Paul Sondo presents at the 9th EDCTP Forum Lisbon, Portugal. Credit Andrea Stewart

Paul Sondo from Nanoro, Burkina Faso, recounts the highlights from his CRDF Fellowship at WWARN

5 March 2019

Paul Sondo is a molecular parasitologist from the Clinical Research Unit of Nanora in Burkina Faso. Paul spent the last 12 months with WWARN as a recipient of the Clinical Research and Development Fellowship (CRDF), jointly implemented by TDR*, the Special Programme for Research and Training in Tropical Diseases, and the European & Developing Countries Clinical Trials Partnership (EDCTP)**. Here, he tells us about his experience as a CRDF Fellow and how it is starting to impact on his clinical research back at the Clinical Research Unit of Nanora.

My motivation to apply for the CRDF Fellowship

I knew about WWARN’s very high-quality research and in particular your work on molecular markers. My mentor Prof Halidou Tinto encouraged me to apply to TDR as I was finishing my PhD in Burkina Faso. My research focuses on assessing the efficacy of antimalarial drugs, studying the genetic diversity of Plasmodium falciparum, and exploring the molecular markers associated with antimalarial drug resistance. I was also familiar with the Parasite Clearance Estimator (PCE).

For my clinical work, we need to estimate the parasite clearance after an artemisinin combination therapy. It is my goal to measure parasite density more frequently to allow for clearance estimation, using the PCE tool, for a new trial in the future.

My research focus at WWARN

I helped to create a database of malaria treatment studies, which we call WWARN Clinical Trials Library. I updated this database with studies indexed in databases EMBASE and Web of Science Core Collection from their inception to 2014. This was a huge amount of work, we found 16,000 potentially eligible studies which we have screened to identify only studies eligible for inclusion in our database (for example, they are all prospective studies). Together with Junko Takata, we are working on a publication to explain how the library was created and to summarise the studies it contains. The updated library, including studies published up to 2018, collected from four databases, will be freely available online soon.

I had the opportunity of being part of the Correlation between K13 mutations and clinical phenotype Study Group, which recently published a paper in BMC Medicine reporting new mutant alleles in the K13 gene linked to delayed parasite clearance.

Setting up the Molecular Markers of Resistance in West Africa Study Group

I also set up the Molecular Markers of Resistance in West Africa Study Group. The work of this group will include a systematic review to update an earlier WWARN literature review examining the associations between treatment outcomes and polymorphisms in genes pfcrt and pfmd1. We will expand the review to include patients treated with artesunate-mefloquine.

Together with Magatte Ndiaye, WWARN West Africa Regional Coordinator, at the University of Cheikh Anta Diop in Dakar, Senegal we plan to create maps that will provide molecular evidence of resistance for all stakeholders in the region. We will maximise this collaboration to train colleagues on data analysis and simple map making.

What next? Sharing my learning with students in Burkina Faso

I want to bring my learning on the important tools within the WWARN Malaria Clinical Trials toolkit  back to Burkina by training colleagues during a workshop I am planning for this year. I will introduce students to the Systematic Review methodology and best practices in data management. I learned and practiced these approaches during the Newton workshop in Nairobi, Kenya and thereafter from WWARN and IDDO colleagues who gave their time to train me and share their experiences.

Systematic Reviews are not easy, and their methodologies are not widely taught in West Africa; I intend to teach to what I learned to undergraduate students. I will also share my learning from co-leading the Molecular Markers of Resistance in West Africa Study Group.

I am planning a workshop this year – as part of this I will also develop a questionnaire to discover what additional tools we need to support research groups in the sub-region; I want to be sure that we can develop the skills of young researchers.

Putting the Toolkit approach into practice in the lab

I am the research lab lead for the Clinical Research Unit Lab in Nanoro. When trying to use Standard Operating Procedures (SOPs), we often have issues identifying the best and most up-to-date SOPs available, for example the SOP for DNA extraction is a procedure that we know needs updating in our lab. Also, the Malaria Case Record Form is a great template we can use.

The WWARN Malaria Clinical Trials toolkit provides guidance that will give me a more structured approach to trials in the lab. Before, I only knew specific parts of the process. This is freely available and easy to access online, and we are very excited to start using these peer-reviewed tools in our lab.

Prof Halidou Tinto has also been teaching some elements of clinical trials at the Nazi Boni University, I hope to join him in this teaching.  

It was memorable being at WWARN, and it challenged me

I was approached by a researcher from Niger who wanted to join the Molecular Markers of Resistance in West Africa Study Group at the 9th EDCTP Forum in Lisbon. This was a great moment; once researchers understand the purpose and benefits of a collaborative approach, they want to be part of it.

I had to deal with big geographic distances between partners. You must be organised to plan and stay connected. I would have appreciated having more funds to meet collaborators face-to-face to train and share ideas on data management approaches.

What would I tell a new EDCTP-TDR Fellow?

To “feel free” to take ownership of your work – to have the freedom to define your own path and plan your work. The WWARN approach is to prepare leaders, to develop leadership skills, rather than defining everything for you step by step. The support from EDCTP and TDR for this Fellowship was fantastic, an amazing opportunity.

Thanks to Paul Sondo for his interview time with Andrea Stewart, Head of Communications & Advocacy at WWARN.

*TDR, is a global programme of scientific collaboration that helps facilitate, support and influence research efforts to combat diseases of poverty. It is hosted at the World Health Organization (WHO) and is sponsored by the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank and WHO.

**The European & Developing Countries Clinical Trials Partnership (EDCTP) funds clinical research to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials. It is a partnership of 16 African and 14 European countries, supported by the European Union under Horizon 2020.