CARDIOVASCULAR RESEARCH

INTRODUCTION

Cardiovascular disease is the leading cause of non-communicable disease-related deaths in Kenya.

Our research team focuses on research on cardiometabolic conditions including Biomedical, genomics and regenerative science, public health and health systems, implementation science and clinical research and precision medicine for key conditions like hypertension and stroke, diabetes, sickle cell disease, and renal diseases. Our research takes a comprehensive view to these conditions, recognizing that their control requires a multifaceted approach and recognizes their influence to the burden of these diseases that examines biological, social and health system influences that contribute to the escalating burden of these diseases.

We make use of a variety of platforms and infrastructure to conduct our work, enabling accrual and follow-up. These include:

  • Advanced health demographic surveillance systems.
  • Clinical care and trials facilities.
  • Clinical and advanced research laboratories.
  • Imaging facilities.

We conduct observational as well as interventional studies including clinical trials of complex interventions. We have a particular interest in determining unique local factors such as the high prevalence of infectious diseases that could be contributing to the development of cardiometabolic conditions. We also conduct implementation research aimed at facilitating the uptake of evidence-based practices into routine activities.

Our Research activities are spread throughout Kenya, and other parts of Africa where we collaborate with international researchers to increase the impact of our work.

Our researchers continually engage with various stakeholders to ensure that the work we do is driven by needs and is able to influence policies aimed at reducing the burden of cardiometabolic conditions.

FLAGSHIP PROJECTS

The HEKIMA Study

Project title: Strengthening the primary care system for prevention and control of cardiovascular diseases in Kenya: feasibility study of health kiosks in community markets.

Project Description

Cardiovascular diseases lead non-communicable disease (NCD)-related mortality in Kenya. Access to health services remains a challenge prompting the need for innovative community-based initiatives that interface with health systems. Community markets are social establishments with untapped potential to promote public health and interventions.

The Health Kiosk in Markets (HEKIMA) is a theoretically driven multi-phased feasibility study in Vihiga County (Kenya) that explores whether kiosks in community markets, manned by community health promoters (CHPs) and supervised by nurses, can support prevention and management of cardiovascular diseases. HEKIMA was co-developed with multi-sectoral community stakeholders including the county government (Health, Trade, Land and Physical Planning, Environmental, Health, Agriculture), the business community (market traders, farmers), NGOs, primary care professionals (CHPs, nurses, medical officers, health promotion and public health officers, patient groups) and market users.

CHPs were trained to conduct simple tests to assess CVD risk such as measuring blood pressure, weight, and using culturally appropriate methods to promote adherence to medication, attendance to clinic appointments, and promote healthy eating and active lifestyles. Market and patient champions promoted kiosk engagement in the community.

Owing to the project’s success, the HEKIMA were fully integrated into community health services and are now formally recognized as primary level facilities focused on disease prevention and health promotion. Study findings are expected to support guidance on how the Kenyan health system and communities can work together to combat NCDs, and the transferability aspects.

Learn more: https://www.kemri.go.ke/hekima/

KEY OUTPUTS

Kenya National Guidelines for the Management of Cardiovascular Disease, 2024.

PUBLICATIONS
  1. Lydia Kaduka, Joanna Olale, Joseph Mutai, Elia Christelle, Schiller Mbuka, Rodgers Ochieng, Boniface Oyugi, Chrispine Oduor, Majella O’Keeffe, Harriet Boulding, Jamie Murdoch, Divya Parmar, Gilbert Kokwaro, Elijah Ogola, Kennedy Cruickshank, Erastus Muniu and Seeromanie Harding. Readiness of primary healthcare and community markets for joint delivery of cardiovascular disease prevention services: An observational feasibility study of Health Kiosk in Markets “HEKIMA” in Kenya. BMJ Open 2024. Article in Press
  2. Fannie Lajeunesse-Trempe, Marie-Ève Piché, Lydia Kaduka, Juan Ricardo Lopez y Taylor and René Crocker Sagastume. Moving from helicopter research to proximity research and capacity building. Trends in Endocrinology and Metabolism 2024. Article in Press
  3. Lajeunesse-Trempe F, Boit MK, Kaduka LU, Lucia-Rolfe E, Baass A, Paquette M, Piché M, Tchernof A & Christensen DL. Validation of the Fatty Liver Index for identifying non-alcoholic fatty liver disease in a Kenyan population. Journal of Tropical Medicine and International Health2023; 1-9. org/10.1111/tmi.13927
  4. Kaduka Lydia, Olale Joanna, Karamanos Alexis…Harding Seeromanie. Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions: Evidence from a mixed methods observational study in Busia and Mandera Counties. BMJ Open 2023;13:e062686. doi:10.1136/bmjopen-2022-062686
  5. Kastberg SE, Lund HS, de Lucia- Rolfe E, Kaduka LU, Boit MK, Corpeleijn E, Friis H, Bernard S, Paquette M, Baas A, Rasmussen JJ & Christensen DL. Hepatic steatosis is associated with anthropometry, cardio- metabolic disease risk, sex, age and urbanisation, but not with ethnicity in adult Kenyans. Trop Med Int Health 2021; 00:1–9. doi: 10.1111/tmi.13696
  6. Kaduka L., Muniu E., Mbui J., Oduor Owuor C., Gakunga R., Kwasa J., Wabwire S., Okerosi N., Korir A., & Remick S.C. Disability-adjusted life years due to stroke in Kenya. Neuroepidemiology 2019; doi 10.1159/000498970.
  7. Lydia Kaduka, Erastus Muniu, Chrispine Oduor, Jane Mbui, Robai Gakunga, Judith Kwasa, Sylvanus Wabwire, Nathan Okerosi, Anne Korir, Scot Remick. Stroke mortality in Kenya’s public tertiary hospitals: A prospective facility-based study. Journal for Cerebrovascular Diseases 2018; 8:70-79.
  8. Lydia Kaduka, Anne Korir, Oduor Chrispine Owuor, Judith Kwasa, Sylvanos Wabwire, Robai Gakunga, Nathan Okerosi, Yvonne Opanga, Isaac Kisiang’ani, Mercy Chepkurui Rotich, Jane Mbui, Erastus Muniu, Scot C.Remick. Stroke distribution patterns and characteristics in Kenya’s leading referral hospitals: Kenyatta National Hospital and Moi Teaching and Referral Hospital. Cardiovascular journal of Africa 2018; 29(2):68-72.
  9. Sharon N. Mokua, Lorraine Ombogo, David Mathu, Prisca Otambo, Lilian Nyandieka, Stephen N. Onteri, Schiller J. Mbuka, James Kariuki, Ismail Ahmed, Violet Wanjihia, Joseph Mutai, Zipporah Bukania. (2024)“For a man to go to hospital, then that would be his last option”: A qualitative study exploring men’s experiences, perceptions and healthcare needs in the implementation of Universal Health Coverage in Kenya. PLOS Glob Public Health 4(5): e0002925.
  10. Edgar Okoth, Violet Wanjihia and Zipporah Bukania. Micronutrient Nutrition Perspectives for Low Income Countries in the Context of COVID-19. J Fam Med Dis Prev. 2021; 7:139

