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\n \n \n \nPosted 09/02/2022. To understand how complex social and programmatic interventions work, a mix of methods that entailed a blend of literature review, reflections from experiential and disciplinary expertise were utilized. This review by Bipin Adhikari and colleagues highlights the complexity of Nepal\u2019s primary health care system (PHC), how it has evolved over the decades and through the current federalization, and challenges and opportunities to transform the PHC.
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\n \n \n \nPosted 04/02/2022. Current knowledge of P. falciparum artemisinin resistance evolution in Asia is as old as 4yrs ago. For swift policy decisions, rapid sharing of data collected over extended periods in the same areas is highly needed. Frank Kagoro and colleagues found a steady increase in geographic locations and the proportion of artemisinin resistance from 2002 to 2018. Using the latest WHO classification, the authors map all published K13 markers in Asia by province and district.
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\n \n \n \nPosted 28/01/2022. This case-control study by Koukeo Phommasone and colleagues aimed to determine the causes of acute respiratory infection (ARI) in patients presenting to a hospital in Laos. ARI was commonly attributed to influenza A and B, human metapneumovirus and respiratory syncytial virus. Other organisms were detected at similar frequency in cases and controls.
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\n \n \n \nPosted 25/01/2022. This latest addition by Elizabeth Ashley and colleagues to the PLOS Medicine Vivax Malaria Collection describes the clinical impacts of Plasmodium vivax malaria, and incorporates a rapid systematic review of severe disease. Reports of severe vivax malaria are increasing, however the literature is dominated by case reports and case series, impeding accurate estimation of incidence.
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\n \n \n \nPosted 05/11/2021. Generation of quality surveillance data is one of the pillars of the WHO response to the global AMR problem. However, work by LOMWRU\u2019s Tamalee Roberts and colleagues estimates that laboratory setup and running costs for hospital-based AMR surveillance in Southeast Asia are likely to be prohibitive in many resource-limited settings.
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\n \n \n \nPosted 23/12/2021. Marcus Schultz and colleagues analysed 4 large prospective observational studies conducted in 534 ICUs in 54 countries. Patients in middle\u2013income countries were younger, shorter with a slightly lower BMI, had more often diabetes and active cancer, but less often COPD and heart failure. Sequential organ failure assessment scores were similar. ICU mortality was higher in middle\u2013income countries, and inversely associated with GDP.
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\n \n \n \nPosted 02/11/2021. Claire Chewapreecha and colleagues employ a powerful combination of genome-wide epistasis and co-selection study (GWES); gene expression analyses and gene knockout assays to identify the key genes that have been repeatedly selected through Burkholderia pseudomallei evolution. The study indicates that the bacterium is evolutionarily primed to survive nutrient-depleted soils and highlights the need to protect environmental health as part of disease prevention.
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\n \n \n \nPosted 20/10/2021. Scrub typhus infects over a million people a year across the Asia-Pacific. The ecology of this important disease, transmitted by chigger mites, remains poorly understood. Ivo Elliott and colleagues report on the identification of key risk factors that determine foci of high disease transmission at 3 sites in Northern Thailand.
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\n \n \n \nPosted 01/10/2021. In 2017 hundreds of thousands of \u2018Rohingya\u2019 fled from Myanmar to refugee camps in Cox\u2019s Bazar, Bangladesh. Health centre data were reviewed to estimate the increase in health care utilization. The presence of a large migrant population relative to a smaller host community burdens the limited facilities and resources of the public health sector, by Lorenz Von Seidlein and colleagues
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\n \n \n \nPosted 29/09/2021. Xin Hui Chan and colleagues report a large individual patient data meta-analysis of malaria clinical trials supporting the cardiovascular safety of amodiaquine and structurally related antimalarials at WHO-recommended dosing regimens alone or in ACTs for the treatment and prevention of malaria, and propose a potential mechanism for amodiaquine-related asthenia.
