Hub Case Studies

A standardised observational framework to characterise dengue clinical epidemiology and address critical knowledge gaps to improve patient outcomes.

Kumasi, Ghana

Learn more about this Hub’s Lead, Dr John Amuasi, here.

The Kumasi Hub has established the ISARIC-WHO (Observational) Clinical Characterization Protocol (CCP) in six countries, across 31 research sites for data collection around retrospective and prospective COVID-19, including the follow-up of discharged cases to assess long-term impact. 

The researchers explored barriers and facilitators in the context of COVID-19 in Ghana, which revealed factors influencing the use of evidence-based guidelines during the pandemic. Recognising and understanding these factors, such as poor emergency preparedness, provided valuable insights for enhancing responses to future infectious disease outbreaks, contributing to more effective and informed healthcare strategies and interventions.

The researchers at this Hub have successfully implemented remote follow-up, which supported the safety of both researchers and participants and is a potential model for conducting future infectious disease research, especially during outbreaks or pandemics. It underscores the importance of adapting research methodologies to ensure data collection while prioritising the well-being of all involved parties. 

The Hub contributed towards policy decisions on the clinical management of COVID-19 in Africa by sharing COVID-19 aggregate data with local, national, and international stakeholders. 

Ongoing Activities:

Retrospective follow-up of over 3,000 COVID-19 patients discharged from critical care across Cameroon, Ghana, Guinea and Uganda is ongoing. Additionally, an extended study is underway assessing the physical and psychosocial effects post-COVID-19 infection, focusing on identifying risk factors and long-term prognosis. 

Rio de Janeiro, Brazil

Learn more about this Hub’s Lead, Dr Fernando Bozza, here.

This Hub has made considerable headway in community engagement within Brazil. The team engaged with the favela of Complexo da Maré, a socially vulnerable community in Rio de Janeiro consisting of 140,000 inhabitants. An intervention combining communication, surveillance, and telehealth, with a strong community engagement component, was able to reduce the COVID-19 mortality and increase case detection in this large Rio de Janeiro community.  These findings show that investment in community-based interventions may reduce mortality and improve pandemic control in vulnerable communities from LMICs. 

The team have also established an ongoing follow-up programme that analysed data on approximately 800 post-COVID confirmed cases until December 2023.  Research in this community of this magnitude has never been previously undertaken.  The team’s community activities have been exceptionally valuable to the community; not only has there been an increase in the awareness of COVID-19 amongst the population, but also managed to increase the accessibility to vaccines.  To that end, a substantial number of individuals have received their COVID-19 vaccine (93.4% coverage with 2 doses in adults in the community).   

Read more about this Hub’s activities in this toolkit.

Karachi, Pakistan 

Learn more about this Hub’s Lead, Dr Madiha Hashmi, here.

This Hub has taken initiatives to improve patient care in Pakistan by standardising data collection processes, which has led to the identification of gaps in patient management and fostered an informed ‘community of healthcare professionals’ within the network. Expanding on ISARIC’s preparedness endeavours and leveraging established connections within the Pakistan Registry of Intensive Care (PRICE), the integration of the ISARIC WHO Case Report Form into the PRICE registry has significantly enhanced data gathering efforts across 80 ICUs. This pioneering approach, which embeds data collection mechanisms within existing registries, enabled the REMAP-CAP collaborative to carry out their trial for COVID. Regular reports on outcomes of COVID-19 patients admitted to ICUs empowered healthcare professionals with valuable insights to optimise patient care. 

Additionally, the Karachi Hub established a comprehensive framework for follow-up studies, incorporating approaches involving patient communities, including implementing follow-up calls post-discharge with access to medical professionals, and designing concise, user-friendly questionnaires for telephone surveys. 

Manila, Philippines

Learn more about this Hub’s Lead, Dr Janice Caoili here.

The Manila Hub played a pivotal role in a project to establish infrastructure for implementing the ISARIC WHO Clinical Characterization Protocol (CCP) during the COVID-19 pandemic. This support aimed to engage new and existing sites, promote data sharing, and bolster local and regional clinical research capacity. As a result, the Manila Hub successfully collected COVID-19 data from over 5,000 patients across seven clinical research sites.  Utilising this data, a clinical data dashboard was developed to inform clinical management, public health planning, and preventive care strategies.  Notably, the hub’s researchers implemented a time-series prediction function, which accurately forecasted a surge in May 2022 based on earlier pandemic data. 

Collaborating closely with the Philippine Society for Microbiology and Infectious Diseases (PSMID), the Manila Hub facilitated the formation of a multi-institutional, multi-center COVID-19 Study Group.  This collaboration led to securing co-funding from the Department of Science and Technology, Philippine Council for Health Research and Development for research on Long COVID, including retrospective and prospective follow-up studies of hospitalised patients with confirmed COVID-19 infection in the Philippines.