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Publication Open Access Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau.(2014-02-06) Vermeersch, Audrey; Libaud-Moal, Anaëlle; Rodrigues, Amabelia; White, Nicholas J; Olliaro, Piero; Gomes, Melba; Ashley, Elizabeth A; Millet, Pascal; Millet, Pascal; Mahidol University. Faculty of Tropical Medicine.of severity and ensuing decisions were not specific for serious illness, indicating that initial training to recognize signs of severe disease and treatment availability for non-severe, fever-associated symptoms will be required to prevent overuse of a newPublication Open Access Primaquine: the risks and the benefits(2014) Ashley, Elizabeth A; Judith Recht; White, Nicholas J; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit,428 (upper 95% CI: one in 407,807). All but one death followed multiple dosing to prevent vivax malaria relapse. Review of dose-response relationships and clinical trials of primaquine in G6PD deficiency suggests that the currently recommended WHO singlePublication Open Access Persistent Plasmodium falciparum and Plasmodium vivax infections in a western Cambodian population: implications for prevention, treatment and elimination strategies(2016) Rupam Tripura; Peto, Thomas J.; Jeremy Chalk; Lee, Sue J.; Pasathorn Sirithiranont; Chea Nguon; Mehul Dhorda; Seidlein, Lorenz von; Maude, Richard J.; Day, Nicholas P. J.; Mallika Imwong; White, Nicholas J.; Dondorp, Arjen M.; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unitof parasitaemia, the entire population of three Cambodian villages in Pailin province were followed for 1 year at three-monthly intervals. A cohort of adult participants found initially to have asymptomatic malaria parasitaemia was followed monthly over the same... period. Results: The initial cross sectional survey in June 2013 (M0) of 1447 asymptomatic residents found that 32 (2.2 %) had Plasmodium falciparum, 48 (3.3 %) had P. vivax, 4 (0.3 %) had mixed infections and in 142/1447 (9.8 %) malaria was detectedPublication Open Access Artemisinin resistance containment project in Thailand. (I): Implementation of electronic-based malaria information system for early case detection and individual case management in provinces along the Thai-Cambodian border(2012-07-29) Amnat Khamsiriwatchara; Prayuth Sudathip; Surasak Sawang; Saowanit Vijakadge; Thanapon Potithavoranan; Aumnuyphan Sangvichean; Wichai Satimai; Delacollette, Charles; Pratap Singhasivanon; ประตาป สิงหศิวานนท์; Saranath Lawpoolsri; สารนาถ ล้อพูลศรี; Jaranit Kaewkungwal; จรณิต แก้วกังวาล; Jaranit Kaewkungwal; Mahidol University. Faculty of Tropical Medicine. Department of Tropical Hygiene; Mahidol University. Faculty of Tropical Medicine. Center of Excellence for Biomedical and Public Health Informatics.initiative, funded by the Bill & Melinda Gates Foundation, to contain anti-malarial drug resistance in Southeast Asia. The main objective of this study was to demonstrate the eMIS' functionality and outputs after implementation for use in the Thailand... artemisinin-resistance containment project. METHODS: The eMIS had been functioning since 2009 in seven Thai-Cambodian border provinces. The eMIS has covered 61 malaria posts/clinics, 27 Vector-borne Disease Units covering 12,508 hamlets at risk of malariaPublication Open Access Participants’ perceptions and understanding of a malaria clinical trial in Bangladesh(2014) Debashish Das; Cheah, Phaik Yeong; Fateha Akter; Dulal Paul; Akhterul Islam; Rasheda Samad; Ridwanur Rahman; Amir Hossain; Arjen Dondorp; Day, Nicholas P; White, Nicholas J; Mahtabuddin Hasan; Aniruddha Ghose; Ashley, Elizabeth A; Abul Faiz; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research UnitBackground: Existing evidence suggests that there is often limited understanding among participants in clinical trials about the informed consent process, resulting in their providing consent without really understanding the purpose of the study..., specific procedures, and their rights. The objective of the study was to determine the subjects’ understanding of research, perceptions of voluntariness and motivations for participation in a malaria clinical trial. Methods: In this study semi-structuredPublication Open Access Application of mobile-technology for disease and treatment monitoring of malaria in the "Better Border Healthcare Programme"(2010-08) Pongthep Meankaew; พงษ์เทพ เมียนแก้ว; Jaranit Kaewkungwal; จรณิต แก้วกังวาล; Amnat Khamsiriwatchara; อำนาจ คำศิริวัชรา; Podjadeach Khunthong; พจเดช ขุนทอง; Pratap Singhasivanon; ประตาป สิงหศิวานนท์; Wichai Satimai; Jaranit Kaewkungwal; Mahidol University. Faculty of Tropical Medicine. Department of Tropical Hygieneanalysis. Following standard public-health practices, access to the patient database was strictly limited to authorized personnel in charge of patient case management. RESULTS: The DTMM module was developed and implemented at the trial site in late.... falciparum-infected cases, but lower rate for P. vivax cases. Patients' symptoms were captured onto the mobile phone during each follow-up visit, either during the home visit or at Malaria Clinic; most patients had headache, muscle pain, and fatiguePublication Open Access Acute Renal Failure in Patients with Severe Falciparum Malaria: Using