Building Laboratory Diagnostic Capacity for Zoonotic Disease Risk Mitigation In Underserved Arid and Semi-Arid Areas of Kenya

Emerging and re-emerging infectious diseases pose serious and ongoing threats to public and veterinary health, both locally and globally. Additionally, the pathogens that cause these diseases provide targets for biological weapons. It is clear that a large majority of emerging pathogens are zoonotic, necessitating a One Health type of approach for detection and control. Analysis of past emergence events makes it clear that there is inevitably a lag period, sometimes
several months long, between the first few cases of a disease and a recognizable outbreak, which makes surveillance and early recognition of emergence of great importance. The geographic focus of the project we propose is the arid and semi-arid lands (ASALs) of Kenya, which has received scant attention with regard to developing the infrastructure and work force necessary for human and animal disease surveillance and diagnosis. We propose a comprehensive program that will focus on three major objectives that are designed to be complementary and sustainable:

1) Develop a disease-reporting system based on mobile computing in two counties of Kenya and focused on rural outpatient clinics (dispensaries) where emergence is most likely to first be detectable. The system will incorporate automated detection of incipient outbreaks and potential bio-threat events that will trigger alerts to medical authorities. We will also evaluate a telemedicine approach to provide enhanced diagnosis and control of disease in the remote areas under surveillance.

2) Provide broad-based capacity building to institutions and individuals in Kenya to enhance diagnostic expertise, reduce time to diagnosis, and establish acceptable biosafety and biosecurity practices. Major targets for capacity building will be the hospital laboratories in Kajiado and Isiola counties that are being renovated by DTRA, but will extend also to dispensary personnel and first responders.

3) Perform targeted surveillance for major zoonotic threats, including pathogen discovery, characterization of the epidemiology of those diseases, and work toward techniques to mitigate pathogen transmission and human infection. Core project personnel will consist of scientists from Colorado State University, the University of Nairobi, and county health and veterinary sector staff. This project is designed to provide not only a sustainable and expandable bio-surveillance system, but to deliver substantive scientific advances for detection and mitigation of emerging infectious diseases.