Global Health Chronicles

Dr. John Nkengasong

David J. Sencer CDC Museum, Global Health Chronicles
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2:27 - Background/Education

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Partial Transcript: Would you tell me about where you grew up and your early family life and then where you went to college

Segment Synopsis: Nkengasong describes his family background and education in Cameroon.

Keywords: Antwerp, Belgium; cousins; Education; free education; mother; only child; P. Piot; PhD; science; scientific interest; siblings

Subjects: Cameroon; Institute of Tropical Medicine; University of Brussels; University of Yaoundé

8:38 - Belgium

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Partial Transcript: Now, you met Peter Piot when you were in secondary school?

Segment Synopsis: Nkengasong describes his graduate program in Antwerp, Belgium as well as his PhD virology work on characterizing strains of HIV in Africa

Keywords: ANT70; Antwerp, Belgium; conference; educational resources; genetic subtype; graduate program; Hepatitis B; HIV Group O; HIV-1; HIV-2; immunology; internship; master’s degree; medical school; P. Ndumbe; P. Piot; pregnant women; scientific skills; Stockholm, Sweden; strains; unpaid internist; virology

Subjects: Belgium Cooperation Scholarship; ELISA test; enzyme-linked immunosorbent assay; France; HIV; human immunodeficiency virus; Institute of Tropical Medicine; Peace Corps; sexually transmitted disease; STD

18:28 - Côte d'Ivoire Laboratory

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Partial Transcript: Can you tell us a little bit about what you were thinking when you took this position and what were the circumstances on the ground when you got there?

Segment Synopsis: Nkengasong describes how he was asked to create and direct a CDC field laboratory in Côte d'Ivoire for Project RETRO-CI

Keywords: A. Greenberg; Abidjan, Côte d'Ivoire; Antwerp, Belgium; application; Brussels, Belgium; chief of virology; culture laboratory; D. Hu; dilapidated; G. Schochetman; Journal of Infectious Diseases; Journal of Virology; journals; M. Kalish; M. Rayfield; one-year contract; PCR; Polymerase chain reaction; publications; son; technical interview; Treichville, Côte d'Ivoire; virologist advertisement; virology; wife

Subjects: Belgium, Kenya; CDC; Centers for Disease Control and Prevention; Côte d'Ivoire; Democratic Republic of the Congo; DRC; Institute of Tropical Medicine Antwerp; Lancet; Projet RETRO-CI; Retrovirus Côte d'Ivoire

24:02 - Virology Lab Abidjan

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Partial Transcript: We’ll talk later about the general but maybe even now you can tell us a little bit about the status of laboratory medicine in Africa at that time.

Segment Synopsis: Nkengasong explains why there was need to build a state-of-the-art laboratory in Côte d'Ivoire and the challenges of creating such a laboratory.

Keywords: Abidjan, Côte d'Ivoire; antibody testing; Antwerp, Belgium; assays; CD-4; cluster of differentiation 4; dual infection; French fluency; G. Schochetman; H. Gayle; HIV serology; HIV treatment; K. Castro; K. De Cock; local capacity; pathogenesis; PCR; quicker interaction; serology; specimen shipping; studies; T. Forks; true prevalence; viable cells; virus cultures; virus differentiation; virus isolation

Subjects: ELISA; enzyme-linked immunosorbent assay; HIV-1; HIV-2; National Institute of Communicable Diseases; National Institute of Virology; Projet SIDA; western blot

31:55 - HIV Assays

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Partial Transcript: It’s a big operation that you’ve entered.

Segment Synopsis: Nkengasong recounts how he set up the laboratory in Côte d'Ivoire to evaluate various HIV assays, scaling up HIV testing, seroprevalence surveys, and introducing PCR testing.

Keywords: A. Greenberg; assay performance; C. Maurice; children; Ivoirian personnel; lab; samples; serology laboratory; sick patients; simplified testing; virology laboratory

Subjects: ELISA; PCR testing; RETRO-CI; western blot

34:41 - Building a Laboratory

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Partial Transcript: So, did that take years?

Segment Synopsis: Nkengasong describes how he recruited team members to strengthen the quality and rigor in the Côte d'Ivoire laboratory. He further details his new found understanding of public health, research, and mentorship.

Keywords: A. Greenberg; abandoned patients; AIDS patients; articles; C. Adje-Toure; HIV patients; infectious disease clinic; laboratory; mentor; no treatment; operational; opportunity; S. Koblavi; S. Wiktor; stressful; team building; two years; virus

Subjects: Belgium; Catholic University of Leuven; Côte d'Ivoire; France; Institut Pasteur; public health

41:52 - Viral Load Testing

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Partial Transcript: And did you have to say no to some aspects?

Segment Synopsis: Nkengasong explains the early day of HIV viral load testing in Côte d'Ivoire and how he collaborated to design a more sensitive test and taught clinicians how to use the test results to appropriately manage a patient.

