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Spatial heterogeneity and temporal trends in malaria on the thai2013myanmar border 201220132017

Spatial heterogeneity and temporal trends in malaria on the Thai–Myanmar border (2012–2017)

MORU

Posted 21/05/2019. Wirichada Pan-ngum and colleagues explore how decreasing trends reflect the achievements of malaria control efforts on the Thai–Myanmar border. However, one of the main challenges facing elimination programs in this low transmission setting is maintaining a strong system for early diagnosis and treatment, even when malaria cases are very close to zero, whilst preventing re-importation of cases.

Biomarkers of post discharge mortality among children with complicated severe acute malnutrition

Biomarkers of post-discharge mortality among children with complicated severe acute malnutrition

KWTRP

Posted 17/05/2019. Undernourished children sustain a high risk of death after discharge from hospital. By examining blood samples taken when children were clinically stable and ready for discharge, Jay Berkley and colleagues found that children who died in the next 60 days had infection-related responses despite following treatment guidelines. Incomplete treatment may underly later mortality.

Intrathecal immunoglobulin for treatment of adult patients with tetanus

Intrathecal Immunoglobulin for treatment of adult patients with tetanus

OUCRU

Posted 15/05/2019. Tetanus antitoxin is a vital component of tetanus treatment. In this clinical trial currently running at OUCRU Ho Chi Minh City, Louise Thwaites and colleagues test whether, in addition to standard intramuscular injection of antitoxin, antitoxin given directly into the central nervous system is beneficial in adult patients with tetanus.

Dynamic prediction of death in patients with tuberculous meningitis

Dynamic prediction of death in patients with tuberculous meningitis

OUCRU

Posted 10/05/2019. Previously, Ronald Geskus and colleagues developed a model based on information at diagnosis that provides mortality risk prediction for patients with tuberculosis meningitis. Prediction improves when we use time-updated Glasgow coma score and plasma sodium collected during the disease course. Our model and accompanying app help define patients with poor prognosis.

Microbiology investigation criteria for reporting objectively micro a framework for the reporting and interpretation of clinical microbiology data

Microbiology Investigation Criteria for Reporting Objectively (MICRO): a framework for the reporting and interpretation of clinical microbiology data

MORU

Posted 07/05/2019. Developed by Paul Turner and fellow members of the Oxford Tropical Network, the MICRO framework provides the scientific community with clear guidance on reporting and interpretation of clinical microbiology and antimicrobial resistance (AMR) data. Use of the framework will result in publication of better quality data for use in the global fight against AMR. The MICRO guideline is also posted on the EQUATOR website www.equator-network.org/reporting-guidelines

Three phylogenetic groups have driven the recent population expansion of cryptococcus neoformans

Three phylogenetic groups have driven the recent population expansion of Cryptococcus neoformans

OUCRU

Posted 03/05/2019. Jeremy Day and colleagues sequenced the genomes of 699 Cryptococcus neoformans isolates from meningitis patients from southeast Asia and Africa. The phylogenetic structure demonstrates a recent, exponential, population expansion, driven almost entirely by three sub-clades (VNIa-4, VNIa-5 and VNIa-93). Mitochondrial recombination seen in VNIa-5 may be important in its ability to infect immunocompetent people. VNIa-93, previously associated with poorer outcomes, is in fact associated with a significantly reduced risk of death.

Increasing womens leadership in science in ho chi minh city

Increasing women's leadership in science in Ho Chi Minh City

OUCRU

Posted 30/04/2019. The Oxford University Clinical Research Unit in Ho Chi Minh City investigated gender-related issues associated with career progression within a LMIC. Ngo Thi Hoa, Louise Thwaites and colleagues surveyed 120 scientists, the majority Vietnamese. They describe barriers to female career progressions such as caring duties and home environments, as well as the specific initiatives launched to increases female leadership.

Clinical characteristics and outcome of children hospitalized with scrub typhus in an area of endemicity

Clinical characteristics and outcome of children hospitalized with scrub typhus in an area of endemicity

MORU

Posted 25/04/2019. It has been almost 30 years since clinicians from northern Thailand first raised the issue of severe scrub typhus and poor responses to treatment in patients. Tri Wangrangsimakul and colleagues show that paediatric scrub typhus is frequently severe, potentially fatal, and associated with high rates of treatment failure. A lack of awareness leading to delays in treatment may have contributed. Investigating the determinants of treatment failure and raising the awareness of this neglected disease remains a priority.

Human population movement and behavioural patterns in malaria hotspots on the thai2013myanmar border implications for malaria elimination

Human population movement and behavioural patterns in malaria hotspots on the Thai–Myanmar border: implications for malaria elimination

MORU

Posted 23/04/2019. Human population movement can lead to the persistence of malaria along the Thai–Myanmar border. Lisa White, Wirichada Pan-ngum and colleagues show that malaria risk is related to the number of days doing outdoor activities in the dry season, especially trips to Myanmar, to forest areas and overnight trips. Understanding movement patterns is important when considering targeted public health interventions, especially during the elimination phase.

