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Human trials of new antimalarial drugs are in the pipeline after KEMRI scientists successfully used bacteria to kill the parasite that causes the disease. Trials in Burkina Faso showed that Ivermectin, a conventional drug used for parasitic diseases including river blindness and elephantiasis, reduced transmission rates. The medication worked by making the blood of people who were repeatedly vaccinated lethal to mosquitoes. The study also found that Ivermectin can kill plasmodium falciparum, the malaria parasite carried by female mosquitoes, when administered to humans.
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CDC/ James Gathany
Changing epidemiology and antimicrobial susceptibility of bloodstream infections at a Vietnamese infectious diseases hospital (2010–2020)
OUCRU
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
OUCRU OUCRU-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
OUCRU
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
OUCRU
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.
Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand–Myanmar border
MORU SMRU
Posted 22/10/2024. Severe neonatal hyperbilirubinaemia is often diagnosed late in low-resources settings because of lack of point-of-care tools. In this study, Germana Bancone and SMRU researchers have evaluated the performance of a transcutaneous bilirubinometer for screening of neonates born along the Thai-Myanmar border. The study was supported by a Wellcome Trust iTPA grant.
Artemisinin-resistant malaria
MORU
Posted 18/10/2024. Nick White and K. Chotivanich publish a review of mechanisms, genetic associations, phenotyping, epidemiology and current status of artemisinin resistance, and a brief discussion of policies and potential counter-measures.
Fractional Doses of Pneumococcal Conjugate Vaccine — A Noninferiority Trial
KWTRP
Posted 10/10/2024. Pneumococcal Conjugate Vaccines (PCV) have had a tremendous impact on childhood morbidity but only 2/3 of children receive a PCV. One obstacle to wider protection is cost. Kate Gallagher, Anthony Scott and others at KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya, showed that a 40% fractional dose of PCV13 had non-inferior immunogenicity to a full dose, suggesting similar benefits could be delivered for lower cost.
In-host modeling of dengue virus and non-structural protein 1 and the effects of ivermectin in patients with acute dengue fever
MORU
Posted 09/10/2024. Junjie Ding and the MORU Clinical Pharmacology Team developed an in-host dengue kinetic model to quantitatively predict drug effects in dengue fever. This model offers valuable insights to inform dengue drug development, and shows that ivermectin reduces NS1 but not viral load. The results are published in a leading PK/PD modelling journal, CPT:PSP.
Emerging Monkeypox Virus Sublineage C.1 Causing Community Transmission, Vietnam, 2023
OUCRU
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
OUCRU
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
Prevalence and associated risk factors of stunting, wasting/thinness, and underweight among primary school children in Kandahar City, Afghanistan: a cross-sectional analytical study
MORU
Posted 17/09/2024. Bob Taylor and colleagues investigated 1205 primary school children in Kandahar and found almost 50% were stunted, 25% were underweight and 20% wasted. Risk factors for stunting in 6–9 year old children were poverty, skipping breakfast, and being a girl from a large family with an uneducated mother and an unemployed father.
Anti-infectivity efficacy and pharmacokinetics of WHO recommended single low-dose primaquine in children with acute Plasmodium falciparum in Burkina Faso: study protocol
MORU
Posted 11/09/2024. The Groupe de Recherche Action en Santé, a Developing Paediatric Primaquine project partner, will assess, for the first time, the transmission blocking efficacy of allometrically-scaled, single low-dose primaquine, using the WHO-recommended 0.25 mg/kg target dose, in under-5 Burkinabe children with uncomplicated Plasmodium falciparum. The study protocol is now published. By Bob Taylor.
Public service motivation, public sector preference and employment of Kenyan medical doctor interns: a cross-sectional and prospective study
KWTRP NDM-CGHR
Posted 11/09/2024. Daniel Mbuthia and colleagues surveyed 356 Kenyan medical doctors, to understand what influences their career choices at labour market entry, specifically understanding the role of public service motivation. They highlighted that nearly all surveyed doctors are public service oriented, many doctors stated intention to work in the public sector but were unable due to lack of job opportunities. Unfortunately, 13% of the doctors were unemployed one year after completing their internship.
Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022
COMRU MORU
Posted 10/09/2024. Collaborating with the Ministry of Public Health, Direk Limmathurotsakul and colleagues utilised an automated tool, evaluated and reported the frequency of antimicrobial-resistant (AMR) infection in 111 public hospitals in Thailand in 2022. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritised.
The mRNA content of plasma extracellular vesicles provides a window into molecular processes in the brain during cerebral malaria
KWTRP
Posted 06/09/2024. Kioko Mwikali, Abdirahman Abdi and colleagues at KEMRI-Wellcome Trust used extracellular vesicles circulating in plasma to noninvasively study the progression of cerebral malaria in children. This provides a mechanism for identifying diagnostic biomarkers and developing therapeutic strategies.
New WHO classification of genetic variants causing G6PD deficiency
MORU SMRU
Posted 04/09/2024. Over 50 years after its first publication, this revised classification of G6PD genetic variants is the result of the 2022 WHO Global Malaria Programme experts’ consultation led by Professor Lucio Luzzatto. The new classification reconciles biochemical and clinical aspects of the different G6PD mutations and provides a reliable reference for scientists and clinicians. By Germana Bancone.
Examining liminality in professional practice, relational identities, and career prospects in resource-constrained health systems: Findings from an empirical study of medical and nurse interns in Kenya
KWTRP NDM-CGHR
Posted 03/09/2024. Yingxi Zhao, Stephanie Nzekwu and colleagues examined new Kenyan doctors' and nurses' experiences of transitioning from training to practising as health professionals, drawing on the concept of liminality. The research highlighted three dimensions of liminal experiences in professional practice, relational inter- and intra-professional identity and status, and professional careers.
Linking Cerebral Malaria Pathogenesis to APOE-Mediated Amyloidosis: Observations and Hypothesis
KWTRP
Posted 06/08/2024. Kioko Mwikali, Abdirahman Abdi and colleagues found that the CSF proteome of cerebral malaria is more similar to Alzheimer's Disease than to acute bacterial meningitis, with cerebral malaria showing elevated amyloidosis. This finding might benefit the search for treatment and management of both Alzheimer's Disease and cerebral malaria.
Relation Between the Dantu Blood Group Variant and Bacteremia in Kenyan Children: A Population-Based Case-Control Study
KWTRP
Posted 02/08/2024. Plasmodium falciparum malaria is a strong predisposing factor for bacteraemia. Silvia Kariuki and colleagues investigated the impact of the rare malaria-protective Dantu blood group variant on susceptibility to bacteraemia. We found that Dantu was significantly protective against bacteraemia only during a high malaria transmission period. This suggested that the protective effect of Dantu on bacteraemia is secondary to its protective effect against malaria.
Genetic diversity, determinants, and dissemination of Burkholderia pseudomallei lineages implicated in melioidosis in Northeast Thailand
MORU
Posted 15/07/2024. A recent study from northeast Thailand identified three major bacterial lineages responsible for melioidosis in the region. Each lineage carries unique gene sets that likely contribute to successful dissemination. These genes are expressed under environmental rather than infectious conditions, with one lineage showing overexpression under nutrient deprivation, highlighting environmental persistence is a prerequisite for infection. By Claire Chewapreecha