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A rapid research needs appraisal methodology to identify evidence gaps to inform clinical research priorities in response to outbreaks2014results from the lassa fever pilot

A rapid research needs appraisal methodology to identify evidence gaps to inform clinical research priorities in response to outbreaks

@Oxford

Posted 18/09/2019. A protocol for carrying out a systematic rapid research needs appraisal of existing evidence within five days, to rapidly inform clinical research prioritize in response to emerging outbreaks globally. This protocol was developed and successfully piloted by Louise Sigfrid and colleagues using a fictitious Lassa fever outbreak scenario. The protocol is optimized by effective use of global time-zones.

Investigating causal pathways in severe falciparum malaria

Investigating causal pathways in severe falciparum malaria

MORU

Posted 06/09/2019. A formal causal inference-based analysis of clinical and laboratory data from 9000+ severe falciparum malaria patients from Africa and Asia by James Watson and colleagues suggests that moderate anaemia may be protective against death in severe malaria. The severe anaemia threshold criteria for a definition of severe falciparum malaria should be reconsidered.

Improving the estimation of the global burden of antimicrobial resistant infections

Improving the estimation of the global burden of antimicrobial resistant infections

MORU

Posted 03/09/2019. Estimating the global burden of antimicrobial resistance (AMR) is essential for resource allocation and to inform AMR action plans at national and global levels. Direk Limmathurotsakul and colleagues discuss the underlying assumptions, characteristics, limitations, and comparability of the approaches used to quantify mortality from AMR bacterial infections. We define key actions required and call for innovative thinking and solutions to address these problems.

Spatiotemporal epidemiology environmental correlates and demography of malaria in tak province thailand 201220132015

Spatiotemporal epidemiology, environmental correlates, and demography of malaria in Tak Province, Thailand (2012–2015)

MORU

Posted 23/08/2019. Tak Province in western Thailand is a significant target area to help achieve nationwide malaria elimination by 2024, and in the Greater Mekong Subregion by 2030. Integrating routine surveillance and publicly available data, Chris Mercado and colleagues demonstrated Tak’s big decline in malaria from 2012 to 2015, a likely result of elimination activities as opposed to climate or forest change.

A population dynamic model to project the burden of undiagnosed diabetes in thailand

A population dynamic model to project the burden of undiagnosed diabetes in Thailand

MORU

Posted 20/08/2019. Demographics changes result in rapid transformation of population structure; together with other factors such as urbanization, household size decreasing and seasonal movement could greatly influence the prediction of disease burden. Wirichada Pan-ngum and colleagues demonstrated this trend using a mathematical modelling approach.

Observational study 27 years of severe malaria surveillance in kilifi kenya

Observational study: 27 years of severe malaria surveillance in Kilifi, Kenya

KWTRP

Posted 30/07/2019. Malaria has been falling in Africa over the last few decades. This reduces the number of children with infection, but the lowered exposure to malaria could change the clinical picture. Work in KEMRI-Wellcome Programme shows this leads to more cerebral malaria and in older children, but fortunately no increase in death rates.

Gastroenteritis aggressive versus slow treatment for rehydration trial who plan versus slow rehydration

Gastroenteritis aggressive versus slow treatment for rehydration: trial WHO plan versus slow rehydration

KWTRP

Posted 26/07/2019. Although WHO rehydration management guidelines (Plan C) for severe dehydration are widely practiced in resource-poor settings, they have never formally been tested in a clinical trial, despite poor outcomes (mortality). Kathryn Maitland and colleagues evaluated current recommendations versus a slower rehydration regime in Ugandan/Kenyan with severe dehydration secondary to gastroenteritis. We found the slower regime giving rehydration therapy over 8 hours to be safe. For clinicians it was easier to implement than the two-stage Plan C regime. Time correct signs of dehydration and hospital stay was similar in the two groups. Future large trials with mortality as the primary endpoint are warranted.

A systematic review and meta analysis of patient data from the west africa 2013 16 ebola virus disease epidemic

A systematic review and meta-analysis of patient data from the west Africa (2013-16) Ebola virus disease epidemic

@Oxford

Posted 23/07/2019. Professor Peter Horby and colleagues at the University of Oxford have compiled data from over 6000 patients to provide a comprehensive clinical description of Ebola virus disease. The team also assessed the quality of the published data and found it to be partial, overlapping, and in many instance non-comparable. For high-threat diseases such as Ebola, the authors recommend the establishment of global, anonymised patient registries as a resource for improving patient care.

