Impact in Kenya

• NTD branch is providing mass drug administration to over 225 communities living along the shores of Lake Victoria for treatment of schistosomiasis and STH through either school based treatment or community wide treatments. The program, supported by University of Georgia Research Foundation (UGRF), will be evaluating the best MDA strategies over a 5 year period.

• NTD branch’s studies on the trends in the efficacy of praziquantel (PZQ) against Schistosoma mansoni infection after 16 years of intense, repeated use in a small geographic area along the shores of Lake Victoria in Kisumu show no resistance to the drug. These findings are welcome for the ongoing control efforts relying on mass treatment programs for we can still rely on praziquantel, but the scientific community needs to continue identifying fall-back measures incase resistance develops.

• Ongoing projects will provide the evidence base to define public health policy for the most cost effective delivery of treatment for schistosomiasis in different prevalence zones.

Neglected Tropical Diseases Factsheet

The KEMRI/CDC Neglected Tropical Disease (NTD) branch is involved in research related to the geographic distribution, prevalence, intensity and morbidities of neglected tropical diseases such as bilharzias (schistosomiasis) and intestinal worms and how people’s immune systems respond to these infections. Diseases targeted for future research include trachoma, tungiasis (jiggers), filariasis (elephantiasis), leishmaniasis (kala-azar) and hydatid among others. The branch also evaluates disease control strategies and the impact of co-infections with other illnesses such as HIV/AIDS, malaria, Soil Transmitted Helminthes (STH), and TB. The NTD branch is involved in identifying strategies, using a community directed approach, to strengthen the Primary Health Care System to control NTD’s.

NTD studies;

Evaluation/Comparison of Diagnostic Tests for Schistosomiasis
KEMRI/CDC’s NTD branch is evaluating how the point of contact (POC) test compares with other tests like ELISA for antibody detection and PCR for sensitivity and specificity of schistosome diagnosis in areas of high, moderate, and low schistosomiasis prevalence. The NTD branch is also evaluating which test has the greatest accuracy for a given cost in various prevalent areas.

Assessment of quality of life as a tool for measuring morbidity due to schistosomiasis and the impact of treatment
In this study, NTD Branch investigated how the control of schistosomiasis through treatment affected quality of life and provided evidence for the benefits of mass drug administrations. The branch used WHO quality of life assessment (WHOQOL-BREF) to measure the benefit of treating schistosomiasis among treatment-naïve individuals in high prevalence areas. Study participants were screened for parasites, HIV, and subjected to the WHOQOL-BREF before and six months after treatment. The study findings indicated a significant reduction in both prevalence and intensity of infection while quality of life significan_tly improved compared to the baseline.

Mapping models for predictive accuracy of schistosomiasis and STH prevalence.
The branch is developing a mapping model that can be generalized and has predictive capacity by applying it to other locations and countries that have already obtained similar prevalence data as area of study on schistosomes and STHs.

Maps are created by collecting prevalence data with respect to population density, water proximity, elevation, sanitation availability and vegetation. A valid, model could greatly reduce a control programs cost reducing the use of treatment drugs where it is not needed reducing the risk from unnecessary treatments. The distribution and intensity of schistosomiasis is focal; however, treatment programs typically aim to cover large areas where risk may not be uniformly present leading to unnecessary costs in resource-constrained environments. Given the likely progression of climate change future control efforts could be better targeted by address changes in risks associated with environmental change.

281 7772400 10058400 259 261 257 276 262 279 1 0`````````````````````` 5 1 0 285 282 1 False 0 0 0 0 -1 304800 243 True 128 77 255 3175 3175 70 True True True True True 278 134217728 1 9 -9999996.000000 -9999996.000000 8 2105633 2105633 130600 0 8079405 8079405 1801059240 0 3196923 3196923 1750860776 11 2967783 2967783 66962152 0 13948636 13948636 741360104 28 11367680 11367680 447216040 0 8799318 8799318 161592744 0 16777215 16777215 8 0 Bluebird 22860000 22860000 (`@````````` 266 263 5 110185200 110185200

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.