A new project led by Judd Walson, a professor of global health at the University of Washington Schools of Public Health and Medicine, has received nearly $1.4 million from the Bill & Melinda Gates Foundation to monitor the spread of the coronavirus disease 2019 (COVID-19) in Africa and how it effects vulnerable populations.
Walson and the Nairobi-based Childhood Acute Illness and Nutrition Network (CHAIN) – an established research network that has laboratory and data management capacity at nine sites across Africa and South Asia – will investigate how COVID-19 effects vulnerable children and adults, health care workers and researchers in low- and middle-income country settings.
"CHAIN researchers, who work closely with ministries of health in Africa, will be able to use the research findings to help inform public health practice in Africa – and ultimately globally in low-resource settings,” said Walson. “The research will help to support health facility leadership and health care workers who are doing heroic work to protect vulnerable communities and slow the spread of the disease.”
In many African countries, the health system infrastructure is not equipped to identify or manage COVID-19 cases. Other factors, such as poverty, high urban population density and lack of high-quality infection control measures could potentially worsen the spread of virus. To make matters worse, many populations in Africa also have high rates of cardiovascular and pulmonary disease, poor nutritional status, HIV infection, tuberculosis and diseases such as malaria and diarrheal disease.
Beginning this month, the project will obtain personal protective equipment and conduct training with CHAIN researchers in Kenya to systematically collect and analyze COVID-19 health data. Four facilities in Kenya (Migori, Kilifi, Kisii and Homa Bay) will use the data collection system, and researchers hope to begin testing for COVID-19 within weeks.
The project will study the outcomes of highly vulnerable patients with COVID-19 – including those with HIV, malaria, tuberculosis and malnutrition – by monitoring trends in geography, case severity and fatality and risk factors for mortality. The second phase of the project will investigate whether fecal shedding plays a role in COVID-19 transmission.
This project is a collaboration with the Kenya Medical Research Institute (KEMRI), the KEMRI/Wellcome Trust Research Programme Clinical Information Network, the University of Oxford and the UW. Through these collaborations, CHAIN will have access to up to an additional 26 county hospitals in Kenya, and can help embed rigorous clinical research into the broader Kenyan Ministry of Health response to COVID-19.