TALLINN, ESTONIA: Finding participants for clinical trials is one of the challenges in the development of new vaccines against tuberculosis (TB). The South African Tuberculosis Vaccine Initiative (SATVI) recently launched a new means to reach out to communities where trials take place: a comic book.
The 12-page comic book, printed in Afrikaans, Xhosa and English, aims to communicate information on TB vaccine clinical research in an entertaining and understandable way. Under the title 'Carina's Choice' it tells the story of a young woman's decision to enroll her baby daughter into a clinical trial for new TB vaccines. “Why did you do that?” a friend asks her on the cover, inside the answer follows.
The comic gives information on TB vaccine clinical trials and deals with common questions and misunderstandings on those trials in communities. Consultative focus group sessions with community stakeholders were held in the development of the comic, which helped shape among others the characterisation, setting, facts and community concerns that needed to be communicated, and language used.
“Many people in the community are not familiar with research,” explains SATVI co-director Hassan Mahomed, adding that levels of education and literacy are often low. “Regarding clinical trials, there is some superstition, many myths exist about e.g. taking blood, as well as ideas that people are used as guinea pigs, bad things will happen, or other negative attitudes. The comic deals with these thoughts, it explains what happens in trials. This way, we hope to increase knowledge and understanding.”
SATVI is conducting clinical trials in South-Africa for multiple novel TB vaccines. According to Mahomed, tuberculosis is widely known among communities, but not everybody is equally familiar with the need for new vaccines. The limitations of Bacille Calmette Guérin (BCG), the currently only available vaccine, are referred to in the comic book as well. Around 10,000 books have been printed, Stop TB Partnership funded the design. “The comics will be handed out through clinics, NGOs and at home visits,” Mahomed said at the sidelines of the Second Global Forum on TB Vaccines in Tallinn (September 21-24), Estonia.
The comic is a new tool for SATVI, which already works with e.g. posters, leaflets and DVDs explaining what clinical trials are all about. “Also through local media, radio, newspapers and NGOs we inform people about trials,” Mahomed adds. SATVI staff go out to communities, workplaces, schools, clinics and homes of newborns to contact and recruit people.
SATVI further works with a community advisory board (CAB) made of individuals from the community to represent the community's interests in clinical trials. “They give advice to the researchers and input from the community. In every way it is very important to engage with communities”
SATVI staff and CAB members are also present in the comic book. It ends with a bill of rights for research participants. “It is all about informed consent,” Mahomed says. “At all times, even when people are participating already, they need to be constantly reminded of their rights and informed about the process of the trial.”
“We don't know yet what impact the comic books will have,” he continues. “The comics will be handed out to groups of community members in different settings. After reading the comics, they will be engaged in focus group discussions to check understanding of the issues raised and also attitudes towards the comics themselves. Of course we hope the comic will have effect and improve understanding.”
The Worcester Senior Secondary, a local high school, has converted the comic book into a theatre play. This play was the centerpiece of the official launch of the book on October 9.
(The author is a freelance journalist writing for Citizen News Service (CNS) and Associate Communications atTuBerculosis Vaccine Initiative – TBVI)
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