The proliferation of poor quality medical products is an important but neglected public health problem, threatening millions of people all over the world, both in developing and wealthy countries. A pioneering conference will bring leading professionals from all over the world to Oxford, September 23-28, to discuss strategies for tackling poor quality medical products on a global scale.
Posted 07/05/2021. Multidrug-resistant tuberculosis (MDR-TB) remains a significant burden in the Southeast Asia region. Using mathematical modelling approach, Wirichada Pan-Ngum and colleagues assessed the population-level impacts of short-course MDR-TB treatment compared to the conventional therapy. Early initiation of treatment and good level of treatment eligibility are identified to be important determinants to the success of MDR-TB control programmes.
Posted 30/04/2021. In many low- and middle-income countries febrile children are managed by health workers with limited training, in settings where referrals can confer substantial costs and risks. Spot Sepsis, a multi-centre study being implemented by MORU and MSF, aims to develop a practical prognostic tool to help community healthcare providers identify febrile children who may benefit from referral for facility-based medical care.
Posted 16/04/2021. This systematic review by Arjun Chandna and colleagues identified clinical and laboratory prognostic factors, measured at the point of presentation, that can help identify children at risk of severe febrile illness. Most studies included only hospitalised children and further work is required to identify the best predictors to build data-driven triage tools for use by community healthcare providers.
Posted 27/04/2021. The complete treatment of vivax malaria requires a radical cure with a course of 8-aminoquinolines. Bipin Adhikari and colleagues interviewed policymakers in Asia why the radical cure is currently so poorly implemented and what can be done to improve the uptake of the radical cure.
Posted 20/04/2021. Artemisinin-based combination therapy (ACT) is the first-line treatment for uncomplicated falciparum malaria, but the ACT drugs are starting to fail. Triple artemisinin-based combination therapy (TACT) is being studied to replace ACTs. In this paper, Phaik Yeong Cheah and colleagues discuss the most important ethical and practical considerations in the potential deployment of TACT.
Posted 30/03/2021. Reactive case detection has played a role in the elimination of malaria in China. The approach has been adapted and is used in the Greater Mekong Subregion. Because it requires considerable man power but only few cases are detected the approach is controversial. Jacqueline Deen, Lorenz Von Seidlein and colleagues included 8 articles in a meta-analysis that found the percentage of positive malaria cases among potential contacts using microscopy or rapid diagnostic test was 0.56%.
Posted 09/03/2021. X-linked glucose-6-phosphate dehydrogenase deficiency is the most common human enzymopathy. Ghulam Awab and colleagues analysed their clinical study and epidemiological data from Afghanistan gathered over the last decade and showed that the G6PD Mediterranean variant provided a marked gene dose proportional protection against P. vivax malaria.
Posted 02/03/2021. Direk Limmathurotsakul and colleagues show that a Sepsis Fast Track (SFT) programme, implemented in Thailand to screen, initiate sepsis care and fast-track them when applicable to ICU upon admission, are associated with higher chances of survival. We analyzed data of a prospective observational study, having control group from both pre and post-intervention periods.
Posted 09/02/2021. Wirichada Pan-ngum and colleagues address key knowledge gaps on human-animal-water-source interactions and leptospirosis in high-risk settings, Thailand. Water-source sharing networks and human–animal contact patterns are key information potentially involved in the epidemiology of leptospirosis. Occupations related to animals/environmental water and consuming water from more than two sources increased the risk exposure to leptospirosis.
Posted 18/12/2020. Lorenz Von Seidlein and colleagues observed that poorest people in rural Tanzania were the oldest people and especially old people without children. This observation came as a surprise because generation, the baby boomers has accumulated wealth throughout life and ended up wealthier by the time they reached retirement. There is a need to provide more financial and housing security for older people in rural Africa. Currently for many older people in rural Africa the only security are their children.
Posted 11/12/2020. COVID-19 has hit informal urban settlements particularly hard. The control and prevention of COVID-19 in slums starts with organizing community infrastructure, provision of basic needs and protection of people at highest risk. Slums are a source for persistent transmission. In view of the constant risk that slums present to the entire population decisive steps need to be taken to rehabilitate and improve informal settlements, Lorenz Von Seidlein and colleagues provide suggestions.
Posted 08/10/2020. “No bacterial culture, no drug-resistant infections.” Cherry Lim, Direk Limmathurotsakul and colleagues show that the impact of low blood culture utilization on the observed proportions and incidences of drug-resistant infections could be high. This is likely happening in most of LMICs. A set of recommendations are proposed.
