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Monkeypox Virus Infection in 2 Female Travelers Returning to Vietnam from Dubai, United Arab Emirates, 2022

OUCRU

Posted 08/02/2023. Dr Anh used metagenomics to whole-genome sequence monkeypox virus in 2 women with mpox returning to Vietnam from the United Arab Emirates. The viruses belonged to an emerging sublineage, A.2.1, distinct from B.1 which is responsible for the ongoing multicountry outbreak. Enhanced genomic surveillance is needed to clarify pathogen evolution.

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

MORU

Posted 07/02/2023. Rachel Greer and team in Chiangrai, Thailand found that the challenges research participants face in their daily lives, such as, language barriers and limited access to healthcare can influence their experiences of taking part in research. Researchers need to be responsive towards these specific vulnerabilities in order to reduce the burdens and maximize the benefits of research for participants.

Flexible resources and experiences of racism among a multi-ethnic adolescent population in Aotearoa, New Zealand: an intersectional analysis of health and socioeconomic inequities using survey data

OUCRU

Posted 03/02/2023. As societies become increasingly diverse, understanding the complex nature of racism for multiple ethnic, social, and economic identities is required. Sonia Lewycka and colleagues in New Zealand showed that indigenous and minority experiences of racism are heterogeneous, and flexible resources such as wealth and perceived whiteness can mitigate against some forms of systemic and interpersonal racism.

A global core outcome measurement set for snakebite clinical trials

KWTRP

Posted 24/01/2023. Snakebite is a priority NTD that causes 94,000 deaths each year and many more cases of severe disability. In research led by PhD student Michael Abouyannis at KWTRP and LSTM, global academics, policy makers, and the Kilifi snakebite patient group developed a globally relevant set of core outcome measures to support future clinical trials.

After sharing how we do research, build teams, transfer know-how and build research careers and systems, what next?

NDM-CGHR

Posted 17/01/2023. PLOS Global Public Health features a blog on The Global Health Network Conference 2022 that took place at the University of Cape Town, South Africa from 24 – 25 November 2022. The theme of the conference was Enabling Health Research in Every Healthcare Setting and 10 Years of addressing inequity in where research happens, who leads and who benefits. There were almost 900 abstract submissions and researchers, clinicians, practitioners, donors, and policymakers from across the world attended.

How does power shape district health management team responsiveness to public feedback in low- and middle-income countries: an interpretive synthesis

KWTRP NDM-CGHR

Posted 13/01/2023. Nancy Kagwanja and colleagues highlight the influence of social norms, structures, and actor power practices on responsiveness. Power practices were rooted in actors’ lived experiences which included social and organizational power relationships, personal characteristics, and worldviews. Our findings emphasize the need to consider actors’ lived experiences when intervening to strengthen responsiveness.

Screening for monkeypox virus infections in men who have sex with men in a sexual health clinic in Hanoi, Viet Nam

OUCRU

Posted 11/01/2023. A collaborative work between the Hanoi Medical University, UCLA, and OUCRU, showed no evidence of circulation of monkeypox virus among men who have sex with men attending a sexual health clinic in Hanoi, Vietnam in 2022. So far, the single case of monkeypox described in Vietnam was imported. By Thomas Kesteman

Louis Pasteur, COVID-19, and the social challenges of epidemics

MORU

Posted 23/12/2022. December 2022 sees two notable anniversaries: the 200th anniversary of the birth of Louis Pasteur and the third anniversary of China's announcement of the COVID-19 outbreak. On these coinciding events, Phaik Yeong Cheah and colleagues reflect on past and current global challenges to bring epidemics under control.

The wrongful indictment of pre-referral rectal artesunate further delays the roll-out of this lifesaving drug

MORU

Posted 22/12/2022. On Jan 27, 2022, WHO recommended a moratorium on the deployment of rectal artesunate suppositories for severe malaria and in doing so stopped the roll-out of a lifesaving intervention. The decision is based on data from a large demonstration project CARAMAL. Lorenz von Seidlein discusses the project and its consequences with two leaders of the project in a point- counterpoint published in the Lancet infectious Diseases.

