Skip to main content
Top
Published in: Malaria Journal 1/2011

Open Access 01-12-2011 | Methodology

Development of standardized laboratory methods and quality processes for a phase III study of the RTS, S/AS01 candidate malaria vaccine

Authors: Christine Swysen, Johan Vekemans, Myriam Bruls, Sunny Oyakhirome, Chris Drakeley, Peter Kremsner, Brian Greenwood, Opokua Ofori-Anyinam, Brenda Okech, Tonya Villafana, Terrell Carter, Barbara Savarese, Adriano Duse, Andrea Reijman, Charlotte Ingram, John Frean, Bernhards Ogutu, the Clinical Trials Partnership Committee

Published in: Malaria Journal | Issue 1/2011

Login to get access

Abstract

Background

A pivotal phase III study of the RTS,S/AS01 malaria candidate vaccine is ongoing in several research centres across Africa. The development and establishment of quality systems was a requirement for trial conduct to meet international regulatory standards, as well as providing an important capacity strengthening opportunity for study centres.

Methods

Standardized laboratory methods and quality assurance processes were implemented at each of the study centres, facilitated by funding partners.

Results

A robust protocol for determination of parasite density based on actual blood cell counts was set up in accordance with World Health Organization recommendations. Automated equipment including haematology and biochemistry analyzers were put in place with standard methods for bedside testing of glycaemia, base excess and lactacidaemia. Facilities for X-rays and basic microbiology testing were also provided or upgraded alongside health care infrastructure in some centres. External quality assurance assessment of all major laboratory methods was established and method qualification by each laboratory demonstrated. The resulting capacity strengthening has ensured laboratory evaluations are conducted locally to the high standards required in clinical trials.

Conclusion

Major efforts by study centres, together with support from collaborating parties, have allowed standardized methods and robust quality assurance processes to be put in place for the phase III evaluation of the RTS, S/AS01 malaria candidate vaccine. Extensive training programmes, coupled with continuous commitment from research centre staff, have been the key elements behind the successful implementation of quality processes. It is expected these activities will culminate in healthcare benefits for the subjects and communities participating in these trials.

