Executive Summary

Research Fellows, mainly from the Department of Immunology of the Noguchi Memorial Institute for Medical Research, as well as Research Assistants and students, attended HEPMAL’S 2-year progress meeting. Among them were Principal investigator (PI) Dr. Kwadwo Asamoah Kusi and co-PIs Dr. Linda Amoah and Dr. JH. Kofi Bonney. Also in attendance were Prof. Michael Fokuo Ofori (Head of Department for Immunology), Dr. Dorotheah Obiri Yeboah, Dr. Ruth Ayanful Torgby and Dr. William van der Puije.

The meeting began at 9:30am, and ended successfully at around 1:40pm after two informative sessions of presentations from the Principal Investigator (PI), the field team, the Data Entry team, and students.

The team members' presentations conveyed the fact that the project was progressing well thus far, and despite some minor challenges, overall progress in the past year was encouraging, and everyone was eager and enthusiastic for Year 3 of the HEPMAL Project.

Opening Session

The meeting commenced at approximately 9:06am with a welcome address from the Principal Investigator of the HEPMAL project, Dr. Kwadwo Asamoah Kusi. He began by welcoming all who were present (in-person and on-line) to the Year 2 progress meeting, acknowledging everyone for honoring the invitation.

He explained that the reason for the gathering was to report on progress in the 2nd year of the HEPMAL project, a four-year research project investigating the effects of Hepatitis B and malaria coinfection, specifically looking at how they both impact the liver and the immune system. He acknowledged the European and Developing Countries Clinical Trials Partnership (EDCTP), who are funding this initiative.

Head of the Immunology Department’s (HOD) Address

As part of the opening ceremony, Professor Michael Fokuo Ofori, Head of the Immunology Department mentioned that the Department was happy to host the project, which was headed by one of its diligent researchers, Dr. Kwadwo Asamoah Kusi. Praising him for his effective job done so far, he also commended the team members for their understanding of the initiative and the training opportunities it offers. He continued by saying that the project's capacity to train 2 PhD and 2 MPhil students is consistent with developing the next generation of scientists. He then extended a warm welcome to all, especially team members and presenters, and wished everyone a great meeting.

Session 1

Updates of field work site and sample collection - Ms. Doreen Teye-Adjei & Mr. Frank Osei

Mr. Frank Osei, the first speaker from the field team, provided a thorough update on the field operations. He described how the team goes about enrolling subjects into to the study, starting with the recruitment procedure, inclusion and exclusion criteria, consenting etc., and continuing through to the monthly follow-ups, sample taking, etc.

He mentioned that for controls (hepatitis B negative), a total of 114 individuals had been recruited so far, along with 120 chronic hepatitis B positive cases although 137 cases in all have been screened. He explained that interestingly, the positive cases were those who were continuously being convinced to continue to participate in the study. About 5 volunteers had been lost to follow up.

Before introducing his co-presenter, Mr. Frank Osei mentioned some of the obstacles the field team encountered such as the relocation of some volunteers and other chronic illness which made it difficult to follow-up with some participants.

The co-presenter from the field team, Ms. Doreen Teye-Adjei, continued with the presentation and provided information on some changes that had been made after the project's initial few months. In the past year the team phlebotomist left and was replaced. The liver function test samples as well were no longer processed at Alwaleed (Noguchi) due to some inconsistencies in delivering results. In order to maintain track of all the information, record keeping was updated along with the documentation in notebooks and database records. In addition to the disadvantages of sometimes having to get up as early as 2 or 3am in the morning to prepare for field work, a few difficulties recently encountered have been addressed, and solutions have been established for them.

Data entry and management - Mr. Edem Badji

Data Manager Mr. Edem Badji brought the meeting up to date with activities on the management of data generated by the project. He explained that information gathered from the field is entered into and managed with the REDCap application. The data entry aspect is done using two data entry personnel who enter the same data independently. The data is then validated after entry, and the application is sensitive enough to detect repeated entries, spelling errors and other inconsistencies. The REDCap application also enables assessment of other data quality parameters. To meet confidentiality requirements, only the data manager has complete access to the data.

With regard to challenges faced by the team, he mentioned that there was sometimes a delay between the time of sample taking and the time of entering data into the system.

Coffee Break

The group took a short coffee break and reassembled for the second session of the meeting.

