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.
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.
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
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.
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.
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.
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.
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
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.
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 \u2018making merit\u2019 (Tham-bun in Thai).
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 \u2018EDCTP Knowledge Hub\u2019: 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
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.
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.
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.
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
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.
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
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.
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.
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.
Posted 07/06/2022. This survey among over 1000 hospital physicians found that antimicrobial stewardship (AMS) implementation in Indonesian hospitals is challenged by institutional, contextual and diagnostic vulnerabilities. Appropriate recognition of the contextual determinants of antibiotic prescribing decision making will be critical to change physicians\u2019 attitudes and develop context-specific AMS interventions. By Ralalicia Limato, Raph Hamers and colleagues.
Posted 01/06/2022. This review represents a first attempt at systematically assessing human antibiotic use in Indonesia in the past 20 years. Ralalicia Limato, Raph Hamers and colleagues identified critical evidence gaps in the private health care sector, and what are the health system drivers of antibiotic use. Optimisation of antimicrobial use should be a priority of the national agenda for universal health coverage.
Posted 31/05/2022. Via online-survey with 332 clinical- and laboratory- based respondents in human and animal sectors across 61 of 63 provinces, followed by face-to-face interviews and review of 10-year-literature, Ngo Thi Hoa and colleagues identified 24 reported circulating-zoonotic diseases in Vietnam. With additional One-Health surveillance on these diseases, we will understand their animal reservoir and impact on human- and animal-health.
Posted 27/05/2022. This randomised controlled trial by Louise Thwaites and colleagues examined two different treatments for adults with tetanus. The first was spinal (intrathecal) injection of antitoxin compared to a sham (dummy) procedure (in addition to normal intramuscular injection) and showed no overall benefit. The second, comparing two types of intramuscular antitoxin (equine and human) also showed no difference between treatments
Posted 24/05/2022. Drug-resistant malaria is now a critical public health emergency on a global scale. The artemisinin resistance confirmed recently in Rwanda and Uganda is likely just the \u2018tip of the spear\u2019, with its spread likely to soon occur widely across endemic countries in sub-Saharan Africa. Philippe Guerin and colleagues make five feasible recommendations, based on learnings from the COVID-19 experience on collecting, sharing and disseminating these critical data efficiently.
Posted 17/05/2022. In this study, leveraging a Kenyan Clinical Information Network, Timothy Tuti, Mike English and colleagues set out to evaluate at the clinical team level, if and how a comprehensive healthcare-specific feedback theory used to design and implement pharmacists-championed feedback strategies could help improve medication prescribing accuracy during inpatient neonatal care.
Posted 17/05/2022. In this study, Margaret Nampijja, Agnes Mutua, Sarah Atkinson and colleagues found that lower maternal and infant hemoglobin levels were associated with reduced psychomotor scores at 15 months, and lower infant hemoglobin levels were associated with reduced language scores. These findings emphasize the importance of managing maternal and child anemia.
Posted 13/05/2022. \u201cUnder the Mask\u201d is a 75-min feature film that follows the lives of patients with TB who live on the Thai-Myanmar border. Phaik Yeong Cheah, Michele Vincenti Delmas and colleagues explains the genesis and development of the film, and how it has been used to engage communities at risk of TB.
Posted 11/05/2022. Yingxi Zhao and colleagues used data from a national health facility assessment to understand the capacity of Kenya internship hospital to provide internship training for medical doctors. They highlight the major gaps in staffing, equipment and service availability in those hospitals and call for more stringent and regular review and re-accreditation of internship hospitals to provide appropriate and well-resourced training.
Posted 10/05/2022. In this study, Reagan Mogire and colleagues found that vitamin D deficiency was associated with a 98% increased risk of iron deficiency in African children and also influenced hepcidin and other markers of iron status. Both nutrients should be considered in strategies to manage their deficiencies in Africa.
Posted 06/05/2022. Animal studies suggest an important role of iron in neurodevelopment. In this systematic review, Agnes Mutua, Sarah Atkinson and colleagues found limited evidence for the effects of iron supplementation on neurodevelopment in African children despite the high burden of iron deficiency in this population. Further well-conducted studies are needed.
Posted 03/05/2022. We\u2019ve all been there! Waiting forever for reviewers comments after submission our paper to a journal. The system is not working. Should we pay reviewers to review a paper? Will it make a difference? Phaik Yeong Cheah and Jan Piasecki give some arguments why we should. What are your thoughts?
Posted 20/04/2022. Although seasonality in tuberculosis is seen on all continents, explanations have remained elusive. In a 10-year population study of TB transmission in Birmingham, UK, Timothy Walker and colleagues see seasonality only among patients linked by recent transmission, with diagnoses peaking in spring time. TB\u2019s incubation period may thus be even shorter than hitherto understood.
Posted 19/04/2022. Jennifer Van Nuil and colleagues used a community-based participatory research approach to engage in dialogues with underserved groups at risk for hepatitis C in Ho Chi Minh City, Vietnam. We present findings from stakeholder mapping meetings held with representatives from local organizations, including the challenges and dynamics of the communities.
Posted 12/04/2022. Evidence on the costs of delivering COVID-19 vaccines are useful inputs in planning for resource mobilization, and can inform vaccine priority setting decisions. Stacey Orangi, Edwine Barasa and colleagues present the unit costs of procuring and delivering the COVID-19 vaccine in Kenya across various vaccination strategies. These cost estimates can be used to inform local policy and may further inform parameters used in cost-effectiveness models.
