CIPDCR research pursuits are intended to contribute to health improvement by positively influencing policy making and implementation science.
Clinical and Laboratory Service
From 1947 the centre has built a reputation in the clinical management skin ailments. The clinical trials that led to the current WHO approved regimen for leprosy management were conducted in the centre. Our research in the 21st centuary has focused on infectious and parasitic diseases. The centre runs an outpatient clinic through which we run our daily clinical services offering evidence-based prevention and treatment. Being the first place of contact with patients, this unit is involved in enrollment of subjects for various research protocols. Current recruitment activities are in support of USAMRUâ‚¬â„¢s Flu Surveillance and Acute Febrile Illness projects and CNHR funded Arboviruses research.
The clinic offers superlative clinical services and serves as a referral health centre for most clinical diseases in the region. Alongside the clinical research we provide medicine at a subsidised price to patients in our well stocked pharmacy.
KEMRI in collaboration with other stakeholders and partners are working to identify the HIV-infected children early, prior to the development of clinical disease, to ensure quick intervention and treatment. The health interventions can be put in place through growth monitoring, developmental monitoring, counseling and education on infant feeding, opportunistic infections prophylaxis and determination of infection status. The Early Infant Diagnosis (EID) program was born from the realization that children below 18 months may not benefit from HIV testing in Kenya and yet they are at risk of getting the virus through their mothers. Although HIV positive mothers can pass the HIV virus to their unborn children, it is not always a guarantee that they will have infected children but they may have the HIV antibodies. Hence this test accurately tests for the virus not the antibodies and thus more accurate for all children born from HIV positive mothers in the whole country.
In collaboration with National Aids and STD Control Programme (NASCOP), National Public Health Laboratories (NPHLS), The Walter Reed Project (WRP), The Clinton Foundation Health Access initiative (CHAI), Centres for Disease Control and Prevention (CDC), International Centre for AIDS Care and Treatment Programs (ICAP), and Academic Modelling Providing Access to Healthcare (AMPATH), KEMRI has since 2006 worked on the study for Early Infant Diagnosis (EID) of HIV in Kenya which is currently being coordinated by the Centre for Infection and Parasitic Diseases Control (CIPDCR), in Alupe-Busia. EID begun in Kenya in 2005, on a small scale in Nairobi and Busia, but has now expanded and covers the entire country. There are currently four main laboratories that carry out Early Infant Diagnosis in the country. These are Nairobi (KEMRI-CVR lab), (KEMRI-WRP CRC lab), Kisumu (KEMRI-CDC Lab) and Busia (KEMRI-ALUPE Lab).
There is currently a coordinated plan to scale up the number of testing laboratories in the country. The EID Project Management Board has negotiated support from Hewlett Packard (HP), Clinton Foundation and other partners that will eventually total approximately US $ 3 million (Kshs. 240 million) to strengthen selected components of KEMRIâ‚¬â„¢s and other partners IT infrastructure capacity in order to support data management for the EID Project . The actual support pledged would include the assembly of a data centre in KEMRIâ‚¬â„¢s Alupe Research Station complete with servers, structured cabling, biometrics and fire suppression capabilities. The emergence of HIV drug resistance is a complex and multifaceted problem, whose true extent has not been described in Kenya. ARV resistance surveillance is a necessary component of rational ARV drug use. Screening pediatric HIV positive samples that arrive in our laboratory for drug resistance, using an anonymous, unlinked identification algorithm. The Information we generated provides to policy makers and other stakeholders in antiretroviral therapy in order to guide rational drug use in pediatric HIV treatment.
Emergence of arboviruses goes undetected most times by the fact that they show similar symptoms with other Tropical fever. Novel diagnosis of this Life threatening infections is important to save life. Currently a seroprevalence study of Dengue-2, Chikungunya, Yellow Fever, Onyong nyong, West Nile Virus and Rift valley fever is being undertaken by various scientists based in Alupe-CIPDCR. We have several study sites spread across the country.
Effective and Efficient diagnosis is key in the management of diseases. Technological advancement has played a key role in the management of health systems. Point of care devises continue to gain popularity due to their ease of use, feasibility and efficacy. One such kind is the PIMA point of care device. The PIMA is a portable analyser, a bench top fixed volume cytometer used for the processing and analysis of the PIMA cartridge. It is designed to measure CD4+ T-cells, absolute Count for the immunological assessment of HIV/AIDS patients in a laboratory and non-laboratory environments. It can be operated using external power or an onboard rechargeable battery. Although this technology is being used in some countries and has generated results comparable to already existing technologies, PIMA has not yet been rolled out in Kenya.This portable devise is still under evaluation in project launched in January 2011.When approved it will be very useful in the management of HIV+ patients who need to be placed under ART therapy . It will reduce the time taken by clinicians to determine commencement of ART treatment. This project is being carried out in collaboration with the Clinton foundation and Allere Corporation, the manufacturer of the device. The device has GSM technology which has enabled partners to monitor and evaluate events from different locations.
GENERAL MICROBIOLOGY RESEARCH
Fungi infection is one of the research programs that is carried at the Centre for Infectious and Parasitic Diseases Control Research (CIPDCR). Although the fungi infection is one of the neglected diseases globally, it is very common in general population and the extent of the increase in Africa is unclear. The manifestations can be very extensive and have unusual morphologies. KEMRI in collaboration with eminent researchers from Nagasaki and Chiba Universities in Japan are working the modalities of improving the existing system of conducting basic, epidemiological and clinical research in fungi infection, with results feeding directly into local and international health policies. We also, aim at capacity building and training to build scientific leadership in the area of mycosis in Kenya which will be co-ordinated by the Center for Infectious and Parasitic Diseases Control Research (CIPDCR) in Alupe, Busia, Kenya.