Community Studies of Viruses

Community based studies of major viral pathogens are undertaken to support epidemiological research of the Department and this work is undertaken in the absence of intervention introduction. Main interest focuses on respiratory viruses especially respiratory syncytial virus, influenza viruses, rhinoviruses and since the year 2020 SARS-CoV-2 virus. The aim of this work is to describe the natural history of infection, the patterns of transmission, and who acquires infection from whom,  to improve understanding of the mechanisms of persistence of these pathogens in the host population and the interaction of infection and population immunity against circulating virus strains.

Community studies of RSV have established a broad area of research to improve the understanding of the disease burden verses cost effectiveness of intervention strategies such as maternal immunization and use of prophylactic monoclonal antibodies among infants. This is to help the government to make an informed decision for investing on these interventions when they become available. Another RSV workstream investigating programmatic and other maternal factors for a successful implementation of a maternal RSV vaccine has been developed which aims to guide policy development for introduction of new maternal vaccines in Kenya.

The community studies for SARS-CoV-2 within households, aims to gain an understanding of how SARS-CoV-2 virus is transmitted among household contacts of PCR-confirmed cases of COVID-19, the duration over which an infected person can transmit or spread the virus to others, and how this relates to symptoms, rate of secondary infections in the household, and associated risk factors, who acquires infection from whom in the household and proportion with evidence of past exposure to the virus. The SARS-CoV-2 surveillance in the outpatient of health facilities aims to improve our understanding of the patterns of spread of SARS-CoV-2 and the associated factors within KHDSS area. Sequencing for all SARS-CoV-2 PCR positive samples is ongoing to investigate the chains and patterns of spread of the virus strains within the KHDSS community. All this knowledge will help in designing better strategies to prevent spread of the virus within the County.

Future research
Discussions are under way for possibilities of introducing vaccine trials to prevent severe RSV associated disease among infants. Although, this is still on very initial stages, the interventions are expected to be of much benefit to the community which has been part of the respiratory viruses surveillance for over two decades.

Investigators :  James Nokes, George Githinji, Charles Sande, Charles Nyaigoti (Bioinformatist) and Joyce Nyiro