Research programs and initiatives in Kenya
One of the unique aspects of the Allen School is its ability to extend research work and apply its findings across the world. Our team members work with local communities in Kenya and assist them with a variety of human and animal health related challenges. Our team is most known for its work in rabies elimination, antimicrobial resistance, and global disease surveillance.
WSU’s Paul G. Allen School for Global Health is leading the USAID Feed the Future Animal Health Innovation Lab (AHIL) focused in Nairobi, Kenya. Working with regional partners, the Feed the Future Innovation Lab will identify interventions to address livestock diseases, particularly East Coast Fever (ECF), develop capacity in-country in both research training, and institutional development for long-term impact.
In August 2020, the Paul G. Allen School for Global Health launched development of the Center for Research in Emerging Infectious Diseases (CREID) in Nairobi, Kenya to support response to outbreaks of emerging infectious diseases such as COVID-19. The Center will have the capacity to address infectious disease outbreaks in eastern and central Africa (ECA) and have an immediate impact to save lives.
The CREID-ECA program is led by M. Kariuki Njenga, and funded by NIH/NIAID.
Population-Based Animal Syndromic Surveillance Project (PBASS)
People who own livestock are better able to feed their families, send their children to school and provide for their medical needs.
In 2012, WSU launched the Population Based Animal Syndromic Surveillance project, a program in Kenya to track the health and livelihood of families and the livestock they own. By focusing on the human-animal-environment interface, researchers are identifying how animal health directly relates to the health and welfare of people and the environment. The program involves monthly interviews of 1,800 homes to gather information about animal and human health.
After collecting data, the information is analyzed to identify effective interventions. Community participants receive access to health care for both humans and animals.
The goal is to better understand how to improve the health and productivity of animals, and then measure the improvement via human development, health, economic stability, and education.
The next phase of the project will look at the impact of targeted interventions on animal health and corresponding economic implications. Allen School researchers are studying the household impact of vaccinating chickens against Newcastle Disease, a highly contagious disease that causes great loss in many small farms in Kenya. By vaccinating chickens, researchers are looking to discover how this translates to protein consumption and nutritional status of children and mothers, and how that translates into health and economic improvements for families.
This program is funded by the Paul G. Allen School for Global Health.
Brucellosis and MERS Coronavirus
More than 65% of the 19-21 million domestic dromedary camels live in the horn of Africa region including Kenya, Ethiopia, and Somalia. The camels are used to transport people and supplies across the desert, for milk, and as a source of meat.
Camels can transmit disease to people, particularly brucellosis and MERS coronavirus, through mechanisms that are not well understood but perhaps involve physical contact and consumption of camel milk. Allen School researchers are testing camels to determine their infection frequency as well as reviewing the transmission pathways between people and camels for both diseases. Camels are a regular source for infection transfer due to their longevity, living 15-20 years compared to cows living approximately four years and goats two years. That longevity provides multiple reinfection opportunities. The Washington Animal Disease Diagnostic Laboratory is involved in determining the brucella strains circulating in camels.
The goal of the studies on brucellosis and MERS CoV in camel populations is to find ways to break the transmission cycle in an effort to control both diseases and reduce death in animal and human populations.
The project is in partnership with CDC Kenya.
Rabies Free Africa Program
As one of its primary research and delivery programs, Allen School researchers are working to eliminate human deaths from canine rabies by 2030.
Human incidence of rabies has dramatically dropped in a region of East Africa thanks to continued vaccination of domestic dogs, in large part due to the success of the Rabies Free Africa program in Tanzania. This initial focus has expanded to address rabies in Kenya.
Rabies Free Kenya
The program focuses on a two-tier approach: mass dog vaccinations and community-based surveillance and treatment. The initial work centered on getting rabies listed as one of the top infectious diseases in Kenya. This led to a national strategy for rabies elimination that is being used to create a model other countries can utilize.
Concurrent with the mass dog vaccination campaigns, the education campaign for dog bite victims is ongoing. This is paired with a surveillance program that traces suspected human cases of rabies exposure and reports back to health facilities and villages to discover other people, and animals, that may have been exposed and not sought treatment.
This program is led by Dr. Thumbi Mwangi and is funded by the Wellcome Trust, World Health Organization, Sanofi Pasteur, Kenyan national and local governments. The program collaborates with Kenya’s Zoonotic Disease Unit and organizations such as World Animal Protection, World Organization for Animal Health (OIE), the Sharon Live-On Foundation, among others.
For more information on Global Health Tanzania and the Rabies Free Tanzania Program visit here.
Wildlife and Livestock Disease Surveillance
Allen School researchers are engaged in a study to identify ways to track infectious disease outbreaks in real time. Utilizing a mobile phone application created by Texas A&M University, wildlife officers in Kenya report disease while in the field. They then have access to real-time feedback on disease in the area to identify trends. Prior to this project, no systematic information was known about Kenyan wildlife diseases.
The mobile phone application is also being used by field veterinarians to report livestock diseases. The livestock reporting app is being piloted in four regions where the field veterinarians using it receive real-time feedback on infectious disease trends in their area before visiting the next farm. This allows them to make recommendations based on prevalence of disease in the area. After expanding the program across the country, the next phase will include data transmission to regional human health care leaders to identify zoonotic disease outbreaks at the outset.