Trial registration

Clinicaltrials.gov NCT00866619
Appendix
Available only for authorised users
Literature
1.
go back to reference Abdulla S, Oberholzer R, Juma O, Kubhoja S, Machera F, Membi C, Omari S, Urassa A, Mshinda H, Jumanne A, Salim N, Shomari M, Aebi T, Schellenberg DM, Carter T, Villafana T, Demoitié MA, Dubois MC, Leach A, Lievens M, Vekemans J, Cohen J, Ballou WR, Tanner M: Safety and immunogenicity of RTS,S/AS02D malaria vaccine in infants. N Engl J Med. 2008, 359: 2533-2544. 10.1056/NEJMoa0807773.CrossRefPubMed Abdulla S, Oberholzer R, Juma O, Kubhoja S, Machera F, Membi C, Omari S, Urassa A, Mshinda H, Jumanne A, Salim N, Shomari M, Aebi T, Schellenberg DM, Carter T, Villafana T, Demoitié MA, Dubois MC, Leach A, Lievens M, Vekemans J, Cohen J, Ballou WR, Tanner M: Safety and immunogenicity of RTS,S/AS02D malaria vaccine in infants. N Engl J Med. 2008, 359: 2533-2544. 10.1056/NEJMoa0807773.CrossRefPubMed
2.
go back to reference Agnandji ST, Asante KP, Lyimo J, Vekemans J, Soulanoudjingar SS, Owusu R, Shomari M, Leach A, Fernandes J, Dosoo D, Chikawe M, Issifou S, Osei-Kwakye K, Lievens M, Paricek M, Apanga S, Mwangoka G, Okissi B, Kwara E, Minja R, Lange J, Boahen O, Kayan K, Adjei G, Chandramohan D, Jongert E, Demoitié MA, Dubois MC, Carter T, Vansadia P, Villafana T, Sillman M, Savarese B, Lapierre D, Ballou WR, Greenwood B, Tanner M, Cohen J, Kremsner PG, Lell B, Owusu-Agyei S, Abdulla S: Evaluation of the safety and immunogenicity of the RTS,S/AS01 malaria candidate vaccine when integrated in the Expanded Program of Immunization. J Infect Dis. 2010, 202: 1076-1087. 10.1086/656190.CrossRefPubMed Agnandji ST, Asante KP, Lyimo J, Vekemans J, Soulanoudjingar SS, Owusu R, Shomari M, Leach A, Fernandes J, Dosoo D, Chikawe M, Issifou S, Osei-Kwakye K, Lievens M, Paricek M, Apanga S, Mwangoka G, Okissi B, Kwara E, Minja R, Lange J, Boahen O, Kayan K, Adjei G, Chandramohan D, Jongert E, Demoitié MA, Dubois MC, Carter T, Vansadia P, Villafana T, Sillman M, Savarese B, Lapierre D, Ballou WR, Greenwood B, Tanner M, Cohen J, Kremsner PG, Lell B, Owusu-Agyei S, Abdulla S: Evaluation of the safety and immunogenicity of the RTS,S/AS01 malaria candidate vaccine when integrated in the Expanded Program of Immunization. J Infect Dis. 2010, 202: 1076-1087. 10.1086/656190.CrossRefPubMed
3.
go back to reference Alonso PL, Sacarlal J, Aponte JJ, Leach A, Macete E, Aide P, Sigauque B, Milman J, Mandomando I, Bassat Q, Guinovart C, Espasa M, Corachan S, Lievens M, Navia MM, Dubois MC, Menendez C, Dubovsky F, Cohen J, Thompson R, Ballou WR: Duration of protection with RTS,S/AS02A malaria vaccine in prevention of Plasmodium falciparum disease in Mozambican children: single-blind extended follow-up of a randomised controlled trial. Lancet. 2005, 366: 2012-2018. 10.1016/S0140-6736(05)67669-6.CrossRefPubMed Alonso PL, Sacarlal J, Aponte JJ, Leach A, Macete E, Aide P, Sigauque B, Milman J, Mandomando I, Bassat Q, Guinovart C, Espasa M, Corachan S, Lievens M, Navia MM, Dubois MC, Menendez C, Dubovsky F, Cohen J, Thompson R, Ballou WR: Duration of protection with RTS,S/AS02A malaria vaccine in prevention of Plasmodium falciparum disease in Mozambican children: single-blind extended follow-up of a randomised controlled trial. Lancet. 2005, 366: 2012-2018. 10.1016/S0140-6736(05)67669-6.CrossRefPubMed
4.
go back to reference Aponte JJ, Aide P, Renom M, Mandomando I, Bassat Q, Sacarlal J, Manaca MN, Lafuente S, Barbosa A, Leach A, Lievens M, Vekemans J, Sigauque B, Dubois MC, Demoitié MA, Sillman M, Savarese B, McNeil JG, Macete E, Ballou WR, Cohen J, Alonso PL: Safety of the RTS,S/AS02D candidate malaria vaccine in infants living in a highly endemic area of Mozambique: a double blind randomised controlled phase I/IIb trial. Lancet. 2007, 370: 1543-1551. 10.1016/S0140-6736(07)61542-6.CrossRefPubMed Aponte JJ, Aide P, Renom M, Mandomando I, Bassat Q, Sacarlal J, Manaca MN, Lafuente S, Barbosa A, Leach A, Lievens M, Vekemans J, Sigauque B, Dubois MC, Demoitié MA, Sillman M, Savarese B, McNeil JG, Macete E, Ballou WR, Cohen J, Alonso PL: Safety of the RTS,S/AS02D candidate malaria vaccine in infants living in a highly endemic area of Mozambique: a double blind randomised controlled phase I/IIb trial. Lancet. 2007, 370: 1543-1551. 10.1016/S0140-6736(07)61542-6.CrossRefPubMed
