New Tropical Medicine Associate Professors and University Research Lecturers

Cost-effectiveness analysis of a multiplex lateral flow rapid diagnostic test for acute non-malarial febrile illness in rural Cambodia and Bangladesh

Posted 09/04/2024. Using data collected in the SEACTN Rural Febrile Illness project, Christopher Chew and colleagues evaluate the cost-effectiveness of a putative multiplex rapid diagnostic test able to diagnose enteric fever and dengue, coupled with CRP measurement to guide antibiotic prescribing for respiratory tract infections, in rural Cambodian and Bangladeshi primary care settings.

Interventions to address antimicrobial resistance: an ethical analysis of key tensions and how they apply in low- income and middle-income countries

Posted 05/04/2024. There are complex ethical tensions and competing interests that surround interventions to mitigate antimicrobial resistance (AMR). In this paper, Phaik Yeong Cheah, Bipin Adhikari and colleagues have identified how these are especially reflected in low- and middle-income countries. They highlight that these ethical tensions need to be kept in mind when designing AMR policies.

Vulnerability and agency in research participants’ daily lives and the research encounter: A qualitative case study of participants taking part in scrub typhus research in northern Thailand

Posted 12/03/2024. Phaik Yeong Cheah and colleagues conducted a qualitative study in northern Thailand among hilltribe ethnic minority groups to understand their challenges related to participating in research. These challenges included language barriers, travel difficulties, uncertain legal status and lack of access to healthcare. Researchers need to be aware of these to minimise the burdens of research participation.

Individualised, short-course antibiotic treatment versus usual long-course treatment for ventilator-associated pneumonia (REGARD-VAP): a multicentre, individually randomised, open-label, non-inferiority trial

Posted 26/01/2024. Ventilator-associated pneumonia is common amongst critically-ill patients. Mo Yin and colleagues investigated a personalized approach to shorten antibiotic duration, and found it as effective as a longer treatment in terms of death or pneumonia recurrence; it also reduced antibiotic side effects significantly. This study provides crucial evidence to guide antibiotic prescription to reduce resistance emergence.

Early warning systems for malaria outbreaks in Thailand: an anomaly detection approach

Posted 16/01/2024. Oraya Srimokla, Sompob Saralamba and their team developed specialized anomaly detection algorithms and a dashboard to enhance Thailand's malaria surveillance and elimination efforts. This system improves outbreak prediction accuracy and integrates seamlessly with existing infrastructure, aiding in the effective monitoring and identification of potential malaria outbreaks at the provincial level.

Expanding the roles of community health workers to sustain programmes during malaria elimination: a meeting report on operational research in Southeast Asia

Posted 10/01/2024. As malaria progressively declines in Cambodia, there's a concern about the diminishing relevance of village malaria workers (VMWs). In August 2023, a meeting addressed the feasibility and policy implications of VMWs managing non-malarial fevers, part of the operational research in western Cambodia to ensure VMWs remain active until malaria elimination is achieved. From Bipin Adhikari.

Ethical and cultural implications for conducting verbal autopsies in South and Southeast Asia: a qualitative study

Posted 20/12/2023. The verbal autopsy method can be sensitive to the individuals interviewed, their families and communities. Prior to study implementation, Nan Shwe Nwe Htun, Tom Peto and SEACTN colleagues sought to explore local beliefs and practices about death to inform appropriate bioethical practices and found that verbal autopsy is acceptable across a wide range of cultural settings in Bangladesh, Myanmar, Thailand, Laos PDR, and Cambodia.

Comparing the roles of community health workers for malaria control and elimination in Cambodia and Tanzania

Posted 12/12/2023. Bipin Adhikari and colleagues compared community health worker programmes between Southeast Asia and Sub-Saharan Africa using a systematic review of the published literature. This was supplemented by discussions with key informants in Cambodia and mainland Tanzania to inform the existing malaria service delivery strategies in Tanzania.

Accuracy of the direct agglutination test for diagnosis of visceral leishmaniasis: a systematic review and meta-analysis

Posted 01/12/2023. Parasitology is the gold standard for the diagnosis of visceral leishmaniasis (VL), however, other less invasive tests are available such as the direct agglutination test (DAT). As part of the series of systematic reviews and meta-analysis on diagnostic accuracy of diagnostics for FIEBRE infections, Tamalee Roberts and colleagues estimate the diagnostic sensitivity and specificity of DAT for the diagnosis of VL.

