Food Security and Health for East Africa
Lead Research Organisation:
University of St Andrews
Department Name: Office of the Principal
Abstract
This "Food Security and Health for East Africa" GCRF GRTA proposal focuses on breaking the current vicious circle of poor sustenance and poor human health by tackling food security and health challenges as a single highly connected developmental issue. The context of our proposal is the interrelationship between people and their environments seen through the lenses of food security and health, with the specific objectives of:
(i) improving the availability of staple food by producing new climate resilient and disease resistant potato varieties that can be grown in East Africa;
(ii) reducing the incidence of human Schistosomiasis by using prawns (Macrobrachium Rosenbergii) to disrupt the infection cycle; and
(iii) increasing diagnostic accuracy of tuberculosis (TB) and Chronic Obstructive Pulmonary Diseases including improving antibiotic stewardship in the treatment of these diseases. Nutrition boosts immunity making nourished people less susceptible to infection, and if infected, they have better treatment outcomes.
(i) improving the availability of staple food by producing new climate resilient and disease resistant potato varieties that can be grown in East Africa;
(ii) reducing the incidence of human Schistosomiasis by using prawns (Macrobrachium Rosenbergii) to disrupt the infection cycle; and
(iii) increasing diagnostic accuracy of tuberculosis (TB) and Chronic Obstructive Pulmonary Diseases including improving antibiotic stewardship in the treatment of these diseases. Nutrition boosts immunity making nourished people less susceptible to infection, and if infected, they have better treatment outcomes.
Planned Impact
The "Food Security and Health for East Africa" transdisciplinary proposal focuses on breaking the current vicious circle of poor sustenance and poor human health by tackling food security and health challenges as a single highly connected developmental challenge. In Kenya, the retail value of annual potato production is £390M and the potato value chain directly or indirectly employs 2.7M people. The cost of schistosomiasis in terms of Disability Adjusted Life Years (DALY) for Uganda, Tanzania, Malawi and Kenya, combined, in 2017 was over 539 DALYS per 100,000 people (a DALY represents the loss of the equivalent of one year of full health). Tuberculosis (TB) and Chronic Obstructive Pulmonary Diseases (COPD) claim >3 million lives per year, with over 90% in LMICS (WHO 2016, 2018). The treatment and care costs average 133 USD and 2,804 USD, respectively, for drug-sensitive and resistant TB, and approx. 6,246 USD/patient/year for COPD.
Our proposal is underpinned by innovative and excellent research in new potato varieties, revolutionary parasite-vector 'biocontrol', and novel diagnostics to identify and treat diseases. It builds on prior GCRF funding jointly developed with our in-country partners: industry, higher education, government and health departments. Crucially, it involves the engagement of and direct benefit to affected communities: farmers and families, fisher men and women, residents around the lake, patients and their families.
To enhance food security via potato agriculture in Kenya and Malawi, we will work with the James Hutton Institute; the Masinde Muliro University of Science and Technology (MMUST), Kenya; the Department of Agricultural Research Services of the Malawi Government (DARS); the International Potato Centre (CIP, Nairobi and Blantyre); and the International Institute of Tropical Agriculture (with presence in Kenya and Malawi). To ensure excellent research translation with maximum impact, our work will also be co-supported by engaging with multi-actor stakeholders, including the Syngenta Foundation (which works with partners in developing countries and emerging markets), James Hutton Limited (who supply plant breeding services to some of the largest names in global consumables), the Kenya Plant Health Inspectorate Service (KEPHIS who inspect National Performance Trials), and the National Potato Council of Kenya and many associated farmer cooperatives.
Reducing the incidence of human schistosomiasis through biocontrol will be developed in Tanzania, Kenya and Uganda, working with the Lake Victoria Fisheries Organisation (LVFO, a specialised institution of the East African Community (EAC)), Kenya Marine and Fisheries Institute (KMFRI) which also has an aquaculture-development mandate, the National Institute of Medical Research in Tanzania, the Uganda National Fisheries Resources Research Institute (NaFiRRI, a public National Agricultural Research Institute), and the Vector Control Division for the Uganda Ministry of Health. To maintain our competitive edge, we will work with the Great British Prawn Company (a prawn farming leader using cutting-edge land-based Recirculating Aquaculture Systems technology) and will explore opportunities for community industry with the African Lakes Company (a Scottish company making investments in growth stage companies in Africa).
