As we officially close for the festive season on 24th December, I hope this message finds you well.
This is also an opportunity to reflect on the year that 2024 has been. Looking back, it is remarkable to see the milestones we have achieved in advancing our goal to identify and treat Multimorbidity.
Here’s a brief recap of the key moments that shaped our year.
January physically brought together Multilink partners from Malawi, Tanzania and the UK for the first time to reflect on the Cohort Study (including recruitment, situation analysis, policy and community engagement) and concretize plans for the implementation of the trial.
In January, we also convened a community consultative meeting, bringing together patients, caregivers, healthcare workers, and research team members, ensuring that the design of the trial has input from the community, including a cross section of leaders represented by the community advisory board members.
February and March, we planned and hosted Directors of Health and Social Services and Chairpersons of Research Committees from the 10 district hospitals where we planned to implement the Multilink trial. The aim of the meeting was to introduce the Multilink study, share progress of implementation and present plans for the next phase (the Trial). We also aimed to get feedback on the scientific and operational plan of the trial, to ensure a contextually appropriate intervention. Also in March, we received the first approval of the trial from COMREC. Since then, we have received subsequent approvals based on changes in design and additional informational deemed necessary by different partners.
In April (and part of March) we introduced Multilink to the 10 district hospitals. This was a mammoth task ably delivered by the study coordinator and clinical lead. Large teams of Research Committees and District Health Management Teams, reviewed the research plans, asked a lot of questions (some of which made us to go back to the drawing board) and we are happy that they eventually approved the study. April was another remarkable month when we started and completed the process of recruiting research nurses. This multistage process resulted in 20 nurses joining the research team.
The month of May had a series of activities including finalising the one year follow up for the cohort study, translating into Chichewa the CRF for the trial (well delivered by the research nurses that participated in the cohort study), clearing data queries from the cohort study, and staring to work of a series of manuscripts from the cohort study. We appreciate the contribution from all that participated in this process.
In June, we planned and trained research nurses in the trial protocol including study procedures and processes. The training included session of Safeguarding, Health and Safety and Good Clinical Practise delivered by the relevant departments in MLW. We were joined by the trial’s chief investigator, Dr Ben Morton.
July and August had the nurses deployed in all the 10 study sites. With support for the study coordinators and administrator, they worked tirelessly to settle down in the hospitals and identify space for research clinics. Since then, they have supported the hospitals in delivery of care, awaiting the start of the trial. Alongside this, we acknowledge the wider Multilink leadership who have worked tirelessly engaging different independent committees and individually in coming up with a robust design of the trial.
September saw a team of 10 site investigators (District Medical Officers) from the district hospitals coming on board and joining the study team. This was in response to a call from the district hospitals for their meaningful engagement and involvement in the delivery of the trial as well as ensuring that there is a local leadership of the trial. The site investigators were trained on the study protocol and other requirements including safeguarding and GCP. In September, we also received the current and v5 approval of the trial protocol considering the changes in the design of the trial.
In October, and continuing from September, some research clinics underwent major renovations in a process of making them conducive for the conduct of the trial. Alongside this activity, we ensured that letters of agreements with the hospitals and their laboratories have been developed and agreed for the smooth delivery of the trial.
As implementation of the trial was nearing, In November, we reconvened the research nurses in a refresher training. This proved important considering the time that elapsed since the first training. In November, we also had a successful site initiation visit by CRSU and Health and Safety departments who eventually gave approval and subsequent greenlight from the sponsor to open the trial in four sites.
And finally, December…
Early in the month, we hosted a delegation from NIHR (Multilink funders). Apart from a meeting that discussed the progress of the study in detail, some of the activities included participating in NIHR partners event and a session for early career researchers for Multilink PhD students. But most exciting of all, is the opening of the trial in four sites where recruitment started on 2nd December. Since then, it has been three weeks of learning from the early stages of the trial. We are also happy that four additional sites have been given a go-ahead for recruitment.
What a full year it has been! I want to extend my heartfelt gratitude to everyone who has contributed. To the Multilink Trial Steering Committee, Data Management Board, Trial
Management Team, Co-Investigators, PhD students – your continued guidance and support fuel our ambition. To the MLW incredible coordinating team, your dedication and creativity ensure our
efforts remain impactful and relevant. To the Multilink frontline implementation team in the district hospitals, your commitment and collaboration ensure that our efforts make a meaningful
impact on the ever-growing burden of Multimorbidity.
From this year to the next, I wish everyone a safe, happy, and healthy 2025.
Warm regards,
Felix Limbani, PhD.
Mwanza District Hospital
NIHR Visit
Nsanje District Hospital
Ntcheu District Hospital
