MOCRU Myanmar (MORU network)
The Myanmar-Oxford Clinical Research Unit (MOCRU) is a tropical medicine research organisation formed as an extension of the medical research activities of the University of Oxford in Southeast Asia. The unit is based in Yangon under the leadership of Professor Frank Smithuis.
Myanmar (Burma) is a low income country with under-developed healthcare, ranking 145 out of 187 countries in the UN Development Programme’s 2016 Human Development Index, and a population of 54 million. Despite Myanmar being isolated from the international community for over five decades the Wellcome Trust Asia Major Overseas Programmes have for over 20 years been conducting research of public health importance there on a project by project basis, collaborating with Professor Frank Smithuis (formerly of Médécins sans Frontières (MSF) and later of Medical Action Myanmar), and with the Department of Medical Research (DMR) and the Directorate of Medical Services (DMS). An academic collaboration with University of Medicine 1 was initiated in 2017, which will facilitate hospital and clinical laboratory based research in Yangon.
In 2013, MORU’s presence in Myanmar was formalised with the setting up of the Myanmar Oxford Clinical Research Unit (MOCRU) and the signing of an MOU with the Ministry of Health, and Frank became the director of this newly formed organisation.
MOCRU has a strong link with Medical Action Myanmar, a non-governmental organisation with a well-established infrastructure of 10 clinics and 1,850 village health workers spread across the poorest rural areas, which are a valuable resource for future research. The MOCRU admin staff and academic leadership share an office and logistical base in Yangon with MAM.
In 2017 Frank was joined by Elizabeth Ashley, a consultant infectious disease physician and microbiologist with vast experience of running clinical research on the Thai Myanmar border and more recently coordinating the DFID-funded multi-country TRAC (Tracking Resistance to Artemisinin Collaboration) study. She is the director of clinical research, and coordinates activities with the SMRU cross border research in Kayin State. In addition to Frank and Liz there are six permanent staff based at the head office in Yangon. Many research staff are based at the research projects, with most research staff on MAM’s payroll.
MOCRU’s current, ongoing research projects are:
- Pilot studies of mass drug administration for malaria elimination in an area of artemisinin resistance
- The TRAC II study in 4 sites across Myanmar: This is a multicentre randomised controlled trial of Triple Artemisinin-based Combinations Therapies (TACTs) versus conventional ACTs to treat P. falciparum malaria
- Determining predictors of mortality and loss-to-follow-up in HIV clinics in Myanmar
- A multi-centre observational study to describe the prevalence of scrub typhus defined as a positive rapid diagnostic test among selected patients presenting with fever to clinics in Myanmar
- Studies of the use of CRP testing to reduce antibiotic usage in patients presenting with febrile illnesses
- Environmental sampling and mapping of the geographic distribution of Burkholderia pseudomallei, the cause of melioidosis, in Myanmar
MOCRU Research Highlights
Posted 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.
The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia
Posted 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.
Effect of point-of-care C-reactive protein testing on antibiotic prescription in febrile patients attending primary care in Thailand and Myanmar
Posted 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!
Posted 17/04/2018. This new Lancet malaria seminar, by Elizabeth Ashley and Charlie Woodrow, is one of a series of clinically focused, structured, up-to-date reviews which are grouped together in The Lancet Clinic with other relevant content. The aim of the seminars is to give a comprehensive overview of diseases to practising clinicians, emphasising recent advances, controversies and uncertainties.