OUR TEAM

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Dr. Lydia Kaduka

Dr. Kaduka is a Principal Research Scientist at Centre for Public Health Research, Kenya Medical Research Institute. Her formal doctoral training is in Medical Biochemistry, and she pursued post-doctoral training in Healthcare Management. Her work has largely focused on cardiovascular diseases and health systems research, and has published widely on inequalities in health, nutrition and cardiovascular epidemiology. She has served as PI/Co-PI/Co-investigator on numerous projects, and led research teams, mentored young investigators, and provided scientific direction in her line of work.
She has contributed to policy and practice development. She serves on various global and national committees such as the UK NIHR Global Health Research Groups Committee, the Kenya National CVD Technical Working Group, the Kenya Commission for University Education Review Panel and various advisory boards. She is the immediate Chair of the Kenya MOH CVD research, monitoring and evaluation committee. She has contributed to the development of various policies including the Kenya National Research for Health Framework 2030, the Kenya National NCD strategic plan 2025/26 and the Kenya National Guidelines for the Management of cardiovascular diseases 2024.

https://orcid.org/0000-0001-8746-0533

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Prof. Anthony O. Etyang

Head of Cardiometabolic Theme, Kenya Medical Research Institute.
Head of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme

Anthony O. Etyang is an Assistant Principal Research Scientist at the Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute and an Associate Professor in the Nuffield Department of Medicine, University of Oxford. He currently heads the Department of Epidemiology and Demography at the KEMRI-Wellcome Trust Research Programme.

He trained in Internal Medicine at the University of Nairobi followed by MSc and PhD training in Epidemiology at the London School of Hygiene and Tropical Medicine.

His work primarily focusses on hypertension where he has and continues to lead several projects looking at topics such as accurate measurement of blood pressure, interactions between hypertension and infectious diseases such as malaria, and community-based approaches to improving the control of hypertension. Additionally, he has extensive experience conducting large scale epidemiological studies as well as clinical trials covering several countries in Africa.

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Prof. Violet Wanjihia

Violet Wanjihia is a Senior Research Scientist based at the KEMRI Centre for Public Health Research. She has over twenty years of research experience in Public Health, Nutrition and Maternal Child Health. Her research interests are in Public Health Nutrition, Non-communicable diseases, Nutritional Programming and Drug addiction. Her current research focuses on data protection and privacy in ehealth research, mhealth technologies for maternal and child Nutrition. She also seeks to establish the role of maternal factors in contributing to Non-communicable diseases susceptibility in offspring later in life (Nutritional Programming). She is also engaged in teaching and supervising post-graduate students at the KEMRI Graduate School under the ITROMID Programme and also within Nagasaki University, Institute of Tropical Medicine where she is also involved in collaborative research as well as being a visiting associate professor.
Violet is also a reviewer for several scientific journals (EAHRJ, EASci),in addition to being a Japan Society for Promotion of Science (JSPS) Research Fellow.
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Dr. Jane Mbui

Jane Mbui is a specialist in internal medicine and epidemiologist with 30 years’ experience in clinical trials, epidemiology and operational research. She is trained in good clinical practice (GCP), bioethics and as a WHO-trained clinical monitor has monitored several clinical trials. She has been involved in epidemiological research in stroke, diabetes and hypertension, notably stroke incidence, risk factors and mortality in Kenya’s leading public tertiary hospitals.
  1. Dr. Veronica Manduku
  2. Dr. Zipporah Bukania
  3. Dr. Fredrick Kirui
  4. Prof. Charles Obonyo
  5. Dr. Lynn Nyamwoso
  6. Dr. Dorcas Wachira
  7. Dr. Linus Ndegwa
  8. Dr. Linnet Ongeri
  9. Dr. Jane Ong’ang’o
  10. Dr. Prisca Otambo