Research Highlights
Nationwide seroprevalence of SARS-CoV-2 during the COVID-19 pandemic and prepandemic periods in Lao PDR
Posted 21/11/2025. Laos reported the region’s fewest COVID-19 cases in 2020–early 2021, leading some to suspect weak surveillance. However, gold-standard serology showed minimal SARS-CoV-2 exposure, no cross-reactive neutralising antibodies before the pandemic, and low seroprevalence before vaccination, confirming Laos had little transmission prior to the surge beginning in May 2021. By Koukeo Phommasone
Causes of death in rural southeast Asia by electronic verbal autopsy: a population-based observational study
Posted 20/11/2025. A five-country rural verbal-autopsy study finds a substantial burden of non-communicable diseases alongside persistent infectious threats. High rates of undocumented home deaths and limited access to care highlight the need to strengthen primary healthcare systems, improve mortality surveillance, and target interventions across Southeast Asia’s rural communities. By Nan Shwe Nwe Htun
Transplacental Transfer of Lumefantrine, Mefloquine, and Piperaquine: A Comparison of Concentrations in Mothers, Neonates, and Cord Blood
Posted 12/11/2025. Malaria parasites cross the placenta, but what about antimalarials? Makoto Saito and SMRU researchers found neonatal capillary drug levels nearly matched maternal levels for piperaquine but were under half for lumefantrine and mefloquine. Cord levels were lowest, suggesting neonatal capillary sampling is essential.
Factors associated with positive blood cultures in children in nine African and Asian countries: the ACORN2 surveillance network
Posted 07/11/2025. Blood culture (BC) yield is low in children. Cristina Ardura-Garcia and colleagues used data from ACORN2, a surveillance network including 19 African and Asian hospitals, to identify routinely collected and readily available factors associated with BC positivity in hospitalised children. These findings may optimise BC indications in children in LMICs.
How should health researchers advance health equity?
Posted 05/11/2025. In tnis commentary. Phaik Yeong Cheah and Michael Parker outline ways in which health researchers can advance health equity. They focus on often-overlooked areas, including identifying context-specific drivers of inequity, carefully selecting research questions and priorities, engaging stakeholders, including those whose voices are seldom heard, improving diversity and inclusiveness among study participants, and using equity-oriented study designs.
Stakeholder analysis for ‘One Health’ approach to tackle antimicrobial resistance
Posted 04/11/2025. The varied understanding of stakeholder engagement often limits its effective use. In their BMJ Global Health analysis, Bipin Adhikari and colleagues draw lessons from Nepal to show how applying stakeholder analysis through a 'One Health' approach can bridge sectors, clarify roles, and strengthen collective action against antimicrobial resistance (AMR).
Placental and cord blood DNA methylation in preterm birth: exploring the epigenetic role of maternal dietary protein
Posted 31/10/2025. Fatima Ahmed, Annalisa Terranegra and SMRU colleagues compared DNA methlyation in placental and cord blood samples from preterm birth and full-term pregnancies among Karen and Burmese populations in Myanmar and Thailand. The findings provide novel insights into how protein deficiency may epigenetically predispose to preterm birth and suggests potential biomarkers for early detection and intervention
Identification and pathogen screening of ectoparasites from companion animals in urban Vientiane, Lao PDR
Posted 29/10/2025. Vanheuang Phommadeechack and colleagues examined the prevalence of zoonotic pathogens within ectoparasites found on dogs and cats in Vientiane, Laos. Fleas and ticks carried Rickettsia and Anaplasmataceae, seen as potential human pathogens. This highlights risks of zoonotic infections and the need for vector control strategies with companion animals, supporting public health and awareness.