5.
go back to reference Bejon P, Lusingu J, Olotu A, Leach A, Lievens M, Vekemans J, Mshamu S, Lang T, Gould J, Dubois MC, Demoitié MA, Stallaert JF, Vansadia P, Carter T, Njuguna P, Awuondo KO, Malabeja A, Abdul O, Gesase S, Mturi N, Drakeley CJ, Savarese B, Villafana T, Ballou WR, Cohen J, Riley EM, Lemnge MM, Marsh K, von Seidlein L: Efficacy of RTS,S/AS01 vaccine against malaria in children 5 to 17 months of age. N Engl J Med. 2008, 359: 2521-2532. 10.1056/NEJMoa0807381.PubMedCentralCrossRefPubMed Bejon P, Lusingu J, Olotu A, Leach A, Lievens M, Vekemans J, Mshamu S, Lang T, Gould J, Dubois MC, Demoitié MA, Stallaert JF, Vansadia P, Carter T, Njuguna P, Awuondo KO, Malabeja A, Abdul O, Gesase S, Mturi N, Drakeley CJ, Savarese B, Villafana T, Ballou WR, Cohen J, Riley EM, Lemnge MM, Marsh K, von Seidlein L: Efficacy of RTS,S/AS01 vaccine against malaria in children 5 to 17 months of age. N Engl J Med. 2008, 359: 2521-2532. 10.1056/NEJMoa0807381.PubMedCentralCrossRefPubMed
6.
go back to reference Asante KP, Abdulla S, Agnandji S, Lyimo J, Vekemans J, Soulanoudjingar S, Owusu R, Shomari M, Leach A, Jongert E, Salim N, Fernandes J, Dosoo D, Chikawe M, Saadou I, Osei-Kwakye K, Lievens M, Paricek M, Möller T, Apanga S, Mwangoka G, Dubois M-C, Tigani M, Kwara E, Minja R, Houkpatin A, Boahen O, Kayan K, Adjei G, Chandramohan D, Carter T, Vansadia P, Sillman M, Savarese B, Loucq C, Lapierre D, Greenwood B, Cohen J, Kremsner P, Owusu Agyei S, Tanner M, Lell B: Safety and efficacy over 19 months of the RTS,S/AS01E candidate malaria vaccine co-administered with Expanded Program of Immunization vaccines: an open randomized controlled trial. Lancet Infect Dis. Asante KP, Abdulla S, Agnandji S, Lyimo J, Vekemans J, Soulanoudjingar S, Owusu R, Shomari M, Leach A, Jongert E, Salim N, Fernandes J, Dosoo D, Chikawe M, Saadou I, Osei-Kwakye K, Lievens M, Paricek M, Möller T, Apanga S, Mwangoka G, Dubois M-C, Tigani M, Kwara E, Minja R, Houkpatin A, Boahen O, Kayan K, Adjei G, Chandramohan D, Carter T, Vansadia P, Sillman M, Savarese B, Loucq C, Lapierre D, Greenwood B, Cohen J, Kremsner P, Owusu Agyei S, Tanner M, Lell B: Safety and efficacy over 19 months of the RTS,S/AS01E candidate malaria vaccine co-administered with Expanded Program of Immunization vaccines: an open randomized controlled trial. Lancet Infect Dis.
7.
go back to reference Sacarlal J, Aide P, Aponte JJ, Renom M, Leach A, Mandomando I, Lievens M, Bassat Q, Lafuente S, Macete E, Vekemans J, Guinovart C, Sigaúque B, Sillman M, Milman J, Dubois MC, Demoitié MA, Thonnard J, Menéndez C, Ballou WR, Cohen J, Alonso PL: Long-term safety and efficacy of the RTS,S/AS02A malaria vaccine in Mozambican children. J Infect Dis. 2009, 200: 329-336. 10.1086/600119.CrossRefPubMed Sacarlal J, Aide P, Aponte JJ, Renom M, Leach A, Mandomando I, Lievens M, Bassat Q, Lafuente S, Macete E, Vekemans J, Guinovart C, Sigaúque B, Sillman M, Milman J, Dubois MC, Demoitié MA, Thonnard J, Menéndez C, Ballou WR, Cohen J, Alonso PL: Long-term safety and efficacy of the RTS,S/AS02A malaria vaccine in Mozambican children. J Infect Dis. 2009, 200: 329-336. 10.1086/600119.CrossRefPubMed
8.
go back to reference Schluger N, Karunakara U, Lienhardt C, Nyirenda T, Chaisson R: Building clinical trial capacity for tuberculosis drugs in high-burden countries. PLoS Med. 2007, 4: e302-10.1371/journal.pmed.0040302.PubMedCentralCrossRefPubMed Schluger N, Karunakara U, Lienhardt C, Nyirenda T, Chaisson R: Building clinical trial capacity for tuberculosis drugs in high-burden countries. PLoS Med. 2007, 4: e302-10.1371/journal.pmed.0040302.PubMedCentralCrossRefPubMed
9.
go back to reference Moorthy V, Reed Z, Smith PG, on behalf of the WHO Study Group on Measures of Malaria Vaccine Efficacy: Measurement of malaria vaccine efficacy in phase III trials: Report of a WHO consultation. Vaccine. 2007, 25: 5115-5123. 10.1016/j.vaccine.2007.01.085.CrossRefPubMed Moorthy V, Reed Z, Smith PG, on behalf of the WHO Study Group on Measures of Malaria Vaccine Efficacy: Measurement of malaria vaccine efficacy in phase III trials: Report of a WHO consultation. Vaccine. 2007, 25: 5115-5123. 10.1016/j.vaccine.2007.01.085.CrossRefPubMed
10.
