Manhica

Mozambique faces a high burden of malaria, with significant variation in transmission across regions. This trial evaluates molecular malaria surveillance (MMS) to track antimalarial drug resistance, rapid diagnostic test effectiveness, and transmission dynamics. The study supports the National Malaria Control Program's 2023-2030 strategy, aiming to guide decisions on diagnostics, treatments, chemoprevention, vaccines, individual interventions, and vector control to reduce malaria impact at individual and community levels. The study involves several sampling strategies including health facility surveys, dense sampling in low-transmission areas, and antenatal care monitoring. Biological samples are collected for genomic sequencing to detect molecular markers of resistance, gene deletions affecting diagnostic tests, and parasite genetic diversity. Vector mosquito surveillance is also conducted to understand species diversity and improve control efforts. Data collection uses digital tools for accuracy, and samples are processed through advanced sequencing and bioinformatics pipelines. Participants undergo malaria testing and provide samples for molecular analysis. The study measures prevalence of resistance markers, gene deletions, and genetic diversity at provincial and regional levels after three years. Data integration and sharing support real-time decision making by health authorities. Training and capacity building for local researchers and health workers are included. The total study duration spans from March 2021 to 2024, with continuous monitoring and periodic reporting to optimize malaria control strategies in Mozambique.

Infections are a leading cause of newborn deaths, with Group B Streptococcus (GBS) being the primary cause of sepsis and bacterial meningitis in infants during their first 90 days of life. Researchers are preparing for late-phase clinical trials of GBS vaccines designed for pregnant women to protect their unborn babies. The PROTECT project supports medical sites in Kenya, Malawi, Mozambique, and Uganda to establish uniform data collection and surveillance systems for GBS and other infections, aiming to improve vaccine trial readiness and vaccine safety monitoring in these regions. The study focuses on three main areas: establishing pregnancy exposure registries using electronic health records to track pregnancy and infant outcomes; developing sentinel site surveillance for laboratory-confirmed GBS infections in infants under 90 days old; and evaluating vaccine confidence among pregnant women and key community stakeholders. The project will develop tools and communication strategies to increase vaccine acceptance and participation in trials, strengthening healthcare systems for future vaccine delivery. Participants will include pregnant women, infants with confirmed GBS infections, and community stakeholders across the four countries. Researchers will collect and analyze health data, monitor infection rates, and assess attitudes toward vaccination. The study will track outcomes such as pregnancy and infant health, infection incidence, and vaccine confidence over multiple years, supporting ongoing safety monitoring and preparation for vaccine rollout through a coordinated network of maternal vaccine trial sites.

Tuberculosis (TB) remains a leading cause of illness and death worldwide. Traditional TB control focuses on clearly defined latent and active stages, but recent research shows TB exists on a spectrum including an asymptomatic stage. This stage, where individuals carry TB bacteria without symptoms, may play a key role in spreading the disease. The TB-QUEST study aims to provide direct evidence of TB transmission from asymptomatic cases and to better understand this stage within TB's natural progression. TB-QUEST is a prospective field study conducted in Mozambique, a region with high TB and HIV rates. It will recruit both asymptomatic and symptomatic TB patients, as well as their close contacts. The study involves an initial screening of people living with HIV during routine visits to identify TB cases. Then, two groups of close contacts exposed to either asymptomatic or symptomatic TB cases will be followed for 12 months to observe new infections and disease transmission. Additional long-term assessments will monitor symptoms, clinical changes, and progression in patients with asymptomatic TB. Participants will undergo regular clinical evaluations, symptom tracking, radiological and microbiological tests, and genomic analysis to link TB cases and confirm transmission. The main outcome measured is the proportion of new TB cases arising from transmission by the index patient over 12 months. This detailed monitoring aims to clarify the role of asymptomatic TB in spreading the disease, which could impact global TB control strategies and future research methods.