A molecular fever panel to support malaria elimination, management of fever, and arbovirus surveillance in a resource-limited district of Colombia

Diagnostics play a major role in the clinical management of infectious diseases and provide support for public health surveillance. When patients present with common symptoms like fever, diagnostics are essential to identify the infection and guide treatment. In tropical countries such as Colombia, malaria is suspected as the primary cause of fever but as malaria cases are declining, other infections are on the rise. These may be other mosquito-borne diseases like dengue or bacterial infections that are transmitted through contaminated soil or water. Diagnostics for many of these other infections are not available or used routinely, yet they can warn of an imminent epidemic - alerting public health teams to respond and curb further spread of disease. This project seeks to develop and evaluate a panel of diagnostics to strengthen the public health system in the Urabá region of Northwest Colombia. After decades of conflict and insecurity, the state government has partnered with the Universidad de Antioquia to launch a health initiative targeting four key priorities in the region. One priority is to improve diagnosis and surveillance of malaria and other infections that cause fever. Our proposal, co-developed with our team in Colombia, aims to support this initiative through the design and pilot of molecular diagnostics for these diseases. We previously developed tests for malaria and dengue that can be performed directly from blood samples, an important advance for implementation of molecular tests in community health facilities. We will expand our tests to include other common and emerging pathogens and evaluate these tests at the local hospital to diagnose patients with fever. We will also apply our malaria test to support screening programs aimed at disrupting malaria transmission in the region. Data from these studies will inform local and national surveillance programs, guide public health interventions, and support access to treatment for patients with fever.