Week 5 : June 30th - July 6th, 2014

MHIRT students in both Thailand and Cameroon reported having surprise birthday parties and pizza.  On July 1, the group in Cameroon surprised Kenji with a chocolate cake and soda. “Overall, it was a success and we surprised him well, it seemed. :).”  On Saturday, Mateo, Chris and Shayne visited the primate park (more later) and stopped by a pizza restaurant in Bastos where many expatriates live.  They said the pizza was yummy. On Sunday July 6, it was 100 degrees Fahrenheit in Bangkok, but Kriszel and Kendrick snuck out and surprised Michellei with a birthday cake (photo) along with a pizza dinner.  Did the three of you really eat the whole cake?  Seems birthdays, pizza and cake are universal.  Belated Happy Birthday to Kenji and Michellei! 

Research Related

In the lab, research continued with everyone making some progress.  With only a few weeks left, everyone is working hard to finish up or over-come those messy PCR problems.  In Cameroon, Chris continued screening samples by Luminex for IL-27 last Monday until Wednesday. On Thursday, he helped optimize a multiplex assay for additional biomarkers, and spent Friday analyzing results.  In Thailand, Kriszel worked to resolve problems with the Hepatitis E RT-PCR assay, as she keeps getting a smear instead of bands.  Her mentors are trying to modify the protocol to get the method to work. Good luck!  In the meantime, Kriszel is having success in detecting GI viruses in pig samples.  However, since there is only one electrophoresis unit that is shared among all the researchers, progress feels slow. 

Michellei and Domenick continue their vector biology projects.  In the lab, Dom’s mosquito larvae are growing well in his algal brew (photo).  Only a vector biologist can get excited about such wiggly creatures.  Dom is beginning PCR studies on detecting flaviviruses in adult mosquitoes. In Thailand, DNA from Michellei’s 3 positive mosquito pools has been obtained and sent for DNA sequencing.  She is trying to optimize PCR assays for alphaviruses using multiple consensus primers, but there is a lot of non-specific binding.  In addition, she is using real time PCR to detect Arboviruses. Using newly prepared primers, she obtained a “positive result for DEN 1, but not yellow fever, West Nile virus and Saint Louis encephalitis, which may indicate the RNA positive control has degraded.”  She met Dr. Jonas Schmidt-Chanasit from Germany who presented his paper “First case of laboratory-confirmed Zika virus infection imported into Europe, November 2013.” The patient had contacted Zika virus in Southeast Thailand.  He looked at Michellei’s notebook and was interested in the Aedes sample that was virus-positive but dengue-negative. Maybe Zika???  So, he gave the research team primers and protocols to detect Zika.  Michellei says “It’s exciting for the lab to be able to detect another arbovirus that is found in Thailand and for us to be able to use these resources to understand better the viruses that are circulating here, and hopefully better treat patients. His talk really opened my eyes to how similar (clinically) flaviviruses (such as Dengue and Zika) and alphaviruses (such as Chikungunya and Mayaro) can present as very similar symptoms, and can be hard to distinguish.”  Yes, and malaria has similar symptoms, too.

As a nice surprise, Dr. Nerurkar dropped by the lab to see how the MHIRT-Thailand students were doing. He heard Kendrick’s journal club presentation on A. Tobian et al. paper on Human papilloma virus clearance .....   After hearing of Dr. N’s marathon grant writing (he submitted two grants in about a month), Ken was inspired to complete his own paper. YEA! The first draft is done and has been sent to his mentors for comments. NOTE: We are working to see if the Hawai’i Journal of Medicine and Public Health will agree to publish an editorial/commentary on what you learned about medicine and public health and/or your results in Thailand and Cameroon. So, keep that thought as you write.

Shayne and Mateo continue their studies in newborns.  Shayne is currently learning to stain and read impression smears of placental tissue for detection of malaria.  This week, she tried to optimize a new staining technique that detects fetal hemoglobin so she can tell if maternal blood in the placenta is contaminated with fetal erythrocytes (i.e., cells that contain fetal hemoglobin).   It is important to make sure you are studying maternal OR fetal blood, not an a mixture. Shayne is actively working with Dr. Anna in designing the Luminex and ELISA assays they will be conducting next week, using the sample from HIV+ and HIV- women.  Mateo and Dr. Sam have been chasing after placentas from women who have placental malaria.  Mateo reported that “We are almost there!  We will need 1 more positive malaria sample and 3 more negative controls.”  Last Monday they “ventured into the rural periphery of Yaounde in search of precious blood samples. Our first stop was the “Centre de la Sante Sociale.”  “In the waiting room, I spotted two things on the wall: a poster delineating the various genetic outcomes of sickle cell anemia among hetero- and homozygous individuals, and a hand-drawn map of the surrounding area.” He learned that people can take a test to see “if they have the sickle cell trait, which has social ramifications in terms of who you date/marry and also factors in prenup agreements.” “The map was interesting because it was written in a way that could be used to easily navigate around the small neighborhood without street signs and numbered blocks.” 

Special Event:  On July 2nd,  MHIRT Thailand students had a field trip to the Sai Yok District, Kanchanburi Province, which is EXTREMELY close to the Thai-Myanmar border.  The area is very rural and known for high prevalence of malaria. The goal was to recruit individuals to participate in a study on the prevalence of intestinal parasites.  “We first visited a “health promotion clinic” which was a community clinic and the first stop for patients in the area experiencing symptoms of any kind. It was staffed by one nurse, one doctor and one dentist.”  They watched the Mahidol staff discuss the informed consent process, how to fill the questionnaire, and how to collect stool samples. They also visited a malaria clinic and learned that malaria is being imported across the border from Myanmar.  The group also “met with community leaders for the region, two older women in their 50's and one younger woman, rocking a young child in a homemade hammock.”  So, they were able to see first-hand some of the things we learned during the workshop about community engagement.