1. WORLD FRIENDS KENYA Addis Ababa, 13 th October 2011 REPORT ON EDTCP PROJECT ACTIVITIES

2. CME on EDTCP project. Neema Hospital 24 th February 2011. Dr. Zazzi (AVS) explains EDTCP project to Neema Hospital staff.

3. 21 st -25 th February 2011. Lab Training on HIV drug resistance KEMRI, Nairobi By M. Zazzi (EuResist Network) and G. Meini (UoS). Facilitated by M. Mwau Topics: Overview of the genotypic antiretroviral resistance testing technology; Setting up the HIV drug resistance testing laboratory Step-by-step parallel theory and practical session : Sample processing & HIV RNA extraction; HIV RNA reverse transcription; Nested PCR; Analysis of PCR products; Storage and shipment of amplified products for remote resistance testing; Collection, storage and shipment of dried blood spots for remote resistance testing.

4. 21 st -25 th February 2011. Lab Training on HIV drug resistance KEMRI, Nairobi LIST OF PARTECIPANTS: Amare Worku; Doreen Mloka; Sabina Mugusi; Stephen Mutuku (RUNH); Arthur Emary; Ezekiel Marandu; Nigus Fikrie; Silvia Kadima (KEMRI); Washington Njogu (RUNH) All participants received a certificate of attendance

5. Sample extraction and lab activities In order to meet EDTCP project’s objectives during 2011, World Friends has taken the following actions: 1.Strengthening partnerships and developing networks on EDTCP project in Kenya.

6. KENYA MEDICAL RESEARCH INSTITUTE (KEMRI) PARTNERSHIP KIVULI DISPENSARY PARTNERSHIP a)Develop questionnaires and consent forms for this research activity in conjunction with WF staff b)Receive samples and store them in a manner that will maintain their integrity c)Conduct the following relevant assays: Viral loads, CD4 enumeration, Full Blood count, HIV testing and the extraction of genetic material for sequencing work, storage and shipment of the relevant materials, as detailed in the research proposal. d) Train the health workers at the Kivuli Centre to determine the criteria for inclusion of the individuals to be recruited in the study. Background: The Kivuli Dispensary has been partnering with WF since 2005; since 2009 within the Continuous Medical Education Programme and on clinical activities. As a first level facility, the Kivuli Dispensary is a very important structure within the World Friends- RU Neema hospital network and referral system. SAMPLE COLLECTION: The team of a Mento Mother, PMTCT Mother, 2 nurses and one Lab Technician employed by the Kivuli Dispensary, from now on called “Team A”, has been put in place in order to implement the activities of the EDTCP project in the Dagoretti Division of Nairobi, under the supervision of the Kivuli Dispensary, in coordination with the Medical Officer in charge of the RUNH and the WF Project Manager.

7. Status of 1. Partnerships and network in place WF KENYA (COORDINATION) KIVULI DISPENSARY First level facility (sample collection) KEMRI Research Institution (Implementation, capacity building) RUARAKA UHAI NEEMA HOSPITAL Integrated Health Facility (LOGISTICS/IMPLEMENTATION)

8. Activity 1. Challenges WF is present in Kenya since many years, therefore its network is stable and trustworthy, nonetheless some internal reorganizations of the staff of Kivuli Dispensary have somehow delayed our timeframe of activities. However, WF has successfully managed to keep continuity of activities by involving the new management of the Kivuli Dispensary into the EDTCP project

9. Sample extraction and lab activities 2. Strengthening Capacities: 2. Strengthening Capacities: Human Resources: a) Training and CME (Continuous Medical Education Programme based in RUNH) b) Collaboration with KEMRI staff Physical resources: a)Improving lab quality and standards (lab quality control guarantee); b)Improving sample storage capacities

10. Status of 2. In progress Successfully completed for the first part of the project (Training); In progress for the second part of the project (selection of workers to be trained in November) Lab quality Control successfully passed; Fridge for sample storage

11. Sample extraction and lab activities 3. Meeting Ethical standards Development and approval of client consent form in close coordination with KEMRI Ensuring consent form is clear and well understood by the clients Best practices for client recruitment

12. Status of 3. In progress/completed Successfully completed for the ethical approval of form to be submitted to clients; Development of best practices and strengthening of system for client recruitment: in progress in close cooperation with the Kivuli staff, still new to the project but adapting very well, system for continuous flow of information already in place

13. Sample extraction and lab activities 4. Sample extraction WF coordinates activities between RUNH Kemri and Kivuli WF-Neema provides reagents and make sure all financial/physical and human resources are available Samples are collected at Kivuli Dispensary and sent to KEMRI for tests

14. Status of 4. Started/In progress On Friday the 7 th of October, the first clients have been recruited by the Kivuli Dispensary. N. 7 Clients have been briefed about scientific purposes of the project and ethical form and booked for sample collection on Wednesday the 12 th of October. The same day the samples are expected to be delivered at Kemri in order to proceed with the tests.

15. THANK YOU FOR YOUR ATTENTION CONTACTS Il progetto in sintesi World Friends Kenya Theta Lane - P.O. BOX 39433-00623, Nairobi, Kenya Tel. +254-20-2726772/3 Fax + 254-20-2726767 nairobioffice@worldfriendskenya.org www.world-friends.it gianfranco.morino@worldfriendskenya.org project.manager1@worldfriendskenya.org washington.njogu@runeemahospital.org