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\n \n \n \nPosted 03/07/2018. Chloroquine, the recommended treatment for vivax malaria, delays but does not prevent relapses. Primaquine is the only widely available drug that prevents relapses but it can induce haemolysis in patients with G6PD deficiency. Cindy Chu and colleagues showed that added to chloroquine, primaquine is very effective for relapse prevention, but should be used alongside quantitative G6PD testing.
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\n \n \n \nPosted 27/06/2018. Current recommended treatment regimens for the most widely used medicine for uncomplicated Plasmodium falciparum malaria may be sub-optimal for small children and pregnant women according to a study led by Professor Joel Tarning.
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\n \n \n \nPosted 15/05/2018. Kartika Karaswati, Stuart Blacksell and colleagues reviewed the diagnostic accuracy of the available scrub typhus point-of-care tests, feasible to be used in resource limited settings. Although the available evidence is varied in methodology and quality, POCTs appear to have low false positive rates, thus confidence in interpreting a positive result can be high.
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\n \n \n \nPosted 08/05/2018. Is it ethical to withhold a recommended treatment from a patient in clinical trial? In this paper we evaluate whether exchanging placebo for an active drug is ethical. We use the example of a randomised control trial of primaquine to determine its anti-relapse efficacy against vivax malaria and conclude that in some cases a placebo arm is imperative.
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\n \n \n \nPosted 20/03/2018. A clinical trial in Cambodia evaluated the safety and effectiveness of mass drug administration (MDA) to interrupt multi-drug resistant falciparum malaria. Coverage with at least one round was 88%, no severe adverse events were reported, and MDA was associated with the absence of clinical P. falciparum cases for at least one year.
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\n \n \n \nPosted 14/03/2018. Blood from patients treated with ivermectin can kill mosquitos. Our results indicate that ivermectin mass drug administration to humans could be a potential malaria control tool to aid malaria elimination efforts in South America.
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\n \n \n \nPosted 13/02/2018. Two mass drug administrations against falciparum malaria were conducted in 2015\u201316, one as operational research in northern Cambodia, and the other as a clinical trial in western Cambodia. During an April 2017 workshop in Phnom Penh the field teams from M\u00e9decins Sans Fronti\u00e8res and the Mahidol-Oxford Tropical Medicine Research Unit discussed lessons for future mass drug administrations.
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\n \n \n \nPosted 16/01/2018. Ethics guidelines have evolved to protect vulnerable groups such as pregnant women from research. This has resulted in a lack of research in these populations making them even more vulnerable because of the lack of evidence-based medical care. In this paper, Professor Phaik Yeong Cheah and her collaborators discuss how regulatory frameworks can sometimes lead to a generalized exclusion of pregnant women from research.
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\n \n \n \nPosted 04/10/2017. Melioidosis is a neglected tropical disease estimated to kill 89,000 people a year across tropical regions and a vaccine is urgently required. In this collaboration with Imperial College, Professor Susanna Dunachie report for the first time a link between people with the HLA-B*46 genotype and around a three-fold increased risk of death. Survival from melioidosis is correlated with immune responses to nine key proteins from the causative bacteria, Burkholderia pseudomallei. This gives the foundation for development of an effective vaccine.
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\n \n \n \nPosted 26/09/2017. Professor Phaik Yeong Cheah and colleagues published a paper describing their experience and challenges engaging with communities involved in the Targeted Malaria Elimination initiative in Karen State, Myanmar. The report gives a detailed account of the activities conducted and challenges encountered which included difficulties explaining concepts like drug resistance and submicroscopic infection.
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\n \n \n \nPosted 05/09/2017. Can faster progress be made in the fight against malaria by targeting interventions to where they will have the most impact? Health economists and mathematical modellers from the Mahidol-Oxford Tropical Medicine Research Unit have developed an approach to use maps of disease risk together with models of the transmission of disease and the costs and effectiveness of malaria interventions to help local decision makers design more impactful malaria control and elimination programmes.
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\n \n \n \nPosted 25/08/2017. In more than 50,000 pregnancies where 16% of women had malaria infection, the odds of small for gestational age and preterm birth following falciparum, and vivax malaria, were quantified. These newborn effects have life-long implications and efforts to effectively prevent malaria in pregnancy must be pursued.
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\n \n \n \nPosted 14/08/2017. Through history and attributes of migration of Multi Drug Resistant Tuberculosis patients before diagnosis and treatment, and spatial analysis of their travelling patterns, the study highlights links between human migration and dispersal of multi-drug resistant Tuberculosis across wide geographic areas. It confirms needs for interventions suited to migrants\u2019 life circumstances.
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\n \n \n \nPosted 13/06/2017. It has been maintained for decades that quinine is the safest drug for treatment of malaria in the first trimester of pregnancy. In the largest analysis of data from Thailand and Africa, artemisinins are reported to be at least as safe as quinine. This will simplify treatment protocols worldwide.
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\n \n \n \nPosted 05/12/2018. A WWARN team recently completed a large systematic literature review to understand whether undernutrition places children at higher, lower, or no differential risk for getting malaria. We raise the concern whether an adapted antimalarial treatment strategy is needed in malnourished children. The results present the risks associated with chronic and severe acute malnutrition and the impact on sub-optimal drug exposure, poor patient outcomes and the potential contribution towards an increased risk of antimalarial drug resistance. Photo credit: Albert Gonz\u00e1lez Farran, UNAMID, 2013
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\n \n \n \nPosted 11/12/2018. Phaik Yeong Cheah and colleagues report a qualitative study on how best to seek broad consent to sharing individual level health research data beyond research collaborations. Their findings demonstrated that research participants prioritise information about the potential benefits and harms of data sharing. The researchers also found that explaining data sharing to research participants was challenging.
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\n \n \n \nPosted 08/01/19. Four out of five people in the world with diabetes now live in low and middle income countries. Professor Susanna Dunachie and her Thai collaborator Parinya Chamnan describe how diabetes leads to increased risk and worse outcomes for global infections such as TB, melioidosis and dengue, alongside discussing potential mechanisms and interventions.
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\n \n \n \nPosted 26/11/2019. Claire Chewapreecha and colleagues combined 753 newly sequenced Thai Burkholderia pseudomallei (the bacteria causing melioidosis) isolates with 258 Australian isolates to identify genes associated with either clinical or environmental strains. They found 47 genes that may provide clues to the strategy used by this microbe to adapt to survive in wide range of ecological niches, including human hosts.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 25/04/2019. It has been almost 30 years since clinicians from northern Thailand first raised the issue of severe scrub typhus and poor responses to treatment in patients. Tri Wangrangsimakul and colleagues show that paediatric scrub typhus is frequently severe, potentially fatal, and associated with high rates of treatment failure. A lack of awareness leading to delays in treatment may have contributed. Investigating the determinants of treatment failure and raising the awareness of this neglected disease remains a priority.
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