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Over 200 delegates travelled from more than 50 countries to attend the first ever conference on Medicine Quality and Public Health (MQPH 2018) in Oxford from 23-28 Sept. The conference, at Keble College, brought together experts in pharmacy, public health, chemistry, law, sociology, governance and ethics, from medicines regulatory authorities, academia, pharmaceutical industry, NGOs, and international organisations.
Serological evidence indicates widespread distribution of rickettsioses in Myanmar
LOMWRU
Posted 05/01/2021. Diagnosing rickettsial infections is difficult in low-resource settings; this leads to delays in receiving appropriate treatment. Before this study the distribution of rickettsioses in Myanmar was not known. This report of a serosurvey by Philip Elders, Elizabeth Ashley and colleagues shows rickettsioses are widespread in Myanmar, with high scrub typhus prevalence in central and northern regions.
How many human pathogens are there in Laos? An estimate of national human pathogen diversity and analysis of historical trends
LOMWRU
Posted 27/10/2020. Madeleine Clarkson, Paul Newton and colleagues reviewed when individual species of human pathogens were described in Laos, and estimated the in-country diversity and how many more pathogens there may be. Combining modelling with historical assessment improved understanding of the factors affecting pathogen description. During the last decade there has been a 33-fold increase in the description rate, coinciding with the strengthening of medical research in Laos.
Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE): protocol for a multisite prospective observational study of the causes of fever in Africa and Asia
LOMWRU
Posted 01/09/2020. This paper provides an overview of FIEBRE’s activities. The study aims to identify infections that are treatable and/or preventable, to assess antimicrobial susceptibility of bacterial pathogens and to collect qualitative data on care-seeking and treatment behaviours. Paul Newton and colleagues detail clinical and laboratory assessments, data analysis plan, and outline the study’s strengths and limitations.
Estimation of incidence of typhoid and paratyphoid fever in Vientiane, Lao People’s Democratic Republic
LOMWRU
Posted 10/03/2020. Incidence data about infectious diseases are needed to inform decisions about vaccine introduction. Using data from health-seeking behaviour survey for fever and data from hospital bloodstream infection, Mayfong Mayxay and colleagues estimated typhoid and paratyphoid fever incidence in Vientiane, the capital of Laos, and found that the incidence is low, with an annual incidence of 4.7 and 0.5 per 100,000 persons, for typhoid and paratyphoid fever, respectively.
Burkholderia pseudomallei multi-centre study to establish EUCAST MIC and zone diameter distributions and epidemiological cut-off (ECOFF) values
LOMWRU
Posted 14/08/2020. David Dance and colleagues describe a multi-centre study, co-ordinated by EUCAST, to establish interpretative criteria for Burkholderia pseudomallei disc diffusion tests. Three MORU network sites (Laos, Thailand and Cambodia) participated. The results, based on 361 isolates, will enable laboratories around the world to conduct quality-assured testing of B. pseudomallei susceptibility.
Screening of ectoparasites from domesticated dogs for bacterial pathogens in Vientiane, Lao PDR
LOMWRU
Posted 28/07/2020. Ticks, fleas and lice from dogs in Vientiane (Lao PDR) were shown to carry a variety of zoonotic pathogens including R. felis (cat-flea typhus). Matthew Robinson and colleagues highlight the risk of these pathogens transmitted between dogs and humans within the city, as well as the role of pets in human diseases, and important public health considerations
Community engagement, social context and coverage of mass anti-malarial administration
COMRU LOMWRU MOCRU MORU Bangkok
Posted 16/04/2019. Lorenz Von Seidlein and colleagues in Thailand, Myanmar, Vietnam, Cambodia, and Laos explored what happens to malaria transmission when all people residing in a village are treated with antimalarials at the same time, whether they are sick or not. They demonstrated that providing the necessary information is important, but building trust between residents and the team providing the antimalarials is most critical for success.
Antimicrobial-resistant Gram-negative colonization in infants from a neonatal intensive care unit in Thailand
COMRU LOMWRU MORU Bangkok
Posted 31/05/2019. Drug-resistant infections caused by Enterobacteriaceae, a family of Gram-negative bacteria, account for a high and increasing disease burden amongst hospitalised neonates in Southeast Asia; carbapenem-resistant strains are particularly important because of limited antibiotic treatment options. Tamalee Roberts and colleagues found that nearly two thirds of infants in a neonatal unit in Thailand became asymptomatic carriers with carbapenem-resistant Enterobacteriaceae during their hospital stays. This work indicates a critical need for interventions to reduce this usually hidden reservoir of drug-resistant bacteria.