Keywords: AmpliPrep test; announcement; CD-4 counts; cost; genetic subtypes; learning; M. Kazatchkine; new; patient management; Sub-Saharan Africa; teaching; viral load test; virology

Subjects: Cameroon; JAMA; NUCLISENS; Projet RETRO-CI; Roche Pharmaceutical Company; The Journal of the American Medical Association; UNAIDS Drug Access Initiative; US Guidelines

49:23 - Research

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Partial Transcript: Were you able to get some of your research interest done in the midst of all the programmatic demands?

Segment Synopsis: Nkengasong talks about some of the research done at the Côte d'Ivoire laboratory.

Keywords: clinicians; dual infection; epidemiologists; laboratory; mother-to-child transmission; partnerships; sex workers; specimens; viral loads

Subjects: azidothymidine; AZT; HIV-1; HIV-2; Journal of Immunology; Projet RETRO-CI

52:18 - Quality Assurance

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Partial Transcript: How did you and how did CDC relate to WHO at that time?

Segment Synopsis: Nkengasong describes how the quality assurance program for diagnostic work in the laboratory in Côte d'Ivoire provided framework for quality assurance and HIV testing in all of Africa as well as being the leader in the area of antimicrobial resistant testing.

Keywords: accreditation; antimicrobial resistance; Antwerp, Belgium; drug resistance; Harare, Zimbabwe; HIV testing; international standards; J. Ridderhof; quality assurance; R. Martin; research labs; resistant; T. Hearn; virus sequencing

Subjects: Côte d'Ivoire; HIVResNEt; South Africa; WHO; World Health Organization

56:47 - Laboratory Network

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Partial Transcript: I’m wondering how you were thinking of that?

Segment Synopsis: Nkengasong describes how investing in training helped the quality of work within the laboratories throughout the continent of Africa, creating consistency within laboratory testing. This lead to the creation of the African Society for Lab Medicine.

Keywords: Antwerp, Belgium; assurance; C. Adje-Toure; connection; consistent; education; human capacity; immunologist; laboratory institutions; lack; M. Kalou; network; quality; training; virologist

Subjects: African Society for Lab Medicine.; Côte d'Ivoire; East Africa, Central Africa, West Africa; Projet RETRO-CI, University of California-Berkeley

61:08 - Global AIDS Program

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Partial Transcript: Can you describe why you took this assignment and what was your initial thinking about the challenges?

Segment Synopsis: Nkengasong explains why he left Côte d'Ivoire and moved to Atlanta, and joining PEPFAR.

Keywords: A. Greenberg; Atlanta, Georgia; B. Martin; basic serology; D. Birx; DHAP; Division of HIV/AIDS Prevention; ensure quality; evaluation of test kits; guidance; J. Mwangi; J. Ridderhof; Pre-exposure prophylaxis; PrEP; R. Downing; rapid test; S. McDougal; scale up; standardization; T. Hearn; vaccine trials

Subjects: Botswana; CDC; Côte d’Ivoire; HIV International Vaccine and Support Laboratory; Kenya; PEPFAR; Thailand; the President’s Emergency Plan for AIDS Relief; Uganda

67:32 - HIV Testing/Treatment

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Partial Transcript: What were some other priorities as you moved along and since there was a dramatic scale up of treatment of HIV in Africa during those years and continuing

Segment Synopsis: Nkengasong explains the technology, costs, and human resource challenges involved in scaling up treatment of HIV in Africa as well as developing an integrated national strategic laboratory plan

Keywords: Becton Dickinson; blood; CD-4 count; centralized; challenges; cost; FACS counter; fluorescence-activated cell sorting; hemolyzed; HIV labs; integrated lab; maintenance; malaria, tuberculosis; platelets; point of care test; poor samples; rapid testing; specialized technicians; strategic plan; transportation; viral load

Subjects: ART treatment; BD FACSCalibur™; Becton Dickinson; donor funding; engagement; expanding technology; FACSCount™; Global Fund; laboratory network; PEPFAR; quality assurance; WHO

76:08 - Laboratory Accomplishments

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Partial Transcript: There were so many, of course.

Segment Synopsis: Nkengasong describes the laboratory accomplishments and the development of accreditation standards and training programs for laboratories in Africa and the scale up of PCR testing using dried blood spots in the diagnosis of children and infants.

Keywords: accreditation; C.Y. Ou; clinicians; dialogue; dried blood spots; early diagnosis; exciting; improvement process; infant diagnosis; lab management; laboratory; reauthorization; reference lab; step-wise lab; strengthen systems; text messages; transport

Subjects: American Society for Clinical Pathology; Botswana; cell phones; Clinton Foundation; deoxyribonucleic acid; DN; PCR testing; PEPFAR; Rwanda; South Africa; WHO

82:53 - Reflections

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Partial Transcript: What did we do terrifically, what could we have done better

Segment Synopsis: Nkengasong takes time to reflect, his gratitude on being part of something larger and given the ability to transform from a basic scientist to an involved public health scientist.

Keywords: build capacity; commitment; contribution; enabling involvement; focus; gratitude; K. De Cock; latitude; leader; mentor; partnerships; resources; senior public health officers; training; transform; wealth of opportunity

Subjects: CDC; HIV; PEPFAR; public health