Vaccines are known to be a cheap, safe and effective method of saving lives. Yet collectively, meningitis caused by Haemophilus influenzae type b (Hib); Streptococcus pneumoniae and Neisseria meningitidis continue to cause over three quarters of a million childhood deaths every year in Sub-Saharan Africa. There is an urgent need for the introduction of appropriate vaccines to tackle these diseases. However to optimise the impact of the vaccines, adequate disease surveillance is essential before and after their introduction into national immunisation schedules.
Many of the countries in the West African Sub-Region are eligible to introduce pneumococcal and Hib vaccines to combat meningitis in the Sub-Region. However, with the exception of The Gambia, surveillance data is lacking. Recently, a week-long workshop sponsored by the WHO, in collaboration with the Medical Research Council and the Gambia Government aimed to address this issue. Workshop Organiser, Dr Martin Antonio (MRC) said ‘The idea is to enhance capacity so that the participating laboratories will be able to contribute data on bacterial meningitis in the context of vaccine introduction.’

At the workshop, laboratory scientists from 12 participating sites in West (and Central) Africa were trained to isolate the three pathogens in question: S. pneumoniae, N. meningitidis and Hib. Dr Antonio said ‘When the participants return to their home countries, they will isolate those pathogens and send them to the MRC as the WHO sub-regional Pneumococcal reference laboratory for serotyping.’

The second aspect of the workshop was the harmonisation of standard operating procedures between the participating laboratories. Dr Antonio continued ‘There were variations in protocols, but we were pleased that we came up with procedures that all the participating labs will follow…We discovered that some of the labs were not following the basic microbiological protocols. As a result they were not able to isolate the pathogens. By having a common protocol we were able to resolve these issues.’

In addition to hands-on work in the laboratories at MRC Fajara, the workshop included sessions on data management, biomedical equipment and quality management. MRC trainers were joined by Gambia Government staff and facilitators from South Africa, Kenya and Burkina Faso.

Speaking on behalf of the Ministry of Health at the official closing of the workshop, the Deputy Permanent Secretary Alhaji Omar Sey said ‘‘This workshop has come at a time whe n almost all countries in Africa, especially our West African Sub-Region have - or are about to - introduce the new PCV-7 vaccine. This initiative of WHO and partners will go a long way in providing evidence and tools to our advocates, policy makers, donors and stakeholders in support of the regional fight against pneumonia and pneumococcal diseases’.

Surveillance will help West African countries including The Gambia to measure the impact of Hib, PCV-7 and other new bacterial conjugate vaccination programmes. Alhaji Omar Sey continued ‘It will also help Ministries of Health to demonstrate the burden of meningitis caused by these three bacterial pathogens, and most importantly it will assist in the advocacy for the currently available Hib vaccine and future conjugate vaccines for S. pneumoniae and N. meningitidis.’

In his address, Dr Jason Mwenda (WHO Africa Regional Office) said ‘Since 2002, WHO has been supporting African countries including The Gambia to conduct surveillance for diseases targeted by new vaccines as part of support to introduce new vaccines. We are pleased to note that The Gambia was the second GAVI eligible country to introduce the pneumococcal vaccine (PCV-7), underlying the Government’s commitment to addressing the mortality and morbidity of children under five years old. WHO is encouraged by this success and is committed to supporting The Gambia and African countries to strengthen the disease surveillance as part of integrated disease surveillance.’

The participants were unanimous in their appreciation of the workshop, having gained valuable skills to take back to their home countries. In her vote of thanks, Mrs Ngozi Onyejiaka, a participant from Nigeria said ‘[This workshop] is the best I’ve attended in my ten years of practice as a medical laboratory scientist. We want to commend the efforts of the management and staff of the Medical Research Council The Gambia for organizing this training, with special thanks to the Director, Professor Tumani Corrah and the Course Director, Dr Martin Antonio.’

Asked to comment on whether future programmes were scheduled, Dr Antonio concluded by stating that an advocacy workshop was being planned to coincide with World Pneumonia Day in November 2010.