Today April 25 is World Malaria Day. We would like to highlight a malaria photography project by photographer Pearl Gan, in collaboration with OUCRU in Vietnam and EOCRU in Indonesia. Pearl's malaria project aims to bring visibility to the people and their malaria burden through her photographs of them and their environment. She hopes to humanise the faces of malaria and the malaria problem in the Asia-Pacific to audiences unfamiliar with it.
Posted 18/06/2021. Grace Irimu and colleagues show that newborns account for 46% of admissions and 66% of deaths among children 0-13years in Kenyan hospitals. Most deaths are caused by preventable and treatable causes. The authors call for need to prioritize newborn care for Kenya to achieve the SDGs target.
Posted 09/06/2021. Chris Paton and colleagues describe how predictive human-computer interaction (HCI) modelling could be used to improve the safety and usability of digital health systems. We reviewed the history of predictive modelling in HCI and describe how modelling could be integrated with the human-centred design techniques used when developing digital health interventions.
Posted 28/04/2021. While Health and Demographic Surveillance Systems (HDSS) involving verbal autopsy provide essential data on deaths, births and other health-related events in LMICs where alternative sources are limited, Vicki Marsh and colleagues argue that current regulatory frameworks do not sufficiently recognise their nature as a form of non-traditional epidemiological research. Ethical challenges include risks of uncompensated burdens that alternative regulatory approaches may more successfully identify.
Posted 13/04/2021. Self-regulated learning (SRL) remains unexplored for healthcare workers in low-income countries. Tim Tuti, Chris Paton and Niall Winters detail how SRL strategies impact on healthcare providers’ learning gains when using digital learning platforms. We apply Latent Profile Analysis (LPA) to questionnaire responses. We provide insights into the learner factors to consider when implementing technology-mediated learning.
Posted 15/04/2021. Philippe Guérin co-authored a letter published in The Lancet drawing attention of the risk of pooling data from uncomplicated illness and more severe ill hospitalised patients in the development of COVID-19 treatment guidelines. Although SARS-CoV-2 is one virus, the COVID-19 disease has a complex and evolving physiopathology pathway and requires different therapeutic approaches depending of the stage of the disease. In low-resource settings, the prevention of hospital admission is the therapeutic priority.
Posted 31/03/2021. Patient safety is a key goal of WHO but identifying harms and developing strategies to deliver safe care has been given little attention. Mike English and colleague describe a ‘portfolio’ approach to safety improvement in four broad categories: prioritising critical processes, improving the organisation of care, control of risks and enhancing responses to hazardous situations that we believe is relevant to low resource settings. We focus attention on the possible roles of practitioner groups and professional associations as key to advancing patient safety through collaboration and skill development in this field
Posted 22/02/2021. Paper continues to be an important medium for recording inpatient care in low‐ and middle‐income countries. Naomi Muinga and colleagues synthesise evidence on how paper‐based nursing records have been developed within inpatient settings to support documentation of nursing care, and that a human‐centred design approach might better meet users' needs
Posted 16/02/2021. Dexamethasone has been shown to reduce mortality in COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Rima Shretta and colleagues estimate that approximately 12,000 lives could be saved in the UK and 650,000 globally between July-December 2020. Dexamethasone is a cost-effective option with an incremental cost of GBP 940 per life-year gained.
Posted 12/06/2020. Safety of drugs is important, particularly during pregnancy. Makoto Saito and colleagues have pooled the data of 4503 women who had malaria in pregnancy and found that the currently used artemisinin-based combination therapies are equally safe for fetus. This study also highlights that risk of small-for-gestational-age (SGA) is high after malaria in pregnancy even treated with highly efficacious drugs, suggesting that prevention is important for reducing SGA in malaria endemic areas.
Posted 14/04/2020. Enormous emergency efforts are underway to find optimal medical products, to prevent, diagnose, and treat COVID-19, that 7.8 billion people will depend on. With dire disruption of pharmaceutical production and supply and increasing falsified and substandard products, we need strategic planning now to ensure global access to quality-assured medical products and monitoring of supply chains
Posted 02/01/2018. Technological potentials have raised high hopes on healthcare access in LMICs like India. However, five years of research by Dr Marco Haenssgen paint a less optimistic picture and show adverse consequences of mobile phone diffusion, which creates more competition and new divisions and leaves the poorest strata of population worse off than before.
Posted 20/03/2020. 199 patients received standard care, of which 99 received lopinavir-ritonavir for 14 days. Lopinavir-ritonavir didn’t induce significant clinical improvement, and mortality was similar in both groups. However, patients treated with lopinavir-ritonavir spent less time in hospital and in intensive care. The trial enrolled severely ill patients and was not big enough to detect modest benefits. Much larger studies are warranted to confirm or exclude if lopinavir-ritonavir treatment can help.