201cwe are called the et cetera201d experiences of the poor with health financing reforms that target them in kenya

“We are called the et cetera”: experiences of the poor with health financing reforms that target them in Kenya

KWTRP

Posted 19/07/2019. Pro-poor health financing reforms have the potential to improve access to health services among the poor in Kenya. However, Evelyn Kabia and colleagues show that, for these reforms to be effective, they need to be accompanied by interventions that address barriers across other access dimensions such as geographical accessibility, availability, and acceptability of care.

Nutrition in transition historical cohort analysis among pregnant women along the thailand2013myanmar border 1986 2016

Nutrition in transition: historical cohort analysis among pregnant women along the Thailand–Myanmar border 1986 - 2016

MORU

Posted 16/07/2019. Worrying nutritional trends in possibly the longest and largest cohort of nearly 50,000 refugee and migrant pregnant women in a LMIC setting. Ahmar Hashmi and colleagues at SMRU summarise trends in under- and over-nutrition among pregnant women, and show a double burden of malnutrition in these marginalised and vulnerable communities from the Myanmar-Thailand border.

Viruses in vietnamese patients presenting with community acquired sepsis of unknown cause

Viruses in Vietnamese patients presenting with community acquired sepsis of unknown cause

OUCRU

Posted 12/07/2019. Sepsis is a devastating clinical condition. However, the etiology remains unknown in the majority of the patients. Herein, Dr Tan and colleagues set out to apply metagenomic next generation sequencing to look for viral contents in ~400 Vietnamese patients presenting with sepsis of unknown cause.

Antimicrobial resistance in cambodia

Antimicrobial resistance in Cambodia

MORU

Posted 09/07/2019. On behalf of the Cambodian Ministry of Health Technical Working Group on Antimicrobial Resistance, Paul Turner and colleagues at COMRU recently led a review of published data on AMR in Cambodia. Significant AMR was identified in a range of priority pathogens although data were limited. On-going national AMR surveillance will address this data gap.

201ci can2019t read and don2019t understand201d health literacy and health messaging about folic acid for neural tube defect prevention in a migrant population on the myanmar thailand border

“I can’t read and don’t understand”: Health literacy and messaging in a migrant population on the Myanmar-Thailand border

MORU

Posted 05/07/2019. Health information can be life-saving, but how can it be conveyed to those who could benefit most? Through analysis of an unsuccessful public health campaign, Mary Ellen Gilder and SMRU colleagues learned from migrant women valuable lessons about health messaging in communities where most women do not complete the fourth grade.

Optimal duration of follow up antimalarial efficacy in pregnancy on the thailand2013myanmar border

Optimal duration of follow-up antimalarial efficacy in pregnancy on the Thailand–Myanmar border

@Oxford MORU

Posted 02/07/2019. Highly efficacious treatment can limit the cumulative deleterious impact of malaria during pregnancy on the mother and fetus. Correct assessment of treatment efficacy with an adequate length of follow up is required. Makoto Saito and colleagues at the Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border suggest that pregnant women need to be followed up longer than the currently recommended duration of follow-up to assess antimalarial drug efficacy.

Serum procalcitonin levels in children with clinical syndromes for targeting antibiotic use at an emergency department of a kenyan hospital

Serum procalcitonin levels in children with clinical syndromes for targeting antibiotic use at an emergency department of a Kenyan hospital

KWTRP

Posted 28/06/2019. Children with severe disease seen at an outpatient department of Kenyan hospital often have elevated procalcitonin, a biomarker for bacterial infection. Samuel Akech and colleagues show that it’s still premature to recommend the use of procalcitonin to guide antibiotic administration unless clinical trials investigating the use of procalcitonin levels to guide antibiotic treatment are done.

