EMD stories: Ghana field site spotlight

Savanna Randi, EMD PhD student, tells us about a long running study site in Ghana

The study site is based in the village of Beposo, in the Pru West District of the Bono East Region, Ghana. Beposo is situated approximately 250 miles northwest of Accra, Ghana’s capital. Building on prior research into hookworm endemicity in this region, this rural, agriculture-rich area offers a prime setting for our collaborative research on soil-transmitted helminth (STH) infections.

In 2006, Dr. Michael Cappello and his Yale colleague Dr. Elijah Paintsil traveled to Ghana, driven by their shared interest in studying diseases that had been largely eradicated in the United States. While Dr. Paintsil focused on preventing maternal-to-child HIV transmission, Dr. Cappello aimed to establish a field-based collaboration to explore the epidemiology and pathogenesis of hookworm and other STH infections.

Drs. Cappello and Painsill connected with researchers at the Noguchi Memorial Institute for Medical Research at the University of Ghana in Accra, a renowned institution founded with Japanese support to honor microbiologist Hideyo Noguchi, who died in Ghana in 1928 while researching Yellow Fever. It was here that Dr. Cappello met Professor Mike Wilson, then Head of the Parasitology Department. Professor Wilson's work centered on parasitic helminth control, particularly in vector-borne diseases such as onchocerciasis and lymphatic filariasis.

This meeting sparked a lasting collaboration focused on research and training, including annual bi-directional exchanges of trainees. Their first joint field study launched in 2008 in the Kintampo North municipality and established a strong foundation for impactful research. The partnership not only advanced the scientific understanding of parasitic infections but also provided invaluable training opportunities for dozens of Yale students at all academic levels.

I have been privileged to work alongside the Noguchi field team in Ghana since I began pursuing my MPH. From my first visit in 2022, I have worked closely with district leaders, local health workers, and community members in Beposo. Over the ensuing years, I have developed strong relationships within this community, built on trust and a shared commitment to improving health outcomes.

My passion for field epidemiology has evolved from a research collaboration to a dedicated, long-term investment. I remain committed to advancing meaningful, evidence-based interventions that address the pressing health challenges faced by communities disproportionately affected by infectious diseases. Working alongside the Noguchi team has been instrumental in driving this work forward and ensuring our research translates into real-world impact.

Our research addresses several key questions related to hookworm transmission and control in rural, resource-limited settings like Beposo. A primary focus is understanding the transmission dynamics of hookworm infection and how host-parasite interactions influence infection susceptibility and post-treatment reinfection patterns. By examining demographic, behavioral, and environmental risk factors alongside immune responses, we aim to identify the key drivers of infection intensity and reinfection cycles in endemic regions.

Ultimately, our research aims to generate actionable insights that drive evidence-based public health strategies and promote sustainable interventions to reduce the burden of soil-transmitted helminths in high-risk regions.

Despite being a major public health issue, STH infections remain a neglected tropical disease, underscoring the need for increased attention and investment to break the cycle of infection and improve the health and well-being of vulnerable communities.

Currently, we are eager to advance our longitudinal field studies and collaborations, with a critical focus on developing and validating community-level sero-monitoring tools to enhance detection and response strategies.