Browsing by Author "Muula, Adamson"

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    Human and infrastructural capacity needs assessment for research ethics system in Malawi
    (Kamuzu University of Health Science, 2021-06-16) Muula, Adamson
    This is a cross-sectional needs assessment survey. Background As international research and ethics training programs increase and evolve, efforts to evaluate and monitor the impact of such programs have emerged. Capacity development and professional training in the ethical issues of global health research has also emerged as a critical area for advanced training. It is therefore important to recognize that the ever increasing health-related research in Africa calls for a proportionate rise in the setting up of functional health research oversight/governance structures and mechanisms. This needs assessment will allow us to appreciate the current state of affairs and the areas that need to be strengthened for a functional research ethics system in Malawi. Results from this exercise will further support development of an action plan for research ethics in the country. We will therefore consider the larger research practice, research oversight systems in place and policy context in the country. Broadly we intend to identify human and infrastructural capacity needs required to support an efficient and effective research ethics system and mechanism in Malawi. to do this, in this study, we will; Explore infrastructural needs of the research ethics committees to provide an effective research ethics oversight. Identify training needs for research ethics committee members for them to be able to effectively manage research ethics review process. Identify the existence and quality of locally relevant research ethics training programs. Assess the need for advanced training program in research ethics by the institutions of higher learning. Identify funding pathways and commitments for research ethics capacity development. Methods This will be a mixed methods study employing a simultaneous quantitative and qualitative approaches. The study will have a national scope targeting respondent from research and ethics committees, training institutions and their affiliate research institutions and study monitors. We will use Key Informant interviews and in depth interviews to collect data. The protocol will be submitted to COMREC for ethical review and clearance. The study will be implemented from April to August, 2021. 16-Jun-2021Expected findings We expect to identify the infrastructural, systems and human resources needs for an effective research ethics system in Malawi. These findings will help align future capacity strengthening efforts with the needs of those within the broader community of research ethics and the relevant stakeholders. Dissemination of study findings A report will be developed following which will be shared to different stakeholders in research ethics including COMREC, we will also disseminate the findings to all participating institutions from which respondents were drawn. We will write manuscripts for publication in reputable journals. We will further organize a dissemination conference for stakeholders in research ethics in Malawi.
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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.
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    A situation assessment of multi-stakeholder experiences, prison system preparedness and health, penal and judicial measures taken to mitigate COVID-19 in Malawian and Zimbabwean prisons
    (Kamuzu University of Health Sciences, 2021-05-12) Muula, Adamson
    Study type: This is a qualitative study using Empirical Phenomenological Psychological (EPP) five-step quality framework. Problem being studied: Prisons in the sub-Saharan region have been neglected in State COVID-19 responses and state budgeting, with efforts by government limited to prison lockdowns, and early release schemes, presidential pardoning and amnesties in an effort to reduce congestion. There are reports of insufficient disease mitigation measures for both staff (testing capacity, personal protective equipment, sanitation, disinfection) and prisoners alike, leading to prison riots and staff strike actions demanding hazard pay. Tackling disease in prisons is a human rights and public health imperative, given the bridge of transmission between prison and community via visitors, legal representatives, staff and prisoners. Broad objective The broad objective of the study is to assess the COVID-19 response and level of human rights assurance of prisoners and staff. Research Objectives: Specific objectives The specific objectives of the study are to: 1. Map and describe international human, health, occupational and gender rights standards applicable to those living and working in prisons, and WHO/UNODC/UNAIDS/OHCHR technical guidance on minimum standards of care and working conditions. 2. Conduct a legal realist analysis of domestic prison policies relating to disease response preparedness, and health, penal and judicial measures taken by the government to mitigate contagion, especially COVID-19; and the extent to which rights of prisoners and staff are upheld. 3. Explore multi-stakeholder perspectives of the COVID-19 response Methodogy: The EPP approach to collecting and analysing data focus on the subjective experience, in this sense the lived experience of COVID-19 in the prison, and adheres to Husserl’s principle of active efforts to ‘bracket out’ the researchers’ theoretical preunderstanding in the first steps of a text analysis. Data will be collected from Chichiri central prison in Blantyre, Malawi. Focus group discussions will be conducted with consenting male and female prisoners and prison warders. Key informant Interviews will be conducted with prison officers, prison medical officer, legal personnel and other key stakeholders who work closely with prisons. All interviews will be recorded, transcribed verbatim and translated into English where required for analysis. In order to ensure scientific rigour, the EPP five-step quality framework will be used to analyse qualitative and observational data. Expected results and benefits: We expect to find gaps in adherence to COVID-19 preventive measures and adherence to standard human rights protocols within the prison setting.These results will help advocate for adherence to health and human rights standards to prevent populations in these settings from getting infected with COVID-19. Dissemination of findings: The findings will be disseminated to study respondents and key stakeholders through meetings/workshop. Again we intend to share the study findings with COMREC and participants at scientific conferences either in Malawi or internationally. The results will also be published in a peer reviewed journal.