A significant research initiative, the Accelerating Chikungunya burden Estimation to inform Vaccine Evaluation (ACHIEVE) study, has been launched to comprehensively track the burden of chikungunya in East Africa. Led by scientists at the Centre for Tropical Medicine and Global Health at the University of Oxford, the study will investigate the number of children and adults affected by chikungunya in Kenya and Tanzania, addressing a critical gap in understanding the disease's prevalence and impact in the region.
Study Details and Objectives
Starting in early spring 2025, the ACHIEVE study will screen and test all patients, including children, presenting with fever or neurological symptoms at ten healthcare facilities across Kenya and Tanzania. This comprehensive screening process aims to provide accurate estimates of chikungunya cases, which are believed to be underreported due to limited testing in the region. The study is supported by USD 10.3 million (GBP 7.9 million) funding from the Coalition for Epidemic Preparedness Innovations (CEPI).
The ACHIEVE study team includes scientists from the University of Oxford, 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 collect data to better estimate the number of people affected by chikungunya and inform outbreak planning efforts.
Expert Insights
Professor George Warimwe, Lead of the ACHIEVE study and Professor of Vaccinology at the Centre for Tropical Medicine and Global Health, emphasized the importance of the study: ‘We lack good estimates of the burden of chikungunya in East Africa, and the clinical manifestations of disease are not well characterised, especially in children. This investment is an important step towards improving our understanding of chikungunya in the region that will ultimately inform disease control strategies.’
Dr. Gabrielle Breugelmans, Director of Epidemiology and Data Science at CEPI, added, ‘Having better insights into chikungunya’s prevalence and its associated symptoms will be crucial in guiding the design and implementation of future vaccine trials and vaccination programmes in affected countries. Understanding at-risk groups in East Africa will also help determine the necessary number of chikungunya vaccine doses to be included in global stockpiles for potential future deployment. Additionally, these insights will enable the development of targeted deployment strategies tailored to different locations, based on the varying epidemiological patterns.'
Context and Implications
Chikungunya is characterized by fever and severe joint pain, which can be debilitating and last for weeks, months, or even years, severely impacting quality of life. Other symptoms include muscle pain, headache, nausea, fatigue, and rash. While chikungunya outbreaks are occurring with increasing regularity around the world—with over 480,000 cases reported this year globally—testing remains largely limited in East Africa.
The study will also investigate the prevalence of chikungunya among pregnant women, which may lead to mother-to-child virus transmission, the economic burden associated with chikungunya on local health systems and communities, and the diversity of chikungunya virus strains in the region. This comprehensive approach will improve understanding of the range of viral mutations that vaccines should be targeting.
Advancing Vaccine Development
The ACHIEVE study will provide important data to advance the development of a vaccine against chikungunya. The first-ever chikungunya vaccine—developed by Valneva with support from CEPI and the European Commission—was licensed last year in the US and has since been approved in Canada and the European Union. CEPI and partners are now working to accelerate access to the vaccines in outbreak-affected regions who are most at risk from the disease, such as East Africa.
With outbreaks occurring with increasing regularity, such as the over 390,000 cases in Brazil this year, and an estimated one billion people living in areas at-risk of Chikungunya transmission, the ACHIEVE study marks a crucial step towards improving disease control and preparedness in East Africa.
