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PROJECT SITE AND PROJECT ACTIVITIES
The activities of the University of Eastern Africa, Baraton-Bill and Melinda Gates Foundation Malaria Research took place in 7 locations of Nandi Central District in Kenya. The seven sites include Baraton, Kaptel, Kombe, Chemuswa, Kilibwoni, Kapkangani and Kapsabet. Kapsabet is the headquarters of the Nandi Central District. The project activity usually begins with communication with the village chiefs and elders through visits to their location by the research team. After discussion and education of the leaders on the aims and objectives and importance of malaria diagnosis, the main aim of the research, the elders are left to disseminate this information to the community. A second communication is made in which the research team informs the community through the chief about the date and time the malaria “baraza” or local meeting will take place. A written communication is made for this purpose. A program was usually held in which the team was introduced to the entire community, followed by drama on the importance of malaria control and various speeches from the team and elders and chiefs. Games were played and incentives given for people who could answer basic questions on malaria diagnosis and control. Children were called first to obtain basic knowledge on malaria and were given sweets as incentives. Adults were pulled to the activities and took part in quizzes on malaria and were given mobile phone scratchcard as incentives for their answers. This activity put everyone in the mood for the research activity of blood collection and diagnosis. The project includes the collection of blood samples from all volunteers that sign up for the study. First, all the participants fill in a form for informed consent. Next, the participants were led to the clinic for blood collection. After obtaining information on the patient, 2ml of venous blood was collected from older children and adults and 0.5 mls from infants. The blood samples were collected in EDTA vacutainer tubes and kept for further analysis in the laboratory. When blood samples were collected, thick and thin blood films were made for each participant on the same slide and labeled. The smears were stained with 10% Giemsa and viewed under high power objective. The results were recorded and the rest of the blood samples were taken to the other side of the laboratory and a chemical reaction to detect the presence of malaria was carried out and the results recorded. On most occasions, people appear in large numbers (between 100 and 250) and this made 100% field analysis of the samples impossible. The team therefore transported the remaining blood samples to the University of Eastern Africa, Baraton for analysis on a later date after separation of the plasma from the whole blood. All slides were however made in the field as soon as blood samples were collected. After the collection, the participants were led to the interview and questionnaire section of the research. With the assistance of education experts, the participants were able to complete the questionnaires. After this, they were led to take refreshments provided by the research team. Any body found positive for malaria was treated with the drug of choice for malaria(Artemether-Lumefantrine) in Kenya recommended by The Ministry of Health. Some drugs were given to the dispensaries for other cases of malaria that later presented at the health centers. This sums up the daily activity of the research project.
INFORMATION

GENERAL INFORMATION ON MALARIA AND DIAGNOSTIC PROCEDURES
Malaria Parasites
Malaria is caused by protozoan parasites of the genus Plasmodium. Four species of Plasmodium cause human malaria, namely falciparum, vivax, malariae and ovale. Plasmodium falciparum if the most dangerous and causes most of the suffering form malaria in Sub-Saharan Africa.

Global Effect of Malaria
Malaria is a serious cause of morbidity, mortality and poverty in Sub-Saharan Africa. It affects the poor of 109 most endemic countries in Africa, Latin America and Asia. It has been estimated that between 300-500 million people become ill globally from malaria annually. Of these, 1.5 to 2.5 million deaths occur annually. Ninety percent of these deaths occur in Africa, mostly in children less than five years of age. The overall effect leads to poor socio-economic development in Africa and the affected countries.

Malaria in Kenya
In Kenya, malaria is the most common cause of morbidity and affects about 75% of the population. 6,000 pregnant women are at risk contributing to 60% miscarriages and births of 4,000 anemic babies with low birth weights. 34,000 children below five years of age die annually from malaria in Kenya alone. Other effects of malaria in children include chronic anaemia, retarded physical growth, and severe mental retardation in some cases. Malaria accounts for 25-45% of outpatient attendance and 20% of in-patient admission at health facilities. These may vary depending on the area. It cause 9-14% of inpatient deaths. It also contributes to 170 million working days annually.

Problem Associated with Malaria Control
The main problems associated with malaria control is increasing resistance to the most available and affordable first line anti-plasmodial drugs such as chloroquine, fansidar and artemisinin that has been reported in Cambodia and Thailand. Mosquitoes have grown resistant to commonly used larvicidal agents. Several countries in Africa lack the resources to control malaria. Present diagnostic methods may be producing unreliable results. Other reliable methods to diagnose malaria may be simply too expensive, unavailable or inaccessible. Even if effective and accurate, most of the expensive techniques also require electricity to be carried out. Some of these include the quantitative buffy coat (QBC) technique, polymerase chain reaction (PCR), and Acridine Orange method among others. There are several villages in poor nations of the world that do not have electricity. Non- Microscopic Rapid diagnostic kits have been recommended by the WHO for malaria diagnosis because of being at least 95% as accurate as microscopy and they are able to detect parasites at their lowest levels, that is levels of 100 parasites/µl (0.002% parasitaemia) should be detected reliably with 100% sensitivity. They are based on detection of the PfHRP2(histidine rich protein 2) of Plasmodium falciparum and other enzymes possessed by the parasites. These tests offer a promise for the future since they can be performed by non-clinical staff in poor villages without electricity.

There is need for more research to be done on new diagnostic methods of malaria detection. Presently, there is interest in detecting various malaria parasite antigens in whole blood, plasma or serum.




