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Oxford Centre for Tropical Medicine and Global Health
Sustainable antimicrobial resistance surveillance: time for a global funding mechanism
Posted 07/01/2025. The continued costs of a standard national AMR surveillance system are predicted to account for over 5% of the total domestic general government health expenditure (GGHE-D) for 28 LMICs and more than 2% of GGHE-D for 46 LMICs. This high cost is not sustainable without a long-term global financing mechanism. By Liz Ashley
AmpC β-lactamases detected in Southeast Asian Escherichia coli and Klebsiella pneumoniae
Posted 20/12/2024. AmpC β-lactamases are a neglected cause of third generation cephalosporin resistance in Southeast Asia. This collaboration between COMRU, LOMWRU and SMRU showed that AmpC β-lactamases are an important cause of infection, though infections may be going undetected due to a lack of testing resulting in sub-optimal treatment for patients. By Tamalee Roberts
Ethical and cultural implications for conducting verbal autopsies in South and Southeast Asia: a qualitative study
Posted 20/12/2023. The verbal autopsy method can be sensitive to the individuals interviewed, their families and communities. Prior to study implementation, Nan Shwe Nwe Htun, Tom Peto and SEACTN colleagues sought to explore local beliefs and practices about death to inform appropriate bioethical practices and found that verbal autopsy is acceptable across a wide range of cultural settings in Bangladesh, Myanmar, Thailand, Laos PDR, and Cambodia.
Accuracy of the direct agglutination test for diagnosis of visceral leishmaniasis: a systematic review and meta-analysis
Posted 01/12/2023. Parasitology is the gold standard for the diagnosis of visceral leishmaniasis (VL), however, other less invasive tests are available such as the direct agglutination test (DAT). As part of the series of systematic reviews and meta-analysis on diagnostic accuracy of diagnostics for FIEBRE infections, Tamalee Roberts and colleagues estimate the diagnostic sensitivity and specificity of DAT for the diagnosis of VL.
A systematic review of neglected tropical diseases (NTDs) in Myanmar
Posted 21/11/2023. Neglected tropical diseases (NTDs) are a group of preventable and treatable diseases common in Myanmar, primarily affecting marginalized rural communities. Myo Swe and colleagues provide an overview of reported NTDs in Myanmar over 100 years, indicating gaps in knowledge about certain diseases to inform future research directions related to NTDs in Myanmar.
A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN): pilot implementation in three countries in Southeast Asia, 2019-2020
Posted 01/11/2023. ACORN (A Clinically Oriented Antimicrobial Resistance Surveillance network) is a WHO GLASS compatible case-based surveillance method for antimicrobial resistance that produces more meaningful and locally actionable data. Rogier van Doorn and colleagues publish the results of a pilot in three countries, showing proof of principle and valuable lessons to be learned going forward. More at: acornamr.net
Longitudinal comparison of bacterial pathogen seropositivity among wet market vendors in the Lao People's Democratic Republic
Posted 31/08/2023. Vendors at wet markets in Laos may be exposed to different zoonotic pathogens depending on the types of food they sell. A one-year serological survey by Matthew Robinson and colleagues identified that individuals selling vegetables, domestic farmed meat, or wildlife meat, were potentially infected by important bacterial pathogens associated with both farmed animals and wildlife.
Malaria outbreak in Laos driven by a selective sweep for Plasmodium falciparum kelch13 R539T mutants: a genetic epidemiology analysis
Posted 14/12/2022. Malaria outbreaks can be driven by genetic selection rather than environmental or behavioural causes. Varanya Wasakul, Olivo Miotto and colleagues investigated a Plasmodium falciparum outbreak in Attapeu, Laos, in 2020-2021, using genomic epidemiology methods to elucidate parasite population dynamics, identify the outbreak’s causes and reconstruct the origin of the circulating strains.
An epidemic of dystonic reactions in central Africa
Posted 17/03/2017. An investigation conducted by the international medical organisation Médecins Sans Frontières revealed that over a thousand people in a remote area of the Democratic Republic of Congo suffered toxic effects after ingesting fake diazepam pills. The research was published in The Lancet Global Health with contribution from Prof Paul Newton from IDDO and LOMWRU.
Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE): protocol for a multisite prospective observational study of the causes of fever in Africa and Asia
Posted 01/09/2020. This paper provides an overview of FIEBRE’s activities. The study aims to identify infections that are treatable and/or preventable, to assess antimicrobial susceptibility of bacterial pathogens and to collect qualitative data on care-seeking and treatment behaviours. Paul Newton and colleagues detail clinical and laboratory assessments, data analysis plan, and outline the study’s strengths and limitations.
