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.
Posted 18/02/2022. Integrating digital health innovations to the public hospital system in Vietnam requires understanding of the local technical and regulation landscape to avoid abandonment and ensure sustainability. Duc Minh Tran and colleagues mapped the relevant policy and academic publications, providing a big picture to inform the adoption of hospital-based digital health systems in Vietnam.
Posted 16/02/2022. Severe malaria is a medical emergency requiring prompt supportive and parenteral (intravenous/intramuscular) treatment. Beatrice Amboko and colleagues showed the inadequacy of the readiness of primary public health facilities to deliver appropriate pre-referral care to children with severe malaria in Kenya between 2017 and 2021.
Posted 15/02/2022. In this cost of illness study, Aishatu Adamu and colleagues found that in children aged <5 years, a week-long hospitalisation with pneumonia or invasive pneumococcal disease resulted in substantial costs to the health provider and households. Expenses were catastrophic for a third of the households, and for over half of the poorest households.
Posted 10/02/2022. In many countries, strict public health measures characterised the first wave of the pandemic, disrupting and changing everyday lives. But how were these measures individually experienced? This qualitative study by Mira Schneiders and colleagues provides a rich account of the challenges, opportunities and coping strategies of people living through the first COVID lockdown in Thailand, Malaysia, Italy, and the UK.
Posted 09/02/2022. To understand how complex social and programmatic interventions work, a mix of methods that entailed a blend of literature review, reflections from experiential and disciplinary expertise were utilized. This review by Bipin Adhikari and colleagues highlights the complexity of Nepal\u2019s primary health care system (PHC), how it has evolved over the decades and through the current federalization, and challenges and opportunities to transform the PHC.
Posted 08/02/2022. There has been very little research on the epidemiology of severe malaria for over 20 years. Alice Kamau and colleagues analysed 52,000 malaria admissions from 49 settings across East Africa. Under high transmission, malaria hospitalisation was concentrated in children <5. Severe malaria anaemia is currently the most common severe disease presentation. Spatially and age targeting interventions, including chemoprevention and vaccines, will have the maximum benefit in areas where prevalence of infection is \u226510%.
Posted 04/02/2022. Current knowledge of P. falciparum artemisinin resistance evolution in Asia is as old as 4yrs ago. For swift policy decisions, rapid sharing of data collected over extended periods in the same areas is highly needed. Frank Kagoro and colleagues found a steady increase in geographic locations and the proportion of artemisinin resistance from 2002 to 2018. Using the latest WHO classification, the authors map all published K13 markers in Asia by province and district.
Posted 01/02/2022. Pham Thanh Duy and colleagues at OUCRU have revealed the endemic circulation of fluoroquinolone-resistant extra-intestinal pathogenic Escherichia coli ST1193 in Vietnam, driven by multiple strain importations and sustained transmissions between humans. These organisms have developed resistance to multiple drugs of choice and are major causes of sepsis in neonates and bloodstream infections in adults in this setting.
Posted 28/01/2022. This case-control study by Koukeo Phommasone and colleagues aimed to determine the causes of acute respiratory infection (ARI) in patients presenting to a hospital in Laos. ARI was commonly attributed to influenza A and B, human metapneumovirus and respiratory syncytial virus. Other organisms were detected at similar frequency in cases and controls.
Posted 26/01/2022. Though Shigella flexneri serotype 6 has been proposed as a target for vaccine development against shigellosis, it is currently understudied. Hao Chung The and colleagues analyzed the genomes of 96 bacteria isolated from Asia, and showed that this pathogen\u2019s dominant lineage likely emerged in 1970s, and predicted that resistance against first-line antimicrobials was rare.
Posted 25/01/2022. This latest addition by Elizabeth Ashley and colleagues to the PLOS Medicine Vivax Malaria Collection describes the clinical impacts of Plasmodium vivax malaria, and incorporates a rapid systematic review of severe disease. Reports of severe vivax malaria are increasing, however the literature is dominated by case reports and case series, impeding accurate estimation of incidence.
Posted 19/01/2022. Rita Njeru, Sassy Molyneux and colleagues examine the role of community health workers in supporting post-discharge recovery in young undernourished children. The authors argue that a targeted and multi-pronged approach initiated before or on discharge is needed, supported by clear guidance and training. The ways in which any new tasks or personnel are incorporated into hospital and broader health system hierarchies and systems need careful planning and tracking.
Posted 13/01/2022. Associate Professor Tan and colleagues demonstrated that Oxford-AstraZeneca COVID-19 vaccine is immunogenic in Vietnamese health-care workers. Neutralizing antibodies were detectable in 98.1% and 94.7% of the study participants at 14 days and month 3 after vaccination, respectively. These data are critical to informing the deployment of the COVID-19 vaccine.
Posted 23/12/2021. Marcus Schultz and colleagues analysed 4 large prospective observational studies conducted in 534 ICUs in 54 countries. Patients in middle\u2013income countries were younger, shorter with a slightly lower BMI, had more often diabetes and active cancer, but less often COPD and heart failure. Sequential organ failure assessment scores were similar. ICU mortality was higher in middle\u2013income countries, and inversely associated with GDP.
