Posted 15/01/2019. Dr Thomal Althaus and colleagues managed to reduce antibiotic prescription using the C-reactive protein (CRP) test among 2,410 children and adults presented with a fever in primary care centres in Thailand & Myanmar. The perspective of a rapid and affordable test for CRP, identifying febrile patients who really need an antibiotic, is now possible!
Posted 08/01/19. Four out of five people in the world with diabetes now live in low and middle income countries. Professor Susanna Dunachie and her Thai collaborator Parinya Chamnan describe how diabetes leads to increased risk and worse outcomes for global infections such as TB, melioidosis and dengue, alongside discussing potential mechanisms and interventions.
Posted 11/12/2018. Phaik Yeong Cheah and colleagues report a qualitative study on how best to seek broad consent to sharing individual level health research data beyond research collaborations. Their findings demonstrated that research participants prioritise information about the potential benefits and harms of data sharing. The researchers also found that explaining data sharing to research participants was challenging.
Posted 05/12/2018. A WWARN team recently completed a large systematic literature review to understand whether undernutrition places children at higher, lower, or no differential risk for getting malaria. We raise the concern whether an adapted antimalarial treatment strategy is needed in malnourished children. The results present the risks associated with chronic and severe acute malnutrition and the impact on sub-optimal drug exposure, poor patient outcomes and the potential contribution towards an increased risk of antimalarial drug resistance. Photo credit: Albert Gonz\u00e1lez Farran, UNAMID, 2013
Posted 13/11/2018. Quinoline and related antimalarial drugs are vital tools in the fight against malaria. However, concerns about their possible effects on the heart rhythm may limit their use. Dr Ilsa Haeusler, Dr Xin Hui Chan, and colleagues found that these serious side effects are reassuringly rare in the treatment of malaria
Posted 06/11/18, review by Professor Nick White. Malaria, a parasitic infection of red blood cells, is a leading cause of anaemia in the tropics. Where malaria transmission is intense patients, typically children, may die from severe anaemia. However when falciparum malaria causes other vital organs to fail, moderate anaemia appears to protect against death.
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 10/10/2018. Community volunteers are used to deliver a number of healthcare interventions. Although these volunteers are not paid, their time still has an economic value, known as an opportunity cost. Dr Hugo Turner and colleagues found that this economic value is significant for mass drug administration programs: for the African Programme for Onchocerciasis Control alone it would be valued at US$60-90 million.
Posted 18/09/2018. Let by Professor Yoel Lubell, researchers from MORU and IDDO estimated the economic costs of AMR associated with the consumption of a range of antibiotic classes in high and lower-middle income countries. These estimates are essential for economic evaluations of interventions that affect antibiotic consumption to reflect the full costs and benefits of their use.
Posted 04/09/2018. DHA-piperaquine is an important antimalarial recommended by the WHO for the treatment of malaria, and an ideal candidate for mass use in malaria elimination. In a large meta-analysis of ~200,000 subjects, Dr Xin Hui Chan and colleagues find the risk of sudden unexplained death after DHA-piperaquine is extremely low and not higher than baseline, confirming the drug\u2019s safety for the treatment and prevention of malaria.
Posted 24/07/18. A study from Bangkok by Professor Wirichada Pan-Ngum and colleagues shows accessing households for proper spraying was a problem for control dengue outbreaks. In addition, inefficient communications among the sectors from hospital to district offices led to inaccurate or missing patient addresses for spraying. Involving community networks help to improve public engagement with and participation in the programmes.
Posted 17/07/2018. This paper by Professor Stuart Blacksell and colleagues describes the first update to the WHO Laboratory Biosafety Manual in 15 years. The need to update international lab biosafety guidance is part of a broader initiative to globalize biosafety, emphasizing principles and approaches that are accessible to countries spanning a broad range of financial, technical and regulatory resources.
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.
Posted 27/06/2018. Current recommended treatment regimens for the most widely used medicine for uncomplicated Plasmodium falciparum malaria may be sub-optimal for small children and pregnant women according to a study led by Professor Joel Tarning.
Posted 15/05/2018. Kartika Karaswati, Stuart Blacksell and colleagues reviewed the diagnostic accuracy of the available scrub typhus point-of-care tests, feasible to be used in resource limited settings. Although the available evidence is varied in methodology and quality, POCTs appear to have low false positive rates, thus confidence in interpreting a positive result can be high.
Posted 08/05/2018. Is it ethical to withhold a recommended treatment from a patient in clinical trial? In this paper we evaluate whether exchanging placebo for an active drug is ethical. We use the example of a randomised control trial of primaquine to determine its anti-relapse efficacy against vivax malaria and conclude that in some cases a placebo arm is imperative.
