Impact in Kenya

• Technically assisted 13 laboratories in Kenya to achieve accreditation through the WHO-AFRO’s Strengthening Laboratory Management Towards Accreditation (SLMTA) Program
• Participation in the development of policy guidelines such as the successful pilot of use of viral load for screening of treatment failure in 26 facilities in Nyanza
• Piloting innovative, evidence-based behavioral interventions in Siaya with a plan for eventual countrywide scale-up
• Door-to-door testing of HIV has been a flagship project and has been scaled-up in the country.
• Supporting the Ministries of Health in the management of multidrug resistant Tuberculosis (MDR-TB) through a pilot community model of patient management.
• Renovating a facility for the isolation of severely ill patients with MDR-TB at NNPGH in 2012.
• Supporting the decentralization of MDR-TB surveillance to Nyanza region
• Coordinating, in collaboration with the Provincial Health Management Team, the establishment of 6 referral centers for Kaposi’s Sarcoma chemotherapy in Nyanza
• Participation in the review of the Kenya National AIDS Strategic Plan- III
• Developing the field-data collection tools for the second Kenya AIDS Indicator Survey (KAIS)
• Coordinating, in collaboration with ITECH and ICAP, the OEConnect Project that aims to improve interoperability between disparate health information systems in Kenya
• Supporting the improvement of biosafety in Kenya. Installed 18 biosafety cabinets countrywide in the last year

HIV Implementation Science and Services Factsheet

The HIV Implementation Science and Services (HISS) Program focuses on activities that strengthen the Kenyan health system, through an approach that progressively improves government ownership of HIV related programs. HISS seeks to ease the impact of the HIV epidemic through delivery of HIV related prevention, care and treatment services and perform HIV-related implementation science studies.

Highlights:

HIV Care and Treatment Services:

• Over 20,000 adults and children offered care and treatment services at the New Nyanza Provincial General Hospital (NNPGH) in Kisumu.
Over 4000 mothers and over 350 children received antiretroviral prophylaxis through Prevention of Mother to Child Transmission (PMTCT) services.
• About 350 HIV/TB co-infection patients received antiretroviral drugs in 2010/2011.
• Approximately 30,000 patients under our care, in other facilities in Nyanza, were transitioned to ICAP and EGPAF in the last financial year (2010/2011)

HIV Prevention: HISS is piloting innovative evidence-based behavioral interventions in Siaya and Nairobi counties.

• The Healthy Choices I & II Programs, which seek to delay sexual debut and promote safer sex, have engaged 1050 adolescents.
• The RESPECT program, which strengthens the risk reduction-counseling component in HIV testing, will begin the second quarter of 2012.
• The Families Matter Program (FMP) has engaged over 650 parents to improve parent-adolescent communication as regards matters of sexual health.

HIV Testing: about 200,000 clients were HIV tested through the facility-based Provider Initiated Testing and Counseling (PITC) Program in 2011. Testing occurred in 110 facilities within Nyanza Province and through the Home-based Testing and Counseling (HBTC) program in Kibera & Mathare slums in Nairobi.
All the facilities supported in PITC, with the exception of NNPGH, transitioned to ICAP and EGPAF.

Laboratory Services: HISS collaborating with the HIVR Branch together runs one of 4 facilities in Kenya that perform PCR-based tests for early infant diagnosis for over 800 facilities. It is also one of the few laboratories offering HIV viral load testing having supported 26 facilities in the Nyanza in 2011. These labs also offer HIV drug resistance tests on a case-by-case basis.
HISS will begin collaborating in January 2012 with the Tuberculosis Branch to support the government’s Division of Leprosy, Tuberculosis and Lung Diseases (DLTLD) to decentralizing TB culture and sensitivity tests in Nyanza region.
HISS is also involved in quality assurance programs at the national level that include technical assistance to 13 laboratories seeking WHO accreditation. Other areas of support offered include policy formulation and equipment procurement, distribution, deployment, certification and maintenance.

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What we’re doing

Developing New Tools for Control

Evaluating the safety and effecacy of a new TB vaccine and a new TB drug to see if they work better than current tools, and we are evaluating new TB diagnostic tests to see how well they work.

Building Collaborations

Working in partnerships with local, national, and international colleagues builds on our collective knowledge of TB. These alliances can speed up
the learning curve to find the answers needed to eliminate TB.

KEMRI/CDC collaborates with the Ministry of Health, for example, to strengthen their TB control program by helping them answer important research questions and helping to make sure answers are translated into policy and practice. The TB branch also collaborates with other KEMRI/CDC branches helping to answer the TB component to other diseases like HIV or schistosomiasis.

Laboratory Services

The KEMRI/CDC TB laboratory is now a biosafety level 3 (BSL 3) laboratory, making it capable of doing sophisticated TB testing, like testing for drug resistance. As of January 2012, it started supporting the Ministry of Health by doing tests for drug resistant TB for all patients who need this test in Nyanza province. This will help these patients get the diagnostic testing results they need more quickly.