The project addresses the third United Nations Sustainable Development Goal (Good health and well-being), contributing to the fight against communicable diseases. In modern human medicine, the use of drugs is essential for the treatment of infectious diseases. However, many pathogens develop resistance to drugs through genetic adaptation, and this poses an increasing threat to effective disease control and eradication. Drug resistance also affects the treatment of malaria, one of the most common infectious diseases in Africa, with approximately 230 million cases and 620,000 deaths a year. Early detection is key to reducing the spread of resistance and maintaining the efficacy of antimalarials. A surveillance system that can generate quality data using standardised methods consistent with WHO guidelines therefore needs to be established. SMART aims to implement a three-step antimalarial resistance surveillance programme in three hospitals in Ghana. This will benefit the rural and semi-rural population in malaria-endemic settings by increasing awareness among hospital staff and communities. The reporting system based on therapeutic efficacy, targeted molecular detection methods and drug sensitivity testing will support stakeholders in controlling antimalarial drug resistance in Ghana.
Strengthening a three-step antimalarial resistance surveillance system in selected hospitals in Ghana.
Training and competence development
Training laboratory personnel and health care workers in state-of-the-art malaria diagnostics, in vitro/ex vivo drug susceptibility testing and molecular surveillance methods; raising awareness among hospital staff and patients on the importance of completing drug treatment to avoid recurrent infection, the use of preventive measures, such as bed nets, and continuous reporting.
Research and provision of evidence
Conducting molecular surveillance of antimalarial drug resistance by screening for mutations using samples from symptomatic patients at three different district hospitals; carrying out ex vivo/in vitro drug susceptibility tests and conducting an antimalarial therapeutic efficacy study in patients testing positive for uncomplicated or severe malaria.
Implementing a three-step surveillance framework consisting of i) a therapeutic efficacy monitoring platform for antimalarial treatment outcomes, ii) in vitro/ex vivo drug susceptibility testing and iii) a molecular surveillance system for artemisinin resistance.