To tackle TB and COPD diagnostic challenge, we will work with partners in Tanzania and Uganda. In Tanzania, we will work with the Kibongo'to Infectious Diseases Hospital, the Kilimanjaro Clinical Research Institute and the National Institute of Medical-Mbeya Medical Research Centre. In Uganda, we work with Makerere University Lung Institute and the Faculty of Social Sciences who together bring expertise in lung health and socio-anthropological research. NHS Fife bring clinical expertise in respiratory diseases and LifeArc, our industry partner whose focus is on translation: from lab-based findings through product development to patient use.
Our proposal is underpinned by innovative and excellent research in new potato varieties, revolutionary parasite-vector 'biocontrol', and novel diagnostics to identify and treat diseases. It builds on prior GCRF funding jointly developed with our in-country partners: industry, higher education, government and health departments. Crucially, it involves the engagement of and direct benefit to affected communities: farmers and families, fisher men and women, residents around the lake, patients and their families.
To enhance food security via potato agriculture in Kenya and Malawi, we will work with the James Hutton Institute; the Masinde Muliro University of Science and Technology (MMUST), Kenya; the Department of Agricultural Research Services of the Malawi Government (DARS); the International Potato Centre (CIP, Nairobi and Blantyre); and the International Institute of Tropical Agriculture (with presence in Kenya and Malawi). To ensure excellent research translation with maximum impact, our work will also be co-supported by engaging with multi-actor stakeholders, including the Syngenta Foundation (which works with partners in developing countries and emerging markets), James Hutton Limited (who supply plant breeding services to some of the largest names in global consumables), the Kenya Plant Health Inspectorate Service (KEPHIS who inspect National Performance Trials), and the National Potato Council of Kenya and many associated farmer cooperatives.
Reducing the incidence of human schistosomiasis through biocontrol will be developed in Tanzania, Kenya and Uganda, working with the Lake Victoria Fisheries Organisation (LVFO, a specialised institution of the East African Community (EAC)), Kenya Marine and Fisheries Institute (KMFRI) which also has an aquaculture-development mandate, the National Institute of Medical Research in Tanzania, the Uganda National Fisheries Resources Research Institute (NaFiRRI, a public National Agricultural Research Institute), and the Vector Control Division for the Uganda Ministry of Health. To maintain our competitive edge, we will work with the Great British Prawn Company (a prawn farming leader using cutting-edge land-based Recirculating Aquaculture Systems technology) and will explore opportunities for community industry with the African Lakes Company (a Scottish company making investments in growth stage companies in Africa).
To tackle TB and COPD diagnostic challenge, we will work with partners in Tanzania and Uganda. In Tanzania, we will work with the Kibongo'to Infectious Diseases Hospital, the Kilimanjaro Clinical Research Institute and the National Institute of Medical-Mbeya Medical Research Centre. In Uganda, we work with Makerere University Lung Institute and the Faculty of Social Sciences who together bring expertise in lung health and socio-anthropological research. NHS Fife bring clinical expertise in respiratory diseases and LifeArc, our industry partner whose focus is on translation: from lab-based findings through product development to patient use.
People |
ORCID iD |
| John Woollins (Principal Investigator) |
Publications
Campbell R
(2023)
Allelic variants of a potato HEAT SHOCK COGNATE 70 gene confer improved tuber yield under a wide range of environmental conditions.
in Food and energy security
Mbelele PM
(2022)
Use of a molecular bacterial load assay to distinguish between active TB and post-TB lung disease.
in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
Mtafya B
(2023)
A practical approach to render tuberculosis samples safe for application of tuberculosis molecular bacterial load assay in clinical settings without a biosafety level 3 laboratory.
