Research Highlights
Age structure and parity status determination of Afrotropical malaria vectors using MALDI-TOF MS
Posted 15/05/2025. Understanding the age structure of a mosquito populations is the best way to evaluate how well vector control interventions are working. However, age-grading is hard and usually done through complex dissections. Here Marta Maia and colleagues present a method using MALDI-TOF MS exploiting protein changes associated with senescence for age-grading of malaria vectors.
Cutaneous leishmaniasis in Afghanistan
Posted 13/05/2025. Cutaneous leishmaniasis (CL) is a very neglected tropical disease. Afghanistan has an exceptionally high CL burden fueled by war and poverty. This review focuses on the clinical and epidemiological aspects of CL and highlights the need to grow the research culture so evidence can inform policy. By Bob Taylor
How do study participants want to be informed about study results: Findings from a malaria trial in Cambodia, Ethiopia, Pakistan, and Indonesia
Posted 13/05/2025. Patient interest in receiving clinical trial results varies widely across countries, underscoring that one-size-fits-all strategies fall short. This study, embedded in an antimalarial trial, explores locally tailored dissemination approaches shaped by patient preferences and stakeholder input offering essential guidance for ethical result sharing in diverse global health settings. By Bipin Adhikari
Placental and cord blood DNA methylation changes associated with gestational diabetes mellitus in a marginalized population: the untold role of saturated fats
Posted 09/05/2025. First report on DNA-methylation changes associated with saturated fat consumption in the context of gestational diabetes in a disadvantaged population. Rose McGready and colleagues suggest that population-specific nutritional interventions to reduce saturated fats, while promoting healthier oil (sunflower or soyabean) intake in pregnancy could mitigate negative consequences of DNA hypomethylation, improving transgenerational health impacts.
Real-time investigation of a Burkholderia cenocepacia bacteraemia outbreak in a Vietnamese Intensive Care Unit
Posted 07/05/2025. Duy Pham and colleagues at OUCRU investigated a Burkholderia cenocepacia bacteraemia outbreak in Vietnam. Their rapid response was made possible by strong collaboration between scientists and hospital staff. Nosocomial infections caused by this and other overlooked pathogens require global efforts to improve diagnostics, treatment guidelines, and infection control strategies.
Incorporating acute HIV infection screening, same-day diagnosis and antiretroviral treatment into routine services for key populations at sexual health clinics in Indonesia: a baseline analysis of the INTERACT prospective study
Posted 02/05/2025. In the INTERACT study, Raph Hamers and collaborators successfully implemented “test-and-immediately-treat” services for persons with acute HIV infection (AHI) at sexual health clinics in Jakarta and Bali. AHI screening at scale offers the potential for enhanced interventions to achieve the full population benefits of “treat-all” strategies and curb the escalated HIV epidemic among key populations in Indonesia.
Defining the noma research agenda
Posted 30/04/2025. The results from a September 2024 symposium on Defining the Noma Research Agenda at the Swiss Tropical and Public Health Institute has identified research needs and the way forward. The symposium included noma survivors as well as clinical and epidemiological researchers, and follows the WHO’s official recognition of noma as a neglected tropical disease. By Philippe Guerin.
Creating different global health futures: mapping the health research ecosystem and taking decolonial action
Posted 29/04/2025. Decolonisation in global health emphasises the need to challenge and change entrenched power asymmetries and unfair health research practices. Nadia Tagoe, Sassy Molyneux, Caesar Atuire and colleagues have proposed practical decolonial action using a four-step framework and a reflexive tool that can help transform key domains of the global health knowledge ecosystem.
Effect of a novel house design (star home) on indoor malaria mosquito abundance in rural Tanzania: secondary outcomes of an open-label, household, randomised controlled trial
Posted 23/04/2025. A novel screened house design with bedrooms on the second storey reduced indoor mosquito abundance (51% less Anopheles gambiae; 61% less Culex species) and were 0·5°C cooler compared with traditional houses in Mtwara, Tanzania. By Lorenz Von Seidlein
Putting health facilities on the map: a renewed call to create geolocated, comprehensive, updated, openly licensed dataset of health facilities in sub-Saharan African countries
Posted 15/04/2025. Healthcare service provision and planning depend on the availability of a comprehensive health facility database (HFDB) to adequately meet the healthcare needs of a population. However, the availability of HFDBs has remained a big challenge in sub-Saharan Africa (SSA). Peter Macharia and colleagues elaborate historical developments and the current status of HFDBS while describing the steps required and challenges to overcome for harmonized SSA-wide HFDBs.
