Child in Rural Thailand
- Characterising the clinical epidemiology of the major infectious diseases in rural areas of South-East Asia. We are developing ways to determine which pathogens are involved in causing septicaemia and unexplained fever, enabling health workers to make a quick and accurate diagnosis and provide the most effective treatment possible.
- Conducting studies to determine and define the biology of the pathogens and how infectious diseases affect the body, to guide the search for new diagnostic tests and novel treatments.
- Regional coordination of studies to determine the proper dosing of drugs, and define their effects on the disease process (pharmacokinetics and pharmacodynamics); as well as clinical trials to determine the safety and efficacy of new treatments, and methods of preventing the emergence of resistance.
- Assessing the impact of research findings on national treatment guidelines and their implementation through health policy research.
- Develop methods to detect and tackle the scourge of fake and substandard anti-infective drugs, and publicizing ways that they can be identified.
- Disseminating research findings through national and international meetings, and publication in the international literature.
- To conduct multi-centre clinical trials to reduce the mortality of severe malaria. These include coordinating, in collaboration with African malaria investigators, a comparison of artesunate and quinine in African children with severe malaria.
- To characterise and quantitate the various factors which reduce microcirculatory flow in severe falciparum malaria.
- To optimise and standardise the assessment of antimalarial drug treatment in falciparum and vivax malaria.
- To determine antimalarial drug pharmacokinetic/pharmacodynamic relationships and use evidence based methodologies to facilitate the development of effective new drugs for the treatment of uncomplicated falciparum and vivax malaria in adults, children, and in pregnancy.
- To determine the optimum treatment of malaria in pregnancy by the establishment of a strong multinational collaboration with centres in Asia and Africa.
- To develop and validate comprehensive models to describe the emergence and spread of antimalarial drug resistance, and use these to assess the costs and benefits of different implementation strategies.
- To incorporate our well-established melioidosis clinical trials base into a larger Thailand Melioidosis Clinical Trials Group, thereby accelerating the assessment of new treatment strategies and reducing the mortality and morbidity from melioidosis.
- To assess the potential role of maternal vaccination in late pregnancy in preventing infant pneumococcal disease, by conducting a large randomised clinical trial in the Karen refugee camps on the Thai-Burmese border.
- To develop a rectal formulation for the acute treatment of life threatening febrile illness in remote rural areas of the rural tropics, and then to conduct clinical trials. This formulation will combine an antimalarial and an antibiotic, and be designed to treat effectively both severe malaria (and prevent the emergence of artemisinin resistance) and severe bacterial sepsis.
- To perform clinical trials of vitamin B1 supplementation of pregnant and post-partum women in Lao PDR with the objective of reducing the high rate of infant mortality.
- To determine the major infectious pathogens causing illness in rural areas of South-East Asia, including Lao PDR and Burma, and to develop simple, rapid and affordable diagnostic tests for these.
- To determine the geographical diversity of rickettsial infections and leptospirosis in Lao PDR and Thailand, to develop methods of diagnosis appropriate to resource-poor rural areas; to conduct clinical trials to optimise the treatment of uncomplicated and severe typhus and leptospirosis.