the coming year will also focus on these efforts.
Update Research Projects (September 2008):
Update Research Projects (August 2007):
- New clinical trial: We recently initiated a new clinical trial entitled "Artesunate resistance in Bangladesh". This is a 3-arm GCP-compliant clinical trial with 42-day follow-up in 100 evaluable patients. This study is part of a consortium effort coordinated by WHO and is a follow-up project to an earlier study using artesunate monotherapy (conducted by H. Noedl and colleagues in western Cambodia). Our earlier studies in Bangladesh suggest a high level of sensitivity to artemisinins in the local parasite populations. The aim of the ongoing project is to collect efficacy data and drug response parameters from an area where artemisinins have never been used on any significant scale as well as in vitro and molecular data on the sensitivity of P. falciparum to artemisinins. The long term goal is to be able to establish the geographical spread of potetial artemisinin resistance.
- Clinical trial completed: The clinical trial "Azithromycin Combination Therapy for the Treatment of Uncomplicated Falciparum Malaria in Bangladesh: an Open Label Randomized Controlled Trial" has been completed, the data have been analyzed and are ready for publication. The combination of azithromycin and artesunate proved to be a well tolerated and highly efficacious combination therapy for the treatment of uncomplicated falciparum malaria in Bangladesh.
- Malaria surveillance and diagnostic studies as well as a project focussing on the causes of febrile illnesses in the Chittagong Hill Tracts are continuing.
Available Laboratory Facilities:
- "Azithromycin Combination Therapy for the Treatment of Uncomplicated Falciparum Malaria in Bangladesh: an Open Label Randomized Controlled Trial". A GCP Phase II/III clinical trial in 210 falciparum malaria patients, age 8-65 years, azithromycin/artesunate vs. Coartem (control), 4 days inpatient, 42-day follow-up (ongoing).
- "Prevalence of malaria and non-malaria febrile illnesses among febrile patients in Bandarban". Cross sectional prevalence study with a sample size of >2500 individuals assessing the prevalence of malaria and selected non-malaria febrile illnesses in all 7 sub-districts of Bandarban District (ongoing, study initiated in Aug 2007).
- Testing of novel antimalarial compounds in clinical field isolates of P. falciparum (ongoing). In vitro characterization, cross-sensitivity, and drug interactions of selected novel compounds. Collaboration with the Department of Medicinal Chemistry (ongoing, project initiated in July 2007).
- In vitro drug interactions of azithromycin and standard antimalarials (ongoing)
- Antimalarial drug resistance in the Chittagong Hill Tracts (ongoing)
- Development of ELISA-based diagnostic tests and a semi-automated P. vivax drug sensitivity assay (ongoing)
- Severe malaria in the Chittagong Hill Tracts (scheduled to start in autumn 2007)
- Causes of febrile illnesses in the Chittagong Hill Tracts (2007)
- Malaria microscopy
- Blood chemistry (Blood chemistry analyzer: Reflotron, Roche)
- CBC (Hematology analyzer: Celltec Alpha, Nihon Kohden)
- Rapid diagnostic and ELISA-based testing for malaria, typhoid, leptospirosis, dengue etc.
- G6PD testing
- Facilities include ELISA, PCR, parasite and bacterial culture, rapid testing for numerous antigens etc.
- In vitro antimalarial drug susceptibility testing using a highly sensitive HRP2 drug sensitivity assay that allows for the testing of virtually any clinical sample directly from the patient (sensitivity: 100 parasites/uL). Testing of individual drugs, activity correlations, drug interactions in combination, in vitro - in vivo correlates
- PCR (on site and collaboration with ICDDR,B in Dhaka, MUW in Vienna, and AFRIMS in Bangkok): MSP1, MSP2, GLURP for recrudescence/reinfection. Diagnostic PCR for mixed infections. Markers of antimalarial drug resistance.