in Tuberculosis (Edinburgh, Scotland)
| Description | TB and COPD are diseases of the lung and together claim over 4 million lives per year globally. The current methods of diagnosing these diseases are poor and take long for the patient to receive results. As a solution, the St Andrews respiratory medicine research developed tests that detect disease in most of the patients and give results in a matter of hours instead of weeks by some of the current standard-of-care tests. The two tests are call tuberculosis Molecular Bacterial Load Assay (TB-MBLA) and COPD-Molecular Bacterial Load Assay (COPD-MBLA). The tests measure number of live bacteria in the patient sputum before and after they have begun treatment in order to inform the doctor whether medicine is working by reducing patient bacterial burden. In this study, we are evaluating the tests for accuracy and ability to applied in routine healthcare. We have a conference abstract presented Oct 2021 and mature manuscript for the TB part of the work. A patent awaiting to be filed, meeting with KT office tomorrow to draw timeline. Patent filing is somewhat delaying publication of the COPD data. Report for Research Fish March 2022 Produce new climate resilient and disease resistant potato varieties tailored to potato production systems This work package had 4 main aims: i. To determine agronomic performance of selected high performing, early-maturing varieties at field scale in two regions. Qualities such as yield, tuber size and shape, analysis of key tuber trait stability under target environments (such as nutrition, dry matter), propensity for accumulation of diseases over time (how many field seasons can seed be grown before disease accumulates), and tests for compatibility with new approaches for management of pests and diseases. ii. To identify socio-economic and cultural preferences (farmers, agri-business, consumer) by conducting consumer taste trials, preferences for colour and shape, processability (for crisps, chips), field demonstrations, gender-sensitive training activities and economic/value chain analysis. iii. To ensure large-scale production, performance trials and routes to market. Preferences for selected clones will be made by diverse stakeholder groups, realistic options for scale-up of production and seed multipliers will be identified to field trial the material. iv. The new varieties will be protected through plant breeders' rights (PBR) and submitted for National Performance Trials (NPT) after field trialling. This is needed for route-to-market (commercial production). We will work with seed multipliers to optimise production of healthy planting material. We will identify and reach agreements with key potato processors and retailers for uptake of varieties. Key findings: Restrictions on movement by the Covid-19 pandemic meant we experienced delays in conducting field trials and were unable to engage fully with some of the industry stakeholders. Therefore, some of the aims in (iii), the identification of seed multipliers and much of (iv) were not completed. Key achievements were that we identified 5 new climate resilient and disease-resistant lines. Five were approved for release in Malawi and four are under trial in Kenya. These lines were higher yielding or had other properties superior to currently grown domestic cultivars and preferences studies showed that growers and consumers particularly valued the traits of short-dormancy and fast cooking. Detailed research report for 2021-22 Previously we developed and applied a glasshouse screen for potato tuber yield under heat stress and identified a candidate gene (HSc70) for heat tolerance by genetic analysis. Specific allelic variants were expressed at high levels on exposure to moderately elevated temperature due to variations in gene promoter sequence. During 2021/22 we extended our understanding of the HSc70 gene and demonstrate that expression level of HSc70 correlates with tolerance to heat stress in a wide range of wild potato relatives. The physiological basis of the protective effect of HSc70 was explored and we show that genotypes carrying the highly expressed HSc70 A2 allele are protected against photooxidative damage to PSII induced by abiotic stresses. Overall, we show the potential of HSc70 alleles for breeding resilient potato genotypes for multiple environments The field trial results in both Kenya and Malawi indicated that some of the 12 genotypes containing different combinations of alleles for heat, early maturity and virus resistance performed well in these environments. End-user acceptability studies identified varieties that were preferred by both farmers and consumers, with traits such as short-dormancy and fast cooking