Understanding COVID-19 transmission and health impacts in Malawi

COVID-19 Transmission and Morbidity in Malawi

Boston University · NCT05973084

This study is trying to understand why COVID-19 seems to affect people in Malawi less severely by looking at factors like immune responses and other health conditions in those who have the virus and their close contacts.

Quick facts

Study typeObservational
Enrollment1500 (estimated)
Ages5 Years to 75 Years
SexAll
SponsorBoston University (other)
Locations2 sites (Boston, Massachusetts and 1 other locations)
Trial IDNCT05973084 on ClinicalTrials.gov

What this trial studies

This observational study aims to investigate the unique factors contributing to lower COVID-19 morbidity and mortality rates in Malawi compared to other regions. It will enroll symptomatic individuals with confirmed SARS-CoV-2 infections, their household contacts, and vaccinated individuals to assess the role of innate immune responses, malaria, and intestinal parasites in influencing susceptibility to infection and vaccine responses. Participants will be followed for up to 1.5 years to evaluate antibody responses and memory B cell longevity.

Who should consider this trial

Good fit: Ideal candidates include individuals aged 5 to 75 years with confirmed COVID-19 symptoms living in Blantyre, Malawi, and their household contacts.

Not a fit: Patients who have received a SARS-CoV-2 vaccine in the previous 3 months may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide insights into protective immune factors that may inform COVID-19 prevention and treatment strategies in similar populations.

How similar studies have performed: While there have been studies on COVID-19 transmission and immunity, this specific focus on the interplay of malaria, intestinal parasites, and innate immunity in a sub-Saharan context is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria Index Cases

1. Presents with symptoms of COVID-19 and has infection confirmed through RT-PCR or a rapid antigen test;
2. Aged 5 years to 75 years and plans to live in Blantyre, in the catchment area of the target research health centers for the following 6 months;
3. Confirmed SARS-CoV-2 infection and share a household with 1 or more individuals of eligible age;
4. Has not received a SARS-CoV-2 vaccine in the previous 3 months
5. Willingness to comply with study procedures and visits, and provides informed consent.

Household Contacts of the Confirmed SARS-CoV-2 Case

1. Aged 5 years to 75 years and plans to live in Blantyre, in the catchment area of the target research health centers in the following 6 months;
2. Willingness to comply with study procedures and follow-up visits and provides informed consent.
3. Has not received a SARS-CoV-2 vaccine in the previous 3 months

Vaccinees

1\) Aged 18 years to 75 years; 2) Willingness to receive the primary regimen of the AZ and/or JJ vaccines 2) Not in the other 2 cohorts; 4) Willingness to comply with study procedures and follow-up visits and provides informed consent.

5\) Has not received a prior dose of a SARS-CoV-2 vaccine

Exclusion Criteria Index Cases

1. Conditions that precludes from adherence to the visit schedule;
2. 50% or more of household members decline to participate.
3. Pregnancy at the enrollment visit
4. Long term use of cotrimoxazole prophylaxis

Household Contacts of the Confirmed SARS-CoV-2 Case

1. Conditions that preclude adherence to the visit schedule.
2. Participants with 2 consecutive negative SARS-CoV-2 RT-PCRs will be excluded from visits after M1.
3. Pregnancy at the enrollment visit
4. Long term use of cotrimoxazole prophylaxis

Vaccinees

1. Conditions that preclude adherence to the visit schedule.
2. Pregnancy at the enrollment visit
3. Long term use of cotrimoxazole prophylaxis

Where this trial is running

Boston, Massachusetts and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: SARS CoV 2 Infection, SARS CoV 2 Vaccination, Natural infection, Immune phenotypes, Innate immunity, SARS CoV 2 adaptive immunity, SARS CoV 2 antibody response, Vacinees

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.