Antiviral efficacy of oral ensitrelvir versus oral ritonavir-boosted nirmatrelvir in COVID-19 (PLATCOV): an open-label, phase 2, randomised, controlled, adaptive trial
Posted 27/10/2025. Ensitrelvir shows strong antiviral activity against COVID-19 in first head-to-head comparison with Paxlovid. In the PLATCOV phase 2 trial, ensitrelvir accelerated SARS-CoV-2 clearance by 82% versus no treatment and was only slightly slower than Paxlovid. Both drugs were well tolerated although bad taste was much less frequent with ensitrelvir. The study supports ensitrelvir as an effective, once-daily oral COVID-19 antiviral alternative. By William Schilling.
Optimal gestational weight gain and pregnancy outcomes, by BMI and height, in a marginalised population of women with short stature living along the Thailand-Myanmar border: A retrospective cohort, 2004–2023
Posted 21/10/2025. Pregnancy guidelines are frequently derived from populations in high income countries. International gestational weight gain guidelines are based on taller populations from North America and Western Europe. Mary Gouws, Rose McGready and SMRU colleagues suggest that lower weight gain during pregnancy in women with short stature on the Thailand-Myanmar border is associated with optimal outcomes.
Plasma folate dynamics in Plasmodium falciparum-infected African children treated with artemisinin combination therapy and single low-dose primaquine or placebo
Posted 20/10/2025. In 408 falciparum-infected under-5 African children treated with single low dose primaquine (SLDPQ) or placebo plus dihydroartemisinin piperaquine, plasma folate dynamics followed those of haemoglobin with an initial fall followed by a rise and were unaffected by SLDPQ or G6PD status. This research provides more evidence of the safety of SLDPQ. By Bob Taylor
Engagement with migrant communities at the Thai-Myanmar border: Lessons learnt from a community advisory board
Posted 26/09/2025. Supa-at Asarath, Napat Khirikoekkong, Phaik Yeong Cheah, and colleagues reflects on engagement with the Tak Province Community Ethics Advisory Board (T-CAB), established in 2009 on the Thai-Myanmar border, capturing views from members on their involvement in health and research topics, their motivations, benefits, and challenges. Findings show how T-CAB improves research ethics, design, and community trust.
Risk stratification of childhood infection using host markers of immune and endothelial activation in Asia (Spot Sepsis): a multi-country, prospective, cohort study
Posted 24/09/2025. WHO danger signs often misclassify febrile children in resource-limited settings. In the first community-based study across seven Asian sites, Arjun Chandna and colleagues show host-response biomarkers, especially sTREM-1, outperform traditional tools for predicting severe illness. These findings highlight the potential for biomarker-based triage tools to transform childhood infection care.
A just war on bugs? Ethical differences between antimalarial resistance and antibacterial resistance
Posted 15/08/2025. In this commentary, Phaik Yeong Cheah and colleagues argue that antimalarial resistance and antibacterial resistance raise distinct ethical considerations. Unlike antibacterial resistance, mitigating antimalarial resistance has well-defined goals and does not involve environmental factors or the use of livestock. These differences make it clear that not all microbes should be addressed in the same way, and that interventions must be tailored accordingly.
Use of the International Classification of Diseases to Perinatal Mortality (ICD-PM) with verbal autopsy to determine the causes of stillbirths and neonatal deaths in rural Cambodia: a population-based, prospective, cohort study
Posted 08/08/2025. Perinatal cause-of-death data in low-resource settings are scarce. Applying the WHO's new ICD-PM classification system to verbal autopsy data in rural Cambodia, Kaajal Patel and colleagues identified hypoxia, prematurity, and infection as leading causes. We found that adaptations to ICD-PM were needed to better classify deaths, especially when the timing of death was unknown.
Handheld Spatially Offset Raman Spectroscopy for rapid non-invasive detection of ethylene glycol and diethylene glycol in medicinal syrups
Posted 06/08/2025. Pavel Matousek, Paul Newton and colleagues from the Medicine Quality Research Group developed a portable laser-based method, SORS, to detect toxic contaminants in medicinal syrups without opening bottles. This innovation addresses the urgent need for accessible screening, following deadly contamination incidents in Asia and Africa. The technology enables rapid, non-invasive testing across supply chains to improve medicine safety.
