Kenya Medical Research Institute (KEMRI)
Operational research to develop an M&E strategy to guide triple drug stopping decisions for lymphatic filariasis in Kenya
- What is the indicator(s) and accompanying M&E strategy that enables country programs to determine when the risk of ongoing transmission of lymphatic filariasis has been reduced so that triple drug therapy with ivermectin, diethylcarbamazine, and albendazole (IDA) can be stopped with little risk of resurgence of transmission?
- Can the use of a tailored social mobilization package be used to strengthen community and health system participation and achieve >80% coverage for IDA in Kenya?
Improving Access to Mass Drug Administration for Lymphatic Filariasis Elimination using a Participatory Approach among Communities of Coastal Kenya
To assess the socio-economic factors contributing to low access to MDA, to identify the existing health services opportunities and other outlets specific to various socio-economic groups that could be used for improving access to MDA, and to develop feasible field-applicable strategies that can be used to reach groups with consistently low access to MDA.
Developing an M&E strategy to guide stopping decisions for IDA in Kenya: the Year 2 Impact Assessment
What is/are the most suitable indicator(s) for monitoring IDA treatment regimen against LF and for making IDA stopping decisions?
To determine the current status of LF using a combination of seroepidemiological tools to determine prevalence of circulating filarial antigen (CFA) and antifilarial antibodies.
Preliminary study findings:
- 2,976 individuals (age: 2 to 100 years) were tested for circulating filariail antigen using the immunochromatographic (ICT) test during daytime visits. Night-time blood samples to detect microfilariae (MF) were requested from those who tested positive via the ICT test.
- Out of the 38 persons found to be positive for LF infection by ICT test, 33 provided a night-time blood sample for examination of MF. Overall, nine individuals were found to be MF positive, with the highest prevalence in Ndau Island.
- The current study suggests that LF transmission may be absent in Taita-Taveta and Tana River counties in coastal Kenya and therefore transmission assessment surveys (TAS) should be considered with a view to stopping MDA. By contrast, evidence for ongoing transmission in Kwale, Kilifi and Lamu counties indicates the need for further MDA rounds in these counties.
- Additionally, the study demonstrated the feasibility of conducting integrated serosurveillance of several infectious diseases of public health interest, as well as levels of seroprotection against vaccine preventable diseases. The findings of the current study underscore the added value of using multiplex antibody measurements to guide and monitor LF elimination efforts.
The Impact of an Integrated Health System Approach in Improving Access to Morbidity Management and Disability Prevention Services for Persons with Leprosy, Hydrocele, and Lymphoedema in Coastal Kenya
Formative: To what extent do individuals have quality of life and access to and utilize MMDP services within the healthcare system; and what are the barriers and facilitators (affordability, availability, approachability, acceptability, and appropriateness) of 1) access to and utilization of quality MMDP healthcare services and 2) management of morbidities at home?
Intervention: What is the effect of an integrated health system approach on access to MMDP healthcare services as measured by affordability, accessibility, acceptability, and availability; and on utilization of services and quality of life?
Would the same programmatic decisions for Oncho Elimination Mapping be made based off of the Ov16 rapid diagnostic test results as compared to the Ov16 SD ELISA results?
Predicting STH prevalence with minimal re-mapping
Can geostatistical models leverage the wealth of well-characterized private and public sector data in Kenya to improve STH prevalence predictions, leading to better program decisions with minimal field cost?
Does greater program engagement and ownership lead to model adoption?
Exploring the persistence of Trichuris trichiura infection in a high transmission setting
What is the persistence of Trichuris trichiura infection in a high transmission setting?
Predicting STH prevalence with minimal re-mapping
Can geostatistical models leverage the wealth of well-characterized private and public sector data in Kenya to improve STH prevalence predictions, leading to better program decisions with minimal field cost?
Does greater program engagement and ownership lead to model adoption?
Operational research to develop an M&E strategy to guide triple drug stopping decisions for lymphatic filariasis in Kenya
- What is the indicator(s) and accompanying M&E strategy that enables country programs to determine when the risk of ongoing transmission of lymphatic filariasis has been reduced so that triple drug therapy with ivermectin, diethylcarbamazine, and albendazole (IDA) can be stopped with little risk of resurgence of transmission?
- Can the use of a tailored social mobilization package be used to strengthen community and health system participation and achieve >80% coverage for IDA in Kenya?
Developing an M&E strategy to guide stopping decisions for IDA in Kenya: the Year 2 Impact Assessment
What is/are the most suitable indicator(s) for monitoring IDA treatment regimen against LF and for making IDA stopping decisions?
POC/CCA tool ongoing studies: Use of testing standards; reader differences; ‘Trace’ result analyses
Gaining schistosomiasis control in Kenya, Mozambique, and Tanzania
Gaining Control: >25% Prevalence MDA strategies; and subtle morbidity of Cohort; Population genetics, and snail monitoring
Sustaining schistosomiasis control in Cote D'Ivoire and Kenya
MDA strategies: Sustaining control at 10 – 24% prevalence
Comparison of muti-parallel qPCR and Kato-Katz for detection of STH in Kenyan children
Is the multiparallel quantitative polymerase chain reaction technique superior to Kato-Katz microscopy in assessing the intensity and prevalence of soil-transmitted helminth infections in stool?
Preliminary Findings and Lessons Learned
- qPCR was more sensitive than Kato-Katz at detecting Ascaris, Trichuris, and hookworm infections in child fecal samples.
- Very few samples were helminth positive by Kato-Katz microscopy that were not also positive by qPCR, suggesting minimal human classification error during microscopy.
- Duplicate qPCR analysis on ~10% of samples by two separate labs (Smith and KEMRI) showed excellent concordance (97-100% agreement for each helminth species).
