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Professor pivots from Kenya to Kansas (and back again) to serve global health needs in pandemic

The work of Sarah Finocchario Kessler, Ph.D., MPH, supports the progressive efforts of Wyandotte County Health Department to address social needs of Covid-positive residents.

Sarah Finocchario Kessler. professor in the Department of Family Medicine and Community Health at the University of Kansas Medical Center, adapted a program she used in her HIV research in Africa to help health departments in Wyandotte and Johnson counties in Kansas. Health officials there used the program as they assisted those with COVID-19. Kessler then offered that same adaptation to her health care partners in Kenya.

There's been a lot of talk about "flexibility" and "resiliency" during the COVID-19 pandemic. So much, in fact, that it's easy for those words to lose their meaning.

But one way to refocus the tenacity it takes to keep pushing ahead is to learn about Sarah Finocchario Kessler.

Kessler, Ph.D., MPH, is an associate professor at the University of Kansas School of Medicine. Her faculty position within the Department of Family Medicine and Community Health was initially centered on HIV research and how the childbearing process could be improved for women who were HIV-positive.

Researching in Africa

Her research took her to Kenya, where the rate of HIV in adults is 4.7%, compared to 0.03% in the United States. "I've been working with a team there since about 2010. I typically go between three and four times a year, and a team from Kenya usually visits the Kansas City area once a year," Kessler said.

She set up important contacts in Kenyan health care not only to advance her research but also to make a real difference in the lives of mothers and babies born under the looming cloud of HIV. She looked at how to speed up the testing of infants born to HIV-positive mothers since quicker medical interventions means better outcomes for the babies who do test positive.

"We looked within the local structure (in Kenya) for ways to intervene and try to expedite services," Kessler said. "For instance, we tracked samples going to the lab for HIV tests, and the results went from taking two to three months to only two to three weeks."

Winning an award for research she couldn't do

But when the pandemic hit, and trips to Kenya were no longer possible, Kessler had to refocus. She won the university's Scholarly Achievement Award in 2020, which is given to only a handful of professors to celebrate their mid-career research. And now, just weeks after accepting the honor, she faced a blockade.

And here's where the resilience part comes in. Sure, Kessler could keep up with her contacts in Kenya through phone calls and video conferencing (when the internet complied), but it would be tough going without face-to-face visits for who knows how long.

And like many faculty members, Kessler wanted to contribute to the fight against COVID-19. With a doctorate from the Johns Hopkins Bloomberg School of Public Health, Kessler knew she was looking down the barrel of the biggest public health crisis of her career. How could she help?

Adapting established software to new pandemic

The answer came from her own research. She already had experience with an HIV Infant Tracking System (HITSystem), which was a software program developed by a former graduate school classmate at Johns Hopkins. Why not use that same system as a basis for a COVID-19 tracking system?

The parallels were there: both HIV and COVID-19 are contagious diseases that depend on quick turnaround of diagnostic tests and early intervention in communicating with the people who may have been exposed.

With a $50,000 pilot grant from KU School of Medicine, Kessler spent about five months developing and refining the system. The COVID-19 Tracking System (CTS) used the same dashboard alerts, algorithm-driven prompts and high-priority alerts as the HITSystem. Also like its predecessor, the CTS can generate specific reports for contact tracers and send out automated text messages to potential contacts of anyone testing COVID-positive.

"The systems target different disease outcomes - one HIV, one COVID - in the very different settings of Kenya versus Kansas," Kessler said. "Each system has been customized for the required data collection, reporting and workflow in each setting."

Serving social needs in Wyandotte and Johnson counties

The CTS was designed for Wyandotte and Johnson counties, but it faced initial problems linking with the state-mandated EpiTrax system. EpiTrax, which Kansas adopted in 2019, is a system to track and report health outbreaks. To avoid duplicating efforts, her team pivoted to support the progressive efforts of the Wyandotte County Health Department to address social needs of Covid-positive residents.

So, case investigators used CTS to:

  • Track and support referrals for food and cleaning supplies
  • Provide referrals to mental health services and/or primary care
  • Link residents with a community health care worker to address additional health issues
  • Track and document community health care worker outreach for COVID-19-related activities

Kessler said she wants to offer the CTS to her colleagues in Africa to bridge any system gaps in their COVID-19 response. "We plan to begin working with the Ministry of Health in Kenya to modify the Kansas version of CTS to meet their needs," Kessler said.

Exemplifying global health

Attending to the pandemic's public health crisis on two continents lends credence to a comment provided by Kimberly Connelly, senior international officer for KU Medical Center. Connelly said Kessler is her "go-to person" for students who want to know more about global health, and Kessler reminds students what "global health" really means.

"The thing is, global health is local. People think it's only international, but those who are interested in global health are interested in health disparities, health inequalities and community health," Connelly said. And Kessler "exemplifies" global health at KU Medical Center, she continued.

"Dr. Kessler genuinely honors the knowledge base of whoever she's working with. People involved in global health are the most humble, kind people, and Dr. Kessler is especially incredible this way," Connelly said. "She listens, and she's very collaborative in all that she does."

Sarah Kessler (right) and May Maloba (left)

In her last trip to Kenya before the pandemic, Kessler (right) met with May Maloba, director of Global Health Innovations. Maloba is a co-investigator with Kessler in HIV research. She also is studying in the online Ph.D. program at the KU School of Nursing while in Kenya.

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