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Congratulations to everyone involved in contributing to FIEBRE’s success - the clinical and laboratory staff, hospital, participants and local communities. The team has continued working throughout the COVID-19 epidemic despite national restrictions which slowed down enrolment and limited field activities.
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.
Perceptions, views and practices regarding antibiotic prescribing and stewardship among hospital physicians in Jakarta, Indonesia: a questionnaire-based survey
EOCRU OUCRU
Posted 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’ attitudes and develop context-specific AMS interventions. By Ralalicia Limato, Raph Hamers and colleagues.
Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention
EOCRU OUCRU
Posted 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.
Genotypes and phenotypes of G6PD deficiency among Indonesian females across diagnostic thresholds of G6PD activity guiding safe primaquine therapy of latent malaria
EOCRU OUCRU
Posted 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.
A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals
EOCRU OUCRU
Posted 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.
Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia
EOCRU OUCRU
Posted 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
Plasma inflammatory biomarkers predict CD4+ T-cell recovery and viral rebound in HIV-1 infected Africans on suppressive antiretroviral therapy
EOCRU OUCRU
Posted 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.
HIV drug resistance in low-income and middle-income countries
EOCRU OUCRU
Posted 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.
Picturing health: making malaria visible in Asia-Pacific
EOCRU OUCRU
Posted 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’s invisible malaria burden.
Essential guidance on malaria elimination in its history
EOCRU OUCRU
Posted 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.