Pediatric Malaria, HIV-1, and Bacteremia Research in Western Kenya
Child with severe malarial anemia in Siaya (Kenya)
Dr. Perkins established research and training sites in western Kenya in 2002 to characterize the various clinical phenotypes that result in severe malarial anemia and to provide comprehensive clinical management of pediatric patients. By partnering with the Kenya Ministry of Health and KEMRI, he established the comprehensive infrastructure required for field-based investigations in Siaya, western Kenya, that currently investigate and clinically manage more than 1000 study participants. The following are highlights of additional activities:
- Established microbiology laboratories to diagnose and manage pediatric HIV-1 and bacteremia. The clinical research facility is located at the Siaya District Hospital pediatric ward. Siaya district is the poorest community in Kenya and also has the highest rates of morbidity and mortality in the country (ranging from 80 to 200 deaths per 1,000 births) due to infectious diseases, such as malaria, HIV-1, and bacteremia. This equatorial community also has one of the highest global rates of malaria in which residents receive up to 300 infective mosquito bites per annum.
- Established molecular-based laboratories at the Centre for Global Health Research with partners at KEMRI in Kisian, a site %7e48 km from the research facilities in Siaya. These facilities perform hematological analyses, parasitemia determination, immunological and genetic investigations, and evaluation of co-infections (e.g., HIV-1, bacteremia, and hookworm). Additional investigations are also focused on the nutritional, demographic, and environmental factors that contribute to the development of pediatric anemia.
- To enhance clinical management and delivery of services, the group also designed and implemented a novel computer-based medical informatics system. In addition, geographic information system (GIS) mapping is utilized to develop a geo-statistical model to investigate the spatial context of disease dynamics and to provide spatial-oriented infrastructure for follow-up of study participants. Several of the informatics systems have been combined into a common computer-based information system to provide a unique and novel methodology for analyzing the complex interactions between genetic, clinical, and environmental factors that influence pediatric infectious diseases.
- The project also established important intellectual capacity within Kenya for successfully investigating pediatric infectious diseases. This was achieved by implementation of the International Malaria Training and Research Program (IMTRP) funded by the Fogarty International Center (PI, Dr. Perkins).