Founded in 1986 to work in camps for refugees from Myanmar, the Shoklo Malaria Research Unit (SMRU) provides quality health care to the marginalized populations living on both sides of the Thai-Myanmar border in the Mae Sot area, Tak Province. It does this by combining research and humanitarian services, with an emphasis on mother and child health and infectious diseases. In 2018 the Borderland Health Foundation was registered in Thailand as a legal structure attached to SMRU to further develop the non-research activities.
The combination of health care and research makes SMRU unique. Its research agenda is driven by the questions faced in clinical practice and whether clinical or laboratory based, SMRU studies seek to identify community needs and strengths to help populations effectively fight infectious diseases. The resulting research has global applicability and has made a global impact, generating for example much of the evidence underpinning the treatment of malaria in pregnancy and the worldwide move in 2006 to the use of artemisinin-based combination therapies (ACTs) for first line therapy for the treatment of uncomplicated falciparum malaria.
SMRU’s ongoing clinical and laboratory work includes studies of P. falciparum and P. vivax malaria, studies in pregnant women and infants, and tuberculosis studies – particularly multi-drug resistant (MDR) TB. SMRU’s activities include malaria elimination deep inside Myanmar; maternal health; laboratory diagnosis of infectious diseases and inherited blood disorders; entomology, bioethics and community engagement.
SMRU has been led by François Nosten since its inception, and currently has 378 staff. It is headquartered in an administrative, logistical and laboratory base in Mae Sot, and has a number of clinics along the border operating outpatient, inpatient and maternity services. It also operates two TB residential clinics, and conducts extensive malaria elimination programme throughout much of Karen State (the Malaria Elimination Task Force (METF). For up to date information please visit the SMRU website
SMRU has an active student programme, with one PhD student Ms Kerryn Moore, the winner of the Excellence Award 2018, recognised for her research on SMRU data into the impact of malaria in pregnancy on birth outcomes in Asia. We regularly host University of Oxford medical students on elective and Masters in International Health and Tropical Medicine students, as well as interns and students from other universities on attachment. Importantly for its continued success, SMRU has an extensive training programme for its staff, training midwifes, obstetric ultra sonographers, health care assistants, public health students, and malaria post workers
SMRU Research highlights
Posted 02/07/2019. Highly efficacious treatment can limit the cumulative deleterious impact of malaria during pregnancy on the mother and fetus. Correct assessment of treatment efficacy with an adequate length of follow up is required. Makoto Saito and colleagues at the Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border suggest that pregnant women need to be followed up longer than the currently recommended duration of follow-up to assess antimalarial drug efficacy.
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.
Posted 25/04/2018. Mary-Ellen Gilder and colleagues at SMRU demonstrate low levels of primaquine in breast milk, findings that should change treatment policy allowing more breastfeeding women to be cured of P.vivax. This will potentially reduce the global burden of this infection which has significant negative consequences for pregnant mothers and infants.
Posted 20/11/18. Malaria in pregnancy affects both mothers and fetuses. Safe and efficacious antimalarials are needed for treating pregnant and breastfeeding mothers to protect them from devastating outcomes due to malaria. Dr Makoto Saito, Professor François Nosten and colleagues at the Shoklo Malaria Research Unit have reviewed and summarised the maternal and fetal safety of the currently available antimalarials in pregnancy and postpartum, spotlighting this neglected and vulnerable population.