The Randomised Evaluation of COVID-19 Therapy (RECOVERY) Trial, the world’s largest clinical trial for COVID-19 treatments, has now expanded internationally with Indonesia and Nepal among the first countries to join. The first patients have been recruited to RECOVERY International.
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.
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.
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.
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.
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.
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.
The RECOVERY Trial has won the Project Management Institute’s Special Covid-19 UK Response Project Award. The award specifically recognised RECOVERY’s work to investigate whether the cheap steroid dexamethasone was an effective treatment for patients hospitalised with severe COVID-19.
COVID-19 has exposed our vulnerability to pandemic infections and shown what works, and what does not. It has tested the effectiveness of the Oxford-based global, open-source, collaborative approach set up 10 years ago to prevent illness and deaths from infectious disease outbreaks: ISARIC, the International Severe Acute Respiratory and Emerging Infection Consortium.
The RECOVERY trial has been jointly awarded Health Data Research UK’s 2021 Impact of the Year Award. This award is open to projects which had effectively used health data to improve people’s lives, including through clinical practice, policy, software, algorithms, or publications. The award was presented by James O’Shaughnessy at HDR UK’s online Annual Scientific Conference: Data Insights in a Pandemic.
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 new study led by the University of Oxford has found that previous infection, whether symptomatic or asymptomatic, does not necessarily protect you long-term from COVID-19, particularly against new Variants of Concern.
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.