News from the Group

Strengthening Lassa Fever Testing: Capacités Renforcées à Parakou, Bénin

Lassa Fever (LF), a disease listed as a priority by the World Health Organization (WHO) R&D Blueprint, continues to pose significant health risks across West Africa. Urgent research, particularly in the development of therapeutics and vaccines, is critical. In this context, the INTEGRATE consortium is dedicated to preparing clinical sites for upcoming trials of LF therapeutic candidates, with a special focus on capacity-building initiatives. As part of this effort, our team, in collaboration with ALIMA (The Alliance for International Medical Action) embarked on a site preparedness programme (SPP) funded by PANTHER (PANdemic preparedness plaTform for Health and Emerging infectious Response) aimed at enhancing laboratory capacities. The programme consisted of a series of online trainings on clinical research and on-site activities in Parakou, Borgou department, Benin through the implementation of RT-PCR diagnostics for Lassa virus (LASV).

The core of our work in Benin centered on strengthening the laboratory workforce. We provided comprehensive training for the handling and testing of Risk Group 4 pathogen samples, such as those of the Lassa virus, ensuring that the lab technicians could safely and effectively manage samples. Additionally, we improved the lab’s workflow by implementing critical procedures for safe sample reception and handling, process documentation, and adopting Good Clinical Practice (GCP) and Good Clinical Laboratory Practice (GCLP) standards.

The programme offered a blended learning experience, combining remote and in-person formats to maximize flexibility and engagement. Five laboratory scientists from the Centre d’Informations de Prospective et de Conseils sur les IST/VIH Sida (CIPEC) in Borgou/Alibori were trained, marking the successful implementation of Lassa virus RT-PCR diagnostics in Northern Benin in November 2023. The trainees not only gained hands-on experience with molecular diagnostics but also attended lectures on clinical research, quality management, and data handling.

Our work in Benin underscores the importance of both national and international collaboration in addressing public health challenges. By building local expertise, we aim to close gaps in logistics, infrastructure, and technical knowledge, ensuring that laboratories in resource-limited settings are prepared for outbreaks and be equal partners for research. The significance of the SPP was highlighted in September 2024 at the World One Health Congress in Cape Town, South Africa. Here, we shared the impact of the collaborative efforts in Benin, showcasing the outcomes of our capacity-strengthening programme and its role in improving Lassa fever diagnosis and treatment efforts across West Africa.

As we move forward, the sustained investment in capacity-building efforts will remain crucial. By continuing to strengthen the research and diagnostic capabilities of laboratories in Benin and beyond, we hope to improve disease surveillance, response, and preparedness for future public health emergencies.

“WONTANARA!”: “Nous sommes ensemble” in Guinea!

Our laboratory support to Guinea continues thanks to the GHPP programs CELESTA and AfroLabNet 2.0 as “We are together”!

Our team has developed an exciting and adaptable training portfolio spanning from real-time RT-PCR diagnostics to serology and up to the complexity of metagenomic sequencing! During a month-long visit in May 2024, we delivered such training at our partner laboratories for viral hemorrhagic fevers (VHFs) in Conakry (CRV-LFHVG), Gueckédou (LFHV-GKD) and N’Zérékoré (HRNZE-LFHV). The three laboratories support the in-country surveillance of infectious viral diseases, and regularly reinforcing such capacity is key. This time, we offered new learning approaches to strongly engage the staff in our trainings, as observing soft white DNA extracts from bananas! Also, two staff from the Gueckédou laboratory joined a training in Conakry to unravel the secrets of nanopore sequencing and phylogenetic analysis. Beyond knowledge increase of staff, it further strengthened the network between these three key laboratories which are pillars of Guinea’s surveillance system of viral hemorrhagic fevers.

