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\n \n \n \nPosted 04/02/2022. Current knowledge of P. falciparum artemisinin resistance evolution in Asia is as old as 4yrs ago. For swift policy decisions, rapid sharing of data collected over extended periods in the same areas is highly needed. Frank Kagoro and colleagues found a steady increase in geographic locations and the proportion of artemisinin resistance from 2002 to 2018. Using the latest WHO classification, the authors map all published K13 markers in Asia by province and district.
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\n \n \n \nPosted 23/12/2021. Marcus Schultz and colleagues analysed 4 large prospective observational studies conducted in 534 ICUs in 54 countries. Patients in middle\u2013income countries were younger, shorter with a slightly lower BMI, had more often diabetes and active cancer, but less often COPD and heart failure. Sequential organ failure assessment scores were similar. ICU mortality was higher in middle\u2013income countries, and inversely associated with GDP.
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\n \n \n \nPosted 12/11/2021. Global antibiotic consumption rates increased by 46 percent in the last two decades, according to the first study to provide longitudinal estimates of human consumption in 204 countries from 2000 to 2018. Annie Browne, Christiane Dolecek and colleagues used a novel approach that deployed statistical modelling techniques and incorporated multiple data sources, to help us address a number of public health challenges, from combating drug resistant infections to providing access to basic treatment
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\n \n \n \nPosted 02/11/2021. Claire Chewapreecha and colleagues employ a powerful combination of genome-wide epistasis and co-selection study (GWES); gene expression analyses and gene knockout assays to identify the key genes that have been repeatedly selected through Burkholderia pseudomallei evolution. The study indicates that the bacterium is evolutionarily primed to survive nutrient-depleted soils and highlights the need to protect environmental health as part of disease prevention.
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\n \n \n \nPosted 20/10/2021. Scrub typhus infects over a million people a year across the Asia-Pacific. The ecology of this important disease, transmitted by chigger mites, remains poorly understood. Ivo Elliott and colleagues report on the identification of key risk factors that determine foci of high disease transmission at 3 sites in Northern Thailand.
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\n \n \n \nPosted 01/10/2021. In 2017 hundreds of thousands of \u2018Rohingya\u2019 fled from Myanmar to refugee camps in Cox\u2019s Bazar, Bangladesh. Health centre data were reviewed to estimate the increase in health care utilization. The presence of a large migrant population relative to a smaller host community burdens the limited facilities and resources of the public health sector, by Lorenz Von Seidlein and colleagues
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\n \n \n \nPosted 29/09/2021. Xin Hui Chan and colleagues report a large individual patient data meta-analysis of malaria clinical trials supporting the cardiovascular safety of amodiaquine and structurally related antimalarials at WHO-recommended dosing regimens alone or in ACTs for the treatment and prevention of malaria, and propose a potential mechanism for amodiaquine-related asthenia.
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\n \n \n \n24/09/2021. Plasmodium vivax in SE Asia and Oceania is less sensitive to primaquine compared to other regions and needs a higher target dose - 0.5 mg/kg. Bob Taylor and colleagues propose a new regimen that was designed using pharmacokinetic simulation and takes into account that children need higher mg/kg doses compared to adults.
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\n \n \n \nPosted 15/09/2021. In Cambodian G6PD deficient variants, G6PD enzyme activity is unaffected by baseline reticulocyte counts but rises and correlates with posttreatment reticulocytosis. Qualitative G6PD tests are unlikely to misdiagnose G6PD deficient males at presentation. Too few G6PD heterozygous females preclude drawing inferences; more research is needed in this group.
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\n \n \n \nPosted 17/09/2021. One of the policies to achieve malaria elimination in the near future is reactive case detection. A secondary analysis of a large dataset of mass drug administrations in Greater Mekong Subregion found that reactive case detection in this setting is costly but results only in minimal benefits, by Lorenz Von Seidlein and colleagues
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\n \n \n \nPosted 27/07/2021. This qualitative study by Mira Schneiders and colleagues discusses the important nutrition-related roles and responsibilities of grandparents caring for grandchildren in rural Cambodian \u2018skip-generation\u2019 households. Grandparents appear highly motivated to improve grandchildren\u2019s health and nutrition, but lack necessary resources, leading to frequent moral dilemmas and ethical trade-offs. Interventions to improve child health and nutrition should be designed to be inclusive of older caregivers.
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\n \n \n \nPosted 16/07/2021. Severe metabolic acidosis and acute kidney injury are major causes of mortality in children with severe malaria but are often underdiagnosed in low resource settings. What prognostic factors are associated with severe metabolic acidosis and uraemia in African children with severe falciparum malaria? Secondary analysis of a randomized trial by Mavuto Mukaka and colleagues
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\n \n \n \nPosted 06/07/2021. Surveillance of Antimicrobial resistance (AMR) is important in generating evidence to support efforts in controlling the infection. Cherry Lim and colleagues discuss the strengths, potential sources of bias, and challenges of routine microbiology data and different surveillance strategies and solutions used in low- and middle-income countries. Areas requiring support and improvement are highlighted.
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\n \n \n \nPosted 16/06/2021. The progress made in treatment of malaria is threatened by the emergence of resistance to current first line treatments artemisinin-based combination therapies (ACTs). There are currently no good alternatives for the treatment of uncomplicated malaria in the African setting in the event of resistance emerging to antimalarials that are in the ACTs. Mainga Hamaluba, Rob van der Pluijm and colleagues demonstrate that triple artemisinin combination therapies (TACTs) can potentially be used safely to prevent, delay or manage uncomplicated malaria in our setting.
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\n \n \n \nPosted 23/04/2019. Human population movement can lead to the persistence of malaria along the Thai\u2013Myanmar border. Lisa White, Wirichada Pan-ngum and colleagues show that malaria risk is related to the number of days doing outdoor activities in the dry season, especially trips to Myanmar, to forest areas and overnight trips. Understanding movement patterns is important when considering targeted public health interventions, especially during the elimination phase.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 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%.
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\n \n \n \nPosted 08/06/2020. Safe and effective radical cure of malaria will require better ways of testing for G6PD deficiency. In a large collaborative study a paper in PLoS Medicine, Daniel Pfeffer, Ric Price and colleagues highlight substantial variation between research laboratories using the current gold standard method (spectrophotometry). The study highlights challenges but also opportunities for new point of care tests.
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