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.
Posted 02/07/2019. Highly efficacious treatment can limit the cumulative deleterious impact of malaria during pregnancy on the mother and fetus. Correct assessment of treatment efficacy with an adequate length of follow up is required. Makoto Saito and colleagues at the Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border suggest that pregnant women need to be followed up longer than the currently recommended duration of follow-up to assess antimalarial drug efficacy.
Posted 20/11/18. Malaria in pregnancy affects both mothers and fetuses. Safe and efficacious antimalarials are needed for treating pregnant and breastfeeding mothers to protect them from devastating outcomes due to malaria. Dr Makoto Saito, Professor François Nosten and colleagues at the Shoklo Malaria Research Unit have reviewed and summarised the maternal and fetal safety of the currently available antimalarials in pregnancy and postpartum, spotlighting this neglected and vulnerable population.
Posted 01/12/2020. This paper confirms that research is important to inform evidence-based medical care in LMICs settings. Napat Khirikoekkong, Phaik Yeong Cheah and colleagues found that migrants living along the Thai-Myanmar border, who were traditionally deemed vulnerable, exercise their agency and resourcefulness when navigating through their daily challenges, and participating in important health research
Posted 27/11/2020. The migrant-friendly residential TB program of SMRU on the Thailand-Myanmar border has achieved high treatment success rate. However, many TB patients admitted to the centers are in advanced stage of disease. Win Pa Pa Htun and colleagues show that early TB death (in the first month of treatment) is highest among pulmonary TB cases and in particular in HIV co-infected patients and in those with co-morbidity. Early detection and treatment for both TB and HIV are crucial for migrants, if the case fatality rate is to be reduced in this marginalized population.
Posted 06/11/20. Victor Chaumeau and colleagues assessed the impact of outdoor residual spraying on the biting rate of malaria mosquitoes in four villages in Kayin state, Myanmar. They reported a 10-fold decrease in mosquito biting rate immediately after the intervention and concluded that outdoor residual spraying can be used to control malaria mosquitoes in this area.
Posted 25/09/2020. Prevention of mother to child transmission of hepatitis B with maternal tenofovir DF is one option to reach elimination of this infection. However, implementing this in a resource limited setting is challenging. Marieke Bierhoff and colleagues describe the most common challenges and possible solutions like transport assistance and local agreements to facilitate access.
Posted 27/08/2020. Germana Bancone and colleagues from EDCD (Nepal) and SMRU conducted this study in malaria endemic districts of Nepal, showing that G6PD deficiency is prevalent among most ethnic groups across the region. G6PD testing will be necessary for safe deployment of 8-aminoquinolines in order to eliminate Plasmodium vivax malaria in Nepal.
Posted 17/10/2016. Training local Karen and Burman women as skilled birth attendants in refugee settings resulted in no adverse perinatal outcomes and many positive outcomes such as a drop in stillbirths and infant deaths and more babies being born in clinics rather than at home, says a new study, led by Professor Rose McGready and published in PLOS ONE.
Posted 22/10/2019. Rose McGready and SMRU colleagues contributed RCT data from the Thailand-Myanmar border to this large review on low- and middle-income countries (21 studies in 20 882 children). The results suggests targeting parental, environmental and nutritional factors from pre-pregnancy through childhood, as a way forward to improve health and development of children in such settings.
Posted 16/07/2019. Worrying nutritional trends in possibly the longest and largest cohort of nearly 50,000 refugee and migrant pregnant women in a LMIC setting. Ahmar Hashmi and colleagues at SMRU summarise trends in under- and over-nutrition among pregnant women, and show a double burden of malnutrition in these marginalised and vulnerable communities from the Myanmar-Thailand border.
Posted 25/04/2018. Mary-Ellen Gilder and colleagues at SMRU demonstrate low levels of primaquine in breast milk, findings that should change treatment policy allowing more breastfeeding women to be cured of P.vivax. This will potentially reduce the global burden of this infection which has significant negative consequences for pregnant mothers and infants.
Posted 17/10/2017. Plasmodium falciparum and Plasmodium vivax malaria in pregnancy both increase stillbirth risk, which is likely to increase as endemicity declines. A study by SMRU and University of Melbourne researchers shows that better P. falciparum malaria control efforts could prevent up to 1 in 5 to 8 stillbirths in sub-Saharan Africa.
Posted 05/07/2019. Health information can be life-saving, but how can it be conveyed to those who could benefit most? Through analysis of an unsuccessful public health campaign, Mary Ellen Gilder and SMRU colleagues learned from migrant women valuable lessons about health messaging in communities where most women do not complete the fourth grade.
The Indonesian government policy to exclude the elderly in the first phase of the COVID-19 vaccination program could hinder the vaccine’s impact in lowering mortality rates. COVID-19 mortality rates in Indonesia, the highest in Southeast Asia, are dominated by those in the 60 years and above age bracket. In this article published in The Conversation, Kartika Saraswati and fellow DPhil students elaborate how, by prioritising vaccination for elderly, Indonesia may optimally reduce the hospital burden and COVID-19 deaths amidst a limited vaccine supply during the first vaccination phase.
A study to explore the variations of how microscopy methods are reported in published malaria studies has recommended standardised procedures should be implemented for methodological consistency and comparability of clinical trial outcomes.
The first patients are being vaccinated as part of the UK’s rollout of the Oxford / AstraZeneca coronavirus vaccine, ChAdOx1 nCoV-19, at the Oxford University NHS Hospitals Trust. The Oxford AstraZeneca vaccinations will be delivered at a small number of hospitals for the first few days for surveillance purposes, as is standard practice, before the bulk of supplies are sent to hundreds of GP-led services later in the week.
Blog by Rima Shretta. Preliminary efficacy results from three vaccine candidates currently in Phase 3 trials have shown an efficacy of more than 90% against the development of symptomatic COVID-19. While these results are promising, all vaccines are in relatively early stages of testing. A comprehensive and transparent roadmap is urgently needed, to determine how limited doses of the first vaccines to be licensed will be distributed, together with which groups will initially be prioritized.
A new study quantifying the high risk of Plasmodium vivax parasitaemia after treatment of Plasmodium falciparum malaria aims to identify populations in which a policy of universal radical cure, combining artemisinin-based combination therapy with a hypnozoitocidal antimalarial drug, would be most beneficial.
Dr Clare Ling has been made an honorary Fellow of the Royal College of Pathologists (FRCPath). Currently running Shoklo Malaria Research Unit (SMRU) Microbiology department and supporting the unit’s molecular activities, Clare is a clinical scientist who has worked at SMRU on the Thai-Myanmar border since 2012.