LAMBARÉNÉ, GABON &
COTONOU, BENIN – TÜBINGEN
TB NETWORK

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PARTNERSHIPS

PARTNERSHIP BETWEEN:

University of Tübingen, Institute of Tropical Medicine / Germany

&

Centre de Recherches Médicales de Lambaréné (CERMEL) / Gabon

Improving treatment of AIDS/HIV and tuberculosis patients

Tuberculosis and HIV in Gabon

Tuberculosis (TB) is one of the top 10 causes of death worldwide. Over 95% of TB deaths occur in low- and middle-income countries (LMIC). Despite the fact that the number of new HIV infections has been reduced worldwide and also in the most affected African countries, this disease still represents a huge problem for the health systems of these countries. Uninterrupted treatment is equally important for TB- and HIV-infected patients to reduce the burden of disease and prevent new infections as well as resistance to available medicine.

MORE ABOUT GABON

  • Gabon, located on the West Coast of Africa, is one of the region’s politically more stable countries. It has 2 million inhabitants on an area of 267,667 sq. km.
  • Since its independence in 1960, Gabon has maintained a close relationship with France. The last decade has seen efforts to diversify its economy and its international relations.
  • Gabon is a major oil producer but a third of its population live in poverty, according to the World Bank.
  • Life expectancy at birth in Gabon is 65(f)/ 68(m) years.
  • The probability of dying before age five was at 45 for 1,000 births in 2018.

 

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Patients suffering from TB need to take the medicine daily for at least half a year, patients living with HIV all their life. Continuous treatment is the key for success. Often, patients do not return to health facilities for monitoring of their treatment and stop or interrupt their treatment. In the 1990s, countries introduced the so called “directly observed treatment strategy” (DOTS), which has not always worked according to expectations.

In Gabon in 2017, the number of new TB infections was 529/100,000 and 147/100,000 died. In Gabon, 56,000 people are infected with HIV. Many of them are infected with HIV and TB at the same time. In 2017, one third of those who died of TB were also HIV-infected. The long-term, regular and uninterrupted treatment for both infections is an important challenge, but is the precondition for a successful treatment leading to a healthy and symptom-free (HIV) life. In Gabon, 50% of TB patients do not complete their treatment.

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The government of Gabon has adopted the HIV and TB strategies of UNAIDS and WHO, but irregular or interrupted treatment of HIV infection and TB puts people’s lives in danger. Video-observed treatment can significantly contribute to treatment success. With the aim of changing the alarming situation, Gabon’s Ministry of Health and the National TB Programme welcome the idea of working with their longstanding German partner institution to take advantage of the widespread distribution of smartphones to improve the treatment of patients with TB or an HIV infection.

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eHEALTH

Our eHealth Contribution

Video-observed treatment of Patients with TB and HIV infection through smartphones and messenger apps.

To improve treatment, patients use their smartphones and an app to produce a video when taking their daily treatment and send the video to a central institution. Here, the nurse can check the video and see whether the treatment was done properly. If no video arrives or treatment has not been done properly, the nurse will contact the patient to find out why the video was not sent or advise him/her on how to take the medication. Patients can also communicate unpleasant side effects of the medication and be advised accordingly.

The partner medical centre in Gabon has a well-functioning IT department and IT specialists who can support the implementation. Nurses involved will receive training in the use of the methodology. The interpretation of the videos is supervised by specialised doctors to assure quality of interpretation and of actions taken. After being piloted in Gabon, the project will be expanded to Benin. Both the Ministry of Health of Gabon and the National TB Programme support the implementation of the strategy and are committed to extending it to the whole country, making it a sustainable approach.

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PARTNERSHIPS

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University of Tubingen, Institute of Tropical Medicine / Germany

The Institute of Tropical Medicine (ITM) in Tübingen is internationally renowned for translational medical research on interventions for infectious diseases. The focus is on the clinical development of drugs, vaccines and diagnostics for poverty-associated diseases (malaria, worm infections, tuberculosis etc.). The ITM is a Centre of Competence for Tropical Medicine in Baden-Württemberg and forms part of the German Centre for Infection Research (DZIF). Some of the eight research groups are located both in Tübingen and at CERMEL in Gabon. The research partnership with CERMEL was established over 20 years ago, and with more than 80 third-party funded projects, this fruitful partnership has been involved in the clinical development of almost all currently available antimalarial drugs and treatment regimens on the market.

Contact:

Dr. Andrea Kreidenweiss
Universität Tübingen
Institut für Tropenmedizin
Wilhelmstraße 27
72074 Tübingen
andrea.kreidenweiss@uni-tuebingen.de

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Centre de Recherches Médicales de Lambaréné (CERMEL) / Gabon

CERMEL is one of the most important medical research centres in Central Africa, with a priority focus on patient-oriented clinical research on poverty-related diseases (malaria, TB etc.). CERMEL is located on the campus of the Albert Schweitzer Hospital, a regional hospital in Lambaréné, and became an independent legal entity in 2012. CERMEL has some 120 employees working in medicine, research-related and infrastructural departments (IT, administration, finance and accounting, data management). CERMEL is the principal recipient for the national TB Programme of the Global Fund to Fight AIDS, Tuberculosis and Malaria and leads the national TB reference laboratory.

Contact:

Dr. Bertrand Lell
CERMEL
Lambaréné
bertrand.lell@cermel.org

MORE INFORMATION

ABOUT

University of Tubingen, Institute of Tropical Medicine / Germany

The Institute of Tropical Medicine (ITM) in Tübingen is internationally renowned for translational medical research on interventions for infectious diseases. The focus is on the clinical development of drugs, vaccines and diagnostics for poverty-associated diseases (malaria, worm infections, tuberculosis etc.). The ITM is a Centre of Competence for Tropical Medicine in Baden-Württemberg and forms part of the German Centre for Infection Research (DZIF). Some of the eight research groups are located both in Tübingen and at CERMEL in Gabon. The research partnership with CERMEL was established over 20 years ago, and with more than 80 third-party funded projects, this fruitful partnership has been involved in the clinical development of almost all currently available antimalarial drugs and treatment regimens on the market.

Contact:

Dr. Andrea Kreidenweiss,
Universität Tübingen
Institut für Tropenmedizin
Wilhelmstraße 27
72074 Tübingen
andrea.kreidenweiss@uni-tuebingen.de

Tübingen Logos

Centre de Recherches Médicales de Lambaréné (CERMEL) / Gabon

CERMEL is one of the most important medical research centres in Central Africa, with a priority focus on patient-oriented clinical research on poverty-related diseases (malaria, TB etc.). CERMEL is located on the campus of the Albert Schweitzer Hospital, a regional hospital in Lambaréné, and became an independent legal entity in 2012. CERMEL has some 120 employees working in medicine, research-related and infrastructural departments (IT, administration, finance and accounting, data management). CERMEL is the principal recipient for the national TB Programme of the Global Fund to Fight AIDS, Tuberculosis and Malaria and leads the national TB reference laboratory.

Contact:

Dr. Bertrand Lell,
CERMEL
Lambaréné
bertrand.lell@cermel.org

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