In a groundbreaking initiative, the Centre for Tropical Medicine and Global Health at the University of Oxford is spearheading the largest-ever study aimed at understanding the burden of chikungunya in East Africa. This pivotal research will take place in Kenya and Tanzania and is set to unravel the true impact of this debilitating disease on both children and adults.

Chikungunya is primarily known for its severe fever and debilitating joint pain that can linger for weeks, months, or even years, drastically impairing the quality of life for many sufferers. Patients may also experience a range of other symptoms including muscle pain, headaches, nausea, fatigue, and rashes. Alarmingly, certain populations may be more susceptible to severe disease or even death from chikungunya, raising urgent public health concerns.

The urgency of this study is underscored by the alarming rise in global chikungunya cases, with a staggering 480,000 infections reported worldwide this year alone. Yet, in East Africa, testing for this virus remains drastically limited, suggesting that many cases could go unreported, further complicating containment efforts.

Beginning in early spring 2025, the study will involve screening and testing all patients—children included—presenting with fever or neurological symptoms at ten healthcare facilities across Kenya and Tanzania. This initiative, aptly named the Accelerating CHIkungunya burden Estimation to inform Vaccine Evaluation (ACHIEVE) study, has garnered USD 10.3 million (approximately GBP 7.9 million) in funding from the Coalition for Epidemic Preparedness Innovations (CEPI).

The diverse research team includes esteemed institutions such as the University of Nairobi, the Kenya Medical Research Institute (KEMRI)-Centre for Global Health Research, the KEMRI-Wellcome Trust Research Programme, and the Ifakara Health Institute in Tanzania. Over the next three years, the team will meticulously collect data to provide a clearer picture of how many individuals are affected by chikungunya in the region and to inform strategies for managing outbreaks effectively.

Professor George Warimwe, the lead investigator of the ACHIEVE study and a recognized authority in vaccinology, emphasized the need for reliable data: “We lack good estimates of the burden of chikungunya in East Africa, and the clinical manifestations of disease are not well characterized, especially in children. This investment is an essential step toward enhancing our understanding which is crucial for effective disease control strategies.”

Not only will this study shed light on the current landscape of chikungunya, but it will also play a critical role in the development of vaccines. A landmark chikungunya vaccine, developed by French pharmaceutical giant Valneva with CEPI's support, gained approval in the United States last year and has since been authorized in Canada and the EU. CEPI is now focused on accelerating access to these vaccines in regions most affected by chikungunya, particularly East Africa.

Dr. Gabrielle Breugelmans, CEPI's Director of Epidemiology and Data Science, stated, “Enhanced insights into chikungunya’s prevalence and symptoms will be crucial for designing future vaccine trials and programs in affected countries. Such knowledge will also aid in determining the necessary number of vaccine doses to be included in global stockpiles, ensuring that we are prepared for potential future outbreaks.”

In an alarming context, chikungunya outbreaks are not limited to Africa; Brazil has reported over 390,000 cases this year alone. It's estimated that over a billion people worldwide live in areas at risk for chikungunya, a situation exacerbated by climate change, which facilitates the virus’s spread.

The ACHIEVE study will also explore several critical aspects, including: - **Chikungunya prevalence among pregnant women**, which can lead to mother-to-child transmission of the virus. - **The economic impact of chikungunya** on local health systems and communities. - **Diversity in chikungunya virus strains**, which is vital for understanding different viral mutations and refining vaccine efficacy.

Stay tuned for ongoing updates on this essential research as it unfolds, potentially shaping the future of infectious disease management in East Africa and beyond!