Browsing by Author "Jere, Khuzwayo"

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    Impact of the COVID -19 pandemic on morbidity and mortality due to enteric infections in children < 5 years of age in Malawi
    (Malawi Liverpool Welcome Trust, 16-03-22) Jere, Khuzwayo
    Study type: Observational study Problem: Since April 2020, Malawi has experienced three waves of Sars-Cov-2 rapid transmission and associated deaths. The spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has impacted health services globally. Consequent disruption of routine health services is expected to have long-term and far-reaching consequences. Significant reductions in the numbers of inpatients or attendance to primary/community health care clinics for illnesses other than COVID-19 have been described in many settings. Among other reasons, these changes could be due to movement restrictions preventing travel to health care facilities, lack of space at these facilities due to COVID-19, or avoidance of medical institutions due to concerns of exposure. Main objective: This protocol aims to assess the impact of COVID-19 on morbidity and mortality associated with enteric illness in Low -Middle-Income Countries (LMICs). Specific objectives: a. Evaluate the temporal diarrheal trends in relation to national and, where available, local COVID-19 activity, by examining routinely collected data on hospital admissions or attendance to the outpatient department (OPD) and community health clinics with a diagnosis of diarrhea. b. Assess the temporal trends in diarrheal disease severity and mortality among children under 5 years of age in relation to COVID-19 activity, by examining hospitalization data with a diagnosis of diarrheal illness. c. Estimate the impact of disruption to Extended Programme on Immunisation (EPI) on rotavirus diarrheal disease Methodology: Data on the monthly number of diarrheal disease cases, on monthly EPI vaccine and dose-specific administration, and on inpatient diarrheal cases’ associated mortality for children <5 for all 28 districts of Malawi will be obtained from the Ministry of Health’s Health Management Information System (HMIS). Data will be aggregated by the 5 health zones (Northern, Central East, Central West, Southeast, and Southwest regions of Malawi). Exploratory analysis will include data aggregation by urban-rural categories too. Where data gaps exist in the electronic database inspection of the physical records will be done in the districts. Expected Results and Dissemination: A negative impact on seeking care for diarrheal disease and on EPI is expected due to fear of contracting COVID19 at health facilities. Once the data is generated and analyzed for trends, the findings thereof will be shared with the College of Medicine Research Ethics Committee (COMREC), the Ministry of Health (MoH), published in peer reviewed journals and will be disseminated to the general public through the annual College of Medicine Research dissemination conference.
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    Seroprevalence of SARS-CoV-2 antibodies in Malawi blood donors
    (Kamuzu University of Health Sciences & Malawi-Liverpool-Wellcome Trust, 2020-09-07) Jambo, Kondwani; Swarthout, Todd; M'baya, Bridon; Heyderman, Robert; Jere, Khuzwayo; French, Neil; Gordon, Stephen; Muula, Adamson; Chibwana, Marah; Kalata, Newton; Hosseinipour, Mina
    Type of study: Cross-sectional observation study. Problem: In low-income countries, such as Malawi, important public health measures including universal face mask use, social distancing or a lockdown, have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. SARS-CoV-2 serosurveys of blood donor samples in blood banks are supported by WHO as a potential useful tool for tracking the emergence and progression of the COVID-19 pandemic. Broad and Specific Objectives: Broad objective: to identify for SARS-CoV-2 antibodies in blood donors in Malawi, as a marker of past infection and an estimate of population exposure. Specific objectives: Primary objective: to estimate the seroprevalence of SARS CoV-2-specific antibodies in blood donor sera of different age-strata across the entire country. Secondary objectives a) to establish when COVID-19 started circulating in Malawi, and b) to determine the COVID-19 epidemic trajectory over time in Malawi Methodology: Repeated cross-sectional investigation of blood donors from across the country. Using the MBTS sample archive database, we will identify sera collected from multiple age groups, including 15-19, 20-29, 30-39, 40-49, 50-59 and 60+. We will conduct two serosurveys using sera collected between December 2019 to May 2020 (Serosurvey 1), and also those to be collected between June 2020 to December 2020 (Serosurvey 2). SARSCoV-2 antibodies will be measured from the sera using ELISA and Luminex-based IgG/IgM multiplex assay targeting Spike (S) and Nucleoprotein (N). We will also measure neutralisation potency of the detected SARS-CoV-2 antibodies. Study setting and period: The laboratory experiments will be conducted at the MLW laboratories. The study will be conducted between October 2020 to July 2021. Ethical considerations: At time of donation, blood donors provide consent to participate in studies of public health importance or those aimed at improving availability of supplies of safe blood. COVID-19 research qualifies for an activity of emergency Public Health importance. We will generate unique sample identifiers and will not have access to the donor details with identifiable names. Data Management and analysis: All data will be stored in secure password protected computers at the MLW. Only study investigators will have access to the data, unless prior collaborative agreements are in place or data has been released as part of open access. We will calculate population and age-specific seroprevalence of SARS CoV-2. These will be reported as proportions of SARS CoV-2 antibody positive individual in the total population or per age strata. We will also estimate the potential period of SARS-CoV-2 entry into Malawi, by using the latest known validated SARS-CoV-2 antibody positive sample. Expected findings: a) Prevalence of SARS CoV-2 exposure amongst blood donors, as a surrogate of population exposure, b) An estimate of potential time of SARS CoV-2 entry into Malawi. Dissemination: The results will be disseminated at local and international conference and manuscripts will be published in an international peer-reviewed journal, and policy-related findings will be shared via the MLW Policy unit. The results will also be shared with COMREC.