Basse is located in the Upper River Region (URR) of The Gambia, the least developed administrative area of the country. The region consists of a narrow strip of land, approximately 50 miles long and 15 miles wide, which stretches along both banks of the River Gambia. URR has an estimated population of 183,000 and is characterised by a youthful population, with about 44% below the age of fifteen.
The MRC has maintained a field site at Basse since 1983 and in the last few years, the facilities have been upgraded to accommodate a large-scale pneumococcal vaccine trial (completed successfully in 2005). Accommodation, laboratory and data management facilities are excellent.
The field site has a long history of collaboration with the Department of State for Health, divisional health team, local government authorities, and Basse Health Centre, and has implemented research interventions through primary health care facilities.
Basse field site is one of the very few clinical trial sites in rural Africa, where the burden of infectious disease is highest. As a result of many preparatory studies for the large vaccine trials undertaken at the site, there is excellent background data on the epidemiology of malaria and respiratory infections in the area. The site is well placed to provide excellent opportunities for training in clinical trials, epidemiology, data handling, field work and project management. It has established its international reputation by hosting more than 10 clinical trials in the last 10 years. These include:
- Safety, immunogenicity and efficacy trials of SPf66 malaria vaccine.
- Safety, immunogenicity and efficacy trials of RTS,S/AS02 malaria vaccine which was first to show efficacy of this vaccine in a malaria endemic country.
- Safety, immunogenicity and efficacy trials of pneumococcal conjugate vaccines which culminated with demonstration that vaccination reduced radiological pneumonia and mortality in young children.
- Efficacy trial of artesunate plus pyrimethamine-sulphadoxine.
- A randomized controlled trial of artemether/benflumetol, a new antimalarial.
- Safety and immunogenicity trial of meningococcal conjugate vaccine.
Current research activities are based on a health and demographic surveillance system for a population of 147,000. Studies are focused on diarrhoeal disease aetiology, burden, and risk factors; surveillance for pneumonia, sepsis and meningitis to evaluate introduction of universal pneumococcal conjugate vaccination; and zinc therapy for severe pneumonia as well as its aetiology and risk factors.
Basse offers excellent opportunities to carry out clinical trials (phase I, II, III trials) of drugs and vaccines relating to malaria, acute respiratory infection, meningococcal and diarrhoeal disease in a rural area where the burden of infectious disease is very high. It also offers the opportunity to measure the long-term impact of these interventions in a meaningful way in a resource-poor setting.
