Basic hospital care may be key to saving newborn lives. Professor Mike English outlines a multidisciplinary project engaging policy-makers and practitioners in Kenya. This project demonstrated poor coverage of Nairobi\u2019s 4.25 million population if a sick newborn baby needs quality hospital care. Using novel research approaches the team also identified how severe shortages of nurses contribute to poor quality of care for patients and negatively affect nurses themselves.
\n \n\n \n \nAlthough incidence of malaria has decreased in Vietnam, the burden of infectious diseases remains high and weighs heavily on the health care system. Clinical research aims to allow investments to go further: findings in the laboratory, tested in clinical trials and then applied to the community, help improve diagnosis and management.
\n \n\n \n \nThe role of biostatisticians in clinical research is to contribute to trial design, by calculating sample size for example, and to help draw correct conclusions from the data, discriminating important information from noise. They are instrumental in the translation of a practical problem into a statistical model, and the translation of the result into practice.
\n \n\n \n \nAntibiotics 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.
\n \n\n \n \nDrug 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.
\n \n\n \n \nTuberculosis 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.
\n \n\n \n \nOUCRU laboratories provide support to the unit\u2019s 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 helps prescribe the right medicine in time, contributing to better patient management.
\n \n\n \n \nIndonesia 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.
\n \n\n \n \nBrain 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.
\n \n\n \n \nAntimicrobial 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.
\n \n\n \n \n