Report

Teaser, summary, work performed and final results

Periodic Reporting for period 2 - DMC-MALVEC (Automated diagnostic platform, data management system and innovative communication tool, for improving the impact of malaria vector control interventions)

Teaser

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...

Summary

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.

Work performed

DEVELOP A FULLY AUTOMATED DIAGNOSTIC PLATFORM: THE LABDISK
During the second reporting period the LabDisk assays have been validated in field samples and compared with assays that are currently widely used and generally regarded as “gold standards”. A blind testing approach was followed, where for each assay and each sample type/population, results between LabDisk assays and “gold standard” assays were in accordance. We further optimized the LabDisk assays for direct (no Nucleic Acid extraction) RT-qPCR thus further minimizing costs and time-to-result. An alternative nucleic acid determination process, which makes the LabDisk significantly simpler, cheaper, and faster (~55 min less overall time) was integrated.
ADAPT A SMART DATABASE: THE DISEASE DATA MANAGEMENT SYSTEM (DDMS)
The latest DDMS+ release integrates data from multiple components of national vector borne disease control programs and related operational partner activities. Data are converted into customizable decision support tools with interactive geo-dashboards, “Kaleidoscopes”, intelligent dataset and report creation, threshold/alert setting for system strengthening and interoperability with other major health information systems. The DDMS+ is being utilized within the DMC-MALVEC project to specifically support collation of entomological data and the reporting needs of the in-country organizations, and to facilitate the use of the LabDisk by providing a platform for LabDisk data to be entered, queried and visualized. The DDMS+ has been uniquely configured for each of the four partner organizations, and staff in each of the countries has been trained. The query builder functionality was enhanced with particular emphasis on pooled data sets and the creation of ad-hoc queries directly through the user interface. A general project-wide implementation and tailored implementation plans have been developed. Training workshops were held in both Cameroon and Cote D’Ivoire with partners in January 2018.
UPGRADE AND VALIDATE THE SERIOUS GAMING TECHNOLOGY: THE GAME
ResistanceSIM has been expanded to incorporate the types of data relevant to the Lab Disk diagnostic system, including molecular identification of vector species, identification of target-site and metabolic resistance mechanisms, and infection with parasites. Decision pathways have been incorporated that require the player to use molecular data in conjunction with bioassay data. An additional module also specifically aims to address knowledge gaps in the biology of resistance, to improve understanding of decision-making processes that rely on resistance data. Training workshops utilizing the ResistanceSIM game and subsequent evaluations of the suitability of training and uptake of the gaming for sustainable knowledge transfer amongst workshop participants have been tailored for each of the four partner organizations
DISSEMINATION ACTIVITIES
The project’s results and activities have been communicated both to the broad scientific community through peer reviewed publications in international journals participation more that forty in key conferences worldwide. We have performed both targeted dissemination activities and have communicated to the general public.

Final results

Progress was made towards developing and implementing a novel automated multiplex diagnostic platform that will be able to produce reliable results, with reduced equipment requirements over existing methods and at a remarkably lower cost.
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 has worked towards the development of 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 contributes to innovation capacity on several levels: 1. The diagnostic tool analyzes 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.

Website & more info

More info: http://www.dmc-malvec.eu/.