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.
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.
Posted 10/04/2018. Antimicrobial resistance (AMR) is a serious threat to public health. A new report by Elizabeth Ashley and colleagues describes the role of supranational networks in AMR surveillance in low- and middle-income countries (LMICs); Liz Ashley and colleagues analysed networks that were in existence between January 2000 and August 2017. This study reveals the challenges of establishing sustainable and effective networks to tackle resistance to antimicrobial medicines.
Posted 29/03/2018. This randomised controlled trial, by Katherine Plewes and colleagues, of acetaminophen (paracetamol) in Bangladeshi patients with severe and moderately severe malaria shows that acetaminophen reduces kidney dysfunction and risk of developing acute kidney injury, particularly in patients with significant haemolysis. This proof-of-principle study supports the underlying hypothesis that acetaminophen inhibits cell-free haemoglobin-mediated oxidative kidney damage.
Posted 20/03/2018. A clinical trial in Cambodia evaluated the safety and effectiveness of mass drug administration (MDA) to interrupt multi-drug resistant falciparum malaria. Coverage with at least one round was 88%, no severe adverse events were reported, and MDA was associated with the absence of clinical P. falciparum cases for at least one year.
Posted 14/03/2018. Blood from patients treated with ivermectin can kill mosquitos. Our results indicate that ivermectin mass drug administration to humans could be a potential malaria control tool to aid malaria elimination efforts in South America.
Posted 06/03/2018. Primaquine is being promoted actively to block the transmission of falciparum malaria parasites between humans and mosquitoes to reduce the spread of highly resistant malaria \u2018superbugs.\u2019 In response, Bob Taylor and colleagues developed a primaquine dosing scheme based on age. This will be useful where there are no functioning weighing scales and when primaquine mass drug treatment will be given.
Posted 13/02/2018. Two mass drug administrations against falciparum malaria were conducted in 2015\u201316, one as operational research in northern Cambodia, and the other as a clinical trial in western Cambodia. During an April 2017 workshop in Phnom Penh the field teams from M\u00e9decins Sans Fronti\u00e8res and the Mahidol-Oxford Tropical Medicine Research Unit discussed lessons for future mass drug administrations.
Posted 16/01/2018. Ethics guidelines have evolved to protect vulnerable groups such as pregnant women from research. This has resulted in a lack of research in these populations making them even more vulnerable because of the lack of evidence-based medical care. In this paper, Professor Phaik Yeong Cheah and her collaborators discuss how regulatory frameworks can sometimes lead to a generalized exclusion of pregnant women from research.
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 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.
Posted 04/10/2017. Recruiting 183 acute melioidosis patients and 21 control subjects in order to explore immune factors associated with survival status and diabetes, this study identified two class I HLA alleles associated with increased risk of death during melioidosis. Stronger T cell responses to nine immunodominant antigens were observed in those who survived, with responses to one of these \u2013 GroEL \u2013 observed to be impaired in patients with diabetes.
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.
Posted 05/09/2017. Can faster progress be made in the fight against malaria by targeting interventions to where they will have the most impact? Health economists and mathematical modellers from the Mahidol-Oxford Tropical Medicine Research Unit have developed an approach to use maps of disease risk together with models of the transmission of disease and the costs and effectiveness of malaria interventions to help local decision makers design more impactful malaria control and elimination programmes.
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.
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\u2019 life circumstances.
Posted 13/06/2017. It has been maintained for decades that quinine is the safest drug for treatment of malaria in the first trimester of pregnancy. In the largest analysis of data from Thailand and Africa, artemisinins are reported to be at least as safe as quinine. This will simplify treatment protocols worldwide.
Posted 17/03/2017. An investigation conducted by the international medical organisation M\u00e9decins Sans Fronti\u00e8res 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 03/11/2016. Six harmonised protocols to capture Zika-related data to help public health professionals, clinicians and clinical researchers to gain a better understanding of the disease has been published on the WHO website. A number of partners - under the leadership of Institut Pasteur and WHO, including ISARIC and CONSISE have contributed to the development of these protocols to address key public health concerns associated with the Zika virus outbreak. The Working Group on ZIKV Harmonized Research, which included Dr Gail Carson and Professor Peter Horby, published a commentary on the project in the Lancet Global Health yesterday.
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.
![\"Thomas](\"https://www.tropmedres.ac/news/research-highlights/effect-of-point-of-care-c-reactive-protein-testing-on-antibiotic-prescription-in-febrile-patients-attending-primary-care-in-thailand-and-myanmar/responsive_image?ratio=r16x9&scale=w760\")
\n \n \n\n\n