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DR EMELDA OKIRO: Pioneer of the saliva test

Saturday March 31 2012

Dr Emelda Okiro is the eighth born of nine siblings.

She studied in Lavington Primary School in Nairobi to Class 4 when her father retired and the family relocated to Kitale.

“Our parents felt there were no schools good enough for us near home. My small sister and I were sent to boarding school. I was only 10, it was a big change and I had to take responsibility for my younger sister. But we managed,” she said.

From Kitale Academy, she attended Kenya High School.

Dr Okiro enrolled for a Bachelor of Science degree in biochemistry and chemistry at Egerton University from 1996-2001.

Her dream job was to be a medical representative but that changed when she came across an advert for a research assistant in KEMRI-Kilifi and applied.

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“There were people at the interview with master’s degrees and more experience than me but I got the job. I had not expected it,” she said.

She was then immersed in work that she had not previously considered.

“I watched other scientists at work but I also enjoyed what I did. My boss, Prof James Nokes, was such an inspiration. It was clear to me then that my career would be in research,” Dr Okiro said.

Within a year, she had enrolled for a PhD programme – according to the UK university she applied to, all she needed was research experience and a good first degree.

For her PhD, she studied the transmission dynamics of Respiratory Syncytial Virus (RSV).

RSV causes a mild respiratory tract infection but in children under one year, it can cause a severe illness, which can be fatal.

After pneumococcal bacteria, RSV is recognised as a major viral cause of lower respiratory tract infections in infants and children.

From data collected in Kilifi, it is estimated that more than 17,000 infants are hospitalised each year in Kenya as a result of pneumonia due to RSV.

Dr Okiro’s study followed children born at the Kilifi District hospital over a period of four years and for those who were admitted with RSV, a household survey was conducted.

Her study also sought to find out whether saliva instead of blood could be used in the diagnosis of RSV infection.

Taking blood samples is not only painful to the study participant but it requires more skilled personnel and takes longer.

This was the first study of its kind for RSV and the results showed that provided stringent care was taken, saliva samples could be used for diagnosis of infection.

Dr Okiro completed her PhD in 2007 aged 30. She decided to shift from RSV to malaria research.

“I wanted to work on a disease that had a bigger public health importance – malaria was one such disease. The epidemiology unit at Nairobi led by Prof Snow, who has a long history of working on malaria, provided an ideal opportunity for me to do some world class research,” Dr Okiro said.

She successfully applied for funding from the Wellcome Trust and has been doing malaria research for the past four years.

Her work is aimed at tracking changes in paediatric admissions for malaria in various hospitals in Kenya, Tanzania, Uganda, Malawi and Rwanda in the period 2000-2010.

The work was necessary because of recent talk about the decline in malaria.

However, the countries in which this has been observed have had lower transmission of malaria but there has been a dearth of information from areas that traditionally have high malaria transmission.

It is hoped the data will fill in this gap and provide accurate information of what the temporal changes in malaria admissions have been in this 11-year period. “Malaria may be declining in some areas but we are a long way from eradication,” Dr Okiro said.

Dr Okiro is currently undertaking a fellowship at the Institute for Health Metrics and Evaluation at the University of Washington working on measures of mortality linked to her previous work.

“After a year in the US, I will come back home and apply for more funding to continue with the research by that time with the added technical skills and knowledge from one-year training abroad.”

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