Kenya has hosted more NPGH Fogarty Fellows than any other country, so previous projects have covered a wide range of topics: everything from shock-related mortality in pediatric patients to STI modeling in non-human primates. Though much research has focused on HIV/AIDS, there have been many different approaches including the effect of hormonal birth control on HIV risk, partner notification in serodiscordant couples, and the interplay between iron deficiency, malaria, and HIV. Dr. Bukusi, Co-Director of the Research Care and Treatment Program at the Kenya Medical Research Institute, gave an interview about her career as an HIV/AIDS researcher on our blog, and Fan Lee, a 2014-2015 Fogarty Scholar also wrote about her experiences at the start of her fellowship.
The University of Nairobi (UON) College of Health Sciences was established in 1968, and was the only medical school in Kenya for more than two decades. Since 1985, the Universities of Washington and Nairobi have been involved in collaborative research and training to study mother-to-child HIV transmission, management of pediatric HIV, HAART adherence interventions, and prevention of HIV transmission in HIV-discordant couples. This UW/Kenya collaborative group has increased local capacity through training U.S. and Kenyan research scientists to perform integrated research on prevention, care and treatment of HIV-related conditions thereby strengthening academic programs at both institutions. Fogarty trainees are highly successful and have made important scientific contributions, assumed leadership positions in research and health care, and influenced HIV prevention, care and treatment policies in Kenya, in Africa and globally. Drs. Elizabeth Bukusi, Chief Research Officer and Deputy Director of the Kenya Medical Research Institute (KEMRI), James Kiarie, Senior Lecturer and PI of the former Kenya MEPI project are both graduates of the UW AIRTP (see letters of support). The success of the UW/Kenya collaborative group is further exemplified by two training grants recently awarded to UW and UON partners to develop innovative teaching models to provide comprehensive medical education to global health leaders. Read more…
KEMRI is the principal medical research institute in Kenya and has collaborated with the UW AITRP since 1989, when the first of seven KEMRI researchers received long-term training at the UW. KEMRI operates the referral laboratory for East Africa and has a 40-bed research ward. Funding for KEMRI comes from the Kenyan government, the CDC, Walter Reed Institute, and the Japanese International Corporation Agency. KEMRI provides a productive research environment for UW Fogarty trainees with many joint projects currently conducted and offering opportunities for additional postdoctoral trainees. Additionally, PI’s from UMN have conducted NIH-funded research and training on the relationship between malaria transmission and immunity with KEMRI since 1996.
KEMRI conducts research from 12 research centers that focus on different areas of national and strategic importance: Centre for Biotechnology Research and Development (CBRD); Centre for Clinical Research (CCR); Centre for Geographic Medicine Research-Coast (CGMR-C); Centre for Global Health Research (CGHR); Centre for Infectious and Parasitic Diseases Control Research (CIPDCR); Centre for Microbiology Research (CMR); Centre for Public Health Research (CPHR); Centre for Respiratory Diseases Research (CRDR); Centre for Traditional Medicine and Drug Research (CTMDR); Centre for Virus Research (CVR); The Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC). KEMRI also has a graduate school known as the KEMRI Graduate School of Health Sciences (KGSHS), a Health Safety and Environment Program, and a production centre.
KEMRI Centre for Global Health Research (CGHR): CGHR is located in Kisumu City, western Kenya, an area that is endemic for major infectious diseases such as malaria and HIV/AIDs. Research conducted in CGHR focuses on infectious diseases of medical importance. Specifically, the Centre has carried out cutting-edge research focusing on trials on the efficacy of drugs, emergence of drug and vector resistance, epidemiology, immunology, molecular biology, vector biology, climate and human health, characterization of malaria vaccine candidate antigens, malaria vaccine trials, malaria in pregnancy and interaction of malaria and human immunodeficiency virus (HIV), schistosomiasis, intestinal helminthes, HIV/AIDS and its impact on the community, HIV interaction with other infectious diseases, tuberculosis and reproductive health.
The Center consists of two administrative buildings, an entomology building, two refurbished laboratory blocks, a new state-of-the-art multidisciplinary laboratory complex and a clinic. The administrative blocks houses the Center Director’s office, offices for senior scientists, collaborating scientists and visiting scientists, senior administrators, a data section, a computer room, a library, storage facilities and 5 modern seminar rooms for training, meetings and holding seminars, with seating capacity ranging from 8 to 40 people. The seminar rooms are equipped with modern audio-visual (AV) equipment including LCDs, permanent and portable screens, TVs and VCRs. Two of the seminar rooms are also equipped with video-conference facilities. The laboratory facilities consist of separate well-equipped rooms for basic laboratory diagnostics, immunology and molecular biology laboratories, parasite cultures and drug sensitivity testing, a clinical hematology and biochemistry laboratory, an insectary and insecticide-testing huts. The current laboratory equipment in the Centre include a modern compound, inverted and fluorescent microscopes, differential Coulter counters, multiparameter biochemistry machines, Hb electrophoresis equipment, refrigerated bench-top centrifuges, multifunctional ELISA readers and automated washers, twin CO2 conventional incubators, liquid scintillation counters, level II biosafety cabinets, FACS count, four and five-color FACSCaliburs and FACScan, PCR enclosures and high capacity PCR machines, real-time PCR machines, 377 and 3100 ABI gene sequencers, UVP gel imaging systems, and nanopure water purification systems. There are numerous -70 ultra-freezers and several bulk liquid nitrogen tanks for sample storage.
