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The department of infectious disease epidemiology consists of an assembly of international teams spread throughout the world.
Team Hamburg is part of the Bernhard Nocht Insitute for Tropical Medicine and also the headquarters of the department. Its focus is Research & Development as well as International Teaching & Capacity Building.
Team Kumasi is based at the Kumasi Centre for Collaborative Research (KCCR), Ghana, as well as at the Agogo Presbyterian Hospital and other hospitals, where most of our clinical studies are conducted.
Team Arusha is located in Arusha, Tanzania, and is mainly working within the East African Community (EAC) to establish a sustainable laboratory infrastructure and response network across East Africa.
Team Tanga is based at the National Institute for Medical Research (NIMR) in Tanga, as well as at the Magunga District Hospital in Korogwe, Tanzania.
Team Antananarivo is based at the University of Antananarivo at the Laboratoire de Microbiologie et de Parasitologie Université Antananarive (LMPUA) in Madagascar and is contributing to our research projects as well.
Team Vientiane is located at the Lao Tropical and Public Health Institute (Lao TPHI) in Vientiane, Laos
Team Hué is based at the Hué University of Medicine and Pharmacy (HUMP) in Vietnam
The focus of the Research and Development group is the performance of studies on communicable diseases of humans. The concept includes the planning, preparation, supervision, performance and analysis of observational studies and clinical trials, combining classical, molecular and clinical epidemiology. Focus diseases are malaria, salmonellosis, cryptosporidiosis, sepsis, neglected tropical diseases (NTD) and co-infections in resource-poor settings. The group is interested in the development, evaluation and application of advanced diagnostics of infectious diseases, integration of electronic surveillance, definition of health priorities, and the analysis of the pathogens and their transmission conditions. The latter includes the analysis of genetic, environmental, socio-economic, demographic, and spatio-temporal risk factors on the host site as well as influence factors of the pathogens and vectors. The superior aim is the translation of results to implementation of diagnostics, treatment, prevention and capacity building in endemic countries. The studies are mainly performed together with the Kumasi Center for Collaborative Research (KCCR), the Ghana School of Public Health of the University of Ghana and different hospitals and communities in the Ashanti Region. Other cooperation partners are in many other African countries as well as in Vietnam and Laos.
Health threats in populations require global and international preparedness and effective responses. The infectious disease epidemiology department of BNITM contributes to this through teaching and capacity-building initiatives in Africa, the Middle East, and Central and South Asia.
These aim to:
“One Health” is a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment” (CDC.gov)
Bacterial infectious diseases are common medical problems in developing countries. Due to limited diagnostic facilities, the causative agents and sources of infection, as well as modes of transmission, often remain unidentified. Empiric treatment is a common practice, fostering the emergence of antibiotic resistance and leading to difficult-to-treat infections. Due to the absence of effective monitoring, knowledge of circulating bacterial strains, their reservoirs and how these change over time, is limited.
Because of our close connection with animals, particularly in developing countries, human infections are often zoonoses. Pathogens can be transmitted to humans through direct contact or through food, water or the environment. Overuse of antibiotics in animal husbandry has significantly contributed to the increase of multi drug resistant bacteria, found both in animals and humans.
Bacteria can also survive for extended periods in the environment. For example, in water, in soil, and of particular concern for human health, in the hospital environment. They are capable of adapting to different environments.
Our research interests cover the generation and comparison of bacteriological data from humans, animals and the environment in countries with limited resources. A special focus is on transmission and the identification of reservoirs of antibiotic resistant bacteria in rural areas of sub-Saharan African countries. Our activities will support and guide patient management and public health measures.
The spread of antimicrobial resistant (AMR) pathogens is not restricted to high-income countries, but will severely affect sub-Sahara Africa in the coming years. For the African continent, a modelling study estimated 4.2 million annual deaths related to AMR for the year 2050, leading to the highest mortality rate worldwide. Multiple factors may contribute to this development. Countries in sub-Sahara Africa suffer from a high burden of poverty-related infectious diseases, amongst them respiratory and gastrointestinal tract infections, which are partly treatable with antibiotic medication. Due to the lack of diagnostic facilities, broad-spectrum antibiotics are prescribed empirically without diagnosing a causative pathogen. In most African countries sub-standard and genuine antibiotics are readily sold without the need of prescriptions in pharmacies and in open street markets both for human consumption and for animal productions. High, insufficiently monitored, antibiotic consumption leads to the emergence of multidrug resistant pathogens, which consecutively spread within hospitals, the community, livestock and wild animals. Nosocomial transmission is facilitated by an African hospital environment that is often characterized by overcrowding, shortage of staff and lack of basic measures of hygiene.
