Posted 22/02/2021. Paper continues to be an important medium for recording inpatient care in low‐ and middle‐income countries. Naomi Muinga and colleagues synthesise evidence on how paper‐based nursing records have been developed within inpatient settings to support documentation of nursing care, and that a human‐centred design approach might better meet users' needs
Posted 16/02/2021. Dexamethasone has been shown to reduce mortality in COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Rima Shretta and colleagues estimate that approximately 12,000 lives could be saved in the UK and 650,000 globally between July-December 2020. Dexamethasone is a cost-effective option with an incremental cost of GBP 940 per life-year gained.
Posted 12/06/2020. Safety of drugs is important, particularly during pregnancy. Makoto Saito and colleagues have pooled the data of 4503 women who had malaria in pregnancy and found that the currently used artemisinin-based combination therapies are equally safe for fetus. This study also highlights that risk of small-for-gestational-age (SGA) is high after malaria in pregnancy even treated with highly efficacious drugs, suggesting that prevention is important for reducing SGA in malaria endemic areas.
Posted 14/04/2020. Enormous emergency efforts are underway to find optimal medical products, to prevent, diagnose, and treat COVID-19, that 7.8 billion people will depend on. With dire disruption of pharmaceutical production and supply and increasing falsified and substandard products, we need strategic planning now to ensure global access to quality-assured medical products and monitoring of supply chains
Posted 02/01/2018. Technological potentials have raised high hopes on healthcare access in LMICs like India. However, five years of research by Dr Marco Haenssgen paint a less optimistic picture and show adverse consequences of mobile phone diffusion, which creates more competition and new divisions and leaves the poorest strata of population worse off than before.
Posted 20/03/2020. 199 patients received standard care, of which 99 received lopinavir-ritonavir for 14 days. Lopinavir-ritonavir didn’t induce significant clinical improvement, and mortality was similar in both groups. However, patients treated with lopinavir-ritonavir spent less time in hospital and in intensive care. The trial enrolled severely ill patients and was not big enough to detect modest benefits. Much larger studies are warranted to confirm or exclude if lopinavir-ritonavir treatment can help.
Posted 12/02/2021. The majority of digital health projects have failed to translate into scaled, routine services, leaving many health leaders cautious and uncertain of how to proceed. Chris Paton and colleagues identify factors that can influence successful and sustainable integration of digital health within local health systems in low resource settings.
Posted 20/02/2018. The malaria parasite is a major cause of illness and deaths throughout the tropics. To survive, the malaria parasite needs to be transmitted by mosquitos form person to person. In this paper Martin Rono and colleagues show at the cellular and molecular level how the parasite balances its investment between growing efficiently in humans and maximising the chances of being transmitted by mosquitos, depending on the local environment.
Posted 12/12/2017. Snakebite envenoming is a neglected tropical disease that kills 100,000 people and maims 400,000 every year. Impoverished populations living in the rural tropics are particularly vulnerable; snakebite envenoming perpetuates the cycle of poverty. Intravenous administration of antivenom is the only specific treatment to counteract envenoming. Confronting snakebite envenoming at a global level demands the implementation of an integrated intervention strategy involving local, national and international organisations.
Posted 05/12/2017. Zika virus RNA is frequently detected in the semen after Zika virus infection. To learn more about persistence of viruses in genital fluids, Dr Alex Salam and Professor Peter Horby searched PubMed and found evidence that 27 viruses can be found in human semen. This may have implications for the risk of sexual transmission, embryonic infection, congenital disease, miscarriage, and infection transmission models.
Posted 28/11/2017. Prabin Dahal reviewed the evolution of statistical methods used to understand and define antimalarial drug efficacy in uncomplicated P. falciparum malaria. The article gives a thorough insight into the historical practices and critically reviews the challenges and limitations associated with current approaches and offers alternative methodologies leading to improved study design and analysis.
Posted 13/10/2017. Professor Peter Horby outlines potential epidemics in Africa. It is difficult to predict when and where new epidemics might occur so we can be better prepared and have a proactive response. This modelling is based on information on each virus as well as governance, communication, infrastructure and health care provision. Some areas remain at high risk and would benefit from improved surveillance, diagnostic capabilities and better health systems and local policies.
Posted 04/10/2017. Melioidosis is a neglected tropical disease estimated to kill 89,000 people a year across tropical regions and a vaccine is urgently required. In this collaboration with Imperial College, Professor Susanna Dunachie report for the first time a link between people with the HLA-B*46 genotype and around a three-fold increased risk of death. Survival from melioidosis is correlated with immune responses to nine key proteins from the causative bacteria, Burkholderia pseudomallei. This gives the foundation for development of an effective vaccine.