Call for a fairer approach to authorship in publishing biomedical research
Posted 11/04/2025. Phaik Yeong Cheah and Michael Parker advocate for fairer authorship in collaborative biomedical research to enhance equity and inclusiveness. They highlight how current practices overlook contributors and discuss challenges in authorship decisions, including project size, multidisciplinary complexity, and the varied roles of researchers at different stages.
Longitudinal tracking of healthcare professionals: a methodological scoping review
Posted 09/04/2025. How do health workers move through their careers - and how do we know? A new scoping review led by Yingxi Zhao and colleagues examined 263 studies tracking healthcare professionals over time, exploring how career choices, working conditions and wellbeing are measured. The review highlights the need for stronger, standardised tracking methods to inform workforce planning and better support health worker wellbeing across contexts.
Situational analysis of antibiotic prescriptions in Kenyan neonatal units for antimicrobial stewardship: a retrospective longitudinal study
Posted 08/04/2025. High antibiotic use in Kenyan neonatal units may contribute to antimicrobial resistance. A study of 88,000 neonatal admissions in 22 hospitals found 62.6% received antibiotics at admission, mostly first-line drugs. However, non-first-line use was higher in outborn neonates. Monitoring antibiotic patterns at scale feasible and crucial for assessing antimicrobial stewardship and reducing resistance. With Jalemba Aluvaala and Mike English
Strengthening the paediatric clinical trial ecosystem to better inform policy and programmes
Posted 04/04/2025. The first WHO Global Clinical Trials Forum was convened in November 2023 to develop a shared vision of an effective global clinical trial infrastructure. In this paper, the Paediatric Clinical Trials Working Group shares perspectives, identify challenges, and proposes solutions to strengthen the global paediatric clinical trials ecosystem. By James Berkley
Effects of health system limitations on the use of blood culture and sensitivity testing in Kenyan county hospitals: an interview-based qualitative study using causal loop diagrams
Posted 02/04/2025. Antibiotic resistance is rising in Africa, but blood culture and sensitivity (BCS) testing faces challenges in Kenyan hospitals. A study using a complex systems approach across eight hospitals found that interconnected issues in both demand and supply, including cost, turnaround time, and logistical barriers undermine the use and sustainability of BCS testing at scale; targeted antimicrobial stewardship may offer a viable alternative. By Jacob McKnight & Mike English with KWTRP colleagues.
Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security
Posted 01/04/2025. Medical oxygen is a critical treatment in severe illness, yet global access remains inequitable, especially in low-income countries. The COVID-19 pandemic highlighted these disparities. The Lancet Global Health Commission emphasizes systemic improvements, investments in infrastructure, workforce training, and affordability. Addressing these gaps can save millions of lives and strengthen global health resilience. With Jacquie Oliwa and Mike English as members of this Lancet Commission.
Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
Posted 27/03/2025. The photovoice sub-study in the BOHEMIA clinical trial let participants document their experiences and perceptions of the intervention. Their photos captured trial experiences, MDA effects and overlooked community concerns. This provided insights from participants' perspectives, highlighting issues beyond the study's scope that local health authorities and researchers might have missed. By Truphena Onyango
Validating a web application’s use of genetic distance to determine helminth species boundaries and aid in identification
Posted 26/03/2025. Helminth species identification is challenging due to their diversity. Abigail Hui En Chan, Sompob Saralamba and their team developed ABIapp, a user-friendly R/Shiny application that helps researchers visualize taxonomic boundaries using genetic distance data. With up to 76% accuracy, ABIapp outperforms existing web-based tools, providing a valuable resource for helminth research.
Multiple insecticide resistance in Anopheles funestus from Mopeia, Central Mozambique
Posted 25/03/2025. Malaria vectors in Mopeia, Mozambique were found resistant to all classes of insecticides used in malaria control. New insecticide classes or non-insecticide-based tools are urgently needed. Resistance markers to dieldrin suggest potential selective pressure by agricultural pesticides. Coordinated and rational insecticide usage between health and agriculture sectors is needed. By Marta Maia.
Treatment and treatment outcomes of snakebite envenoming in Uganda: a retrospective analysis
Posted 20/03/2025. Snakebite envenoming is a neglected tropical disease that causes significant morbidity and mortality in rural sub-Saharan Africa. While victims seek emergency care, documentation on their treatment remains limited. Stella Nanyonga and colleagues reviewed snakebite management in Uganda among 532 snakebite victims and found that only 6.9% of patients received snake antivenom.
