Siems, Lilly

Zimbabwe

Malaria Transmission and the Impact of Control Efforts in Southern Africa

The student will assist with an initiative to accelerate malaria control in Southern Africa through an NIH-funded International Center of Excellence for Malaria Research. Our goal is to make substantial contributions to regional malaria control in Zambia and Zimbabwe through state-of-the-art research on malaria epidemiology, vector biology and the genetics of the malaria parasite in three different epidemiological settings, representing regions of effective malaria control (Choma District, Zambia), ineffective malaria control (Nchelenge District, Zambia) and resurgent malaria (Mutasa District, Zimbabwe). .

Global Health Mentor: William John Moss, MD, Head of Epidemiology, IVAC

With funding and support from the Johns Hopkins Center for Global Health’s Established Field Placement program, I completed my Masters Practicum in Honde Valley, Zimbabwe in collaboration with the Southern Africa International Centers of Excellence in Malaria Research (ICEMR) and Professor William Moss, M.D. For three months I lived in Honde Valley, Zimbabwe supporting and assisting an ongoing study investigating malaria epidemiology in Mutasa District, Zimbabwe.

Johns Hopkins Bloomberg School of Public Health is the lead institution for the Southern Africa ICEMR focused on studying malaria transmission and the impact of control efforts in three locations in Zambia and Zimbabwe. My practicum focused on understanding malaria epidemiology in Mutasa District, Zimbabwe by supporting the existing study methods. The Zimbabwe site consists of cross-sectional and longitudinal cohort studies. My responsibilities included attending daily visits to cross-sectional and longitudinal households and assisting in data collection and recording. Information collected at these household visits includes rapid diagnostic tests for malaria, dried blood spot samples, hemoglobin levels, and qualitative interviews on malaria knowledge, participation in prevention behaviors and travel histories.

In addition to assisting in daily study operations, the main focus for my practicum project was to understand cross-border malaria and the effect of population movement on malaria transmission. Because of the porous border between Mozambique and Zimbabwe, population movement across the border is frequent and unregulated. This has led to increasing concerns of disease transmission due to a very high burden of malaria in Mozambique. Cross-border malaria is a concern for controlling malaria in Zimbabwe, yet it is difficult to quantify. The goal of this practicum was to learn more about cross-border malaria in Zimbabwe and to investigate what is known and unknown about population movement and malaria. My responsibilities for this portion of my practicum included collecting information about current programs studying cross-border malaria or population movement between Zimbabwe and Mozambique, attending meetings related to cross-border malaria, and expanding ICEMR data on cases of malaria in Mozambique residents presenting in Zimbabwean health centers by collecting incident malaria cases from district health centers.

My experience living and working in Mutasa District, Zimbabwe exposed me to the intricacies of conducting a large scale cross-sectional and longitudinal study. It was exciting to investigate population movement, an issue that is not currently addressed in many countries or programs, yet likely has large impacts on infectious disease transmission. I had an incredible experience getting to know the country of Zimbabwe and immersing myself into this culture. This was in fact my third time in the country, however, this work experience allowed me to get to know the country and the people of Zimbabwe in a more intimate setting. I am so grateful for the experience that I had in Zimbabwe and am excited to continue my work in global health following this experience.  

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