Table 1.
Overview of Malawi ICEMR-supported studies
| Study design (years) | Settings | Participants | Participant follow-up | Associated vector sampling |
|---|---|---|---|---|
| A. ICEMR Phase 1: Determinants of Malaria Disease in Malawi | ||||
| Characterize the changing epidemiology of malaria in diverse settings | ||||
| Facility-based surveillance (2012–2013) | Peri-urban Rural highland Rural lowland | All ages, presenting at health center | > 50,000 visits, 25,486 with a febrile illness | N/A |
| Household-based cross-sectional surveys (2012–2016) | Peri-urban Rural highland Rural lowland | All ages | 16,650 visits over six surveys | Prokopack aspiration, CDC light traps |
| School-based cohort (2015) | Rural highland Rural lowland | 5- to 15-year-old students | 786 students; 2,888 visits | N/A |
| Community cohort (2014–2017) | Rural lowland | All ages after malaria diagnosis | 120 participants; 1,062 visits | N/A |
| Evaluate patterns and drivers of malaria in “urban” settings | ||||
| Case–control (2012–2015) | Urban/peri-urban | Children under 5 years | 850 | Prokopack aspiration, CDC light traps |
| Transect (2015–2016) | Urban-to-rural continuum | Children under 5 years | 1,400 | Prokopack aspiration, CDC light traps |
| B. ICEMR Phase 2: The Intransigence of Malaria in Malawi: Understanding Hidden Reservoirs, Successful Vectors and Prevention Failures | ||||
| Epidemiology of malaria risk in Malawi: vector resistance, ITNS, and human behavior | ||||
| Community cohort (2019–2021*) | Rural—pyrethroid only LLINs Rural—PBO LLINs | 6 months–15 years | 1,883 participants; 16,900 active and 4,398 passive case detection visits | Prokopack aspiration, CDC light traps, human landing catches, larval sampling for resistance testing |
| Reservoirs of transmission: targets for malaria control interventions | ||||
| Community cohort (2019–2021*) | Rural—pyrethroid only LLINs Rural—PBO LLINs | All ages | 804 participants; 6,759 active and 1,290 passive case detection visits | Prokopack aspiration, pyrethrum spray catches, CDC light traps |
| Community cohort (2021–present) | Rural—PBO LLINs | All ages | Ongoing | Pyrethrum spray catches, CDC light traps (planned) |
| Malaria pathogenesis: the spectrum from asymptomatic infection to life-threatening disease | ||||
| Community cohort (2021–present) | Rural—pyrethroid only LLINs Rural—PBO LLINs | 2–8 years | Five cohorts, 200 participants each Ongoing | N/A |
| Case–control (2021–present) | Referral hospital and rural-to-urban catchment areas | Cases: severe malaria Controls: age- and gender-matched in case village | 25 cases, 23 controls Ongoing | N/A |
| VANSS: combined effects of RTS, S vaccination and PBO nets on malaria infection and transmission in Malawi | ||||
| Community cohort (2020) | Rural—pyrethroid only LLINs Rural—RTS,S vaccine + PBO LLINs | 7–18 months (index children, age eligible for RTS,S vaccine 19 months–10 years (siblings) | 919 (index + siblings) in pyrethroid-only LLINs 773 (index + siblings) in RTS,S/PBO | CDC light traps |
ICEMR = International Center of Excellence for Malaria Research; LLIN = long-lasting insecticidal nets; N/A = not applicable; PBO = piperonyl butoxide; VANSS = Vaccine and Nets Study.
*
Study activities halted due to COVID April 2020–April 2021.