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. 2024 Oct 8;112(4_Suppl):119-126.
doi: 10.4269/ajtmh.23-0893. Print 2025 Apr 1.

Operational Research to Support Rapid Evidence-Based Responses to Outbreaks: Learnings from COVID-19

Anne Hoppe  1   2 , Pallavi Dani  1 , Grace Mwangoka  3 , Stephen Vreden  4 , Guillaume Breton  5 , Jerome Ateudjieu  6 , Joaniter I Nankabirwa  7 , Júlia Sambo  8 , Rose Masaba  9 , Tatenda Maparo  10 , Goodman Sibeko  11 , Richard Njouom  12 , Boris Tchounga  13 , Isaac Ssewanyana  14 , Chancy Chavula  15 , Lindiwe Nchimunya  16 , Tatiana Djikeussi  13 , Sam Accellam  1   14 , Hedley Cairo  17 , David Walcott  18 , Aamir J Khan  19 , Shaukat Khan  1   20 , Daniel G Bausch  1
Affiliations

Operational Research to Support Rapid Evidence-Based Responses to Outbreaks: Learnings from COVID-19

Anne Hoppe et al. Am J Trop Med Hyg. .

Abstract

During the COVID-19 pandemic, the need for making testing readily available was recognized as an important factor for individuals to help make informed decisions, including to isolate or seek care, and for policymakers to control transmission. Toward this end, FIND and the Access to COVID-19 Tools Accelerator funded 16 rapid operational research studies and one implementation project in Africa, the Caribbean, and Asia evaluating the utility, acceptability, and feasibility of different community-based SARS-CoV-2 testing approaches. Here, we discuss common factors and challenges encountered during study implementation. We note six key factors essential for success: 1) collaboration and partnerships; 2) buy-in of local stakeholders, including communities; 3) access to affordable supplies; 4) flexible financing; 5) effective approval systems; and 6) a skilled and motivated workforce. We also note various challenges that must be addressed to fully capitalize on these success factors. In particular, ethics committees are often not well equipped to assess operational research during outbreaks. Outbreaks, especially of novel pathogens, are unpredictable, and transmission dynamics are even more likely to change if the pathogen is prone to frequent mutations, such as SARS-CoV-2. Research that aims to evaluate strategies for curbing transmission must hence be easily and swiftly adaptable. This requires flexibility from researchers, funders, staff conducting the studies, and ethics and other approval committees. International guidelines for evaluating operational research protocols in outbreaks are needed to provide timely evidence to enable informed decisions by individuals, communities, and policymakers, thereby reducing both the human and the economic impact of outbreaks.

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Figures

Figure 1.
Figure 1.
Four key criteria for mitigating the spread of an infectious disease with known pathogens and transmission patterns.
Figure 2.
Figure 2.
Communities in which SARS-CoV-2 testing was performed. SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.
Figure 3.
Figure 3.
Key success factors for OR. OR = operational research.
Figure 4.
Figure 4.
Timelines for study approvals. OR = operational research.
See this image and copyright information in PMC

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