SARS-CoV-2 infection, transmission dynamics and household impact in Malawi (SCATHIM)
Lead Research Organisation:
University of Malawi
Department Name: College of Medicine
Abstract
Sub-Saharan African countries have adopted COVID-19 prevention methods similar to those used in developed countries although their people live in a different context. The spread of COVID-19 in African households and people's adherence to preventive measures are not known, but this information is required to develop appropriate prevention measures. We aim to determine the intensity of COVID-19 spread in households located in urban medium-density, urban high-density and rural-high density areas in Malawi, Africa, factors that promote the spread of the disease and the impact of the disease on people's lives. Our specific objectives are to: (1) estimate the proportion of people living in the same household with infected people who become infected, (2) assess whether the risk of getting infected and developing severe symptoms are influenced by personal and nutritional characteristics and immunity to COVID-19; other infections (HIV, TB, malaria) or their treatments; and the household environment (3) assess whether the use of personal protective equipment is acceptable, feasible, and effective among people living with infected individuals (4) describe the experiences of caregivers of COVID-19 infected individuals (5) estimate the costs and lost income associated with home-based care for infected people. Study findings will help to identify high risk households/areas and design appropriate social safety nets for affected households. Our research team's existing collaboration with policy makers and local health department will facilitate the use of research findings to strengthen the fight against the disease.
Technical Summary
Sub-Saharan African countries have adopted prevention measures similar to those used in developed countries to combat the SARS-CoV-2 virus (COVID-19) pandemic, although their social, cultural and economic contexts are markedly dissimilar. Limited empirical data exist on SARS-CoV-2 transmission dynamics and the feasibility of prevention measures in diverse African households, to guide the adaptation of the preventive measures. We aim to determine the transmission dynamics, determinants and socio-economic impact of SARS-CoV-2 infection in households located in urban medium-density, urban high-density and rural-high density locations in Malawi, Africa. Our specific objectives are to (1) measure the secondary attack rates of SARS-CoV-2 infection within households of symptomatic and asymptomatic index cases, (2) assess how SARS CoV-2 susceptibility and clinical outcomes among household contacts of index cases are influenced by socio-demographic, nutritional and anti-SARS CoV-2 immunological status; co-infections (HIV, TB, malaria) and their treatments, and household environment, (3) assess the acceptability, feasibility, adoption and effectiveness of personal protective equipment among household members of index cases, (4) describe lived experiences of caregivers of SARS-CoV-2 index cases, and (5) estimate the direct and indirect costs associated with SARS-CoV-2 prevention and care in households of index cases. Through this study, we will generate contextually-relevant empirical data for identifying high risk individuals; predicting the intensity of SARS-CoV-2 transmission and the impact of preventive measures; and designing appropriate social safety nets for households affected by SARS-CoV-2. Our research team's existing engagement with policy makers and local health department will facilitate knowledge translation and enhance their pandemic response capacity.
Organisations
Publications
Chinkhumba J
(2023)
Household costs and care seeking patterns associated with COVID-19 in Blantyre, Malawi.
in PLOS global public health
Myroniuk TW
(2024)
Surprising Gendered Age Differences in Rural Malawians' Early COVID-19 Pandemic Prevention Efforts.
in The journals of gerontology. Series B, Psychological sciences and social sciences
Nyondo-Mipando AL
(2023)
"Why take the patient back home?": Exploring the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi.
in PLOS global public health
Description | COVID-19 exerts enormous psychological and financial burden on caregivers, particularly the ultra-poor, who need external support to avoid plunging them in deeper poverty. |
Exploitation Route | The Department of Gender, Children and Social Welfare need to include households caring for COVID-19 patients as social safety nets beneficiaries. |
Sectors | Government Democracy and Justice |
Description | Blantyre District Health Rapid Response Team meeting |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Members of the district health management team attended the meeting which was aimed at developing harmonized plans for contact tracing COVID-19 cases in Blantyre |
Year(s) Of Engagement Activity | 2021 |
Description | COVID - 19 Building Back Better Dissemination Conference |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | This was a national research dissemination conference organized by the Malawi Ministry of Health to promote the sharing of lessons learned from COVID-19-related research and management. The following were the titles of our presentations: 1. Genomic epidemiology of SARS-CoV-2 during the first two epidemic waves in Malawi: a retrospective analysis from April 2020 to February 2021 2. Exploring the lived experiences of caregivers of COVID- 19 infected individuals in Blantyre, Malawi 3. Acceptability and adoption of COVID-19 preventive measures among caregivers and individuals living in communities within the vicinity of confirmed SARS CoV-2 cases in Blantyre, Malawi 4. SARS-CoV-2 Delta variant infection is associated with greater transmissibility than the Beta variant but is cleared faster in COVID-19 vaccinated individuals: a household transmission study 5. COVID-19 transmission dynamics and factors associated with susceptibility to infection in Blantyre: a preliminary analysis |
Year(s) Of Engagement Activity | 2021 |
Description | Community health worker engagement meeting |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | 29 community health workers and representatives of Community Health Action Groups (CHAG) in Blantyre district attended the workshop aimed at establishing collaboration with them in conducting community contact tracing of COVID-19 cases and facilitating dissemination of results in the community. |
Year(s) Of Engagement Activity | 2020 |
Description | Media Briefing |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Engaged with with media practitioners to develop plans and strategies for reporting emerging study findings to the general public through mass media (radio and television). |
Year(s) Of Engagement Activity | 2021 |
Description | SCATHIM Project Local Dissemination Conference |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | The purpose of the conference was to share with members of the general public preliminary findings from the research project and solicit clarifications from media representatives and community leaders. The audience understood the problems posed by COVID-19 variants and the need for repeated doses of vaccinations. |
Year(s) Of Engagement Activity | 2021 |
Description | SCATHIM Project sub-district Research Dissemination Workshop |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | The purpose was to share and validate preliminary findings from the SCATHIM project to representatives of community health workers in Blantyre district where the project was implemented. The workshop sparked discussions about causes of mistrust between government health workers implementing COVID-19 preventive measures and the general public, that limit the provision of support to households managing COVID-19 cases. |
Year(s) Of Engagement Activity | 2021 |