Managing health research capacity strengthening consortia

Managing health research capacity strengthening consortia

KWTRP

Posted 25/01/2019. As investments in health research capacity strengthening (HRCS) consortia increase, it is essential to consider the role of management approaches used. Nadia Tagoe and colleagues present current evidence and discourse on HRCS consortium management, and show that it is critical to pay attention to both relational and operational aspects of consortia to achieve desired outcomes.

Prevalence intensity and risk factors of tungiasis in kilifi county kenya ii results from a school based observational study

Prevalence, intensity and risk factors of tungiasis in Kilifi County, Kenya II: Results from a school-based observational study

KWTRP

Posted 21/06/2019: Neglected tropical skin disease caused by sand fleas (tungiasis) inflicts misery on millions of children across the Tropics. Lynne Elson and colleagues show that tungiasis could be controlled through strengthening hygiene practices and sealing house and school floor

2018antibiotic footprint2019 as a communication tool to aid reduction of antibiotic consumption

‘Antibiotic footprint’ as a communication tool to aid reduction of antibiotic consumption

MORU

Posted 18/06/2019. How should we communicate to the public the magnitude of antibiotic use in humans and animals? Led by Direk Limmathurotsakul, our scientists and global partners propose the concept of ‘antibiotic footprint’. It could support individual, national and global actions against superbugs as 'carbon footprint' has done for climate change

Missed nursing care in newborn units a cross sectional direct observational study

Missed nursing care in newborn units: a cross-sectional direct observational study

KWTRP

Posted 14/06/2019. Insufficient nurses caring for sick babies on hospitals’ neonatal units in Kenya seriously undermine efforts to deliver high quality, safe care and make reducing neonatal mortality rates very difficult. Led by David Gathara, the Kenyan and Oxford team conducted the first ever direct observational study of which tasks nurses were able to perform and quantified how much care is missed. Previous work on missed nursing care largely conducted in rich countries has relied on questionnaires so this new work is an important advance.

Novel approaches to control malaria in forested areas of southeast asia

Novel approaches to control malaria in forested areas of Southeast Asia

MORU

Posted 11/06/2019. Remaining foci of malaria transmission are often in forests, where vectors tend to bite during daytime and outdoors thus reducing the effectiveness of insecticide treated bednets. Limited periods of exposure suggest that chemoprophylaxis could be a promising strategy to protect forest workers against malaria. Lorenz Von Seidlein and colleagues discuss which antimalarial drug regimens are most appropriate, how frequently the chemoprophylaxis should be delivered, and how to motivate forest workers to use and adhere to malaria prophylaxis.

The affordability of antimicrobials for animals and humans at retail in vietnam a call for revising pricing policies

The affordability of antimicrobials for animals and humans at retail in Vietnam: A call for revising pricing policies

OUCRU

Posted 07/06/2019. Juan Carrique-Mas and colleagues quantified the retail prices of the most common antimicrobials used in chicken farms in Vietnam. By comparing these costs with antibiotics for human use, they conclude that extreme low prices of antimicrobials for animal production may be a major factor driving excessive use. The authors advocate for a taxing system that restricts the use of critically important antimicrobials in agriculture.

Malaria morbidity and mortality following introduction of a universal policy of artemisinin based treatment for malaria in papua indonesia

Malaria morbidity and mortality following introduction of a universal policy of artemisinin-based treatment for malaria in Papua, Indonesia

MORU

Posted 04/06/2019. In Papua, where multidrug resistant P. falciparum and P. vivax are coendemic, the introduction of a universal policy of ACT plus IV artesunate for all patients with malaria halved hospital admissions and malarial deaths. However the reduction in P. vivax was far less than that for P. falciparum. This study by Ric Price and colleagues emphasizes the need for better drug regimens to clear the liver stages of P. vivax.

Antimicrobial resistant gram negative colonization in infants from a neonatal intensive care unit in thailand

Antimicrobial-resistant Gram-negative colonization in infants from a neonatal intensive care unit in Thailand

MORU

Posted 31/05/2019. Drug-resistant infections caused by Enterobacteriaceae, a family of Gram-negative bacteria, account for a high and increasing disease burden amongst hospitalised neonates in Southeast Asia; carbapenem-resistant strains are particularly important because of limited antibiotic treatment options. Tamalee Roberts and colleagues found that nearly two thirds of infants in a neonatal unit in Thailand became asymptomatic carriers with carbapenem-resistant Enterobacteriaceae during their hospital stays. This work indicates a critical need for interventions to reduce this usually hidden reservoir of drug-resistant bacteria.

