nalidixic acid was found.  The E. coli isolated from

research units are located, trained local laboratorians

the Masai site showed resistance to tetracycline (80%)

and epidemiologists and basic communications infra 

and sulfamethoxazole (68%).  Again no resistance to

structure are much more available.  In Kenya, more

norfloxacin or nalidixic acid was found.  At the

emphasis has been required on employee training and

Mathare site, 100% of Shigella flexneri isolates were

on the acquisition of Internet services through purchase

resistant to erythromycin. Over 90% of these species

of a Very Small Aperture Terminal (VSAT) satellite

were also resistant to tetracycline, ampicillin, and

antenna.  A notable development related to communi 

sulfamethoxazole.  Significant resistance to first line

cation this fiscal year was the launching of the

antibiotics was also seen in Shigella dysenteriae, S.

USAMRU K web site, http://www.usamrukenya.org.

boydii, and S. sonnei.  No resistance was noted to

nalidixic acid or norfloxacin.  Shigella from the

 2. Enhance biomedical and behavioral research

Masai site also showed resistance to tetracycline

efforts on emerging infectious diseases. 

(63%) and sulfamethoxazole (44%).  No resistance

was noted to nalidixic acid or norfloxacin.  The high

The DoD GEIS program is organized and funded as

rate of Campylobacter isolation in this study is note 

a public health surveillance, response, training, and

worthy since Campylobacter has not been an etiology

capacity building program.  Most emerging infections

of interest in most diarrheal studies in Kenya.  

research conducted by the Department of Defense is

managed and funded separately by the Military

During FY 2001, USAMRU K began operation of the

Infectious Disease Research Program (MIDRP) under

first in vitro anti malaria drug testing facility in

the direction of the Commanding General of the

East Africa.  Initial analyses focused on 400 frozen

Army Medical Research and Materiel Command

P. falciparium specimens from the previous two

(MRMC).  Nevertheless, DoD GEIS has been in the

years.  Results are pending.

position to facilitate the research agendas of the

MIDRP and other partners.  As noted above, both

USAMRU K also provides extensive support, in

domestically and internationally, DoD GEIS assets

partnership with the CDC, to the WHO Virus Reference

have leveraged diagnostics development.  The DoD 

Centre at the Kenya Medical Research Institute.  The

GEIS surveillance program is well positioned to

main work of this center is surveillance for yellow

recognize research questions that need to be answered

fever at 22 hospitals and clinics around Kenya.  This

pertaining to the epidemiology and control of emerging

infrastructure also facilitates surveillance for other

and re emerging agents.  

hemorrhagic fevers.  In October 2000, this Centre

diagnosed the first confirmed case of human Crimean 

A particular research emphasis of DoD GEIS has been

Congo hemorrhagic fever in Kenya.  Using RT PCR,

to focus on the development of innovative methods

a diagnosis was made within 24 hours after receipt of

for surveillance, such as ESSENCE, EWORS, and the

the serum sample from one of the surveillance sites.

joint DoD GEIS/NASA Rift Valley Fever predictive

Because ticks can transmit a wide range of pathogens,

model based on information from satellites.

the Reference Center is currently investigating for

Recognition of the re emergence of malaria in Korea

viral pathogens 16,250 ticks collected at two Nairobi

has stimulated survey research into the knowledge,

slaughterhouses.  To date 39 viruses have been isolated

attitudes, and behaviors of soldiers toward personal

and are being characterized.

protective measures such as military insect repellants.

The significant needs of Kenya and other countries

The collation of MIDRP projects and DoD GEIS

in the region have necessitated notable investments in

projects at field sites associated with the overseas

staff training and infrastructure.  In the localities

research activities contributes to both scientific and

where the other four DoD tropical overseas medical

fiscal efficiency.  

32