What We Do
Surveillance Systems
Since 2017, M-TECH has provided surveillance-related technical support through human resources, management support, and other capacity-building strategies to strengthen the PHIM and the National HIV Reference Laboratory (NHRL). This capacity has strengthened Malawi’s surveillance system to respond adequately to outbreaks such as cholera, Mpox and pink eye). M-TECH has strengthened the following surveillance systems:
HIV Recent Infection Surveillance (RS): Since April 2019, an RS system was established by including a rapid test for recent infection (RTRI) in routine HIV testing services at entry points such as antenatal care clinics and voluntary counseling and testing sites. Recency results aid in the identification of individuals who have acquired HIV within the past several months and may therefore be at high risk of transmitting HIV to their unborn child, infants, and uninfected sexual partners due to a high VL in the early stage of chronic infection. The recent infection surveillance is implemented in 301 sites across Malawi. M-TECH also implemented Public Health Response in the areas identified as having significant number of new HIV infections, or hot spots. The initiative has improved ART linkage and PrEP uptake
Birth Defects Surveillance (BDS): M-TECH supported establishment of a BDS in Malawi and implementation of a nested-case control within BDS to establish factors associated with birth defects implemented in four high delivery sites since 2016. The surveillance has so far enrolled over 300,000 participants, providing new insights into the prevalence of major external birth defects and birth defects incidence related to HIV.
HIV Drug Resistance (HIVDR) surveys:The World Health Organization (WHO) recommends countries routinely implement nationally representative HIVDR surveys among people infected with HIV to measure the level of drug resistance. The results of HIVDR surveys are a critical component of HIV programs and can guide changes to pediatric and adult antiretroviral therapy (ART) treatment regimens, including first- and second-line regimen decisions. M-TECH has been implementing the following HIVDR Surveys in Malawi (since 2016) on Infant HIVDR, ANC/Pregnant Women HIVDR, DTG HIVDR and SARS-CoV-2.
Building Surveillance Systems to Detect and Respond to Outbreaks:M-TECH supports the response to COVID-19 in Malawi through the development of a National Public Health Emergency Operations Center at PHIM, able to coordinate and direct the national response and produce timely data on the number of cases and deaths. M-TECH has developed strong laboratory systems for COVID-19 testing and genotyping and contributed to the design and implementation of strategic information and reporting systems for COVID-19 at the national and district levels the establishment of national strategic plans, policies, and guidelines for COVID-19 transmission prevention and vaccination.
Capacity-building Field Epidemiology Program (FETP): M-TECH provides technical assistance through an FETP expert to PHIM for the implementation of the FETP Frontline and intermediate programs. To date, a total of 303 trainees have graduated from Malawi’s FETP Frontline program while the intermediate has graduated 22 trainees. The graduates are serving as critical resources for disease surveillance and outbreak response within the Malawi health system. They have been key to outbreak investigation and response to outbreaks such as cholera and Mpox.