Posted 13/09/2017. Amanda Rojek and Peter Horby published a review aimed at clinicians who may treat patients with Ebola Virus Disease. This review outlines advances in understanding the clinical presentation, outcomes and long term sequelae of the disease, and outlines the status of experimental vaccines and treatments.
Posted 22/08/2017. Selecting and trialling therapeutics for preventing congenital Zika disease is challenging. The target product should be low risk, acceptable to the mother, highly effective in preventing adverse fetal outcomes, and practical for widespread clinical use in resource-limited settings. Professor Peter Horby and fellow researchers discuss strategies for addressing these challenges in a recent paper.
Posted 17/03/2017. An investigation conducted by the international medical organisation Médecins Sans Frontières revealed that over a thousand people in a remote area of the Democratic Republic of Congo suffered toxic effects after ingesting fake diazepam pills. The research was published in The Lancet Global Health with contribution from Prof Paul Newton from IDDO and LOMWRU.
Posted 03/11/2016. Six harmonised protocols to capture Zika-related data to help public health professionals, clinicians and clinical researchers to gain a better understanding of the disease has been published on the WHO website. A number of partners - under the leadership of Institut Pasteur and WHO, including ISARIC and CONSISE have contributed to the development of these protocols to address key public health concerns associated with the Zika virus outbreak. The Working Group on ZIKV Harmonized Research, which included Dr Gail Carson and Professor Peter Horby, published a commentary on the project in the Lancet Global Health yesterday.
Posted 08/01/2021. Patient safety is much less well studied in low-resource settings than in higher income settings. Mike English and colleagues suggest how concepts being employed to advance patient safety thinking in higher income settings could be usefully applied by practitioners in low-resource settings. The ability to diagnose system weaknesses should become a core skill for those leading teams, wards, departments or facilities in low-resource settings
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 29/01/2019. Gail Carson, Peter Horby, Laura Merson and colleagues promote the importance of developing clinical research networks in low-resource settings as a pillar to epidemic preparedness in a Letter to Lancet Global Health. The CTM&GH researchers are focused on developing capacity and partnerships across settings at highest risk of infectious disease outbreaks.
The Randomised Evaluation of COVID-19 Therapy (RECOVERY) Trial, the world’s largest clinical trial for COVID-19 treatments, has now expanded internationally with Indonesia and Nepal among the first countries to join. The first patients have been recruited to RECOVERY International.
The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial has demonstrated that tocilizumab, an anti-inflammatory treatment, reduces the risk of death when given to hospitalised patients with severe COVID-19. The study also showed that tocilizumab shortens the time until patients are successfully discharged from hospital and reduces the need for a mechanical ventilator.
Evidence from a new study, initiated by the Primaquine Roll Out Group and conducted at WWARN, supports the World Health Organization (WHO) recommendation for use of 0.25mg/kg dose of primaquine (PQ) combined with artemisinin-based combination therapies (ACT) to block Plasmodium falciparum transmission.
The WHO 2030 NTD Roadmap has just been launched, and a recent Geneva Health Forum panel took that as its starting point to discuss the possibility of eliminating neglected tropical diseases (NTDs). Professor Philippe Guérin, IDDO’s Director, joined co-panellists Dr Amy Fall, the Global Health Medical for Africa Region Lead at Sanofi, Dr Mwele Malecela, Director of the Department of Control of Neglected Tropical Diseases at the WHO, and Dr Nathalie Strub-Wourgaft, Medical Director at Drugs for Neglected Diseases initiative (DNDi) back in November 2020.
Baricitinib – an anti-inflammatory treatment for rheumatoid arthritis– is being investigated in the RECOVERY trial, the world’s largest clinical trial of treatments for patients hospitalised with COVID-19, taking place in 177 hospital sites across the UK and with over 33,000 patients recruited so far. As an anti-inflammatory, baricitinib may block the signalling activity of cytokine molecules which contribute to the hyper-inflammatory state seen in severe COVID-19. It is thought that baricitinib may act also have some anti-viral activity. The other treatments currently being investigated in the RECOVERY trial are Regeneron’s antibody cocktail, Aspirin and Colchicine.
KWTRP initial community and public engagement strategy was developed in 2005 with three goals: build understanding and trust between researchers and communities, enhance ethical conduct of research, and disseminate research findings to promote uptake into policy. Our programme has since developed and now includes engagement with media, radio programme, media engagement workshops, various meetings and forums, and a fully-fledged school engagement programme that was awarded the 2019 Oxford VC Public Engagement with Research Award.