Predicting the next epidemic: DHIS2-based risk modeling

Project summary

Unexpected onset of large-scale epidemics caused by climate-sensitive vector-borne diseases (VBDs) present a growing risk to human health and societal stability throughout the world. The situation is especially critical in LMICs as health systems struggle to absorb the full scale of mass hospitalizations due to acute VBD epidemics, while public and private sectors may suffer substantial productivity and commercial losses.
Tanzania is experiencing significant changes in VBD transmission patterns in particular with respect to mosquito-borne diseases, such as malaria and dengue. Notably, dengue epidemics recently became a recurrent phenomenon, while observed changes in malaria epidemiology suggest a shift from stable, holoendemic-, to unstable, hypoendemic transmission marked by increasing risk of malaria epidemics. The complex processes that drive VBD epidemics are not fully understood-yet climatic, environmental and socio-economic factors are known modulators.
This project addresses the need for improved prediction and prevention of epidemic risks by assessing novel modelling approaches and opportunities for translating complex model outcomes into easily disseminated risk assessments for targeted and timely interventions.
Specifically, we aim to explore key predictors and to combine modelling approaches, coupling
vector ecological niche models with mathematical micro-epidemiological models, in order to obtain timely, high-resolution risk projections of VBD epidemics. To ensure that these projections are readily available, we will develop an adjunct application on top of the existing DHIS2 platform, through which risk assessments are presented to end-users in the form of user-friendly risk maps and epidemic alerts. The project will use dengue and malaria as tracers for epidemic VBDs in Tanzania - and Unguja and Tanga Regions as specific study areas as they cover diverse climatic, environmental and socio-economic settings for comprehensive model development.


First year report
The official staring date of the project was delayed to June 2020 due to covid-19 pandemic. All partnership agreements were signed by June 2020 and the “Teams” platform was established for all partners for easy communication and cloud storage of relevant documents.
The launch meeting was held on November 5th 2020 in Moshi with participation of all South collaborators, PI and WP1 leader from UCPH and other North partners through “Teams”. The period to date included: seeking ethical clearance (granted for Tanzania mainland and for Unguja), formulation of field study protocols and purchasing and shipment of equipment of relevance for the field studies (mosquito traps etc.) to Tanga and Unguja.
The call for the WP1 PhD was announced January 2021, 6 candidates applied (4 males, 2 females), out of which, 3 were selected for online interviews. Neema Kulaya, (female) was offered the PhD fellowship and is currently developing her proposal for submission to KCMUCo. The call for the second PhD fellowship (WP2/3) was announced April 2021. 18 candidates applied from Tanzania/Zanzibar, Uganda, Zimbabwe and Kenya (14 males, 4 females) out of which 5 were invited for online interview. Lembris Njotto (male) was offered the PhD fellowship and we are currently negotiating contract terms.
The entomological fieldwork will begin late August/September 2021 depending on the ongoing covid-19 pandemic and logistics.

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