What do a mathematician, an epidemiologist, a vaccine developer, a protein crystallographer and a whole bevy of immunologists and infectious disease specialists have in common? Answer: they’re just some of the Oxford University researchers coming together to fight the novel Coronavirus outbreak. Science blog by Charvy Narain
Posted 19/01/2022. Rita Njeru, Sassy Molyneux and colleagues examine the role of community health workers in supporting post-discharge recovery in young undernourished children. The authors argue that a targeted and multi-pronged approach initiated before or on discharge is needed, supported by clear guidance and training. The ways in which any new tasks or personnel are incorporated into hospital and broader health system hierarchies and systems need careful planning and tracking.
Posted 16/11/2021. In response to the Zika epidemic the Research Preparedness Network (REDe) engaged local health research communities to enhance long-term research capacity building. This publication is based on a call to fund research training workshops in Brazil and captures the process and impact of this approach. REDe also developed an implementation toolkit to foster similar initiatives and ultimately contribute to local ownership in global health.
Posted 12/11/2021. Global antibiotic consumption rates increased by 46 percent in the last two decades, according to the first study to provide longitudinal estimates of human consumption in 204 countries from 2000 to 2018. Annie Browne, Christiane Dolecek and colleagues used a novel approach that deployed statistical modelling techniques and incorporated multiple data sources, to help us address a number of public health challenges, from combating drug resistant infections to providing access to basic treatment
Posted 21/09/2021. The WHO's ‘5 moments’ is the dominant paradigm for hand hygiene globally. While ‘5 moments' has many benefits and has had a significant clinical impact, it also has many weaknesses. Jacob McKnight and colleagues explore how this important paradigm can be improved to reflect the latest research in hand hygiene.
Posted 27/08/2021. Demographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for paediatric complex and chronic conditions, however such expansion is threatened by workforce shortages. Yingxi Zhao and colleagues reviewed how task sharing could support expanded paediatrics services provision in LMICs, especially beyond acute infectious diseases and malnutrition that are widely and historically shifted.
Posted 06/08/2021. Preprints are increasingly being used to share non-peer-reviewed manuscripts to enable the rapid dissemination of research. In particular, they have become an important source of information for wider audiences keen to follow COVID-19 research developments, including news, social media and policymakers. This practice raises several challenges in publication ethics and integrity. Paul Newton and colleagues set out the need for good practice.
Posted 03/08/2021. Ribavirin is the only available Lassa fever treatment. The rationale for using ribavirin is based on one clinical study conducted in the early 1980s. However, reanalysis by Alex Salam and colleagues of previous unpublished data reveals that ribavirin may actually be harmful in some Lassa fever patients. An urgent reevaluation of ribavirin is therefore needed.
Posted 23/07/2021. Effective management and leadership are essential for everyday health system resilience, but health managers are often under-prepared and under-supported in these roles. Particular challenges have been observed in communication skills, emotional competence and supportive oversight. Jacinta Nzinga and colleagues share their learning from implementing a package of leadership development interventions in Kenya
Posted 20/07/2021. The ethical dilemmas faced by frontline staff conducting health research among ‘vulnerable’ populations are increasingly recognized. However, there is little documented on how staff might be supported in identifying and handling these dilemmas. Sassy Molyneux and colleagues share an approach and tools they developed in Kenya, centred on group reflections linked to a set of policy responses tailored to the context. They encourage further adaptation and evaluation of the approach
Posted 02/07/2021. Chemoprophylaxis against emerging and pandemic infections offer potential for prevention. Lakshmi Manoharan and colleagues evaluated significant design features of COVID-19 chemoprophylaxis trial registrations. The findings illustrate that the majority of trials were underpowered to detect clinically meaningful protection at epidemiologically informed attack rates. Future trials should be large enough to generate strong evidence and allow structured entry and exit of candidate agents. International trial coordination mechanisms and collaboration is required.
Posted 25/06/2021. In the ISARIC multicentre, cohort of 48 902 patients, admitted to UK hospital with COVID-19 during the first pandemic wave (6 Feb-8 June 2020), bacterial infections were uncommon. 85% of patients were prescribed antibiotics, with substantial regional variations highlighting that antimicrobial stewardship should be prioritised and integrated into Covid19 care pathways, by Louise Sigfrid and colleagues.
Posted 18/06/2021. Grace Irimu and colleagues show that newborns account for 46% of admissions and 66% of deaths among children 0-13years in Kenyan hospitals. Most deaths are caused by preventable and treatable causes. The authors call for need to prioritize newborn care for Kenya to achieve the SDGs target.
Posted 09/06/2021. Chris Paton and colleagues describe how predictive human-computer interaction (HCI) modelling could be used to improve the safety and usability of digital health systems. We reviewed the history of predictive modelling in HCI and describe how modelling could be integrated with the human-centred design techniques used when developing digital health interventions.
Posted 28/04/2021. While Health and Demographic Surveillance Systems (HDSS) involving verbal autopsy provide essential data on deaths, births and other health-related events in LMICs where alternative sources are limited, Vicki Marsh and colleagues argue that current regulatory frameworks do not sufficiently recognise their nature as a form of non-traditional epidemiological research. Ethical challenges include risks of uncompensated burdens that alternative regulatory approaches may more successfully identify.
Posted 13/04/2021. Self-regulated learning (SRL) remains unexplored for healthcare workers in low-income countries. Tim Tuti, Chris Paton and Niall Winters detail how SRL strategies impact on healthcare providers’ learning gains when using digital learning platforms. We apply Latent Profile Analysis (LPA) to questionnaire responses. We provide insights into the learner factors to consider when implementing technology-mediated learning.
Posted 15/04/2021. Philippe Guérin co-authored a letter published in The Lancet drawing attention of the risk of pooling data from uncomplicated illness and more severe ill hospitalised patients in the development of COVID-19 treatment guidelines. Although SARS-CoV-2 is one virus, the COVID-19 disease has a complex and evolving physiopathology pathway and requires different therapeutic approaches depending of the stage of the disease. In low-resource settings, the prevention of hospital admission is the therapeutic priority.
Posted 31/03/2021. Patient safety is a key goal of WHO but identifying harms and developing strategies to deliver safe care has been given little attention. Mike English and colleague describe a ‘portfolio’ approach to safety improvement in four broad categories: prioritising critical processes, improving the organisation of care, control of risks and enhancing responses to hazardous situations that we believe is relevant to low resource settings. We focus attention on the possible roles of practitioner groups and professional associations as key to advancing patient safety through collaboration and skill development in this field
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.
Antimicrobial resistance (AMR) is responsible for at least 1.27 million deaths per year — with over 97,000 deaths in 2019 in SE Asia alone, according to a study published in The Lancet by the Global Research on AntiMicrobial resistance (GRAM) project, who urged urgent action from policymakers and health communities to avoid further preventable deaths.
The world’s largest clinical trial investigating treatments for COVID-19 has now launched in South Africa, with the first patient recruited today. This is the fifth country to take part in RECOVERY, joining Nepal, Indonesia, Vietnam, and the United Kingdom.
Patients in north Africa and the Middle East are using antibiotics in sharply rising quantities far beyond the global average, raising concerns over the escalating risks of resistance to medicines to treat bacterial infections. Estimated antibiotic consumption for 204 countries between 2000 and 2018 shows a 46 per cent increase in global antibiotic usage, with a surge in nations including India and Vietnam.
Professor Paul Newton was announced new Distinguished International Fellow at the ASTMH Annual Meeting Awards Ceremony on the 17th November. This distinction formally recognizes individuals who have made eminent contributions to a particular aspect of tropical medicine or hygiene.