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Oxford Centre for Tropical Medicine and Global Health
Defining the noma research agenda
Posted 30/04/2025. The results from a September 2024 symposium on Defining the Noma Research Agenda at the Swiss Tropical and Public Health Institute has identified research needs and the way forward. The symposium included noma survivors as well as clinical and epidemiological researchers, and follows the WHO’s official recognition of noma as a neglected tropical disease. By Philippe Guerin.
Creating different global health futures: mapping the health research ecosystem and taking decolonial action
Posted 29/04/2025. Decolonisation in global health emphasises the need to challenge and change entrenched power asymmetries and unfair health research practices. Nadia Tagoe, Sassy Molyneux, Caesar Atuire and colleagues have proposed practical decolonial action using a four-step framework and a reflexive tool that can help transform key domains of the global health knowledge ecosystem.
Longitudinal tracking of healthcare professionals: a methodological scoping review
Posted 09/04/2025. How do health workers move through their careers - and how do we know? A new scoping review led by Yingxi Zhao and colleagues examined 263 studies tracking healthcare professionals over time, exploring how career choices, working conditions and wellbeing are measured. The review highlights the need for stronger, standardised tracking methods to inform workforce planning and better support health worker wellbeing across contexts.
Situational analysis of antibiotic prescriptions in Kenyan neonatal units for antimicrobial stewardship: a retrospective longitudinal study
Posted 08/04/2025. High antibiotic use in Kenyan neonatal units may contribute to antimicrobial resistance. A study of 88,000 neonatal admissions in 22 hospitals found 62.6% received antibiotics at admission, mostly first-line drugs. However, non-first-line use was higher in outborn neonates. Monitoring antibiotic patterns at scale feasible and crucial for assessing antimicrobial stewardship and reducing resistance. With Jalemba Aluvaala and Mike English
Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security
Posted 01/04/2025. Medical oxygen is a critical treatment in severe illness, yet global access remains inequitable, especially in low-income countries. The COVID-19 pandemic highlighted these disparities. The Lancet Global Health Commission emphasizes systemic improvements, investments in infrastructure, workforce training, and affordability. Addressing these gaps can save millions of lives and strengthen global health resilience. With Jacquie Oliwa and Mike English as members of this Lancet Commission.
Effects of health system limitations on the use of blood culture and sensitivity testing in Kenyan county hospitals: an interview-based qualitative study using causal loop diagrams
Posted 02/04/2025. Antibiotic resistance is rising in Africa, but blood culture and sensitivity (BCS) testing faces challenges in Kenyan hospitals. A study using a complex systems approach across eight hospitals found that interconnected issues in both demand and supply, including cost, turnaround time, and logistical barriers undermine the use and sustainability of BCS testing at scale; targeted antimicrobial stewardship may offer a viable alternative. By Jacob McKnight & Mike English with KWTRP colleagues.
Treatment and treatment outcomes of snakebite envenoming in Uganda: a retrospective analysis
Posted 20/03/2025. Snakebite envenoming is a neglected tropical disease that causes significant morbidity and mortality in rural sub-Saharan Africa. While victims seek emergency care, documentation on their treatment remains limited. Stella Nanyonga and colleagues reviewed snakebite management in Uganda among 532 snakebite victims and found that only 6.9% of patients received snake antivenom.
Can solidarity in global health curb the next outbreak? A commentary on mpox
Posted 18/03/2025. Appeals to solidarity are common during disease outbreaks. Yet, what solidarity means and how it is practiced varies across contexts. Caesar Atuire and colleagues bring conceptual clarity by distinguishing between deep and responsive solidarity. They argue that global health needs deep solidarity to curb outbreaks like mpox and to ensure that responsive solidaristic appeals are effective.
Submicroscopic malaria in pregnancy and associated adverse pregnancy events: A case-cohort study of 4,352 women on the Thailand–Myanmar border
Posted 11/03/2025. Malaria is known to be dangerous for pregnant women and their developing babies. But how much malaria is too much malaria? Using an ultra-sensitive PCR method that detects one parasite per drop of blood, Mary Ellen Gilder and SMRU colleagues found that even infections with very few parasites are associated with adverse pregnancy outcomes.
Adaptation of Plasmodium falciparum to its transmission environment
Posted 20/02/2018. The malaria parasite is a major cause of illness and deaths throughout the tropics. To survive, the malaria parasite needs to be transmitted by mosquitos form person to person. In this paper Martin Rono and colleagues show at the cellular and molecular level how the parasite balances its investment between growing efficiently in humans and maximising the chances of being transmitted by mosquitos, depending on the local environment.
