Stephen R. Manock 1 , 2 , * , Ali Mtoro 3 , Vicente Urbano Nsue Ndong 4 , Ally Olotu 3 , 5 , Mwajuma Chemba 3 , Antonio E. Sama Roca 6 , Esther Eburi 6 , Guillermo A. García 7 , Carlos Cortes Falla 6 , Julie Niemczura de Carvalho 7 , Jaime Contreras 8 , Baltasar Saturno 8 , Juan de Dios Riocalo 8 , José Luis Nze Mba 9 , Rima Koka 10 , Seung Tae Lee 10 , Hari Menon 11 , L. W. Preston Church 1 , Mitoha Ondo’o Ayekaba 4 , Peter F. Billingsley 1 , Salim Abdulla 3 , Thomas L. Richie 1 , Stephen L. Hoffman 1
23 November 2020
Providing medical care for participants in clinical trials in resource-limited settings can be challenging and costly. Evaluation and treatment of a young man who developed cervical lymphadenopathy during a malaria vaccine trial in Equatorial Guinea required concerted efforts of a multinational, multidisciplinary team. Once a diagnosis of diffuse large B-cell lymphoma was made, the patient was taken to India to receive immunochemotherapy. This case demonstrates how high-quality medical care was provided for a serious illness that occurred during a trial that was conducted in a setting in which positron emission tomography for diagnostic staging, an oncologist for supervision of treatment, and an optimal therapeutic intervention were not available. Clinical researchers should anticipate the occurrence of medical conditions among study subjects, clearly delineate the extent to which health care will be provided, and set aside funds commensurate with those commitments.