CISM STUDY ACCEPTABILITY AND FEASIBILITY OF INTRODUCING LONG-ACTING INJECTIONS FOR MALARIA PREVENTION

The initiative is coordinated by the Population Studies Unit

The Manhiça Health Research Centre (CISM) will implement a new study aimed at assessing the acceptability and feasibility of an innovative strategy for malaria prevention, based on long-acting injections. The research, entitled “Acceptability and Operational Feasibility of Long-Acting Malaria Prophylaxis in Endemic Districts of Mozambique”, emerges in response to persistent challenges in controlling the disease, which remains one of the leading causes of mortality in the country.

Malaria remains one of the major global public health challenges. According to the World Malaria Report 2025 by the World Health Organization (WHO), an estimated 282 million cases and 610,000 deaths occurred in 2024, reflecting an increase compared to the previous year. The African region continues to bear the greatest burden of the disease, accounting for approximately 94% of cases and 95% of deaths, mainly affecting children under five years of age. Mozambique remains among the most affected countries, contributing significantly to the global number of cases and deaths, with millions of cases reported annually and a considerable impact on the national health system.

Currently, malaria prophylaxis is largely based on the regular administration of tablets. However, adherence to this regimen has been limited, with fewer than 60% of users completing the treatment, often due to discomfort and side effects. In this context, long-acting injections (LAIs) present a promising alternative, potentially offering protection for up to 90 days with a single administration.

The study, to be conducted between April 2026 and December 2027, aims to generate evidence on the acceptability of this approach among communities, healthcare professionals, and policymakers, as well as to assess the health system’s capacity for its implementation. Key aspects to be analysed include social perceptions regarding the use of injections for malaria prevention, logistical challenges, gender dynamics, and levels of trust in new medicines.

The research will be conducted in the districts of Manhiça and Matutuíne, in Maputo Province, involving between 70 and 94 participants, including policymakers, health programme managers, frontline healthcare workers, and community members. Data collection will be carried out through interviews, group discussions, and direct observation, following a qualitative approach.

In addition to exploring community acceptance, the study will also assess key health system requirements, such as workforce training, supply chain capacity, pharmacovigilance, and regulatory processes—elements considered crucial for the potential introduction of this technology in the country.

The results of this study are expected to contribute to the development of new malaria prevention strategies, not only in Mozambique but also in other endemic countries, strengthening global efforts to control and eliminate the disease.

The study is conducted in collaboration with the Fiocruz Foundation (Brazil) and funded by Queen’s University Belfast (Northern Ireland). It is coordinated by CISM researcher Estêvão Mucavele, with Hermínio Cossa, also a CISM researcher and head of the Population Studies Unit, serving as the Local Principal Investigator.