Last Updated: 29/07/2024
GenMoz 2: Malaria molecular surveillance in Mozambique
Objectives
To build malaria molecular surveillance capacity for parasites and vectors in Mozambique.
The specific aims are:
- Real-time tracking of biological threats (diagnostic and treatment failures/resistance)
- Characterize transmission sources at local and national level (genetic classification of cases in low transmission settings (district level)
- Develop tools to guide decisions upon threats to new antimalarial approaches to be deployed in Mozambique.
- Monitor intervention-driven changes in transmission using parasite genetic diversity metrics.
- Increase production and uptake of MMS indicators for informing decision making through the strengthening of analytical & interpretative capacities
Mozambique faces a significant malaria burden, with 10.3 million cases reported in 2021. Malaria transmission is highly heterogeneous across the country, with a high burden in the north and a very low burden in the south, therefore requiring different strategies for effective control and potential elimination. The GenMoz project (NCT05306067, March 2021-Feb 2024) has operationalized a functional malaria molecular surveillance (MMS) to:
– Detect mutations causing resistance to antimalarials and issues with diagnostic test sensitivity.
– Analyze malaria transmission patterns to identify hotspots and distinguish between local and imported cases.
– Assess how genetic diversity in P. falciparum informs on transmission and intervention effectivenes.
– Use P. falciparum genetic surveillance into antenatal care (ANC) clinics to demonstrate the value of cost-effective surveillance approaches
The National Malaria Control Program (NMCP) is entering a new strategic cycle (2023-2030) with a plan that includes genomic surveillance to guide programmatic decisions on six key malaria control tools : 1. Malaria diagnostics using rapid diagnostic tests (RDTs) based on histidine-rich protein 2 (HRP2); 2. Treatment with artemisinin-based combination therapies (ACTs), including diversification schemes to reduce the emergence of resistance; 3. Chemoprevention for pregnant women and children; 4. R21/Matrix-M vaccine rollout; 5. Individual-level interventions in very low transmission settings and 6. Vector control.
In this new phase 2 of the project (2024-207), the aim is to integrate MMS into this broader surveillance framework and scale up MMS in Mozambique to optimise the public health benefits of the NMCP 2023-2030 strategy in a quality, timely and appropriate manner, both proactively and adaptively.
Diagnostics
Drug Resistance
Health Workforce
Parasite Genetic Diversity
Surveillance
Mar 2024 — Feb 2027
$7M