Catching disease in academic mesh

If they were species, facemasks would be endangered ones by now.

This is because the protective gear is fast becoming a relic of Covid, now that it seems to be far from everyday discourse.

“We are facing a lot of challenges now, one of them being hunger. Why should we be thinking about Covid, with cases almost non-existent now?” questions Mary Gama from Kaputu in Salima District.

Who can blame her? The Malawi Vulnerability Assessment Committee indicated in its report that up to 4.4 million people are facing hunger in Malawi.

However, Covid is still on the mind of Kamuzu University of Health Sciences (Kuhes) Associate Professor Benjamin Kumwenda.

“We, as researchers, continue to measure the effectiveness of [Covid] vaccines. There is ongoing research on rotavirus. Even malaria drugs are changing; there is no end to medical research,” he says.

In fact, research into Covid continues all over the world.

For instance, in the Lancet: Respiratory Medicine journal, researchers who investigated the ‘Long-term Effectiveness of Covid Vaccines against Infections, Hospitalisations, and Mortality in Adults: Findings from a Rapid Living Systematic Evidence Synthesis and Meta-analysis up to December, 2022— and the findings were published in February this year— indicate that Covid and its effects may linger for some time.

The researchers— Nana Wu, Kven Joyal- Desmarais, Paula A.B. Ribeiro, Ariany Marques Vieira, Jovana Stojanovic, Comfort Sanuade, among others— indicate that the findings may inform policy decisions on Covid as well other other pandemics.

“Synthesising evidence on the long-term vaccine effectiveness of Covid vaccines (BNT162b2 [Pfizer–BioNTch], mRNA-1273 [Moderna], ChAdOx1 nCoV-19 [AZD1222; Oxford– AstraZeneca], and Ad26. COV2.S [Janssen]) against infections, hospitalisations, and mortality is crucial to making evidence-based pandemic policy decisions,” they indicate.

“In this rapid living systematic evidence synthesis and meta-analysis, we searched Embase and the US [United States] National Institutes of Health’s iSearch Covid Portfolio, supplemented by manual searches of Covid-specific sources, until December 1, 2022, for studies that reported vaccine effectiveness immediately and at least 112 days after a primary vaccine series or at least 84 days after a booster dose. Single reviewers assessed titles, abstracts, and full-text articles, and extracted data, with a second reviewer verifying included studies. The primary outcomes were vaccine effectiveness against SARS-CoV-2 infections, hospitalisations, and mortality, which were assessed using three-level meta-analytic models,” they indicate in their findings.

Among other findings, they indicate that vaccine effectiveness generally decreases over time against SARS-CoV-2 infections, hospitalisations and mortality.

“The baseline vaccine effectiveness levels for the omicron variant were notably lower than for other variants. Therefore, other preventive measures (eg, facemask wearing and physical distancing) might be necessary to manage the pandemic in the long term,” the journal indicates.

So, as some Malawians have largely forsaken the life-saving facemask, their behaviour may, in the short or long term, complicate management of Covid, which is still around— perhaps preparing for a great comeback in the background.

That is where the likes of Kumwenda— who is an Associate Professor in Bioinformatics of Computational Biology, by the way— come in.

“Universities have a role in generating knowledge through research and, as such, there is a need for continued research, even here in Malawi. [There is a need for continued research into] SARS-Cov-2, for example,” he points out.

Kumwenda adds that Malawi does not have to wait for outsiders to conduct research into diseases when it has a horde of experts who can equally deliver.

Malawi is lucky in the sense that, every year, Kuhes holds the research dissemination conference— which will this year be held under the theme ‘Tackling the Malawi 2063 Health Research Priorities through A Multi-disciplinary Approach’— as one way of contributing solutions to the health sector and reducing the disease burden.

Kuhes Vice Chancellor Professor Macpherson Mallewa indicates that, through the dissemination conference, the university has become an integral part of solutions to health challenges facing Malawi, the region and the world as a whole.

“Take, for instance, the issue of coronavirus sequencing. When Malawi registered its first case of coronavirus on April 2 2020, we were sending samples to South Africa. Today, thanks to advanced equipment we have, we do it right here— at the click of the button.

“Not only that; we can respond to emerging issues and know if responses, for instance medicines, are working. We have eminent researchers here, including Professor Kamija Phiri, who has just been recognised as a global leader. His work has impacted on care of patients in Malawi and informed how we treat diseases,” Mallewa points out.

Phiri has been a leader in academic teaching and research and was the founding dean of the School of Public Health and Family Medicine at the College of Medicine – now Kuhes— University of Malawi, and primarily responsible for developing its growth strategy.

Last year, in June, he was also recognised, prompting the university to splash warm words on him.

“Congratulations to Professor Kamija Phiri of Kamuzu University of Health Sciences) and his team (an international consortium) for the adoption of their research work on Post-discharge Malaria Chemoprevention by the World Health Organisation (WHO). The studies were largely done in Malawi and the policy recommendation is for all countries where malaria is endemic.

“On 3rd June 2022, the WHO published a package of new and updated recommendations across a number of technical areas – from malaria chemoprevention and mass drug administration to elimination. The guidelines encourage countries to tailor the recommendations to local disease setting for maximum impact,” the academic institution, which touts itself as the epicentre of “Excellence for Life”, posted on its Facebook page.

This year, he is expected to continue making his contribution to the health sector during the conference, which will run from November 30 to December 1 at Kuhes campus in Blantyre.

According to Kuhes Director of Finance and Investment, who is also co-chair of the university’s Finance and Fundraising Committee, George Namandwa; Dr Cecilia Maliwichi Nyirenda, who is the Director of Research Support Centre and Chairperson for Protocol; and Dr Diston Chiweza, librarian, there is a lot to discuss this year.

With thematic areas such as nutrition, mental health, infectious diseases, environmental health, health systems and policy, non-communicable diseases, social and behavioral sciences, trauma and emergency medicine, epidemiology and public health, maternal, neonatal and child health, among others, the river of knowledge may become the ocean of life.

“We expect over 600 participants and over 300 abstracts to be reviewed,” Mallewa points out.

The idea is to fill up the chasm of disease, which has been serving as a mantrap all this long.