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\n \n \n \nPosted 28/07/2020. Ticks, fleas and lice from dogs in Vientiane (Lao PDR) were shown to carry a variety of zoonotic pathogens including R. felis (cat-flea typhus). Matthew Robinson and colleagues highlight the risk of these pathogens transmitted between dogs and humans within the city, as well as the role of pets in human diseases, and important public health considerations
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\n \n \n \nPosted 31/07/2020. Myo Maung Maung Swe and colleagues describe evaluation and experience of using the forum theatre technique, a novel form of public engagement. Our experience was fun, informative and encouraged widespread participation around the subject of antibiotic use. We believe that this technique will be of great interest to scientists who engage in activities using participatory techniques.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 15/01/2019. Dr Thomal Althaus and colleagues managed to reduce antibiotic prescription using the C-reactive protein (CRP) test among 2,410 children and adults presented with a fever in primary care centres in Thailand & Myanmar. The perspective of a rapid and affordable test for CRP, identifying febrile patients who really need an antibiotic, is now possible!
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\n \n \n \nPosted 21/08/2020. Frank Smithuis and colleagues did a retrospective cohort analysis looking at integration of HIV care with general health care clinics in Yangon, Myanmar. HIV patient survival was high at 0.95 at 1 year and 0.90 at 5 years. Integration is effective to attain early linkage to care but attention should be given to disengagement from care, in particular for pregnant women.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 05/11/19. High quality laboratory data is the cornerstone of antimicrobial resistance surveillance. In this recent article in The Lancet Infectious Diseases, Paul Turner, Elizabeth Ashley and colleagues from COMRU and LOMWRU highlight the problems associated with poor quality data and call for standardised data reporting via the MICRO framework
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 23/10/18. A plethora of innovative portable devices to screen for poor quality medicines has become available. In a review of the scientific evidence regarding their performances, Dr Celine Caillet and colleagues show that there is a vitally important lack of independent evaluation of the majority of the 41 devices (most being spectrophotometers) found in our search, particularly in field settings. Intensive research is needed in order to inform national medicines regulatory authorities of the optimal choice of device to combat poor quality medicines.
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\n \n \n \nPosted 17/10/2016. Training local Karen and Burman women as skilled birth attendants in refugee settings resulted in no adverse perinatal outcomes and many positive outcomes such as a drop in stillbirths and infant deaths and more babies being born in clinics rather than at home, says a new study, led by Professor Rose McGready and published in PLOS ONE.
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\n \n \n \nPosted 22/10/2019. Rose McGready and SMRU colleagues contributed RCT data from the Thailand-Myanmar border to this large review on low- and middle-income countries (21 studies in 20\u2009882 children). The results suggests targeting parental, environmental and nutritional factors from pre-pregnancy through childhood, as a way forward to improve health and development of children in such settings.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 25/04/2018. Mary-Ellen Gilder and colleagues at SMRU demonstrate low levels of primaquine in breast milk, findings that should change treatment policy allowing more breastfeeding women to be cured of P.vivax. This will potentially reduce the global burden of this infection which has significant negative consequences for pregnant mothers and infants.
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\n \n \n \nPosted 17/10/2017. Plasmodium falciparum and Plasmodium vivax malaria in pregnancy both increase stillbirth risk, which is likely to increase as endemicity declines. A study by SMRU and University of Melbourne researchers shows that better P. falciparum malaria control efforts could prevent up to 1 in 5 to 8 stillbirths in sub-Saharan Africa.
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\n \n \n \nPosted 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.
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\n \n \n \nPosted 11/08/2020. This very large molecular epidemiology study done over 12 years describes the evolution and spread of antimalarial drug resistance across the entire Greater Mekong subregion (GMS). Mallika Imwong and colleagues show no evidence of spread of artemisinin resistant parasite lineages from the eastern to the western GMS. There is also no evidence for piperaquine resistance in the western GMS.
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\n \n \n \nPosted 21/07/2020. This article by Arjen Dondorp and colleagues provides guidance on respiratory support for patients with severe COVID-19 focusing on low- and middle-income countries, based on current evidence and experience. Rather than the usual focus on mechanical ventilation, it emphasizes the importance of having the right modalities for non-invasive oxygen therapy in place
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\n \n \n \nPosted 14/07/2020. Non-adherence in non-inferiority trials typically dilutes observed treatment effects, leading to a higher probability of claiming non-inferiority. Mo Yin and colleagues describe different patterns of non-adherence and the influence of the confounders on treatment effects. Causal inference methods that account for these confounders can minimise bias and risk of false non-inferiority claims.
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