Karonga Prevention Study
Introduction
Please note: The Karonga Prevention Study is currently in the process of changing it's name to the Malawi Epidemiology and Intervention Research Unit (MEIRU).
The Malawi Epidemiology and Intervention Research Unit (MEIRU) is a partnership between the Malawi College of Medicine and the London School of Hygiene and Tropical Medicine (LSHTM). MEIRU works closely with the Ministry of Health, with its research agenda aligned to the Ministry of Health research priorities. Co-investigators from each of the 3 institutions play a leading role in setting the research agenda. The PI is Shabbar Jaffar, a Professor of Epidemiology within the Faculty of Epidemiology and Population Health at LSHTM, and based in Lilongwe. The lead investigators at the College of Medicine and the Ministry of Health are Moffat Nyirenda, Professor of Research, and Dr Charles Mwansambo, the Principal Secretary of Health.
Our research programme started in Karonga District in 1979 to study the incidence and risk factors of leprosy, funded by the British Leprosy Relief Association (LEPRA) and until recently was known as the Karonga Prevention Study. We have been predominantly funded by the Wellcome Trust since 1996. Over the years, the major research focus has been on tuberculosis, demography and HIV/AIDS with field activities based in Karonga District where the programme has a long-term and detailed understanding of demography and disease epidemiology. Our database links work over time and activity and includes data on more than 300,000 individuals. We have a biorepository of over 100,000 samples and continuous demographic surveillance system (DSS) in a sub-population of 35,000. Research in Karonga will continue, building on the past findings to address new questions. The activities will be co-ordinated by the Deputy Director, Dr Mia Crampin, a Senior Lecturer in Epidemiology, supported by the Programme Manager, Yoryos Ponnighaus. Both are based in Chilumba.
A major new focus for the programme is research on non-communicable diseases given their rapid rise, including among young people in Africa, and the high priority placed by government for research in this area. We plan, in the first instance, to estimate the burden of hypertension, diabetes and hyperlipidaemia, to quantify the risk factors including smoking, diet and lifestyle, and to examine the barriers to accessing care for people with non-communicable diseases. These studies will be done over a 1-2 year time period and are designed to inform large-scale intervention studies. The non-communicable disease programme will be led by Prof Moffat Nyirenda.
Intervention research in non-communicable diseases will be a major area of expansion for the group in the near future. The programme is opening up a research centre in Lilongwe to complement the work in Karonga and enable rural-urban comparisons. In Lilongwe, MEIRU will be based within the Ministry of Health Community Health Sciences Unit with research activity mostly in Area 25 and Area 18. Urban- rural comparisons will be done in non-communicable disease epidemiology and in impact evaluation of interventions both for non-communicable diseases and for HIV/AIDS policy. It is in light of the change in our research emphasis to intervention research and the widening of our perspective to both urban and rural populations, that we changed our name from Karonga Prevention Study to the Malawi Epidemiology and Intervention Research Unit.
As well as the strong emphasis in research, MEIRU will develop capacity in NCD research, medical statistics and epidemiology, principally through the College of Medicine. Our key partner in capacity development will be Prof Ken Maleta, principal of the Malawi College of Medicine. We will also forge links with other institutions in the region with a view to conducting multi-country studies.
We have many other partners who play a major role in the research programme. They include Profs Judith Glynn and Basia Zaba at LSHTM who are both co-applicants on the strategic award core grant, Dr Victor Mwapasa and Dr Bagrey Ngwira at the College of Medicine;Dr Storn Kabuluzi (Director, Preventive Health Services), Dr Ben Chilima (Director, Community Health Sciences Unit), Dr Frank Chimbwandira (Director, HIV/AIDS), Dr George Chithope-Mwale (Director, Clinical Services), Dr James Mpunga (Director, National tuberculosis control programme) and Dr Michael Kayange (Head, Karonga District Health Management team) at the Ministry of Health; Prof Anthony Harries at the International Union Against Tuberculosis and Lung Disease (former advisor to the Malawi HIV/AIDS Unit and National TB Control programme); and Profs Shah Ebrahim, Peter Piot, Peter Smith at LSHTM who are advisors to the Director.
MEIRU is also part of the Indepth Network: www.indepth-network.org
