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The University of Oxford, MORU, the University of Cape Town, the Thai Ministry of Public Health, and UNICEF Thailand worked together to promote lifelong health and well-being, and prevent violence against children. Led by Amalee McCoy from MORU Department of Bioethics & Engagement, this project involved the cultural adaptation and testing of an evidence-based parenting intervention for low-income families with children aged 2-9 living in Udon Thani, Thailand.
Ethical and cultural implications for conducting verbal autopsies in South and Southeast Asia: a qualitative study
LOMWRU MORU Bangkok SMRU
Posted 20/12/2023. The verbal autopsy method can be sensitive to the individuals interviewed, their families and communities. Prior to study implementation, Nan Shwe Nwe Htun, Tom Peto and SEACTN colleagues sought to explore local beliefs and practices about death to inform appropriate bioethical practices and found that verbal autopsy is acceptable across a wide range of cultural settings in Bangladesh, Myanmar, Thailand, Laos PDR, and Cambodia.
A systematic review of neglected tropical diseases (NTDs) in Myanmar
LOMWRU MOCRU MORU Bangkok SMRU
Posted 21/11/2023. Neglected tropical diseases (NTDs) are a group of preventable and treatable diseases common in Myanmar, primarily affecting marginalized rural communities. Myo Swe and colleagues provide an overview of reported NTDs in Myanmar over 100 years, indicating gaps in knowledge about certain diseases to inform future research directions related to NTDs in Myanmar.
A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN): pilot implementation in three countries in Southeast Asia, 2019-2020
COMRU LOMWRU MORU Bangkok SMRU
Posted 01/11/2023. ACORN (A Clinically Oriented Antimicrobial Resistance Surveillance network) is a WHO GLASS compatible case-based surveillance method for antimicrobial resistance that produces more meaningful and locally actionable data. Rogier van Doorn and colleagues publish the results of a pilot in three countries, showing proof of principle and valuable lessons to be learned going forward. More at: acornamr.net
Improving neonatal health in rural Africa: how much do we know about neonatal jaundice?
KIMORU MORU Bangkok SMRU
Posted 26/09/2023. In this pilot study, Caterina Fanello and colleagues evaluated the prevalence of neonatal hyperbilirubinemia and related neonatal and maternal risk factors in a semi-rural area of the Democratic Republic of Congo. They also explored knowledge and practices of expectant mothers regarding this condition. Ways forward to improve diagnosis and treatment in these settings are discussed.
Severe falciparum malaria in pregnancy in Southeast Asia: a multi-centre retrospective cohort study
MORU Bangkok SMRU
Posted 30/08/2023. This study by Makoto Saito and colleagues analysing 213 severe malaria cases in pregnancy at SMRU, MORU and OUCRU showed vital organ dysfunction led to high maternal and fetal mortality. In contrast, severe anaemia or hyperparasitaemia alone did not. This marked difference may explain the variation of mortality reported in the literature. Early diagnosis and treatment of malaria and anaemia in antenatal care should be promoted.
Fever and health-seeking behaviour among migrants living along the Thai-Myanmar border: a mixed-methods study
MORU Bangkok SMRU
Posted 18/08/2023. Fever is a common reason to seek healthcare in Southeast Asia, and the decline of malaria has further complicated fever perceptions and actions taken. This mixed-methods study from 2019, on Thai-Myanmar border revealed diverse range of fever conceptions, symptoms and believed causes. Napat Khirikoekkong, Supa-at Asarath and colleagues mapped out context-specific healthcare seeking strategies and discussed its influencing key determinants.
Defining the role of host biomarkers in the diagnosis and prognosis of the severity of childhood pneumonia: a prospective cohort study
COMRU MORU Bangkok SMRU
Posted 16/08/2023. Tools for safe community-based childhood pneumonia management are needed. Studies often do not include outpatients or consider whether laboratory tests add value to clinical assessment. Arjun Chandna and colleagues found that Angiopoietin-2 improved performance of a validated risk score (LqSOFA) to predict oxygen requirement amongst refugee children with pneumonia on the Thailand-Myanmar border.
Born too soon in a resource-limited setting: A 10-year mixed methods review of a special care baby unit for refugees and migrants on the Myanmar-Thailand border
SMRU
Posted 09/05/2023. Implementation of evidence-based newborn care interventions in low-resource settings works! Very and moderate preterm neonatal mortality reduced by 68% and 53% between 2008-2017 in refugees and migrants. Find out how Ahmar Hashmi, Verena Carrara, Rose McGready and SMRU colleagues achieved this.