In line with the global health security agenda, the real-time reporting from livestock and wildlife disease provides opportunities to prevent spillover to humans. Working with the Ministry of Health and county health departments, researchers can use this disease surveillance apparatus to intervene in disease outbreaks. The long-term objective is to utilize this application and surveillance model tracking of infections zoonotic disease globally within wildlife and livestock populations.
This program is in partnership with CDC Kenya and Food and Agricultural Organization of the United Nations (FAO).
Zika is a disease transmitted to people through bites from insects, most commonly from mosquitoes but it can also be spread from ticks and some flies. Adults that contract the disease usually show mild symptoms but infection during pregnancy can impede fetal brain development resulting in microcephaly.
Researchers from the Allen School are leading the largest Zika study in Sub-Saharan Africa, located in Mombasa, Kenya. Researchers are following approximately 3,000 pregnant women recruited from three hospitals in Mombasa through the course of their pregnancy to identify evidence of Zika virus infection and its outcome.
The study will provide data leading to evidence-based strategies to prevent Zika virus infection during pregnancy in Africa. It could also lead to vaccine introduction and improved counseling of patients about risks to their pregnancies and their children. The information will contribute to effective preparedness for health facilities providing services to affected children and families.
This program is in partnership with CDC Kenya.
H5N8 Influenza virus
The H5N8 Influenza virus is a highly pathogenic avian virus that has caused wild and domestic bird deaths in 35 countries in Asia, Europe, the Middle East, and Africa as of early 2017. The quickly spreading nature of this virus poses a major threat to poultry producers.
Researchers at the Allen School are conducting a study to understand the transmission of this strain of influenza between migratory wild birds and domestic poultry in order to find ways to break the transmission cycle. They are also looking to determine the extent to which H5N8 has already infected birds available in live bird markets in both urban and rural settings.
This project is in partnership with CDC Kenya.
Anthrax remains a regional health problem in East Africa. Anthrax persists in ecosystems resulting in loss of human and animal life if there is no intervention and is a solid example of the challenges to be addressed by better understanding the human-animal-environment interfaces.
In Kenya, more than 10 outbreaks of anthrax occur every year, leading to loss of livestock, wildlife, and sometimes human deaths. Cattle, sheep, goats, and camels die within a day of contracting the disease. Alternatively, humans show signs of illness, with the vast majority recovering. Dogs that scavenge the carcasses of deceased animals, generally show no symptoms.
Allen School researchers are using historical data and current outbreaks to develop an anthrax risk map for the country, and to discover the factors leading to outbreaks in specific sites, such as soil types, topography or vegetation. By utilizing this data, researchers will be able to identify opportunities for prevention and intervention to slow or stop the spread of Anthrax.
This project is in partnership with the United States Defense Threat Reduction Agency.
Antimicrobial Resistance (AMR)
The Allen School’s expertise in understanding how human-animal-environment interfaces contribute to the emergence and spread of disease makes it a natural leader of efforts to tackle antimicrobial resistance (AMR). AMR is particularly challenging in low- and middle- income countries where the most affordable antibiotics are the ones for which resistance is most common.
In East Africa our team has focused on identifying what behaviors, environmental exposures and other factors contribute to the risk of carrying gut bacteria that are resistant to antibiotics for both people and animals. This work has included diverse communities, from rural agricultural and pastoralist areas in northern Tanzania, to a densely populated informal settlement (Kibera) in Nairobi, Kenya.
Our Tanzania work has highlighted the importance of environmental transmission and the cultural factors. For example, Massai households that consume raw milk are at particular risk for having antibiotic-resistant gut bacteria. Boiling milk is not culturally acceptable, so we are introducing specially-designed thermometers that help people determine when milk has reached pasteurization temperatures. Early work shows that people are more likely to treat their milk when this option is available. We anticipate that this intervention will help improve milk safety, which will likely have important health benefits for children and pregnant women.
In Nairobi we have found that antibiotic use at the individual level is not linked to carriage of antibiotic-resistant gut bacteria, but the prevalence of these resistant bacteria is so high that the community may be completely saturated with these organisms. The most effective interventions in this case need to focus on ways to limit the transmission of these organisms within and between households. Transmission is also important between communities and hospitals, which is why we are preparing to conduct a colonization study to identify factors that influence how people are colonized with “high level resistance” (e.g., carbapenems) in Kibera and an associated hospital. We are also working to understand how antibiotics are used in the Kenyan health care system.
These programs are in partnership with the Centers for Disease Control and Prevention (CDC), and the National Science Foundation.
Drinking Water Quality & Safety
This Allen School project addresses the quality and safety of drinking water available to people in Kenya, especially in areas where people and livestock live in close proximity. The project will help understand two aspects of water quality in Kenya: what contaminants are in the water, and how contaminants move through the ecosystem.
A low technology test, microbial source tracking, is used to screen water sources and water available for drinking at households to distinguish contamination through livestock waste from that of human waste. These data are related to observed household morbidity to determine the contribution of water availability and safety, sources of contamination on incidence of diarrhea among children.
This project is in partnership with the Medical Research Council of the UK as a collaboration between University of Southampton, University of Brighton, Victoria Institute for Research on Environment and Development (VIRED) and the Kenya Medical Research Institute.