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« Back to Research HighlightsInflammation impairs post-hospital discharge growth among children hospitalised with acute illness in sub-Saharan Africa and south Asia
Posted 05/12/2025. Data from the CHAIN Network show that among children hospitalised in sub-Saharan Africa and South Asia, persistent systemic inflammation has a greater role than gut damage or social factors in driving poor post-discharge weight gain and suppresses key growth mediators, helping explain continued growth faltering after discharge from hospital. By James Njunge and Jay Berkley
Guidelines for the treatment of tungiasis
Posted 03/12/2025. Tungiasis, a neglected tropical skin disease, lacked evidence-based treatment until recently. Lynne Elson chaired an expert group that created new PAHO/WHO guidelines. These provide governments in endemic regions with a vital tool to strengthen disease control, marking a significant advance in public health intervention and neglected tropical disease management.
Plasma lipopolysaccharide levels predict mortality in acutely ill children in Low- and Middle-Income Countries
Posted 02/12/2025. Data from the CHAIN Network show that in acutely-ill hospitalised children from sub-Saharan Africa and South Asia, high plasma levels of bacterial Lipopolysaccharide (LPS) at admission, independently of malnutrition, predict 90-day mortality, linking microbial translocation and systemic inflammation to death risk. By Jay Berkley
Serial cross-sectional school surveys identifies C469Y, P553L, R561H and A675V kelch 13 mutations associated with artemisinin resistance in Western Kenya
Posted 23/11/2025. Analysis of over 24,000 samples from schoolchildren in western Kenya revealed rising genetic mutations linked to artemisinin resistance, including the emerging A675V and newly detected R561H. This study by Isabella Oyier and colleagues highlights school-based surveillance as an effective tool to detect early resistance and calls for urgent follow-up to safeguard malaria treatment efficacy.
Leveraging malaria microscopy infrastructure to diagnose common and neglected skin diseases using direct microscopy in Sumba, Indonesia
Posted 22/11/2025. Our new study in The Lancet Regional Health – Western Pacific describes how existing malaria microscopy infrastructure in Sumba, eastern Indonesia, can be leveraged to diagnose common and neglected skin diseases using direct microscopy. This low-resource, scalable approach has the potential to greatly improve access to skin health in remote communities. By Marlous Grijsen
Climate change, disability, and water, sanitation and hygiene: A scoping review of evidence and interventions in low and middle-income countries
Posted 22/11/2025. Climate shocks destabilise WASH (Water, Sanitation, and Hygiene) services in LMICs, intensifying risks of waterborne disease, dehydration and psychological distress. Women, girls and people with disabilities face the steepest barriers. Communities improvise but fixes remain fragile. Julian Natukunda and colleagues call for disability-disaggregated data and gender-responsive, community-led, climate-resilient WASH policies and evaluated interventions.
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.
A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia
Posted 11/11/2025. Anthony Etyang and colleagues found that adding low-dose oral steroids to routine antibiotic treatment reduced pneumonia deaths among adults in Kenyan hospitals. The SONIA trial, involving 2,180 patients across 18 sites, showed improved 30-day survival without increased side effects, suggesting a safe, low-cost intervention for resource-limited settings.
Factors associated with positive blood cultures in children in nine African and Asian countries: the ACORN2 surveillance network
Posted 07/11/2025. Blood culture 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 blood culture positivity in hospitalised children. These findings may optimise blood culture indications in children in LMICs.
How should health researchers advance health equity?
Posted 05/11/2025. In this 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
Newborn technology use in low-resource settings: the role of health professionals’ communication in implementation
Posted 16/10/2025. How does the hospital environment in low-resource settings influence the use of newborn care technologies? Gloria Ngaiza and colleagues examined Continuous Positive Airway Pressure (CPAP) and phototherapy. They highlight how the physical setting, socio-organizational factors, technological features, and the broader context impact how health professionals in Kenya communicate, and, ultimately, make decisions to use or not use technologies.
Sustainable by Design: Digital Health Business Models for Equitable Global Health Impact in Low-Income and Low-Middle-Income Countries
Posted 13/10/2025. Drawing on the business model challenges faced by digital health entrepreneurs in LMICs and lessons from market-shaping approaches that have expanded access to essential medicines in global health, Elvin Irihamye and colleagues provide a framework that shows how business strategy and market-shaping practices can be adapted to align digital health business models with the delivery of tangible global health impact.
Applying a multi-layered, mixed methods approach to evaluate technology and workforce interventions in Kenyan neonatal units
Posted 07/10/2025. How do we design and ethically implement complex health interventions and evaluations in settings that are under resourced without compromising patient care or research data? Michuki Maina and colleagues used layered mixed methodologies and sustained stakeholder engagement to design and conduct implementation research of a complex intervention in Kenyan neonatal hospitals.
