Research Highlights
Methods for estimating the burden of acute tropical infectious diseases: A scoping review
Posted 12/05/2026. This scoping review synthesised methods used to estimate the burden of acute tropical infectious diseases, particularly neglected tropical diseases. Reviewing 60 studies, Qian and colleagues identified major advances in machine learning and geospatial modelling, while highlighting persistent challenges including underreporting, data sparsity, and methodological uncertainty that limit evidence-based public health decision-making.
Predicting referral need for febrile children in low-resource community settings in South and Southeast Asia
Posted 08/05/2026. A new multi-country study implemented across South and Southeast Asia, led by MORU and MSF, shows that triage tools combining simple clinical assessments with pulse oximetry or a targeted blood test outperform current globally recognised danger signs in identifying febrile children at highest risk, while substantially reducing unnecessary hospital referrals. By Arjun Chandna
A repetitive nucleotide insertion in the rplV gene is associated with in vitro resistance to azithromycin in Rickettsia typhi
Posted 07/05/2026. Weerawat Phuklia and colleagues showed that reduced susceptibility to azithromycin in Rickettsia typhi can be induced under laboratory drug pressure. A small genetic change in a ribosomal protein likely affects how the drug binds. The change was reversible without antibiotic pressure, helping improve laboratory methods for studying antibiotic susceptibility in this bacterium.
Effect of external cephalic version in a resource-limited setting on the Thailand-Myanmar border: a retrospective cohort with propensity score analysis
Posted 06/05/2026. Pregnant women with breech presentation are offered external cephalic version (ECV) to avoid breech birth. Nay Win Tun, Sue Lee and colleagues found no difference in presentation at birth between women who were offered ECV or not. However, successful ECV was associated with significantly better outcomes, highlighting the importance of improving practitioner skill and ECV success rates to maximise clinical benefit.
Plasmodium vivax malaria relapse risk depends on transmission intensity: evidence from a longitudinal study in Northwest Thailand
Posted 05/05/2026. A prospective longitudinal cohort study in Thailand (2010-2014) showed declining incidence (0.19 to 0.09 per person-year) of Plasmodium vivax infections after primaquine radical cure. Primaquine efficacy at 4 months was 75% less than predicted in a previously published taylor-made probability model. This suggests higher doses of 8-aminoquinolines may not be needed in pre-elimination settings. By Cindy Chu
A sustainable house design to improve child health in rural Africa: a cluster-randomized controlled trial
Posted 28/04/2026. Children in Tanzania that lived in novel design houses were less likely to get malaria, diarrhoea and respiratory infections than were those living in conventional homes during a 3-year trial. The two-storey ‘Star Home’ puts bedrooms on the upper floor, where mosquitoes abundance is lower, and the latrine outside to help reduce the spread of diarrhoeal diseases. The design is a proof of concept to demonstrate that research can inform architecture that improves health outcomes. By Lorenz Von Seidlein
Missed at birth: a cross-sectional analysis of national determinants and subnational changes in birth registration coverage in Kenya, using 2014 and 2022 Demographic and Health Survey (DHS) data
Posted 27/04/2026. Bibian Robert, Emelda Okiro and colleagues examine national and subnational trends in birth registration in Kenya using 2014 and 2022 Demographic and Health Surveys data. They identify persistent gaps and key determinants of under-registration, highlighting inequities by geography and socio-economic status, and underscores the need for targeted policies to improve civil registration system coverage and inclusivity.
A four-item risk score to target acute HIV infection testing among men who have sex with men in Indonesia: development and validation in the INTERACT prospective cohort
Posted 23/04/2026. Gilbert Lazarus, Raph Hamers and colleagues developed a simple four-item risk score accurately identified acute HIV infection among Indonesian men who have sex with men. The risk score enables targeted resource-efficient testing for acute HIV infection. Early diagnosis and prompt treatment are critical steps to reduce onward transmission and curb the escalated HIV epidemic among key populations in Indonesia.
Sustaining community-based malaria services through stakeholder engagement: lessons from co-creation in northeastern Thailand
Posted 22/04/2026. This public engagement project explored how active participation by malaria post workers and community members can maintain malaria awareness and elimination advocacy in low-transmission settings. Through iterative stakeholder engagement in northeastern Thailand bordering Laos and Cambodia, Monnaphat Jongdeepaisal and colleagues co-created locally owned health education tools integrating malaria with local health priorities to support a stronger and sustainable community-based health care in the Greater Mekong Subregion.
