EMINI - Establishment of the infrastructure for the Evaluation and Monitoring of the Impact of New Interventions
The overall objective of the EMINI project is to contribute to the overall improvement of health by trying to help control two of the three major communicable diseases in Africa. This overall objective should be achieved through two specific objectives. These are
i. The reinforcement of the existing health care structures so they become conducive to new interventions
ii. The establishment of an up-to-date capacity to evaluate and monitor the impact of improved health care infrastructure and new interventions.
These new interventions include drugs and vaccines for HIV, TB and malaria and active TB case finding; just to mention some of them. The target group for this action is the general population of the Mbeya Region.
As part of the second objective the study aims to describe the epidemiology of infectious diseases, including HIV, TB, malaria, schistosomiasis and helminth infections and causes of morbidity in the studied population. The study shall also establish the data that are required for community randomized controlled trials.
The initial EMINI study was a 3 year EC funded project which started in May 2005. The initial funding by the EC has been completed, however, the survey of the EMINI study is still ongoing under another EC funded project (ADAT). The EMINI survey is a closed population based cohort with annual visits of 18,000 individuals (age 1 and above) enrolled from 10% of all households, randomly selected in 9 dedicated EMINI sites (urban, semi urban and rural). The project sites were chosen according to the specific characteristics in the Mbeya Region in order to give a good representation of the geographic diversity of the Region
Embedded into EMINI are several focused studies such as NVBD that determines the presence of antibodies against numerous viral and bacterial febrile diseases, including Chikungunya, Dengue, O`nyong nyong, West Nile, Yellow Fever, Rift Valley-Fever as well as other tropical Arboviruses, but also rickettsia, yersinia pestis, anthrax and brucellosis. Other studies embedded into the EMINI survey are WHIS, SOLF and MATHIS. WHIS concentrates on the influence of helminth infection on HIV epidemiology and immunology. The SOLF study aims to assess the prevalence of lymphatic filariasis (LF) and the impact of annual Ivermectine-Albendazole mass treatment on LF prevalence in Southwest Tanzania, whereas the MATHIS study examines the effects of helminth infections on allergy specific parameters in a well characterized cohort in Southwest Tanzania. All these smaller studies are described separately in this web page.
The reinforcement part of the EMINI study was completed with the end of the initial funding by the EC in 2008. The survey itself is still being conducted under another EC funded project (ADAT) and going well. The 5th survey round has started on the 19th July 2010. This round, which will be the last survey round, is expected to be completed by the middle of 2011.
The HIV prevalence stayed stable throughout the first three annual surveys with a slight decline in prevalence. The prevalences were 7.4%, 7.21% and 7.23% in survey 1 to 3. Malaria prevalences have declined considerably during the course of the project, most probably due to the introduction of ALU as the new first line treatment. Schistosoma haematobium infection has equally declined in the study population. Other helminth infections show marked differences between age groups and sites.
MMRC: Petra Clowes (study coordinator), Anthony Nsojo (laboratory), Dickens Kowuor (data) and Leonard Maboko (site principle investigator)
LMU: Elmar Saathoff (epidemiologist) and Michael Hoelscher (principal investigator)
EMINI is funded by the European Union through EuropAid, contract numbers SANTE/2004/078-545 EMINI and SANTE/2006/129-931.
The project is a collaboration of
NIMR-Mbeya Medical Research Center in Mbeya, Tanzania.
Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Germany.
Findings of the HIV prevalence for the first three years of the survey (2006 to 2009) have already been presented at several venues, such as the NIMR 24th Annual Joint Scientific Conference in Arusha from 16.-18 March 2010.
Publications regarding these and other results of the EMINI study are presently in preparation.