TESTsmART Team Training

17-18 February 2020

Eldoret, Kenya

The TESTsmART Team is used to meeting virtually, and had mastered the art of Zoom meetings before it became the modus operandi of the post-COVID world. Team members are physically based in the USA (from Durham, NC to San Francisco, CA), Kenya, Nigeria, and Uganda, but every Wednesday, the entire team logs onto Zoom to meet and discuss the study. Team members provide status updates, review monitoring and evaluation reports, and collaborate on solutions to operational challenges.

Right before the COVID-19 pandemic hit and life as the world knew it was severely interrupted, the TESTsmART study team snuck in one last in-person meeting to prepare for the launch of Aim 2 of our study.

After months of hard work and preparation for the study launch (which included developing the study protocol , designing the data collection tools, obtaining ethics approval from 3 different institutional review boards (IRBs), and conducting baseline surveys at potential retail outlets, writing standard operating procedures for every aspect of study implementation), the international team decided to officially kickoff Aim 2 by convening together in Eldoret, Kenya for a two day, in-person training.

The TESTsmART Team member who attended the team training in Eldoret

Day 1 kicked off with a study overview and review of the 12 study standard operating procedures (SOPs).  Team members took turns presenting and were quizzed on their knowledge of the protocol and all the SOPs in a high stakes challenge between the Duke-Kenya and CHAI-Nigeria study teams. Up for grabs was bragging rights and the study mascot, affectionately known as the TESTsmART Teddy. At the end of the day, Kenya team prevailed!

Day 2 started early with the entire team traveling out to the field site in Webuye, about 2 hrs from the Eldoret office. The team met the Field Researchers at the home base at PEARL, and discussed the next stages of the launch focused on the retail outlets including enrollment, training, and arm randomization. The teams split up into smaller groups to go out and gain firsthand experiences at retail outlets in the area. In the afternoon, the team members reconvened to debrief about their observations from the day and chart timelines and next steps for rolling out the study intervention.

Everyone left feeling energized and excited for the launch of the project that they had been working so hard to prepare for.

Updates from Turkana

Over the last few months, we have worked on setting up community-based malaria surveillance in Turkana with the help of the County Health Leadership. Here are a few highlights:

We trained 100 community health workers from five communities to follow malaria cases identified in the health facility to their home and test household members for malaria

No power in the training hall so all of our ‘slides’ had to be drawn by hand

We also initiated surveillance of travelers coming into Turkana via the road and the airstrip. We offer free malaria diagnostic testing and treatment following a positive test. We have screened hundreds of passengers and found several malaria cases among them.

Entomological surveillance for both larvae and adult vectors is now beginning.

Hand-dug canals leading from the Turkwel river into the fields are a potential source of mosquitoes if the water is not moving or if stagnant pools form.

Along the dry riverbed, people dig shallow pits where water seeps up from below. Water is scooped out for household use. The pits are excellent mosquito breeding sites

We also tested light traps for catching blood-seeking mosquitoes inside homes

We had the good fortune to sleep outside at the Turkana Basin Institute and see the sunrise over the river.

Opening of the Partnership for Education and Academic Research Laboratory in Webuye, Kenya!

Wendy OMeara and Eric Nalianya demonstrate for Governor Wangamati and Dean Atwoli the telemedicine capacity being developed at PEARL

On Thursday, the Governor of Bungoma County, the Vice Chancellor of Moi University, the Dean of Medicine and Dean of Public Health of Moi University joined Dr. O’Meara, Dr.

Laktabai and Dr. Kisaka to official open the PEARL laboratory in Webuye, Kenya. 

PEARL is the latest development in a longstanding partnership between Moi University in Eldoret, Kenya, Webuye County Hospital and Duke University. The lab is being established under the leadership of Jeremiah Laktabai, chair of the Department of Family Medicine at Moi University, and Wendy Prudhomme-O’Meara, an associate professor of medicine and global health at Duke University who’s based full-time in Eldoret.

Housed in two forty-foot refurbished shipping containers with a state-of-the-art multi-head teaching microscope, the lab will initially focus on building clinical microscopy skills among technicians across 224 facilities in the region. Microscopes are a cost-effective and versatile tool for examining patient specimens and making accurate diagnoses, and nearly every rural health center in Kenya has a microscope. However, with the exception of malaria smears, these diagnostic tests are rarely performed due primarily to lack of expertise.

“There are so many different ways you can improve patient care with a microscope if you have the training to use it,” said Prudhomme-O’Meara. “We’re developing programs to help technicians in rural facilities learn how to better support clinical care with their microscope, which in many cases is the only piece of diagnostic equipment they have.”

Another goal of the lab is to support ongoing research efforts in Bungoma County, including studies on and interventions for HIV, hypertension, diabetes, fevers in children and malaria transmission, led by local and international faculty and trainees.

“Through our collaborative research projects, we’ve been able to improve care and prevention for illness in Bungoma County and beyond,” said Prudhomme-O’Meara. “We expect that PEARL will help us expand this work and impact, as access to a research laboratory will allow Moi University faculty and their partners to tackle critical research questions affecting clinical care and community health.”

Here’s a link to a story in the Kenyan national news:

Moi University to put up a research laboratory for Webuye Sub County Hospital

The lab building and infrastructure were made possible by support from Webuye County Hospital, Duke University and The Bill & Melinda Gates Foundation.

Turkana, Kenya

April 2018

Members of the ExactDx team visited Lodwar, Kenya to meet with government health officials, visit public health facilities and learn about malaria in the region. 

We visited several government and mission clinics in Turkana Central. Hoping our fact-finding mission leads to some productive partnerships and new approaches to malaria control in this challenging setting.

Dispensary 30 kilometers outside of Lodwar serving a pastoralist community near the Turkwel river