Kinetics of Neutralizing Antibodies against Omicron Variant in Vietnamese Healthcare Workers after Primary Immunization with ChAdOx1-S and Booster Immunization with BNT162b2

OUCRU

Posted 20/12/2022. Tan and colleagues showed that booster vaccination by BNT162b2 induced cross-neutralizing activities against Omicron variant sub-lineages BA.1 and BA.2 in Vietnamese health care workers completing primary immunization with ChAdOx1-S. These responses however significantly reduced at month 3 post booster doses. The need for a second booster merits further research.

Technical evaluation and usability of a quantitative G6PD POC test in cord blood: a mixed-methods study in a low-resource setting

MORU SMRU

Posted 20/12/2022. G6PD deficiency is a major risk factor for severe neonatal jaundice among neonates born at the Thailand-Myanmar border. Early identification of G6PD deficiency can dramatically improve clinical care. In this study Germana Bancone and colleagues showed that a new point-of-care quantitative G6PD test used by trained midwives can reliably identify neonates with abnormal G6PD at birth.

Village malaria workers for the community-based management of vivax malaria

MORU

Posted 16/12/2022. Radical cure of vivax malaria with primaquine requires testing for glucose-6-phosphate dehydrogenase deficiency, which is currently not provided at the community level in Cambodia. In this article, Bipin Adhikari and colleagues describe the core components needed for implementing radical cure at the community, which will increase coverage important for rapid vivax malaria elimination.

Malaria outbreak in Laos driven by a selective sweep for Plasmodium falciparum kelch13 R539T mutants: a genetic epidemiology analysis

LOMWRU MORU

Posted 14/12/2022. Malaria outbreaks can be driven by genetic selection rather than environmental or behavioural causes. Varanya Wasakul, Olivo Miotto and colleagues investigated a Plasmodium falciparum outbreak in Attapeu, Laos, in 2020-2021, using genomic epidemiology methods to elucidate parasite population dynamics, identify the outbreak’s causes and reconstruct the origin of the circulating strains.

Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens

KWTRP

Posted 13/12/2022. Pregnant women in sub-Saharan Africa experience the highest levels of maternal mortality and stillbirths due to predominantly avoidable causes. However, Antenatal care (ANC) can prevent, detect, alleviate, or manage these causes. To inform planning, Peter Macharia and colleagues modelled ANC4+ coverage stratified by household wealth, maternal education, and spatial access to healthcare in East Africa.

Genomic epidemiology, antimicrobial resistance and virulence factors of Enterobacter cloacae complex causing potential community-onset bloodstream infections in a tertiary care hospital of Nepal

OUCRU OUCRU-Nepal

Posted 09/12/2022. Community-onset bloodstream infections caused by multidrug resistant Enterobacter cloacae complex (ECC) species are increasing, underscoring their potential emerging role. This study by Abhilasha Karkey and colleagues elucidated detailed genomic epidemiology of ECC isolates showing complex transmission dynamics within the community. Genomic evidence of resistance to several major antimicrobial classes including carbapenems was detected.

Antibody Responses and Reactogenicity of a Heterologous, Full-Dose Messenger RNA-1273 Booster in Heavily SARS-CoV-2–Exposed CoronaVac-Vaccinated Health-Care Workers in Indonesia: A Real-World Observational Study

EOCRU OUCRU

Posted 07/12/2022. In this real-world cohort study in Indonesia, Raph Hamers and colleagues found high antibody responses and good tolerability of a heterologous, full-dose mRNA-1273 (Moderna) booster after two doses of inactivated vaccine (CoronaVac) in healthcare workers in Indonesia, with and without previous SARS-CoV-2 infection, including in those who had very low antibody levels.

