The Bacterial Diseases Programme (BDP) is composed of two main divisions: Acute Respiratory Infections (ARI) and Tuberculosis (TB).

The BDP is engaged in a wide range of projects dealing with clinical, epidemiological and laboratory science often preparatory to small scale (phase I and II) and large scale clinical intervention (phase III and IV) trials. The trials are undertaken in collaboration with the Gambia Government and entire communities are often involved in programme activities. In addition, BDP provides laboratory diagnostic services for the MRC hospital and reference culture and drug susceptibility services for the Gambia Government National TB control programme. WHO African Region designated the MRC Microbiology laboratory as a sub-regional reference laboratory for surveillance and response for epidemic pathogens in February 2004 and our bacteriology laboratory has been accorded a WHO sub-regional pneumococcal reference centre.

The Bacterial Diseases Programme benefits from outstanding collaborations and partnerships with institutions that represent the best centres of excellence overseas. The collaborations include training and exchange of staff and transfer of technology, which ensures the establishment of a sub regional centre for high quality and relevant ARI and TB research.

Despite important advances in several approaches, there are major information gaps, which are hampering effective ARI control. Gaps in vaccines and case management have informed the vision for our ARI studies. The main goal of our studies is reduction of ARI mortality and morbidity by prevention, through vaccination and other simple interventions and by improved case management. Our TB research is focused on immuno-epidemiology, biomarkers conferring protection against progression to disease from Mycobacterium tuberculosis infection, TB diagnosis and vaccine studies.

Publications: Up to 37 publications from the BDP have appeared in peer-reviewed journals in the last two years (2005 and 2006).

Below is a list of ongoing projects within the Bacterial Diseases Programme:

• Pneumococcal carriage and vaccine studies
• Immune responses to pneumococcal protein antigens
• Population biology of invasive pneumococci and other bacterial pathogens
• Clinical studies of severe pneumonia
• Meningococcal group A vaccine studies
• TB cases and contact studies
• Biomarkers of protection against progression from M. tuberculosis infection
• MVA85A vaccine studies
• Molecular epidemiology of M. africanum
• Improved Laboratory Diagnosis of M. tuberculosis
• A double blind placebo-controlled randomized trial of isoniazid for reversion of a positive IFNy elispot in TB case contacts
• Characterisation of mycobacterial immunity during progression to AIDS and reversal on ART
• TB Public Health studies