IMMRSE-U

IMMRSE-U STUDY

Project Title: Implementing Malaria Molecular Surveillance in Uganda

Project period: 1 Nov 2024 – 30 Oct 2027

Project synopsis: To develop, implement, and integrate malaria molecular surveillance in Uganda

Principal investigators:

• Isaac Ssewanyana, Prof Moses Kamya (Uganda)
• Jessica Briggs, Prof Bryan Greenhouse (UCSF)

Co-investigators:

Bosco Agaba, Catherine Maiteki-Sebuguzi, Joaniter Nankabirwa, Philip Rosenthal, Bryan Greenhouse, Melissa Conrad, Victor Asua, Jerry Mulondo, Sam Nsobya.

Project Partners:

• Infectious Diseases Research Collaboration (IDRC)
• University of California, San Francisco (UCSF)
• Ministry of Health/ National Malaria Elimination Division (NMED).

Project Funder: Gates Foundation

Project Overview:

To develop, implement, and integrate malaria molecular surveillance in Uganda

Project Summary:

The Implementing Malaria Molecular Surveillance in Uganda (IMMRSE-U) study is a joint effort by the Infectious Diseases Research Collaboration (IDRC), the University of California, San Francisco (UCSF), and the Ministry of Health/ National Malaria Elimination Division (NMED).
Dried Blood Spot (DBS) samples are collected once a year from patients with microscopy-confirmed malaria at MRCs (Health Center III/IVs in 38 districts under the Uganda Malaria Surveillance Program.

Malaria parasite DNA is sequenced at the Ministry of Health genomics laboratory at CPHL in Kampala, for parasites resistant to antimalarial drugs or diagnostics.

Study Objectives:

The aims of this study include:

1. To estimate the prevalence and spread of anti-malarial drug and diagnostic resistance-conferring mutations using molecular approaches
2. To estimate the prevalence of non-falciparum malaria infections across Uganda
3. To characterise heterogeneity in transmission intensity using malaria parasite genomic data and epidemiological parameters from a subset of malaria reference centres (MRCs)
4. To determine the drivers of transmission in the southwest region of Uganda to inform efforts at enhanced control and elimination
5. To regularly disseminate genomic data to the Ministry of Health/ NMED to inform malaria control policies

Study Achievements:

1. Laboratory

• Optimised and managed bioinformatics pipelines used to sequence malaria molecular study samples for various projects at CPHL

Over 14,700 samples have been sequenced to date under the IMMRSE grant. The turnaround time has been improved through clear lab systems, optimised activities, and better coordination of field activities. The lab now performs sequencing for samples from community surveys and the Uganda National Malaria Indicator Survey.
B. Conferences
Results from the IMMRSE-U project were presented at several key conferences. These included:
Ministry of Health and Makerere University Joint Annual Scientific Conference (JASH) in Kampala, Uganda, and the American Society of Tropical Medicine and Hygiene (ASTMH) conference in Toronto, Canada.

Publications:

1. Katairo T, Asua V, Nsengimaana B, Tukwasibwe S, Semakuba FD, Wiringilimaana I, et al. Performance of Molecular Inversion Probe DR23K and Paragon MAD4HatTeR Amplicon Sequencing Panels for Detection of Plasmodium falciparum Mutations Associated with Antimalarial Drug Resistance. 2025;1.
2. Aranda-Díaz A, Vickers EN, Murie K, Palmer B, Hathaway N, Gerlovina I, Boene S, García-Ulloa M, Cisteró P, Katairo T, Semakuba FD. Sensitive and modular amplicon sequencing of Plasmodium falciparum diversity and resistance for research and public health. bioRxiv. 2025 Feb 19:2024-08.
   3. Kabbale, K.D., Nsengimaana, B., Semakuba, F.D. et al. Field evaluation of the Bioline Malaria Ag P.f/Pan rapid diagnostic test: causes of microscopy discordance and performance in Uganda. Malar J 24, 138 (2025). https://doi.org/10.1186/s12936-025-05379-6
   4. Kiyaga S, Mbabazi M, Katairo T. Accuracy of Plasmodium falciparum genetic data for estimating parasite prevalence and malaria incidence in Uganda Malaria Journal [Internet]. doi:10.1186/s1293
   5. Mbabazi M, Kiyaga S, Katairo T, Kabbale KD, Asua V, Kagurusi BA, et al. Imported malaria predominates in near-elimination settings in Southwestern Uganda. medRxiv. 2026 Jan 27. doi:10.64898/2026.01.25.26344810 PubMed PMID: 41646777.