particularly appreciated. Several genotypes were identified that had good processing traits. Five genotypes were put forward for National Performance Trials (NPT) in Malawi and were named Chikoka-JHI95, Chitute-JHI304, Tinyadile-JHI278, Khutula-JHI229 and Phindu-JHI269. In December 2021 these clones were officially accepted in Malawi for cultivation. One season of NPT has been conducted in Kenya with four candidate lines and the first season results are promising a second season will be conducted April- July 2022. We conclude that this study provides an example of translation of molecular physiological and genetic studies to the development of new potato varieties for the target environment. Further work will aim to promote the marketing and commercial success of the selected lines by 1) undertaking evaluations of the methods of producing pre-basic healthy planting material, 2) identify seed producers and upskill them in the preferred methods 3) engage growers, commercial off-takers and consumers to raise awareness of the material and 4) develop a business plan with routes to market. We have applied for Follow-on-funding to support this work. Manuscript has been accepted for publication in the journal Food and Energy Security: Allelic variants of a potato HEAT-SHOCK COGNATE 70 gene confer improved tuber yield under a wide range of environmental conditions Raymond Campbell1, Laurence Ducreux1, Graham Cowan1, Vanessa Young2, Gift Chinoko3, Gloria Chitedze4, Stanley Kwendani4, Margaret Chiipanthenga4, Craita E Bita2, Obed Mwenye3, Hassan Were5, Lesley Torrance1,6, Sanjeev Kumar Sharma1, Robert D. Hancock1, Glenn J Bryan1 and Mark Taylor Workshop A workshop entitled "Food Security and Human Health" was held in Nairobi, Kenya, Monday November 29 - Tuesday November 30, 2021 A Collaborative Meeting organised by the University of St Andrews, UK, with assistance from the Lake Victoria Fisheries Organisation, and financial support from UK Research and Innovation (UKRI) under the Global Challenges Research Fund. Ca 40 delegates representing the three strands of the project shared project results and vision for a one health future approach. Research Fish submission, February 2023 Field evaluations of the 12 candidate potato genotypes were done in different agri-environments in Kenya and Malawi. This work allowed identification of four genotypes in Kenya and five in Malawi that gave high yields in warmer areas, were resilient to diseases and were suitable for table, crisp or chipping uses. These lines were submitted for National Performance Trials in both countries and in Malawi, five were approved for release in December 2021. The lines grew well and outperformed check varieties in these tests. The lines were given Chichewa names (Chikoku-95, Chitute-304, Khutula-229, Tinyadile-278, Phindu-269). They are now being evaluated by commercial growers for yield and processing quality in different farms with a view to scale up of seed production to supply farmers with high quality seed. In Kenya, four lines were submitted (95, 304, 278, 299) and one has passed NPT (278) and was approved for release in November 2022. We are currently discussing scale up and demonstration of this line with local farmers and commercial processors. Further funding is being sought to grow the line at large scale for demonstration to farmers in different areas and attract commercial investment. Impact: we have shown that these potato genotypes have great potential to promote food security and economic development of 10,000s of farmers in both Malawi and Kenya. Increasing diagnostic accuracy and implementability of tuberculosis (TB) and Chronic Obstructive Pulmonary Disease (COPD) Key Findings Tuberculosis With the UKRI Global translation research award, we piloted implementation of tuberculosis Molecular Bacterial Load Assay (TB-MBLA) in routine healthcare district hospital as hub in Southwest Tanzania. TB-MBLA is a novel test that detects and quantifies live TB bacteria in a patient sample and measures the efficacy of anti-TB antibiotics in killing these bacteria once patients begin treatment. As part of the pilot, healthcare workers were trained on how to implement TB-MBLA and interpret results. A TB-MBLA unit consisting of RNA extraction- and real-time PCR equipment was established within an existing Xpert MTB/RIF room and manned by healthcare staff. This unit served as a TB-MBLA testing hub for 21 healthcare centres in the Mbeya-Songwe regions of Southwest Tanzania. Turn-around-time was 24h for TB-MBLA versus average 4 weeks for MGIT culture result. TB positivity rate was 31.9% (22/69) consistent with the national bacteriological confirmation rate of 32%. A method was optimised to render TB samples safe to work