Global Health Research Program
The Malawi WES program began in 2018, tracking pathogens in pit latrines. Since 2022, weekly samples have been collected at two healthcare facilities and an institution of higher education. In 2024, sample collection began at a refugee camp as well.
Sample Collection: The weekly grab samples are collected from non-sewered sanitation using a cup on a stick. A single sample may represent several hundred people (refugee camp) to several thousand people.
Sample Analysis: The targets of interest vary by site, but include cholera (all sites), SARS-CoV-2, measles, influenza A, and influenza B. Cholera is detected by culture methods, while the PCR or genomic sequencing is used for the other targets.
Data Use: Of particular concern was the presence of V. cholerae in wastewater at the Malawi University of Science and Technology campus when the on-campus healthcare facility did not have the capacity for V. cholerae clinical testing. Based on the data, diarrheal cases were referred to the nearest hospital for cholera testing.
Program Partners:
- University of Louisville – program coordination
- Malawi University of Science and Technology – collection, testing, analysis
- UNHCR
- Malawi Ministry of Health
Contact:
Rochelle H. Holm, PhD
Associate Professor
Christina Lee Brown Envirome Institute
School of Medicine/Department of Medicine
University of Louisville
rochelle.holm@louisville.edu