Achievements and projects in Laos

LOWMRU’s high level achievements since its founding in 2000 include:

  1. Clinical trial (the first in Laos) evidence that helped change the Lao nationally recommended uncomplicated P. falciparum malaria treatment regimen to an artemisinin combination therapy (ACT)
  2. Demonstration that rickettsioses, especially scrub typhus and murine typhus, are major causes of non-malarious fever in Laos. The rediscovery of the related sennetsu (Neorickettsia sennetsu) in Asia and the first description of the pathogen in fish, supporting the Japanese hypothesis that the disease is contracted from eating raw fish. A large prospective analysis demonstrated the importance of rickettsial and leptospiral pathogens in central nervous system infections, impacting on treatment policy
  3. Epidemiological evidence of the importance of S. pneumoniae and Japanese Encephalitis Virus in Laos contributed to the implementation of vaccination against these pathogens in Laos
  4. The first evidence from mainland Asia of the causes of fever when malaria tests are negative, informing empirical patient management algorithms. The first fever web-based mapping work, in collaboration with the Foundation for Innovative Diagnostics (FIND) and WWARN
  5. The first description of melioidosis in Laos and the first Asian random survey of B. pseudomallei distribution in soil
  6. The first clinical trial of typhoid therapy, influencing policy across the country. Demonstration that rapid diagnostic tests (RDT) for typhoid antigen can accurately detect S. Typhi after short blood culture incubation and molecular markers of drug resistance can be detected from the dry RDT
  7. Discovery of noma (cancrum oris) as a significant public health problem and worrying indicator of the extent of historical poverty in Laos – it is not just a disease of Africa
  8. Demonstration that clinical infantile beriberi and cryptic biochemical thiamin deficiency are common in Vientiane and that markers of cardiac dysfunction, such as troponin T, may be accessible surrogate markers of clinical infantile beriberi
  9. The science of medicine quality has lagged behind mainstream medical research. LOMWRU has helped to put science and public health advocacy into medicine quality research globally through precipitating discussions of the optimal sampling and reporting strategies, conducting statistically valid surveys, mapping the evidence, working with chemists on the development and evaluation of new medicine quality analysis techniques (both field techniques and sophisticated reference assays), investigating novel forensic techniques such as pollen, stable isotope and DNA analysis. The first published forensic analysis of a falsified medicine (artesunate) to obtain evidence as to origin, using identification of pollen inside tablets and stable isotope analysis prompted the arrest and imprisonment of fake medicine traders
  10. Significant capacity building, in clinical and laboratory routine and research work, good clinical practice (GCP), safety and laboratory management and dissemination of results and policy discussions
  11. LOMWRU co-ordinates an infectious disease consultancy service at Mahosot Hospital
Mahosot Hospital Infectious Disease Centre