The Ministry of Health, Kenya Transplant and Transfusion Authority, African Institute for Health and Development, Bill and Melinda Gates Foundation, plan to implement a lab based NTD surveillance program in coastal region of Kenya where vector borne diseases such as Lymphatic Filariasis (LF), dengue, and chikungunya are endemic. The three blood detectable diseases are co-endemic in the coastal region, where mosquito densities are higher in the region due to favorable climatic conditions conducive to breeding. Kenya, just like other countries, is in the trajectory of eliminating LF by 2030. However, the country similar to other countries globally, has experienced recent outbreaks of dengue and chikungunya with cases increasing drastically and are showing no signs of slowing down. LF, dengue, and chikungunya are blood detectable. WHO recommends testing for LF through a field-based point-of-care diagnostic kit called the Filarial Test Strip (FTS). Currently, access to FTS is primarily through donations. The kit donations are periodic and subject to WHO’s approvals and can only be used for mapping/remapping, pre-transmission assessment survey, TAS 1, and surveillance surveys (TAS 2 and TAS 3). This makes accessibility and reliance on FTS for routine surveillance difficult.
Also, the three TAS (1,2 &3) are conducted two years apart, targeting 6-7-year-olds only as recommended by WHO, which principally excludes the older population who are potential reservoirs of filarial parasites. With the increasing mosquito density, it becomes very easy for a drastic spread of LF infection, as has been seen in the recent trends for DENV and CHIKV in case of a positive case. As such, establishing a routine surveillance system to timely detect any potential recrudescence for LF or an outbreak of DENV and CHIKV is thus important.
The proposed project aims to pilot integrated lab-based surveillance for chikungunya, dengue, and lymphatic filariasis in six coastal counties through the blood donation program in Kenya to overcome the above-stated challenges. It intends to test approximately 50% of all of the donated blood from the coastal region during the project duration and provide trends and distribution patterns of the three diseases.