Our research interests include hospital and community surveillance of AMR pathogens in low- and middle-income countries with the aim to integrate data from humans and animals. A special emphasis is put on the identification of transmission routes and reservoirs of AMR bacteria between animals and humans in rural sub-Sahara Africa guiding preventive public health measures.
The joint effort of the freeBILy team in Madagascar led to the finalization of the recruitment for freeBILy in the country. A total of 5203 women accepted to be part of the study. Women were recruited thanks to the work in the field of our 25 nurses and midwives, 4 doctors, 4 data manager, 5 lab technicians, 6 international doctoral students and 4 drivers! Their integration within the community, the trust they gained among the women, the harmony within the team and the passion of all those involved, brought lot of attention to the trial in the country. In the last weeks the recruitment numbers increased notably because within the communities the message was circulating about the approaching closure of recruitment. The road is still long , but today we feel stronger to reach the end! All together to win the fight against schistosomiasis.
Auf der Website von ONE ist gerade vom Deutschen Netzwerk ein Gastbeitrag von Johanna Brinkel veröffentlicht worden: https://www.one.org/de/blog/warum-gibt-es-jetzt-auch-noch-den-welttag-gegen-vernachlaessigte-tropenkrankheiten/
The Hospital Partnership between BNITM in Hamburg and Setthatirath Hospital in Vientiane, Lao PDR improved Management of snakebite envenoming in Lao PDR
The BNITM was formally recognized as a member institute of the tropEd Network for Education in International Health (https://www.troped.org) at the tropEd General Assembly, which took place in London at the University College London – Global Health Institute, 13-15 September 2019. tropEd is an international network of member institutions for higher education in international/global health from Europe, Africa, Asia, Australia and Latin America. tropEd provides postgraduate opportunities for education and training contributing to sustainable development. It focuses on improving the management of health services for disadvantaged populations. The innovative approach is based on mobility of people, the exchange of experiences in different disciplines and the establishment of a common standard in education and training.
On April 11th 2019, the Deputy Minister of Health in Tanzania announced an outbreak of Dengue fever in Tanzania.
Within the collaboration between the National Institute for Medical Research (NIMR) and the Bernhard Nocht Institute for Tropical Medicine (BNITM), the Department Infectious Disease Epidemiology at BNITM supports the response to the current outbreak of Dengue fever in Tanga, Tanzania. We offer support by the provision and implementation of routine diagnostics such as rapid tests and PCR-based molecular methods for Dengue fever, which, until now, were not available on site. In addition, we offer differential diagnostics for other febrile illnesses including sepsis and malaria. Furthermore, innovative diagnostics developed at BNITM for the serological differentiation of antibodies directed against different Dengue virus serotypes with minimized flavivirus cross reactivity will be validated for use in African countries.
This study is funded by the German Ministry of Health (BMG)
The second workshop of the fifth GIBACHT (Global Partnership Initiated Academia for the Control of Health Threats) cohort took place at the Robert Koch-Institute (RKI) in Berlin from 15-19 July 2019. The programme is led by the BNITM and implemented in partnership with the RKI, the Swiss Tropical and Public Health Institute, and the African Field Epidemiology Network. Four former GIBACHT fellows from Pakistan, Ghana, Sudan, and Uganda joined us to support the workshop and share their expertise with the 18 participants from 12 countries.
During the workshop, the participants had to apply their acquired knowledge in biosafety and biosecurity in group work, including several real-time simulations of health emergencies. These involved different aspects of outbreak investigations, the use of personal protective equipment, dealing with health communication at various levels (e.g. media, at-risk population, public), and following different leads in a biosafety/biosecurity investigation.
The third and last workshop of the current cohort will take place in Kampala /Uganda in October 2019.
The ASAAP project – a multi-country, multi-site clinical study to evaluate a new malaria triple therapy for children – has its kick-off meeting from 16th to 17th of June in Accra, Ghana. Seven reputable institutions across Sub-Saharan Africa, Germany, and France have come together to run the project which is led and coordinated by Dr Oumou Maiga-Ascofaré of the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR; Kumasi, Ghana) under the authority of the Kwame Nkrumah University of Science and Technology. EDCTP is funding this project and was well represented at the meeting.
