Malaria Molecular Surveillance in Tanzania Phase 2 - "MSMT2 Project"

The Malaria Molecular Surveillance in Tanzania Phase 2 (MSMT2) project, funded by the Bill and Melinda Gates Foundation, is an initiative led by the Ifakara Health Institute, with Dr. Deusdedith R.S Ishengoma, a Senior Research Officer from the National Institute for Medical Research (NIMR), at the forefront. The project aims to inform the National Malaria Control Program (NMCP) through extensive national surveillance of antimalarial resistance and pfhrp2/3 gene deletions.

Objectives
The MSMT2 project focuses on several key objectives:

1. To conduct antimalarial resistance and pfhrp2/3 deletion surveillance on a national scale to inform NMCP decision-making. This will involve activities aiming at:
   > Surveillance of antimalaria resistance mutations in the parasites and performance of different antimalarial drugs.
   > Monitor for emergence and spread of parasites with histidine-rich protein 2/3 (hrp2/3) gene deletions. This will be done using a new approach and will help to generate evidence on the performance of HRPZ based rapid diagnostic tests (RDTs).
2. To conduct serological surveillance and vector genomic surveillance (as secondary objectives)
3. To conduct antimalarial resistance modelling in collaboration with colleagues at Ifakara Health Institute
4. To deliver training and capacity building to the national public laboratory to ensure sustainability

Strategies and platforms
The MSMT2 project will employs a comprehensive approach through multiple strategies. These strategies include:

1. Field Collection of Samples: Health facility (HF) surveys will be conducted across various regions over the course of the project duration, with cross-sectional and follow-up surveys in select regions, and pilot surveys for vector genomics.
2. Lab Analyses: The project will utilize qPCR for detecting Plasmodium falciparum (Pf) and non-Pf species, apply multiplex immunoassay panels (MIP) to mRDT-positive samples, conduct whole genome sequencing (WGS) on selected samples, and detect antigens and perform PCR genotyping for pfhrp2/3 deletions. Additionally, the project will optimize Oxford Nanopore Technologies (ONT) and sequence vectors using MIP.
3. Training and Capacity Building: A dedicated MSMT2 team will be formed, with training in new methods like WGS, ONT, serology, and vector genomics. The project will enhance computational and bioinformatics skills, support MSc and PhD students, interns, and post-doctoral fellows, and offer specific courses for staff, students, and fellows. It will also build capacity for integrated Malaria Molecular Surveillance (iMMS) and modeling.
4. Engagement: The project will establish a governance structure and collaborate with Ifakara Health Institute, NMCP and other stakeholders, plan and disseminate results, train students, staff, and regional teams on molecular malaria surveillance, and provide ongoing technical support.