Mapping the global prevalence and socioecological drivers of child sexual abuse: a systematic review and synthesis
Posted 14/04/2026. Child sexual abuse affects millions of children worldwide yet remains largely underreported. Salum Mshamu and colleagues highlight its global prevalence and key risk factors across individual, family and societal levels. Prompted by field experiences, they explore how child sexual abuse may surface in global health research, helping researchers better recognize and respond during fieldwork.
A mixed-methods evaluation of outreach service provision by the “Strengthening Migrant Access to Reproductive Health in Thailand” Initiative, 2020–2024
Posted 13/04/2026. Beginning in 2020, SMRU set out on something bold. It completely restructured maternal health services to incorporate outreach delivery—meeting migrant women where they are. Through COVID and a coup in Myanmar, this program delivered and offset the structural barriers migrant women face in accessing care. By Rose McGready
African-specific genetic loci determine iron status and risk of severe malaria and bacteremia in African children
Posted 10/04/2026. In a genetic study of nearly 4,000 African children, John Muriuki and colleagues iidentified African-specific variants that regulate iron and are also linked to risk of severe malaria and bacteremia. These findings highlight iron’s role in host–pathogen interactions and call for population-specific research and more targeted, safer public health strategies to address iron deficiency and anemia.
Community perceptions and acceptance of ivermectin for malaria control on Sumba Island, Indonesia
Posted 01/04/2026. This qualitative study led by OUCRU and MORU researchers and local partners, explores community perceptions and acceptance of using ivermectin-treated livestock for malaria control in Sumba, Indonesia. It finds generally positive attitudes, shaped by perceived benefits, trust and local relevance, while highlighting the importance of respectful research interactions and community engagement. By Mary Chambers
The ‘Public’ in Public Involvement: A Call to Centre Frontline Staff Voices in Health Workforce Research
Posted 31/03/2026. Who counts as the “public” for public involvement in health workforce research, and whose voices are missing? In this viewpoint, Yingxi Zhao and colleagues argue that current involvement frameworks overlook frontline staff. They call for broader, more flexible approaches that centre staff experiences to improve relevance, impact, and meaningful involvement in workforce research.
Impact of switching from manual to automated aerobic blood culture on bacteremia diagnosis in Lao PDR
Posted 25/03/2026. At a Lao primary-to-tertiary hospital, automated blood culture processing did not increase growth yield but shortened time to pathogen detection versus manual methods. However, adopting a single bottle reduced blood volume submitted across ages. Monitoring and clinician feedback on volumes may improve practice, though adding extra bottles would double costs. By Risara Jaksuwan
Prevalence, spatial and temporal distribution of tungiasis in the Kilifi Health and Demographic Surveillance System (KHDSS) in Kenya
Posted 24/03/2026. Using geostatistical techniques, Nelson Ouma, Lynne Elson and colleagues found that tungiasis cases in the Kilifi HDSS area are mainly concentrated in the southern regions. They also observed that prevalence changes throughout the year and different households are affected at different times. Factors linked to tungiasis include population density, rainfall, land surface temperature, vegetation cover, altitude, soil aluminium and organic carbon content, as well as the absence of a house floor.
Cohort Profile: the SMRU Refugee and Migrant Pregnancy Study in Western Thailand and Eastern Myanmar
Posted 17/03/2026. The “Shoklo Malaria Research Unit Refugee and Migrant Pregnancy Cohort” established 40 years ago describes outcomes of refugee and migrant pregnancies at the Thailand-Myanmar border. With 94,645 registrations, the evidence has had local and international impact, improving maternal-newborn health practices, and changing the WHO guidelines on malaria treatment during pregnancy. By Rose McGready
“The most stress comes from witnessing the abuse of children” — challenges faced by research assistants in community-based research in Mtwara, Tanzania
Posted 12/03/2026. While conducting fieldwork for a housing study in rural Tanzania, research assistants (RAs) identified several cases of child sexual abuse. This qualitative study explores how RAs encounter situations that can trigger moral distress, particularly when witnessing participant suffering, including cases of child sexual abuse. The nature and extent of these challenges, how RAs navigated moral distress, and potential solutions are discussed in this article. By Salum Mshamu, Bipin Adhikari & colleagues.
Aetiology of acute respiratory infection in Vientiane, Lao PDR, from a case–control study
Posted 10/03/2026. A case–control study in Laos investigated causes and risk factors of hospitalised acute respiratory infections in children under five. Respiratory syncytial virus and H. influenzae were major contributors. Exclusive breastfeeding and pneumococcal vaccination reduced risk, while low birth weight and household smoking increased risk, highlighting priorities for targeted prevention strategies. By Audrey Dubot-Pérès
Tackling the global hypertension crisis
Posted 06/03/2026. Anthony Etyang and colleagues argue that the global hypertension crisis, affecting over 1.4 billion people, with fewer than one in five adequately controlled, is no longer a problem of insufficient evidence but of insufficient implementation. They call for stronger community engagement, equitable access to affordable medicines, and accountability-driven monitoring systems.
