NEGLECTED TROPICAL DISEASE UNIT (NTD)

ABOUT NTD UNIT

The Neglected Tropical Diseases (NTD) Unit hosted at CGHR brings together different researchers working on disease specific aspects of NTDs at KEMRI. The Unit addresses the critical need to align research program with national and current global agenda.

Neglected tropical diseases (NTDs) are a group of chronic disabling infections affecting more than one billion people worldwide, mainly in Africa and mostly those living in remote rural areas, urban slums or conflict zones.

Beyond their negative impact on health, NTDs contribute to an ongoing cycle of poverty and stigma that leaves people unable to work, go to school or participate fully in family and or community life.

They range from Trypanosomal parasites (Leishmaniasis, Human African Trypanosomiasis, Chagas disease /American trypanosomiasis); Helminth parasites (Schistosomiasis, Lymphatic Filariasis, Onchocerciasis, Drancunculiasis, Echinococcosis, Taeniasis/Cysticercosis, Ascariasis, Trichuriasis, Hookworm, Strongyloidiasis); Bacterial infections (Leprosy, Buruli ulcer, Noma, Trachoma, Cholera, Yaws) and Viral infections (Yellow fever, Dengue fever, Japanese Encephalitis, Rabies).

The diseases are called neglected because, compared with malaria, HIV and TB for example, they have received relatively much less funding or attention from national governments and medical and donor communities despite the vast numbers of people affected.

Lacking a strong political voice, people affected by these tropical diseases have a low profile and status in public health priorities. Lack of reliable statistics and ‘unpronounceable’ names of diseases have all hampered efforts to bring them out of the shadows.

Neglected Tropical Diseases (NTDs) are a devastating obstacle to human settlement and socioeconomic development of already impoverished communities. A growing body of evidence demonstrates that control of these diseases can contribute directly to achievement of several Millennium Development Goals (MDGs).

Interventions against NTDs mostly in the form of mass distribution of medicines donated by pharmaceutical companies have already benefited millions of people, protecting them from physical pain, disability and poverty. Over the past decades, the World Health Organization (WHO), together with its partners, has formulated an innovative strategy to ensure cost-effective, ethical and sustainable control towards elimination or eradication of several NTDs.

major challenges for controlling NTDs and zoonoses

  • Sensitivity of current copromicroscopy methods is sufficient for informing early stages of control (mapping and monitoring impact of Mass Drug Administration – MDA), but is inadequate when infections are reduced to low levels by MDA to inform late stages of control (decision to reduce or stop MDA and post-elimination surveillance), underscoring the urgent need to develop more sensitive alternative diagnostic tools
  • Need for effective alternative medicines and pesticides to mitigate against any potential resistance to monotherapies such as Praziquantel (PZQ) used against schistosomes.
  • Provision of treatment and other interventions free of charge to communities in need
  • A system for delivery of medicines to cover the entire at-risk population
  • Lack of a suitable PZQ pediatric formulation
  • Promotion of integrated vector management
  • Advocating an intersectoral, interprogrammatic approach to control of NTDs
  • Early protection of children
  • Post-implementation surveillance and monitoring
  • Need for capacity building for increasing pool of researchers in NTDs

Our research in western Kenya region has mainly focused on Schistosomiasis and Soil-Transmitted Helminths (STH), addressing some of the pressing challenges outlined above.

ONGOING PROJECTS

Study Title SERU Principal Investigator (PI)
Identification of genital schistosomiasis due to S. mansoni and association with HIV among women of reproductive age in Rarieda district, western Kenya 2937 Huldah Sang
Randomized controlled trial of the impact of mobile phone delivered reminders and travel subsidies to improve childhood immunization coverage rates and timeliness in western Kenya 2409 Dr. Frank Odhiambo.
Comparison of School-based MDA Delivery Strategies for Control of S. mansoni Infections in Western Kenya with 10-24 % prevalence 1800 Dr. Diana Karanja.
Genetic basis of Praziquantel resistance 3218. Dr. Eric Ndombi
Role of 1gE in human schistosomiasis (RO1) 3025 Dr. Pauline Mwinzi
Effect of Schistosoma mansoni infection on incidence of plasmodium falciparum malaria among 1-5 year old children in Western Kenya (MERCK-PSAC) 3245 Dr. Pauline Mwinzi
Effect of Mass Drug Administration on morbidity/resistance to schistosomiasis in school age children Dr. Diana Karanja

Effect of schistosomiasis on vaccines

  1. BCG, DPT, HepB, MCV,
  2. Meningococcal, Tetanus, Hep B
Dr. Diana Karanja
Impact of Mass Drug Administration for control of Schistosoma mansoni infections in Kisumu, Siaya and Homa bay Counties, Kenya: Understanding factors associated with sustained high prevalence in some areas despite repeated high treatment coverage (Sm2A) 3267 Rosemary Musuva
Defining cut-offs for the Point-of-Care Circulating Cathodic Antigen (POC-CCA) assay in areas of low Schistosoma mansoni prevalence in western Kenya 3279 Dr. Maurice Odiere
Control of Schistosomiasis in an Urban setting in western Kenya: Closing the gap through targeting street children 3042 Dr. Pauline Mwinzi
Randomized controlled trial of the impact of the mobile phone delivered reminders and unconditional travel subsidies on measles vaccination in western Kenya: The mobile and scalable innovations for measles immunization (M-SIMI) trial 3311 Benard Omondi Ochieng
Randomized controlled trial of the impact of the mobile phone delivered reminders and unconditional travel subsidies on measles vaccination in western Kenya: The mobile and scalable innovations for measles immunization (M-SIMI) trial 3311 Benard Omondi Ochieng
Estimating Effective Vaccination Coverage with Immune Markers: Validation of anti-tetanus toxoid IgG and anti-measles IgG assays for use with dried blood spots and oral fluid samples in western Kenya 2855 Dr. Maurice Odiere
Capturing the impact of an integrated control program for schistosomiasis and soil-transmitted helminthes through monitoring of prevalence and morbidity in high prevalence areas of Western Kenya 2185 Dr. Maurice Odiere
Comparison of school and community-based mass drug administration delivery strategies for control of Schistosoma mansoni infections in western Kenya in areas with >25% prevalence (SCORE SM2) 1820 Dr. Pauline Mwinzi
Persistent Hot-spot Intervention Strategies in SCORE Sm2 Study Sites (Sm2B) 3423 Dr. Maurice R. Odiere
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