Achievements

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Since 2005 we have published over 300 articles in peer-reviewed journals (see the bibliography), along with numerous reviews and book chapters. The Programme’s work has formed the basis for the treatment of severe and uncomplicated malaria, as embodied in the 2006 WHO Guidelines, and has defined the best practice treatment for melioidosis. The following sections describe our recent achievements:

Malaria

  • Research from MORU has provided the biological, economic, and clinical basis for changing global antimalarial treatment recommendations to artemisinin combination therapies (ACTs). This is the most important development in antimalarial chemotherapy in the past fifty years.
  • The largest ever clinical trial in severe malaria (SEAQUAMAT) demonstrated that artesunate was associated with a 35% reduction in mortality compared with quinine. SEAQUAMAT was a multicentre study conducted in Bangladesh, Myanmar, India and Indonesia and coordinated by MORU in Bangkok.
  • Work on the Thai-Burma border, undertaken by Shoklo Malaria Research Unit (SMRU) treats 20,000 malaria patients each year and has enrolled more patients in antimalarial studies than any other.
  • SMRU is the major source of information on antimalarial drug treatment in pregnancy and has contributed 8 of the 12 existing studies on antimalarial drugs in pregnancy and worked with 69% of all patients studied.
  • We have conducted and published surveys uncovering the deadly use of fake antimalarial drugs throughout Southeast Asia and we have provided simple methods for their detection.

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Bacterial and viral diseases, and nurtrition

  • Melioidosis remains a major cause of severe illness in parts of SE Asia and there are increasing numbers of cases in India, China, and Brazil. MORU has studied over 3,000 patients with melioidosis since 1986 and current WHO treatment recommendations are based on our work.
  • We have identified scrub typhus and leptospirosis as major causes of febrile illness (fever) leading to hospital admission in rural areas of Thailand and Laos. Large scale comparisons of diagnostic tests for scrub typhus have been conducted, and the results are currently being analysed.
  • We have identified infantile beriberi (vitamin B1 deficiency) as a major cause of infant death in rural SE Asia – particularly in very poor rural communities. Treatment for this condition by SMRU has eliminated beriberi in the refugee camps where we work.

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