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Day one

The meeting was preceded by a site visit at Meshualekia Health Center in Addis Ababa.

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AHRI. Site visit conducted at Meshualekia Health Center in Addis Ababa.

The visit was conducted in the morning session to assess the health center’s capacity in diagnosing cryptosporidiosis using LED-AP and the management of diarrhea. The team first visited the tuberculosis laboratory and observed the availability of functional LEDÌýmicroscopy and its reagents. The laboratory head informed the team that they use the LED microscopy for follow up purposes only rather than using it for primary diagnosis of tuberculosis.

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AHRI. The research team visited the laboratory unit of the health center.

The laboratory head also added 0.1% methylene blue used as a counterstain instead of potassium permanganate. The laboratory experts from partner institute had demonstrated and checked the functionality of the LED microscope using a Cryptosporidium oocyst positive slide. Additionally, the team also checked the material used for staining procedure, and ensured that the necessary equipment, and standard operating procedures are put in place.Ìý The research team also visited the outpatient diagnostics and looked at the health center’s patient pathways in the management and diagnosis of childhood diarrhea including its supply and referral systems.

After lunch, the meeting began with speeches from Prof Afework Kassu, Director General of AHRI and the Deputy Director General of AHRI, Dr Alemsged, who is also a co-investigator in the project. Prof Afework emphasized the need for collaboration to solve public health challenges and also the role played by the University of Bergen (UiB) in the initial establishment of AHRI and UiB is now a coordinator in this project. Dr Alemseged then highlighted the evidence generated by the Crypto-POC study and how it led the to CryptoT&T.

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AHRI

The meeting was officially opened by Dr Mariamawit Asfaw, Maternal, Child and Adolescent health Service Lead Executive Officer, at Ministry of Health Ethiopia.

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AHRI

Dr Mariamawit highlighted the strides Ethiopia has made in reducing maternal and child mortality and the work that still remains to be done in order to achieve SDGs. She emphasized the important role of Cryptosporidium spp as a cause of diarrhea and the impact of diarrhea in children. She expressed the strong support for the CryptoT&T project from MOH Maternal, Child and Adolescent health Service Lead Executive Office.

This was followed by a presentation by Dr Abel Abera, scientific lead of the project. His presentation highlighted the importance of Cryptosporidium spp as a cause of childhood diarrhea and its role especially in causing growth faltering and malnutrition. He indicated that the project aims to assess the clinical effectiveness of LED-AP testing, in conjunction with access to targeted drug treatment, in reducing the duration of cryptosporidiosis-induced diarrhea. This includes evaluation of diagnostic accuracy, operational issues, cost-effectiveness, and test turnaround times in realistic setting in Ethiopia and Mozambique.ÌýEffective POC diagnostics and treatment are expected to alleviate cryptosporidiosis-induced diarrhea and reduce long-term complications. Prof Kurt Hanevik, coordinator of the project also highlighted the collective effort by CryptoT&T team who were able to write an excellent proposal, which was selected by the EU-EDCTP3 for funding.

There were also presentations by Dr Inacio Mandomando, CSIM, Mozambique on the role of Cryptosporidium in causing diarrhea. Dr Mandomando also shared his experience from the GEMS study. This was followed by presentation by Dr Øystein H Johansen, Consultant Microbiologist at the Southern Health and Social Care Trust, NorthernÌýIreland.ÌýHe highlighted his experiences from the CRYPTO-POC study that took place in Jimma, South-Western Ethiopia and also guided participants through a practical demonstration of LED-AP.

During this first day of the meeting the participants in the meeting included co-investigators from Mozambique, Simbona PLC and stakeholders from Ministry of Health, Armauer Hansen Research Institute, Addis Ababa Health Bureau, Addis Ababa University School of Medicine, WHO Ethiopia, Ethiopian Pediatrics Association.

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HARI. Participants at the meeting

Day 2

The consortium members introduced themselves and their contribution to the project (Mozambique, Ethiopia, and UiB). A status report was presented by each work package lead from each working group on clinical trial, data management, and dissemination. Thereafter various topics relevant for work packages were discussed.

• WP3: Trial protocol
• WP4: Diagnostic accuracy
• WP5: Capacity building – PhDs and workshops
• WP6: Data management and analysis/Security and RED Cap demonstration
• WP7: Economic impact and cost effectiveness of the CryptoT&T study
• WP8: Microscope maintenance and training
• WP9: Communication, dissemination, and exploitation

In the afternoon group discussion were held in working groups on:

• Group 1: Sample collection and storage strategies
• Group 2: Dissemination plan
• Group 3: Data management plan

Day 3:

WP1 & 2 management and reporting and a were presented By Abela Abera and Kurt Hanevik. A publication guideline draft and risk mitigation report were presented. In the latter part of the meeting digital meeting with the Scientific Advisory Board was conducted.