The West African Ebola outbreak of 2014-2015 exposed the fragility of Sierra Leone’s health system and highlighted the need for further investments to ensure its future capability of responding to a disease outbreak of this magnitude. The goal of our project is to design and conduct health services research and that can generate the evidence needed for improving the delivery of quality health services for patients with endemic viral hemorrhagic fevers (VHF) such as Lassa fever, as well as emerging infections such as SARS-CoV-2. In addition, we aim to strengthen in-country capacity for the conduct of clinical trials, with a special emphasis on vaccine studies. In 2018, Principal Investigators Drs. Troy Moon (VUMC), John Schieffelin (Tulane University), and Donald Grant (University of Sierra Leone and Kenema Government Hospital) completed a one-year planning grant funded by the Fogarty International Center at NIH that allowed our consortium to evaluate the existing research capacity of our in-country partner organizations, while refining our strategies for best approaches to address gaps in that capacity. This experience, along with our team’s extensive knowledge and history of conducting research in Sierra Leone, allowed us to develop the Partnership for Research in Emerging Viral Infections-Sierra Leone (PREVSL), a five-year project to substantially advance implementation science research capacity at Sierra Leone’s principal medical school, the College of Medicine and Allied Health Sciences (COMAHS) of the University of Sierra Leone (USL); as well as clinical trial capacity at the Kenema Government Hospital (KGH).
Our Specific Aims are to:
1) Enhance research capacity at KGH and COMAHS for the conduct of scientifically valid and ethically acceptable clinical trials, with a focus on emerging infections.
2) Strengthen and expand the KGH and COMAHS research pool with a focus on Implementation Science research for the clinical management of patients with VHF and other emerging infections.
3) Nurture innovative mentored research by PREVSL trainees/alumni to address the clinical management of VHF.
Our comprehensive training program consists of a combination of:
- Long-term Master’s training in clinical investigation (MSCI) with a focus on vaccine clinical trial capacity (Vaccine Fellowship at the Vanderbilt Vaccine Research Program VVRP)
- Short- to medium-term clinical trial management training that reinforces south-south collaborations and builds regional networks
- Short and long-term capacity building in health services implementation science research through in-country short courses and master’s training in Public Health
- Sustainable capacity building at KGH and COMAHS for the management and administration of future research grant opportunities
Our first trainee from Sierra Leone, Dr. Robert Samuels, completed the two-year MSCI degree which consisted of a one-year Vaccine Fellowship at the VVRP. His Master’s thesis consisted of an evaluation of the clinical presentation and management of children with Lassa Fever in Sierra Leone, which was published in AJTMH. During his VVRP fellowship, Dr. Samuels served as a research assistant on the Moderna phase III mRNA clinical trial for COVID-19. This experience led to two publications, one in JAMA and the other in the NEJM. In addition, Dr. Samuels designed and began implementation of a study, at KGH in Sierra Leone, to evaluate the prevalence of respiratory syncytial virus and influenza in hospitalized children less than two-years of age.
Our second trainee, Dr Foday Morovia has completed his first year of classes in the MSCI program and is currently beginning his fellowship with the VVRP. His research interests include improving the clinical management of patients with VHF like Lassa and Ebola as well as in exploring ways to reduce antimicrobial resistance in Sierra Leone’s health care system. Dr. Morovia is expected to graduate in 2022.
The Fogarty International Center supports this project under agreement 5U2RTW011248.