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Prof Paul Newton, Director of LOMWRU and Head of the Medicine Quality Group at the Infectious Diseases Data Observatory IDDO, explains the history of falsified medicines and highlights what needs to be done to avert a problem that threatens us all.
Tenofovir disoproxil fumarate in pregnancy for prevention of mother to child transmission of hepatitis B in a rural setting on the Thailand-Myanmar border
SMRU
Posted 05/03/2021. Prevention of mother to child transmission of Hepatitis B can be challenging in resource limited settings. Marieke Bierhoff and colleagues look at strategies that might be more feasible in these settings. TDF (tenofovir disoproxil fumarate) after rapid diagnostic test may be a more feasible strategy to implement in resource limited settings, TDF after hepatitis B e-antigen test is a cheaper option.
Research ethics in context: understanding the vulnerabilities, agency and resourcefulness of research participants living along the Thai–Myanmar border
MORU Bangkok SMRU
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
TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border
SMRU
Posted 27/11/2020. The migrant-friendly residential TB program of SMRU on the Thailand-Myanmar border has achieved high treatment success rate. However, many TB patients admitted to the centers are in advanced stage of disease. Win Pa Pa Htun and colleagues show that early TB death (in the first month of treatment) is highest among pulmonary TB cases and in particular in HIV co-infected patients and in those with co-morbidity. Early detection and treatment for both TB and HIV are crucial for migrants, if the case fatality rate is to be reduced in this marginalized population.
Impact of outdoor residual spraying on the biting rate of malaria vectors in Myanmar
SMRU
Posted 06/11/20. Victor Chaumeau and colleagues assessed the impact of outdoor residual spraying on the biting rate of malaria mosquitoes in four villages in Kayin state, Myanmar. They reported a 10-fold decrease in mosquito biting rate immediately after the intervention and concluded that outdoor residual spraying can be used to control malaria mosquitoes in this area.
Tenofovir for prevention of mother to child transmission of hepatitis B in migrant women in a resource-limited setting on the Thailand-Myanmar border: a commentary on challenges of implementation
SMRU
Posted 25/09/2020. Prevention of mother to child transmission of hepatitis B with maternal tenofovir DF is one option to reach elimination of this infection. However, implementing this in a resource limited setting is challenging. Marieke Bierhoff and colleagues describe the most common challenges and possible solutions like transport assistance and local agreements to facilitate access.
G6PD deficiency in malaria endemic areas of Nepal
SMRU
Posted 27/08/2020. Germana Bancone and colleagues from EDCD (Nepal) and SMRU conducted this study in malaria endemic districts of Nepal, showing that G6PD deficiency is prevalent among most ethnic groups across the region. G6PD testing will be necessary for safe deployment of 8-aminoquinolines in order to eliminate Plasmodium vivax malaria in Nepal.
Birth attendant training course may be global model for safer birth care in poor communities
SMRU
Posted 17/10/2016. Training local Karen and Burman women as skilled birth attendants in refugee settings resulted in no adverse perinatal outcomes and many positive outcomes such as a drop in stillbirths and infant deaths and more babies being born in clinics rather than at home, says a new study, led by Professor Rose McGready and published in PLOS ONE.
Nutrition in transition: historical cohort analysis among pregnant women along the Thailand–Myanmar border 1986 - 2016
MORU Bangkok SMRU
Posted 16/07/2019. Worrying nutritional trends in possibly the longest and largest cohort of nearly 50,000 refugee and migrant pregnant women in a LMIC setting. Ahmar Hashmi and colleagues at SMRU summarise trends in under- and over-nutrition among pregnant women, and show a double burden of malnutrition in these marginalised and vulnerable communities from the Myanmar-Thailand border.
