The Department of Defense Global Emerging Infection Surveillance and Response System (DoD-GEIS) was established in 1996 to strengthen United States support of global surveillance, training, research, and response to emerging infectious disease threats worldwide.  DoD-GEIS performs both international and domestic surveillance projects.  Its international efforts are coordinated from regional overseas military laboratories, located in Egypt, Indonesia, Kenya, Peru, and Thailand.

 GEIS activities at USAMRU-K are centered on a developing infectious disease surveillance network.  Hospitals are selected in each province of Kenya to serve as infectious disease surveillance sites.  Additionally, a site is operated in southern Uganda.  Each site is then provided with the infrastructure and personnel support required to perform case identification, sample collection, sample processing, and secure record maintenance.  The staff at these sites is also trained in outbreak identification and control techniques and in infection control measures.

 Current GEIS activities at these sites include sentinel surveillance for viral hemorrhagic fevers, such as Ebola and Yellow Fever; determination of nonbacterial causes of severe febrile illnesses; determination of the regional antimalarial drug resistance patterns; and SARS clinical surveillance.  Soon, GEIS will initiate a project to determine the causes and effective treatment for diarrheal illnesses throughout Kenya.

 USAMRU-K GEIS participates in WHO and Ministry of Health outbreak investigations, providing laboratory and/or epidemiology support.

 Infrastructure development projects supported by USAMRU-K GEIS include presentation of outbreak identification courses to Ministry of Health and other personnel, a student attachment program for Kenyan laboratory technology students, and sponsored graduate education programs for scientists and support staff employed by USAMRU-K.    

GEIS productivity 2004

Publications:

Onyango CO, Ofula VO, Sang RC, Konongoi SL, Sow A, De Cock KM, Tukei PM, Okoth FA, Swanepoel R, Burt FJ, Waters NC, and Coldren RL.  “Yellow Fever Outbreak, Imatong, Southern Sudan.” Emerg Infect Dis [serial on the Internet]. 2004 Jun.

Abstracts:

Waters NC, Mbaisi A, Liyala P, Eyase F, Achilla R, Akala H, Wangui J, Mwangi J, Osuna F, Coldren R. “Genetic Variation and drug susceptibility of Plasmodium Falciparum isolated from geographically distinct areas of Kenya." Molecular Parasitology, Woods Hole, MA, September 2003.

Waters NC, Mbaisi A, Liyala P, Eyase F, Achilla R, Akala H, Wangui J, Mwangi J, Osuna F, Davis J, Smoak B,  Coldren R, Kyle D, Shanks D, Mason C. “Correlation of drug susceptibility and genetic variation of Plasmodium Flaciparum isolated from distinct geographical regions of Kenya."  American Society of Tropical Medicine and Hygiene Meeting, Philadelphia, PA, December 2003.    

Shanks GD, Hay SI, Biomndo K, Coldren R, Martin S. “How did highland malaria transmission change in 2002 on one Kenyan Tea Estate without affecting the adjacent site?." American Society of Tropical Medicine and Hygiene Meeting, Philadelphia, PA, December 2003.

Norman Waters, Abigael Mbaisi, Pamela Liyala, Fredrick Eyase, Rachel Achilla, Hosea Akala, Julia Wangui, Josephat Mwangi, Finnley Osuna, Uzma Fazal, Bonnie Samoa, John Davis, Dennis Kyle, Dennis Shanks, Carl Mason, Rodney Coldren.  “Determining the extent of malaria drug resistance throughout Kenya using genetic analysis and drug screening methodologies. ”Molecular Approaches to Malaria – 2004, Lorne, Australia, February 2004. 

Protocols:

Shanks, Oloo, Coldren. “Epidemiology of Malaria in Kenyan Adults”  WRAIR #682  May 2002 – July 2003.

Coldren, Onsongo, Waters, Lodenyo, Mbui. “Acute, Febrile Illness Surveillance in Kenya”  WRAIR #963  November 2002 - present.     

Coldren, Waters, Mbui, Ocholo, Adoyoadoyo, Achilla.  “Epidemiology of Malaria and Drug Sensitivity Patterns in Kenya”  WRAIR # 980  January 2003 – present. 

Sang, Coldren, Mbui.  “Epidemiology of diarrheal illness in Kenya”  WRIAR #964  January 2004 – present. 

Adungo, Ogolla, Prosser, Coldren.  “Serosurvey of Arboviral Illnesses, Socioeconomic Determinants of Arboviral Infection and Determination of in vivo Antimalarial Resistance in Three Distinct Districts of Kenya”  WRAIR #1113  July- August 2004.

Candidates for Degrees: 

PhD – Willie Sang

           Maurice Adoyo-Adoyo

           Rachel Achilla 

MSc – Fredrick Eyase

           Caroline Tungwony

           Bonventure Juma

           Hosea Akala

           Pamela Liyala

           Clayton Onyango

           Victor Otieno 

  MPH –Shirley Segecha 

  BSc – Alexander Sio

Sponsored Travel: 

            Caroline Tungwony : 2004 DOD Pest Management Workshop 

Shirley Segecha :    2004 International Conference on Emerging Infectious Diseases 

Training Courses: 

            Outbreak Investigation –       July 2002

                                                      April 2004 

Students Trained: