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Automated diagnostic platform, data management system and innovative communication tool, for improving the impact of malaria vector control interventions

Periodic Reporting for period 3 - DMC-MALVEC (Automated diagnostic platform, data management system and innovative communication tool, for improving the impact of malaria vector control interventions)

Reporting period: 2019-02-01 to 2020-05-31

Malaria causes more than 500,000 deaths every year in sub-Saharan Africa. Prevention of the disease is best achieved by vector control which relies on the use of insecticides. Monitoring mosquito vector populations is a prerequisite for effective interventions. Several individual methods are used for vector monitoring, however, there are many challenges in organizing, interpreting and communicating vector control data.
DMC-MAVEC aims to address these challenges through the development and integration of a fully automated diagnostic platform (LabDisk), a data management system (DDMS) and an innovative communication tool (GAME).
The LabDisk will constitute an ideal diagnostic tool for monitoring which mosquito species are present, the infection status of mosquitoes and whether they are resistant to insecticides. For the first time in an operational setting, the LabDisk will enable the application of diagnostic tests in a low resources environment, that can currently only be analyzed in centralized labs using sophisticated equipment. The system will provide sample-to-answer determinations, which will substantially facilitate the uptake of protocols in target countries. It will be also capable of analyzing pools of 10 mosquitoes to perform genotyping at substantially lower cost (1 diagnostic run instead of 10), compared to the individual assays that are currently extensively used in Africa.
The LabDisk will be interfaced with a Disease Data Management System (DDMS), a custom-made data management software program (smart database) with the inbuilt capability to collect data from routine entomological monitoring activities, store, and make available stratified information based on “user queries” in a standardized way.
The “GAME”, a user-friendly modern ICT platform that employs interactive ways of communicating guidelines and exemplifying good practices of successful insecticide resistance management use, will be also employed. The platform will be upgraded and adapted to include the new data that will be produced by the LabDisk system.
Overall the DMC-MALVEC project offers a focused and pragmatic approach that will deliver novel and improved tools for malaria control within the timeframe of the work program, which will increase the impact of vector control programs and help to secure the ultimate aim of malaria elimination.
We have successfully developed and validated two diagnostic technologies for malaria vector monitoring: the DMC-MALVEC “ready-to-use lyopellets” and the DMC-MLAVEC LabDisk. We have successfully implemented the two diagnostic technologies in Africa and we have installed devices and distributed diagnostic kits. The field validation using mosquito samples collected from the African partners has been concluded and provided results that were highly consistent with previously published data for the areas tested and/or laboratory data that were collected by the African partners using the usual “gold-standard” methodologies.
The DDMS+ was uniquely configured for each of the four partner organisations, and staff in all four countries have been trained in the use of the DDMS+ entomology and administrator modules. Each of the four installations were adapted to include a tailored DDMS+ data entry form to allow for LabDisk information to be entered, stored and queried and reports generated. Country Data Managers have also been trained in how the DDMS+ can be utilised to import other intervention and surveillance data, including data from the DMC-MAVEC diagnostic technologies. Tailored implementation plans to support the specific context of each of the in-country partner organisations were developed with the representative partner organisations.
The GAME was expanded to incorporate the types of data relevant to the DMC-MALVEC diagnostic systems, including molecular identification of vector species, target-site and metabolic resistance mechanisms, and infection with parasites. In addition, decision pathways were incorporated that require the player to use the molecular data they generate in conjunction with data from insecticide resistance bioassays. A further module also aims to address knowledge gaps in the biology of resistance and to improve understanding of decision-making processes that rely on resistance data. Training workshops utilising the GAME have now been delivered in the four partner countries. Subsequent evaluations of the suitability of training and uptake of the gaming for sustainable knowledge transfer amongst workshop participants were tailored for each partner organisation. Facilitator training materials for an IRM course utilising the GAME have been developed to support wider dissemination of across all four partner countries, which have now been trained and localised dissemination plans were developed.
The project’s results and activities have been communicated both to the broad scientific community through twelve peer reviewed publications in international journals, two patents and through participation in more than fifty conferences worldwide. DMC-MALVEC was also communicated both to the general public (open days, public press articles, podcasts, newsletters, posts on social media, updates on project’s website) and to targeted groups, including key malaria stakeholders.
Progress was made towards developing and implementing two novel multiplex diagnostic platforms able to produce reliable results, with reduced equipment requirements over existing methods and at a remarkably lower cost. The field validation using mosquito samples collected from the African partners has been concluded and provided results with emphasis on the practicalities of the novel DMC-MALVEC assays, the ability to capture simultaneously multiplex markers including operationally valuable for resistance monitoring markers for metabolic resistance.
Exchange of personnel between different European and African Institutes and several joint workshops and training sessions took place in order to promote the transfer of technology between European laboratories and between African and European Institutes.
The transfer of technology, in the field of diagnostics, and especially in the field of information management (DDMS) and GAME between LSTM and each of the African partners has been established and will remain in place for the project.
DMC-MALVEC consortium developed a new tool for malaria epidemiology in order to address the crucial need for improving the quality of data available and facilitate evidence-based decision making in malaria vector control.
DMC-MALVEC contributed to innovation capacity on several levels: 1. The diagnostic tools analyze mosquitoes for determining their species, infection status and resistance to insecticides. 2. The DDMS can be used not only in central laboratories but also at the point-of-need. 3. The interfacing of the diagnostic platform with the DDMS and the GAME provides a highly added value to all these individual components.
Significant environmental benefits are also envisaged by the optimum and judicious use of insecticides, through the implementation of evidence-based Insecticide Resistance Management (IRM) and Integrated Vector Management (IVM) strategies, which aim to suppress vector populations by using a minimum - optimum use of insecticides.