SELeCT bears fruit in Liberia

The third scientific article of the project, whose objective was to strengthen capacities in the country affected by Ebola, has been published.

Just over a year after its conclusion, the SELeCT project has published the third article resulting from a series of activities focused on strengthening research capacity in Liberia. The project, which began in February 2016 and ended in August 2017, was funded by the EDCTP and led by ISGlobal – a center promoted by the “la Caixa” Banking Foundation – in collaboration with the Juan Ciudad Foundation and Saint Joseph Catholic Hospital (SJCH) in Monrovia

The Ebola epidemic in West Africa (2014-2016) highlighted the need to strengthen capacity to conduct research and clinical trials in affected countries. This was precisely the objective of SELeCT, which, between February 2016 and July 2017, trained SJCH staff in good clinical and laboratory practices and conducted the hospital's first research study on malaria prevalence in pregnant women.

As part of the training course, a practical exercise on malaria prevalence in pregnant women attending the hospital's antenatal care service. Of the nearly 200 women recruited during the exercise, 12% were infected with P. falciparum, most of whom were young and first-time mothers. “This is the first study in Liberia to assess malaria prevalence in pregnant women following the Ebola epidemic,” says Alfredo Mayor, principal investigator of the project. “Our molecular analysis revealed a high frequency of chloroquine-resistant parasites, but fortunately, no markers of resistance to artemisinin, the first-line treatment, were detected.”

In a second studyThe project analyzed the barriers and opportunities for pregnant women to participate in clinical studies, based on a series of interviews and group discussions. The results show that fear and mistrust of science, which were amplified during the Ebola outbreak, represent a significant barrier. Proposed strategies to encourage participation include educating the general population, involving traditional healers, and mobilizing the community, as well as an effort by the scientific community to inform women about the study's objectives. "We need to further empower women and address the problems of inequality," comments Guillermo Martínez, project manager. "Only in this way can we ensure that this population, particularly vulnerable to malaria, trusts research results and eventually adopts new prevention and treatment measures," he adds.   

He third study sought to explore community perceptions and attitudes toward malaria through a series of interviews with various stakeholders. The results indicate that poverty, lack of education, corruption, and distrust of health systems outweigh traditional beliefs in preventing access to government-recommended control interventions. “To increase access to and adherence to treatment, we first need to understand people's needs and perceptions about the disease,” says Martínez.

In addition to training activities and scientific publications, SELeCT laid the groundwork for IGORCADIA, a second capacity-building project in Liberia, also funded by the EDCTP and led by ISGlobal. “The objective of the project, which began less than a year ago, is to strengthen the capacities of the country's regulatory authorities in the use and research of diagnostic tests for various infectious diseases,” explains project manager Cristina Muñoz.

Below, we provide the references:

Martínez Pérez G, Tarr-Attia CK, Breeze-Barry B, et al. 'Researchers have love for life': opportunities and barriers to engage pregnant women in malaria research in post-Ebola Liberia. Malar J. 2018 Apr 2;17(1):132. doi:10.1186/s12936-018-2292-7.

Martínez-Pérez G, Lansana DP, Omeonga S, et al. Prevalence of Plasmodium falciparum infection among pregnant women at first prenatal visit in post-Ebola Monrovia, Liberia. Malar J. 2018 Oct 11;17(1):357. doi:10.1186/s12936-018-2506-z.

Tarr-Attia CK, Bassat Q, Breeze-Barry B, et al. Community-informed research on malaria in pregnancy in Monrovia, Liberia: a grounded theory study. Malar J. 2018 Oct 23;17(1):382. doi:10.1186/s12936-018-2529-5.