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On 4 June 2020, after a week of increasing scientific concern and scrutiny, first The Lancet, then the New England Journal of Medicine, retracted studies that were based on inaccessible data. The studies have been extremely damaging to chloroquine and hydroxychloroquine COVID-19 clinical trials around the globe. MORU researchers played a key role in bringing this scandal to light, whose consequences continue to play out.
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
Real-time investigation of a Burkholderia cenocepacia bacteraemia outbreak in a Vietnamese Intensive Care Unit
Posted 07/05/2025. Duy Pham and colleagues at OUCRU investigated a Burkholderia cenocepacia bacteraemia outbreak in Vietnam. Their rapid response was made possible by strong collaboration between scientists and hospital staff. Nosocomial infections caused by this and other overlooked pathogens require global efforts to improve diagnostics, treatment guidelines, and infection control strategies.
Incorporating acute HIV infection screening, same-day diagnosis and antiretroviral treatment into routine services for key populations at sexual health clinics in Indonesia: a baseline analysis of the INTERACT prospective study
Posted 02/05/2025. In the INTERACT study, Raph Hamers and collaborators successfully implemented “test-and-immediately-treat” services for persons with acute HIV infection (AHI) at sexual health clinics in Jakarta and Bali. AHI screening at scale offers the potential for enhanced interventions to achieve the full population benefits of “treat-all” strategies and curb the escalated HIV epidemic among key populations in Indonesia.
Tracing epistemic injustice in global antimicrobial resistance research
Posted 14/03/2025. This commentary explores whether there is epistemic injustice in global antimicrobial resistance (AMR) research – who sets priorities, who produces knowledge, and which types of knowledge are valued. Prof Phaik Yeong Cheah and colleagues argue that epistemic injustice may have created blind spots in policy. Addressing this requires a commitment to diversity, equity, and inclusion.
Challenges associated with dapsone for leprosy treatment in Indonesia - urgent need for access to alternative antimicrobial drugs
Posted 05/03/2025. Marlous Grijsen and colleagues highlight the challenges associated with dapsone for leprosy treatment in Indonesia. Dapsone, a key drug in multi-drug therapy, can cause life-threatening adverse drug reactions, including dapsone hypersensitivity syndrome and hemolytic anemia. Routine screening could prevent these complications, but in many leprosy-endemic areas, testing and alternative regimens are inaccessible or unaffordable. We call for better diagnostics and alternative treatments to ensure safer care.
Rethinking neglected tropical diseases: A shift towards more inclusive and equitable terminology
Posted 05/02/2025. Neglected tropical diseases (NTD) affect >1 billion people, disproportionally affecting under-resourced communities. While the term ‘NTD’ has been instrumental in driving critical funding and policy initiatives, it may also carry unintended negative consequences. Marlous Grijsen and colleagues explore the term NTD to foster dialogue and advocate for more inclusive and equitable language.
Sustainable antimicrobial resistance surveillance: time for a global funding mechanism
Posted 07/01/2025. The continued costs of a standard national AMR surveillance system are predicted to account for over 5% of the total domestic general government health expenditure (GGHE-D) for 28 LMICs and more than 2% of GGHE-D for 46 LMICs. This high cost is not sustainable without a long-term global financing mechanism. By Liz Ashley
Leprosy
Posted 03/12/2024. This comprehensive review, co-authored by Marlous Grijsen and a multidisciplinary team of global experts from leprosy endemic and non-endemic countries, describes the epidemiology, pathophysiology, clinical manifestations and management of leprosy and the impact it has on quality of life. The paper addresses knowledge gaps and research priorities and offers an up-to-date perspective on leprosy.
Changing epidemiology and antimicrobial susceptibility of bloodstream infections at a Vietnamese infectious diseases hospital (2010–2020)
Posted 24/10/2024. Duy Pham’s lab performed comprehensive epidemiological analysis of bloodstream infections (BSI) in Vietnam (2010-2020), revealing an increasing trend of E. coli and K. pneumoniae as predominant pathogens. Both showed rising multidrug resistance, primarily affecting elderly individuals with comorbidities. Antibiotic prescriptions declined significantly following control policies. Their work highlights the needs for community surveillance and antimicrobial stewardship to manage BSIs in Vietnam.
A nationwide mixed methods study of gaps and barriers to implementation of antimicrobial stewardship programs in hospitals in Indonesia
Posted 23/10/2024. Robert Sinto, Raph Hamers and colleagues conducted a nationwide evaluation of antimicrobial stewardship programmes (ASP) in Indonesian public and private hospitals. They found that to date most hospitals only reached an inadequate or basic level of ASP implementation, and they identified several globally-relevant and context-specific barriers. The paper formulates actions recommended for sustainable improvement.
