Human and Veterinary Medicine

North-South-Alliance for Health

As part of its North-South Cooperation, the University of Zurich collaborates with Makerere University in Uganda. At the beginning of July, researchers from both universities convened at a symposium in Uganda, where they discussed existing and potential new projects in the fields of medicine and veterinary medicine. Jan Fehr, attending physician at UniversityHospital Zurich, reported on a study geared to improving the treatment of tuberculosis.

Adrian Ritter

Several members of the UZH delegation that traveled to Uganda at the beginning of July (from left to right): Vice President Daniel Wyler, Prof. Rainer Weber (Vice Dean of the Faculty of Medicine), Dr. Jan Fehr (Group leader SOUTH Project), Yasmine Inauen (International Relations Office) and Prof. Paul Torgerson (Vetsuisse Faculty). (Image: Department of International Relations, UZH)

HIV is one of the most common infectious diseases in Africa, and in Uganda, an estimated seven percent the population is infected with the virus. Because the disease weakens the immune system, some victims also contract secondary diseases such as tuberculosis. It is precisely these patients with HIV and tuberculosis that SOUTH,  Study on Outcome-related Tuberculosis-HIV drug-concentration, hopes to help.

To this end, UZH and UniversityHospital Zurich are working together with the Infectious Disease Institute (IDI) of Makerere University in the Ugandan capital, Kampala. IDI is one of the leading African research institutes for infectious diseases, but also a center for the treatment of HIV patients.

Main building of Makerere University Uganda (MAK): UZH has been collaborating with the university in the Ugandan capital of Kampala since 2008. (Image: Nina Pfenninger)

Of global interest

140 patients who are coinfected with HIV and tuberculosis are currently taking part in SOUTH. They receive medicine to treat both diseases and undergo regular blood tests as part of the study.

The study examines existing correlations between the outcome of the therapy and the concentration of TB drugs in the blood. A reliable threshold value of the concentration would make it possible to treat patients more efficiently and with fewer side effects.

Jan Fehr, who is a consultant at the Division of Infectious Diseases and Hospital Epidemiology at UniversityHospital Zurich and heads the study, reported on the initial findings of the study at the symposium at Makerere University (see box below). The findings show that the threshold values used thus far are not reliable and – as suspected by some experts – need to be redefined.

«A study like this would not be possible in Switzerland on account of the low number of persons infected there. The findings will be of global interest», Fehr believes.

The project commenced in April 2013 and is part of the University of Zurich’s North-South Cooperation. Since 2008, this initiative has been promoting an exchange of knowledge and mutual intercultural learning with academic institutions in Africa. The cooperation supports sustainable projects in research and teaching as well as in capacity development.

Developing capacity

The SOUTH Project also involves biostatisticians from the Division of Infectious Diseases and Hospital Epidemiology as well as the Division of Clinical Pharmacology and Toxicology and the Institute of Clinical Chemistryat UniversityHospital Zurich.

The study aims to be more than a mere research project. Another objective is to enhance diagnosis and treatment capacity at IDI. The cooperation therefore also includes training modules for doctors and nursing staff and the creation of a PhD program. A doctor from Uganda is currently the first to be completing her doctorate as part of SOUTH. A laboratory technician from IDI received training at University HospitalZurich to operate an existing analysis device in Kampala. He is now able to measure tuberculosis drugs and other medicines in the bloodstream.

Participants in the symposium «One Health from Different Perspectives»: Representatives from the veterinary and medicine faculties at UZH and Makerere University Uganda (MAK).

New study planned

But the flow of  knowledge transfer is not only in the direction of the South to North. Lars Henning, a doctor from Jan Fehr’s team, has established and accompanied the study in Kampala over the past year and a half. Now another doctor from UniversityHospital Zurich, Amrei von Braun, has traveled to Kampala to start another cooperation project there.

The new project will carry out research to determine whether the monitoring system for HIV patients advocated by WHO makes sense. According to the current system, a patient’s health can be assessed using what is referred to as the patients’ ‘immune status,’ which is measured on the basis of the T-helper cells. Amrei von Braun will examine how many patients do not get the best possible treatment based on those guidelines. In the event of treatment failure, viruses are also to be tested for resistance.

According to Jan Fehr, the findings could represent significant new information in particular for poorer countries that work in accordance with WHO guidelines. At the same time, new findings on resistance are also of interest to richer countries like Switzerland.

New agreement: UZH Vice President Daniel Wyler (left) hands the signed agreement to MAK Chancellor George Mondo Kagonyera. This agreement allows medical students at UZH to study at MAK’s College of Health Sciences. (Image: Department of International Relations, UZH)

Symposium at Makerere University

nullnullUZH and the Infectious Disease Institute (IDI) at Makerere University (MAK) organized the symposium «One Health from Different Perspectives», which took place on 7 and 8 July 2014. The objective was to deepen existing cooperation in the field of medicine and to open up new opportunities for contact between researchers. nullThirteen members of UZH attended, including researchers from the fields of medicine and veterinary medicine as well as Vice President Daniel Wyler. In addition to SOUTH, other studies were introduced, including research done on on zoonoses (infectious diseases that can be transmitted between animals and humans).
To round off the program, potential new research cooperation opportunities in the areas of pediatric infectious diseases, diabetology, food safety, and veterinary epidemiology were discussed. nullTwo UZH summer schools on the topics of applied ethics and «Disability and Technology» took place at MAK at the same time as the symposium. nullThanks to a new agreement between the College of Health Sciences at MAK and the Faculty of Medicine at UZH, in the future, medical students from UZH can spend four to twelve weeks at the College. nullUZH has been collaborating with MAK since 2008. Since that time, numerous joint projects have been realized in a vast array of disciplines - and not only in human and veterinary medicine, but also in ethnology, linguistics, and philosophy. null

Adrian Ritter is an editor for UZH News.

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