Risk factors and mitigation strategies of laboratory-acquired infections in research and clinical laboratories worldwide: a systematic review
Posted 01/08/2025. Causes of laboratory‑acquired infections and pathogen escapes are often under‑reported. A review from 2000–2024 identified 712 cases and 17 deaths. Common incidents included needlestick injuries and PPE failures. Research laboratories reported more decontamination issues, while clinical laboratories faced sample‑handling risks. These findings support targeted improvements in laboratory risk management practices. By Sandhya Dhawan
Optimization of heat inactivation protocols for Orientia and Rickettsia species
Posted 30/07/2025. Stuart Blacksell and colleagues evaluated heat inactivation of Orientia tsutsugamushi, Rickettsia typhi, R. conorii, and R. honei at 56 °C, 80 °C, and 90 °C for varying times. All were inactivated at 56 °C for 5 minutes. O. tsutsugamushi showed greater reduction, with time–temperature effects differing by species, highlighting important pathogen‑specific heat‑treatment requirements for biosafety purposes.
Over the counter use of topical corticosteroid for skin conditions among patients before attending skin specialist clinic in Nepal: A qualitative study
Posted 29/07/2025. Why do many patients arrive at skin clinics only after their conditions worsen, despite early treatment? This study from Nepal reveals how over-the-counter steroid use, informal networks, convenience, and customary practices shape care-seeking for skin conditions. These factors also mirror patterns seen in over-the-counter antimicrobial use. By Bipin Adhikari.
Evaluation of the Wondfo G6PD/Hb Test for glucose-6-phosphate dehydrogenase deficiency: preliminary performance, matrix equivalence, and usability
Posted 25/07/2025. Increased availability of validated G6PD tests can enhance diagnostic capacity in LMIC for vivax radical cure and neonatal health. This preliminary evaluation of a new point-of-care G6PD quantitative test showed excellent performance in frozen and fresh samples collected in Thailand (SMRU) and USA. A WHO pre-qualification study is now ongoing in Brazil and Thailand. By Germana Bancone
Comparative virulence analysis of seven diverse strains of Orientia tsutsugamushi reveals a multifaceted and complex interplay of virulence factors responsible for disease
Posted 17/07/2025. Scrub typhus, caused by Orientia tsutsugamushi, varies in severity depending on the bacterial strain. Jeanne Salje and colleagues compared seven strains in mice and found no single predictor of virulence. Instead, disease severity results from multiple bacterial genes influencing immune responses. These findings could inform future vaccine development and diagnostics.
Single low dose primaquine to block the transmission of Plasmodium falciparum—proposed stand-alone and ACT-adapted regimens
Posted 16/07/2025. At long last and almost 13 years since the WHO recommendation, we now have evidenced-based regimens of single low dose primaquine to block the transmission of Plasmodium falciparum and help eliminate artemisinin and partner drug resistant malaria which is currently spreading rapidly across eastern Africa and beyond. By Bob Taylor
Why should we be concerned by internalised racism in global health?
Posted 15/07/2025. Internalised racism is an overlooked concept that can shape how professionals from historically marginalised backgrounds see themselves within global health. This essay by Bipin Adhikari and colleagues offers a space for reflection on how deep-rooted racial hierarchies may quietly influence identity, behaviour, and institutional culture. Advancing equity in global health also means understanding how these patterns take hold within us.
Pneumococcal density and respiratory co-detection in severe pediatric pneumonia in Laos
Posted 03/06/2025. Worldwide, acute respiratory infection is the leading cause of morbidity and mortality in children. The first study in Laos on respiratory pathogen co-detection was conducted at Mahosot Hospital and confirmed an association between pneumococcal density and influenza but not between respiratory syncytial virus and severe pneumonia in children less than 5 years old. By Audrey Dubot-Peres and Sue Lee.
