The Mwanza Research Centre (MRC) is located in Mwanza City on the shores of Lake Victoria. For a number of years, the Centre has been involved in research on soil transmitted helminthiasis including schistosomiasis. Over the period of 33 years, Mwanza Centre has expanded its research portfolio from research on schistosomiasis and intestinal helmith infections to research on the control of HIV and other sexually transmitted infections, malaria, and tuberculosis. The current research projects are categorized into four programmes, namely (i) Sexual and Reproductive Health; (ii) Parasitic Diseases; (iii) Clinical Research; and (iv) Health Systems and Policy.
During the past three decades, the number of research staff has expanded from 2 research scientists and 1 laboratory technician (in 1980) to 26 scientists and 19 laboratory technicians (in 2012). Over the period, 18 research scientists have acquired Masters degrees and 9 have acquired PhDs in fields ranging from epidemiology, microbiology, public health, parasitology, medical demography, biostatistics, medical anthropology and sociology.
Research infrastructure has expanded from a few laboratories housed in the main Mwanza Research Centre building in Isamilo to a purpose built state of art laboratory with the capability to perform high tech tests such as Polymerase Chain Reaction (PCR), Gene Sequencing, and Biochemistry analysis. Within the laboratory, Category 3 containment has been developed to support research on highly infectious pathogens. Furthermore, the centre has established a state of the art data management system operated through a centralized server and capable of handling both paper and electronic format data collection systems. The Centre is therefore capable of using personal digital assistants (PDAs) and smart phones during data collection. The data management unit also has high throughput data handling capability for data collected in paper format using Teleform.
In 2009, the Mwanza Interventions Trial Unit (MITU) was constructed within Mwanza Centre campus through funding from the UK Medical Research Council. MITU comprises of purpose-built offices and conference and training facilities. MITU will enhance NIMR Mwanza’s capability to conduct cutting edge clinical trials. The Unit was established through a partnership between the London School of Hygiene and Tropical Medicine (LSHTM) and the National Institute for Medical Research. The new Unit aims to develop as an East African centre of excellence in research on the control of HIV and related infections, with a special focus on rigorously-conducted intervention trials.
In order to provide adequate oversight to the expanding research portfolio in the Lake Victoria zone, the Centre in Partnership with other Institutions namely Bugando Medical Centre Catholic University of Health and Allied Science-Bugando, African Medical Research Foundation and Tanzania Netherlands Project to Support AIDS control (TANESA) established the Lake Victoria Zone institutional Review Board (LZIRB) in 2008.
Scientists from LSHTM and NIMR have worked together in Mwanza for the past 20 years on research into the prevention and control of HIV/AIDS and other sexually transmitted infections. The Mwanza Centre has developed a reputation as one of the leading worldwide centres for HIV prevention research.
There are number of significant achievements Mwanza Centre has recorded. The Kisesa HIV open cohort that was established in 1994 to monitor the trend and impact of the HIV/AIDS epidemic at the general population level has been a successful endeavour. The cohort is the 3rd longest continuous running HIV cohort in sub-Saharan Africa. Currently it has a population of 30,000 inhabitants with annual growth rate of 2.8%. The cohort is linked with demographic, epidemiological, antenatal surveillance systems and other nested studies. Results from the Kisesa demographic surveillance site have influenced the formulation of national policy and practice in various ways.
Mwanza Sexually Transmitted Diseases (STD) Trial, a community-randomised trial conducted from 1990 to 1995 has shown that improved treatment services for STDs reduce HIV incidence by 40%. This was the first randomised trial in the world to demonstrate the impact of an intervention on HIV incidence in the general population. The findings of this trial have had a substantial influence on AIDS control policies in Tanzania and in many parts of the world.
Recently, studies on the efficacy and safety of vaginal microbicide (PRO 2000) in preventing vaginally acquired HIV have been carried out and completed in Mwanza. Moreover, other studies assessed the efficacy and safety of suppressive HSV treatment on HIV transmission among high risk women. These two trials have shown that the tested products were safe but not able to prevent HIV transmission.
Studies have been carried out on the effect of syphilis on pregnancy outcomes and impact of a single dose benzathine penicillin treatment. Single dose benzathine penicillin treatment was found to be effective and can avert adverse pregnancy outcomes. In addition, an evaluation of simple and rapid diagnostic tests for syphilis was carried out in a rural district of the Lake Victoria zone. Simple and rapid diagnostic tests for syphilis were found to be cheap and with good performance characteristics. Currently, a project on the feasibility and cost-effectiveness of rapid diagnostic tests is being implemented in Geita district and preparation for scale up of rapid tests has started.
Mema kwa Vijana community randomised school based adolescent sexual and reproductive health trial conducted in 20 rural communities in four districts of Mwanza Region has shown remarkable impact on the intervention on HIV incidence, STDs, pregnancy and reported sexual behaviour. The trial which commenced in 1997 has show that young people’s knowledge about how to prevent HIV increased, and that these effects were sustained for at least 5 years. However, the intervention did not lead to a reduction in HIV, other sexually transmitted infections or unplanned pregnancies.