Culturally responsive research ethics: How the socio-ethical norms of Arr-nar/Kreng-jai inform research participation at the Thai-Myanmar border
MORU Bangkok SMRU
Posted 23/05/2023. Napat Khirikoekkong, Supa-at Asarath, Phaik Yeong Cheah, and colleagues analyse how the socio-cultural norm of Arr-nar or Kreng-jai influences the research experiences of individuals taking part in research on the Thai-Myanmar border. Arr-nar (in Burmese/Karen) or Kreng-jai (in Thai) encompasses multiple meanings including consideration for others and graciousness.
Technical evaluation and usability of a quantitative G6PD POC test in cord blood: a mixed-methods study in a low-resource setting
SMRU
Posted 20/12/2022. G6PD deficiency is a major risk factor for severe neonatal jaundice among neonates born at the Thailand-Myanmar border. Early identification of G6PD deficiency can dramatically improve clinical care. In this study Germana Bancone and colleagues showed that a new point-of-care quantitative G6PD test used by trained midwives can reliably identify neonates with abnormal G6PD at birth.
Pregnancy outcomes after first-trimester treatment with artemisinin derivatives versus non-artemisinin antimalarials: a systematic review and individual patient data meta-analysis
SMRU
Posted 29/11/22. Makoto Saito and colleagues evaluated the fetal safety of antimalarials in the first trimester of pregnancy. Pregnant women who were treated with artemisinin-based combination therapy (ACT) in the first trimester had fewer fetal losses and congenital anomalies than quinine-treated women. Updated WHO guidelines recommend ACT, particularly artemether-lumefantrine, for all trimesters.
Outdoor residual spraying for malaria vector-control in Kayin (Karen) state, Myanmar: A cluster randomized controlled trial
SMRU
Posted 14/09/2022. Victor Chaumeau and colleagues evaluated the efficacy of outdoor residual spraying for malaria vector control on the Thailand-Myanmar border. Intervention was showed to rapidly interrupt transmission in a setting where the vectors bite mostly outdoors and at a time when people are not protected by mosquito bed nets.
High burden of childhood tuberculosis in migrants: a retrospective cohort study from the Thailand–Myanmar border
SMRU
Posted 14/07/2022. Children bear a substantial burden of TB disease on the Thai-Myanmar border. Treatment success rate exceeded the WHO End TB target of 90%, suggesting that similar vulnerable populations could benefit from the enhanced support of this residential TB program offered by Francois Nosten and colleagues. However better child-friendly diagnostics are needed to improve the detection of TB in children.
Contribution of genetic factors to high rates of neonatal hyperbilirubinaemia on the Thailand-Myanmar border
MORU Bangkok SMRU
Posted 22/06/2022. Mutations on the G6PD and UGT1A1 genes play a large role in neonatal jaundice, including the severe forms, among Karen and Burman neonates. Germana Bancone and colleagues show that improved diagnostics are urgently needed and different screening strategies should be considered in populations with a high prevalence of these traits.
Under the Mask: A Film on Tuberculosis at the Thai-Myanmar Border
MORU Bangkok SMRU
Posted 13/05/2022. “Under the Mask” is a 75-min feature film that follows the lives of patients with TB who live on the Thai-Myanmar border. Phaik Yeong Cheah, Michele Vincenti Delmas and colleagues explains the genesis and development of the film, and how it has been used to engage communities at risk of TB.
Anopheles salivary antigens as serological biomarkers of vector exposure and malaria transmission: A systematic review with multilevel modelling
SMRU
Posted 08/03/2022. In this review, Victor Chaumeau and colleagues assessed the level of association between antibody responses to mosquito salivary antigens and the metrics of malaria transmission across different areas of the globe. They identified knowledge gaps that need to be addressed before these serological markers of exposure to vector bites can be used operationally for malaria elimination.
Suicidal ideation in the perinatal period: findings from the Thailand–Myanmar border
SMRU
Posted 24/08/2021. Suicide is a leading cause of maternal death globally. On the Thailand-Myanmar border, 8% of refugee women and 3% of migrant women experienced suicidal thoughts during pregnancy and postnatally. The greatest risk factors for suicidal thoughts were unplanned pregnancy and past trauma. Community interventions and targeted prevention initiatives are urgently needed to help lower the rates of people dying by suicide, by Gracia Fellmeth and colleagues.
A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border
SMRU
Posted 23/06/2021. In an RCT of three artemisinin-based combination therapies in pregnancy on the Thailand-Myanmar border where artemisinin resistance is widespread, only dihydroartemisinin-piperaquine provided satisfactory efficacy for P. falciparum, in this study by Makoto Saito & colleagues. Mefloquine-artesunate provided the longest recurrence-free period for P. vivax. Vivax recurrence was so common, chloroquine prophylaxis is warranted after malaria of any species.
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.
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.