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The World Mosquito Program posted the results of a 3-year randomised controlled trial in Yogyakarta, Indonedia, providing compelling gold standard evidence for the efficacy of the Wolbachia method in controlling dengue. The deployment of Wolbachia-carrying Aedes aegypti mosquitoes lead to a reduction of 77% in dengue incidence in Wolbachia-treated versus untreated areas.
Reducing antimicrobial usage in small-scale chicken farms in Vietnam
OUCRU
Posted 02/02/2021. Indiscriminate antimicrobial use (AMU) in animal production is a driver of antimicrobial resistance globally. In this trial, Juan Carrique-Mas and colleague provided regular veterinary advice to chicken farmers in Vietnam aiming to reducing AMU. AMU was quantitatively reduced by 66% and flock mortality by 40%. This study demonstrates that reductions in AMU without compromising health and productivity can be achieved in LMICs.
Plasma inflammatory biomarkers predict CD4+ T-cell recovery and viral rebound in HIV-1 infected Africans on suppressive antiretroviral therapy
EOCRU OUCRU
Posted 22/01/2021. Raph Hamers and colleagues conducted a multi-country prospective study of Africans with HIV-1 on suppressive antiretroviral therapy. Plasma concentrations of sCD14 and CRP predicted subsequent poor CD4+ T-cell recovery, and CXCL10 and sCD163 predicted viral rebound. Further research is needed to increase our understanding of and to explore the potential for adjunctive therapeutic interventions targeting these pathways.
Viral metagenomic analysis of cerebrospinal fluid from patients with acute central nervous system infections of unknown origin, Vietnam
OUCRU
Posted 19/01/2021. Tan Le Van and colleagues show that metagenomics could detect enteroviruses (n=23), hepatitis B virus (3), HIV (2), molluscum contagiosum virus (1) and germycircularvirus (1) in 14.7% of 204 cerebrospinal fluid from Vietnamese patients presenting with central nervous system infections of unknown origin. It remains a challenge to identify a plausible cause in patients with brain infections.
The emergence of azithromycin-resistant Salmonella Typhi in Nepal
OUCRU OUCRU-Nepal
Posted 12/01/2021. Azithromycin is effectively the last remaining oral antimicrobial to treat typhoid fever and is widely used for empirical therapy in South Asia. Although azithromycin resistance in Salmonella Typhi has rarely been reported, Abhilasha Karkey and colleagues show that an increasing reliance on this drug has led to the emergence of azithromycin resistant S. Typhi in the region.
Towards a fair and transparent research participant compensation and reimbursement framework in Vietnam
OUCRU
Posted 20/11/2020. Providing compensation for participants in clinical research is well established but defining compensation in low-resource settings is challenging due to ethical concerns and the lack of appropriate frameworks. Evelyne Kestelyn and colleagues at OUCRU Vietnam developed a compensation and reimbursement framework, providing a consistent, fair and transparent decision-making process that will be implemented across all future clinical research.
Antibiotic use and prescription and its effects on Enterobacteriaceae in the gut in children with mild respiratory infections in Ho Chi Minh City, Vietnam
OUCRU
Posted 17/11/20. Rogier van Doorn and colleagues show that antibiotics were prescribed to almost all 500 children with mild respiratory infection presenting to an outpatient clinic. They assessed prior antibiotic use by questionnaire and urine testing (HPLC), and reported overuse and overprescription of antibiotics when most respiratory infections are caused by viruses, and selection of resistant Enterobacteriaceae in gutflora with transmission potential.
Trimethoprim-sulfamethoxazole (SXT) versus azithromycin for the treatment of undifferentiated febrile illness in Nepal
OUCRU OUCRU-Nepal
Posted 20/10/2020. Buddha Basnyat and colleagues describe findings from NUFIT, the Nepal Undifferentiated Febrile Illness Trial, a randomized, double blind, placebo controlled trial. The trial revealed that 7 days of sulphamethoxazole-trimethoprim (Bactrim) is inferior to azithromycin in the treatment of undifferentiated febrile illness (fever without a focus) and enteric fever in Nepal and the wider region in South Asia.