Besides diagnostic capacities, our joint research efforts aim at understanding the circulation of relevant viral diseases in communities. Thanks to the serology platforms established in the laboratories of Gueckédou and N’Zérékoré, crucial studies are ongoing. The “REALISE” study, led by Fara Raymond Koundouno, will soon give us more insights into the seroprevalence of Lassa fever, Marburg virus disease and COVID-19 in communities of the Gueckédou prefecture, whereas Youssouf Sidibé, leading another study, will finally give us soon answers on Lassa fever seroprevalence in another prefecture, N’Zérékoré. We expect compelling outcomes from these researches that will guide health systems of Guinea and other affected countries.

In partnership with WHO Geneva and WHO Guinea Country Office, the preparedness and readiness level of the three laboratories has been bolstered by the provision of diagnostics reagents for the detection of Ebola virus, Marburg virus, Lassa virus, Yellow fever virus and Dengue virus, allowing for full diagnostic activities in the coming months.

Seven people in colourful clothes, three with WHO vests, are standing on the door step of a building in Guinea. In front of them are two big white and blue boxes that have just been delivered. — One laboratory staff receiving two big boxes with reagents in the presence of three representative of WHO, one BNITM expert and two representatives from hospital. ©BNITM

Das Bild zeigt vier Menschen in z.T. bunter Alltagskleidung an einem Tisch. Eine von ihnen zieht ein Stäbchen aus einem Teströhrchen, die anderen beobachten den Vorgang. — One laboratory staff pulling out DNA from a tube with the help of one BNITM trainer in the presence of three colleagues. ©BNITM

Ten Guinean lab staff in casual clothes are leaning over a table pointing at small plastic cards for an excercise. One person on the right wears a purple headscarf and a white shirt. — Ten laboratory staff with plastic cards performing a group task. ©BNITM

A lab staff is pipetting a sample into a sequencing device, watched by a colleague. He is wearing a blue lab suit and bright blue gloves, red, orange, yellow and blue lab equipment is on the table. — One laboratory staff loads a sequencing device in the presence of one colleague and one BNITM trainer. ©BNITM

Embarking on a New Era: Enhanced Sequencing Capacity at Irrua Specialist Teaching Hospital (ISTH), Nigeria

As the dry season unfolds in 2024, clinicians, healthcare professionals, and laboratory experts at the Irrua Specialist Teaching Hospital (ISTH) in Nigeria brace themselves for the onset of yet another Lassa Fever outbreak. Lassa fever, an acute viral hemorrhagic illness caused by Lassa virus, remains a persistent challenge in West Africa, particularly in Nigeria. Swift and accurate detection, coupled with real-time monitoring of circulating viruses, are paramount to reinforce the efforts of the Ministry of Health (MoH), the Nigeria Center for Disease Control (NCDC), and the World Health Organization (WHO) in controlling the outbreak.

In line with our commitment to collaborative activities, in February 2024 a team from BNITM embarked on a journey to ISTH as part of our Global Health Protection Program (GHPP) CELESTA which aims to fortify local genomic surveillance capabilities. Our mission? To expand the pre-existing SARS-CoV-2 nanopore sequencing capacity at the Institute of Viral and Emergent Pathogens Control and Research (IVEPCR) of ISTH. This expansion is geared towards empowering IVEPCR to establish a comprehensive genomic surveillance framework, employing the metagenomics approach on the MinION sequencing platform, to track not only Lassa virus but also any emerging RNA pathogens.

Following an intensive two-week training, the dedicated sequencing team at ISTH mastered the hands-on sequencing practice and the implementation of cutting-edge bioinformatic tools for sequencing data and phylogenetic analyses. Equipped with these skills, the local team now stands poised to independently operate the sequencing unit onsite. This capability enables real-time characterization of circulating Lassa viruses and other RNA pathogens, empowering ISTH and the broader Nigerian public health response in combating the ongoing Lassa fever outbreak.

The inauguration of this enhanced sequencing capacity marks a significant milestone, underscoring our collective dedication to supporting surveillance efforts. Moreover, it serves as a testament to the commitment of both BNITM and ISTH to collaborative research (for further details, see here. With the support of GHPP-CELESTA, BNITM will continue to provide ongoing support to the ISTH sequencing team through future training initiatives, as well as theoretical and technical assistance.

