Outline of the Project

Project Name

The Project for Development of Rapid Diagnostics and the Establishment of an Alert System for Outbreaks of Yellow Fever and Rift Valley Fever in Kenya

Country

Kenya

Date of R/D Signed

December 14, 2011

Term of Cooperation

January 31, 2012 to January 30, 2017

Implementing Organization

Ministry of Health (MoH) /Kenya Medical Research Institute (KEMRI)

Organization for the Joint Research

Nagasaki University

Background

Outbreaks of arthropod-borne viral (in short, arbovirus) infections such as yellow fever (YF) and Rift Valley fever (RVF) are periodically reported in Kenya and its neighboring countries. YF outbreaks occurred in 1992-1993 at Kerio Valley, Western Kenya (at least 55 clinical cases, 29 died, Case Fatality Rate (CFR): 52.7%), and in 2005, Southern Sudan (555 clinical cases, 142 died, CFR: 25.6%). RVF outbreaks occurred in 2006-2007 in Kenya, Somalia and Tanzania (1062 clinical cases, 315 died, CFR: 29.7% among three countries). The most recent outbreak of RVF seems to have started from Kenya in November, 2006, and then spread to Somalia and Tanzania. In all the outbreaks, it took several days for diagnosis to be confirmed in humans and livestock.

Most arboviruses are normally maintained in nature, such as jungle, however, it suddenly come into human society and spread. To control the disease infection, it is considered that early detection of infectious cases to implement emergency vaccinations and vector control after cases are confirmed (so-called "early containment" measures) are much effective than periodic vaccination. However, simple rapid diagnostic test kits for YF and RVF are not commercially available; thus, most countries where there is outbreak of those diseases are required to acquire simple diagnostic test by themselves. Furthermore, in Kenya, even though a reporting system exist, such as a surveillance information delivery from local medical institution to a national level, a surveillance information on yellow fever and Rift Valley fever is not functioning. Therefore, an alert system for outbreak is also desired, which is suitable and sustainable for the socioeconomic infrastructure in those countries.

To control arbovirus infection is a common challenge in East Africa; therefore, the approach, developing rapid diagnostic test and alert system model, implemented in the Project shall fit in the situation of socioeconomic situation of East African countries including Kenya and it is expected to contribute to control infectious disease.

Project Purpose

Outbreak containment system of YF and RVF is strengthened in Kenya through the development of rapid diagnostics and establishment of a sustainable outbreak vigilance and response mechanism.

Outputs

1. Rapid diagnostics (test kits) for YF and RVF are developed in collaboration between researchers from Kenyan and Japanese sides
2. Advanced rapid and accurate reference activities are in place and functional in KEMRI headquarters as well as CIPDCR-KEMRI (Alupe) in collaboration between Kenyan and Japanese sides
3. Bidirectional early vigilance and rapid response mechanism model for YF and RVF outbreaks is established and evaluated in collaboration with MOH officials, selected health facilities officials and JICA Experts

Activities

Output 1

1-1	Preparation of reference antigens of YF and RVF by large-scale cell culture systems
1-2	Preparation of genetically-engineered antigens of YF virus and RVF virus　for development of antibody-detecting rapid diagnostic test kit
1-3	Production of conjugated monoclonal and polyclonal anti YF virus and RVF virus antibodies
1-4	Production of rapid diagnostic test kits for point-of-care (POC) testing of YF and RVF using immunochromatography technology
1-5	Preparation of ELISA tests for YF and RVF as higher reference diagnostics

Output 2

2-1	Strengthening reference capacity for rapid confirmation of YF and RVF at KEMRI headquarters
2-2	Establishment of primary reference capacity for confirmation of YF and RVF at CIPDCR-KEMRI (Alupe)

Output 3

3-1	Integration of YF and RVF outbreak response network model into the existing communicable diseases response system in MOH/DDSR (Division of Disease Surveillance and Response)
3-2	Set up the mobile phone linked to network of selected health facilities and laboratories in Central, Coast, Nairobi, North Eastern, and Western Provinces
3-3	Conduct outbreak report and response simulation including table-top exercises in collaboration with DDSR, KEMRI, selected health facilities and other relevant agencies
3-4	Verify the effectiveness of the novel outbreak vigilance and response system on spreading rate of communicable diseases and its responses by evaluating the data from the simulation in 3-3
3-5	Revise and finalize the Operational Manual on the basis of the assessment results from the test operations and the simulations

Inputs

Japan

Dispatch of Experts:

• Long term expert (1)：Project Coordinator
• Short-term expert (4)：Chief Advisor, Development of Rapid diagnostics, Establishment of alert system, Development of test kits

Training in Japan：1-2 researcher(s) for 2 months per year
Equipment and materials
Overseas Activity Expense

Kenya

Services of counterpart personnel
Suitable office, laboratory and research space with necessary equipment
Available data, clinical specimens and information related to the Project Running expenses necessary for the implementation of the Project