Orientia tsutsugamushi in Chiggers and Small Mammals in Laos

LOMWRU MORU

Posted 06/12/2011. Scrub typhus is an important cause of febrile illness in Laos. Ivo Elliott and colleagues collected, identified and tested small mammals hosts and vector chigger mites for Orientia tsutsugamushi, the causative pathogen. A single pool of chiggers tested PCR positive and 16/52 (31%) of small mammals were seropositive. These are the first molecular and serological data on O. tsutsugamushi in vectors and non-human hosts from Laos.

Moderate and transient impact of antibiotic use on the gut microbiota in a rural Vietnamese cohort

OUCRU

Posted 02/12/22. PhD research from Vu Thi Ngoc Bich at OUCRU Hanoi (with NIHE, Radboud and Maastricht University) on samples from our longitudinal community cohort in Ha Nam, Vietnam, shows that frequent antibiotic exposure may push microbiota to different steady state that is less diverse but more resilient to disruption by subsequent antibiotic use.

Pregnancy outcomes after first-trimester treatment with artemisinin derivatives versus non-artemisinin antimalarials: a systematic review and individual patient data meta-analysis

MORU NDM-CGHR SMRU

Posted 29/11/22. Makoto Saito and colleagues evaluated the fetal safety of antimalarials in the first trimester of pregnancy. Pregnant women who were treated with artemisinin-based combination therapy (ACT) in the first trimester had fewer fetal losses and congenital anomalies than quinine-treated women. Updated WHO guidelines recommend ACT, particularly artemether-lumefantrine, for all trimesters.

Ownership of individual-level health data, data sharing, and data governance

MORU

Posted 22/11/2022. Who owns individual-level health data collected from health research and clinical care? In this paper Phaik Yeong Cheah and Jan Piasecki argues that neither public ownership nor private ownership will allow us to resolve all the problems associated with effective, equitable, and ethical use of data.

Balancing uncertainty and proactivity in care seeking for hepatitis C: qualitative research with participants enrolled in a treatment trial in Ho Chi Minh City, Vietnam

OUCRU

Posted 16/11/2022. In this qualitative study, Jennifer Van Nuil and colleagues explored care seeking and treatment experiences for participants enrolled in hepatitis C clinical trials in Ho Chi Minh City, Vietnam. They found that experiences included the following themes: navigating uncertainty, proactivity in the face of challenges, living in fear with faith, and dynamic support systems.

Improving in-patient neonatal data quality as a pre-requisite for monitoring and improving quality of care at scale: A multisite retrospective cohort study in Kenya

KWTRP NDM-CGHR

Posted 11/11/2022. In this study, Timothy Tuti and colleagues discuss the characteristics of a neonatal inpatient dataset from a network of Kenyan hospitals that allows for exploration of trends in performance and could support better impact evaluation, exploration of links between health system inputs and outcomes, and scrutiny of variation in quality of hospital care.

Evaluating the effects of supplementing ward nurses on quality of newborn care in Kenyan neonatal units: protocol for a prospective workforce intervention study

NDM-CGHR

Posted 09/11/2022. Abdul Imam and colleagues studied the effect on the quality of patient care of prospectively adding extra nursing staff to newborn units in a resource constrained LMIC setting in Kenya and described the relationship between staffing and quality of care.

Cardiovascular Concentration-Effect Relationships of Amodiaquine and its Metabolite Desethylamodiaquine: Clinical and Pre-clinical Studies

MORU

Posted 21/10/2022. Amodiaquine is an important antimalarial widely used for the treatment and prevention of malaria, protecting millions of African children every year. Xin Hui Chan and colleagues characterised the concentration-dependency of the bradycardic, hypotensive, and QT-prolonging effects of amodiaquine and its active metabolite desethylamodiaquine in clinical and pre-clinical studies, providing evidence of their causal role.

Trust is the common denominator for COVID-19 vaccine acceptance: A literature review

MORU

Posted 18/10/2022. Trust is perhaps the most frequently attributed element in decision making for vaccine uptake. But what is trust, and how does it affect vaccine decision? In this qualitative review, Bipin Adhikari and colleagues explored how decisions on vaccine uptake are made, the role of trust and ways to build it.

