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 01/10/2021. In 2017 hundreds of thousands of ‘Rohingya’ fled from Myanmar to refugee camps in Cox’s 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’ 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
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.
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 21/09/2021. The WHO's ‘5 moments’ is the dominant paradigm for hand hygiene globally. While ‘5 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.
Posted 15/09/2021. In Cambodian G6PD deficient variants, G6PD enzyme activity is unaffected by baseline reticulocyte counts but rises and correlates with posttreatment reticulocytosis. Qualitative G6PD tests are unlikely to misdiagnose G6PD deficient males at presentation. Too few G6PD heterozygous females preclude drawing inferences; more research is needed in this group.
Posted 14/09/2021. Little is known about why scrub typhus and murine typhus vary through time and space. Tamalee Roberts and colleagues investigated the impacts of climate and environment on both neglected diseases in Laos. The results suggest that global heating will increase their incidence and distribution, requiring interventions to reduce their burden.
Posted 17/09/2021. One of the policies to achieve malaria elimination in the near future is reactive case detection. A secondary analysis of a large dataset of mass drug administrations in Greater Mekong Subregion found that reactive case detection in this setting is costly but results only in minimal benefits, by Lorenz Von Seidlein and colleagues
Posted 02/09/2021. A cross-sectional survey of G6PD deficiency genotypes and phenotypes of nearly two thousand girls and women living on malarious Sumba island in eastern Indonesia assessed risk of hemolytic crisis with primaquine therapy against latent malaria with G6PD screening technologies. These findings by Kevin Baird and colleagues will help guide the selection of G6PD screening methodology and practice.
Posted 01/09/2021. Rob Paton, Alice Kamau and colleagues analysed a data series of over 6000 hospital records of malaria admissions among children aged 3 months to 9 years. A 25% reduction in transmission halved the rate of severe malaria hospitalization. Severe malaria remains a burden predominantly in children under 5 years, regardless of the level of malaria transmission.
Posted 31/08/2021. Using a simple One Health survey design, this pilot study by Juan Carrique-Mas and colleagues measured AMU in the four commonly farmed animal species in the Mekong Delta (Vietnam) and compared it to human AMU using different metrics. Lessons from this study can be used in the formulation of One Health surveillance systems.
Posted 27/08/2021. Demographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for paediatric complex and chronic conditions, however such expansion is threatened by workforce shortages. Yingxi Zhao and colleagues reviewed how task sharing could support expanded paediatrics services provision in LMICs, especially beyond acute infectious diseases and malnutrition that are widely and historically shifted.
Posted 24/08/2021. Suicide is a leading cause of maternal death globally. On the Thailand-Myanmar border, 8% of refugee women and 3% of migrant women experienced suicidal thoughts during pregnancy and postnatally. The greatest risk factors for suicidal thoughts were unplanned pregnancy and past trauma. Community interventions and targeted prevention initiatives are urgently needed to help lower the rates of people dying by suicide, by Gracia Fellmeth and colleagues.
Posted 06/08/2021. Preprints are increasingly being used to share non-peer-reviewed manuscripts to enable the rapid dissemination of research. In particular, they have become an important source of information for wider audiences keen to follow COVID-19 research developments, including news, social media and policymakers. This practice raises several challenges in publication ethics and integrity. Paul Newton and colleagues set out the need for good practice.
Posted 03/08/2021. Ribavirin is the only available Lassa fever treatment. The rationale for using ribavirin is based on one clinical study conducted in the early 1980s. However, reanalysis by Alex Salam and colleagues of previous unpublished data reveals that ribavirin may actually be harmful in some Lassa fever patients. An urgent reevaluation of ribavirin is therefore needed.
Posted 30/07/2021. A reliable catchment area is essential to define community needs (education, health care and social care) and population denominators. However, catchments are often implemented based on convenience disregarding implications on accuracy, planning and service seeking behaviour. Peter Macharia and colleagues revisit the issue by considering common approaches, key issues, and best practices in defining a reliable service catchment area
Posted 27/07/2021. This qualitative study by Mira Schneiders and colleagues discusses the important nutrition-related roles and responsibilities of grandparents caring for grandchildren in rural Cambodian ‘skip-generation’ households. Grandparents appear highly motivated to improve grandchildren’s health and nutrition, but lack necessary resources, leading to frequent moral dilemmas and ethical trade-offs. Interventions to improve child health and nutrition should be designed to be inclusive of older caregivers.
Posted 23/07/2021. Effective management and leadership are essential for everyday health system resilience, but health managers are often under-prepared and under-supported in these roles. Particular challenges have been observed in communication skills, emotional competence and supportive oversight. Jacinta Nzinga and colleagues share their learning from implementing a package of leadership development interventions in Kenya
The fast spread of the highly infectious Delta variant underscores the need for faster identification of COVID-19 mutations. Uniting governments and medical communities in this challenge, the University of Oxford and Oracle’s Global Pathogen Analysis System (GPAS) is now being used by organizations on nearly every continent. Institutions using the platform include OUCRU in Vietnam and institutions in Canada, Chile, Australia and the UK. GPAS is also now part of the Public Health England New Variant Assessment Platform.
Following the meeting of the Medical Sciences Divisional Committee to consider applications for the conferral of the title of Associate Professor, we are pleased to announce that Rashan Haniffa, Dorcas Kamuya, Isabella Oyier, Le Van Tan and Timothy Walker have been awarded the title Associate Professor
Nguyen Lam Vuong, Sophie Yacoub & colleagues have identified a combination of biological markers in patients with dengue that could predict whether they go on to develop moderate to severe disease. Biomarkers are used to identify the state or risk of a disease in patients; these findings could aid the development of biomarker panels for clinical use and help improve triage and risk prediction in patients with dengue.
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.
The pioneering work of members of the University of Oxford has been recognised in The Queen's Birthday Honours List. The honorands include Professor Peter Horby and six researchers that have played key roles in leading the University’s response to the Coronavirus pandemic, from the development of new vaccines to the discovery of new drug treatments. Professor Guy Thwaites is appointed a Member of the Order of the British Empire.
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.