Many households in Vietnam raise animals for food production, particularly chickens, using large amounts of antimicrobials with no veterinary support, and those antimicrobials find their way into the food chain. The ViParc project conducts intervention trials similar to human clinical trials, to help farmers reduce the level of antimicrobials used when raising chickens.
\n \n\n \n \nThere 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.
\n \n\n \n \nInfections such as dengue and Japanese encephalitis are important problems in Laos but confirmed data are lacking, particularly from outside the capital Vientiane. Rapid diagnostic tests that can be kept at tropical room temperature help better diagnosis and treatment, and also inform policy to implement vaccination programmes.
\n \n\n \n \nScrub 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.
\n \n\n \n \nMultidrug 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.
\n \n\n \n \nPrescription of antibiotics at the point of care is very high in Southeast Asia. Simple tests can help health workers determine which patients actually need antibiotics, but we need to ensure that the benefits and advantages are clearly explained. In the long term, those tests could represent a sustainable alternative to the massive prescription of antibiotics in developing countries.
\n \n\n \n \nPrimaquine can be used both to treat vivax malaria and to prevent the transmission of falciparum malaria from human to mosquito. A shorter and age-based primaquine regimen would reduce the burden of vivax malaria. It would also allow primaquine to be used more widely to block the transmission of falciparum malaria.
\n \n\n \n \nMathematical modelling, particularly when combined with economical modelling, allows researchers and policy makers to determine the most effective interventions to fight infectious diseases such as malaria. We can use those models to explore \u2018what ifs\u2019 scenarios, at country or province level, save more lives and limit costs.
\n \n\n \n \nVivax malaria used to be considered benign but is now recognised as an important cause of morbidity and mortality. Resistance to chloroquine (given to treat the parasite blood stage) is growing and ACT (artemisinin-based combination therapy) is becoming common treatment for vivax malaria. New drugs and better public health strategies can help elimination targets, anticipated for 2030.
\n \n\n \n \nGenomics is the study of the complete DNA sequence, for example of a particular parasite, allowing us to analyse its evolution and the impact of human interventions. Alongside clinical date, we use genomics to identify mutations that are markers for drug resistance. Mapping out drug resistance then helps inform elimination programmes.
\n \n\n \n \nAlthough malaria is decreasing in Myanmar, resistance to anti-malarials is on the rise in the region and the focus is now to treat people early, particularly in remote communities. MOCRU has set up a network of community health workers, trained and supplied with diagnostics, bednets and treatments, to help improve access to healthcare as well as produce the evidence to encourage policy changes.
\n \n\n \n \nIn the falciparum malaria parasite cycle, the gametocyte stages are responsible for the transmission from person to mosquito, then to other persons. A better understanding of how gametocytes respond to malaria treatments would help us block transmission and ultimately eliminate malaria.
\n \n\n \n \nAnti-malaria drug resistance is spreading throughout Southeast Asia and we need to find new treatments. Our researchers at MORU use a combination of artemisinin and two partner drugs instead of one. If confirmed safe and tolerable, triple artemisinin combination therapies might be a good option to treat multi-drug resistant malaria, as well as slow down the emergence and spread of anti-malarial resistance.
\n \n\n \n \nPrimaquine is a drug used to eliminate vivax malaria from the liver and prevent relapses. However, it causes anaemia in patients with G6PD deficiency. A new, slightly longer regimen with increasing doses of primaquine could allow to safely treat all patients with vivax malaria.
\n \n\n \n \nMalaria is the most important parasitic infection to still affect humans, and a safe use of antimalarial drugs is paramount. The current explosion of clinical data is causing a jungle of data; making sense of all this data will greatly help us in our fight to eliminate malaria.
\n \n\n \n \nAlthough malaria has greatly declined in Southeast Asia this century, treating clinical cases won\u2019t be sufficient to eliminate it from the region. Mass drug administration allows to eliminate parasites from asymptomatic carriers, and careful engagement with whole communities is key.
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