- A reanalysis of the effect of a combined water, sanitation, and hand washing (WASH) intervention on child helminth infections with qPCR data compared to Kato-Katz data gave very similar results.
POC/CCA screening/mapping tool initial Studies
POC/CCA screening/mapping tool initial Studies
TakeUp: Testing the Impact of Incentives on Compliance with Community-based Mass Deworming through a Field Experiment in Kenya
•What is the influence of social and behavioural incentives on the increase in cost-effective demand for deworming medication among adult population?
•What is the impact of social incentives on take-up and cost-effectiveness of deworming treatment?
•What is the impact of consumption incentives on take-up and cost-effectiveness deworming treatment?
•Can any increase in takeup be attributed to signaling effect wherein individuals are motivated to access treatment in order to demonstrate that they have engaged in pro-social behavior?
Snail Control follow-up study of P. clarkii 20 years later
The TUMIKIA Project aims to determine whether combining school- and community-based deworming is more effective at controling and eliminating soil-transmitted helminths (STH or intestinal worms) in Kenya than school-based deworming alone.
The two-year trial will provide the drug albendazole to all residents from 150 communities in Kwale County, Kenya. There are three study groups:
- Base: annual school-based deworming (ages 2-14)
- Increased coverage: annual school- and community-based deworming (ages 2-99)
- Increased coverage and frequency: bi-annual school- and community-based deworming (ages 2-99)
TUMIKIA stands for 'Tuangamize Minyoo Kenya Imarisha Afya,' which means “eradicate worms in Kenya to improve health,” in Swahili.
Leveraging the experience of community-based HIV prevention responses for increasing awareness and demand for FGS prevention, diagnosis and treatment
This study aims to understand and address several issues: lack of knowledge among health care workers (HCW) and community health workers (CHW) about FGS, knowledge and stigma at the community level, the potential for integrating FGS into existing sexual and reproductive health (SRH) education, and the potential for improving equity of MDAs for women of reproductive age.
Formative research will be used to develop HCW training modules, social mobilization and sensitization messaging, and to assess baseline knowledge. The team plans to conduct cross-sectional community surveys, focus groups with CHWs, and interviews with health workers that measure KAPs. In the intervention phase, the team plans to incorporate FGS material into existing SRH programs, including an online/social media platform used to teach teenage girls about HIV and STIs. They are also planning community outreach activities that coincide with the planned MDAs and are planning to field test the community-based drug delivery outlined in Kenya’s “Breaking Transmission” strategy. Testing and treatment for FGS will be improved at health facilities. Radio messaging using crafted behavior change messaging will be deployed.
Production of a New Dual Antigen Test Strip as a Tool to Support Epidemiologic Assessments of Onchocerciasis
How does the performance of the new Ov16/Ov3261 test strip compare to that of the SD Ov16 RDT and the SD Ov16 ELISA?
Comparison of muti-parallel qPCR and Kato-Katz for detection of STH in Kenyan children
Is the multiparallel quantitative polymerase chain reaction technique superior to Kato-Katz microscopy in assessing the intensity and prevalence of soil-transmitted helminth infections in stool?
Preliminary Findings and Lessons Learned
- qPCR was more sensitive than Kato-Katz at detecting Ascaris, Trichuris, and hookworm infections in child fecal samples.
- Very few samples were helminth positive by Kato-Katz microscopy that were not also positive by qPCR, suggesting minimal human classification error during microscopy.
- Duplicate qPCR analysis on ~10% of samples by two separate labs (Smith and KEMRI) showed excellent concordance (97-100% agreement for each helminth species).
- A reanalysis of the effect of a combined water, sanitation, and hand washing (WASH) intervention on child helminth infections with qPCR data compared to Kato-Katz data gave very similar results.
District Mapping Onchocerciasis and Lymphatic Filariasis in Kenya
To assess the programmatic feasibility of and determine the most appropriate age group and sample strategy for an onchocerciasis mapping survey for ivermectin-naïve areas.
Identification of serosurveilance antigens for schistosomiasis
To identify antigens that can be produced as recombinant proteins and to document elimination of schistosomiasis.
To identify antigens that differentiate between infections with Schistosoma mansoni and Schistosoma haematobium and that can be used in an ELISA, lateral flow assay or multiplex format.
TakeUp: Testing the Impact of Incentives on Compliance with Community-based Mass Deworming through a Field Experiment in Kenya
•What is the influence of social and behavioural incentives on the increase in cost-effective demand for deworming medication among adult population?
•What is the impact of social incentives on take-up and cost-effectiveness of deworming treatment?
•What is the impact of consumption incentives on take-up and cost-effectiveness deworming treatment?
•Can any increase in takeup be attributed to signaling effect wherein individuals are motivated to access treatment in order to demonstrate that they have engaged in pro-social behavior?
The TUMIKIA Project aims to determine whether combining school- and community-based deworming is more effective at controling and eliminating soil-transmitted helminths (STH or intestinal worms) in Kenya than school-based deworming alone.
The two-year trial will provide the drug albendazole to all residents from 150 communities in Kwale County, Kenya. There are three study groups:
- Base: annual school-based deworming (ages 2-14)
- Increased coverage: annual school- and community-based deworming (ages 2-99)
- Increased coverage and frequency: bi-annual school- and community-based deworming (ages 2-99)
TUMIKIA stands for 'Tuangamize Minyoo Kenya Imarisha Afya,' which means “eradicate worms in Kenya to improve health,” in Swahili.
A portable multiplexing electrochemical metalo-immunosensor array for detection of Schistosoma cercarial antigens in polluted waters
Can we identify diagnostic markers of Schistosoma mansoni in environmental water samples?