PREVAIL History Study Impacts Communities

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The social mobilization and communications team of the Liberia-US Clinical Research Partnership, PREVAIL, continues to make headways in its advocacy and community engagement activities across Liberia. Much was achieved in April and the impact has left many relishing the opportunity to join. Aside from the physical presence at various communities, communication and media events such as talk show appearances and media training to enhance science communication among health reporters have played vital roles in disseminating accurate information to the target groups, communities, and other stakeholders about the impact of the PREVAIL research program and how it promises to raise the profile of Liberia in the global public health square.

So, on April 1, 2017, Liberia and the world saw another history in the making. After recording success in the PREVAIL I Vaccine study in which 1,500 volunteers enrolled, PREVAIL started another vaccine effort with the launch of PREVAIL 5. Over 50 volunteers have so far joined the study.

The vaccine study will assess three different test vaccine strategies in an effort to find out which shows the most promise to prevent or quickly control future Ebola outbreaks. It is an expansion of the vaccine study which started in February 2015.

Another reason for the study is to assess the safety and ability of each of the three different Ebola vaccine strategies to stimulate an immune response to the virus that may be protective. Key goals are to determine how quickly immune responses to the vaccines are generated; how strong the immune response is; and how long it lasts.

The study will also continue to monitor the safety of the test vaccines in adults and carefully test their safety record in children, a population particularly vulnerable to Ebola.

Vice President Joseph Nyumah Boakai and the US Ambassador to Liberia, Christine Elder, represented by the Deputy Country Director for Programs at the US Centers for Disease Control and Prevention, Dr. Emily Kainne Dokubo, expressed the commitment of their respective governments to finding a vaccine and therapeutics to tackle Ebola.

The vaccine study is being conducted under the auspices of the West Africa Regional Consortium grouping health authorities from Liberia, Guinea and Sierra Leone. Guinea started their study on March 27, with Sierra Leone to follow later during the year.

An advanced team from the office of the US Secretary of Health and Human Services, Tom Price, visited PREVAIL facilities at the Redemption Hospital, a site of the vaccine study, and the JFK Medical Center, one of three sites where the Ebola Natural History Study is being conducted. The delegation also visited the Liberia Institute for Biomedical Research, which receives huge US National Institute of Health support, including capacity building, technology input, and infrastructure development.

Appearing on the regular Information Ministry Press briefing at MICAT, the Principal Investigator for the vaccine study, Dr. Mark S. Kieh, and the Co-Lead for PREVAIL Social Mobilization and Communications, Barthalomew Wilson, said under the PREVAIL study nobody knows the type they are getting, not even the nurse or study physician. “And because no one knows which vaccine they are getting, that process is called randomization or in simple Liberian terms as ‘ini-mini-myni-mo,’” he added.

The vaccines proved to be safe as suggested by data from previous studies, including the PREVAIL I study.

Officials said the study, which in Liberia is called PREVAIL V, elsewhere as PREVAC, will be conducted in two parts. The first part, now underway in Guinea and Liberia, will enroll up to 600 people 12 years and older. The second part, expected to start in the second half of 2017, aims to enroll 4,900 people, including 3,500 healthy men and women aged 18 years and older, and 1,400 children over one year old.

But there was no shortage of Social Mobilization and Communications activities to provide accurate information through community awareness events.

As part of its efforts to extend the research to other counties, PREVAIL visited Nimba County. Advocacy and community engagement events were held in Sanniquellie and Ganta and attracted hundreds of survivors, health workers, community and other leaders, as well as members of the security sector.

In Ganta, PREVAIL was hailed by the County Inspector for reaching out to county authorities. Inspector Reginald Mehn said too many “fly by night” organizations visit the county claiming to provide humanitarian services to the people but begin and end with the wrong approaches. But PREVAIL has demonstrated that they are in to transform Liberian public health system. The county issued PREVAIL a permit to operate, a document one has to have before being allowed to operate in the county.

In Nimba, survivors received information about the Natural History and the Persistence Viral RNA Studies, and the processes of joining the studies. The survivors in return thanked PREVAIL for reaching out to them in far-away Nimba County.

Meanwhile, several advocacy and community engagement events were also conducted in Montserrado and Margibi counties. The latter is conducted by Cultural Ambassador Juli Endee and her Liberia Crusaders for Peace, which heads the pillar.

At the various events, Liberia’s Research Scientist Dr. Jestina Doe-Anderson; Amb. Juli Endee; SMC Co-Lead, Barthalomew Wilson; and Advocacy lead, Joseph Boyer Cooper encouraged survivors and non-survivors to join the PREVAIL studies.

The speakers spoke of the safety of the vaccine program and the need for Liberians to join the study to enable researchers find a lasting solution to Ebola and for Liberia to make history. They however, said some members of the population are not eligible to enroll in the study. They are people who are tested to be sick, Ebola survivors, pregnant women, and breastfeeding mothers

On the Natural History Study, they explained that with many survivors experiencing a range of health problems, it was important they joined the study in order to undergo examination to determine whether they are now free of the virus. Dr. Anderson and Amb. Endee stressed that PREVAIL only conducts examination and research to find out their health status but does not treat.

Barthalomew and Boye Cooper further explained that the study is targeted at Ebola survivors and their close contacts. They said with many survivors experiencing a range of health problems, it was important they join the study in order to examine them to determine whether they are now free of the virus.

The President of the Survivors Network of Liberia and West Africa, Patrick Faley, spoke of the availability of healthcare assistance for Ebola survivors through the John Snow Incorporated at some medical facilities while plans are underway by the survivors’ network to get many other health facilities to cater to them.

They spoke of other sub-studies such as the eye, semen collection, neurology/lumber puncture, and birth cohorts as some of the studies being conducted to find out if there is any residual or persistent virus in survivors. Cooper pointed out that since the intervention of PREVAIL through the launch of the birth cohorts in December 2015, miscarriages and still births, which were common occurrences among female survivors, are now things of the past and urged pregnant survivors and close contacts to enroll in the birth cohorts, close contacts, and semen sub-studies respectively.

As the deadline for enrollment in the Natural History Study approaches by the end of June this year, PREVAIL has enrolled more than one thousand survivors and thousands more of their close contacts. Survivors with health problems are being treated by JSI and the Government of Liberia. PREVAIL also provides psycho-social counselling to survivors and their close contacts as part of the research program.

As the outreach events were being held in the various communities, the communications team organized radio and TV talk shows with relevant authorities to interact with listeners from across Liberia with the aim of reinforcing the messages.

Amb. Ednee also spoke of the state-of–the-art equipment employed by PREVAIL, the enormous infrastructure and capacity building program, as well as the employment of clinical and other staff, including communicators and mobilizers.

The vigorous program of social mobilization, advocacy, and communications carried out by trained PREVAIL staff has played a critical role in overcoming public perceptions about the PREVAIL study, recruiting trial volunteers, and maintaining the excellent rates of the follow-up in this study.

In all of these engagements, the PREVAIL SMC team urged the communities and survivors alike to take advantage of the research study to find out their health status. They stressed enrollments for close contacts, birth cohorts, and semen collection to find out if they are free from Ebola.

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