School theatre for vaccine trial

One of the world’s leading tuberculosis (TB) vaccine research institutions has banded together with drama students from a school in Worcester, in Western Cape in efforts to build awareness of the disease and promote clinical trials for possible breakthrough vaccines.

Established in 2001 by Professor Gregory Hussey, an infectious diseases specialist and the director of the Institute of Infectious Diseases at the University of Cape Town, the South African Tuberculosis Vaccine Initiative (Satvi) is among the world leaders in TB vaccine clinical research. It has developed a number of different vaccines and vaccination strategies that are being tested to ensure their safety and effectiveness.

SATVI 2Performances were undertaken in the third quarter, but have been suspended for the fourth term as most of the cast and crew are pupils and are busy preparing for and writing examsIn its efforts to teach people about its clinical trials – and the pivotal role they would play in ensuring the success of the trials – in a fun and understandable way, the partners produced a play, Karina se Keuse, which is Afrikaans for Karina’s Choice.

The play is based on a comic of the same name and was written with the intention of bringing a message to the people of Worcester, the majority of whom speak Afrikaans. The comic was written by Linda Rhoda, at the time Satvi’s communications manager, in 2010, and was financially backed by a grant from the World Health Organization’s Global Partnership to Stop TB.

The comic’s storyline has some resemblance to many of the experiences of the people of Worcester in its portrayal of a young mother who decides to enlist her baby as a subject in a clinical TB vaccine trial. She is met with resistance from her family and friends, who frown on her decision. The story goes on to illustrate how this young mother deals with these pressures.

DRAMA

“The play has been very well received and as a means of raising awareness has undoubtedly succeeded,” says Satvi’s Dr Michelle Tameris, who was charged with evaluating the effectiveness of the drama as a tool to build awareness. “We are busy with analysing pre- and post-knowledge assessment completed by all learners who saw the play, and hopefully will have a measurable outcome in the near future.”

Veronica Baxter, a drama lecturer at the University of Cape Town who has been involved in a number of HIV/Aids education initiatives in many communities, worked with some of her senior students on the play. They helped Worcester Senior Secondary School’s drama teacher, Natasha Africa, develop and professionalise the production before it was staged. Already it has been seen many times at schools throughout Worcester.

Baxter and her students, along with the increasingly enthusiastic group of pupils at Worcester Senior Secondary, spent a large portion of their weekends and holidays developing a script, composing songs and raps as well as designing a wardrobe and sets for the play. The university’s contingent also helped the pupils develop their acting skills and knowledge of the world of theatre.

SATVI 3Baxter and her students, along with the increasingly enthusiastic group of pupils at Worcester Senior Secondary, spent a large portion of their weekends and holidays developing a script, composing songs and raps as well as designing a wardrobe and sets for the play (Images: Amber Abrams)Performances were undertaken in the third quarter, but have been suspended for the fourth term as most of the cast and crew are pupils and are busy preparing for and writing exams. Tameris explains that further performances will be considered on an ad hoc basis.

Baxter says that drama has often played a significant role in teaching people about health issues and she is confident that Karina se Keuse has helped teens and adults in Worcester learn about the importance of the research.

It has also ensured that they have the right information about the illness and the clinical trials that Satvi is conducting, in the hope of undoing any misconceptions and helping them embrace the trials.

AN ONGOING BATTLE

TB is a serious and sometimes fatal disease caused by a micro-organism called Mycobacterium Tuberculosis, which is a form of bacteria that can attack any part of the human body. In most cases, though, it settles in the lungs.

When dormant, the disease is 40 times more likely to become active in people who are HIV-positive or have Aids than in individuals who do not have the virus. Given the high HIV infection rate in South Africa, finding effective TB vaccines is of particular importance to the country.

The vaccine currently in use around the world is Bacillus Calmette Guérin, or BCG. It has been in use since 1921. It is effective about 80% of the time; there some issues regarding its efficacy, which varies according to the area in which it is used. This has highlighted the need for a new and alternative vaccine to either replace, be used in combination with, or as an alternative to the somewhat outdated BCG vaccine.

VACCINE

Satvi has racked up a number of successes since it was established, and has grown at a remarkable rate. When it started, there was only 11 members of staff; today it has two world-class laboratory facilities, in Cape Town and Worcester, that are manned by more than 200 highly trained professionals at work at what have become the world’s leading TB vaccine research sites.

The Boland area in which Worcester is situated has one of the world’s highest TB infection rates, making it an ideal site for Satvi’s research. It has a population of about 350 000, more than 20 000 of whom have already taken part in the initiative’s studies and trials.

There are still a number of phases that are yet to be completed and the success of the project is heavily dependent on the participation of and buy-in from the people of Worcester. Before a new vaccine is made available, it still has to undergo many lengthy tests to ensure that it is safe to use, but the progress and results of Satvi’s trials look promising. Tameris gives a timeline: “It is thought a new vaccine will only be on the market in 10 to 15 years.”