Northern Region Malaria Project NORMAP

The Northern Region Malaria Project (NORMAP) was established in 2000 as a co-operation between the Malaria Unit, ITM Berlin, the School of Medicine and Health Sciences (SMHS), Tamale, and the Regional Health Directorate (MoH), Northern Region, Ghana.

The focus of activities lies in Tamale, the regional capital of Ghana’s Northern Region, with a population of approx. 300,000. Clinico-epidemiological studies on malaria are conducted at Bulpeila Health Centre (BHC), at the Tamale Teaching Hospital, and in the rural environment of Tamale. The co-operation aims at providing research results which can be applied in malaria control. While the Regional Health Directorate provides infrastructure and access to health facilities, the SMHS forms the administrative frame. The Malaria Unit is responsible for the actual conduct of the individual projects. NORMAP is considered a platform for clinico-epidemiological studies and is open to projects beyond the named target. Apart from malaria, respiratory infections, diarrhoea, malnutrition, meningitis, and guinea worm are important causes of paediatric morbidity. Projects are reviewed and approved by the Ethics Committee, University for Development Studies, Tamale and by the Health Research Unit, MoH, .

1. Bulpeila Health Centre, Tamale, Northern Region

Initial projects on malaria were initiated in 2000 at Bulpeila Health Centre (BHC). Located in a low-income area of Tamale, BHC is a primary health post responsible for medical care of a population of approx. 50,000 inhabitants. Regular staff consists of one medical assistant, two nurses and five midwifes. For NORMAP projects, BHC has been upgraded by installing a field laboratory for basic parasitological, haematological, and biochemical analyses. Back-up and further examinations and long-term sample storage takes place at the Primary Health Care Laboratory on the premises of Tamale Teaching Hospital. Tamale Teaching Hospital also serves as a reference centre for patients seen at BHC and requiring hospitalisation. The current NORMAP staff at BHC involves: 2 clinicians/MDs, 2 nurses, 1 midwife, 2 laboratory technicians, 9 community workers. Since 2000, approx. 4,500 children have been examined within NORMAP projects (23,000 individual clinical and parasitological examinations), the majority at BHC. NORMAP projects benefit from close linkages with the community they serve. Regular meetings with traditional and official opinion leaders cause high acceptance in the community. Compliance rates in longitudinal studies commonly exceed 90-95%.

NORMAP is currently extending and renovating BHC to be able to cope with the intense usage of the facility by the community. These works are expected to be completed by the beginning of 2005.

2. Tamale Teaching Hospital

Tamale Teaching Hospital is the regional reference centre and teaching hospital of the School of Medicine and Health Sciences. The paediatric ward comprises 55 regular beds but does not have facilities for intensive care. In the rainy season, up to 80 admissions per day are recorded. For studies on the pathophysiology of severe malaria, NORMAP has established a basic parasitological and biochemical laboratory on the ward. In addition, at Tamale Teaching Hospital, NORMAP has access to the Primary Health Laboratory (MoH) which offers state-of-the-art laboratory and sample storage facilities.

3. Northern Region, Ghana

Epidemiological field studies are carried out in the rural environment of Tamale. Census data, cluster-sampling and GPS are used for the selection of villages adjusting for population-density. For these field activities, a mobile laboratory and power generators are carried along to be able to perform basic laboratory examinations on the spot and to eventually initiate appropriate treatment. Due to the infrastructural limitations in the Northern Region, particularly in the rainy season, these studies can be associated with tours of several days duration and cumbersome conditions.

4. Education and Training

NORMAP provides training units on study conduct, clinical trial standards (GCP, SOPs, etc.), bio statistical procedures and epidemiology of two to three weeks duration. Venue of these courses is the Tamale Centre for Cross-Cultural Studies which provides appropriate teaching rooms as well as accommodation and catering.

5. Transport and accommodation

Ghana is located approx. seven hours by plane from major European cities. Tamale is situated some 700 km north of the capital Accra. Transport from Accra to Tamale takes up to 12 h by car or 45 min. by plane. Tamale offers several hotels and many restaurants. Visiting scientists, MD and MSc International Health students, and guests are hosted at NORMAP´s guesthouse. Phone and mobile phone lines and internet access are available in Tamale.

Co-operations

Institute of Tropical Medicine Berlin Malaria Unit

The Malaria Unit, Institute of Tropical Medicine (ITM) Berlin, was established in 1997 and conducts malaria-related, clinico-epidemiological studies in endemic regions. Due to continuous projects, research activities, and training programmes in northern Ghana, the Malaria Unit has intense experience and linkages with the complex aspects of the most important parasitic disease of human. The current focus of research can be summarized as:

• Role of genetic polymorphisms in susceptibility to and manifestation of malaria

• Treatment trials and antimalarial resistance markers

• Pathophysiology

Contact

Dr. med. Frank P. Mockenhaupt
Malaria Unit, Institute of Tropical Medicine Berlin
Spandauer Damm 130, 14050 Berlin, Germany
Tel.: +49 30 30116 815
Fax: +49 30 30116 888