Malaria operations research to improve malaria control and reduce morbidity and mortality in western Kenya

This application is for the fourth, 5-year CoAG between CDC’s Malaria Branch and the Liverpool School of Tropical Medicine (LSTM). Activities take place in western Kenya under the umbrella of the long-term collaboration between the Kenya Medical Research Institute (KEMRI), CDC, and LSTM and benefit from LSTM’s existing infrastructure in Kenya. To maintain low transmission status, this requires a shift from the existing periodic, district-level surveillance to systems where surveillance itself becomes an intervention and can detect individual geo-located cases near real-time for rapid notification and foci investigation. The project will support the Kenyan Ministry of Health (MoH) with their goal to digitise the data collected on their paper-based health registers using software that makes them scannable (1.1.5). This will include registers that capture case-burden data used in out-patient departments (1.1.6) and by community health workers as part of integrated community case management (ICCM) (1.1.7), and antenatal clinic registers that capture malaria infection prevalence during first antenatal clinic visits. This is a novel method to track the asymptomatic parasite reservoir in populations (1.1.8). Combined, this allows, for the first time, sustainable, daily, near real-time surveillance to track progress towards malaria transmission reduction targets. The project will also conduct continuous malaria indicator household surveys (cMIS) to track malaria prevalence and intervention coverage (1.1.9) and entomological monitoring (1.2), both using adaptive sampling frameworks that can respond to challenges related to rapid changes in malaria transmission. The optimal combination of novel or improved interventions will be developed in close collaboration with CDC in 2020/21. This is likely to include enhanced case- management using digitally supported quality improvement approaches of ICCM, enhanced vector control with larval source management and insecticide-treated piperonyl butoxide (PBO) nets, and mass drug administration with dihydroartemisinin-piperaquine and ivermectin targeting the asymptomatic parasite reservoir (2.1). The project will liaise with CDC’s laboratories in Atlanta for the molecular monitoring of drug resistance.

Project details

Combination of Interventions
Epidemiology
Health Workforce
Surveillance

Sep 2020 — Aug 2025

$8.83M

Kenya

Larval source management