Glucose 6 Phosphate Dehydrogenase (G6PD) quantitation using biosensors at the point of first contact: a mixed method study in Cambodia

MORU

Posted 07/10/2022. G6PD measurement is critical before including primaquine or tafenoquine in the treatment for vivax malaria. Bipin Adhikari and colleagues explored whether first line health care providers can safely handle G6PD biosensors in the rural Cambodia. Our findings suggest that the radical cure for vivax malaria can be safely administered at the point of first contact, thus preventing relapse and continued transmission in a much larger population than through hospital based management.

Barriers to Quality Perioperative Care Delivery in Low- and Middle-Income Countries: A Qualitative Rapid Appraisal Study

MORU

Posted 05/10/2022. Sutharshan Vengadasalam, Timo Tolppa and colleagues employed pathway mapping, ethnography, and interviews in Colombia, South Africa, Sri Lanka, Tanzania and Uganda, and found four common barriers to the delivery of quality perioperative care - Fragmented care pathways, limited human and structural resources, direct and indirect costs, and patients' low expectations of care.

A modified Sequential Organ Failure Assessment score for dengue: development, evaluation and proposal for use in clinical trials

OUCRU

Posted 27/09/2022. In this study, Sophie Yacoub and colleagues at OUCRU evaluated whether using a dynamic delta modified SOFA score might be a feasible endpoint for future therapeutic trials in dengue. They found that the delta mSOFA performed well, and was associated with requirement for organ support, duration of treatment and mortality.

Combining school-catchment area models with geostatistical models for analysing school survey data from low-resource settings: Inferential benefits and limitations

KWTRP

Posted 23/09/2022. Peter Macharia and colleagues propose a geostatistical modelling framework that accounts for the uncertainty in the residence location of students from school-based infection sample surveys when only school location data are available. The proposed framework offers inferential benefits by leveraging spatial access and school catchment models to improve standard geostatistical approaches.

Ethical considerations in deploying triple artemisinin-based combination therapies for malaria: An analysis of stakeholders’ perspectives in Burkina Faso and Nigeria

MORU

Posted 21/09/2022. Phaik Yeong Cheah and colleagues asked malaria stakeholders in Burkina Faso and Nigeria: What are the key ethical considerations to be considered in the deployment of Triple Artemisinin-based Combination Therapies for malaria in Africa when artemisinin combination therapies are effective in most of Africa?

Outdoor residual spraying for malaria vector-control in Kayin (Karen) state, Myanmar: A cluster randomized controlled trial

MORU SMRU

Posted 14/09/2022. Victor Chaumeau and colleagues evaluated the efficacy of outdoor residual spraying for malaria vector control on the Thailand-Myanmar border. Intervention was showed to rapidly interrupt transmission in a setting where the vectors bite mostly outdoors and at a time when people are not protected by mosquito bed nets.

The quality of veterinary medicines and their implications for One Health

MORU NDM-CGHR

Posted 31/08/2022. Substandard and falsified anti-infectives used in human and animals are common, especially in Low- and Middle-Income countries, leading to poor clinical outcomes, adverse drug reactions, economic losses, mistrust in health systems and potentially leading to AMR emergence and spread. One Health research is needed to assess their impact on AMR, by Celine Caillet and colleagues.

A family cluster of cutaneous Leishmania major infection unresponsive to intralesional meglumine antimonial: Case reports

MORU

Posted 12/08/2022. This small series describes four family members who contracted cutaneous leishmaniasis due to Leishmania major that did not improve in two patients and worsened in the other two despite 4 weeks of intralesional meglumine antimoniate. All responded to a 4-week course of oral ketoconazole. The paper provides an interesting discussion, by Bob Taylor and colleagues

Perioperative Care Pathways in Low- and Lower-Middle-Income Countries: Systematic Review and Narrative Synthesis

MORU

Posted 09/08/2022. Timo Tolppa and CCAA colleagues reviewed the literature on perioperative care pathways in resource-poor settings and found that pathways are increasingly used there with an aim to improve care quality. Patient and clinician beliefs were a major challenge in care pathway implementation, whereas facilitators included context-relevant adaptations, strong evidence-base and teamwork.

