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Military-Relevant Infectious Diseases Endemic to Kenya-Epidemiology, Immunology, Pathophysiology, Treatment and Prevention

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Annual rept. 1 Mar 2002-28 Feb 2003

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Major expansion in personnel and infrastructure took place in the first year of this Cooperative Agreement. Clinical research facilities for the evaluation of drugs and vaccines for malaria and HIVAIDS are under construction in Kisumu and Kericho, respectively. A Phase I trial MAL-024 in 40 malaria-exposed adults, demonstrated that MSP-1, was safe, well tolerated and immunogenic in this population. It also demonstrated that complex clinical trials can be successfully undertaken in our field sites. Laboratory studies demonstrated differences in the level of expression of CR1 and CD55 in children with severe malarial anemia and cerebral malaria versus their respective controls. Studies also showed an age-dependent pattern of expression of RBC complement regulatory proteins which increase from childhood to adulthood and that children with severe malaria have increased levels of immune complexes on their erythrocytes. Preparation for evaluating novel drugs and vaccines for HIVAIDS was undertaken. Local HIV clades were characterized and incidence levels determined. In addition, ARV protocols and networking with local health programs were initiated. The Molecular Malaria Laboratory conducted research aimed at understanding the molecular mechanisms of drug resistance. Identification of mutations that confer resistance will allow assessment of the severity of drug resistant malaria and provide indications as to the effectiveness of current and future anti-malaria therapies. The combined vector, environmental, and map database were used to address questions about malaria transmission focality. Maps of the site were constructed using the differential global positioning system GPS. On-site mosquito collections provided data for Entomological Innoculation Rates EIRs which indicated that the highest monthly EIR was 0.14, or an infective bite every three days in May. It was also determined that An. funestus tend to seek blood meals earlier than infective An. gambiae. 7

Subject Categories:

  • Medicine and Medical Research
  • Pharmacology

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