UnMASC: Uganda Malaria Actionable Surveillance in the time of Coronavirus

The EPPIcenter was recently funded by the Bill & Melinda Gates Foundation to perform malaria surveillance in Uganda to generate actionable knowledge for Ugandan policymakers about how to reduce the spread of COVID-19 and reduce the impact of the epidemic on morbidity and mortality from malaria.

Enhanced malaria surveillance will be essential to understanding the ripple effects of the COVID-19 pandemic on malaria transmission, burden, and care, and to respond quickly if needed. To complete this project, we will take advantage of a project called the Uganda Malaria Surveillance Project (UMSP), established by our group at UCSF in 2006 in collaboration with the National Malaria Control Program (NMCP) and the Infectious Diseases Research Collaboration (IDRC) in Uganda. This project now includes 68 health facilities in areas of varying malaria prevalence, termed Malaria Reference Centers (MRCs). 

At many of the MRCs, we have been collecting malaria indicator data for years. As a result of this project, we will be able to track changes in these indicators as relates to the COVID-19 pandemic. We will also be able to collect additional data, including effects on antimalarial and rapid diagnostic testing availability at these facilities.

Simply measuring these changes will not provide a full picture. The effects of the lockdown, people avoiding the clinic because of the COVID-19 pandemic, drug or test stockouts, or changes in malaria control interventions, might all affect the flow through the 68 MRCs. Therefore, we will perform community-based surveys in the catchment areas surrounding a subset of 10 MRCs, combining questionnaires regarding changes in healthcare seeking behavior due to COVID-19 and coverage of vector control interventions with community parasite prevalence and seroprevalence for malaria.

In addition, our work with IDRC to develop high-throughput approaches to discover novel precision biomarkers of recent Plasmodium falciparum exposure means that sophisticated laboratory capacity exists in Uganda for precision serosurveillance. By combining data on microscopic parasite prevalence and data generated from precision serosurveillance, we will be able to estimate recent malaria transmission intensities that will be essential to interpret changes in malaria indicators from MRCs.

As in most of our work, partnerships are key. The IDRC team in Uganda, lead by PI Isaac Ssewanyana, is a key partner on this project and has also been funded by the Gates Foundation to support this work. 

The EPPIcenter is thrilled to have been awarded this 18 month grant from the Gates Foundation, particularly as it will support a current and a new postdoctoral scholar. The center is committed to strong programs in research, developing new resources, and training the next generation of experts.