Posted 08/04/2022. Kwashiorkor, a type of severe malnutrition associated with oedema, has been known for centuries but its mechanism remains elusive. This research by Jay Berkley and colleagues confirmed that low plasma albumin levels are necessary but not sufficient for oedema formation. Our findings suggest that lymphatic drainage may be impaired, which is a new discovery.
Posted 29/03/2022. In regions with low Covid-19 vaccine coverage, health systems remain vulnerable to surges in infections. Arjun Chandna and colleagues developed three clinical prediction models to help identify patients safe for community-based management. Each model contains three simple clinical parameters (age, sex, SpO2) and one point-of-care biomarker, and could help protect resource-limited health systems.
Posted 25/03/2022. Alun Davies and colleagues used Participatory Video (PV) to explore how engagement with researchers influenced Kenyan school students\u2019 perceptions of research and aspirations. PV highlighted the complex context in which engagement is situated where students\u2019 time and attention is competed for against curricular, extracurricular, and social-cultural factors. We emphasise the importance of ensuring that engagement benefits students.
Posted 23/03/2022. In this review, Piero Olliaro and colleague Els Torreele analyse the successes and failures with coronavirus disease 2019 and Ebola virus disease in shaping health systems and research for infectious disease epidemics. They highlight that epidemic preparedness means also tackling a series of ongoing outbreaks and make the case for a coordinated, public health-driven, portfolio approach.
Posted 22/03/2022. The first randomised trial of artemether-lumefantrine plus amodiaquine for uncomplicated falciparum malaria in areas with a high prevalence of artemisinin resistance shows it is a well-tolerated, effective treatment for multidrug-resistant parasites. Coordinated by Tom Peto, James Callery and Rupam Tripura, the triple therapy provides an alternative first-line treatment in Southeast Asia and elsewhere, with an expected longer therapeutic lifetime than current artemisinin combination therapies.
Posted 18/03/2022. Steven Wambua and colleagues analysed monthly reports on utilization of outpatient and immunization services between Jan-2018 and Mar-2021 by all health facilities in Kenya to quantify the impact of COVID-19 on the utilization of the health services. Data was obtained from the District Health Information Software 2 (DHIS 2). We observed varied effects of the pandemic, with significant drops in attendance for most outpatient services while immunisation services remained unaffected.
Posted 15/03/2022. Bipin Adhikari reviews a book titled \u2018Phantom Plague: How Tuberculosis Shaped History\u2019 by Vidya Krishnan--a prominent medical science reporter. The book is a compelling journey into a history of medicine, current development of Tuberculosis epidemiology and treatment, and Global Health and is an essential read in Global Health.
Posted 11/03/2022. In paediatric research, a legal representative must provide consent on behalf of the child. Using Thailand as a case study, Sheila Varadan, Phaik Yeong Cheah and colleagues contemplate how international legal frameworks could be leveraged to navigate legal uncertainty in the informed consent process, enabling more children to participate in paediatric clinical research.
Posted 08/03/2022. In this review, Victor Chaumeau and colleagues assessed the level of association between antibody responses to mosquito salivary antigens and the metrics of malaria transmission across different areas of the globe. They identified knowledge gaps that need to be addressed before these serological markers of exposure to vector bites can be used operationally for malaria elimination.
Posted 04/03/2022. In a secondary analysis of a transfusion trial, Kathryn Maitland and colleagues showed that of 3188 children with severe anaemia (haemoglobin < 6 g/dl) 41% received a whole blood transfusion. Compared with whole blood, children receiving packed cells had a worse haemoglobin correction by 8 hours, required more additional transfusions and had longer hospital stays. We found no adverse effects of whole blood compared to packed cells.
Posted 02/03/2022. There are many benefits of vaccinating population against COVID-19 including a reduction in transmission, likelihood of severe disease, and pressure on health system. We assessed geographic inequalities in vaccine access in Kenya over the past year and show that despite on-going efforts, only 30% of adult population will have been vaccinate by April 2022, highlighting the disproportionate access to vaccine is Africa population.
Posted 01/03/2022. Nils Kaehler and colleagues, policymakers and researchers involved in malaria offered insights on strategies for community engagement for malaria elimination in the Greater Mekong Subregion. More than ever, sustaining community engagement and engaging with community-based health workers are critical to ensure that the last remaining malaria cases are not left 'untreated'.
Posted 25/02/2022. The burden of neurological impairments in older children from Africa remains unknown. Modelling empirical and literature estimates, Jonathan Abuga and colleagues demonstrate the high burden of fatal and non-fatal outcomes associated with active and lifetime epilepsy, and moderate/severe impairments in cognitive, motor, vision and hearing functions among older children (5-14) residing in a rural setting along the Kenyan coast. Interventions to prevent premature mortality and improve the wellbeing of these children are needed
Posted 23/02/2022. Simple diagnostics are needed for enhanced antimicrobial resistance surveillance. Tamalee Roberts and colleagues showed how InTray COLOREX Screen chromogenic agar can be used for simple and rapid detection of uropathogens and ESBLs in LMIC settings. Inoculated agar plates also have the potential for easy storage and transport from field sites to central laboratories.
Posted 22/02/2022. In many sub-Saharan African countries, including Kenya, the use of mortality and morbidity audits in maternal and perinatal/neonatal care as an avenue for learning and improving care delivery is sub-optimal due to structural, organizational, and human barriers. In this exploratory qualitative study, Joyline Jepkosgei and colleagues examined process-related factors that generally influence M&M audits including health workers\u2019 interactions and their experiences, institutional cultures, and broader health system contextual influences, which remain inadequately explored.
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