Characterising COVID-19 occupational exposure among healthcare workers through the validation of point-of-care diagnostics

Academic lead: Dr Antonia Ho

A substantial number of COVID-19 cases have been reported in healthcare workers (HCWs). HCWs in Malawi are particularly vulnerable, owing to the lack of personal protective equipment (PPE) and infection prevention and control measures in healthcare facilities. Protection of HCWs is a key priority.

Similar to many low-and-middle-income countries (LMICs), Malawi has limited capacity and capability to perform reverse-transcriptase polymerase chain reaction (RT-PCR), the gold standard test to diagnose COVID-19 infection, or antibody tests to understand population exposure to COVID-19. As per WHO, testing and tracing are key to controlling the outbreak and mitigating COVID-19-associated morbidity and mortality. POC tests may be the solution, but many available POC antibody tests for COVID-19 suffer from low sensitivity and specificity. To inform public health guidance in Malawi and other LMICs, Toni and her team will both evaluate existing POC diagnostics against RT-PCR and antibody-based tests, and develop a new RNA-based test, while evaluating HCW exposure to COVID-19 in parallel.

This project aims to address the following research questions:

  1. Do HCWs have greater exposure to SARS-CoV-2 than community members?
  2. What are the most sensitive and specific POC antibody tests available in Malawi?
  3. Can we develop and implement low-cost rapid POC LAMP assays for community and HCW testing in Malawi (that can apply to other LMICs)?


Image of a researcher in full PPE taking a swab from an African patient

COVID-HCWEXPO participant receiving a nasopharyngeal swab from the study team.


You can find out more about this project and their methodologies here. 


Immuno-epidemiology in Urban and Rural Cohorts in Malawi: Generating Evidence to Inform Regional Medium- and Long-term Decision-making

Utilising the longitudinal urban and rural cohorts established by the Malawi Epidemiology and Intervention Research Unit, and supported by international and national expertise, we will undertake population immunoepidemiological surveillance to understand the trends in exposure and transmission of SARS-CoV-2, risk factors for SARS-CoV-2 infection and severe disease, as well as the proportion of asymptomatic or pauci-symptomatic infection in the population to enable an accurate estimate of infection fatality rate.

Furthermore, we will recruit individuals with evidence of past SARS-CoV-2 infection or have received COVID-19 vaccine to a nested cohort with 3-monthly sampling, to explore the magnitude and duration of antibody response and protective immunity in the Malawian population, and at the same time creating a biorepository for further in-depth virological and immunological studies.

A member of the Coverso project study team sat on a motorbike