Assessing novel intervention strategies for malaria elimination in difficult-to-reach communities in the Peruvian Amazon
Project Summary
Some malaria-endemic countries around the world have transitioned from high/moderate to low transmission. This resulted in a patched distribution of infections in remote-indigenous areas, where their detection is hindered due to very low parasitemia, asymptomatic infections and the usage of microscopy or rapid tests as routine surveillance tools. The latter ones, under decrease their sensitivity and specificity elimination contexts, causing undiagnosed infections that are mistreated, and maintaining the malaria reservoir. Therefore, WHO highlights the need to urgently adapt elimination strategies with accurate diagnosis and more robust health systems for effective disease management in elimination contexts.
In the present project, we aim to develop and implement an improved malaria diagnostic approach in remote communities with a high burden of low-density infections in the Peruvian Amazon. In collaboration with Peruvian partner institutions, we will support the development and adaptation of an in-house loop-mediated isothermal amplification (LAMP) as a molecular diagnostic tool to be used as a point-of-care during routine examination and the national elimination interventions of the Ministry of Health (MoH) in remote areas. Moreover, through mixed methods designs, we will evaluate the cost-effectiveness and the impact of implementing a new diagnostic tool by deploying seroepidemiology approaches, modelling data, and conducting qualitative research to assess the acceptability of the LAMP.
Implementing LAMP into routine diagnosis and within the intervention's strategies can drastically reduce the malaria burden in remote, indigenous areas. This PhD project will provide relevant evidence about implementing a molecular diagnosis and its impact in endemic areas, the hotspots, and reservoirs of malaria in the Amazon.