Primaquine pharmacokinetics in lactating women and breastfed infant exposures
MORU Bangkok SMRU
Posted 25/04/2018. Mary-Ellen Gilder and colleagues at SMRU demonstrate low levels of primaquine in breast milk, findings that should change treatment policy allowing more breastfeeding women to be cured of P.vivax. This will potentially reduce the global burden of this infection which has significant negative consequences for pregnant mothers and infants.
Early life risk factors of motor, cognitive and language development
SMRU
Posted 22/10/2019. Rose McGready and SMRU colleagues contributed RCT data from the Thailand-Myanmar border to this large review on low- and middle-income countries (21 studies in 20 882 children). The results suggests targeting parental, environmental and nutritional factors from pre-pregnancy through childhood, as a way forward to improve health and development of children in such settings.
“I can’t read and don’t understand”: Health literacy and messaging in a migrant population on the Myanmar-Thailand border
SMRU
Posted 05/07/2019. Health information can be life-saving, but how can it be conveyed to those who could benefit most? Through analysis of an unsuccessful public health campaign, Mary Ellen Gilder and SMRU colleagues learned from migrant women valuable lessons about health messaging in communities where most women do not complete the fourth grade.
Optimal duration of follow-up antimalarial efficacy in pregnancy on the Thailand–Myanmar border
SMRU
Posted 02/07/2019. Highly efficacious treatment can limit the cumulative deleterious impact of malaria during pregnancy on the mother and fetus. Correct assessment of treatment efficacy with an adequate length of follow up is required. Makoto Saito and colleagues at the Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border suggest that pregnant women need to be followed up longer than the currently recommended duration of follow-up to assess antimalarial drug efficacy.
Quantification of the association between malaria in pregnancy and stillbirth
SMRU
Posted 17/10/2017. Plasmodium falciparum and Plasmodium vivax malaria in pregnancy both increase stillbirth risk, which is likely to increase as endemicity declines. A study by SMRU and University of Melbourne researchers shows that better P. falciparum malaria control efforts could prevent up to 1 in 5 to 8 stillbirths in sub-Saharan Africa.
Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy
MORU Bangkok SMRU
Posted 12/06/2020. Safety of drugs is important, particularly during pregnancy. Makoto Saito and colleagues have pooled the data of 4503 women who had malaria in pregnancy and found that the currently used artemisinin-based combination therapies are equally safe for fetus. This study also highlights that risk of small-for-gestational-age (SGA) is high after malaria in pregnancy even treated with highly efficacious drugs, suggesting that prevention is important for reducing SGA in malaria endemic areas.
Feeding practices and risk factors for chronic infant undernutrition among refugees and migrants along the Thailand-Myanmar border
SMRU
Posted 20/12/2019. How do birth outcomes, a mother’s nutrition, and how a mother feeds her infant relate to chronic undernutrition among refugee and migrant infants along the Thailand-Myanmar border? Why do these mothers feed their infants as they do? Come learn more from a recent study by Ahmar Hashmi and colleagues at the Shoklo Malaria Research Unit.
Malaria
MOCRU MORU Bangkok SMRU
Posted 17/04/2018. This new Lancet malaria seminar, by Elizabeth Ashley and Charlie Woodrow, is one of a series of clinically focused, structured, up-to-date reviews which are grouped together in The Lancet Clinic with other relevant content. The aim of the seminars is to give a comprehensive overview of diseases to practising clinicians, emphasising recent advances, controversies and uncertainties.
Comparison of the Cumulative Efficacy and Safety of Chloroquine, Artesunate, and Chloroquine-Primaquine in Plasmodium vivax Malaria
MORU Bangkok SMRU
Posted 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.
Community engagement for the rapid elimination of malaria
MORU Bangkok SMRU
Posted 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.
Influence of number and timing of malaria episodes during pregnancy on prematurity and birthweight
MORU Bangkok SMRU
Posted 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.
Migration histories of multidrug-resistant tuberculosis patients from the Thailand-Myanmar border, 2012–2014
MORU Bangkok SMRU
Posted 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’ life circumstances.