eview model international partnership for community-based research on accine-preventable diseases : The Kamphaeng Phet-AFRIMS Virology esearch Unit ( KAVRU )

This paper describes an international collaboration to carry out studies that contributed to the understanding of pathogenesis, diagnosis, treatment, and prevention of several diseases of public health importance for Thailand and the United States. In Kamphaeng Phet Province, Thailand, febrile syndromes, including encephalitis, hepatitis, hemorrhagic fever, and influenza-like illnesses, occurred commonly and were clinically diagnosed, but the etiology was rarely confirmed. Since 1982, the Kamphaeng Phet Provincial Hospital, the Thai Ministry of Public Health, and the US Army Component of the Armed Forces Research Institute of Medical Sciences, along with vaccine manufacturers and universities, have collaborated on studies that evaluated and capitalized on improved diagnostic capabilities for infections caused by Japanese encephalitis, hepatitis A, dengue, and influenza viruses. The collaboration clarified clinical and epidemiological features of these infections and, in large clinical trials, demonstrated that vaccines against Japanese encephalitis and hepatitis A viruses were over 90% efficacious, supporting licensure of both vaccines. With the introduction of Japanese encephalitis vaccines in Thailand’s Expanded Program on Immunization, reported encephalitis rates dropped substantially. Similarly, in the US, particularly in the military populations, rates of hepatitis A disease have dropped with the use of hepatitis A vaccine. Studies of the pathogenesis of dengue infections have increased understanding of the role of cellular immunity in responding to these infections, and epidemiological studies have prepared the province for studies of dengue vaccines. Approximately 80 publications resulted from this collaboration. Studies conducted in Kamphaeng Phet provided experience that contributed to clinical trials of hepatitis E and HIV vaccines, conducted elsewhere. To provide a base for continuing studies, The Kamphaeng Phet-AFRIMS Virology Research Unit (KAVRU the scientific observations mad ∗ Corresponding author at: 6405 Cardinal Lane, Columbia, MD, United States. Tel.: +1 3 E-mail addresses: RobertVGibbons@gmail.com (R.V. Gibbons), AnandaN@afrims.org (A awong), kam.director1@gmail.com (K. Rungsimunpaiboon), david.w.vaughn@gsk.com ( B.L. Innis), DonBurke@pitt.edu (D.S. Burke), mammen.mammen@vical.com (M.P. Mamme HHokeJr@gmail.com (C.H. Hoke Jr.). 1 Author addresses: R.G., A.N., I.Y., D.T., D.V., T.E., B.I., D.B., M.M., S.T., and C.H. were ass he work described in this paper was accomplished. RMS was assigned to the Walter Ree 264-410X/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. ttp://dx.doi.org/10.1016/j.vaccine.2013.07.082 ) was established. This paper reviews the origins of the collaboration and e between 1982 and 2012. © 2013 Elsevier Ltd. All rights reserved. 01 452 8897. . Nisalak), Inkyu.yoon@afrims.org (I.-K. Yoon), DaruneeT@afrims.org (D. TannitisuD.W. Vaughn), EndyT@upstate.edu (T.P. Endy), Bruce.2.Innis@GSK.com n Jr.), scottrmcn@cs.net (R.M. Scott), Stephen.J.Thomas3.mil@mail.mil (S.J. Thomas), igned to the Armed Forces Research Institute of Medical Sciences (AFRIMS) when d Army Unit Nepal (WARUN).