Pandemic preparedness and responsiveness of research review committees: lessons from review of COVID-19 protocols at KEMRI Wellcome Trust Research Programme in Kenya

KWTRP NDM-CGHR

Posted 05/08/2022. During a rapidly unfolding catastrophic pandemic, research is most needed to inform on nature, containment and prevention of the pandemic. Ethics review and regulatory authorities are important gatekeepers for research, and can facilitate scientifically rigorous and ethically sound relevant research. Alex Hinga, Dorcas Kamuya and colleagues examined how research review was undertaken during COVID19 in one of the review systems in Kenya, factors that enabled and/or hindered accelerated review including the political landscape, and make some recommendations for review systems in LMICs.

Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities

KWTRP NDM-CGHR

Posted 03/08/2022. Naomi Muinga and colleagues report on a process of implementing a co-designed, paper-based newborn monitoring chart in a network of hospitals in Kenya. While the chart was well-received, challenges with full uptake persist and offer opportunities to strengthen the process as well as future implementations.

Improving the diagnosis of severe malaria in African children using platelet counts and plasma PfHRP2 concentrations

MORU

Posted 02/08/2022. Severe malaria is difficult to diagnose in high malaria transmission areas because of the high coincidence of malaria with other febrile illnesses. James Watson and colleagues analysed platelet counts and plasma PfHRP2 concentrations from >2000 severely ill children and show that around a third of children diagnosed with severe malaria have in fact another cause of illness.

Phagocytosis of Plasmodium falciparum ring-stage parasites predicts protection against malaria

KWTRP

Posted 29/07/2022. Ring-stages are the predominant parasite forms detected in the blood of humans infected with Plasmodium falciparum. Fauzia Musasia, Faith Osier and colleagues found that their active destruction through antibody-dependent phagocytosis predicted how well individuals responded to an experimental malaria infection. Targeting ring-stages may limit exponential parasite multiplication and prevent the progression to clinical malaria

Decentralised hepatitis C testing and treatment in rural Cambodia: evaluation of a simplified service model integrated in an existing public health system

MORU

Posted 28/07/2022. Meiwen Zhang and Tom Peto start a prevalence survey, including Hepatitis B and Hepatitis C, among the rural population in Bangladesh, Cambodia, and Thailand. In 2021 Meiwen and colleagues published a pilot implementation project on hepatitis C testing and treatment in rural Cambodia.

“Like a wake-up call for humankind”: Views, challenges, and coping strategies related to public health measures during the first COVID-19 lockdown in Thailand

MORU

Posted 26/07/2022. In this paper, Phaik Yeong Cheah and colleagues describe the challenges and coping strategies related to public health measures during the first COVID-19 lockdown in Thailand. Major challenges identified included financial hardship, social isolation and loneliness. Coping strategies included turning to religion, practicing acceptance and ‘making merit’ (Tham-bun in Thai).

The European & Developing Countries Clinical Trials Partnership (EDCTP) Knowledge Hub: developing an open platform for facilitating high-quality clinical research

NDM-CGHR

Posted 22/07/2022. In recognition of emergent data on what the barriers and enablers are to long-term, sustainable capabilities to run studies, The Global Health Network and EDCTP developed the ‘EDCTP Knowledge Hub’: a set of online, open access, cross-cutting tools and resources to support the planning, writing and delivery of high-quality health research studies, available to research staff wherever they are in the world, especially those in low-resource settings. By Samuel Driver and colleagues

Impact of delayed processing of positive blood cultures on organism detection: a prospective multi-centre study

COMRU LOMWRU MORU

Posted 19/07/2022. What effect temperature and time have on organism detection from positive blood culture bottles is unknown. Tamalee Roberts, Arjun Chandna and colleagues found that the majority of organisms were recoverable from positive blood culture bottles stored at room temperature. Amies transport swabs also proved effective for transporting blood culture broth and preserving organism viability.

