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\n \n \n \nPosted 31/08/2023. Vendors at wet markets in Laos may be exposed to different zoonotic pathogens depending on the types of food they sell. A one-year serological survey by Matthew Robinson and colleagues identified that individuals selling vegetables, domestic farmed meat, or wildlife meat, were potentially infected by important bacterial pathogens associated with both farmed animals and wildlife.
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\n \n \n \nPosted 25/08/2023. Dorothy Oluoch, Lisa Hinton and colleagues in a new Viewpoint explore the rich potential for patient narratives to complement typical epidemiological and health service evidence on the status of health systems in low-income countries. They explain that we have much to learn about the improvements needed to systems and where to intervene from patients\u2019 stories about their experiences of health care, and that doing this is key to developing person-centred care.
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\n \n \n \nPosted 25/08/2023. Mike English and colleagues outline in their Lancet Global Health Viewpoint the challenges of measuring quality of care and the challenging pathways from measurement to actual improvement in health service delivery. They argue in particular that collecting data for measuring quality is too often the main focus with little attention is paid to the complex work required to actually change health care practices.
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\n \n \n \nPosted 23/08/2023. Kenyan medical schools are now estimated to be training and graduating increasing numbers of doctors, however recent data suggested that only less than half of these trainees are being absorbed by the public sector. Yingxi Zhao and colleagues conducted a qualitative case study to understand how post-internship medical trainees are absorbed into the Kenyan public sector.
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\n \n \n \nPosted 22/08/2023. Medical devices are a fundamental component of health systems, but how are these governed to ensure benefits are achieved and harms are minimised? Naima Nasir and collesgues explore governance arrangements for medical devices in African countries and proposes a conceptual framework for the exploration of governance realities across the health system.
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\n \n \n \nPosted 18/08/2023. Fever is a common reason to seek healthcare in Southeast Asia, and the decline of malaria has further complicated fever perceptions and actions taken. This mixed-methods study from 2019, on Thai-Myanmar border revealed diverse range of fever conceptions, symptoms and believed causes. Napat Khirikoekkong, Supa-at Asarath and colleagues mapped out context-specific healthcare seeking strategies and discussed its influencing key determinants.
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\n \n \n \nPosted 16/08/2023. Tools for safe community-based childhood pneumonia management are needed. Studies often do not include outpatients or consider whether laboratory tests add value to clinical assessment. Arjun Chandna and colleagues found that Angiopoietin-2 improved performance of a validated risk score (LqSOFA) to predict oxygen requirement amongst refugee children with pneumonia on the Thailand-Myanmar border.
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\n \n \n \nPosted 02/10/2018. Rising prevalence of HIV drug resistance in low and middle-income countries poses a growing threat to the HIV response. To curb resistance, enhanced strategies are needed that improve quality of ART care and treatment. Raph Hamers reviews contemporary data and highlights the potential impact and resistance risks of novel ART strategies and knowledge gaps.
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\n \n \n \nPosted 22/01/2021. Raph Hamers and colleagues conducted a multi-country prospective study of Africans with HIV-1 on suppressive antiretroviral therapy. Plasma concentrations of sCD14 and CRP predicted subsequent poor CD4+ T-cell recovery, and CXCL10 and sCD163 predicted viral rebound. Further research is needed to increase our understanding of and to explore the potential for adjunctive therapeutic interventions targeting these pathways.
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\n \n \n \nPosted 07/04/2017. Collaboration between photographer Pearl Gan and Professor Kevin Baird from our EOCRU unit in Jakarta, Indonesia, this photographic project aims to raise public awareness of malaria as a serious health problem for the region by telling the human story of Asia\u2019s invisible malaria burden.
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\n \n \n \nPosted 07/06/2022. This survey among over 1000 hospital physicians found that antimicrobial stewardship (AMS) implementation in Indonesian hospitals is challenged by institutional, contextual and diagnostic vulnerabilities. Appropriate recognition of the contextual determinants of antibiotic prescribing decision making will be critical to change physicians\u2019 attitudes and develop context-specific AMS interventions. By Ralalicia Limato, Raph Hamers and colleagues.
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\n \n \n \nPosted 02/09/2021. A cross-sectional survey of G6PD deficiency genotypes and phenotypes of nearly two thousand girls and women living on malarious Sumba island in eastern Indonesia assessed risk of hemolytic crisis with primaquine therapy against latent malaria with G6PD screening technologies. These findings by Kevin Baird and colleagues will help guide the selection of G6PD screening methodology and practice.
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\n \n \n \nPosted 01/06/2022. This review represents a first attempt at systematically assessing human antibiotic use in Indonesia in the past 20 years. Ralalicia Limato, Raph Hamers and colleagues identified critical evidence gaps in the private health care sector, and what are the health system drivers of antibiotic use. Optimisation of antimicrobial use should be a priority of the national agenda for universal health coverage.
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\n \n \n \nPosted 14/06/2023. This scoping review, led by Raph Hamers with WHO, aggregated knowledge gaps in antimicrobial resistance in bacteria, including TB, and fungi: 2340 knowledge gaps were consolidated into 177 thematic research questions across 14 AMR areas. The findings informed research priorities in the novel WHO AMR Global Research Agenda for human health.
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\n \n \n \nPosted 07/12/2022. In this real-world cohort study in Indonesia, Raph Hamers and colleagues found high antibody responses and good tolerability of a heterologous, full-dose mRNA-1273 (Moderna) booster after two doses of inactivated vaccine (CoronaVac) in healthcare workers in Indonesia, with and without previous SARS-CoV-2 infection, including in those who had very low antibody levels.
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\n \n \n \nPosted 04/05/2021. This survey in Jakarta, Indonesia, led by Licia Limato & Raph Hamers, evaluated patterns and quality indicators of antibiotic prescribing in six public and private hospitals. The study reported a high rate of empirical use of broad-spectrum antibiotics, coupled with poor documentation and guideline adherence, suggesting important areas for antimicrobial stewardship interventions.
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\n \n \n \nPosted 12/03/2021. Henry Surendra, Raph Hamers and colleagues report a large retrospective study of patients hospitalised with COVID-19 in Jakarta, Indonesia. In-hospital mortality was lower than reported in high-income countries, likely explained by the younger population, fewer comorbidities and less severe disease. Nonetheless, this study affirmed the vulnerability of elderly and comorbid patients as well as children under 5 years in LMICs
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\n \n \n \nPosted 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
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\n \n \n \nPosted 28/05/2019. Kevin Baird calls attention to the importance of local expertise in anopheline mosquito ecology as an essential weapon in striving to eliminate malaria. Slight but very specific modifications to environments that disfavour those mosquitoes achieved very significant gains before the advent of DDT insecticide and synthetic antimalarial commodities in the middle of the 20th century. Loss of those commodities, and a lack of alternative strategies, led to the great malaria resurgence of the latter 20th century.
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\n \n \n \nPosted 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.
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