The MRC Unit The Gambia at LSHTM’s main operational base is in Fajara. It has been in existence for over 70 years and is approximately 9 miles down the coast from the capital Banjul. The 100 acre site in Fajara has over 40 residential units and its home to the main administrative, infrastructural and technical support departments including Information Technology, Facilities, Biomedical Engineering, Procurement, Logistics, Transport Services, Human Resources, Finance and Health, Safety & Environment departments. These services provided by the operations team underpins the diversity of high quality scientific endeavours while establishing more effective cross cover of specialized expertise to drive improvements and operational efficiency.
The Clinical Services Department in Fajara runs an extremely busy 42-bed ward which provides in-patient care for both research and non-research cases admitted through the OPD/Gate clinic. It also serves as a referral centre for patients from MRCG at LSHTM field stations, other hospitals, clinics and health centres. The clinic has long been recognised nationally and internationally for the excellent and cost-effective healthcare it provides to Gambian and other nationalities that are residents of The Gambia and from neighbouring Senegal, Mali and Guinea Bissau.
There are excellent laboratory facilities in Fajara which comprises of the Research Platform Labs (RPL), Clinical lab, TB, Malaria, Microbiology labs and the Clinical Laboratories. Activities supported in the various laboratories span from basic research in immunology, microbiology, virology and molecular biology to large epidemiological studies, intervention trials and routine clinical diagnosis.
The Himsworth Laboratory also located in Fajara is home of the World Health Organisation Regional Reference Laboratory (WHO RRL). Its mandate is to provide diagnostic services to support the surveillance network for Invasive Bacterial Vaccine-Preventable Diseases (IB-VPD) in the WHO African Region (AFRO). Our laboratories have consistently maintained Good Clinical Laboratory Practice (GCLP) accreditation since 2010. A key event for the Laboratory Services Department was the attainment of ISO 15189:2012 accreditation for the Routine Diagnostic Laboratories comprising the Clinical, Serology and Tuberculosis (TB) Diagnostics Laboratories, in 2012.
The DNA bank, recognised by the World Health Organisation as the first biobank in Africa, is a major infrastructure for health research and serves as a repository of human DNA samples to improve the prevention, diagnosis and treatment of a wide range of diseases but focusing primarily on malaria, HIV and tuberculosis. With the broad aim of supporting studies on the genetics of complex diseases, the DNA bank in Fajara is set to expand its current repository of approximately 50,000 DNA samples and associated data. Its operations are regulated by the provisions of the Gambia Ethics Committee for sample collection, archiving, data storage and privacy protection.
MRC Unit The Gambia at LSHTM Basse Field Station is located in the Upper River Region (URR) in the eastern part of The Gambia about 350 km from Banjul. The Field Station was established in 1982 and in the past few years its facilities have been upgraded to accommodate large‐scale trials/studies, such as Pneumococcal Vaccine Trial, Meningitis Vaccine Project, Pneumococcal Surveillance Project, Global Enteric Multi-centre Study and Vaccine Impact on Diarrhoea in Africa, and the trial on the efficacy of single low dose of primaquine in malaria asymptomatic carriers.
Basse has a long history of cordial collaboration with the Department of State for Health, the Regional Health Team, local government authorities and Basse District Hospital and has implemented research interventions targeting grass root communities through primary health care facilities in the region. Over the past quinquennium, Basse has hosted several large scale studies initiated by the Disease Control & Elimination Theme, most of which were supported by external grants.
Basse Field Station currently employs about 264 staff, most of them (85%) on externally‐funded projects. It has excellent laboratory facilities for microbiology, immunology, molecular biology and tissue culture and also has capacity for temporary storage of biological samples in ‐70°C and ‐20°C freezers before transferring them to Fajara (main site) for long term storage. The Field Station has a well structured and maintained insectary with a susceptible colony of Anopheles gambiae s.s.
It is possible to conduct transmission and transmission blocking research by direct membrane feeding experiments measuring human infectiousness to mosquitoes. In addition, wild caught mosquitoes and larvae are reared for the determination of local insecticide resistance profiles. The station has a well-established Health & Demographic Surveillance System (HDSS) and is well placed to provide excellent opportunities for training in clinical trials, epidemiology, entomology, data handling, fieldwork and project management.
Walikunda Field Site, located in CRR (Central River Region) 120km from Basse, is directly managed from Basse. The field site functions as a centre for studying mosquito behaviour and ecology. Its central location serves as a hub for malaria and entomological research carried out by the Disease Control & Elimination Theme. There is a fully functioning insectary in Walikunda with a colony of dichloro-diphenyl-trichloroethane (DDT) susceptible strain of Anopheles gambiae s.s. The facilities at the field site have been recently upgraded to include a new laboratory, solar-powered borehole and a new 4 bed-sitter accommodation block with wireless internet and satellite TV. The perimeter fencing has also been replaced and reinforced with wire-mesh chain link fencing to further improve security at the site.
MRC Unit The Gambia at LSHTM Keneba is a rural Field Station situated in the Kiang West region of The Gambia, about 2 hours by road from MRC Fajara. It is located in the village of Keneba, the largest village in an area of predominantly subsistence agriculture. MRC Unit The Gambia at LSHTM has had a presence in the area for nearly 70 years and enjoys an excellent relationship with the local community. Most research activities of the Nutrition Theme are done in Keneba.
The Keneba Clinic (backed by the custom-built Keneba Electronic Medical Register – KEMReS – introduced in 2007) is a vital facility for data collection and study implementation as well as supporting the core platform for the past 40 years. The clinic provides an extensive, outpatient‐based service concentrating on maternal and child health provision and working closely with the local Gambian Government Divisional Health Team. Keneba also runs a supplementary feeding centre for malnourished children. The clinic also supports the local Karantaba Health Centre and the Maternal and Child Health trekking teams that deliver health care directly to the villages.
This intensity of health care has resulted in impressive improvements in mortality rates but a high burden of infectious diseases and under‐nutrition remains. The field station has a strong record in training our Gambian and other West African staff from basic to post‐doctoral levels. Keneba hosts many overseas students and researchers, especially medical elective and MSc students.
The villages of Keneba, Manduar and Kantong‐Kunda have traditionally maintained the closest relationship with the field station and have unique demographic and health databases spanning 65 years. Increasingly our studies and clinical services involve many other villages across West Kiang (supported by the West Kiang DHSS). Keneba maintains advanced laboratory facilities that have recently received a major upgrade.
The Keneba biobank is currently a major user of bench space and facilities in storing residual samples from on‐going and completed studies. We are currently creating a comprehensive biobank of all consenting individuals across West Kiang. Data and samples from 11000+ individuals have been already banked, it is our intention to ‘externalise’ the biobank to make it more readily available to external collaborators in order to maximise the use of the samples in support of our ethics responsibilities.
Keneba also maintains the Bakary Dibba Clinical Physiology Laboratories containing state‐of‐the‐art imaging and test systems for assessing bone density, morphology and architecture, infant and adult body composition. Other advanced imaging systems are used in the BRIGHT and FaCE studies.