Evidence supports WHO recommendation for primaquine combined with ACTs to block Plasmodium falciparum transmission
12 February 2021
Evidence from a new study, initiated by the Primaquine Roll Out Group and conducted at WWARN, supports the World Health Organization (WHO) recommendation for use of 0.25mg/kg dose of primaquine (PQ) combined with artemisinin-based combination therapies (ACT) to block Plasmodium falciparum transmission.
13 January 2021
A study to explore the variations of how microscopy methods are reported in published malaria studies has recommended standardised procedures should be implemented for methodological consistency and comparability of clinical trial outcomes.
18 December 2020
The responsiveness of a health system is one of its goals, alongside fairness in financing and outcomes. Listening and responding to the public can make a health system stronger and fairer. However, responsiveness is likely to be undermined, especially for vulnerable and marginal populations, in periods of crises such as disease outbreaks. In the current COVID-19 crisis, there has been more focus on health system control interventions, with minimal consideration of community views. KWTRP colleagues in Kenya consider community engagement and citizens feedback channels, concerns raised by the public and how they were handled, and highlight lessons learned.
4 December 2020
Blog by Piero Olliaro, Josephine Bourner and Lakshmi Manoharan. The COVID-19 pandemic has highlighted the limits of the current peer-review model, which is collapsing under the number of articles and volume of information, unable to cope with the conflicting needs for speed and quality of information. The peer review process is often slow, opaque, unaccountable and biased; it is now time to focus on tangible improvements, making transparency our top priority. We need a system reset, not tinkering in the margin.
1 December 2020
A new study quantifying the high risk of Plasmodium vivax parasitaemia after treatment of Plasmodium falciparum malaria aims to identify populations in which a policy of universal radical cure, combining artemisinin-based combination therapy with a hypnozoitocidal antimalarial drug, would be most beneficial.
24 September 2020
Covid-19 continues to cause huge disruption worldwide. As well as the ongoing immediate health impacts of the pandemic, its economic toll is being felt across the world, particularly in LMICs like Nepal. In addition to the wide-ranging disruption of health services, Covid-19 has shifted research priorities and stalled other essential ongoing research. Despite many problems, Covid-19 has afforded a unique opportunity for a better understanding of health research and methodologies in infectious diseases.
Large scale systematic review details causes of non-malarial febrile illnesses globally and identifies research priorities
21 September 2020
A series of articles that set out to explore the global distribution of infections that cause non-malarial febrile illness has been published in BMC Medicine. The series brings together the results of large-scale systematic reviews of the causes of fever in Africa, Latin America, and Southern and South-Eastern Asia, and has helped identify major knowledge gaps, geographical differences, priority areas for diagnostics research and development, and enabled the most comprehensive systematic review of literature to date.
10 September 2020
Research Malaria Microscopy Standards (ReMMS) applicable to malaria clinical research studies have been published in Malaria Journal. The paper describes the rationale for proposed standards to prepare, stain and examine blood films for malaria parasites.
9 September 2020
ISARIC has launched a longitudinal observational study to measure prevalence and risk factors of long-term health and psychosocial consequences of COVID-19. The researchers are inviting hospitals and healthcare sites worldwide to join this new study. The patient survey has been designed to assess long-term health and psychosocial consequences of COVID-19 at serial intervals for up to three to five years, depending on resources.
5 August 2020
Blog by Professor Christiane Dolecek. Antimicrobial resistance is a critical problem in enteric fever. Drug-resistant infections can have severe consequences, and slowing their spread requires our urgent attention. The most important intervention is to reduce the number of infections; vaccines are a critical tool, alongside surveillance and diagnosis. To achieve this control, strong partnerships between WHO, governments, NGOs, academia, private sector and communities are needed.
5 August 2020
Over the past few weeks, the UK government has gradually eased national lockdown measures. As the economy reopens, the number of contacts an individual has with other people inevitably increases. Since then, there has been an increase in COVID-19 cases, as well as spikes in transmission in certain areas. In response, rather than locking down the whole country again, the government has brought in local lockdowns in affected areas. Lakshmi Manoharan, Medical Epidemiologist at ERGO tells us how to make local lockdowns a success.