Community engagement social context and coverage of mass anti malarial administration

Community engagement, social context and coverage of mass anti-malarial administration

MORU

Posted 16/04/2019. Lorenz Von Seidlein and colleagues in Thailand, Myanmar, Vietnam, Cambodia, and Laos explored what happens to malaria transmission when all people residing in a village are treated with antimalarials at the same time, whether they are sick or not. They demonstrated that providing the necessary information is important, but building trust between residents and the team providing the antimalarials is most critical for success.

Tetanus

Tetanus

OUCRU

Posted 12/04/2019. Tetanus continues to be a significant problem in many countries. This seminar, written by OUCRU researchers Lam Minh Yen and Louise Thwaites describes the evidence base for tetanus treatment, current vaccination challenges and research questions for the future.

Exploring the space for task shifting to support nursing on neonatal wards in kenyan public hospitals

Exploring the space for task shifting to support nursing on neonatal wards in Kenyan public hospitals

KWTRP

Posted 09/04/2019. An ethnography work on neonatal nursing, led by Jacinta Nzinga in Nairobi, shows that to cope with incredibly high workloads, informal task shifting is already happening where non-clinical tasks are delegated to students, mothers and support staff. However, nurses are anxious about professional boundaries and the added responsibilities of supervising a potential new cadre.

The rise and fall of long latency plasmodium viva

The rise and fall of long-latency Plasmodium vivax

MORU

Posted 05/04/2019. Until World War II the only Plasmodium vivax malaria generally recognised had either a long (8–9 months) incubation period or a similarly long interval between initial illness and the first relapse. Long-latency P. vivax ‘strains’ were the first in which relapse, drug resistance and liver stage development were described, yet in recent years they have been largely forgotten.

Melioidosis misdiagnosed in nepal

Melioidosis: misdiagnosed in Nepal

OUCRU

Posted 02/04/2019: Underdiagnosed in South Asia, melioidosis is caused by a bacterium called Burkholderia pseudomallei which is often referred to as a remarkable imitator. Pulmonary involvement including infections mimicking tuberculosis is a common form of presentation. In this case report, Buddha Basnyat and colleagues show that if a South Asian patient does not respond to anti tuberculosis treatment, melioidosis should be considered.

How context can impact clinical trials

How context can impact clinical trials

MORU

Posted 29/03/19. This qualitative study documents how clinical interventions are influenced by their local context. Factors like health policies or physicians’ fears of under-treating infectious diseases can influence adherence to the intervention and potentially hamper efforts to reduce antibiotic use in developing countries. The work was led by former CTMGH member Marco J Haenssgen, drawing on clinical trials in Southeast Asia by Yoel Lubell and Heiman Wertheim.

The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in southeast asia

The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia

MORU

Posted 26/03/19. Lorenz Von Seidlein and colleagues wanted to know whether well-resourced mass drug administrations (MDA) can accelerate malaria elimination in the Greater Mekong Subregion. They randomised 16 villages in Myanmar, Vietnam, Cambodia, and Laos to receive MDAs with antimalarial drugs. The intervention had a substantial impact on the prevalence of P. falciparum infections by month 3 after the start of the MDAs. Over the subsequent 9 months, P. falciparum infections returned but stayed below baseline levels.

How can interventions that target forest goers be tailored to accelerate malaria elimination in the greater mekong subregion

How can interventions that target forest-goers be tailored to accelerate malaria elimination in the Greater Mekong Subregion?

Posted 18/03/2019. Tailored interventions that specifically target at-risk populations, such as forest-goers, will be crucial for achieving malaria elimination in Southeast Asia. This review By Tom Peto and colleagues highlights the behaviours and attitudes of forest-goers towards malaria prevention and control interventions to identify what changes can be made to reduce the malaria incidence in this population.

Mortality after inpatient treatment for diarrhea in children

Mortality after inpatient treatment for diarrhea in children

KWTRP

Posted 15/03/2019. There is increasing recognition that children remain at increased risk of death following discharge from hospital in resource-poor settings. Alison Talbert and colleagues found that admission in children aged under 5 years with diarrhoea alone does not increase 12-month post-discharge mortality compared to admission with other conditions excluding severe pneumonia.

Collider bias and the apparent protective effect of g6pd deficiency on cerebral malaria

Collider bias and the apparent protective effect of G6PD deficiency on cerebral malaria

MORU

Posted 12/03/2019. Large case-control studies have reported that glucose-6-phosphate dehydrogenase deficiency exists due to its opposing effects on falciparum malaria: protection against cerebral malaria but an increased propensity to develop severe malarial anaemia. A reanalysis of these claims by James Watson and colleagues shows they are likely explained by 'collider bias', as case definitions excluded patients with both anaemia and coma on presentation.

Sub national variation and inequalities in under five mortality in kenya since 1965

Sub national variation and inequalities in under-five mortality in Kenya since 1965

KWTRP

Posted 08/03/2019. Peter Macharia and colleagues used all available census and survey data in Kenya to evaluate subnational changes in child mortality rates between 1965 and 2015. Although Kenya has made huge gains in reducing child mortality, with a 62% reduction, the success remains uneven with considerable disparity. The study also demonstrates suboptimal performance to meet global milestones in child survival. The results are key in tracking SDG 3.2

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