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Results of the Wellcome Trust funded trial of the experimental anti-Ebola drug TKM-130803 have been published today in PLOS Medicine. Using a novel approach designed to get rapid indications of a drug's effectiveness, the trial showed that at the dose given the drug did not improve survival compared to historic controls.
Perioperative Care Pathways in Low- and Lower-Middle-Income Countries: Systematic Review and Narrative Synthesis
MORU
Posted 09/08/2022. Timo Tolppa and CCAA colleagues reviewed the literature on perioperative care pathways in resource-poor settings and found that pathways are increasingly used there with an aim to improve care quality. Patient and clinician beliefs were a major challenge in care pathway implementation, whereas facilitators included context-relevant adaptations, strong evidence-base and teamwork.
Pandemic preparedness and responsiveness of research review committees: lessons from review of COVID-19 protocols at KEMRI Wellcome Trust Research Programme in Kenya
KWTRP OCGHR
Posted 05/08/2022. During a rapidly unfolding catastrophic pandemic, research is most needed to inform on nature, containment and prevention of the pandemic. Ethics review and regulatory authorities are important gatekeepers for research, and can facilitate scientifically rigorous and ethically sound relevant research. Alex Hinga, Dorcas Kamuya and colleagues examined how research review was undertaken during COVID19 in one of the review systems in Kenya, factors that enabled and/or hindered accelerated review including the political landscape, and make some recommendations for review systems in LMICs.
A family cluster of cutaneous Leishmania major infection unresponsive to intralesional meglumine antimonial: Case reports
MORU
Posted 12/08/2022. This small series describes four family members who contracted cutaneous leishmaniasis due to Leishmania major that did not improve in two patients and worsened in the other two despite 4 weeks of intralesional meglumine antimoniate. All responded to a 4-week course of oral ketoconazole. The paper provides an interesting discussion, by Bob Taylor and colleagues
Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities
KWTRP OCGHR
Posted 03/08/2022. Naomi Muinga and colleagues report on a process of implementing a co-designed, paper-based newborn monitoring chart in a network of hospitals in Kenya. While the chart was well-received, challenges with full uptake persist and offer opportunities to strengthen the process as well as future implementations.
Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations
MORU
Posted 02/08/2022. Severe malaria is difficult to diagnose in high malaria transmission areas because of the high coincidence of malaria with other febrile illnesses. James Watson and colleagues analysed platelet counts and plasma PfHRP2 concentrations from >2000 severely ill children and show that around a third of children diagnosed with severe malaria have in fact another cause of illness.
“Like a wake-up call for humankind”: Views, challenges, and coping strategies related to public health measures during the first COVID-19 lockdown in Thailand
MORU
Posted 26/07/2022. In this paper, Phaik Yeong Cheah and colleagues describe the challenges and coping strategies related to public health measures during the first COVID-19 lockdown in Thailand. Major challenges identified included financial hardship, social isolation and loneliness. Coping strategies included turning to religion, practicing acceptance and ‘making merit’ (Tham-bun in Thai).
Phagocytosis of Plasmodium falciparum ring-stage parasites predicts protection against malaria
KWTRP
Posted 29/07/2022. Ring-stages are the predominant parasite forms detected in the blood of humans infected with Plasmodium falciparum. Fauzia Musasia, Faith Osier and colleagues found that their active destruction through antibody-dependent phagocytosis predicted how well individuals responded to an experimental malaria infection. Targeting ring-stages may limit exponential parasite multiplication and prevent the progression to clinical malaria
The European & Developing Countries Clinical Trials Partnership (EDCTP) Knowledge Hub: developing an open platform for facilitating high-quality clinical research
OCGHR
Posted 22/07/2022. In recognition of emergent data on what the barriers and enablers are to long-term, sustainable capabilities to run studies, The Global Health Network and EDCTP developed the ‘EDCTP Knowledge Hub’: a set of online, open access, cross-cutting tools and resources to support the planning, writing and delivery of high-quality health research studies, available to research staff wherever they are in the world, especially those in low-resource settings. By Samuel Driver and colleagues
Impact of delayed processing of positive blood cultures on organism detection: a prospective multi-centre study
COMRU LOMWRU MORU
Posted 19/07/2022. What effect temperature and time have on organism detection from positive blood culture bottles is unknown. Tamalee Roberts, Arjun Chandna and colleagues found that the majority of organisms were recoverable from positive blood culture bottles stored at room temperature. Amies transport swabs also proved effective for transporting blood culture broth and preserving organism viability.
