A Identifying The Molecular-Genetic Mechanisms Driving Disparities In Covid-19 Presentation In Kenya( IDZOMO)Identifying The Molecular-Genetic Mechanisms Driving Disparities In Covid-19 Presentation In Kenya( IDZOMO)ation


Global epidemiology of prostate cancer


PCa is most frequently diagnosed cancer worldwide amongst men and then number one cause of mortality as well (1).  Burden of PCa has been reported as highest among men of African descent then men from other racial backgrounds (2, 3). The incidence and mortality rates are 1.6 times and 2.4 times greater, respectively, amongst African American (AA) men compared to European Americans (3). Great variation in incidence and mortality has been observed across geographic regions and populations (1), suggesting multifactorial impacts of genetic variation; genetic differences, lifestyle, diet and environmental factors; access to care and overall life expectancy; and differences in policies for the use of PSA in screening for PCa.



African burden of prostate cancer  

The most frequently diagnosed cancers in Africa are breast cancer in women and PCa in Men (4). PCa incidence rates for African American men are among the highest in the world (5). In Africa, PCa rates have increased and have been found to be comparable to rates for distant stage disease among AAs (5). The advanced stage of presentation is common for most cancer diagnosis in Africa. The suggested reasons for the late diagnosis are shortage of screening, limited initial detection facilities, insufficient knowledge of the early presentation symptoms and signs of cancer amongst the populace and health care workers, and the cancer stigma (4).


Kenyan burden of Prostate cancer  

In a study recently conducted in Kenya, PCa was the leading diagnosed cancer in men causing 15.6% of all cases with an agestandardized rate of 40.6 per 100,000 (6). Because of late presentation of PCa patients to the hospital (7), most of the reported PCa cases in sub-Saharan Africa, including Kenya, are hospital based with few studies conducted on the indigenous population. Among the 108 cases handled at Kenyatta National Hospital (KNH), 26% had PCa (8). The Nairobi cancer registry was established in 2001 in an effort to capture more cases of cancer reported from private and public clinical centers, capturing data on patient demographics, nature of the tumor (diagnosis), treatment, source of data (hospital/laboratory name) and patient follow-up (dead or alive) including the cause. A retrospective analysis of this data to advice on policy intervention and patient safety improvement is lacking. Our study will collect this data and publish our research findings jointly from other i-DZOMO partners for both scientific and general public regarding the burden of PCa, achievements and challenges to overcome.



Principle Instigator
Prof. Peter M.Ngugi


Establishing a Genomic Signature For Aggressive Prostate Cancer in Men From Kenya to Inform population Specific Treatment Strategies


Prostate cancer is the most commonly diagnosed cancer and leading cause of cancer-related deaths amongst men globally. The management of prostate cancer has changed over the last two decades. However, there is paucity of data on individual genetic determinants and role of environmental factors in influencing tumour progression and treatment outcomes especially in patients presenting with aggressive prostate cancer.

Broad Objective

Identify the genetic factors (gene variants and pathways) that drive aggressive prostate cancer in Kenyan men, with the goal to establishing genetic subtypes that could lead to novel curative therapies.

Study Design

A prospective Case Only Study

Study Setting

KNH and Upper Hill Medical Centre


Eligible 100 men patients presenting with aggressive PCa symptoms (age-matched with controls) will be administered a questionnaire to capture their demographics, risk factors and have their blood samples (20mls) and tissue biopsies taken for PSA comparison and DNA extraction and sequencing at Garvan Institute of Medical Research (GIMR, collaborating institution) to identify genetic signatures predisposing to aggressive prostate cancer in relation to environmental factors in a given geographic locations. Two-well-trained Research Assistants will be responsible for data collection and entry in Kenya using the data collection form.  De-identified data will be shared between the sites via the central i-DZOMO database, which will be housed at the Garvan Institute of Medical Research (GIMR). The databases will be used for further analyses and local training in statistical analyses provided under the leadership of the GIMR team.