Primaquine can be used to prevent the transmission of falciparum malaria from human to mosquito. Bob Taylor and colleagues at the Mahidol Oxford Research Unit (MORU) have developed an age-based regimen for single low-dose primaquine to block the transmission of malaria in sub-Saharan Africa.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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
Millions of children weighing less than 15kg are currently denied access to Ivermectin treatment due to insufficient safety data being available to support a change to the current label indication. The WorldWide Antimalarial Resistance Network’s new meta-analysis provides evidence that supports removing this barrier and improving treatment equity.
Evidence from a new study, initiated by the Primaquine Roll Out Group and conducted at WWARN, supports the World Health Organization (WHO) recommendation for use of 0.25mg/kg dose of primaquine (PQ) combined with artemisinin-based combination therapies (ACT) to block Plasmodium falciparum transmission.
The Indonesian government policy to exclude the elderly in the first phase of the COVID-19 vaccination program could hinder the vaccine’s impact in lowering mortality rates. COVID-19 mortality rates in Indonesia, the highest in Southeast Asia, are dominated by those in the 60 years and above age bracket. In this article published in The Conversation, Kartika Saraswati and fellow DPhil students elaborate how, by prioritising vaccination for elderly, Indonesia may optimally reduce the hospital burden and COVID-19 deaths amidst a limited vaccine supply during the first vaccination phase.
A study to explore the variations of how microscopy methods are reported in published malaria studies has recommended standardised procedures should be implemented for methodological consistency and comparability of clinical trial outcomes.
Susie Dunachie joins a prestigious group of leading health researchers in the latest cohort of NIHR Global Research Professors. These awards fund research leaders of the future to promote effective translation of research and to strengthen health, public health and care research leadership at the highest academic levels. Research conducted by Global Research Professors directly benefits people in LMICs. A Consultant in Infectious Diseases and Medical Microbiology, Susie works on the development of a vaccine to prevent death from melioidosis in people with type 2 diabetes mellitus in LMICs, and supports vaccine research in Thailand. Congratulations!
Blog by Rima Shretta. Preliminary efficacy results from three vaccine candidates currently in Phase 3 trials have shown an efficacy of more than 90% against the development of symptomatic COVID-19. While these results are promising, all vaccines are in relatively early stages of testing. A comprehensive and transparent roadmap is urgently needed, to determine how limited doses of the first vaccines to be licensed will be distributed, together with which groups will initially be prioritized.