Time for change in implementation research and practice
Posted 04/03/2026. Our debate article shows how time is an often scarce resource, an element of resilience and an expression of value while time-bound schedules and routines shape work. Mike English and colleagues argue that implementation research and practice should take account of time’s multiple dimensions that all influence whether interventions are adopted and sustained.
Burden of disease modelling should be grounded in local knowledge
Posted 20/02/2026. Alice Kamau and Emelda Okiro argue that disease estimates, built on sparse data and layered assumptions, risk misleading policy in Africa. Models are useful, but cannot replace local surveillance, validation and context. Public health decisions require investment in primary data systems and genuine engagement with local expertise to ground predictions in reality.
“Poverty is a social issue, not a mathematical problem”: examining the lessons for beneficiary identification from implementation of the UHC indigent program in Kenya
Posted 17/02/2026. Beryl Maritim and colleagues analyse Kenya’s Universal Health Coverage indigent programme, highlighting challenges in identifying poor households for subsidised health insurance. Implementation proved complex, with inconsistent targeting and exclusion of vulnerable groups. The findings stress that poverty is contextual and argue for combining technical tools with locally informed approaches under the new Social Health Insurance framework.
Reimagining primary health care: a historical and contemporary scoping review of community-based primary health care models and innovations
Posted 13/02/2026. Can community-based primary health care survive rapid demographic change, rising chronic diseases, and digital disruption? Drawing on global evidence from 1975–2025, Bipin Adhikari and colleagues show how community health workers transformed access and equity, and why CBPHC must now evolve into an integrated, people-centered, and digitally enabled model to achieve universal health coverage.
Rapid diagnosis of skin and soft tissue melioidosis in children
Posted 11/02/2026. Keang Suy and colleagues evaluate the impact and accuracy of the Active Melioidosis Detect rapid test in children. By focusing on skin and soft tissue cases, this study expands our understanding of paediatric melioidosis, a vulnerable population often overlooked, ensuring they receive the rapid diagnostic attention and tailored clinical care they deserve.
Antimicrobial resistance in bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae (2010–24): a systematic review and meta-analysis
Posted 10/02/2026. Gilbert Lazarus and Raph Hamers analysed antimicrobial resistance in bacterial meningitis, synthesising global data on Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae from 88 studies across 37 countries. Resistance to first-line antibiotics is common and rising in LMICs, threatening effective treatment and progress toward defeating meningitis by 2030. Strengthening syndrome-specific surveillance is critical to keeping treatment guidelines effective.
Laboratory diagnosis of melioidosis
Posted 06/02/2026. Vanaporn Wuthiekanun and colleagues outline current best practices and challenges in the laboratory diagnosis of melioidosis, a frequently underdiagnosed yet life-threatening disease caused by Burkholderia pseudomallei. Drawing on global expertise from endemic and non-endemic regions, the authors highlight the importance of integrating rapid lateral flow assays, PCR, and genomic approaches to improve early detection and global surveillance.
Diaries in global health: a southern perspective
Posted 04/02/2026. Diaries in Global Health: A Southern Perspective traces Bipin Adhikari’s journey from rural Nepal to global health practice, using personal narratives to explore power, inequality, and contemporary global health discourses such as decolonisation. The book calls for epistemic indebtedness and positions Global South scholars as active producers of knowledge in a more humane, pluralistic global health field.
Support for the wellbeing of frontline healthcare workers should be incorporated in health emergency preparedness planning
Posted 03/02/2026. Kate McNeil and colleagues discuss the need to protect and promote frontline healthcare staff wellbeing within everyday practices of health organizations and in planning for health emergencies. They explore challenges facing staff and how crises add to routine stresses facing health systems, and then suggested potential next steps for action.
Spatiotemporal trends in P. falciparum malaria and identification of high-risk villages in Eastern Myanmar: an 8-year observational study
Posted 30/01/2026. Using routine weekly surveillance data from malaria posts in Hpapun Township, Myanmar (2014 - 2021), Jade Rae and colleagues developed a geostatistical model to estimate monthly Plasmodium falciparum incidence and identify villages with persistently higher-than-expected incidence, providing a practical approach for targeting resources and supporting malaria elimination.