High burden of childhood tuberculosis in migrants: a retrospective cohort study from the Thailand–Myanmar border
MORU SMRU
Posted 14/07/2022. Children bear a substantial burden of TB disease on the Thai-Myanmar border. Treatment success rate exceeded the WHO End TB target of 90%, suggesting that similar vulnerable populations could benefit from the enhanced support of the residential TB program offered by Francois Nosten and colleagues. However better child-friendly diagnostics are needed to improve the detection of TB in children.
A scoping review of antibiotic use practices and drivers of inappropriate antibiotic use in animal farms in WHO Southeast Asia region
OCGHR
Posted 13/07/2022. Many of the antibiotics used in animal farms in Southeast Asia are critically important for humans. The scarcity of standardised antibiotic and livestock quantification methods limits existing literature. Ease of access to poorly regulate antibiotics, inaccessible quality animal healthcare, and insufficient preventive services likely drive inappropriate antibiotic use, by Aronrag Meeyai and colleagues.
African Plasmodium vivax malaria improbably rare or benign
EOCRU OUCRU
Posted 08/07/2022. We have long believed most of sub-Saharan Africa to be free of Plasmodium vivax malaria due to the dominance of Duffy blood factor negativity. Recent work nonetheless reveals stable P. vivax transmission across Duffy-negative Africa, very probably causing an infection of deep organs responsible for harm of unrecognized origin. Review by Kevin Baird
Gametocyte carriage of Plasmodium falciparum (pfs25) and Plasmodium vivax (pvs25) during mass screening and treatment in West Timor, Indonesia
EOCRU OUCRU
Posted 30/06/2021. In a cluster-randomised trial of mass microscopic diagnostic screening and treatment for malaria in eastern Indonesia, Kevin Baird and colleagues show that the intervention had no impact on the prevalence of carriage of gametocytes infectious to mosquitoes. The findings highlight the requirement for much greater sensitivity of diagnostics for this intervention to provide benefit to communities.
Incidence of chikungunya virus infections among Kenyan children with neurological disease, 2014–2018: A cohort study
KWTRP
Posted 06/07/2022. Chikungunya Virus (CHIKV) has been associated with neurological illness in many parts of the world, but there have been no reports of CHIKV-associated neurological illness in Africa. This study by Doris Nyamwaya and George Warimwe reveals that CHIKV infections are relatively more common than cerebral malaria and bacterial meningitis among children hospitalized with neurological disease in coastal Kenya, and systematic surveillance should be an urgent priority.
Decentralised hepatitis C testing and treatment in rural Cambodia: evaluation of a simplified service model integrated in an existing public health system
MORU
Posted 28/07/2022. Meiwen Zhang and Tom Peto start a prevalence survey, including Hepatitis B and Hepatitis C, among the rural population in Bangladesh, Cambodia, and Thailand. In 2021 Meiwen and colleagues published a pilot implementation project on hepatitis C testing and treatment in rural Cambodia.
Infection with Burkholderia pseudomallei – immune correlates of survival in acute melioidosis
OCGHR
Posted 04/10/2017. Recruiting 183 acute melioidosis patients and 21 control subjects in order to explore immune factors associated with survival status and diabetes, this study identified two class I HLA alleles associated with increased risk of death during melioidosis. Stronger T cell responses to nine immunodominant antigens were observed in those who survived, with responses to one of these – GroEL – observed to be impaired in patients with diabetes.
Tackling typhoid fever burden in south Asia
OUCRU OUCRU-Nepal
Posted 28/06/2022. South Asia is a hub for typhoid fever, a biblical disease in the West. The new conjugate vaccine, which we studied and now implemented by the Nepali government, is very important for the control of typhoid fever. But well-done treatment trials with adequate sample size are also of paramount importance. By Buddha Basnyat
Contribution of genetic factors to high rates of neonatal hyperbilirubinaemia on the Thailand-Myanmar border
MORU SMRU
Posted 22/06/2022. Mutations on the G6PD and UGT1A1 genes play a large role in neonatal jaundice, including the severe forms, among Karen and Burman neonates. Germana Bancone and colleagues show that improved diagnostics are urgently needed and different screening strategies should be considered in populations with a high prevalence of these traits.
Experience of Kenyan researchers and policy-makers with knowledge translation during COVID-19: a qualitative interview stud
KWTRP
Posted 17/06/2022. Reducing the devastating impact of COVID-19 requires the use of best available evidence to inform responses. Fatuma Guleid, Edwine Barasa and Researchers at the KEMRI-Wellcome Trust carried out knowledge translation (KT) activities to support national COVID-19 policy-making. In the study, we describe our experiences and the impact of KT in responding to public health crises.