Hide and seek with falsified medicines: Current challenges and physico-chemical and biological approaches for tracing the origin of trafficked products
Posted 28/05/2025. The trade in falsified medical products is a major public health threat and also a huge, profitable business. Despite detection methods, tracing their origin remains difficult. Cathrin Hauk and colleagues explore analytical techniques adapted from other fields such as food, drug, and wildlife investigation to help identify their sources and empower enforcement efforts.
Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion
Posted 27/05/2025. The GenRe-Mekong project analysed 5,982 Plasmodium falciparum samples in the Greater Mekong Subregion (2017–2022), using genetic surveillance to inform malaria control. A sharp decline in piperaquine-resistant strains followed drug policy changes, highlighting how real-time genetic data can support timely, evidence-based responses to shifting malaria threats. By Varanya Wasakul
Operational evaluation of the deployment of Malaria/CRP Duo and Dengue Duo rapid diagnostic tests for the management of febrile illness by village malaria workers in rural Cambodia
Posted 23/05/2025. Village malaria workers in rural Cambodia provide essential early diagnosis and treatment; however, their importance is diminishing following a significant decline in malaria. James Callery and colleagues explore the potential expansion of their roles to ensure that febrile patients continue to utilise their services until local malaria elimination is achieved and the risk of reimportation subsides.
A comparison of national seasonal influenza treatment guidelines across the Asia Pacific region
Posted 21/05/2025. Seasonal influenza remains a major health burden in Asia. Our new comparative analysis reviews national influenza treatment guidelines across Asia Pacific countries, finding significant variation in availability, rigour, and recommendations. Our findings reveal key opportunities to strengthen evidence-informed, systematic guideline development as part of national and regional influenza preparedness and response. By Ellen Beer.
The impact of mass screening and treatment interventions on malaria incidence and prevalence: a retrospective analysis of a malaria elimination programme in eastern Myanmar, and systematic review and meta-analysis
Posted 20/05/2025. Targeted interventions are often necessary to eliminate malaria, but some are more effective than others. Jade Rae and colleagues investigated the impact of village-level mass screening and treatment interventions, highlighting key factors that influence the effectiveness of targeted malaria interventions, including baseline endemicity, population demographics, and the timing and uptake of the intervention.
Cutaneous leishmaniasis in Afghanistan
Posted 13/05/2025. Cutaneous leishmaniasis (CL) is a very neglected tropical disease. Afghanistan has an exceptionally high CL burden fueled by war and poverty. This review focuses on the clinical and epidemiological aspects of CL and highlights the need to grow the research culture so evidence can inform policy. By Bob Taylor
How do study participants want to be informed about study results: Findings from a malaria trial in Cambodia, Ethiopia, Pakistan, and Indonesia
Posted 13/05/2025. Patient interest in receiving clinical trial results varies widely across countries, underscoring that one-size-fits-all strategies fall short. This study, embedded in an antimalarial trial, explores locally tailored dissemination approaches shaped by patient preferences and stakeholder input offering essential guidance for ethical result sharing in diverse global health settings. By Bipin Adhikari
Placental and cord blood DNA methylation changes associated with gestational diabetes mellitus in a marginalized population: the untold role of saturated fats
Posted 09/05/2025. First report on DNA-methylation changes associated with saturated fat consumption in the context of gestational diabetes in a disadvantaged population. Rose McGready and colleagues suggest that population-specific nutritional interventions to reduce saturated fats, while promoting healthier oil (sunflower or soyabean) intake in pregnancy could mitigate negative consequences of DNA hypomethylation, improving transgenerational health impacts.