Comparing HemoCue® and Quantitative Buffy Coat® and Coulter Counter-measured haemoglobin concentrations in African children with acute uncomplicated malaria: a Bland–Altman analysis
Posted 19/03/2025. Malaria studies often involve blood transfusion to severe malarial anaemic children. Accurate Anaemia diagnosis is crucial for effective management. Hence, important to determine the level of agreement among haemoglobin concentrations measurement methods. HemoCue® should be used with caution in settings where decisions about blood transfusions are made. By Mavuto Mukaka
Can solidarity in global health curb the next outbreak? A commentary on mpox
Posted 18/03/2025. Appeals to solidarity are common during disease outbreaks. Yet, what solidarity means and how it is practiced varies across contexts. Caesar Atuire and colleagues bring conceptual clarity by distinguishing between deep and responsive solidarity. They argue that global health needs deep solidarity to curb outbreaks like mpox and to ensure that responsive solidaristic appeals are effective.
Tracing epistemic injustice in global antimicrobial resistance research
Posted 14/03/2025. This commentary explores whether there is epistemic injustice in global antimicrobial resistance (AMR) research – who sets priorities, who produces knowledge, and which types of knowledge are valued. Prof Phaik Yeong Cheah and colleagues argue that epistemic injustice may have created blind spots in policy. Addressing this requires a commitment to diversity, equity, and inclusion.
Submicroscopic malaria in pregnancy and associated adverse pregnancy events: A case-cohort study of 4,352 women on the Thailand–Myanmar border
Posted 11/03/2025. Malaria is known to be dangerous for pregnant women and their developing babies. But how much malaria is too much malaria? Using an ultra-sensitive PCR method that detects one parasite per drop of blood, Mary Ellen Gilder and SMRU colleagues found that even infections with very few parasites are associated with adverse pregnancy outcomes.
Antibiotic duration for common bacterial infections - a systematic review
Posted 07/03/2025. Reducing antibiotic duration is key to antimicrobial stewardship. A review of 315 trials found strong evidence for shorter courses in common infections but limited data for severe infections and low-income settings. Only 15% had low bias risk. More research is needed in critical care and resource-limited environments. By Mo Yin
Challenges associated with dapsone for leprosy treatment in Indonesia - urgent need for access to alternative antimicrobial drugs
Posted 05/03/2025. Marlous Grijsen and colleagues highlight the challenges associated with dapsone for leprosy treatment in Indonesia. Dapsone, a key drug in multi-drug therapy, can cause life-threatening adverse drug reactions, including dapsone hypersensitivity syndrome and hemolytic anemia. Routine screening could prevent these complications, but in many leprosy-endemic areas, testing and alternative regimens are inaccessible or unaffordable. We call for better diagnostics and alternative treatments to ensure safer care.
Cost-effectiveness of a short-course antibiotic treatment strategy for the treatment of ventilator-associated pneumonia: an economic analysis of the REGARD-VAP trial
Posted 04/03/2025. Previously, the REGARD-VAP trial found that giving patients with ventilator-associated pneumonia (VAP) a personalised, shorter antibiotic treatment was just as effective as usual care. Mo Yin and colleagues showed this approach is also cost-effective in Nepal, Singapore, and Thailand. This approach could save money, reduce antibiotic use, and help policymakers make better healthcare decisions despite some uncertainties.
Dose-Optimization of a Novel Co-Formulated Triple Combination Antimalarial Therapy: Artemether-Lumefantrine-Amodiaquine
Posted 18/02/2025. Emerging artemisinin-resistance in Africa threatens our ability to treat malaria. Joel Tarning and colleagues developed an optimal weight-based dosing of a fixed-dose artemether-lumefantrine-amodiaquine formulation using population pharmacokinetic modelling. Dosing was designed to achieve consistent drug exposure across all body weights. This formulation should simplify manufacturing and improve adherence, when treating resistant malaria.
Rethinking neglected tropical diseases: A shift towards more inclusive and equitable terminology
Posted 05/02/2025. Neglected tropical diseases (NTD) affect >1 billion people, disproportionally affecting under-resourced communities. While the term ‘NTD’ has been instrumental in driving critical funding and policy initiatives, it may also carry unintended negative consequences. Marlous Grijsen and colleagues explore the term NTD to foster dialogue and advocate for more inclusive and equitable language.
Catastrophic expenditure associated with childhood hospitalisation for acute illness in Kenya and Uganda: a cross-sectional study
Posted 04/02/2025. In Kenya and Uganda, hospital care for under-fives is intended to be free. James Berkley and colleagues studied families’ healthcare, travel, other costs, and loss of earnings due to child admissions at six hospitals. 74% to 92% of households experienced ‘catastrophic’ expenditure (depending on the definition used) in relation to monthly income.
