Professor O’Meara is named as one of five women driving innovation in the fight against malaria by Malaria No More!
International Women’s Day 2026
Seasonal Malaria Chemoprevention (SMC) in Northern Kenya; Through the eyes of an elder
The first ever round of SMC was administered in Northern Kenya, Turkana Central this year in the June – September peak malaria transmission season. This piece explores the community’s experiences with and perceptions of SMC from a leader of a vast and hilly village, Nayanae-Ao.
“My village, Nayanae Ao spreads across hills. Manyattas are spread out as families are pastoralists and need enough land to graze their livestock. The land is ours, so we all find a place for our animals. It has 5 subvillages; Lopalia, Nayanae-Ao, Nakino; Kaemegur and Ayanae Turkan. In the first and 2nd SMC cycles, the health facility sent a community health promoter (CHP) of another village to distribute SMC in my area. You see, in my village, no one has gone beyond nursery school, therefore nobody can read nor write. For this reason, my village does not have a CHP. There is hope though, 2 villagers have joined the ‘gumbaru’ (adult learning classes in Kalokol – a neighbouring town). When this CHP from Lokalalio unit was sent to distribute SMC, he was not able to reach most households especially in Lopalia.
After the second SMC cycle, the chief asked me to assemble mothers and their children under five years at different points so that the children would gather and receive SMC. The chief trusts me, I am a man of the chief, so I walked to all parts of the village until my feet hurt. I asked them to assemble at different points on different days; like in Kaimegur, they gathered at the waterpoint on Sunday and under a tree in Lopalia on Saturday, this way, most children received SMC.
I am very grateful for SMC. The closest facility, Lokalalio, to my village is 30 Kilometers away. On a good day a motorbike charge Ksh 1500 and Ksh 1000 if you bargain. Since SMC began, very few children have been taken to the health facility because of malaria. Luckily, some families have motorbikes, if a child of the very poor gets sick, their neighbors will carry them to hospital, we do not allow them to suffer, we are a community. You see, in my village, women have another child before the young one grows and often they get sick because the mothers attention shifts to the newborn. I also feel that SMC has protected those young ones, they no longer fall ill all the time.
When I received the call from Moi/Duke university about the endline survey, I walked to Lokalalio to find Thomas. He is a teacher and a CHP. They told me that they want a list of all children under five to select some for their work. I am a man of the chief, I always walk around in the village, it is my job to know everything, I know every family with these children Thomas helped me to list them.
It would be good for SMC to continue next year, my people are still having children, there are newborns that will still need it!”
…….Erukudi Edapal
Turkana County gets bednets!
Turkana County is a rural area in the northwestern part of Kenya. It is primarily populated by nomadic pastoralist communities. Previously, malaria endemicity in Turkana was categorized as low, epidemic prone. Work by the Moi-Duke team demonstrated significant local transmission and now Turkana county has been recognized as having endemic transmission. Last week, mass distribution of bednets was conducted for the first time in Turkana County! This was a massive undertaking given how vast the county is and how remote and dispersed the majority of the population is.
Here is a mother preparing her new bednet over an outdoor sleeping space in front of her home.
Director of the Kenya National Malaria Control Programme visits ExactDx team
On Friday, June 14th, Dr. Kibor Keitany paid a visit to the Eldoret-based team. He wore his support on his sleeve!
Dr. Kibor assumed leadership of the NCMP a year ago and has focused on improving strategies to bring research to practice to alleviate the devastating burden of malaria that persists in several regions of Kenya. He is a graduate of Moi University.
SMC Begins in Turkana County!!
Turkana County Health Team and CRS successfully kicked off SMC on June 13th and the first cycle is now complete! SMC protected about 40,000 children this month. Next cycle begins July 11th.
Our own Diana Menya, Kibor Keitany (Director NMCP) and Gilchrist Lokoel (Chief Officer, Turkana County) share their enthusiasm for the program on this newscast:
Moi-Duke team joins Turkana County and Catholic Relief Services to roll out new intervention to protect children from malaria
April 2024
Our team has recently documented very high transmission of malaria in Turkana, a semi-arid zone in the northern part of Kenya that was previously considered unsuitable for transmission. Children in Turkana are at high risk of malaria, yet very few families have bednets. Many families sleep outside on the ground and some move with their herds which complicates consistent net use. Moi University and Duke University have partnered with Turkana County government and CRS to roll out a drug based prevention intervention to children under 5 in Turkana Central, a subcounty with very high burden of malaria.
Moi and Duke researchers brief county team on emerging threats in Turkana, discuss innovative prevention strategies
Lodwar, March 24, 2023 (Directorate of Communication-Ministry of Health)
Malaria specialists from Moi and Duke University, yesterday in Lodwar met with County Health Officials to initially discuss a proposal to introduce Seasonal Malaria Chemoprohylaxis (SMC) as an additional strategy to reduce malaria related deaths among children in Turkana.
Speaking while closing the meeting at County Health Ministry Headquarters Acting Chief Officer Joyce Illikwel said that introduction of SMC strategy in Turkana will be a milestone in the fight against Malaria and will reduce child mortality rates caused by Malaria parasite.
