Changing the practices of health care workers in multiple hospitals in low-income settings is a major contemporary challenge that requires people to think about the complex set of influences that affect clinicians’ behaviour. In this report, Professor Mike English describes a multi-layered strategy utilising a new implementation typology linked to overarching theories of change.
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.
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.
Selecting and trialling therapeutics for preventing congenital Zika disease is challenging. The target product should be low risk, acceptable to the mother, highly effective in preventing adverse fetal outcomes, and practical for widespread clinical use in resource-limited settings. Professor Peter Horby and fellow researchers discuss strategies for addressing these challenges in a recent paper.
Malaria transmission is patchy at local levels, and when a group of houses is located in a high transmission patch this is labelled a "hotspot". Looking at 19 studies in 7 African Countries, we see that hotspots are the norm, and especially prominent when malaria transmission falls.
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’ life circumstances.
For more than a decade, Professor Mike English and his team have worked with the Kenyan Ministry of Health and professionals to develop national clinical guidelines. This paper describes how this approach has become both more rigorous and more collaborative while offering lessons to other LMIC on how to develop high quality guidelines with limited resources.
Professor Jeremy Day and fellow researchers from OUCRU, in collaboration with colleagues from the Genome Institute Singapore, have published the first whole genome sequences of Vietnamese isolates of the yeast Cryptococcus neoformans, in an attempt to better understand the genes that enable some families of this usually accidental pathogen to cause disease in people with normal immune systems.
The WWARN Vivax Surveyor provides an interactive map that summarises the prevalence and degree of chloroquine resistance in Plasmodium vivax parasites across the world. This tool provides a clear and standardised visualisation of vivax clinical trials to date to inform key international, regional and national monitoring strategies.
We used a qualitative approach to study how public hospitals in Kenya make resource allocation decisions. We found that these decisions were influenced by (1) scarcity of financial resources, and poorly designed financing processes, (2) limited flexibility in resource allocation decisions, and (3) inadequate management and leadership capacity in the hospitals. Read more on Improving priority settting practices in Kenya's hospitals.