Communication among health professionals using newborn technology for care: an exploratory scoping review
Posted 30/09/2025. Effective communication supports the adoption of health interventions. Gloria Ngaiza and colleagues reviewed communication among health professionals using newborn technology for care. The findings showed limited information, centred on a few technologies and disciplines of health professionals. The context of technology use was also crucial in communication, and further research is necessary to explore these areas.
Antimicrobial usage among acutely ill hospitalized children aged 2‒23 months in Sub-Saharan Africa and South Asia
Posted 29/09/2025. Overuse of antimicrobials strongly drives antimicrobial resistance (AMR). Among 3,101 acutely ill children admitted to 9 hospitals in Africa and South Asia, 91% received antimicrobials, including 11% where antimicrobials were not indicated. Notably, there was limited escalation and de-escalation of antimicrobial treatment, likely due to a lack of guidance. By Jay Berkley
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.
Making MALDI-TOF MS for entomological parameters accessible: A practical guide for in-house library creation
Posted 23/09/2025. MALDI-TOF MS remains underutilised in entomology due to challenges in reference library construction. Marta Maia and colleagues demystify the process and share a detailed workflow for creating in-house libraries. The versatility of this platform is highlighted as it may be used for analysing multiple parameters including species, age, infection, and blood-meal source.
Delivery of care in high mortality hospital settings: a direct observational study examining 1848 h of neonatal nursing in Kenya
Posted 20/08/2025. In resource-constrained countries, deploying better technologies is expected to improve neonatal care, but little attention has been paid to nurse staffing. Abdulazeez Imam and colleagues demonstrate high levels of missed nursing care and ‘off-loading’ of care to largely unsupervised nursing students and mothers, resulting from severe newborn unit nursing shortages in Kenya.
A clinical practice guideline for tuberculous meningitis
Posted 19/08/2025. Joseph Donovan and colleagues at OUCRU took a leading role in the development of the first international clinical practice guideline for tuberculous meningitis. This collaboration reviewed evidence to guide diagnosis and treatment of the most lethal form of tuberculosis, providing recommendations, identifying knowledge gaps, and setting global research priorities for improved care.
A just war on bugs? Ethical differences between antimalarial resistance and antibacterial resistance
Posted 15/08/2025. IIn 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 in 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.
Safety and tolerability of metformin in overweight and obese patients with dengue: An open-label clinical trial (MeDO)
Posted 05/08/2025. Nguyet Nguyen Minh and colleagues at OUCRU-Vietnam investigated the safety and tolerability of metformin as an adjunctive therapy in patients with dengue and obesity. Metformin was associated with more adverse events, mainly severe gastrointestinal symptoms and did not improve clinical, laboratory or virological parameters. The data does not support progression to a larger randomised controlled trial.
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
R21/Matrix-M malaria vaccine drives diverse immune responses in pre-exposed adults: insights from a phase IIb controlled human malaria infection trial
Posted 23/07/2025. Elizabeth Kibwana and colleagues show the R21/Matrix-M vaccine induces broad, durable and functional antibody responses (IgG1/3, IgA, IgM) with complement fixing ability, and produces memory B cells, along with increased T follicular helper cells in Kenyan adults. These findings support its potential effectiveness in malaria-endemic populations, advancing vaccine strategies for individuals with prior exposure
Changing the narrative: visual methods can reinforce or reduce disease-related stigma
Posted 22/07/2025. Visual methods, like photography and video, play a powerful role in shaping perceptions of skin diseases in global health. They can overcome language barriers, amplify lived experiences, and challenge stigma. Yet, if poorly designed, they risk reinforcing harmful stereotypes and further marginalizing affected communities. Ethical, inclusive approaches are essential for meaningful impact. By Marlous Grijsen
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.
Phenotypic and genotypic insecticide resistance profiles of main malaria vectors in Kwale county, coastal Kenya
Posted 17/06/2025. Marta Maia and colleagues characterised phenotypic and genotypic insecticide resistance of malaria vectors in Coastal Kenya. Multiple mutations associated with resistance mechanisms were detected, including target site (L1014S and L1014F) and metabolic resistance (CYP6P9a, CYP6P9b, 6.5kb S.V, GSTe2-L119F). Resistance has increased since 2017. Evidence supports regular monitoring and the use of PBO-combination nets.
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.
Age structure and parity status determination of Afrotropical malaria vectors using MALDI-TOF MS
Posted 15/05/2025. Understanding the age structure of a mosquito populations is the best way to evaluate how well vector control interventions are working. However, age-grading is hard and usually done through complex dissections. Here Marta Maia and colleagues present a method using MALDI-TOF MS exploiting protein changes associated with senescence for age-grading of malaria vectors.
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