21 July 2020
A team of scientists at Oxford University’s Jenner Institute and Oxford Vaccine Group has taken the next step towards the discovery of a safe, effective and accessible vaccine against coronavirus. The results of the Phase I/II trial published in The Lancet indicate no early safety concerns and induces strong immune responses in both parts of the immune system.
15 July 2020
The global research community asks for the right research in the right places for COVID-19. The Global Health Network, the African Academy of Sciences and UK Collaborative on Development Research release a report in Nature that calls for the use of research evidence on the optimal implementation of public health interventions for COVID-19 in varied global settings.
14 July 2020
The UK should change its COVID-19 strategy to try to eliminate COVID-19 even without a vaccine rather than simply managing the disease. New Zealand has effectively managed to eliminate the virus, but can states with much larger, denser populations that have experienced much bigger outbreaks hope to do the same? Or is it more realistic to accept that the disease is likely to continue to circulate at some level and plan for that? Lakshmi Manoharan, Medical Epidemiologist with ERGO, tells us we should focus on reducing the amount of community transmission first before allowing economic and social activity to resume as normal.
3 July 2020
Dr Le Van Tan in OUCRU, in collaboration with the Hospital for Tropical Diseases and the Department of Health, has shown that it is common for people who are infected with the virus that causes COVID-19 (SARS-CoV-2) to have no symptoms whatsoever. By testing quarantined people in Vietnam, his team was able to detect asymptomatic individuals. The virus disappeared faster from the bodies of the asymptomatic carriers than from that of symptomatic individuals, but it appeared that some of them still managed to pass the infection on to others.
2 July 2020
Ghana cut malaria deaths by 65% from 2005 to 2015. In a paper published in the Malaria Journal, Rima Shretta estimates that the COVID-19 outbreak threatens this progress, as lockdowns limit access to health facilities and preventive malaria interventions have been interrupted. Ghana’s transition to a lower middle income status results in lower donor support for malaria control, and the government must step up to avert a feared rise in cases.
19 June 2020
Epidemics and pandemics disproportionately affect populations with greater impacts on the most vulnerable and less resilient communities. Hence Kenya’s response to the COVID-19 pandemic calls for more context adapted public health measures reflecting our improved understanding of who is the most vulnerable and their geographical location. This policy brief presents evidence on localized vulnerability indices to identify areas and people who require greater support while highlighting inequities to inform the COVID-19 response in Kenya.
Clinical trials on hydroxychloroquine/ chloroquine in COVID-19. Statement in response to damaging recent events
5 June 2020
On 4 June 2020, after a week of increasing scientific concern and scrutiny, first The Lancet, then a little over an hour later the New England Journal of Medicine, retracted studies that were based on inaccessible data, provided by the Surgisphere corporation. The studies have been extremely damaging to chloroquine and hydroxychloroquine COVID-19 clinical trials around the globe. Here is MORU’s statement in response to these events.
3 June 2020
What are the health and socio-economic impacts of physical distancing in African countries and how can they be mitigated? This work by Edwine Barasa and colleagues reviews the effects of physical distancing restrictions and recommends that African countries need to consider the broader net benefit of measures that they choose to implement and to adapt and localize their response to align with the contextual realities of the continent, and to optimize expected benefits of physical distancing, while minimizing the undesired impacts.
30 April 2020
The results of a placebo-controlled randomised trial of remdesivir in COVID-19 patients have been published in the Lancet. Supported by the ISARIC Support Centre, scientists in China launched a trial of remdesivir in patients hospitalised with COVID-19. The results found no clinical benefit from use of the drug; however, while not statistically significant, the time to clinical improvement and duration of invasive mechanical ventilation were shorter in people treated with remdesivir.
10 April 2020
Global health experts have united in a call for governments and international organisations around the world to plan strategically for the coordinated production, equitable distribution and surveillance of COVID-19 medical products to ensure access to quality-assured medications for everyone.
11 March 2020
Adding a third anti-malaria drug to current artemisinin-combination therapies (ACTs) provides effective treatment against multidrug-resistant falciparum malaria in Southeast Asia, say Oxford researchers in a study in The Lancet. Using TACTs should extend current malaria drugs so drug-resistant malaria doesn't kill millions more and derail hopes of controlling and eliminating malaria.
28 February 2020
A statistical analysis of WWARN data from 4,214 participants across multiple study sites in Africa has been published in BMC Medicine. Results indicate that the local prevalence of resistance-associated markers should be considered when choosing a first-line drug to ensure optimal duration of protection.
