As the global COVID-19 pandemic spreads, there are increasing numbers of cases in low- and middle-income country (LMIC) settings, including in many African countries. A new $1.38 million UW research project funded by the Bill and Melinda Gates Foundation will monitor the spread of COVID-19 in sites in Africa in order to increase understanding of the effects of COVID-19 on vulnerable children and adults, healthcare workers and researchers in low-resource settings.
The project, led by Judd Walson, Professor, UW Global Health, is being conducted by the Nairobi-based Childhood Acute Illness and Nutrition Network (CHAIN), an established research network that has laboratory and data management capacity at nine sites in Africa and South Asia.
“CHAIN researchers, who work closely with Ministries of Health in Africa, will be able to use the research findings to help inform public health practice in Africa - and ultimately globally in low-resource settings,” said Walson. “The research will help to support health facility leadership and healthcare workers who are doing heroic work to protect vulnerable communities and slow the spread of the disease.”
The project, which begins this month, is procuring personal protective equipment (PPE) and conducting training with CHAIN researchers in Kenya to systematically collect and analyze SARS CoV-2 health data. The data collection system will be in place at four facilities in Kenya (Migori, Kilifi, Kisii and Homa Bay) in May, and researchers aim to initiate SARS-CoV-2 testing within weeks.
The project will help track trends in geography, case severity and fatality and risk factors for mortality, through tracking outcomes of highly vulnerable patients with SARS-CoV-2, including those with HIV, malaria, tuberculosis and malnutrition. The second phase of the project will seek to understand the implications of fecal SARS-CoV-2 shedding. Researchers will determine the contribution to transmission of fecal shedding of SARS-CoV-2 in LMIC settings where risk of fecal-oral contamination is high.
This project is a collaboration with the Kenya Medical Research Institute (KEMRI), the KEMRI/Wellcome Trust Research Programme Clinical Information Network (CIN), the University of Oxford and the University of Washington. Through these collaborations, CHAIN has access up to an additional 26 county hospitals in Kenya, and can help imbed rigorous clinical research into the broader Kenyan MOH response to COVID-19.
Globally, the health system infrastructure in many countries is not prepared to identify or manage SARS-CoV-2 cases. Poverty, high urban population density and lack of high-quality infection control measures in many settings threaten to exacerbate the spread of SARS-CoV-2. In Africa, many populations have high rates of cardiovascular and pulmonary disease, along with poor nutritional status, HIV infection, tuberculosis and diseases such as malaria, diarrheal disease and others. As a result, SARS-CoV-2 may be particularly devastating to the populations of many African nations.
According to a new report that cites modeling from Imperial College London, Africa could see 300,000 deaths from the coronavirus this year even under the best-case scenario, and under the worst-case scenario with no interventions against the virus, Africa could see 3.3 million deaths and 1.2 billion infections, according to a new report by the U.N. Economic Commission for Africa.