Detection of low frequency artemisinin resistance mutations, C469Y, P553L and A675V, and fixed antifolate resistance mutations in asymptomatic primary school children in Kenya
Posted 31/01/2025. This is an important finding for Kenya, artemisinin resistance k13 mutations previously identified in Uganda (C469Y and A675V) and SE Asia (P553L) are described. Though at low frequencies, 4%, 1.7% and 1.2%, respectively, they sound the alarm for studies to determine their impact on the efficacy of artemisinin-based combination therapies. By Isabella Oyier
Overcoming research challenges in resource-limited settings: perspectives from Thailand
Posted 29/01/2025. Conducting research in LMICs is undeniably challenging, with brain drain often surpassing reverse brain drain. We share an opinion discussing both the difficulties and rewards of working in this space. Claire Chewapreecha and Thongchai Chewprecha hope it will encourage international and national funding agencies to invest in LMIC talent, and drive meaningful, lasting impact.
After neonatal care, what next? A qualitative study of mothers’ post-discharge experiences after premature birth in Kenya
Posted 28/01/2025. Each year, 15 million babies are born prematurely, with Sub-Saharan Africa and Asia accounting for over half. Weak healthcare systems and poverty in SSA worsen outcomes for mothers and babies. This study by Justinah Maluni and Dorothy Oluoch explores the challenges mothers face post-discharge and suggests strategies to improve care and reduce mortality and readmission rates.
Community responses to a novel house design: A qualitative study of “Star Homes” in Mtwara, southeastern Tanzania
Posted 24/01/2025. Salum Mshamu and colleagues evaluate community responses to novel design homes in Mtwara, Tanzania, aimed at reducing childhood diseases such as malaria, respiratory infections, and diarrhoea. Using qualitative research, the study explores how residents and neighbours interact with the novel housing design including its impact on residents' lives, social, cultural, and health-related issues. The findings offer insights for future community wide novel housing interventions.
Understanding health system responsiveness to public feedback at the sub-national level: Insights from Kilifi County, Kenya
Posted 22/01/2025. Nancy Kagwanja and colleagues examined public feedback in health systems, focusing on its forms, channels, processing, and responses. Feedback mechanisms often operated in isolation, excluding vulnerable groups. Organisational challenges, such as inadequate resources, weak policies and power dynamics limited effectiveness. Integrating diverse mechanisms and addressing system capacities are vital for improved responsiveness.
Acceptability of improved cook stoves-a scoping review of the literature
Posted 21/01/2025. Novel housing interventions (Star Homes) in Tanzania aim to prevent childhood diarrhea, malaria, and respiratory infections by addressing multiple aspects of housing—one of which is cooking stoves. Our research on Star Homes in rural Tanzania revealed inconsistent use of improved cookstoves, sparking a systematic review into factors influencing stove acceptability globally. By Bipin Adhikari
Identification of Southeast Asian Anopheles mosquito species with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry using a cross-correlation approach
Posted 17/01/2025. Victor Chaumeau and colleagues developed a reference MALDI-TOF mass spectra database for the identification of Anopheles mosquitoes from the Thailand-Myanmar border allowing rapid, affordable and accurate identification of medically important vector species, an important prerequisite to assess disease transmission and evaluate vector control. This is the first free open-source data analysis pipeline allowing anyone to replicate the analysis and develop reference database in-house.
Sustainable antimicrobial resistance surveillance: time for a global funding mechanism
Posted 07/01/2025. The continued costs of a standard national AMR surveillance system are predicted to account for over 5% of the total domestic general government health expenditure (GGHE-D) for 28 LMICs and more than 2% of GGHE-D for 46 LMICs. This high cost is not sustainable without a long-term global financing mechanism. By Liz Ashley
AmpC β-lactamases detected in Southeast Asian Escherichia coli and Klebsiella pneumoniae
Posted 20/12/2024. AmpC β-lactamases are a neglected cause of third generation cephalosporin resistance in Southeast Asia. This collaboration between COMRU, LOMWRU and SMRU showed that AmpC β-lactamases are an important cause of infection, though infections may be going undetected due to a lack of testing resulting in sub-optimal treatment for patients. By Tamalee Roberts
Population genomics and transcriptomics of Plasmodium falciparum in Cambodia and Vietnam uncover key components of the artemisinin resistance genetic background
Posted 17/12/2024. Tom Peto and colleagues collected Plasmodium falciparum parasites from malaria patients in Cambodia and Vietnam between 2018 and 2020 in the MORU-led TACT-CV study. Novel molecular analyses of these samples at Nanyang Technological University identified new genetic factors that appear under selective pressure and may contribute to artemisinin resistance mechanisms in clinical settings.