Clinical, etiological and epidemiological investigations of hand, foot and mouth disease in southern Vietnam during 2015 – 2018
OUCRU
Posted 11/09/2020. Nineteen different enterovirus serotypes were detected in 1196 Vietnamese children presenting with hand foot and mouth disease during 2015-2018. Le Van Tan and colleagues show that EV-A71 was the major cause, especially in those with severe disease, followed by CV-A6, CV-A10 and CV-A16. Multivalent vaccines are urgently needed to control hand foot and mouth disease.
Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions
OUCRU OUCRU-Nepal
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.
Phase 3 Efficacy Analysis of a Typhoid Conjugate Vaccine Trial in Nepal
OUCRU OUCRU-Nepal
Posted 17/12/2019. Typhoid fever is rampant in South Asia. This new typhoid vaccine (studied in Kathmandu, Nepal, by Buddha Basnyat and colleagues) appears to be very effective in the prevention of typhoid. Administration of the new vaccine, especially in children, will revolutionize the prevention of this disease. And, crucially, help fight typhoid treatment resistance, a burgeoning problem.
COVID-19 lung injury is different from high altitude pulmonary edema
OUCRU OUCRU-Nepal
Posted 18/05/2020. The etiology of high altitude pulmonary edema (HAPE), a disease sometimes seen in sojourners to high altitude, is lack of adequate oxygen and not an inflammation provoked by an infectious agent like the novel coronavirus. Except for supplemental oxygen, Buddha Basnyat and colleagues strongly caution against managing COVID-19 lung injury with treatments that are used for HAPE.
Melioidosis: misdiagnosed in Nepal
OUCRU OUCRU-Nepal
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.
HIV drug resistance in low-income and middle-income countries
EOCRU OUCRU
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.
Picturing health: making malaria visible in Asia-Pacific
EOCRU OUCRU
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’s invisible malaria burden.
Essential guidance on malaria elimination in its history
EOCRU OUCRU
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.
Dengue virus induces PCSK9 expression to alter antiviral responses and disease outcomes
OUCRU
Posted 06/08/2020. Cholesterol is required for efficient dengue virus (DENV) replication, however statin treatment did not show efficacy against dengue in clinical trials, and underscored the need for a more detailed understanding of the interaction between DENV and cellular cholesterol. In this paper, in collaboration with DUKE-NUS, Sophie Yacoub and colleagues demonstrate the pivotal role of PCSK9 in DENV infections.
Value of lipocalin 2 as a potential biomarker for bacterial meningitis
OUCRU
Posted 24/07/2020. A team from OUCRU led by Le Van Tan, Hospital for Tropical Diseases, Vietnam, and the Target Discovery Institute at the University of Oxford showed that lipocalin 2 is a sensitive and specific biomarker for discriminating bacterial meningitis from a broad spectrum of other brain infections, and outperforms routine CSF markers such as leukocytes, glucose, protein and lactate.
Performance of metagenomic next-generation sequencing for the diagnosis of viral meningoencephalitis in a resource-limited setting
OUCRU
Posted 05/06/2020. Tan Le Van and colleagues showed that metagenomics can accurately detect a wide range of neurotropic viruses, especially vaccine-preventable-disease causing viruses such as mumps, in CSF of 66 consecutively treated adults with meningoencephalitis. Prospective study is needed to demonstrate the benefit metagenomics may add to the management of devastating diseases such as meningoencephalitis.
The natural history and transmission potential of asymptomatic SARS-CoV-2 infection
OUCRU
Posted 09/06/2020. Dr Le Van Tan and colleagues from OUCRU, Vietnam, demonstrate that 43% of quarantined people who were RT-PCR positive for SARS-CoV-2 were asymptomatic, but potentially contagious. The results emphasize the importance of contact tracing, airport quarantine and RT-PCR screening for SARS-CoV-2 among isolated people in controlling the ongoing pandemic.
Tuberculous meningitis: where to from here?
OUCRU
Posted 15/05/2020. Tuberculous meningitis is the most severe form of tuberculosis. Here Joseph Donovan and colleagues review tuberculous meningitis research during the last 2 years, focusing on that considered to have a major impact in advancing understanding, diagnosis, treatment of this disease in children and adults