Effect of a novel house design (star home) on indoor malaria mosquito abundance in rural Tanzania: secondary outcomes of an open-label, household, randomised controlled trial
Posted 23/04/2025. A novel screened house design with bedrooms on the second storey reduced indoor mosquito abundance (51% less Anopheles gambiae; 61% less Culex species) and were 0·5°C cooler compared with traditional houses in Mtwara, Tanzania. By Lorenz Von Seidlein
Call for a fairer approach to authorship in publishing biomedical research
Posted 11/04/2025. Phaik Yeong Cheah and Michael Parker advocate for fairer authorship in collaborative biomedical research to enhance equity and inclusiveness. They highlight how current practices overlook contributors and discuss challenges in authorship decisions, including project size, multidisciplinary complexity, and the varied roles of researchers at different stages.
Validating a web application’s use of genetic distance to determine helminth species boundaries and aid in identification
Posted 26/03/2025. Helminth species identification is challenging due to their diversity. Abigail Hui En Chan, Sompob Saralamba and their team developed ABIapp, a user-friendly R/Shiny application that helps researchers visualize taxonomic boundaries using genetic distance data. With up to 76% accuracy, ABIapp outperforms existing web-based tools, providing a valuable resource for helminth research.
Comparing HemoCue® and Quantitative Buffy Coat® and Coulter Counter-measured haemoglobin concentrations in African children with acute uncomplicated malaria: a Bland–Altman analysis
Posted 19/03/2025. Malaria studies often involve blood transfusion to severe malarial anaemic children. Accurate Anaemia diagnosis is crucial for effective management. Hence, important to determine the level of agreement among haemoglobin concentrations measurement methods. HemoCue® should be used with caution in settings where decisions about blood transfusions are made. By Mavuto Mukaka
Tracing epistemic injustice in global antimicrobial resistance research
Posted 14/03/2025. This commentary explores whether there is epistemic injustice in global antimicrobial resistance (AMR) research – who sets priorities, who produces knowledge, and which types of knowledge are valued. Prof Phaik Yeong Cheah and colleagues argue that epistemic injustice may have created blind spots in policy. Addressing this requires a commitment to diversity, equity, and inclusion.
Submicroscopic malaria in pregnancy and associated adverse pregnancy events: A case-cohort study of 4,352 women on the Thailand–Myanmar border
Posted 11/03/2025. Malaria is known to be dangerous for pregnant women and their developing babies. But how much malaria is too much malaria? Using an ultra-sensitive PCR method that detects one parasite per drop of blood, Mary Ellen Gilder and SMRU colleagues found that even infections with very few parasites are associated with adverse pregnancy outcomes.
Antibiotic duration for common bacterial infections - a systematic review
Posted 07/03/2025. Reducing antibiotic duration is key to antimicrobial stewardship. A review of 315 trials found strong evidence for shorter courses in common infections but limited data for severe infections and low-income settings. Only 15% had low bias risk. More research is needed in critical care and resource-limited environments. By Mo Yin
Cost-effectiveness of a short-course antibiotic treatment strategy for the treatment of ventilator-associated pneumonia: an economic analysis of the REGARD-VAP trial
Posted 04/03/2025. Previously, the REGARD-VAP trial found that giving patients with ventilator-associated pneumonia (VAP) a personalised, shorter antibiotic treatment was just as effective as usual care. Mo Yin and colleagues showed this approach is also cost-effective in Nepal, Singapore, and Thailand. This approach could save money, reduce antibiotic use, and help policymakers make better healthcare decisions despite some uncertainties.
Dose-Optimization of a Novel Co-Formulated Triple Combination Antimalarial Therapy: Artemether-Lumefantrine-Amodiaquine
Posted 18/02/2025. Emerging artemisinin-resistance in Africa threatens our ability to treat malaria. Joel Tarning and colleagues developed an optimal weight-based dosing of a fixed-dose artemether-lumefantrine-amodiaquine formulation using population pharmacokinetic modelling. Dosing was designed to achieve consistent drug exposure across all body weights. This formulation should simplify manufacturing and improve adherence, when treating resistant malaria.
