SCIENTIFIC PROGRAMS

Coordinator

Endemic diseases such as HIV, malaria, tuberculosis, and cholera continue to be a burden on public health in the country, presenting high incidence and prevalence, spreading rapidly and causing outbreaks and epidemics. Thus, in order to reduce the burden of these diseases, the PDEGIS was created, which integrates the research, laboratory, surveillance, training, and communication activities carried out by the INS in its thematic area.

Program Objectives

Investigate, monitor, and evaluate endemic diseases with a major impact on public health.

This action refers to the investigation of the main transmissible infections for most of the national territory. In line with the institution's scientific strategy, the PDGIS provides support and scientific guidance through:

• Conducting disease prevalence surveys with a significant public health impact;
• Implementation and monitoring of sentinel-based and laboratory surveillance systems for major syndromes with epidemic potential;
• Implementation of new robust diagnostic, research, and surveillance platforms for major endemic diseases;
• Conducting clinical-epidemiological research on major public health conditions to identify key transmission and propagation points of endemic diseases;
• Evaluation of new health technologies, including vaccines, for Sexually Transmitted Infections (STIs), urinary tract infections, respiratory infections, and gastrointestinal infections.;
• Conducting fundamental biological studies within the scope of endemic diseases to understand the interactions between disease-causing agents and hosts and/or vectors and the environment.

Research Areas

• Biomedical Research

This area is primarily focused on laboratory-based research (also involving fieldwork) with a main focus on the pathogen. This research, on the one hand, comprises fundamental and translational laboratory research, and on the other hand, the bio-molecular aspects of pathogen transmission and population dynamics. These research areas are broken down into five sub-areas:

1. Infectious Disease Bacteriology (PB-BDE): is dedicated to the study of bacteria relevant to public health, their identification, molecular variants, as well as their antimicrobial susceptibility profile. The main bacteria studied in the endemic diseases program include Mycobacterium tuberculosis, Vibrio cholerae, Salmonella spp., Shigella spp., Escherichia coli, Streptococcus spp., Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum, Haemophilus influenzaee Klebsiella pneumoniae.
2. Virology of infectious diseases (PB-VDE):It is dedicated to applying cell biology and molecular biology methods in the investigation of viral diseases. This sub-area aims to establish scientific bases for the improvement of diagnosis, treatment, epidemiology, and control of viral diseases. The main viruses studied in the endemic diseases program include human immunodeficiency virus (HIV), human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), herpes simplex virus (HSV), respiratory syncytial virus (RSV), Influenza, Rotavirus, Adenovirus, Astrovirus, Sapovirus, Norovirus, and severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2).
3. Human Parasitology (PB-PH)its main focus is the study of malaria caused by Plasmodium spp, particularly the Plasmodium falciparum.These studies are focused on evaluating new diagnostic methods, molecular characterization of circulating strains, and their association with antimalarial resistance and transmissibility. This sub-area also conducts research activities aimed at improving knowledge of other parasites and fungi of great public health relevance, such as, Trichomonas vaginalis, Cryptosporidium spp., Isospora cayetanensis, Cyclospora cayetanensis, Giardia intestinalis, Entamoeba histolytica e Cryptococcus neoformans.
4. Immunology of Tropical Infectious Diseases (PB-IDET):It is dedicated to the multidisciplinary study of immunological processes at the cellular, molecular, and genetic levels and their implications in health and the pathogenesis of infectious diseases. This sub-area also focuses on the interaction between the immune system, the composition of the human microbiota, and the pathogenicity of infectious agents.
5. Genetics in Molecular Epidemiology for Health (PB-GEMS): that applies concepts and methods from genetics and molecular biology to the study of endemic diseases of great public health relevance and factors that confer host susceptibility or resistance to such diseases.

• Clinical Research

For this area, the host/patient is the main focus of research, with these studies being the application of the scientific foundations of biomedical research. Research fields include evaluating approaches for the diagnosis, prevention, and treatment of infectious diseases of great public health importance, in a given patient. The research includes:

1. Therapeutic or prophylactic clinical trials (PC-ECTP)they conduct a systematic evaluation of products such as vaccines, antibodies, or medications in human volunteers strictly following scientific method guidelines. The objective of these studies is to discover or confirm the effects and/or identify adverse reactions to the product under investigation and/or study the pharmacokinetics of active ingredients, in order to determine their efficacy and safety. The main clinical trials include evaluation of vaccines or other prophylactic approaches for HIV, rotavirus, polio, HPV, and SARS-CoV-2; evaluation of new therapeutic approaches for TB, malaria, HIV, and SARS-CoV-2.
2. Prospective cohort observational studies (PC-EOC)investigate the long-term health outcomes of a group of people (longitudinal studies). In these studies, individuals with one or more endemic disease exposure profiles are followed to assess the incidence, prognosis, and causes of the disease over a specific period.
3. Case-Control Observational Studies (CCOS): compare individuals with a known health condition, in this case an endemic disease, and those without it, to understand why some individuals get sick and others do not.
4. Cross-sectional observational studies (PC-EOS): generally used to compare groups at a single point.

• Public Health Research

This line includes epidemiological and disease control studies at the human population level. Here, descriptive epidemiological studies of population-wide scope and disease surveillance approaches for endemic diseases with significant health impact are focused. This area includes small and large prevalence surveys of major endemic diseases, such as HIV, malaria, tuberculosis, and recently the novel coronavirus SARS-CoV-2/COVID-19. This area also includes laboratory-based surveillance, at sentinel sites and community-based, for major syndromes with epidemic potential, with special emphasis on acute respiratory and diarrheal infections.

Partners

The PDEGIS establishes partnerships with national and international institutions with the aim of strengthening the technical-scientific aspects of the INS, through the creation of synergies that lead to the exchange of research experiences with an impact on public health and capacity development. These partnerships not only support the development of program activities but also allow for support in the strategic axes defined by the INS, with a primary emphasis on teaching and education, where students from national universities and technicians of different levels benefit from long-term and short-term scholarships funded by our partners.

Below are some of our partners:

Nationals

• Manhiça Health Research Center (CISM)
• Eduardo Mondlane University (UEM)
• Higher Institute of Health Sciences (ISCISA)
• Pedagogical University (UniMaputo)
• Lúrio University (UniLúrio)
• Universidade Rovuma (UniRovuma)
• Elizabeth Glaser Pediatric AIDS Foundation
• CDC Global Health – Mozambique
• Mozambique – Clinton Health Access Initiative
• Doctors Without Borders (MSF)

International

• Ludwig Maximilian University of Munich (LMU), Germany
• University of Bordeaux, France
• Barcelona Institute for Global Health (ISGlobal), Spain
• The London School of Hygiene & Tropical Medicine (LSHTM), United Kingdom
• Institute of Tropical Medicine Antwerp (ITM), Belgium
• Institute of Hygiene and Tropical Medicine (IHMT), Portugal
• HIV Vaccine Trials Network (HVTN), United States of America
• US Military’s HIV Research Program (MHRP), United States of America
• Division of AIDS, National Institutes of Health, United States of America
• Karolinska Institute, Sweden
• The Public Health Agency of Sweden (Folkhälsomyndigheten), Sweden
• Oswaldo Cruz Foundation (Fiocruz), Brazil
• Federal University of Rio de Janeiro (UFRJ), Brazil