High burden of childhood tuberculosis in migrants: a retrospective cohort study from the Thailand–Myanmar border

MORU SMRU

Posted 14/07/2022. Children bear a substantial burden of TB disease on the Thai-Myanmar border. Treatment success rate exceeded the WHO End TB target of 90%, suggesting that similar vulnerable populations could benefit from the enhanced support of the residential TB program offered by Francois Nosten and colleagues. However better child-friendly diagnostics are needed to improve the detection of TB in children.

A scoping review of antibiotic use practices and drivers of inappropriate antibiotic use in animal farms in WHO Southeast Asia region

NDM-CGHR

Posted 13/07/2022. Many of the antibiotics used in animal farms in Southeast Asia are critically important for humans. The scarcity of standardised antibiotic and livestock quantification methods limits existing literature. Ease of access to poorly regulate antibiotics, inaccessible quality animal healthcare, and insufficient preventive services likely drive inappropriate antibiotic use, by Aronrag Meeyai and colleagues.

African Plasmodium vivax malaria improbably rare or benign

EOCRU OUCRU

Posted 08/07/2022. We have long believed most of sub-Saharan Africa to be free of Plasmodium vivax malaria due to the dominance of Duffy blood factor negativity. Recent work nonetheless reveals stable P. vivax transmission across Duffy-negative Africa, very probably causing an infection of deep organs responsible for harm of unrecognized origin. Review by Kevin Baird

Incidence of chikungunya virus infections among Kenyan children with neurological disease, 2014–2018: A cohort study

KWTRP

Posted 06/07/2022. Chikungunya Virus (CHIKV) has been associated with neurological illness in many parts of the world, but there have been no reports of CHIKV-associated neurological illness in Africa. This study by Doris Nyamwaya and George Warimwe reveals that CHIKV infections are relatively more common than cerebral malaria and bacterial meningitis among children hospitalized with neurological disease in coastal Kenya, and systematic surveillance should be an urgent priority.

Tackling typhoid fever burden in south Asia

OUCRU OUCRU-Nepal

Posted 28/06/2022. South Asia is a hub for typhoid fever, a biblical disease in the West. The new conjugate vaccine, which we studied and now implemented by the Nepali government, is very important for the control of typhoid fever. But well-done treatment trials with adequate sample size are also of paramount importance. By Buddha Basnyat

Contribution of genetic factors to high rates of neonatal hyperbilirubinaemia on the Thailand-Myanmar border

MORU SMRU

Posted 22/06/2022. Mutations on the G6PD and UGT1A1 genes play a large role in neonatal jaundice, including the severe forms, among Karen and Burman neonates. Germana Bancone and colleagues show that improved diagnostics are urgently needed and different screening strategies should be considered in populations with a high prevalence of these traits.

Childhood encephalitis in the Greater Mekong region (the SouthEast Asia Encephalitis Project): a multicentre prospective study

LOMWRU MORU

Posted 21/06/2022. The South-East Asia Encephalitis Consortium, coordinated by Institut Pasteur-Paris, published in Lancet Global Health, a large prospective study of childhood encephalitis in Cambodia, Laos, Vietnam and Myanmar. The Lao site was coordinated by LOMWRU/Microbiology Laboratory, Mahosot Hospital. This demonstrated the vital importance of prevention, especially vaccination against Japanese encephalitis, and access to rapid, tiered diagnosis and treatment.

Experience of Kenyan researchers and policy-makers with knowledge translation during COVID-19: a qualitative interview stud

KWTRP

Posted 17/06/2022. Reducing the devastating impact of COVID-19 requires the use of best available evidence to inform responses. Fatuma Guleid, Edwine Barasa and Researchers at the KEMRI-Wellcome Trust carried out knowledge translation (KT) activities to support national COVID-19 policy-making. In the study, we describe our experiences and the impact of KT in responding to public health crises.

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