She said Malaria is a top killer disease in Turkana and all efforts to eradicate it, are highly welcome, adding that the team selected from health officials will offer its expertise on Malaria to make SMC a policy to combat the disease.
Illikwel said that the ministry will push the executive to support the joint collaboration in research, policy formulation and funding of the SMC strategy to prevent Malaria related deaths that have diverse negatives effects on people’s lives.
Since 2018, a joint Moi/Duke University and County health team have been studying Malaria prevalence, found anopheles stephensi and plasmodium vivax, a new vector and new mosquito species respectively in Turkana. The two present new malaria control challenges in the County.
While presenting the jointly produced esearch proposal on the efficacy of the SMC approach Moi/Duke University Principal Investigator Wendy O’meara said that the strategy involves administration of two antimalarial drugs at intervals to children to prevent malaria during the malaria season in areas with highly seasonal transmission.
O’meara said that SMC has been used in Sahel countries and also piloted in Karamoja region of Uganda with remarkable results in reduction of Malaria prevalence by at least 75%.
She further explained that SMC goal is to establish antimalarial drug concentrations in the blood that clear existing infections and prevent new ones during the period of greatest risk. Dr. Omeara was flagged by her team mates Principal Investigator Dr. Diana Menyan and Malaria Research Coordinator Joseph Kipkoech.
The meeting selected a joint technical working team to document the discussions of the meeting so as to develop a road map for implementation of the proposal.
The meeting was also attended by Acting Director Medical Services Dr. Yvonne Musa, Public Health Deputy Director Daniel Esmit, Deputy Director Health Products and Technologies Units David Moru, Deputy Director Rehabilitative and Psychosocial Services Dr. Joseph Lolepo, County School Health Coordinator Rael Akoru, County Pharmacist Brian Muokani, Deputy County Pharmacist Paul Kare, County Malaria Coordinator David Ekai, County Coordinator CHVs Jonathan Longiti, County Public Health Officer Lucas Edete, M&E officer Julius Gogong among others.
The approach will be implemented in select Sub-Counties for a start before rolling out to the rest of the Sub-Countues as part of the impact evaluation study.
2023 Sporozoite Summit
This month, the Duke team enjoyed hosting a team of collaborators from Johns Hopkins University to talk about the current knowledge regarding malaria sporozoites and how this stage of the parasite’s development is implicated in malaria transmission dynamics.
The malaria parasite requires both the mosquito vector and mammalian host to complete its full life cycle. Research frequently focuses on [….] to disrupt transmission. Understanding how sporozoites develop from oocysts in the mosquito stomach and what determines which sporozoites will transfer to the vector’s salivary glands may provide further avenues for disrupting malaria infection pathways.
To learn more about sporozoites and the malaria parasite’s life cycle [ insert link… wikipedia? ]
ASTMH Annual Meeting – 2023
Our team was well-represented at the 2023 American Society of Tropical Medicine and Hygiene’s Annual Meeting, when 8 principal investigators, 5 research staff, and 1 trainee traveled to Chicago, Illinois in October.
Six posters were accepted for presentation at the conference, covering early findings from the TESTsmART trial, qualitative studies on bednet use in our longitudinal cohort and water gathering behavior in northwestern Kenya, and larval surveillance for the invasive Anopheles stephensi mosquito.
Christine Markwalter, PhD, was selected to give an oral presentation on “The Influence of Anopheline biting preferences on the Plasmodium falciparum human infectious reservoir in Western Kenya,” which sparked interesting conversation among the attendees.
NaMaSte study
Quantifying the relationship between human mobility and disease transmission is critical for identifying disease sources and designing interventions. Methods for capturing mobility patterns have largely been used to characterize settled populations. Mobility patterns in mobile populations, such as nomads, are less well known. These populations may be at higher risk of acquiring new infections or may import/transmit new infections as they move. Characterizing their mobility and disease exposure rates is crucial to understanding their role in disease transmission.
Dr. Hannah Meredith was awarded a Fogarty International Fellowship to expand upon our group’s work with the Turkana, a semi-nomadic population, to test the hypothesis that the Turkana are at greater risk of exposure to vector-borne diseases during seasonal treks than when staying at their semi-permanent settlements. For the last year, Dr. Meredith has lived in Kenya, working with community health workers in Turkana to enroll semi-nomadic households in the study, screen them for malaria before and after their seasonal treks, and assign GPS loggers to migrating pastoralists to collect information on their migration routes. Analysis is ongoing, but preliminary results of malaria prevalence in the community further demonstrates the need for interventions that are more suitable for mobile, outdoor dwelling populations.
Households typically build structures out of sticks and palm fronds (right) surrounded by a fence to keep livestock corralled at night. These structures are quick to build (a few days) and are usually built to store belongings and provide some shelter from the elements; however, many household members sleep outside. On the left are a set of 4 sticks that were sometimes used to suspend a bednet over the sleeping area; however, few households reported having access to bednets.