Session 2

The second session of the meeting continued with student presentations. All four students (2 PhD and 2 MPhil) made their individual presentations on their project topics as follows;

Influence of viral and host biology on progression of liver damage in HBV and Plasmodium coinfection – Diana Asandem (PhD student)

Diana presented her work which aims at investigating the effect of viral and host genetic diversity on HBV coinfection with Plasmodium and the outcome on liver pathology. She presented the objectives of her research which are;

Diana also shared preliminary data comparing liver function test results for baseline, month four, and month seven for both chronic (HBV+) and uninfected (HBV-) individuals. She added that Plasmodium detection data is pending for her part of research objectives.

Evaluation of the effect of chronic HBV on malaria-specific cytokine expression in co-infected persons – Mr. Selorm Philip Segbefia (PhD student)

Mr. Segbefia shared his project which aims at investigating the effect of chronic HBV on malaria-specific cytokine expression in co-infected persons. His work’s specific objectives are to;

He added that the expected outcome of his work will be useful to improve therapeutic protocols for HBV monitoring, management and education and help researchers and policy makers in developing and making decisions regarding malaria vaccines. He also presented data on the progress made since the last meeting and concluded on the way forward for his work, projecting thesis submission, defense and graduation within the second or third quarter of 2024.

Mr. Segbefia expressed his profound gratitude to every member contributing to the success of his research. He then took some questions and comments from the audience. These sought clarifications on some of his flow cytometry and whole blood assay protocols he was using. There was also a query on diversity concerning the peptide samples for the whole blood cultures.

Effect of antigen polymorphisms on the role of anti-CSP antibodies as markers of recent exposure to malaria– Ms. Rawdat Baba-Adam (MPhil student)

Miss Baba-Adam shared her work which aims at determining the effect of polymorphisms in the CSP gene on the role of anti-CSP antibodies as markers of recent exposure to malaria. As sample collection, sample processing and data collection were still ongoing, she presented and discussed the available data so far. She expressed confidence in completing her research work by the close of 2022. Few questions and comments on her presentation was made which she answered accordingly. Specifically, she was asked to clarify if the adult and children populations in her cohort were directly compared, and whether the hepatitis status of the children she was working on was known. Another query sought to clarify the sequencing techniques she was using.

Immunomodulatory effect of Moringa oleifera and Phyllantus niruri extracts on anti-HBV cytokine production by human peripheral blood mononuclear cells – Mr. Bright Asare (MPhil. student).

Mr. Asare, the last student presenter, started his presentation with an introduction about medicinal plants and how they play an important role in disease prevention and treatment due to the presence of bioactive compounds in these plants. His work aims to evaluate in-vitro, the immunostimulatory properties of Moringa oleifera and Phyllantus niruri extracts on human peripheral blood mononuclear cells (PBMCs) from chronic HBV carriers and from uninfected controls. He added that he specifically intends to;

Sample processing and data collection are still ongoing, so Bright presented and discussed the currently available data. He added that the MTT assay for the infected group and cytokine measurements by multiplex assays were yet to be conducted. He also took some questions and comments from the audience.

One of the questions was a request to explain his work with the medicinal plants in non-scientific, layman’s terms on how these plants may help in the management of viral hepatitis.

Also, there were questions about some of his analysis and the lack of duplication in his experiments, to which Bright responded that the experiments were still underway and that this would be done.

Both MPhil students assured their supervisors that they were on track to complete their research in the coming months before the end of 2022.

Highlights of project achievements and outlook for coming year - Dr. Kwadwo Asamoah Kusi

Finally Dr. Kusi, PI of HEPMAL, gave an overview and progress of the project so far. He indicated that one of the major problems that has hindered particularly laboratory work is the delayed acquisition of reagents due to bureaucracy and procurement proceedings. He also firmly stated that review papers from the PhD students were long overdue and encouraged them to complete this in the shortest possible time.

Dr. Kusi acknowledged all members of the team, especially the co-investigators of the project Dr. Linda Amoah and Dr. Kofi Bonney, for their immense and diverse contributions towards the success of the HEPMAL project. Dr. Kusi spoke about the highlights of the previous year and the submission of a successful first year report and encouraged all to continue to excel in their individual duties and responsibilities to produce a positive synergistic result. He also congratulated the field team for the successful completion of recruitment of participants.

He then gave a projection on expectations for the next six months. He mentioned particularly, conclusion of the follow up component of the field work as well as the completion of work and graduation of the two MPhil students. He also urged the team, particularly the data entry team, to spare no effort in putting together a clean and complete data for easy access and smooth analysis.

He finally thanked all those who participated in the meeting.