ED

Epidemiology and Demography

We undertake work on invasive bacterial disease (focusing on pneumococcal disease), human genetic factors (focusing on genetic red cell abnormalities and host susceptibility to malaria) and viral epidemiology and control (focusing on transmission of pathogens in the community at local, national and international scales). We provide strategic direction to the Surveillance Research Platform.

We have had a major input in evaluating the effectiveness and wider impact of the pneumococcal conjugate vaccine (PCV10) in Kenya, including studies of the effect on carriage, invasive disease, burden of pneumonia and pathogen structure. We are expanding our platform of surveillance to incorporate assessments of the safety of EPI vaccines, direct and indirect effects of rotavirus vaccination, and studies of the non-specific effects of vaccination. We will examine the epidemiology of invasive salmonella infection and salmonella carriage in children and adults, and participate in the clinical development of a whole cell pneumococcal vaccine which is serotype independent.

Our work on human genetics has included candidate-gene and whole-genome levels, case-control datasets that includes 2500 well-characterised cases of severe malaria, over 2000 cases of invasive bacterial disease and 4000 community controls. Through the follow up of a birth cohort of 16,000 children we are examining the effects of common red cell genetic polymorphisms (including sickle haemoglobin, -thalassaemia, G6PD deficiency and the ABO blood group system) on the disease-specific incidence of admission to KDH and all-cause mortality.

The Viral Epidemiology and Control research is investigating the transmission patterns of respiratory viruses throughout Kenya at a range of organisational levels (countrywide, County, school and household). Using virus sequence data (RSV, influenza, rhinovirus, coronaviruses), integrated with spatial-temporal case data and human contact networks to characterise transmission pathways and ‘Who acquires infection from whom’. We are collaborating with the PERCH study to investigate the molecular diversity of key respiratory viruses 2011-13 : RSV, human metapneumoviruses, Influenza A, B and Coronavirus NL63 from 5 African (Gambia, Kenya, Mali, Zambia, South Africa) and two Asian (Bangladesh, Thailand) sites. Working through PATH and WHO we are planning Phase 2 trials of RSV vaccines for GSK (set for 2018) and Novavax.