Five Nigerian laboratory staff and two BNITM trainers in colourful clothes are standing in the entrance of a building. They are proudly holding up their training certificates. — Sequencing lab staff from ISTH together with BNITM trainers at the end of the 2-weeks metagenomics sequencing training at ISTH. February 2024, Irrua, Nigeria ©BNITM

The photo shows five Nigerian colleagues at a lab bench with two laptops on it. They are looking at one of the screens on which a bioinformatic analysis is being performed. — Sequencing lab staff performing bioinformatics analysis of sequencing results to obtain sequences alignments for phylogeny. February 2024, Irrua, Nigeria. ©BNITM

The photo shows a Nigerian lab team of four and their trainer at a lab bench. They wear blue and green lab coats and gloves. One of them is loading a sequencing device with a pipette while the others observe. — ISTH sequencing lab staff loading sequencing samples in a MinION flow cell (Oxford Nanopore Technologies) for metagenomics sequencing. February 2024, Irrua, Nigeria ©BNITM

Postcard from Forest Guinea: setup of new laboratory capacities to strengthen the surveillance of viral hemorrhagic fevers

As part of our GHPP-funded programs Celesta and AfroLabNet 2.0 we traveled to Forest Guinea in November 2023 to expand the serological and genomic surveillance capacities of two collaborating laboratories, respectively the Laboratoire des Fièvres Hémorragiques Virales de l’Hôpital Régional de N’Zérékoré (LFHV-HRNZE) in N’Zérékoré and the Laboratoire des Fièvres Hémorragiques Virales de Gueckédou (LFHV-GKD) in Gueckédou.

Forest Guinea has faced several epidemics of viral hemorrhagic fevers (VHFs) in previous years such as Ebola and Marburg virus diseases, as well as Lassa fever. In support of Guinea’s laboratory epidemic preparedness, our programs focus on addressing laboratory gaps by implementing new capacities to complement the already established VHF diagnostics platforms of LFVH-HNRZE and -GKD.

Following a 1-week training in N’Zérékoré with four participants, our team successfully completed the setup of a new serology unit at LFHV-HRNZE. The training specifically focused on the detection of immunoglobulin M and G antibodies against Lassa virus. The latter is currently used for operational research on VHFs.

In addition we held a 2-week introductory training on nanopore sequencing (Oxford Nanopore Technologies) applied to RNA-virus genomic surveillance at LFHV-GKD in Gueckédou. The six staff attending it were primed to basic hands-on and related bioinformatics analysis. This was a milestone achievement in preparation of the VHF genomic surveillance unit to be implemented in 2024-2025 at LFHV-GKD.

These trainings were key in allowing the two laboratories to expand their portfolio of services for the benefit of the Guinean public health surveillance system. BNITM, through GHPP, will continue to support Guinea with other trainings in the coming months and, remotely, with theoretical and technical assistance.

A laboratory scene in Guinea. One local lab staff is pipetting while the trainer and two others are observing. — Lab staff from LFHV-HRNZE pipetting an ELISA plate during the serology training. November 2023, N’Zérékoré, Guinea ©BNITM

A class room scene in Guinea. A trainer is explaining something shown on a laptop, while six Guinean laboratory staff are listening. — A BNITM trainer and lab staff from LFHV-GKD during an introduction to nanopore sequencing. November 2023, Gueckédou, Guinea. ©BNITM

A laboratory in Guinea: One lab staff member is loading a flow cell while three colleagues are observing. — Lab staff from LFHV-GKD during hands-on sequencing training in loading and handling a MinION flow cell (Oxford Nanopore Technologies). November 2023, Gueckédou, Guinea. ©BNITM

The EMLab participates in the medical EU-MODEX in Çanakkale, Türkiye (18-22 Sept. 2023)

The European Mobile Laboratory (EMLab), managed through the Virology Department and Mobile Laboratory group at BNITM, successfully participated in the medical European Union Module Exercise (EU-MODEX¹) for civil protection capacities under the EU Civil Protection Mechanism (UCPM²) in Çanakkale, Türkiye (18-22 September 2023). This was part of the final step towards certification of the EMLab in the EU Civil Protection Pool (ECPP³) as a mobile laboratory capacity from Germany.

