The AITHM Clinical Research and Training Facility on Thursday Island (TI) recently provided crucial technical back-up for a tuberculosis (TB) vaccine research project receiving frontline support from local health workers and residents keen to safeguard Torres Strait Islander communities from the disease, which is rife in neighbouring Papua New Guinea.
AITHM Senior Research Fellow and microbiologist Dr Andreas Kupz and medical scientist Lidia Hristov spent five days at the TI research facility in May, while the Torres and Cape Hospital and Health Service Tuberculosis Control Unit was visiting the island and neighbouring communities to vaccinate young children who missed out on routine immunisation after birth, due to a prolonged global shortage of the TB vaccine, BCG.
The AITHM research project is integrally linked to this vaccination delay. It is providing the researchers with a unique opportunity to compare the immune responses generated in newly vaccinated three-to-five-year-olds, with those of children of a similar age, who were exposed to TB before they could be vaccinated. (All of whom are now being successfully treated for the disease.)
“We will be able to analyse which immune pathways were activated in these children, following direct exposure to the pathogen, and how these pathways are different from what happens after children get the vaccine,” said Dr Kupz. “This is important, because obviously you want to have a vaccine that induces the same type of immune response that you need to fight the real pathogen.
“If it turns out that the children exposed to the real pathogen actually have a very different immune response, compared to what BCG induces in the vaccinated children, then this would tell us that we need to modify the vaccine to actually induce those other immune responses.”
Dr Kupz had previously spent time on TI, building relationships with healthcare workers and sharing his research project goals. The May visit was the first to put those relationships to the test, when he and Mrs Hristov, a trained phlebotomist, sought blood samples from three of the Torres Strait Islander children exposed to TB.
They received outstanding assistance, in terms of both cultural and logistical support.
“Huge amounts of trust were involved, including the trust of parents who gave consent,” said Dr Kupz. “Much explaining and use of appropriate language (involving Indigenous Queensland Health staff) were required to make sure we did not scare the children. For some of them, it was the first time they had seen a needle. So yes, it was quite a sensitive thing to do.”
Logistically, the clock was ticking; blood samples needed to be obtained and processed within 24 to 36 hours, in order to undergo further analysis downstream in AITHM Cairns laboratories.
Two of the three children lived on TI, but one resided on the distant island of St Pauls. TI Hospital staff, including the pathology unit, swung into action. A doctor who flew to St Pauls for the day helped to obtain the blood sample and return it to TI the same day.
The AITHM Clinical Research and Training Facility then came into its own. “We were able to process the blood samples in our JCU building, from start to finish,” said Mrs Hristov.
“To be able to do this within a 24-hour period was great,” added Dr Kupz. “If that blood had to be sent to Cairns it would have taken at least another day on a plane and would have probably arrived at least two or three days after it was taken.”
Access to AITHM laboratory facilities on TI, combined with the committed, resourceful support of TI Hospital staff, was a “game changer” in terms of pursuing their research project, according to Dr Kupz.
“I think both Lidia and I have realized how much easier it is sometimes to get things happening in a small hospital, where everyone knows everyone and where staff are more willing to improvise,” he said.
“Once you have those relationships established, I think people are very happy to go the extra mile to make things happen, because that's what they do on a daily basis anyway. They are used to these kinds of logistical challenges and everything that comes with it.
“I am now confident that we will be able to get blood samples to Cairns within 24 hours, without us having to fly up. And that is really, really important for us, moving forward.”
Mrs Hristov agreed. “There's a lot of support from hospital staff for us to continue doing what we're doing. Doctors, nurses, pretty much everyone in the hospital environment are very keen to continue working with us.