Projects

A core group of faculty in the Department of International Health, where Stop Cholera is based, have several ongoing cholera projects in Africa and Asia.  These include

  1. Cholera Genomics. This project, funded by the Bill and Melinda Gates Foundation and being carried out in partnership with the African Centre for Disease Control  https://africacdc.org/ is building capacity in the national laboratories of five African countries, enabling them to understand the genomics of cholera in Africa.  The countries include Nigeria, Cameroon, Democratic Republic of Congo, Uganda, Mozambique, Malawi and Zambia. 

    Mboowa G, Matteson NL, Tanui CK, et al. Multicountry genomic analysis underscores regional cholera spread in Africa. medRxiv 2024: 2024.11.15.24317392.  https://www.medrxiv.org/content/medrxiv/early/2024/11/15/2024.11.15.24317392.full.pdf)

     

  2. Epidemiology and Ecology of Cholera in Africa.  This project, funded by National Institutes of Health is studying cholera transmission patterns and mechanisms of spread.  By identifying risk factors in micro-hotspots in Nigeria and Uganda, it will identify ways to stop its spread, Also, the project will further define a cholera elimination scorecard to help countries monitor progress toward national elimination.  

    Bwire G, Sack DA, Lunkuse SM, et al. Development of a Scorecard to Monitor Progress toward National Cholera Elimination: Its Application in Uganda. Am J Trop Med Hyg 2023; 108(5): 954-62 (https://www.ncbi.nlm.nih.gov/pubmed/37037429)

    Findings from the project are summarized in this paper below, but a more complete list of publications related to epidemilogy of cholera from the team is found at https://publichealth.jhu.edu/stop-cholera/about/publications. 

    Sack DA, Debes AK, Ateudjieu J, et al. Contrasting Epidemiology of Cholera in Bangladesh and Africa. J Infect Dis 2021; 224(12 Suppl 2): S701-S9   (https://www.ncbi.nlm.nih.gov/pubmed/34549788) 

     

  3. Diagnostic tests for cholera. Scientists at JHU have developed assays to identify and confirm cholera, focusing on use of these tests to be used in remote areas where cholera often occurs.  

    • RISE project. The RISE project, funded by GAVI is being carried out in partnership with Group for Technical Assistance https://www.gtanepal.org/  and International Vaccine Institute https://www.ivi.int/. This project is evaluating the effective use of dipstick rapid diagnostic tests (RDTs) to determine how and when to use these relatively new test strips.  By improving the availability and their effective use, GAVI hopes to better target the use of oral cholera vaccine. 

      Debes AK, Ateudjieu J, Guenou E, et al. Clinical and Environmental Surveillance for Vibrio cholerae in Resource Constrained Areas: Application During a 1-Year Surveillance in the Far North Region of Cameroon. Am J Trop Med Hyg 2016; 94(3): 537-43 (https://www.ncbi.nlm.nih.gov/pubmed/26755564)

      Debes AK, Luo W, Waswa E, Boru W, Sack DA. Cholera rapid diagnostic tests recycled for PCR confirmation. The Lancet Global health 2022; 10(1): e35-e6

     

  4. qPCR technology. Following the COVID pandemic, qPCR is now available in many LMICs and commercial kits are being employed for cholera.  Scientists at JHU are validating the methods to determine how best to use this technology with fecal samples as well as samples collected on filter paper and RDT dipstick.

  5. Rapid Loop Diagnostic Test (RLDT). Dr Chakraborty, with support from Wellcome Trust, developed the Rapid Loop Diagnostic Test (RLDT) for Cholera which provides a result within one hour with sensitivity and specificity equal to a qPCR.

    Chakraborty S, Velagic M, Connor S. Development of a simple, rapid, and sensitive molecular diagnostic assay for cholera. PLoS Negl Trop Dis 2023; 17(2): e0011113 (https://www.ncbi.nlm.nih.gov/pubmed/36745674)

     

  6. WASH strategies. In the long term, provision of safe water and high-quality sanitation is way to eliminate cholera; however, this will take time and an enormous amount of resources. In the meantime, Dr. George has developed practical and effective interventions that can stop transmission among the highest risk groups, namely households and neighbors of cholera patients. In Bangladesh, an intervention called CHoBI7 reduced the risk to household members by 50%. A similar intervention, PICHA7, is being evaluated in the Democratic Republic of the Congo. This approach is now being refined and made even more effective with the use of cell phone messaging. 

    George CM, Parvin T, Bhuyian MSI, et al. Randomized Controlled Trial of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) Cholera Rapid Response Program to Reduce Diarrheal Diseases in Bangladesh. Int J Environ Res Public Health 2022; 19(19)  (https://www.ncbi.nlm.nih.gov/pubmed/36232205)

    Zohura F, Thomas ED, Masud J, et al. Formative Research for the Development of the CHoBI7 Cholera Rapid Response Program for Cholera Hotspots in Bangladesh. Int J Environ Res Public Health 2022; 19(20). (https://www.ncbi.nlm.nih.gov/pubmed/36293930