Browsing by Author "Tonney, Nyirenda"

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    Characterising COVID-19 occupational exposure among healthcare workers through the validation of point-of-care diagnostics
    (Kamuzu University of Health Sciences, 2020-06-02) Tonney, Nyirenda
    Study type Prospective cohort study Problem A substantial number of COVID-19 infections have been reported in health care workers (HCWs) in over 50 countries. In Malawi, HCWs are particularly vulnerable, owing to the lack of personal protective equipment and infection prevention and control measures in healthcare facilities, fragile healthcare infrastructure and the lowest number of physicians per population. In Malawi, COVID-19 infection amongst HCWs can have devastating effects on an already fragile healthcare system. A key challenge facing Malawi is the lack of access to specialist laboratory infrastructure. If the pandemic takes off in Malawi, these diagnostic facilities will be rapidly overwhelmed. Validation of low-cost rapid diagnostic tests will allow the accurately diagnosis of COVID- 19 infection.Validation of low-cost rapid diagnostic tests that can accurately diagnose current COVID-19 infection. Timely diagnosis of current COVID-19 infection will enable timely health facilities to make investigations and implement institution of containment measures, such as quarantine and contract tracing. Objectives  Characterise COVID-19 occupational exposure among healthcare workers in Blantyre district  Evaluate existing point-of-care (POC) antibody tests, an in-house enzyme-linked immunosorbent assay (ELISA) and a novel POC loop-mediated isothermal amplification (LAMP) assay. The study will recruit 150 HCWs and 150 matching community controls at the following healthy facilities in Blantyre district: Queen Elizabeth Central Hospital (QECH), Kameza Isolation Centre and health centres in Blantyre urban To determine current infection and exposure, nasopharyngeal and serum samples will be screened for SARS-CoV-2 by RT-PCR and immune response (IgM/IgG) evaluated respectively using in-house and commercial SARS-CoV-2 enzyme-linked immunosorbent assays (ELISA). We will also carry out a double-blind investigation to validate a novel RTLAMP assay using RT-PCR as gold standard. Additionally, we will evaluate the performance of other commercially available point-of-care (POC) rapid diagnostic tests (RDTs). We will then use bulk and single cell transcriptomic approaches to try and understand why immunological response varies. Laboratory analyses will be performed at College of Medicine, University of Malawi. Expected findings The risk of HCW to COVID-19 will be established; this will inform guidelines on occupational safety. POC assays will be validated, which will establish the best diagnostics for use in district hospitals and health centres, where there are no RT-PCR facilities. Furthermore, the study will provide guidance on diagnostics for COVID-19. Finally, we will evaluate the immunological response to SARS-CoV-2 and why this varied between individuals and attempt to determine why some individuals exhibit symptoms.