Health-economic impacts of age-targeted and sex-targeted Lassa fever vaccination in endemic regions of Nigeria, Guinea, Liberia, and Sierra Leone: a modelling study
Posted 29/01/2026. Deirdre Hollingsworth and colleagues evaluated Lassa fever’s health and economic burden across West Africa and assessed future vaccination strategies. Preventive vaccine campaigns, particularly targeting adolescents and adults, could deliver substantial health and economic benefits once safe vaccines are available, supporting efficient and equitable immunisation planning in endemic regions.
Exploring leprosy perceptions in South Sulawesi, Indonesia: A mixed-methods study on knowledge, attitudes, practices, and stigma
Posted 28/01/2026. This mixed-methods study from Indonesia highlights low leprosy knowledge and persistent stigma driven by misconceptions and cultural beliefs. Stigma hinders care-seeking, social inclusion, and service delivery. Marlous Grijsen and colleagues call for integrated, stigma-sensitive community education, strengthened training for frontline healthcare workers, and sustained political and financial commitment to strengthen leprosy programmes.
Institutional design features of health insurance subsidy programmes in Africa: a narrative review
Posted 27/01/2026. Beryl Maritim and colleagues reviewed the design of 25 health insurance subsidy programmes across 18 African countries. They found that programmes are more effective when eligibility rules clearly and consistently include poor and vulnerable populations, funding is reliable, risks are pooled broadly, benefit packages are comprehensive, and out-of-pocket co-payments are low. Weak design results in uneven coverage and limited financial protection.
Low-dose yellow fever vaccination in infants: a randomised, double-blind, non-inferiority trial
Posted 23/01/2026. George Warimwe and colleagues investigated fractional dosing of yellow fever vaccine in Kenya and Uganda. While 500 IU was effective in adults, new results show it is insufficient in infants. These findings support WHO’s dose-sparing strategy for adults during outbreaks but confirm standard doses are necessary for routine infant immunisation.
One health perspective of antibiotic resistance in enterobacterales from Southeast Asia: a systematic review and meta-analysis
Posted 21/01/2026. Antimicrobial resistance in Enterobacterales remains a critical challenge in Southeast Asia. Yewei Xie, Mo Yin and colleagues synthesised regional data, identifying high resistance burdens across sectors while revealing critical gaps in cross-sectoral surveillance. These findings highlight the urgent need for a standardised regional network to strengthen evidence-informed preparedness and response
Housing modifications for heat adaptation
Posted 20/01/2026. Better housing can lead to better health. Retrofitting of existing housing may be the fastest way and needs the least start up capital but the results are often suboptimal compared to a novel house design. Salum Mshamu, Lorenz von Seidlein, and Jakob Knudsen comment on a recent study of house modification in Kenya in nature medicine.
Developing and integrating physician assistants/associates in UK hospital teams: a realist review of lessons from international experiences
Posted 16/01/2026. Physician associates / assistants (PAs) were introduced into NHS hospitals to help address workforce shortages, but recent controversy exposed concerns about roles, supervision, and professional boundaries. Yingxi Zhao and colleagues reviewed international evidence on how PAs are developed and integrated in hospital teams, offering practical lessons to inform ongoing workforce reforms in the UK.
Teledermatology Exposes a Neglected Endemic: The Hidden Burden of Tinea Imbricata in Eastern Indonesia
Posted 14/01/2026. Tinea imbricata is a severely neglected skin condition that remains under-reported in Indonesia. Through their teledermatology initiative, Marlous Grijsen and colleagues identified six individuals affected by this condition and demonstrated how digital tools can help bridge gaps in access to skin care in remote settings.
Longitudinal patterns of antiretroviral treatment interruptions in a high burden, low-resource setting in South Africa: a retrospective cohort study
Posted 13/1/2026. This analysis of a large South African cohort demonstrated that HIV treatment interruptions were common and recurrent: nearly three-quarters of people disengaged from ART within six years, undermining the impact of antiretroviral programmes. Although most re-engaged, viral suppression remained poor after return, and interruptions were poorly predicted by routine demographic and clinical profiles, highlighting the need for more nuanced targeting of engagement support. By Claire Keene
Tafenoquine lactation pharmacokinetics: a pilot study
Posted 09/01/2026. First report: tafenoquine antimalarial concentrations in breast milk have been measured by Mellie Gilder, Eh Heet and colleagues at Shoklo Malaria Research Unit, an important step to vivax elimination. Details of drug concentrations in foremilk vs. hindmilk, and abundant vs. scarce milk volumes shed new light on the dynamics of lactation pharmacokinetics.