with, effectively demonstrating TB-MBLA can be performed without need of biosafety level 3 laboratory that are only available at national reference laboratory level in most Low- and middle-Income countries1. This is crucial because it increases accessibility to diagnosis since most TB patients tend to be primary healthcare level. Treatment completion rate was 85% against the national 5-year average of 92% reported by World Bank for Tanzania2. Drawing on this experience we have applied to the MRC Applied Global Health board to conduct a large-scale implementation study covering Tanzania, Nigeria, and Uganda. In this study we address the implementational issues of TB-MBLA at routine healthcare level under the national TB control programme context and accelerate the endorsement of the test by World Health Organisation. A total of 12 routine healthcare laboratory scientists from Kenya, Rwanda, Tanzania and Uganda were trained to perform TB-MBLA. This cohort also served as a pilot to assess whether online laboratory skill training is as effective as in-person training. The in-person trained participants performed their TB-MBLA task much faster than the online trained but there no difference in the understanding the theoretical principles that underpin TB-MBLA. We concluded that online laboratory training can reduce the number of in-person hours required to train a laboratory scientist but does not obviate the need for in-person training experience. Chronic Pulmonary Obstructive Disease (COPD) With the funding, we evaluated clinical application the novel COPD Molecular Bacterial Load Assay (COPD-MBLA) in Fife Scotland and Kampala Uganda. COPD-MBLA detects and quantifies live bacteria that underlie exacerbation of COPD symptoms among patients. Three detection panels of PCR were developed and optimised to detect Pseudomonas aeruginosa, Haemophilus influenza, Moraxella catarrhalis, Streptococcus pneumoniae, Streptococcus pyogenes complex, and Staphylococcus aureus. There were three key findings: 1. The current standard-of-care method, culture underdiagnoses bacteria which underlie exacerbation. It missed 9 out 10 patients that were accurately diagnosed by COPD-MBLA. 2. COPD-MBLA showed that antibiotic treatment of COPD exacerbation is stopped too early. At the end the treatment course (often 7 days), patients still had significant bacterial load that relapsed as soon as antibiotic therapy was stopped. This has an implication on antibiotic stewardship and antimicrobial resistance because premature stop of antibiotic therapy or unnecessary administration of the antibiotic therapy increases the risk of bacteria becoming antibiotic resistant. 3. Pseudomonas aeruginosa was the most common bacteria underlying exacerbation in Fife-Scotland compared to Haemophilus influenza in Kampala-Uganda. A patent to protect the intellectual property of COPD-MBLA has being filed through Knowledge Transfer office of the University of St Andrews. Further funding is being explored with the Lung foundation to conduct a large-scale clinical validation of the test in the UK. References 1 Mtafya B, Qwaray P, John J, et al. A practical approach to render tuberculosis samples safe for application of tuberculosis molecular bacterial load assay in clinical settings without a biosafety level 3 laboratory. Tuberculosis 2023; 138. DOI:10.1016/j.tube.2022.102275. 2 World Bank. Tuberculosis treatment success rate (% of new cases)-Tanzania World Health Organization, Global Tuberculosis Report. Washington D.C., 2023 https://data.worldbank.org/indicator/SH.TBS.CURE.ZS (accessed Feb 14, 2023). |
| Exploitation Route | the agronomic performance of 12 selected potato clones were evaluated at field scale over two or three growing seasons in both Kenya and Malawi. The field trials at sites in Kenya and Malawi have shown differences in yield, date of tuber maturity and quality characteristics among the 12 candidate clones. The data indicate that to date, 5-6 perform well with good yields and quality properties in the regions. TB-MBLA - This test has passed accuracy evaluation and is currently being evaluated for applicability in routine healthcare. We have successfully validated a procedure to inactivate TB-causing bacteria and render the sputum samples safe for manipulation in low level biosafety laboratories found in most routine healthcare practices. By heating at 80oC for 20 min or incubating in Guanidine thiocyanate for 15 min at room temperature we able to completely inactivate TB bacteria and render non-infectious. COPD-MBLA - this test is being investigated for accuracy to detect bacteria that exacerbation of COPD symptoms. We have analytically evaluated in the lab and found that it has 100% specificity to the target bacteria and limit of detection of around 100 CFU/ml. The next step is clinical evaluation using sputum samples from COPD patients in NHS Fife and Uganda. So far, the Uganda site has enrolled 22 patients of the targeted 50. Most of the enrolled patients have severe COPD with high prevalence of infectious COPD exacerbation as demonstrated by 64% culture positivity among the 47 cultures performed. |