A systematic review of neglected tropical diseases (NTDs) in Myanmar

Posted 21/11/2023. Neglected tropical diseases (NTDs) are a group of preventable and treatable diseases common in Myanmar, primarily affecting marginalized rural communities. Myo Swe and colleagues provide an overview of reported NTDs in Myanmar over 100 years, indicating gaps in knowledge about certain diseases to inform future research directions related to NTDs in Myanmar.

A Prognostic Model for Critically Ill Children in Locations With Emerging Critical Care Capacity

Posted 20/11/23. Tools to assess illness severity are often impractical in settings with emerging critical care capacity. A prognostic model developed by Arjun Chandna and colleagues proved effective for triaging critically ill children. The tool provides holistic assessment of critical illness by combining measures of organ dysfunction with important contextual determinants of outcome, such as healthcare accessibility and the nutritional status of a child.

Use of antimicrobials during the COVID-19 pandemic: A qualitative study among stakeholders in Nepal

Posted 17/11/2023. Early critical phase of the COVID-19 pandemic added tremendous pressure to find curative therapies. A lot of empirical treatments, including antimicrobials, were recommended. Drawing on interviews with patients, clinicians and drug dispensers, Bipin Adhikari and colleagues explore how and why antimicrobials may have been used for the management of COVID-19 in Nepal.

The uncertain role of substandard and falsified medicines in the emergence and spread of antimicrobial resistance

Posted 10/22/2023. Sean Cavany and colleagues publish a new perspective in Nature Communications that describes the possible mechanisms by which substandard and falsified antimicrobials could affect antimicrobial resistance and suggests ways to improve our understanding of this relationship. The article arose from the work of the FORESFA project, funded by a Wellcome Collaborative Award.

A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN): pilot implementation in three countries in Southeast Asia, 2019-2020

Posted 01/11/2023. ACORN (A Clinically Oriented Antimicrobial Resistance Surveillance network) is a WHO GLASS compatible case-based surveillance method for antimicrobial resistance that produces more meaningful and locally actionable data. Rogier van Doorn and colleagues publish the results of a pilot in three countries, showing proof of principle and valuable lessons to be learned going forward. More at: acornamr.net

Vaccine mandates and public trust do not have to be antagonistic

Posted 29/10/2023. Historically, vaccine mandates and opposition to vaccines have co-existed, starting with smallpox vaccination mandates in the 1800s. During the COVID-19 pandemic, the benefits of vaccine mandates were weighed against potential damage to public trust. Bipin Adhikari and colleagues discuss whether and how vaccine mandates can co-exist with public trust.

Leadership in global health

Posted 24/10/2023. In the review of a book ‘Tore Godal and the evolution of global health by Conrad Keating’, Bipin Adhikari and Lorenz von Seidlein discuss Tore Godal’s contributions to Global Health projects while remaining in the background. There are lessons for those aspiring to influence Global Health.

Pharmacokinetics of single low dose primaquine in Ugandan and Congolese children with falciparum malaria

Posted 29/09/2023. This large study on the pharmacokinetics of single low dose primaquine in young Ugandan and Congolese children will help the MORU team develop an optimal dose for children with falciparum malaria to block malaria transmission and contribute to malaria elimination, especially of resistant falciparum parasites. By Bob Taylor

Improving neonatal health in rural Africa: how much do we know about neonatal jaundice?

Posted 26/09/2023. In this pilot study, Caterina Fanello and colleagues evaluated the prevalence of neonatal hyperbilirubinemia and related neonatal and maternal risk factors in a semi-rural area of the Democratic Republic of Congo. They also explored knowledge and practices of expectant mothers regarding this condition. Ways forward to improve diagnosis and treatment in these settings are discussed.

Expanding the role of village malaria workers in Cambodia: Implementation and evaluation of four health education packages

Posted 22/09/2023. The transformation of village malaria workers (VMWs) into community health workers with roles beyond malaria is a promising approach for sustaining health care provision in remote areas. Rupam Tripura and colleagues discuss on how training on health education could be optimized for VMWs.

Sharing results with participants (and community) in malaria related research: Perspectives and experience from researchers

Posted 08/09/2023. Sharing results with participants from research studies is largely underappreciated. Bipin Adhikari and colleagues explore the perception and practice of results-sharing in malaria related clinical trials among researchers. Although there was a consensus on the rationale of result sharing to participants, most researchers thought that disseminating results to policymakers and stakeholders for research translation was more important.

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