Overcoming research challenges in resource-limited settings: perspectives from Thailand
Posted 29/01/2025. Conducting research in LMICs is undeniably challenging, with brain drain often surpassing reverse brain drain. We share an opinion discussing both the difficulties and rewards of working in this space. Claire Chewapreecha and Thongchai Chewprecha hope it will encourage international and national funding agencies to invest in LMIC talent, and drive meaningful, lasting impact.
Community responses to a novel house design: A qualitative study of “Star Homes” in Mtwara, southeastern Tanzania
Posted 24/01/2025. Salum Mshamu and colleagues evaluate community responses to novel design homes in Mtwara, Tanzania, aimed at reducing childhood diseases such as malaria, respiratory infections, and diarrhoea. Using qualitative research, the study explores how residents and neighbours interact with the novel housing design including its impact on residents' lives, social, cultural, and health-related issues. The findings offer insights for future community wide novel housing interventions.
Acceptability of improved cook stoves-a scoping review of the literature
Posted 21/01/2025. Novel housing interventions (Star Homes) in Tanzania aim to prevent childhood diarrhea, malaria, and respiratory infections by addressing multiple aspects of housing—one of which is cooking stoves. Our research on Star Homes in rural Tanzania revealed inconsistent use of improved cookstoves, sparking a systematic review into factors influencing stove acceptability globally. By Bipin Adhikari
Identification of Southeast Asian Anopheles mosquito species with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry using a cross-correlation approach
Posted 17/01/2025. Victor Chaumeau and colleagues developed a reference MALDI-TOF mass spectra database for the identification of Anopheles mosquitoes from the Thailand-Myanmar border allowing rapid, affordable and accurate identification of medically important vector species, an important prerequisite to assess disease transmission and evaluate vector control. This is the first free open-source data analysis pipeline allowing anyone to replicate the analysis and develop reference database in-house.
Sustainable antimicrobial resistance surveillance: time for a global funding mechanism
Posted 07/01/2025. The continued costs of a standard national AMR surveillance system are predicted to account for over 5% of the total domestic general government health expenditure (GGHE-D) for 28 LMICs and more than 2% of GGHE-D for 46 LMICs. This high cost is not sustainable without a long-term global financing mechanism. By Liz Ashley
AmpC β-lactamases detected in Southeast Asian Escherichia coli and Klebsiella pneumoniae
Posted 20/12/2024. AmpC β-lactamases are a neglected cause of third generation cephalosporin resistance in Southeast Asia. This collaboration between COMRU, LOMWRU and SMRU showed that AmpC β-lactamases are an important cause of infection, though infections may be going undetected due to a lack of testing resulting in sub-optimal treatment for patients. By Tamalee Roberts
Population genomics and transcriptomics of Plasmodium falciparum in Cambodia and Vietnam uncover key components of the artemisinin resistance genetic background
Posted 17/12/2024. Tom Peto and colleagues collected Plasmodium falciparum parasites from malaria patients in Cambodia and Vietnam between 2018 and 2020 in the MORU-led TACT-CV study. Novel molecular analyses of these samples at Nanyang Technological University identified new genetic factors that appear under selective pressure and may contribute to artemisinin resistance mechanisms in clinical settings.
A hill tribe community advisory board in Northern Thailand: lessons learned one year on
Posted 22/11/2024. Since 2023 the Chiang Rai community advisory board helped researchers understand the many local ethnic minority groups of Northern Thailand and vice-versa, improving cooperation and research activities. Over time, benefits have grown. Carlo Perrone and colleagues present their experience one year on, supporting long-term partnerships over project-based ones.
Community engagement to develop a dialogue-drama on adolescent pregnancy in a marginalised migrant population on the Thailand-Myanmar border: an ethnographic approach to participatory action research
Posted 20/11/2024. A participatory-action approach involving community members and adolescents resulted in a dialogue-drama (Karen and Burmese versions) on adolescent pregnancy, contraception, and choice in the event of an unplanned pregnancy. The dialogue-drama augmented discussion of traditionally taboo issues and this ethnographic method is potentially useful for similar global health settings. By Rose McGready