The yearly tradition continues in its fifth year. The 18 fellows of the 2019 cohort of the GIBACHT programme (Global Partnership Initiated Academia for the Control of Health Threats) met at the BNITM for its first workshop from 8-12 April 2019. This training is part of the German Biosecurity Programme, funded by the Federal Foreign Office and led by BNITM with the partner institutions Robert Koch Institute, Swiss Tropical and Public Health Institute, and the African Field Epidemiology Network.
GIBACHT is responding to the need of countries with insufficiently prepared health systems and risk of accidental and deliberate release of infectious agents.The GIBACHT training consists of 20 e-learning modules, three face-to-face workshops (in Hamburg, Berlin, and Kampala/Uganda), and distance-based group work to develop teaching materials (case studies). To date, 64 fellows from 19 countries have been trained.
The next meeting will take place during a second workshop at the Robert Koch Institute in Berlin in July 2019.
freeBILy, the clinical trial to improve health of pregnant women and children, has officially started the recruitment on April the 4th in the city of Imerinsietoska in Madagascar. Three women have been recruited in the first 2 days of activities. " It was tough but it was a good start." Said Rado, our Malagasy research nurse who is in charge of the activities in town. Follow the trial on https://twitter.com/free_bily.
The preparation of the research sites in Madagascar for the freeBILy clinical trial entered its last phase. Staff has been recruited and a dedicated training has been coordinated in Ambositra by the BNITM team. Leaders of the partners institutions (University of Antananarivo, University of Fianarantsoa and Centre d’Infectiologie Charles Mérieux) actively contributed to the training activities. A successful clinical trial must involve the communities. The staff must be ready to vehiculate targeted and correct information about the study at any moment. In this view, research nurses, data manager, lab technicians but also the drivers were all trained on the main objectives of the study and on good clinical practices. Simulation exercises have been performed in order to mimic their future routine activities but also to prepare the staff to prompt and efficient reactions in case of non-expected scenarios. freeBILy is a project targeting mothers and child health. Many of the nurses within the staff are mothers and their children already became the mascot of the team! The trial is expected to start in the first months of 2019.
The third and last workshop of the GIBACHT (Global Partnership Initiated Academia for the Control of Health Threats) programme took place in Kampala/Uganda from 15-19 October 2018. Together with our partners from the Robert Koch Institute, the Swiss Tropical and Public Health Institute, and the African Field Epidemiology Network, we spent a week with the 15 fellows from 11 countries to complete their one-year biosafety and biosecurity training. Over the course of the programme, each of the fellows had developed a written case study with relevance for biosafety and biosecurity to be used as a teaching tool. A main focus of the workshop was the pilot testing of the case studies with students invited from the Makerere University of Kampala. Within the next six months, the fellows are going to apply the train-the-trainer concept and implement the case studies at their home institutions.
In January 2019, the department Infectious Disease Epidemiology at the BNITM will launch a new project in both Ghana and Tanzania on "genetic adaptation of non-typhoid Salmonella within human and animal reservoirs in sub-Sahara Africa". This work will be funded by the German Research Foundation (DFG), which supports joint research projects between scientists in Germany and Africa investigating infectious diseases and their social implications.
Within the cooperation between Setthatirath Hospital in Vientiane capital city, Lao PDR and Bernhard Nocht Institute (Klinikpartnerschaften) our team in Vientiane organises workshops about management of snakebites for medical staff in central, provincial and district hospitals. Capacity building is crucial to improve medical care for snakebite victims and to implement solid research thereafter.
After the first workshop of the GIBACHT programme (Global Partnership Initiated Academia for the Control of Health Threats) at the BNITM in April (see below), the fellows met for a second workshop at the Robert Koch Institute (RKI) in Berlin from 16-20 July 2018. With our partners from the RKI, the Swiss Tropical and Public Health Institute, and the African Field Epidemiology Network, we continued the biosafety and biosecurity training with real-time simulations of catastrophic health events. In group work, the fellows had to respond to fictional biological incidents from the perspective of a public health institution. This involved performing risk assessments of the evolving situation, deciding on control and containment measures, incorporating communication with the public, and developing preparedness plans for future incidents. The fellows will meet again during the third/last workshop of this cohort in Kampala /Uganda in October 2018.
From 16-20 April 2018, the fourth cohort of the GIBACHT programme (Global Partnership Initiated Academia for the Control of Health Threats) met for a workshop at the BNITM. This training is part of the German Biosecurity Programme, funded by the Federal Foreign Office and led by BNITM with the partner institutions Robert Koch Institute, Swiss Tropical and Public Health Institute, and the African Field Epidemiology Network. The goal of the programme is to strengthen national capacities in disaster management and the control of biological agents, and to foster international scientific exchange. After an introduction to the subject through e-learning modules in their home countries, the 15 participants from 11 countries got together for the first time in Hamburg and were further introduced to the topics biosafety, biosecurity and case study development. The next meeting will take place during a second workshop in Berlin in July 2018.