Essential guidance on malaria elimination in its history

Essential guidance on malaria elimination in its history

OUCRU

Posted 28/05/2019. Kevin Baird calls attention to the importance of local expertise in anopheline mosquito ecology as an essential weapon in striving to eliminate malaria. Slight but very specific modifications to environments that disfavour those mosquitoes achieved very significant gains before the advent of DDT insecticide and synthetic antimalarial commodities in the middle of the 20th century. Loss of those commodities, and a lack of alternative strategies, led to the great malaria resurgence of the latter 20th century.

Sustaining pneumococcal vaccination after transitioning from gavi support a modelling and cost effectiveness study in kenya

Sustaining pneumococcal vaccination after transitioning from Gavi support: a modelling and cost-effectiveness study in Kenya

KWTRP

Posted 24/05/2019. As low-income countries’ economies grow and financial support from Gavi (the Vaccine Alliance) diminishes, governments need to consider the value of continuing previously-subsidized vaccine programmes at full cost. Anthony Scott and colleagues assess the incremental cost-effectiveness of continuing pneumococcal vaccination use between 2022 and 2032, and found the programme to be highly cost effective.

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?

MORU

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

Optimal dosing of dihydroartemisinin piperaquine for seasonal malaria chemoprevention in young children

Optimal dosing of dihydroartemisinin-piperaquine for seasonal malaria chemoprevention in young children

MORU

Posted 05/03/2019. Seasonal malaria is common in the Sahel, resulting in malaria-related morbidity and mortality, particularly in young children. Seasonal chemoprevention with the antimalarial drug dihydroartemisinin-piperaquine is effective and safe. However, results presented here by Palang Chotsiri and colleagues show that malaria incidence could be reduced substantially by using an increased and extended dosage in young children.

International biological reference preparations for epidemic infectious diseases

International biological reference preparations for epidemic infectious diseases

@Oxford

Posted 01/03/2019. Peter Horby and colleagues highlight the essential importance of standardised biological reference materials (such as antibodies) for the development of new diagnostic tests, treatments and vaccines, yet their widespread absence for dangerous diseases such as viral haemorrhagic fevers. They suggest a framework for developing these materials that addresses practical as well as ethical and equity issues

Tafenoquine versus primaquine to prevent relapse of plasmodium vivax malaria

Tafenoquine versus Primaquine to Prevent Relapse of Plasmodium vivax Malaria

MORU

Posted 26/02/2019. In this multi-center randomized controlled trial, Cindy Chu and colleagues assess the safety of a single dose tafenoquine for Plasmodium vivax radical cure. With appropriate G6PD testing, the number of adverse events, frequency and severity of haemoglobin reduction are similar to primaquine. Anti-relapse efficacy of tafenoquine is similar to primaquine; 69.1% vs 73.2%, respectively.

Molecular characterization and mapping of g6pd mutations in the greater mekong subregion

Molecular characterization and mapping of G6PD mutations in the Greater Mekong Subregion

MORU

Posted 19/02/2019. Germana Bancone and colleagues characterized glucose-6-phosphate dehydrogenase deficiency in over 10 thousand samples collected in 138 villages in Cambodia, Lao PDR, Myanmar, Thailand and Vietnam, showing a country-level prevalence in males ranging from 7.3% to 18.8%. Given this high prevalence, G6PD testing should be carried out in the Greater Mekong Subregion before P. vivax radical cure with 8-aminoquinolines.

Risk of plasmodium vivax parasitaemia after plasmodium falciparum infection

A high risk of P. vivax after P. falciparum infection

OUCRU

Posted 12/02/2019. In this study, Professor Ric Price, Rob Commons and colleagues show a high risk of vivax parasitaemia after treatment of falciparum malaria, particularly in areas with short relapse periodicity and after rapidly eliminated treatment. In co-endemic regions, universal radical cure for all patients with uncomplicated malaria has the potential to prevent recurrent parasitaemia, reduce ongoing transmission, and enhance malaria elimination efforts.

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