What is the molecular genetic basis of anxiety in a very-low-income African setting? The Genetics of Anxiety In Malawi (G-AIM) Study.

Building on an existing longitudinal mental health resource in rural and urban Malawi, we will bring together national and international expertise to conduct the first large genetic association analysis of a broad anxiety measure in an African population. We will link this work to a new understanding of the lived experience of severe anxiety in highly vulnerable populations, exposed to multiple insecurities and set the foundations for a precision medicine approach to prevent and treat anxiety. We seek to (1) identify the impact of anxiety on lives and livelihoods (2) identify the correlates, antecedents and consequences of anxiety using traditional epidemiological approaches (3) understand the genetic architecture, and molecular mechanisms of anxiety, (4) identify the risk signatures in young children and adults to signpost possible disease mechanisms and for risk stratification. We will conduct repeat measures of generalised anxiety disorder and conduct qualitative research in key age groups in both rural and urban populations and work with experts in the fields of genomics and metabolomics research to build capacity in these disciplines within Malawi. We will explore the potential and acceptability of industry partnerships to ensure that future discovery using these tools includes those of African ancestry.