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In the next 5 years, SMRU will continue to work with the objective of eliminating malaria, improving maternal and child health and combat tuberculosis. While SMRU will concentrate on the research activities, its humanitarian arm, the Borderland Health Foundation, will provide much needed health care services to this marginalized border population in close collaboration with the National Programs of both Thailand and Myanmar as well as the local Community Based Organizations.

Smru_myanmar health sector © 2019 MORU
SMRU Director François Nosten (back, centre) meets with the Myanmar Health Sector Coordination Committee (MHSCC) and Myanmar and Karen health authorities to assess the SMRU malaria elimination and TB programmes in Kayin State

SMRU future work involves work in these important Thai-Myanmar border health research areas and supporting structures:

Malaria Elimination Task Force | Laboratory Department | Mother and child health | Medical Department | Public engagement

Malaria Elimination Task Force

  • What are the best methods to prove elimination and prevent re-introduction of P. falciparum?
  • Has artemisinin resistance been contained along the Thai-Myanmar border and in Karen State?
  • What is the most effective vector control intervention?
  • How do we eliminate P. vivax?

Laboratory Department

 

The central laboratories at SMRU provide both diagnostic services and high-profile research support to malaria and other infectious disease investigations. They include: microscopy, malaria in-vitro, entomology, haematology, and microbiology laboratories© 2019 MORU. Photographer: Gerhard Jørén The central laboratories at SMRU provide both diagnostic services and high-profile research support to malaria and other infectious disease investigations. They include: microscopy, malaria in-vitro, entomology, haematology, and microbiology laboratories
  • What is the best method to detect G6PD deficiency at the point of care?
  • What are the major determinants of anaemia in the population?
  • How is iron deficiency best diagnosed in a population with moderate prevalence of haemoglobinopathies?
  • What are the main causes of fever in the rural population along the Thai-Myanmar border?
  • What are the main pathogens causing respiratory infections?
  • What is the situation with antimicrobial resistance in the main circulating pathogens?
  • Is melioidosis an important health risk in Karen state?
  • Are there emerging pathogens in this population?
  • Can the diagnosis of (MDR) tuberculosis be improved?
  • Can new compounds be identified and tested against P. vivax hypnozoites?
  • Can P. vivax be maintained in culture?
  • Is insecticide resistance a major issue in malaria vectors in this area?

Mother and child health

Active on the Thai-Myanmar border since 1994, SMRU Deputy Head Rose McGready leads a Mother and Child Health team that completed recruitment to three large prospective cohort trials with major analysis still ongoing. Strongly focused on capacity building, Rose has helped train several generations of local midwives and medics© 2019 MORU. Photographer: Stéphane Ribrault Active on the Thai-Myanmar border since 1994, SMRU Deputy Head Rose McGready leads a Mother and Child Health team that completed recruitment to three large prospective cohort trials with major analysis still ongoing. Strongly focused on capacity building, Rose has helped train several generations of local midwives and medics  
  • Can biological systems approaches be used to identify pregnancies at risk?
  • What are the main determinants of maternal anaemia?
  • What are the determinants and the consequences of the changing nutritional status of pregnant women in this border population?
  • What are the consequences of maternal morbidities on the child physical and neurodevelopment?
  • Can tenofovir be used to prevent vertical transmission of Hepatitis B?
  • What is the safety and efficacy of antimicrobials for urinary tract infection in pregnancy in the presence of rising ESBL bacteria?
  • What are the determinants and the consequences of neonatal jaundice in this population?
  • What are the best methods to detect, treat and prevent gestational diabetes?
  • Can a pre-pregnancy package of interventions be developed to improve the health status of pregnant women?
  • Can ceftriaxone reduce mortality in neonatal sepsis?

Medical Department

  • Can a model be developed to establish the risk of haemolysis in G6PD deficient individuals exposed to primaquine?
  • Can a safer regimen of primaquine be developed?
  • Can tafenoquine be used to eliminate P. vivax?
  • What is the optimum treatment of rickettsiosis infections?
  • Rural health: what are the main causes of fever in the rural population of Karen state? What are the village-based interventions that can reduce morbidity and mortality?

Public engagement

  • What are the gaps in the current health system in the border population and what are the health consequences?
  • What are the potential interventions to improve access to health care for the marginalized segments of the population?
  • In a post-conflict setting what are the barriers and enablers to reducing maternal mortality?