Home Project Our services References Analysis Result About us Contact us	PROJECT SITE AND PROJECT ACTIVITIES The activities of the University of Eastern Africa, Baraton-Bill and Melinda Gates Foundation Malaria Research took place in 7 locations of Nandi Central District in Kenya. The seven sites include Baraton, Kaptel, Kombe, Chemuswa, Kilibwoni, Kapkangani and Kapsabet. Kapsabet is the headquarters of the Nandi Central District. The project activity usually begins with communication with the village chiefs and elders through visits to their location by the research team. After discussion and education of the leaders on the aims and objectives and importance of malaria diagnosis, the main aim of the research, the elders are left to disseminate this information to the community. A second communication is made in which the research team informs the community through the chief about the date and time the malaria “baraza” or local meeting will take place. A written communication is made for this purpose. A program was usually held in which the team was introduced to the entire community, followed by drama on the importance of malaria control and various speeches from the team and elders and chiefs. Games were played and incentives given for people who could answer basic questions on malaria diagnosis and control. Children were called first to obtain basic knowledge on malaria and were given sweets as incentives. Adults were pulled to the activities and took part in quizzes on malaria and were given mobile phone scratchcard as incentives for their answers. This activity put everyone in the mood for the research activity of blood collection and diagnosis. The project includes the collection of blood samples from all volunteers that sign up for the study. First, all the participants fill in a form for informed consent. Next, the participants were led to the clinic for blood collection. After obtaining information on the patient, 2ml of venous blood was collected from older children and adults and 0.5 mls from infants. The blood samples were collected in EDTA vacutainer tubes and kept for further analysis in the laboratory. When blood samples were collected, thick and thin blood films were made for each participant on the same slide and labeled. The smears were stained with 10% Giemsa and viewed under high power objective. The results were recorded and the rest of the blood samples were taken to the other side of the laboratory and a chemical reaction to detect the presence of malaria was carried out and the results recorded. On most occasions, people appear in large numbers (between 100 and 250) and this made 100% field analysis of the samples impossible. The team therefore transported the remaining blood samples to the University of Eastern Africa, Baraton for analysis on a later date after separation of the plasma from the whole blood. All slides were however made in the field as soon as blood samples were collected. After the collection, the participants were led to the interview and questionnaire section of the research. With the assistance of education experts, the participants were able to complete the questionnaires. After this, they were led to take refreshments provided by the research team. Any body found positive for malaria was treated with the drug of choice for malaria(Artemether-Lumefantrine) in Kenya recommended by The Ministry of Health. Some drugs were given to the dispensaries for other cases of malaria that later presented at the health centers. This sums up the daily activity of the research project. INFORMATION GENERAL INFORMATION ON MALARIA AND DIAGNOSTIC PROCEDURES Malaria Parasites Malaria is caused by protozoan parasites of the genus Plasmodium. Four species of Plasmodium cause human malaria, namely falciparum, vivax, malariae and ovale. Plasmodium falciparum if the most dangerous and causes most of the suffering form malaria in Sub-Saharan Africa. Global Effect of Malaria Malaria is a serious cause of morbidity, mortality and poverty in Sub-Saharan Africa. It affects the poor of 109 most endemic countries in Africa, Latin America and Asia. It has been estimated that between 300-500 million people become ill globally from malaria annually. Of these, 1.5 to 2.5 million deaths occur annually. Ninety percent of these deaths occur in Africa, mostly in children less than five years of age. The overall effect leads to poor socio-economic development in Africa and the affected countries. Malaria in Kenya In Kenya, malaria is the most common cause of morbidity and affects about 75% of the population. 6,000 pregnant women are at risk contributing to 60% miscarriages and births of 4,000 anemic babies with low birth weights. 34,000 children below five years of age die annually from malaria in Kenya alone. Other effects of malaria in children include chronic anaemia, retarded physical growth, and severe mental retardation in some cases. Malaria accounts for 25-45% of outpatient attendance and 20% of in-patient admission at health facilities. These may vary depending on the area. It cause 9-14% of inpatient deaths. It also contributes to 170 million working days annually. Problem Associated with Malaria Control The main problems associated with malaria control is increasing resistance to the most available and affordable first line anti-plasmodial drugs such as chloroquine, fansidar and artemisinin that has been reported in Cambodia and Thailand. Mosquitoes have grown resistant to commonly used larvicidal agents. Several countries in Africa lack the resources to control malaria. Present diagnostic methods may be producing unreliable results. Other reliable methods to diagnose malaria may be simply too expensive, unavailable or inaccessible. Even if effective and accurate, most of the expensive techniques also require electricity to be carried out. Some of these include the quantitative buffy coat (QBC) technique, polymerase chain reaction (PCR), and Acridine Orange method among others. There are several villages in poor nations of the world that do not have electricity. Non- Microscopic Rapid diagnostic kits have been recommended by the WHO for malaria diagnosis because of being at least 95% as accurate as microscopy and they are able to detect parasites at their lowest levels, that is levels of 100 parasites/µl (0.002% parasitaemia) should be detected reliably with 100% sensitivity. They are based on detection of the PfHRP2(histidine rich protein 2) of Plasmodium falciparum and other enzymes possessed by the parasites. These tests offer a promise for the future since they can be performed by non-clinical staff in poor villages without electricity. There is need for more research to be done on new diagnostic methods of malaria detection. Presently, there is interest in detecting various malaria parasite antigens in whole blood, plasma or serum.

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