30 January 2020
Policy makers are interested in practical steps to a more gender-equitable and transformative health system. A guide published by Research in Gender & Ethics aims to help policy makers adopt a gender lens in policy deliberations on health systems. In order to prompt reflections on how gender affects health systems, we include case studies from Cambodia, Democratic Republic of Congo, Kenya, Liberia, Malawi, Sierra Leone, South Africa, Tanzania and Uganda.
17 January 2020
A specialist technique used to study drugs has been completed for the first time during an outbreak of Ebola virus disease.
Global study highlights the extent and impact of drug-resistant enteric fever and the urgent need for new approaches
23 December 2019
A new study conducted by Christiane Dolecek and colleagues analysed data on antimicrobial resistance of the bacteria Salmonella Typhi and Salmonella Paratyphi, from around the globe, spanning the time from 1990 to 2018. The study highlights the impact of drug resistance and the urgent need for interventions.
18 December 2019
Science Blog - George Busby of Oxford University's Big Data Institute discusses his team's research into human genetic resistance to malaria and humanity's age-old struggle against the disease.
11 December 2019
A large field study of typhoid conjugate vaccine (TCV) in Nepal has shown a single dose to be safe and effective in reducing typhoid in children aged 9 months to <16 years in an endemic setting. OUCRU-Nepal Professor Buddha Basnyat took part in this study.
6 December 2019
Earlier this year, OUCRU Photographer in Residence Pearl Gan conducted a project focusing on dengue. In that project, she took photos of dengue patients and health care workers at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam. She also took photos of dengue patients in their homes and at research sites in the city. This project was funded by the Wellcome Trust, and this week selected photos from that project have been published in The Lancet as a photo story.
The practice and ethics of participatory visual methods for community engagement in public health and health science
26 November 2019
Mary Chambers (OUCRU Public Engagement Vietnam) and Gill Black (Sustainable Livelihood Foundation, South Africa) have partnered with The Global Health Network training centre to published this online course and handbook
8 November 2019
Noting that substandard and falsified medical products (including medicines, vaccines, biologics, and diagnostics) represent a significant and growing threat to human health, The Lancet Global Health published 'The Global access to quality-assured medical products: the Oxford Statement and call to action'. The Oxford Statement has been signed by 159 attendees at the 2018 Oxford Conference on Medicine Quality and Public Health from governments, multilateral agencies, academia and civil society.
5 November 2019
Women continue to be under-represented in leadership positions across a range of sectors and geographic regions. In the health sector specifically, women comprise a substantial proportion of the global health workforce but are over-represented in lower-paying, lower-status occupations. The role of gender in healthcare leadership in LMIC settings remains under-researched. KWTRP undertook a study to understand and explore career progression and experiences of healthcare leaders at sub-national level in Kenya.
New research supports co-administration of primaquine with artemisinin-based combination therapies for P. vivax malaria
8 October 2019
An individual patient data meta-analysis of 2,017 patients from 19 studies has found a high risk of recurrence following treatment of P. vivax malaria with artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) unless they are co-administered with primaquine. The research supports recommendations that these artemisinin-based combination therapies (ACT) should be combined with primaquine.
26 August 2019
The provision of high-quality care to sick newborns presents challenges in any health system. International guidelines suggest that even for babies who do not require intensive care, there should be one nurse for every 2 – 4 sick babies. However, recent studies conducted in Nairobi show that one nurse takes care of between 20 – 40 newborns. In a recently published policy brief the KEMRI Wellcome Trust programme highlights the experience of nurses in Nairobi’s New Born Units.
Latest research finds primaquine improves haemoglobin by day 42 following treatment of P. vivax malaria
1 August 2019
An IDDO/WWARN study has found that primaquine is not associated with increased levels of anaemia following treatment of patients without G6PD deficiency for P. vivax malaria and should be used as part of a radical cure. In the largest study of its kind to date, researchers carried out a systematic review and individual patient data meta-analysis which involved 3,421 patients in 29 studies published in BMC Medicine.