Posted 01/12/2020. This paper confirms that research is important to inform evidence-based medical care in LMICs settings. Napat Khirikoekkong, Phaik Yeong Cheah and colleagues found that migrants living along the Thai-Myanmar border, who were traditionally deemed vulnerable, exercise their agency and resourcefulness when navigating through their daily challenges, and participating in important health research
Posted 24/11/2020. Malaria Screener is a smartphone application developed by the National Library of Medicine, in partnership with Richard Maude and colleagues at MORU Epidemiology, aiming to improve the availability of high quality malaria diagnosis. It is cheap, fast and easy-to-use with a standard smartphone and microscope and detects malaria parasites by machine learning.
Posted 13/11/2020. Use of antimicrobials in animals and the environment has been established to contribute to the global antimicrobial resistance (AMR), and yet there have been inadequate collaborative efforts to tackle this problem. Sunil Pokharel, Bipin Adhikari and colleagues discuss how and why ‘One health’ approach is important to tackle antimicrobial resistance.
Posted 10/11/20. Artemisinin-based combination therapies are not only effectively curing malaria, they also impact male malaria parasites in their capacity for onward transmission to the mosquito. Here, Andrea Ruecker and colleagues provide clear evidence that artemisinin resistant parasites overcome this sterilising effect to successfully infect mosquitoes under drug pressure, facilitating the spread of artemisinin resistance.
Posted 13/10/2020. Xin Hui Chan and colleagues summarise their rapid reviews on the efficacy of personal protective equipment for preventing COVID-19 in primary and community care. They highlight how PPE is designed for use as an ensemble, is a complex intervention which should include appropriate training and support, and is the least effective of the hierarchy of controls.
Posted 07/10/2020. The Asia-Pacific region is the epicentre of the emergence of resistance against frontline antimalarials, and also faces a high proportion of non-falciparum malaria. Sarah Auburn and colleagues review novel approaches for molecular surveillance that can help track drug resistant parasites and the spread of parasites across the region, discussed at a recent APMEN workshop in Jakarta, and how these approaches can provide important information for policy makers in malaria-endemic regions.
Posted 22/09/2020. This case-control study, conducted by Direk Limmathurotsakul and colleagues in Thailand, shows that wearing masks all the time, maintaining >1 m distance, having close contact for <15 minutes, and frequent handwashing are independently associated with lower risk for SARS-CoV-2 infection (COVID-19)
Posted 18/09/2020. New findings by Ric Price and colleagues highlight that a remarkably high number of P. vivax infections arise from relapses (reactivation of dormant liver stages). This has important implications since almost 85% of recurrent infections could be prevented if more patients were treated with primaquine. The study emphasises the important of work done by the VxWG (Vivax Working Group for the Asia Pacific Malaria Eliminiation Network) in promoting wider access to safe and effective radical cure.
Congratulations to everyone involved in contributing to FIEBRE’s success - the clinical and laboratory staff, hospital, participants and local communities. The team has continued working throughout the COVID-19 epidemic despite national restrictions which slowed down enrolment and limited field activities.
The University of Oxford has awarded CTMGH two new Professors. Elisabeth Ashley - UK-trained physician who specialises in infectious diseases and medical microbiology & virology, and Director of the Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU) in Lao PDR since 2019, Liz is conferred the title of Professor of Tropical Medicine. Stuart Blacksell - Senior Research Scientist based at the Mahidol-Oxford Tropical Medicine Research Unit (MORU) in Thailand, Stuart is conferred the title of Professor of Tropical Microbiology.
A series of articles that set out to explore the global distribution of infections that cause non-malarial febrile illness has been published in BMC Medicine. The series brings together the results of large-scale systematic reviews of the causes of fever in Africa, Latin America, and Southern and South-Eastern Asia, and has helped identify major knowledge gaps, geographical differences, priority areas for diagnostics research and development, and enabled the most comprehensive systematic review of literature to date.
We are delighted to announce that Professor Paul Newton has won the Helen-Clark-JoPPP Award for Pharmaceutical Policy and Practice Research. This award is based on the scientific merit of his work, as well as its impact on patients, decisions makers, and on governments. It recognizes the talents of exceptional researchers who are making a significant contribution to the field of pharmaceutical policy and practice.
IDDO and MORU released its Medicine Quality Scientific Literature Surveyor. The surveyor delivers summaries of published scientific reports on the quality of the classes of essential medicines listed below, across regions and over time. We hope it will help medicine regulators, scientists, health professionals, purchasers and officials fill critical information gaps.
The results of the University of Oxford’s Recognition of Distinction exercise for Associate Professor and University Research Lecturer are in, and I am delighted to announce that the University has conferred titles on the following MORU staff: