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.
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.
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.
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.
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.
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.
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.
Posted 08/02/2019. Dengue has been estimated to cause a substantial health and economic burden globally. However, the specific estimates from different studies vary significantly. This review by Dr Hugo Turner and colleagues provides an overview of the different dengue burden estimates, using Vietnam as a case study. Understanding the methodology behind these calculations is vital when interpreting economic evaluations of novel dengue interventions.
Posted 21/12/18. A photo from Pearl Gan, Photographer In Residence for OUCRU, was selected for The Lancet Highlights 2018. The picture shows Senior Nurse Shikh Rema changing the dressing for Jabeda Begom, a 65-year-old woman with leprosy, at the Jalchatra Hospital in Bangladesh. Treatment of leprosy is a lengthy process, but thanks to dedicated staff, patients are given the care and attention they need.
Posted 27/11/2018. Since January 2018 there has been a significant increase in hospital admissions due to hand, foot and mouth disease across Vietnam. In collaboration with Children\u2019s Hospital 1 in Ho Chi Minh City, Dr Tan and colleagues set out to describe the etiology, clinical characteristics and demographics of the affected patients.
Posted 16/10/18. Clinical research is a crucial component of outbreak response as it provides evidence to improve the prevention and treatment of diseases with epidemic potential. However, disease epidemics are unpredictable and often short-lived, and this adds many challenges to the conduct of clinical research. Professor Peter Horby and colleagues have evaluated some commonly used clinical trial designs in order to determine the optimal design for this context.
Posted 10/10/2018. Community volunteers are used to deliver a number of healthcare interventions. Although these volunteers are not paid, their time still has an economic value, known as an opportunity cost. Dr Hugo Turner and colleagues found that this economic value is significant for mass drug administration programs: for the African Programme for Onchocerciasis Control alone it would be valued at US$60-90 million.
Posted 02/10/2018. Rising prevalence of HIV drug resistance in low and middle-income countries poses a growing threat to the HIV response. To curb resistance, enhanced strategies are needed that improve quality of ART care and treatment. Raph Hamers reviews contemporary data and highlights the potential impact and resistance risks of novel ART strategies and knowledge gaps.
Posted 25/09/2018. Invasive non-typhoidal Salmonella disease is common in parts of Africa; there is an ill-defined burden in Asia. Stephen Baker and colleagues describe a new variant of Multi-Drug Resistant Salmonella associated with invasive disease in Vietnam. The identification of this organism highlights new ways zoonotic pathogens can exploit human niches to cause serious infections.
Posted 10/07/2018. The decline of malaria in Vietnam can largely be attributed to the use of artemisinin-combination therapy (ACT) for case management. Recent analyses from Africa showed that insecticide-treated nets had the greatest effect on lowering malaria prevalence, suggesting that the success of interventions is region-specific. Malaria elimination efforts should focus on both vector control and increased access to ACT.
Posted 19/06/2018. Many people with pre-existing heart problems (including heart attack, pacemaker implantation, arrhythmia), high blood pressure and even past history of a stroke seek advice regarding high altitude travel ( > 2500m) for recreation, meetings or pilgrimages. Dr Buddha Basnyat and colleagues succinctly try to address these conditions at altitude and make reasonable recommendations in the face of limited data.
Posted 30/05/2018. Drug resistant bacterial infections are becoming a major problem. Genomics has become a fundamental tool for tracking bacteria and provides us with the data and knowledge to begin to initiate a response. Stephen Baker and colleagues discuss how resistant bacteria emerge and spread and outline some approaches and knowledge gaps that can help us tackle this global heath emergency.
Posted 01/05/2018. Hand, foot and mouth disease is a major public-health issue in Asia. Herein, Dr Tan and colleagues at OUCRU report the first detection of emerging coxsackievirus A6 among hand, foot and mouth disease patients in Vietnam, and document how this emerging virus evolves and spreads in space and time.
Posted 27/02/2018. The human papilloma virus is primarily known as the causative agent of cervical cancer, but it also causes anal cancer. It is easily transmitted, but often cleared, and only few infections develop
Posted 09/01/2018. OUCRU researcher Lauren Carrington has provided evidence supporting the introduction of Wolbachia, a bacteria that manipulates its host reproductive system, into areas where there are dengue virus-transmitting mosquitoes, as a biocontrol method to reduce the transmission of dengue and other arboviruses.
Posted 25/10/2017. Professor Stephen Baker recruited more than 3,000 children with severe diarrhoea in high usage, high resistance settings in Ho Chi Minh City, Vietnam. He found that antimicrobial usage did not result in reducing the time of symptoms, and actually prolonged it in most cases.
Posted 25/07/2017. Professor Jeremy Day and fellow researchers from OUCRU, in collaboration with colleagues from the Genome Institute Singapore, have published the first whole genome sequences of Vietnamese isolates of the yeast Cryptococcus neoformans, in an attempt to better understand the genes that enable some families of this usually accidental pathogen to cause disease in people with normal immune systems.
Posted 30/06/2017. Acute mountain sickness is a potentially life-threatening illness for sojourners to high altitude (> 2500m). Where pharmacological prophylaxis is indicated, Diamox is the drug of choice, but it has distressing side-effects. This Everest-based, double-blind, randomized controlled trial revealed that paracetamol, like ibuprofen, could potentially replace Diamox for prophylaxis.
Posted 30/05/2017. Rotavirus is a complex RNA virus with a genome comprised of multiple segments. The virus causes diarrhoea and extracting pure virus from stool samples limits our ability to sequence its genome. A team led by Professor Stephen Baker developed a new capture/purification method for rotavirus allowing us to perform whole genome sequencing from stool samples for the first time.
Posted 25/04/2017. South Asia, which includes Nepal, is a hub for typhoid fever. Trials conducted in Nepal since 2005 confirm that fluoroquinolones are failing for typhoid fever treatment. The WHO and health ministries in the region recommend fluroquionolones as the drugs of choice for typhoid fever. This recommendation needs to be changed.
Posted 07/04/2017. Collaboration between photographer Pearl Gan and Professor Kevin Baird from our EOCRU unit in Jakarta, Indonesia, this photographic project aims to raise public awareness of malaria as a serious health problem for the region by telling the human story of Asia\u2019s invisible malaria burden.
Posted 31/03/2017. Using epidemiological and microbiological approaches and sequencing data, this study, led by Prof. Constance Schultsz of the Academic Medical Center and Assoc. Prof. Ngo Thi Hoa, shows that usage of antimicrobials in food animal production selects for antimicrobial resistant bacteria (AMRB) in animals, which increases the risk for faecal colonisation of AMRB in humans.
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