One of the objectives of the Charles Mérieux Infectiology Center is to improve diagnostic tools in the fight against infectious diseases in Madagascar to improve the health of patients.
The Centre’s research activities respond to public health issues by focusing specifically on infectious diseases. Projects carried out can be fully funded by institutions or foundations, such as the International Vaccination Institute, Fondation Mérieux, or in partnership with other institutions such as the Centre for International Cooperation in Agronomic Research for Development (CIRAD), Institut Pasteur de Madagascar (IPM), the NGO “Reggio Terzo Mondo”, Caprion Proteomics in Canada, the University of Grenoble, the Centre for Research and Monitoring of Emerging Diseases in the Indian Ocean (CRVOI) of La Réunion, the National Cancer Institute (INcA) in Paris, and the EDCTP (European & Developing Countries Clinical Trials Partnership).
The Centre has participated in the multi-centre study of the GABRIEL network, which aims to determine and characterize the pathogens (bacteria and/or viruses) responsible for pneumonia in hospitalized children.
In 2017, the Centre joined the Doctoral Reception Team 3 (EAD3), “Biodiversity and Health” of the Doctoral School 4 (ED4), “Life and Environmental Sciences” of the Faculty of Sciences at the, University of Antananarivo.
Since its creation, several training courses have been conducted at the Centre, in particular in molecular biology, epidemiology, external fundraising, scientific writing, and research bioethics.
Projects currently carried out by the Centre:
Chromomycosis and sporotrichosis: diagnosis, epidemiology, and environmental surveillance (supported Fondation Mérieux)
The responsible fungal species are characterized at the Centre by direct examination, culturing of fungi followed by macroscopic and microscopic examinations, and by the sequencing of specific genome regions. Fungal strains are also analysed in Grenoble by the MALDI-ToF technique.
Rapid, easy, and reliable diagnostics for the elimination of schistosomiasis in young children and mothers
This 4-year clinical research project (October 2017 – July 2021) involving eight national institutions from the North (Netherlands, Germany, Spain) and the South (Gabon, Madagascar), is funded by EDCTP (European & Developing Countries Clinical Trials Partnership). The project in Madagascar is being conducted as part of an evaluation of schistosomiasis treatment based on the rapid diagnostic test “Point of Care Circulating Cathodic Antigen, POC-CCA” in pregnant women and young children.
Study on drug-resistant leprosy, genotyping and molecular epidemiology of Mycobacterium leprae
In collaboration with Ecole Polytechnique Federale de Lausanne (EPFL) and Hopital Lariboisière (APHP)
This activity is supported by Fondation Merieux. The detection of M. leprae is performed by PCR amplification of a repeated sequencing of the genome, genotyping by partial sequencing, and detection of mutations involved in the resistance to rifampicin, fluoroquinolones, and dapsone by line probe assay (LPA) and sequencing. The Centre was declared by the Ministry of Health as “National Reference Laboratory for the Monitoring Drug-resistant Leprosy” in April 2017.
Pilot study for the evaluation of blood biomarkers for the diagnosis and monitoring of the effectiveness of treatment against leprosy: IGRA and HBHA (HILE).
HILE is a two-year pilot study on the serological diagnosis of leprosy (May 2018 ̶Dec 2020) coordinated by Laboratory of Emerging Pathogens of the Fondation Mérieux (LPE). It aims at identifying biomarkers for early detection of leprosy cases. Clinical recruitment is carried out at the dermatology department of the Joseph Raseta Befelatanana Hospital and at the University Health and Public Health Insitute (ex-IHS) at Analakely, and biological investigations are carried out at CICM. This project is funded by Fondation Mérieux and the Raoul Follereau Foundation.
Surveillance of bacterial meningitis (supported by the Mérieux Foundation)
The detection of Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b is performed through cooperation with the Laboratory of Emerging Pathogens (LPE) in Lyon. The objective is to rewrite the bacterial etiology of meningitis and/or meningoencephalitis in patients hospitalized in paediatrics or in the adult wards and to ensure microbiological monitoring of the emergence or reemergence of pathogenic strains.
Evaluation of HIV 1 viral loads (CV-HIV 1) of patients living in Antananarivo (supported by Fondation Mérieux)
CV-HIV 1 has been available since August 2015 thanks to the participation of hospitals in the capital and outlying regions, health centres, the national reference laboratory, associations, and the support from France Expertise International and from the Executive Secretariat of the National AIDS Control Committee.
Tricycleevaluation and monitoring of the prevalence of Escherichia coli producers of broad-spectrum beta-lactamases, in Madagascar (April 2018 – May 2019 and October 2019 – September 2020)
Antimicrobial resistance has become an issue for global human public health, and in the food and environmental chain. Given this, WHO launched a “One Health” surveillance programme in 2015 basing the species Escherichia coli as a resistance indicator. The study's main objective is to determine the prevalence of E. coli producers of broad-spectrum beta-lactamases (E. coli BLSE) in humans, the food chain, and the environment in Madagascar.
Post-exposure prophylaxis against leprosy in the Comoros and Madagascar
This is a 4-year clinical trial (September 2018 – October 2022), coordinated by the Institute of Tropical Medicine, Antwerp, Belgium, involves participants from the Damien Foundation of the Comoros and Belgium, the CICM of Madagascar, the Raoul Follereau Foundation of Madagascar, Leidsch Universitair Medisch Centrum of the Netherlands, the Public Health Hospitals of Paris, France, Genoscreen in Lille, France, and Fiocruz in Rio de Janeiro, Brazil. This study was approved at the end of 2018 and is funded by EDCTP.
Stronger treatment of tuberculosis with or without aspirin to reduce mortality from tubercular meningitis in HIV-infected and non-infected patients: Phase III randomized controlled trial.
The project will last 60 months, including 40 months of recruitment, and will be implemented in four countries: Ivory Coast, Uganda, Madagascar, and South Africa. The study sites in Madagascar will include the Infectious Diseases department of CHUJRB Antananarivo, the Infectious Diseases department of CHU Tambohobe Fianarantsoa and the Internal Medicine/Rheumatology department of CHU Morafeno Toamasina. CICM is involved in bringing the laboratories of CHUJRB Antananarivo, CHU Fianarantsoa and CHU Toamasina into service by making a technical contribution for the purchase of equipment, materials, reagents, and consumables and for the launch of laboratory tests.