Posted 08/12/2021. The prevalence of malaria parasite in the population is a key metric used for disease stratification. At sub-national levels, this prevalence is strikingly heterogenous, transcending national borders in Kenya, Tanzania and Uganda. Approximately 12.7 million people in East Africa continue to live in areas with over 30% prevalence. This mapping by Victor Alegana and colleagues highlights why countries must work together to reduce burden and prevent further malaria deaths.
Posted 26/11/2021. Steven Wambua and colleagues analysed monthly reports in 204 Kenyan hospitals and quantified the impact of COVID-19 on utilization of inpatient services. Data was obtained from the District Health Information Software 2 (DHIS 2). We observed significant drops in monthly volumes of live-births, over-fives admissions for medical, and surgical care with the greatest declines in the under-five\u2019s admissions.
Posted 16/11/2021. In response to the Zika epidemic the Research Preparedness Network (REDe) engaged local health research communities to enhance long-term research capacity building. This publication is based on a call to fund research training workshops in Brazil and captures the process and impact of this approach. REDe also developed an implementation toolkit to foster similar initiatives and ultimately contribute to local ownership in global health.
Posted 12/11/2021. Global antibiotic consumption rates increased by 46 percent in the last two decades, according to the first study to provide longitudinal estimates of human consumption in 204 countries from 2000 to 2018. Annie Browne, Christiane Dolecek and colleagues used a novel approach that deployed statistical modelling techniques and incorporated multiple data sources, to help us address a number of public health challenges, from combating drug resistant infections to providing access to basic treatment
Posted 05/11/2021. Generation of quality surveillance data is one of the pillars of the WHO response to the global AMR problem. However, work by LOMWRU\u2019s Tamalee Roberts and colleagues estimates that laboratory setup and running costs for hospital-based AMR surveillance in Southeast Asia are likely to be prohibitive in many resource-limited settings.
Posted 02/11/2021. Claire Chewapreecha and colleagues employ a powerful combination of genome-wide epistasis and co-selection study (GWES); gene expression analyses and gene knockout assays to identify the key genes that have been repeatedly selected through Burkholderia pseudomallei evolution. The study indicates that the bacterium is evolutionarily primed to survive nutrient-depleted soils and highlights the need to protect environmental health as part of disease prevention.
Posted 20/10/2021. Scrub typhus infects over a million people a year across the Asia-Pacific. The ecology of this important disease, transmitted by chigger mites, remains poorly understood. Ivo Elliott and colleagues report on the identification of key risk factors that determine foci of high disease transmission at 3 sites in Northern Thailand.
Posted 19/10/2021. The search for more effective and affordable treatments for cryptococcal meningitis must go on, as results of a trial repurposing tamoxifen, a drug developed for breast cancer, found it had no effect in a trial in Vietnam, by Nguyen Thi Thuy Ngan and Jeremy Day. Although tamoxifen shows activity against Cryptococcus neoformans in vitro, there was no evidence of benefit in patients. The OUCRU team will keep looking for better treatments for cryptococcosis.
Posted 15/10/2021. Tan Le Van and colleagues showed Delta variant breakthrough infections may cause asymptomatic or mild disease, but are associated with high viral loads and low levels of vaccine-induced neutralizing antibodies. The data suggested ongoing transmission had occurred between fully-vaccinated individuals. Social distancing measures remain critical to reduce the transmission of SARS-CoV-2.
Posted 01/10/2021. In 2017 hundreds of thousands of \u2018Rohingya\u2019 fled from Myanmar to refugee camps in Cox\u2019s Bazar, Bangladesh. Health centre data were reviewed to estimate the increase in health care utilization. The presence of a large migrant population relative to a smaller host community burdens the limited facilities and resources of the public health sector, by Lorenz Von Seidlein and colleagues
Posted 29/09/2021. Xin Hui Chan and colleagues report a large individual patient data meta-analysis of malaria clinical trials supporting the cardiovascular safety of amodiaquine and structurally related antimalarials at WHO-recommended dosing regimens alone or in ACTs for the treatment and prevention of malaria, and propose a potential mechanism for amodiaquine-related asthenia.
Posted 28/09/2021. Despite most neonatal deaths being preventable, neonatal mortality remains unacceptably high globally. Saving Babies\u2019 Lives (SBL) is a stepped-wedge cluster-randomised trial, which will develop, implement, and assess an iterative package of neonatal interventions combining community and primary care strategies to reduce neonatal mortality in a rural Cambodian province, by Claudia Turner and colleagues
24/09/2021. Plasmodium vivax in SE Asia and Oceania is less sensitive to primaquine compared to other regions and needs a higher target dose - 0.5 mg/kg. Bob Taylor and colleagues propose a new regimen that was designed using pharmacokinetic simulation and takes into account that children need higher mg/kg doses compared to adults.
Posted 22/09/2021. Kelvin Mokaya, Sarah Atkinson and colleagues found that children with severe malaria anaemia have higher risk of non-typhoidal Salmonella bacteraemia, and lower levels of the iron-regulating hormone, hepcidin (even with Salmonella coinfection) compared to other forms of malaria. Reduced hepcidin may increase iron availability for bacterial growth in the Salmonella-containing vacuole.
Posted 21/09/2021. The WHO's \u20185 moments\u2019 is the dominant paradigm for hand hygiene globally. While \u20185 moments' has many benefits and has had a significant clinical impact, it also has many weaknesses. Jacob McKnight and colleagues explore how this important paradigm can be improved to reflect the latest research in hand hygiene.
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