Building resilience to climate-sensitive mosquito-borne viral diseases: preventing hospital-acquired infections and their epidemic spread through integrated mosquito control and sentinel surveillance in Zanzibar hospitals

Project summary

Hospitals can be hotspots for the initiation and spread of infectious disease outbreaks. However, in tropical areas more research is needed to identify and pilot sustainable interventions to minimize the risk of hospital-transmission and epidemic spread of climate-sensitive mosquito-borne viral disease as for example dengue and Zika. The standard of waste and water management in the local environment generates multiple habitats for mosquitoes, while the open structure of tropical hospitals offer easy access for blood-seeking mosquitoes to around-the-clock presence of patients, relatives and staff. This situation creates highly favorable conditions for the spread of mosquito-borne viral diseases. Here one infected person may initiate transmission and result in others carrying infections back to their homes and communities. Zanzibar represents one such setting. The significance of the problem is amplified by the ongoing climate change, poorly developed surveillance capacity and lack of treatment options.

This research aims to build resilience to mosquito-borne viral diseases in Zanzibar by preventing hospital-acquired infections through integrated mosquito control and sentinel surveillance in Zanzibar hospitals. The core team behind the research represents a very broad range of disciplines, sectors and professions needed to come up with innovative, effective and sustainable interventions to address the problem. The research will be guided by previously identified proven and promising interventions including architectural adjustments and the use of mosquito mass trap technologies. The research will advance our knowledge by developing procedures for the selection, co-creation and adoption of interventions into the hospital setting, undertake feasibility and impact assessments and assess novel surveillance approaches for the detection of viruses in mosquitoes. Throughout the project, research capacity will be strengthened focusing at South partner institutions. Dedicated project activities emphasize research to program and research to policy translation.


First year report
The project has suffered considerable delays due to unforeseen changes to the selected study sites. This includes demolition of existing hospital structures end of 2022. Changes to the hospital management system is also expected but the scope and nature remain uncertain. We expect to resume all activities in line with the project objectives as soon as the new hospitals and management systems are in full operation. Hopefully, the delays can be absorbed, and progress made as required for the mid-term report.

Status for outputs
Given the described delays, output indicators remain at baseline. In terms of capacity development, however, two PhD candidates have been selected among twenty applicants. Both candidates are from Tanzania and are expected to enroll at KCMUCo within the PhD programme of Environmental Health. In addition, one (extra) PhD fellow has been enrolled at KADK.

Status for partnership and joint activities
Initial visits to selected hospital sites including discussions with then hospital management were completed as a joint activity in April 2022. This was followed by an inaugural meeting in August 2022 including further site visits by partners. Since then, all sites have been subject to substantial changes as mentioned. Local partners have provided regular updates, but have faced challenges in obtaining any reliable information as to the detailed plans for each hospital site.The next joint meeting is expected end of August 2023.

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