Single-step versus conventional injectable artesunate for severe malaria in children: an open label, non-inferiority randomized clinical trial, Democratic Republic of the Congo and United Republic of Tanzania
Posted 7/1/2026. In the Democratic Republic of the Congo and Tanzania, a randomized clinical trial led by Prof Marie Onyamboko, Dr Samwel Gesase, and Dr Caterina Fanello demonstrated that, in children with severe malaria, one-step injectable artesunate was quicker and cheaper to administer and had equivalent safety and efficacy compared with the conventional formulation.
The underperforming Abbott-Bioline Malaria Ag P.f/P.v rapid diagnostic test: a whiter shade of pale - where the truth is not plain to see
Posted 06/01/2026. Widely used Abbott-Bioline malaria RDTs failed to detect most vivax malaria cases in Myanmar (sensitivity: 0.24). The absence of the positivity colour band was objectively confirmed using ImageJ® image-processing software. Despite clear evidence of poor performance presented since August 2024, neither WHO (ISF) nor Abbott took action, resulting in large-scale, preventable morbidity and mortality. These RDTs should not be used. By Frank Smithuis.
Prospective characterisation of drug-resistant bloodstream infections in Africa and Asia (ACORN2): a surveillance network assessment
Posted 17/12/2025. The burden of antimicrobial resistance (AMR) in many low- and middle-income countries remains largely unknown. The Wellcome-funded ACORN2 study worked with clinical teams in 19 hospitals across Africa and Asia to identify a high incidence of AMR in bloodstream infections caused by global priority bacterial pathogens. By Paul Turner
Assessing the impact of tungiasis on children’s quality of life in Kenya
Posted 16/12/2025. Tungiasis, a neglected tropical skin disease, harms children’s quality of life. Lynne Elson and colleagues found its effects worsened when caregivers were depressed but lessened with caregiver affection. The infection disrupts sleep and provokes sadness and shame, underscoring the importance of psychosocial factors in disease burden and child well‑being.
Access to hypertension services and health-seeking experiences in rural Coastal Kenya: A qualitative study
Posted 12/12/2025. Robinson Oyando, Benjamin Tsofa and colleagues examined barriers to hypertension care in rural coastal Kenya, revealing low awareness, weak patient-provider relationships, medicine shortages, and financial challenges. Many begin treatment late, often after complications arise. These findings highlight the need for patient-centred care and stronger health system capacity to improve hypertension management and outcomes.
Engagement and justice considerations in mitigation of antimicrobial resistance
Posted 10/12/2025. In this paper, Phaik Yeong Cheah and colleagues stressed that mitigation of antimicrobial resistance should include perspectives of communities most affected by it. They also said that multiple dimensions of justice should be considered e.g. procedural justice, distributive justice, reparative justice.
Methods for assessing climate vulnerability in Africa across two decades: a scoping review
Posted 09/12/2025. Effective climate vulnerability assessment helps identify at-risk communities and guide appropriate interventions. Emily Odipo and colleagues reviewed approaches for assessing climate vulnerability in Africa. Their findings highlighted the methodological robustness of existing methods, while emphasizing the importance of choosing models that reflect the unique dynamics and context of the systems being evaluated. Notably, climate vulnerability assessment within the health sector was limited, highlighting a significant research gap.
Inflammation impairs post-hospital discharge growth among children hospitalised with acute illness in sub-Saharan Africa and south Asia
Posted 05/12/2025. Data from the CHAIN Network show that among children hospitalised in sub-Saharan Africa and South Asia, persistent systemic inflammation has a greater role than gut damage or social factors in driving poor post-discharge weight gain and suppresses key growth mediators, helping explain continued growth faltering after discharge from hospital. By James Njunge and Jay Berkley
Guidelines for the treatment of tungiasis
Posted 03/12/2025. Tungiasis, a neglected tropical skin disease, lacked evidence-based treatment until recently. Lynne Elson chaired an expert group that created new PAHO/WHO guidelines. These provide governments in endemic regions with a vital tool to strengthen disease control, marking a significant advance in public health intervention and neglected tropical disease management.
Plasma lipopolysaccharide levels predict mortality in acutely ill children in Low- and Middle-Income Countries
Posted 02/12/2025. Data from the CHAIN Network show that in acutely-ill hospitalised children from sub-Saharan Africa and South Asia, high plasma levels of bacterial Lipopolysaccharide (LPS) at admission, independently of malnutrition, predict 90-day mortality, linking microbial translocation and systemic inflammation to death risk. By Jay Berkley