Key research areas and achievements of the KEMRI-Wellcome Trust Research Programme
Although malaria remains a major focus of research at the Programme, there are many complex interactions with other diseases and with predisposing factors at the individual, community or health system level.
Key research areas
Research at the Programme is organised under four broad themes:
- clinical sciences, including bedside research, developmental medicine and disability, and therapeutics
- epidemiological and human genetics research on infectious diseases, including malaria, HIV and pneumonia, and non-infectious diseases such as epilepsy, sickle-cell disease and malnutrition
- pathogen and vector biology, involving basic science research on immunity, pathogenesis and drug targets
- social, behavioural and public health research, where social scientists, health economists and others study the social and behavioural aspects of healthcare at different levels, helping to shape local policy.
Recent research includes a new global malaria atlas, studies on the clinical features and neurological effects of malaria, antimalarial drug resistance, treatments for acute respiratory infections, the natural history of sickle-cell disease, a large genetic birth cohort study, managing severe malnutrition, the management of paediatric HIV infection and the epidemiology of epilepsy. Working with the community, researchers are also looking at local perceptions of research and the consent process, helping to raise awareness of medical ethics in resource-poor countries.
Key achievements
The Programme has spearheaded efforts to quantify the burden and prevalence of malaria. The Malaria Atlas Project provides the first comprehensive description of the epidemiology and burden of the disease worldwide, at regional, continental and global scales. Meanwhile, studies have delivered the first comprehensive characterisation of severe malaria in African children, and provided evidence that the influence of HIV, severe malnutrition and bacteraemia are over-represented in severe malaria. Through the recently established Clinical Trial Facility, Kilifi served as one of two sites involved in a phase II trial of a new malaria vaccine candidate, RTSS, which has shown significant protection in young children. This has led to a phase II trial in which the Programme is also participating. Clinical and therapeutic research from the Programme directly informs the Kenyan government's guidelines for hospital care for children and newborns.
The Kenya Programme has contributed to the growing body of evidence supporting the use of insecticide-treated bed nets to prevent diseases, such as malaria, spread by mosquitoes. Researchers carried out one of the four large-scale trials on which current international policy is based, but the Programme has also demonstrated that millions of African children remain unprotected by the nets. Policy researchers have conducted extensive studies on paediatric admissions in health systems. They developed a 'shopkeeper training programme' for improving the treatment of childhood fevers in rural areas, which was adopted as a national programme and has had a major influence on programmes in other African countries. The Programme also helped the Kenyan Ministry of Health to establish its 2001 National Malaria Strategy and runs demographic surveillance survey as part of INDEPTH, an international organisation evaluating populations and their health in low- and middle-income countries.