The field exercise simulated a medical emergency in the aftermath of an earthquake in Çanakkale, Türkiye, requiring the deployment of different ECPP capacities including emergency medical teams (EMTs), ambulance services, air medical evacuation, technical support assistance teams (TAST), as well as mobile labs. The EMLab team worked closely with other response capacities and provided support to EMTs and local hospitals with basic point of care tests, molecular diagnostics and genomic surveillance.

Check out the official event video from the MODEX press team here:

https://youtu.be/Wfoi_n6imSs?feature=shared

Interoperability and coordination in emergency situation are one of the key components in such MODEX and EMLab, in addition to collaborating closely with various response capacities, also interacted with stakeholders from other relevant organizations including the European Commission (EC), World Health Organization (WHO), United Nations (UN), Turkish Ministry of Health and Turkish Ministry for Disaster Management and Civil Protection (AFAD).

The EMLab team comprised 12 experts from the BNITM and from other institutions part of the EMLab network including the Robert Koch Institute (Berlin, Germany), Scientific Solutions (Stockholm, Sweden) and University of Pécs (Pécs, Hungary).

The image shows a large truck with opened trailer that is loaded with stacks of orange transport boxes. — EMLab boxes arrived at the base of operations to start setup of the lab, in an inflatable tent. The laboratory unit was shipped from the EMLab HQ in Hamburg, Germany and arrived in Çanakkale by truck through the collaboration and support of the Turkish Ministry of Health. ©EMLab, BNITM

The image is shot in the dark. In the foregound is a large red tent with a brightly lit lab inside. Behind the tent blocks of flats are visible. — EMLab set up their laboratory operations in an inflatable tent on a base of operations shared with other response capacities including the Turkish Type IV RRML and Type II EMT. ©EMLab, BNITM

The image shows a laboratory in a red tent with staff in lab coats working on benches and with glove boxes. — EMLab team members worked inside a field laboratory setup inside an inflatable tent during the EU MODEX. ©EMLab, BNITM

A picture of the twelve members of the EMLab Team in front of a white truck, all wearing blue EMLab shirts and vests, looking tired but very happy. — The twelve members of the EMLab team who participated in the EU MODEX in Çanakkale, Türkiye 17-22 September 2023. ©EMLab, BNITM

The image shows a lab bench lit by a camping light while a staff member pipettes samples into tubes in a green rack. — EMLab member preparing samples in the field laboratory for RT-PCR based human diagnostic tests as part of the MODEX and ECPP certification process. ©EMLab, BNITM

First step in the expansion of genomic surveillance capacity in Guinea and Nigeria

To strengthen the pre-existing sequencing capacities of our GHPP-partner laboratories in Conakry (Guinea) and Irrua (Nigeria), a joint two-week training on metagenomic sequencing was held in Conakry, Guinea, in June 2023.

Following the successful establishment of two SARS-CoV-2 field sequencing laboratories at the Laboratoire des Fièvres Hemorragiques Virales en Guinée (CRV-LFHVG) in Guinea in 2021, and at the Irrua Specialist Teaching Hospital (ISTH) in Nigeria in 2022, the Outbreak Preparedness and Response (OPR) BNITM team continues its long-term program of sequencing capacity reinforcement in our partner laboratories in West Africa. Our project CELESTA, which is part of the new program phase of GHPP (2023-2025), will expand the genomic surveillance capacity for RNA viruses to support the national surveillance system against future epidemics and pandemics.

Taking advantage of the previously established Nigeria-Guinea cooperation, a team from BNITM and four lab scientists from ISTH traveled to CRV-LFHVG in Conakry in June 2023 to conduct a two-week training course. Four laboratory staff from CRV-LFHVG also participated in the training. The main goal was to train local sequencing staff on a new next generation sequencing workflow for metagenomic sequencing, from sample preparation to in-country analysis. During the training the local staff was also introduced to general concepts of virus phylogeny and new bioinformatic analysis tools.