Posted 12/02/2021. The majority of digital health projects have failed to translate into scaled, routine services, leaving many health leaders cautious and uncertain of how to proceed. Chris Paton and colleagues identify factors that can influence successful and sustainable integration of digital health within local health systems in low resource settings.
Posted 20/02/2018. The malaria parasite is a major cause of illness and deaths throughout the tropics. To survive, the malaria parasite needs to be transmitted by mosquitos form person to person. In this paper Martin Rono and colleagues show at the cellular and molecular level how the parasite balances its investment between growing efficiently in humans and maximising the chances of being transmitted by mosquitos, depending on the local environment.
Posted 12/12/2017. Snakebite envenoming is a neglected tropical disease that kills 100,000 people and maims 400,000 every year. Impoverished populations living in the rural tropics are particularly vulnerable; snakebite envenoming perpetuates the cycle of poverty. Intravenous administration of antivenom is the only specific treatment to counteract envenoming. Confronting snakebite envenoming at a global level demands the implementation of an integrated intervention strategy involving local, national and international organisations.
Posted 05/12/2017. Zika virus RNA is frequently detected in the semen after Zika virus infection. To learn more about persistence of viruses in genital fluids, Dr Alex Salam and Professor Peter Horby searched PubMed and found evidence that 27 viruses can be found in human semen. This may have implications for the risk of sexual transmission, embryonic infection, congenital disease, miscarriage, and infection transmission models.
Posted 28/11/2017. Prabin Dahal reviewed the evolution of statistical methods used to understand and define antimalarial drug efficacy in uncomplicated P. falciparum malaria. The article gives a thorough insight into the historical practices and critically reviews the challenges and limitations associated with current approaches and offers alternative methodologies leading to improved study design and analysis.
Posted 13/10/2017. Professor Peter Horby outlines potential epidemics in Africa. It is difficult to predict when and where new epidemics might occur so we can be better prepared and have a proactive response. This modelling is based on information on each virus as well as governance, communication, infrastructure and health care provision. Some areas remain at high risk and would benefit from improved surveillance, diagnostic capabilities and better health systems and local policies.
Posted 04/10/2017. Melioidosis is a neglected tropical disease estimated to kill 89,000 people a year across tropical regions and a vaccine is urgently required. In this collaboration with Imperial College, Professor Susanna Dunachie report for the first time a link between people with the HLA-B*46 genotype and around a three-fold increased risk of death. Survival from melioidosis is correlated with immune responses to nine key proteins from the causative bacteria, Burkholderia pseudomallei. This gives the foundation for development of an effective vaccine.
Posted 13/09/2017. Amanda Rojek and Peter Horby published a review aimed at clinicians who may treat patients with Ebola Virus Disease. This review outlines advances in understanding the clinical presentation, outcomes and long term sequelae of the disease, and outlines the status of experimental vaccines and treatments.
A trial in infants and toddlers in Burkina Faso showed that experimental malaria vaccine R21/MM confers 77% protection, an unprecedented level and the first malaria vaccine to exceed WHO’s goal of 75% efficacy. While a larger trial is needed to assess its safety and efficacy, R21/MM may substantially reduce child mortality in Sub-Saharan Africa. But this vaccine may be less relevant to Asia Pacific where malaria causes severe morbidity and mortality in all age groups, asymptomatic malaria infections are frequent, and the vaccine may not be effective against P. vivax.
COVID-19 in Nepal is out of hand and slowly, but surely tracking the infection in India. Although many healthcare workers have been vaccinated throughout the country, the actual vaccination rate is likely very low for the entire country. Buddha Basynat discusses Nepal’s COVID response so far, and why vaccines are an urgent priority.
Director for the Oxford University Clinical Research Unit Nepal, Professor Buddha Basnyat is a medical doctor based in Kathmandu, Nepal. His research interests are infectious diseases and high altitude medicine, and he has almost 300 publications in peer-reviewed medical journals. One of his primary interests is to encourage young people to do clinical research.
Live and on-line from Bangkok! Be ready for Thursday 13th May, when Pint of Science Thailand will stream live from Bangkok. Join us via Facebook, YouTube or right here from the Pint of Science Thailand website as we journey from bacterial infections to viruses, discover how clinical trials work, and how scientific development is seen in the eyes of the law!
Nepal is seeing a COVID surge that is proportionately similar to India. While we try to treat the sick by increasing hospital space and ensuring oxygen supply, we must also plan for an exit strategy. Over-preparation rather than under-preparedness needs to be our mantra, with widespread vaccination the key to get us out of this pandemic, by Professor Buddha Basnyat
The International Girl’s in ICT day is commemorated to create awareness on the critical need for more girls and women in the ICT sector, encourage and inspire young girls to actively pursue careers in STEM as well as engage the community to promote collaboration through partnerships. Kathreen Wafula, an ICT Support Technician in Kilifi, joins a strong team of techies and is one of the 4 women in the department.