go back to reference Greenwood BM, Armstrong JRM: Comparison of two simple methods for determining malaria parasite density. Trans R Soc Trop Med Hyg. 1991, 85: 186-188. 10.1016/0035-9203(91)90015-Q.CrossRefPubMed Greenwood BM, Armstrong JRM: Comparison of two simple methods for determining malaria parasite density. Trans R Soc Trop Med Hyg. 1991, 85: 186-188. 10.1016/0035-9203(91)90015-Q.CrossRefPubMed
11.
go back to reference Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG: Comparison of methods for the rapid laboratory assessment of children with malaria. Am J Trop Med Hygiene. 2001, 65: 599-602. Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG: Comparison of methods for the rapid laboratory assessment of children with malaria. Am J Trop Med Hygiene. 2001, 65: 599-602.
12.
go back to reference World Health Organization: Informal consultation on quality control of malaria microscopy. 2006, Geneva: WHO World Health Organization: Informal consultation on quality control of malaria microscopy. 2006, Geneva: WHO
13.
go back to reference Westgard JO: Basic QC Practices: Training in Statistical Quality Control for Medical Laboratories. 2010, Madison WI: Westgard Quality Corporation, 3 Westgard JO: Basic QC Practices: Training in Statistical Quality Control for Medical Laboratories. 2010, Madison WI: Westgard Quality Corporation, 3
14.
go back to reference Vekemans J, Marsh K, Greenwood B, Leach A, Kabore W, Soulanoudjingar S, Asante KP, Ansong D, Evans J, Sacarlal J, Bejon P, Kamthunzi P, Salim N, Njuguna P, Hamel M, Otieno W, Gesase S, Schellenberg D: Assessment of severe malaria in a multicentre, phase III, RTS,S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care. Malar J. Vekemans J, Marsh K, Greenwood B, Leach A, Kabore W, Soulanoudjingar S, Asante KP, Ansong D, Evans J, Sacarlal J, Bejon P, Kamthunzi P, Salim N, Njuguna P, Hamel M, Otieno W, Gesase S, Schellenberg D: Assessment of severe malaria in a multicentre, phase III, RTS,S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care. Malar J.
15.
go back to reference Mahon CR, Manuselis G: Textbook of Diagnostic Microbiology. 2000, Philadelphia: Saunders, 2 Mahon CR, Manuselis G: Textbook of Diagnostic Microbiology. 2000, Philadelphia: Saunders, 2
16.
go back to reference Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, Woods G: Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 2006, Philadelphia: Lippincott Williams and Wilkins, 6 Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, Woods G: Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 2006, Philadelphia: Lippincott Williams and Wilkins, 6
17.
go back to reference Participants in the 2001 Conference on Ethical Aspects of Research in Developing Countries [Participants]. Fair benefits for research in developing countries. Science. 2002, 298: 2133-2134. 10.1126/science.1076899. Participants in the 2001 Conference on Ethical Aspects of Research in Developing Countries [Participants]. Fair benefits for research in developing countries. Science. 2002, 298: 2133-2134. 10.1126/science.1076899.
18.
go back to reference Participants in the 2001 Conference on Ethical Aspects of Research in Developing Countries [Participants]. Moral standards for research in developing countries. From "reasonable availability" to "fair benefits". Hastings Cent Rep. 2004, 34: 17-27. Participants in the 2001 Conference on Ethical Aspects of Research in Developing Countries [Participants]. Moral standards for research in developing countries. From "reasonable availability" to "fair benefits". Hastings Cent Rep. 2004, 34: 17-27.
19.
Metadata
Title
Development of standardized laboratory methods and quality processes for a phase III study of the RTS, S/AS01 candidate malaria vaccine
Authors
Christine Swysen
Johan Vekemans
Myriam Bruls
Sunny Oyakhirome
Chris Drakeley
Peter Kremsner
Brian Greenwood
Opokua Ofori-Anyinam
Brenda Okech
Tonya Villafana
Terrell Carter
Barbara Savarese
Adriano Duse
Andrea Reijman
Charlotte Ingram
John Frean
Bernhards Ogutu
the Clinical Trials Partnership Committee
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2011
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-10-223

Other articles of this Issue 1/2011

Malaria Journal 1/2011 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.