The center has recently installed a liquid nitrogen generator with capacity to produce 500 liters of liquid nitrogen per day. In addition to the above facilities, there are several facilities for conducting hospital-based clinical studies. The biggest of these is a stand-alone Clinical Research Centre located at the New Nyanza Provincial Hospital in Kisumu City. It consists of a pediatric ward, clinical laboratory, offices and HIV counseling facilities. Plans are at an advanced stage to convert part of this facility into a vaccine trial site. This will be in addition to an already existing state-of-the-art and well-equipped vaccine and drugs trial site with capacity to conduct GCP/GLP compliant trials at Kombewa, situated about 30 kilometers from Kisumu City. Read more…
KNH is on the forefront of clinical and prevention care in Kenya and has strong ties to the Kenyan Ministry of Health and the University of Nairobi. The hospital was established in 1901 with a bed capacity of 40 and in 1965 became a Ministry of Health department and the first medical training college in Kenya. In 1981, the hospital’s capacity increased to 2,000 inpatient beds with the construction of the current 10-story building. KNH remains one of two national referral hospitals in Kenya and is a major training facility of health care professionals at the undergraduate, post-graduate, and medical specialty level, as well as for paramedical personnel, including clinical officers, health information specialists, and laboratory technologists.
The hospital’s mission is to “provide accessible specialized quality health care, facilitate medical training, research; participate in national health planning and policy,” and its mandate includes providing facilities for medical education and research, as well as participating in national health planning. As a regional referral hospital, there is a wealth of data that can be utilized to inform and improve health care provision within and outside Kenya, especially around HIV care and treatment. KNH provides HIV care for thousands of inpatients each month and sees hundreds of HIV-infected adults and children each day at the HIV Comprehensive Care Center (CCC). The CCC has >5,000 HIV-infected adults registered in outpatient follow-up and >700 HIV-infected children enrolled in care. Eighty-one percent of these adults are currently on ART and 467 new patients were initiated during the last 6 months of 2011 alone. In the inpatient setting, KNH has implemented routine provider-initiated HIV testing (PITC), successfully testing approximately 1,000 patients monthly and finding prevalence to be >6% in this population.
The KNH Department of Research Chair Dr. Nelly Mugo, and Vice-Chair Dr. John Kinuthia, who both earned MPH degrees at UW with Fogarty funding, have identified implementation science as their current research priority and this has been endorsed at meetings with the hospital’s Deputy CEO as recently as May 2012 when Dr. Carey Farquhar met with KNH leadership to discuss research directions for the institution and future collaborations.
AIDS International Research Training Program (AIRTP): Since 1985 when Drs. Joan Kreiss and King Holmes began working in Nairobi in collaboration with the University of Nairobi and Kenyatta National Hospital, UW faculty have conducted several hundred research projects on HIV prevention, treatment and pathogenesis. This longstanding partnership between UW and KNH, and the solid research foundation that has been built over more than two decades, can be readily leveraged to focus on implementation science training relevant to the HIV care cascade. More than 450 papers have been published with AITRP trainees as first or co-authors and this number has steadily increased by 20-30 publications each year for the last 5 years. All of these publications address HIV and a significant proportion have been led by Kenyan investigators and have Kenyans as first authors, including several papers in high-profile journals such as the Lancet and JAMA. Major research projects that have been completed or are ongoing are included below to demonstrate the ability of the UW/Kenya collaboration to absorb new trainees. Those based at KNH will also build capacity for research at the institution. All will provide rich opportunities for trainees in the proposed program to conduct research in a rigorous manner with strong mentorship by experienced U.S. and Kenyan investigators. Read more…
Our mentors have collaborated with Moi University in Eldoret, Kenya through the Academic Model Providing Access to Healthcare (AMPATH) for over a two decades. The AMPATH program provides training to dozens of US and Kenyan doctoral and post-doctoral trainees every year, and houses numerous potential faculty mentors at Indiana University and Moi University in Kenya who work in research areas that include HIV infection, malaria, cancer, hematologic disease and neonatal health. Former NPGH Co-PI, Dr. Chandy John currently leads the AMPATH program at the University of Indiana and with his collaboration trainees will receive access to workspace, administrative services, and laboratory facilities necessary to carry out their projects. Read more…
- Shock-related mortality in pediatrics
- STI modeling in non-human primates
- Effects of hormonal birth control on HIV risk
- Partner notification in serodiscordant couples
- Interplay between iron deficiency, malaria, and HIV
For a list of projects in Kenya: click here
Current Fogarty Trainees