Notes from the Field 2008

First, let me introduce myself. My name is Melissa and I'm an MPH candidate in epidemiology with a concentration in global health and interests in infectious diseases. I'll be heading to Kenya in a few days, June 15th, to help with a malaria research project in Kisumu.

The project is headed by a physician at the U, Dr. Chandy John, and is in collaboration with the Kenya Medical Research Institute (KEMRI) in Kisumu where I'll be stationed day-to-day. I have a graduate research assistantship with Dr. John, which is how I got connected with this experience. I've mostly been spending my year analyzing data from a different project in Uganda, but have been most intrigued by the epidemiologic processes and questions that are part of Dr. John's Kenya work. Needless to say, I’m looking forward to actually getting my hands dirty in all that data! Little bit of a stats nerd in that regard;)

The project is comprised of about 6000 people who live in two villages in the Nandi district. The district in just north of Kisumu in the highlands, which flank the Rift Valley. Because the villages are at higher altitudes they tend not to see malaria on a regular basis (aka, non-endemic… in epi speak). This is great from an overall health perspective but it does create some interesting situations of epidemic transmission and some interesting immunological responses. Malaria tends to cause what we call “waning immunity� in the endemic areas. So, people who live and breath around malaria all the time will acquire some immunity to the parasite, as they grow older (which is one of the reasons we tend to see malaria in children who are still picking up their immunity). Those who live in non-endemic settings (such as these two villages) never get the chance to acquire immunity, so it’s suspected that older people will get sick as well as the young and there might be some additional immunological characteristics that are different.

The cohort is composed of both active case surveillance (where surveys go out looking for people who might be sick) and passive surveillance (where case detection is conducted at a health clinic); the real meat of a long-term epi cohort. There are also periodic sitewide blood collections that occur in both villages for immunology questions the project is addressing. I am lucky enough to be in-country when one of these is slated to take place. I have this image of a massive circus every time I think about the "sitewide" collection...so I'll have to let you know if it’s truly that crazy.

But for now, until I’m on the ground and no longer have to imagine what’ll be like, I’m checking my packing list, getting last minute boxes in order (I’m also playing the role of currier for the lab…), gearing up for my first foray into the developing world, and (rightfully so, I think) freaking out just a tiny bit.

Hopefully, this blog will help you travel with me and at least give you a glimpse into the cultures and adventures that I’ll be a part of this summer. Good lord, it’ll be fun!

Cheers,
Melissa