We will take advantage of a project called the Uganda Malaria Surveillance Project (UMSP), established by our group at UCSF in 2006 in collaboration with the National Malaria Control Program (NMCP) and the Infectious Diseases Research Collaboration (IDRC) in Uganda. This project now includes 68 health facilities in areas of varying malaria prevalence, termed Malaria Reference Centers (MRCs). we will perform community-based surveys in the catchment areas surrounding a subset of 10 MRCs, combining questionnaires regarding changes in healthcare seeking behavior due to COVID-19 and coverage of vector control interventions with community parasite prevalence and seroprevalence for malaria. In addition, our work with IDRC to develop high-throughput approaches to discover novel precision biomarkers of recent Plasmodium falciparum exposure means that sophisticated laboratory capacity exists in Uganda for precision serosurveillance. By combining data on microscopic parasite prevalence and data generated from precision serosurveillance, we will be able to estimate recent malaria transmission intensities that will be essential to interpret changes in malaria indicators from MRCs.
Aim 1: Investigate the effect of the COVID-19 pandemic on routine malaria care, healthcare-seeking behavior, and household-level malaria control interventions by combining data from MRCs and community-based surveys in the surrounding districts
Aim 2: Estimate malaria transmission in communities surrounding MRCs using parasite prevalence and precision serosurveillance to contextualize changes in malaria indicators as measured by MRCs during the COVID-19 pandemic