CK25-035 Monitoring, Operations Research, Evaluation of Tools for Malaria Control and Prevention in Kenya

Project Summary: This CoAg between CDC's Malaria Branch and Liverpool School of Tropical Medicine (LSTM) builds on a 15-year collaboration with the Kenya Medical Research Institute (KEMRI) in western Kenya. The research strategy addresses 3 objectives through 13 interconnected activities. Under the first objective, to inform malaria control in Kenya, we will evaluate novel preventive interventions including assessment of monoclonal antibodies in 6-week-old infants (Activity [Act]-1); expanded use of R21 malaria vaccine beyond routine childhood immunization for post-discharge prevention in hospitalised children with severe anaemia and in pregnancy (Act-2); evaluation of M5717+pyronaridine as a novel prevention strategy for malaria in pregnancy (Act-3); and testing of spatial repellents and next-generation insecticide- treated nets (Act-4). To improve intervention uptake, we will support implementation of post-discharge malaria chemoprevention following WHO's 2022 recommendation (Act-5), strengthen community-based antenatal care delivery through innovative digital platforms (Act-6), and develop implementation strategies for intermittent preventive treatment in schoolchildren (Act-7). Case management activities include evaluating the malaria case management pathway (Act-8), monitoring antimalarial drug efficacy (Act-9), and developing novel methods to assess chemoprevention efficacy (Act-10). For the second objective, advancing epidemiologic methods for monitoring impact, we will create an enhanced epidemiological surveillance network integrating facility and community-based data (Act-11) and expanding entomological monitoring focused on insecticide resistance and emerging vectors like Anopheles stephensi (Act-12). The third objective focuses on advancing laboratory methods and strengthening local capacity. We will establish advanced molecular methods, including next-generation sequencing, implement serological testing using multiplex bead-based assays, develop quality management systems for routine microscopy, and enhance capacity for detecting drug resistance markers and monitoring vaccine escape mutants (all under Act-13). This research leverages KEMRI's extensive infrastructure including state-of-the-art laboratories, demographic surveillance systems covering 260,000 participants, GCP-compliant pharmacies and clinical research centers at major hospitals in western Kenya. The collaboration combines LSTM's global malaria expertise, CDC's technical capabilities, and KEMRI's regional research infrastructure. The strong partnership with Kenya's National Malaria Control Program and County Health Management Teams ensure research findings translate directly to policy. The program includes extensive capacity building through PhD training, postdoctoral fellowships, and establishment of sustainable laboratory capabilities. This strategy addresses critical challenges in malaria control while building local research capacity to generate evidence that will inform national and global malaria policy.