AKU’s Department of Population Health in Nairobi aims to shed light on the epidemiology of the novel coronavirus in rural sub-Saharan Africa through a pair of studies conducted in Kenya’s Kilifi County, where the University has been working to track and improve health for years.
The studies will help to establish the virus’s transmissibility, how long antibodies against it last, rates of asymptomatic infection, risk factors for infection and more. They will also provide information on participants’ compliance with preventative measures and willingness to get vaccinated. And they will assess the performance of a new device that makes it possible to capture blood samples and store them for antibody testing at a later date, without the need for cold storage. With Nanjing Biopoint’s VLPlasma device, health workers take blood with a fingerprick and a dried plasma spot is stored for future analysis.
“We don’t really know what level of exposure there has been in these rural communities,” said Professor Stanley Luchters, Chair of the Department of Population Health and the study’s principal investigator in Kenya. “It could be that 60 percent have been exposed, but maybe it’s 10 to 15 percent and they’re at risk for new waves. It’s also important that our understanding of the virus reflects its behaviour in diverse settings.”
The first study is a small household cluster survey. In households where one member has tested positive for the virus, researchers will test all members for the virus and take blood samples on a weekly basis for 28 days. Part of the purpose is to determine the reliability of the VLPlasma device, which will be done by testing both dried plasma spots and blood drawn in standard fashion from each subject. An identical study is being conducted in South Africa by the University of the Witwatersrand.
The second study involves conducting periodic testing of roughly 1,600 individuals in 487 households to determine how many have antibodies to the virus as a result of a past exposure and how many have new infections. Testing will be conducted every six weeks for six months, and other health data will be collected simultaneously. The households have been randomly selected from 18,000 households that AKU visits every six months as part of its ongoing health and demographic surveillance project in the Kaloleni/Rabai area of Kilifi. Both studies follow the standardized UNITY protocols for COVID-19 seroepidemiological investigations developed by the World Health Organization. The protocols are meant to facilitate research that is comparable across countries, helping to rapidly answer key questions about the virus.
AKU’s local collaborators are the Kilifi County Department of Health, the Kenya Medical Research Institute-Kilifi and the Aga Khan Health Services. Its international partners are Heidelberg University’s Heidelberg Institute of Global Health, the University of the Witwatersrand’s Wits Reproductive Health and HIV Institute, the Burnet Institute in Australia, Nanjing Biopoint in China and the Barcelona Institute for Global Health. The studies are funded by the European & Developing Countries Clinical Trials Partnership.