| Sectors | Agriculture, Food and Drink,Other |
| Description | TB-MBLA - Ability to render safe from infectious TB bacteria obviates the need for category 3 containment laboratories for performance of TB-MBLA. This has a long-lasting impact for application of the test in routine healthcare laboratories in low- and middle-income settings. Additionally, future research assessing the utility of novel TB tests or expanding TB-MBLA testing in routine heath care settings will adopt our sputum inactivation methodology to render sputum safe from infectious Mycobacterium tuberculosis before processing in level II laboratories. COPD-MBLA: The analytical specificity and sensitivity of the test indicate that the test has potential to be superior to current standard-of-care tests in detecting bacteria underlying infectious COPD exacerbation. This also means that results will be obtained faster and inform doctors not to prescribe antibiotics unnecessarily. Ethics review and approval: TB-MBLA: The clinical part of the TB-MBLA study in Mbeya region of Tanzania received approval by institutional Research ethics Board (IRB) and is in final stage of receiving the Tanzania national ethics approval. COPD-MBLA: The study received both IRB and national ethics approval in Uganda and that's why it has already started recruiting study participants. Field trials were performed evaluating plants grown from mini tubers (G0) produced in the UK. The harvested tubers were named G1. The G1 tubers were planted in further trials to yield the G2 harvest. The G1 and G2 tubers were compared with check varieties and found to perform well in terms of yield and disease status. One of the clones grown in Kenya has shown potential to be processed as crisps by a commercial manufacturer. We have had discussions with Syngenta seeds 2B fund who have agreed to assist with national performance trials in Kenya during the 2021 growing seasons. Harvest of the second field trials at two sites in Malawi (Zomba and Chitedze) are ongoing and we expect to conduct quality test on harvested G1 tubers in March and April 2021. Socio-economic experiments: Despite the restrictions on gathering due to the Covid19 pandemic we have been able to conduct focus group meetings with growers in both Kenya and Malawi and devise choice experiments for quantitative analysis of farmer preferences for the types of potato tuber they grow. The data will be analysed over March and April 2021. We plan to have large stakeholder events in June/July and October November if allowed. Some comments on the 'prawn' element of the project: We are using giant river prawns, Macrobrachium rosenbergii (invertebrates) M. rosenbergii found in rivers north of Mombasa, collected live, held in tanks at KMFRI, and successfully spawned. Larvae have been kept alive to c. 10 days. Colleagues in Kenya have been able to make progress with prawn aquaculture. Mature adult Macrobrachium rosenbergii were obtained from rivers north of Mombasa and transported to the Kenya Marine Fisheries Research Institute in Mombasa. At the Institute, spawning was achieved, and larvae have been reared to around 10 days old. Feed trials are ongoing to try to grow larvae beyond this stage. Brierley and Whiston visited KMFRI in November 2020 after C19 travel restrictions had eased. We also visited one of the sites - Lake Jipe on the Kenya/Tanzania border - we had proposed to test control of schistosomiasis vector-snails by prawns. All UK and East African partners came together in Nairobi in the last week in November 2020 to present project achievements. Several MSc students from universities in Mombasa have been involved in the prawn aquaculture activities at KMFRI |
| First Year Of Impact | 2020 |
| Sector | Agriculture, Food and Drink,Other |
| Impact Types | Cultural,Societal,Policy & public services |
| Description | Syngenta Foundation CHBS |
| Organisation | Syngenta International AG |
| Department | Syngenta Seeds |
| Country | Switzerland |
| Sector | Private |
| PI Contribution | Provision of tubers and description of attributes of selected clones for trialling |
| Collaborator Contribution | Collaboration to engage with Kenyan plant health authorities and others to shepherd candidate potato clones through National Performance trials in Kenya |
| Impact | ongoing |
| Start Year | 2021 |