Field detection devices for screening the quality of medicines
LOMWRU
Posted 23/10/18. A plethora of innovative portable devices to screen for poor quality medicines has become available. In a review of the scientific evidence regarding their performances, Dr Celine Caillet and colleagues show that there is a vitally important lack of independent evaluation of the majority of the 41 devices (most being spectrophotometers) found in our search, particularly in field settings. Intensive research is needed in order to inform national medicines regulatory authorities of the optimal choice of device to combat poor quality medicines.
Molecular characterization and mapping of G6PD mutations in the Greater Mekong Subregion
COMRU LOMWRU MOCRU MORU Bangkok
Posted 19/02/2019. Germana Bancone and colleagues characterized glucose-6-phosphate dehydrogenase deficiency in over 10 thousand samples collected in 138 villages in Cambodia, Lao PDR, Myanmar, Thailand and Vietnam, showing a country-level prevalence in males ranging from 7.3% to 18.8%. Given this high prevalence, G6PD testing should be carried out in the Greater Mekong Subregion before P. vivax radical cure with 8-aminoquinolines.
The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia
COMRU LOMWRU MOCRU MORU Bangkok
Posted 26/03/19. Lorenz Von Seidlein and colleagues wanted to know whether well-resourced mass drug administrations (MDA) can accelerate malaria elimination in the Greater Mekong Subregion. They randomised 16 villages in Myanmar, Vietnam, Cambodia, and Laos to receive MDAs with antimalarial drugs. The intervention had a substantial impact on the prevalence of P. falciparum infections by month 3 after the start of the MDAs. Over the subsequent 9 months, P. falciparum infections returned but stayed below baseline levels.
Quality of medical products for diabetes management
LOMWRU
Posted 01/10/2019. In the light of the alarming global increase in diabetes, Kartika Saraswati and colleagues at the LOMWRU-IDDO Medicine Quality team found few investigations on the quality of antidiabetics and supplies for self-monitoring of blood glucose. However, poor quality medical products were identified on four continents. This important public health issue should thus be further investigated.
An epidemic of dystonic reactions in central Africa
LOMWRU
Posted 17/03/2017. An investigation conducted by the international medical organisation Médecins Sans Frontières revealed that over a thousand people in a remote area of the Democratic Republic of Congo suffered toxic effects after ingesting fake diazepam pills. The research was published in The Lancet Global Health with contribution from Prof Paul Newton from IDDO and LOMWRU.
Microbiology Investigation Criteria for Reporting Objectively (MICRO): a framework for the reporting and interpretation of clinical microbiology data
COMRU LOMWRU
Posted 07/05/2019. Developed by Paul Turner and fellow members of the Oxford Tropical Network, the MICRO framework provides the scientific community with clear guidance on reporting and interpretation of clinical microbiology and antimicrobial resistance (AMR) data. Use of the framework will result in publication of better quality data for use in the global fight against AMR. The MICRO guideline is also posted on the EQUATOR website www.equator-network.org/reporting-guidelines
Estimating the burden of scrub typhus Estimating the burden of scrub typhus
LOMWRU MORU Bangkok
Posted 21/11/2017. Scrub typhus is a serious mite-transmitted and difficult-to-diagnose infectious disease increasingly recognised as a major treatable cause of febrile illnesses with a wider distribution beyond Asia. Despite many limitations on the amount and quality of available reports to date, scrub typhus remains a severely underappreciated tropical disease, deserving more attention.
Optimizing respiratory management in resource-limited settings
LOMWRU MORU Bangkok
Posted 01/02/2019. In many low- and middle-income countries, putting a critically ill patient on a ventilator is associated with a high risk of the patient dying or developing additional problems. In this paper, Rebecca Inglis and colleagues explore measures avert to the need for a ventilator. They also look at ways to improve the safety of ventilators in low-resource settings.
Plasmodium falciparum ATP4 inhibitors to treat malaria: worthy successors to artemisinin?
LOMWRU
Posted 28/04/2020. In this comment Elizabeth Ashley and Aung Pyae Phyo discuss two recent studies of SJ733, a PFATP4 inhibitor. Compounds from this promising novel class of antimalarials kill parasites rapidly, a property previously unique to the artemisinin derivatives among antimalarials in use, and one that underpins their enormous success.
COVID-19 and risks to the supply and quality of tests, drugs, and vaccines
LOMWRU
Posted 14/04/2020. Enormous emergency efforts are underway to find optimal medical products, to prevent, diagnose, and treat COVID-19, that 7.8 billion people will depend on. With dire disruption of pharmaceutical production and supply and increasing falsified and substandard products, we need strategic planning now to ensure global access to quality-assured medical products and monitoring of supply chains