Antibiotic duration for common bacterial infections - a systematic review
Posted 07/03/2025. Reducing antibiotic duration is key to antimicrobial stewardship. A review of 315 trials found strong evidence for shorter courses in common infections but limited data for severe infections and low-income settings. Only 15% had low bias risk. More research is needed in critical care and resource-limited environments. By Mo Yin
Cost-effectiveness of a short-course antibiotic treatment strategy for the treatment of ventilator-associated pneumonia: an economic analysis of the REGARD-VAP trial
Posted 04/03/2025. Previously, the REGARD-VAP trial found that giving patients with ventilator-associated pneumonia (VAP) a personalised, shorter antibiotic treatment was just as effective as usual care. Mo Yin and colleagues showed this approach is also cost-effective in Nepal, Singapore, and Thailand. This approach could save money, reduce antibiotic use, and help policymakers make better healthcare decisions despite some uncertainties.
Catastrophic expenditure associated with childhood hospitalisation for acute illness in Kenya and Uganda: a cross-sectional study
Posted 04/02/2025. In Kenya and Uganda, hospital care for under-fives is intended to be free. James Berkley and colleagues studied families’ healthcare, travel, other costs, and loss of earnings due to child admissions at six hospitals. 74% to 92% of households experienced ‘catastrophic’ expenditure (depending on the definition used) in relation to monthly income.
After neonatal care, what next? A qualitative study of mothers’ post-discharge experiences after premature birth in Kenya
Posted 28/01/2025. Each year, 15 million babies are born prematurely, with Sub-Saharan Africa and Asia accounting for over half. Weak healthcare systems and poverty in SSA worsen outcomes for mothers and babies. This study by Justinah Maluni and Dorothy Oluoch explores the challenges mothers face post-discharge and suggests strategies to improve care and reduce mortality and readmission rates.
Population genomics and transcriptomics of Plasmodium falciparum in Cambodia and Vietnam uncover key components of the artemisinin resistance genetic background
Posted 17/12/2024. Tom Peto and colleagues collected Plasmodium falciparum parasites from malaria patients in Cambodia and Vietnam between 2018 and 2020 in the MORU-led TACT-CV study. Novel molecular analyses of these samples at Nanyang Technological University identified new genetic factors that appear under selective pressure and may contribute to artemisinin resistance mechanisms in clinical settings.
Public service motivation, public sector preference and employment of Kenyan medical doctor interns: a cross-sectional and prospective study
Posted 11/09/2024. Daniel Mbuthia and colleagues surveyed 356 Kenyan medical doctors, to understand what influences their career choices at labour market entry, specifically understanding the role of public service motivation. They highlighted that nearly all surveyed doctors are public service oriented, many doctors stated intention to work in the public sector but were unable due to lack of job opportunities. Unfortunately, 13% of the doctors were unemployed one year after completing their internship.
Examining liminality in professional practice, relational identities, and career prospects in resource-constrained health systems: Findings from an empirical study of medical and nurse interns in Kenya
Posted 03/09/2024. Yingxi Zhao, Stephanie Nzekwu and colleagues examined new Kenyan doctors' and nurses' experiences of transitioning from training to practising as health professionals, drawing on the concept of liminality. The research highlighted three dimensions of liminal experiences in professional practice, relational inter- and intra-professional identity and status, and professional careers.
New Tools and Nuanced Interventions to Accelerate Achievement of 2030 Roadmap for Neglected Tropical Diseases
Posted 15/05/2024. Collection of articles in the Clinical Infectious Disease Journal supplement. NTDs are a major cause of death, disability, and economic hardship, particularly in low- and middle-income countries. The research by Professor Déirdre Hollingsworth et al aims to better understand which interventions are needed to achieve the 2030 NTD targets, determine the best strategies for keeping NTDs under control after target achievement, and assess the costs associated with different options.
Climate change, malaria and neglected tropical diseases: a scoping review
Posted 10/05/2024. The NTD Modelling Consortium contributed to the World Health Organization scoping review led by Petra Klepac et al. It highlights the urgent need for collaborative modelling and greater evidence to understand the effects of climate change impacts on neglected tropical diseases and malaria.
Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
Posted 10/07/2024. Physician associate and nurse practitioner roles have been developed largely to meet changing healthcare demand and increasing workforce shortages. Yingxi Zhao and colleagues summarise the factors influencing their development and integration in hospital teams, advocating for organisation context-specific workforce solutions, long-term investment, substantial resources, and transparent processes to meet evolving healthcare challenges.