Global Health

Dr Tri Wangrangsimakul from our MORU unit and based in Chiangrai, northern Thailand, tells us about his research on scrub typhus. Scrub typhus is an infection caused by Orientia tsutsugamushi, a bacteria transmitted by the bite of an infected chigger mite. Characterised by a variety of symptoms and a high mortality rate, scrub typhus is an underfunded, neglected tropical disease not even listed by the WHO. Better diagnostic tests and optimised treatments are being developed since no vaccine is currently available.

Professor Rogier van Doorn, director of our OUCRU unit in Hanoi, Vietnam, tells us about his research on antimicrobial resistance and avian influenza. Antibiotics are widely used in Vietnam, leading to widespread antimicrobial resistance. Monitoring antibiotic use helps inform the government to change treatment guidelines and implement antibiotic stewardship programmes. This may also prevent the transmission of resistant bacteria outside the country.

Professor Heiman Wertheim from our OUCRU unit in Hanoi, Vietnam, tells us about his research on drug resistant infections in low and middle-income countries. Drug resistant infections are a global crisis and we cannot focus on our own country only. Clinical trials in low and middle income countries where the burden is highest, as well as work with local communities and engagement with policy makers help influence public health policies.

Professor Guy Thwaites, director of our OUCRU unit in Vietnam, tells us about his research on tuberculosis meningitis. Tuberculosis meningitis affects a fractions of TB patients but causes high levels of mortality and morbidity. A recent trial at OUCRU showed that aspirin can greatly improve outcomes. Such trial is typical of the work done in our Vietnam units, where all the research is focussed on improving the outcome for patients directly.

Dr Motiur Rahman from our OUCRU unit in Ho Chi Minh City, Vietnam, tells us about his responsibilities in laboratory management. OUCRU laboratories provide support to the unit's extensive clinical research programme, from level 2 laboratory to SAPO 4 laboratory for high-risk pathogens responsible for zoonotic infections. Early diagnosis and detection of antimicrobial resistance help prescribe the right medicine in time, contributing to better patient management.

Dr Raph Hamers from our EOCRU unit in Jakarta, Indonesia, tells us how he developed collaborative clinical trials. Indonesia is a very populous country with a huge burden of infectious diseases such as TB, malaria, HIV and CNS infections. Running clinical trials requires high levels of expertise, currently developed and strengthened by institutions such as IOCRL (Universities of Indonesia and Oxford Clinical Research laboratory). Better collaborations will also help great ideas make a bigger impact.

Professor Jeremy Day from our OUCRU unit in Ho Chi Minh City, Vietnam, tells us about his research on central nervous system and HIV infections in Vietnam. Brain infections such as meningitis and encephalitis are highly debilitating diseases, and an accurate diagnostic is essential to give patients the best treatment available. For cryptococcal meningitis, clinical trials focus on prevention, for an early diagnosis, and novel ways to use existing treatments or repurpose old drugs.

Dr Abhilasha Karkey from our Clinical Research Unit in Kathmandu, Nepal, tells us how research is brought to local communities in Nepal. Antimicrobial resistance is a huge burden in Nepal, particularly in hospitals where many nosocomial infections are caused by resistant pathogens. With limited resources, little infection controls and proper guidelines in place, finding out the main risk factors helps reduce infection rates within a hospital and better target vaccination campaigns.

Dr Marco Haenssgen tells us about his research on Health policy and systems. There is long tradition of social sciences in medicine, and the communication with the medical sciences is now improving. Social researchers can help, for instance, better design clinical trials to include social factors, contextualise interventions and put the results at a population level perspective.

Dr Tom Crellen from MORU (Mahidol Oxford Research Unit) in Bangkok, Thailand, tells us about his research on transmission dynamics of infections aquired in hospitals. Multidrug resistant bacteria are a major problem in Southeast Asia, particularly for infections acquired in hospitals. Patients data and bacteria sequence allow the reconstruction of transmission networks. Using these date, we can also build simulations to investigate the impact of possible interventions, which then inform future clinical trials.