Does Zika Virus Cause Birth Defects in Africa?
by Eric Osoro, a physician and medical epidemiologist with the Paul G. Allen School for Global Animal Health. Dr. Osoro serves as the Deputy Director of Public Health for WSU Global Health-Kenya. This column is a personal account of his research in Kenya on the Zika virus. On a typical day, the maternal and child health unit at Coast General Hospital in Mombasa, Kenya, will be bustling with dozens of pregnant women waiting to be attended by the doctor and find out how their babies were progressing. For the women, this is a reassuring monthly routine in a country with high numbers of maternal and infant deaths. Besides the maternal and neonatal deaths, a worry which occupies the pregnant women is the possibility of a baby born with birth defects. When the World Health Organization determined that Zika virus causes microcephaly, a birth defect that causes a baby’s head to be smaller than normal, there was concern about the potential implications in Kenya. Zika virus is transmitted by the Aedes aegypti mosquito, which is prevalent in coastal regions and was already associated with an outbreak of dengue fever—a disease related to the Zika virus. Furthermore, Zika virus was first detected in a neighboring country whose disease profile is similar to that of Kenya. Could it be possible that Zika was responsible for some of the birth defects in Kenya and the health authorities were not aware? In October 2017, researchers from the WSU Allen School commenced a study to determine the outcomes of Zika infection among pregnant women and infants in Kenya. In the study, we are recruiting pregnant women in early pregnancy in selected Mombasa hospitals. We will follow the women over the course of their pregnancy to identify any evidence of Zika virus infection and outcomes. The pregnant women are often at the prenatal unit area early in the morning, well before the health workers start attending to them. While at the waiting bay, we approach the women and talk with them about the study. Typically, they would vaguely recall aspects of Zika virus, but could readily identify the mosquito transmitting the virus once we described it. “If it is the same mosquito which bites during the day and brings dengue, I have been bitten by them several times,” said one woman, and it is a typical response. We then provide them with information on the study and their involvement for purposes of informed consent. Once informed consent is obtained, the mother is taken through a questionnaire before a blood sample is drawn for Zika virus testing. She is then scheduled for monthly follow up until delivery. After delivery we will follow up with the infants to assess for growth and neurodevelopment. The study is funded by Centers for Disease Control and Prevention and is collaboratively implemented by WSU and local partners including the Kenyatta National Hospital, University of Nairobi, Kenya Medical Research Institute, and Mombasa County government. As part of the entry and preparation for implementation of the study, we conducted sensitization meetings with stakeholders including community women groups, local health workers, religious leaders, and the local administration. “We have a lot of these mosquitoes and we thought they only spread dengue,” said one of the community women leaders. “We are very willing to learn how much Zika we have and what problems it is causing in our area.” Dr. Hafsa Jin, an obstetrician in one of the study sites, welcomed the study and looks forward to the findings. “We do see some children with microcephaly, but we rarely get to know the cause,” said Dr Jin. “This study gives us an opportunity to quantify the burden of birth defects and probably establish their causes. This will be very useful information for planning prevention.” The study will provide data leading to evidence-based strategies to prevent Zika virus infection in pregnancy in Africa. It could lead to improved counseling of patients about risks to their pregnancies and their children. The information will also contribute to effective preparedness for health facilities providing services to affected children and families.
Message from the WSU Senior Director of Global Health
Our encompassing goal is to improve public health and catalyze human opportunity through research, teaching, and outreach. To achieve this goal, it requires committed individuals. In October, we celebrated professor Kariuki Njenga who was elected to the National Academy of Medicine. It is described as “one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.” Read more at go.wsu.edu/Njenga. This richly deserved recognition adds to the national and international reputation of the Allen School faculty. All of WSU’s National Academy of Medicine members are Allen School faculty, six are fellows of the American Association for the Advancement of Science, and six are members of the Washington State Academy of Science, including professors Doug Call and Jon Yoder who were elected earlier this year. Election to these bodies reflects not only the highest levels of scholarship, but also a commitment to serving society through science. As impressive as these achievements are, they are in many ways only the “tip of the iceberg.” The Allen School has an outstanding group of young faculty, already widely recognized among their peers for their accomplishments, who will undoubtedly emerge as the next generation of nationally and internationally recognized fellows and academy members. I look forward to seeing how they help meet our goals to improve health and opportunity for everyone, everywhere. Guy Palmer Creighton Endowed Chair and WSU Senior Director of Global Health
Faculty News Summer 2017
Douglas Call, professor in the Allen School, received the Sahlin Faculty Excellence Award for Research, Scholarship, and Arts. His research has led to greater understanding about the ways bacteria develop resistance to antibiotics. In east Africa, where people, domestic livestock, and wildlife live close together, Dr. Call is leading a multidisciplinary team to understand how antibiotic resistance arises and spreads through communities.
Student and Fellow News Summer 2017