Leprosy
Posted 03/12/2024. This comprehensive review, co-authored by Marlous Grijsen and a multidisciplinary team of global experts from leprosy endemic and non-endemic countries, describes the epidemiology, pathophysiology, clinical manifestations and management of leprosy and the impact it has on quality of life. The paper addresses knowledge gaps and research priorities and offers an up-to-date perspective on leprosy.
A hill tribe community advisory board in Northern Thailand: lessons learned one year on
Posted 22/11/2024. Since 2023 the Chiang Rai community advisory board helped researchers understand the many local ethnic minority groups of Northern Thailand and vice-versa, improving cooperation and research activities. Over time, benefits have grown. Carlo Perrone and colleagues present their experience one year on, supporting long-term partnerships over project-based ones.
Community engagement to develop a dialogue-drama on adolescent pregnancy in a marginalised migrant population on the Thailand-Myanmar border: an ethnographic approach to participatory action research
Posted 20/11/2024. A participatory-action approach involving community members and adolescents resulted in a dialogue-drama (Karen and Burmese versions) on adolescent pregnancy, contraception, and choice in the event of an unplanned pregnancy. The dialogue-drama augmented discussion of traditionally taboo issues and this ethnographic method is potentially useful for similar global health settings. By Rose McGready
Prevalence and risk factors of vitamin D deficiency among Afghan primary school children
Posted 19/11/2024. Bob Taylor and colleagues determined that vitamin D deficiency is exceptionally high, 85%, in 510 5-15 years-old school children from Kandahar city, Afghanistan. Half had severe deficiency. Older children from poor families with limited outdoor activity and inadequate sun exposure were more likely to be deficient. These data provide evidence for a mitigation strategy.
Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic
Posted 13/11/2024. Ruth Lucinde, Anthony Etyang and colleagues conducted a prospective longitudinal hospital-based sentinel surveillance at 16 public hospitals in Kenya during the COVID-19 pandemic to describe the clinical and demographic pattern of patients admitted with severe acute respiratory illness (SARI), and evaluate COVID-19 vaccine effectiveness. They identified key risk factors for mortality and reported a moderate vaccine effectiveness of 59% against progression to inpatient mortality.
Changing epidemiology and antimicrobial susceptibility of bloodstream infections at a Vietnamese infectious diseases hospital (2010–2020)
Posted 24/10/2024. Duy Pham’s lab performed comprehensive epidemiological analysis of bloodstream infections (BSI) in Vietnam (2010-2020), revealing an increasing trend of E. coli and K. pneumoniae as predominant pathogens. Both showed rising multidrug resistance, primarily affecting elderly individuals with comorbidities. Antibiotic prescriptions declined significantly following control policies. Their work highlights the needs for community surveillance and antimicrobial stewardship to manage BSIs in Vietnam.
A nationwide mixed methods study of gaps and barriers to implementation of antimicrobial stewardship programs in hospitals in Indonesia
Posted 23/10/2024. Robert Sinto, Raph Hamers and colleagues conducted a nationwide evaluation of antimicrobial stewardship programmes (ASP) in Indonesian public and private hospitals. They found that to date most hospitals only reached an inadequate or basic level of ASP implementation, and they identified several globally-relevant and context-specific barriers. The paper formulates actions recommended for sustainable improvement.
Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand–Myanmar border
Posted 22/10/2024. Severe neonatal hyperbilirubinaemia is often diagnosed late in low-resources settings because of lack of point-of-care tools. In this study, Germana Bancone and SMRU researchers have evaluated the performance of a transcutaneous bilirubinometer for screening of neonates born along the Thai-Myanmar border. The study was supported by a Wellcome Trust iTPA grant.
Genomic insights unveil the plasmid transfer mechanism and epidemiology of hypervirulent Klebsiella pneumoniae in Vietnam
Posted 22/10/2024. Duy Pham's lab investigated hypervirulent Klebsiella pneumoniae bloodstream infections in Vietnam, uncovering high strain diversity likely driven by horizontal transfer of non-self-transmissible virulence plasmids. Plasmid acquisitions led to the independent emergence of MDR hypervirulent strains. Significant gaps persist in understanding community transmission for targeted interventions, especially in Asia where new strains are emerging.
Artemisinin-resistant malaria
Posted 18/10/2024. Nick White and K. Chotivanich publish a review of mechanisms, genetic associations, phenotyping, epidemiology and current status of artemisinin resistance, and a brief discussion of policies and potential counter-measures.