Our research fellow Oumou Maiga-Ascofaré was recently interviewed about her work and
her career path by the German Center for Infection Research (DZIF).
Here is the link to the full interview:
The second GIBACHT-cohort completed the Global Partnership Initiated Biosecurity Academia for Controlling Health Threats (GIBACHT) fellowship, a course series including computer learning activities and three on-campus workshops which were held in Hamburg and Berlin (Germany) and Kampala (Uganda).
Development and use of training material is a substantial part of the GIBACHT fellowship, thus making GIBACHT graduates multipliers who can train others in biosecurity and management of catastrophic health events. The final course of the second GIBACHT series took place in Kampala, organized by the African Field Epidemiology Network (AFENET). In the final workshop, GIBACHT fellows implemented their newly developed biosecurity and biosafety relevant case studies with students of the Makerere University (Kampala, Uganda)
The Infectious Disease Epidemiology working group at the BNITM starts a new project on "Genetic determinants for the transmission of Cryptosporidium spp. among humans and animals in Africa" in May 2016. The project will be funded by the German Research Foundation (DFG) within the "German-African collaborations in infectiology" Initiative. This program aims to investigate neglected infectious diseases in humans and animals as well as to establish research capacities in Africa and to build up inner- African research networks.
Cryptosporidium is a globally distributed single-celled organism that causes persistent diarrhea and malnutrition in immunocompetent individuals as well as severe diarrhea in immunosuppressed patients. Although Cryptosporidium is one of the most common pathogens causing diarrhea in children under the age of two in Africa, a substantial number of cases are thought to remain undiagnosed. The pathogen can be found in both humans and animals. However, there has been very little knowledge yet about the routes of transmission and the reservoirs in Africa. Treatment options have been insufficient.
The objective of this research project is to analyze the genetic diversity of African Cryptosporidium isolates by using whole genome sequencing methods in order to decode chains of transmission and to identify genetic determinants that affect the host specificity. The data will be important to introduce prevention measures and to find potential drug targets. The study will be conducted at four African research sites, in Gabon, Ghana, Madagascar and Tanzania, within a period of three years. The study will be accompanied by an extensive training program for young African scientists to establish a sustainable scientific network in East, West and Central Africa.
Prof. Jürgen May
Funding (last 3 years) by
Bundesministerium für Bildung und Forschung (BMBF)
Bundesministerium für Gesundheit (BMG)
Bundesministerium für Wirtschaftliche Zusammenarbeit und Entwicklung (BMZ)
Auswärtiges Amt (AA)
Deutsche Forschungsgemeinschaft (DFG)
Deutsches Zentrum für Infektionsforschung (DZIF)
European & Developing Countries Clinical Trials Partnership (EDCTP)
Else-Kröner-Fresenius Stiftung (EKFS)
Bill & Melinda Gates Foundation (BMGF)
Vereinigung der Freunde des Tropeninstituts e.V.
Positions and Activities
seit 2020 Member of the Steering Committee of the "German Alliance for Global Health Research" (BMBF)
seit 2020 Member of the Scientific Advisory Board of Leibniz-Institut für Präventionsforschung und Epidemiologie (BIPS)
seit 2019 Member of the "Lancet One Health Commission“
seit 2018 Nominated Representative of Germany and Luxemburg at the Joint Coordination Board (JBC) of WHO-TDR (Special Program for Research and Training in Tropical Diseases)
seit 2017 Co-Speaker of the Site Hamburg-Lübeck-Borstel of the DZIF
seit 2017 Member of the Round Table of the German Government „Internationalisierung in Bildung, Forschung und Wissenschaft“
seit 2017 Member of the Competence team „Antibiotika“ (BMG)
seit 2017 Member of the Competence team „Bedeutung der Globalisierung für die Gesundheitsversorgung“ (BMG)
seit 2016 Member of the „Global Outbreak Alert and Response Network (GOARN)" (WHO)
seit 2016 Member of the Steering Committee of the „Schnell Einsetzbaren Expertengruppe bei Gesundheitsgefährdungen (SEEG)" (BMZ)
seit 2012 Coordinator of the „Translational Infrastructure African Partner Institutions (TI API)" (DZIF)
seit 2012 Co-Coordinator „Translational Thematic Unit Malaria (TTU Malaria)" (DZIF)