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In Southeast Asia, some types of the malaria parasite develop resistance to the drug combinations used to cure and prevent the disease. If this drug resistance spread to Africa, it’d be a disaster. Fortunately, partners on the front lines are finding ways to fight back. Watch this video about the amazing work our team of SMRU researchers is doing to combat drug resistance in Thailand.
Tafenoquine lactation pharmacokinetics: a pilot study
Posted 09/01/2026. First report: tafenoquine antimalarial concentrations in breast milk have been measured by Mellie Gilder, Eh Heet and colleagues at Shoklo Malaria Research Unit, an important step to vivax elimination. Details of drug concentrations in foremilk vs. hindmilk, and abundant vs. scarce milk volumes shed new light on the dynamics of lactation pharmacokinetics.
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.
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.
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
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.
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
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.
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.
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.
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.
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
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
Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand–Myanmar border
Posted 22/10/2024. Severe neonatal hyperbilirubinaemia is often diagnosed late in low-resources settings because of lack of point-of-care tools. In this study, Germana Bancone and SMRU researchers have evaluated the performance of a transcutaneous bilirubinometer for screening of neonates born along the Thai-Myanmar border. The study was supported by a Wellcome Trust iTPA grant.
New WHO classification of genetic variants causing G6PD deficiency
Posted 04/09/2024. Over 50 years after its first publication, this revised classification of G6PD genetic variants is the result of the 2022 WHO Global Malaria Programme experts’ consultation led by Professor Lucio Luzzatto. The new classification reconciles biochemical and clinical aspects of the different G6PD mutations and provides a reliable reference for scientists and clinicians. By Germana Bancone.
Comparison of lumefantrine, mefloquine, and piperaquine concentrations between capillary plasma and venous plasma samples in pregnant women with uncomplicated falciparum and vivax malaria
Posted 01/05/2024. Makoto Saito and SMRU colleagues compared capillary and venous plasma concentrations of mefloquine, lumefantrine, and piperaquine in pregnant women with malaria. While there was a strong correlation, direct interchangeability was limited. Predictability within a ±10% precision range varied by drug. Caution is needed when converting capillary samples at the individual level.
Ethical and cultural implications for conducting verbal autopsies in South and Southeast Asia: a qualitative study
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
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
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?
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
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.