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\n \n \n \nPosted 28/09/2021. Despite most neonatal deaths being preventable, neonatal mortality remains unacceptably high globally. Saving Babies\u2019 Lives (SBL) is a stepped-wedge cluster-randomised trial, which will develop, implement, and assess an iterative package of neonatal interventions combining community and primary care strategies to reduce neonatal mortality in a rural Cambodian province, by Claudia Turner and colleagues
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\n \n \n \n24/09/2021. Plasmodium vivax in SE Asia and Oceania is less sensitive to primaquine compared to other regions and needs a higher target dose - 0.5 mg/kg. Bob Taylor and colleagues propose a new regimen that was designed using pharmacokinetic simulation and takes into account that children need higher mg/kg doses compared to adults.
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\n \n \n \nPosted 15/09/2021. In Cambodian G6PD deficient variants, G6PD enzyme activity is unaffected by baseline reticulocyte counts but rises and correlates with posttreatment reticulocytosis. Qualitative G6PD tests are unlikely to misdiagnose G6PD deficient males at presentation. Too few G6PD heterozygous females preclude drawing inferences; more research is needed in this group.
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\n \n \n \nPosted 14/09/2021. Little is known about why scrub typhus and murine typhus vary through time and space. Tamalee Roberts and colleagues investigated the impacts of climate and environment on both neglected diseases in Laos. The results suggest that global heating will increase their incidence and distribution, requiring interventions to reduce their burden.
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\n \n \n \nPosted 17/09/2021. One of the policies to achieve malaria elimination in the near future is reactive case detection. A secondary analysis of a large dataset of mass drug administrations in Greater Mekong Subregion found that reactive case detection in this setting is costly but results only in minimal benefits, by Lorenz Von Seidlein and colleagues
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\n \n \n \nPosted 24/08/2021. Suicide is a leading cause of maternal death globally. On the Thailand-Myanmar border, 8% of refugee women and 3% of migrant women experienced suicidal thoughts during pregnancy and postnatally. The greatest risk factors for suicidal thoughts were unplanned pregnancy and past trauma. Community interventions and targeted prevention initiatives are urgently needed to help lower the rates of people dying by suicide, by Gracia Fellmeth and colleagues.
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\n \n \n \nPosted 27/07/2021. This qualitative study by Mira Schneiders and colleagues discusses the important nutrition-related roles and responsibilities of grandparents caring for grandchildren in rural Cambodian \u2018skip-generation\u2019 households. Grandparents appear highly motivated to improve grandchildren\u2019s health and nutrition, but lack necessary resources, leading to frequent moral dilemmas and ethical trade-offs. Interventions to improve child health and nutrition should be designed to be inclusive of older caregivers.
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\n \n \n \nPosted 16/07/2021. Severe metabolic acidosis and acute kidney injury are major causes of mortality in children with severe malaria but are often underdiagnosed in low resource settings. What prognostic factors are associated with severe metabolic acidosis and uraemia in African children with severe falciparum malaria? Secondary analysis of a randomized trial by Mavuto Mukaka and colleagues
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\n \n \n \nPosted 07/07/2021. Frank Smithuis and colleagues conducted a large cluster randomized evaluation of mass drug administration (MDA) with dihydroartemisinin-piperaquine for malaria elimination in an area with high artemisinin resistant Plasmodium falciparum. MDA was a safe and effective tool to accelerate P. falciparum elimination, alongside routine community-based malaria control measures. It was well tolerated and well accepted. MDA did not select for drug resistant parasites.
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\n \n \n \nPosted 06/07/2021. Surveillance of Antimicrobial resistance (AMR) is important in generating evidence to support efforts in controlling the infection. Cherry Lim and colleagues discuss the strengths, potential sources of bias, and challenges of routine microbiology data and different surveillance strategies and solutions used in low- and middle-income countries. Areas requiring support and improvement are highlighted.
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