25 July 2019
KWTRP has launched a dataset of comprehensive public health facilities from 50 countries in sub- Saharan Africa. This new dataset locates health facilities in relation to the communities they are intended to serve, to help ensure that services are accessible to the right populations and that no one is geographically marginalized from essential services. This is critical for attainment of Sustainable Development Goal 3 on good health and wellbeing.
24 July 2019
MORU researchers have found that severe malnutrition is associated with lower exposure to the antimalarial drug lumefantrine in children treated with artemether-lumefantrine, the most common treatment for uncomplicated falciparum malaria. The study, which is the first to specifically address this, calls urgently for further research into optimised dosing regimens for undernourished children.
Rapidly spreading multidrug-resistant parasites render frontline malaria drug ineffective in southeast Asia
23 July 2019
The findings of two studies, published in The Lancet Infectious Diseases journal, reveal that by 2016–2018 malaria parasites resistant to both artemisinin and its widely used partner drug piperaquine represented more than 80% of the parasites circulating in northeast Thailand and Vietnam, despite having only emerged in western Cambodia in 2008.
19 July 2019
A large clinical trial in Africa and Asia has shown that a 7 day course of high dose primaquine, a drug used to treat P. vivax malaria, is well tolerated and just as effective as the current standard 14 day regimen, according to a study published this week in The Lancet. These findings have important implications for the treatment and elimination of vivax malaria in the Asia Pacific.
2 July 2019
New research by Makoto Saito and colleagues at SMRU found that a longer follow-up is required to assess antimalarial drug efficacy in pregnant women. This was found across all drugs assessed in low malaria transmission settings. The report’s authors have called for guidelines specifically for pregnant women and further investigation of optimal follow-up periods in high malaria transmission settings.
12 June 2019
A ground-breaking study in Bangladesh co-lead by MORU has found that using data from mobile phone networks to track the movement of people across the country can help predict where outbreaks of diseases such as malaria are likely to occur, enabling health authorities to take preventative measures.
25 April 2019
Increased funding is needed to eliminate malaria across 22 Asia-Pacific countries and save an estimated 400,000 lives, according to research published in a new collection of studies on Wellcome Open Research.
26 February 2019
On 12 Feb 2019, Professor Arjen Dondorp published a new book: Sepsis Management in Resource-limited Settings. The result of a 3-year project led by MORU and the European Society of Intensive Care Medicine (ESICM), the book was written by critical care physicians from around the globe.
18 January 2019
A recent WWARN individual patient meta-analysis has gathered 18 published and unpublished studies from Africa and Asia to explore the relationships between identified Kelch 13 mutant alleles and delayed parasite clearance. The study results show one P. falciparum specific mutant and 20 pfk13 propeller region mutant alleles are strongly associated with the slow clearance phenotype, including 15 mutations that have not been confirmed before. It was reassuring that no pfk13 alleles associated with slow parasite clearance were observed in the parasites from African studies gathered between 2000-2017.
22 December 2018
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.
9 November 2018
A systematic review analyses the results of 177 trials conducted between 1982 and 2016, including 18,436 patients who underwent electrocardiographic evaluation during malaria clinical trials. Nick White and colleagues found that serious cardiovascular side effects, which include sudden cardiac death, are very rare in the treatment of malaria with quinoline antimalarials. The work emphasises the importance of continued pharmacovigilance with the increasing use of quinoline antimalarials in mass treatment strategies such as intermittent preventative treatment and mass drug administration.
7 November 2018
The manufacture and distribution of medicines is a global industry, tainted by fake and substandard products. Not only might these drugs not work as expected, but some are even contributing to antimicrobial resistance. So, what’s in your medicine cabinet? This is an article on Mosaic, a Wellcome publication
7 November 2018
Every person has the right to expect that when they use a medical product, whether medicine, vaccine or diagnostic kit, it works. But too often, that is not the case. Substandard medical products result from errors, negligence or poor practice in manufacturing, transportation and/or storage. In contrast, falsified products result from criminal fraud. Both innovative and generic products are affected.
4 September 2018
A team of researchers led by Yoel Lubell at MORU and IDDO used data from the USA and Thailand to link the consumption of antibiotics with the direct and indirect costs of treating patients for five drug-resistant bacterial infections.
20 July 2018
A team of malaria experts from a large international research collaboration has today published results supporting the need for a radical cure strategy to tackle one of the most debilitating forms of malaria caused by the Plasmodium vivax parasite.