Quality of medical products for diabetes management
Posted 01/10/2019. In the light of the alarming global increase in diabetes, Kartika Saraswati and colleagues at the LOMWRU-IDDO Medicine Quality team found few investigations on the quality of antidiabetics and supplies for self-monitoring of blood glucose. However, poor quality medical products were identified on four continents. This important public health issue should thus be further investigated.
How many human pathogens are there in Laos? An estimate of national human pathogen diversity and analysis of historical trends
Posted 27/10/2020. Madeleine Clarkson, Paul Newton and colleagues reviewed when individual species of human pathogens were described in Laos, and estimated the in-country diversity and how many more pathogens there may be. Combining modelling with historical assessment improved understanding of the factors affecting pathogen description. During the last decade there has been a 33-fold increase in the description rate, coinciding with the strengthening of medical research in Laos.
Orientia tsutsugamushi in Chiggers and Small Mammals in Laos
Posted 06/12/2011. Scrub typhus is an important cause of febrile illness in Laos. Ivo Elliott and colleagues collected, identified and tested small mammals hosts and vector chigger mites for Orientia tsutsugamushi, the causative pathogen. A single pool of chiggers tested PCR positive and 16/52 (31%) of small mammals were seropositive. These are the first molecular and serological data on O. tsutsugamushi in vectors and non-human hosts from Laos.
Impact of delayed processing of positive blood cultures on organism detection: a prospective multi-centre study
Posted 19/07/2022. What effect temperature and time have on organism detection from positive blood culture bottles is unknown. Tamalee Roberts, Arjun Chandna and colleagues found that the majority of organisms were recoverable from positive blood culture bottles stored at room temperature. Amies transport swabs also proved effective for transporting blood culture broth and preserving organism viability.
Childhood encephalitis in the Greater Mekong region (the SouthEast Asia Encephalitis Project): a multicentre prospective study
Posted 21/06/2022. The South-East Asia Encephalitis Consortium, coordinated by Institut Pasteur-Paris, published in Lancet Global Health, a large prospective study of childhood encephalitis in Cambodia, Laos, Vietnam and Myanmar. The Lao site was coordinated by LOMWRU/Microbiology Laboratory, Mahosot Hospital. This demonstrated the vital importance of prevention, especially vaccination against Japanese encephalitis, and access to rapid, tiered diagnosis and treatment.
Utility of InTray COLOREX Screen agar and InTray COLOREX ESBL agar for urine culture in the Lao PDR
Posted 23/02/2022. Simple diagnostics are needed for enhanced antimicrobial resistance surveillance. Tamalee Roberts and colleagues showed how InTray COLOREX Screen chromogenic agar can be used for simple and rapid detection of uropathogens and ESBLs in LMIC settings. Inoculated agar plates also have the potential for easy storage and transport from field sites to central laboratories.
A case–control study of the causes of acute respiratory infection among hospitalized patients in Northeastern Laos
Posted 28/01/2022. This case-control study by Koukeo Phommasone and colleagues aimed to determine the causes of acute respiratory infection (ARI) in patients presenting to a hospital in Laos. ARI was commonly attributed to influenza A and B, human metapneumovirus and respiratory syncytial virus. Other organisms were detected at similar frequency in cases and controls.
Clinical impact of vivax malaria: A collection review
Posted 25/01/2022. This latest addition by Elizabeth Ashley and colleagues to the PLOS Medicine Vivax Malaria Collection describes the clinical impacts of Plasmodium vivax malaria, and incorporates a rapid systematic review of severe disease. Reports of severe vivax malaria are increasing, however the literature is dominated by case reports and case series, impeding accurate estimation of incidence.
Antimicrobial resistance detection in Southeast Asian hospitals is critically important from both patient and societal perspectives, but what is its cost?
Posted 05/11/2021. Generation of quality surveillance data is one of the pillars of the WHO response to the global AMR problem. However, work by LOMWRU’s Tamalee Roberts and colleagues estimates that laboratory setup and running costs for hospital-based AMR surveillance in Southeast Asia are likely to be prohibitive in many resource-limited settings.
A spatio-temporal analysis of scrub typhus and murine typhus in Laos; implications from changing landscapes and climate
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.