Genomic insights unveil the plasmid transfer mechanism and epidemiology of hypervirulent Klebsiella pneumoniae in Vietnam
Posted 01/02/2022. Pham Thanh Duy and colleagues at OUCRU have revealed the endemic circulation of fluoroquinolone-resistant extra-intestinal pathogenic Escherichia coli ST1193 in Vietnam, driven by multiple strain importations and sustained transmissions between humans. These organisms have developed resistance to multiple drugs of choice and are major causes of sepsis in neonates and bloodstream infections in adults in this setting.
Genomic insights unveil the plasmid transfer mechanism and epidemiology of hypervirulent Klebsiella pneumoniae in Vietnam
Posted 22/10/2024. Duy Pham's lab investigated hypervirulent Klebsiella pneumoniae bloodstream infections in Vietnam, uncovering high strain diversity likely driven by horizontal transfer of non-self-transmissible virulence plasmids. Plasmid acquisitions led to the independent emergence of MDR hypervirulent strains. Significant gaps persist in understanding community transmission for targeted interventions, especially in Asia where new strains are emerging.
Emerging Monkeypox Virus Sublineage C.1 Causing Community Transmission, Vietnam, 2023
Posted 02/10/2024. Le Van Tan and colleagues studied a community cluster of mpox in Vietnam caused by emerging MPXV sublineage C.1, imported into Vietnam through 2 independent events; 1 major cluster carried a novel APOBEC3-like mutation. Three patients died; all had advanced HIV co-infection. Viral evolution and its potential consequences should be closely monitored.
Hospital-acquired infections and unvaccinated children due to chronic diseases: an investigation of the 2017–2019 measles outbreak in the northern region of Vietnam
Posted 24/09/2024. Measles-infected children with chronic diseases had lower vaccination rates and a higher proportion of hospital-acquired infections during the 2017–2019 outbreak in northern Vietnam. Early nosocomial transmission was detected before community outbreaks in several provinces. Strengthening hospital infection control and raising awareness about the importance of vaccination for vulnerable groups is essential. By Thinh Ong Phuc
Towards a machine-learning assisted non-invasive classification of dengue severity using wearable PPG data: a prospective clinical study
Posted 05/07/2024. Early warnings of clinical deterioration through continuous non-invasive monitoring could benefit clinical care in dengue-endemic settings. Taking the approach of using low-cost wearables, Chanh Ho Quang and colleagues successfully demonstrate the ability to classify dengue patients with different severity and disease state. The implementation of these models could improve patient outcomes and resource allocation
Mitigating machine learning bias between high income and low–middle income countries for enhanced model fairness and generalizability
Posted 03/07/2024. Collaborative AI efforts between high-income countries (HICs) and low- to middle-income countries (LMICs) are essential for pooling resources and expertise. Jenny Yang, Louise Thwaites and colleagues show that AI approaches can lead to divergent outcomes across HIC and LMIC settings. Using COVID-19 screening data, we demonstrate that bias mitigation methods improve fairness and maintain diagnostic sensitivity.
Leprosy identified in Sumba Island, eastern Indonesia: elimination targets under threat
Posted 24/05/2024. Frontline healthcare workers detected 60 persons affected by leprosy in Sumba Island, Indonesia, through teledermatology, over a 3-year period. Marlous Grijsen and colleagues at the Sumba Foundation and Gadjah Mada University highlight the challenges of delivering leprosy care in remote areas, how these translate into population risks of ongoing transmission and disabilities, and how leprosy can re-emerge after reaching national elimination targets.
Feasibility of wearable monitors to detect heart rate variability in children with hand, foot and mouth disease
Posted 26/03/2024. Dr Le Nguyen Thanh Nhan and colleagues at the Oxford University Clinical Research Unit showed that wearable devices could be used to monitor heart activity in children with hand foot and mouth disease. This monitoring method was feasible even in young children, and the heart activity measured was linked with the virus causing the disease.
Emerging Enterovirus A71 Subgenogroup B5 Causing Severe Hand, Foot, and Mouth Disease, Vietnam, 2023
Posted 14/02/2024. Le Van Tan and colleagues describe a 2023 outbreak of severe hand, foot, and mouth disease in Vietnam caused by an emerging lineage of enterovirus A71 subgenogroup B5. Affected children were significantly older than those reported during previous outbreaks. The virus should be closely monitored to assess its potential for global dispersal.
Characteristics and clinical outcomes of patients with pre-delta, delta and omicron SARS-CoV-2 infection in Indonesia (2020–2023): a multicentre prospective cohort study
Posted 26/01/2024. A recent prospective study among Indonesian patients hospitalised with COVID-19, from 2020 to 2023, demonstrated that, despite lower disease severity than delta, the omicron variant still caused substantial patient burdens. Older and unvaccinated individuals remained at higher risk of adverse outcomes, warranting optimised treatment and vaccine booster strategies for this setting. By Raph Hamers