the WHO 2006 and RIFLE Criteria(2013) Vipa Thanachartwet; วิภา ธนาชาติเวทย์; Varunee Desakorn; วารุณี เทศะกรณ์; Duangjai Sahassananda; ดวงใจ สหัสสานนท์; Kyaw Win, Ko Ko Yazar; Thanom Supaporn; Vipa Thanachartwet; Mahidol University. Faculty of Tropical Medicine. Department of Clinical Tropical MedicineThere are limited data on the application of the RIFLE criteria among patients with severe malaria. This retrospective study was conducted by reviewing 257 medical records of adult hospitalized patients with severe falciparum malaria at the Mae Sot General Hospital, Tak province in the northern part of Thailand. The aims of this study were to determine the incidence of acute renal failure (ARF) in patients with severe falciparum malaria and its association with RRT as well as in-hospital mortality. Using the WHO 2006 criteria, ARF was the second most common complication with incidence of 44.7% (115 patients). The requirement for RRT was 45.2% (52 patients) and the in-hospital mortality was 31.9% (36 patients). Using the RIFLE criteria, 73.9% (190 patients) had acute kidney injury (AKI). The requirement for RRT was 11.6% (5 patients) in patients with RIFLE-I and 44.9% (48 patients) in patients with RIFLE-F. The in-hospital mortality gradually increased with the severity of AKI. The requirement for RRT (P < 0.05) and the in-hospital mortality (P < 0.05) were significantly higher in ARF patients with severe falciparum malaria using both criteria. In conclusion, the RIFLE criteria could be used for diagnosing AKI and predicting outcomes in patients with severe malaria similar to the WHO 2006 criteria.Publication Open Access Ethical considerations in malaria research proposal review: empirical evidence from 114 proposals submitted to an Ethics Committee in Thailand(2015) Pornpimon Adams; Sukanya Prakobtham; Chanthima Limphattharacharoen; Pitchapa Vutikes; Srisin Khusmith; Krisana Pengsaa; Polrat Wilairatana; Jaranit Kaewkungwal; Mahidol University. Faculty of Tropical Medicine. Department of Tropical HygieneBackground: Malaria research is typically conducted in developing countries in areas of endemic disease. This raises specific ethical issues, including those related to local cultural concepts of health and disease, the educational background of study subjects, and principles of justice at the community and country level. Research Ethics Committees (RECs) are responsible for regulating the ethical conduct of research, but questions have been raised whether RECs facilitate or impede research, and about the quality of REC review itself. This study examines the review process for malaria research proposals submitted to the Ethics Committee of the Faculty of Tropical Medicine at Mahidol University, Thailand. Methods: Proposals for all studies submitted for review from January 2010 to December 2014 were included. Individual REC members’ reviewing forms were evaluated. Ethical issues (e.g., scientific merit, risk–benefit, sample size, or informed-consent) raised in the forms were counted and analysed according to characteristics, including study classification/ design, use of specimens, study site, and study population. Results: All 114 proposals submitted during the study period were analysed, comprising biomedical studies (17 %), drug trials (13 %), laboratory studies (24 %) and epidemiological studies (46 %). They included multi-site (13 %) and international studies (4 %), and those involving minority populations (28 %), children (17 %) and pregnant women (7 %). Drug trials had the highest proportion of questions raised for most ethical issues, while issues concerning privacy and confidentiality tended to be highest for laboratory and epidemiology studies. Clarifications on ethical issues were requested by the ethics committee more for proposals involving new specimen collection. Studies involving stored data and specimens tended to attract more issues around privacy and confidentiality. Proposals involving minority populations were more likely to raise issues than those that did not. Those involving vulnerable populations were more likely to attract concerns related to study rationale and design. Conclusions: This study stratified ethical issues raised in a broad spectrum of research proposals. The Faculty of Tropical Medicine at Mahidol University is a significant contributor to global malaria research output. The findings shed light on the ethical review process that may be useful for stakeholders, including researchers, RECs and sponsors, conducting malaria research in other endemic settings.Publication Open Access Malaria burden and artemisinin resistance in the mobile and migrant population on the Thai-Myanmar border, 1999-2011: an observational study(2014-04-24) Carrara, Verena I.; Lwin, Khin Maung; Phyo, Aung Pyae; Ashley, Elizabeth; Wiladphaingern, Jacher; Sriprawat, Kanlaya; Rijken, Marcus; Boel, Machteld; McGready, Rose; Proux, Stephane; Chu, Cindy; Pratap Singhasivanon; ประตาป สิงหศิวานนท์; White, Nicholas; Nosten, Francois; Nosten, Francois; Mahidol University. Faculty of Tropical Medicine. Mahidol Oxford University Research Unitefficacy were monitored. Over this period, the number of malaria cases detected increased initially, but then declined rapidly. In children under 5 y, the percentage of consultations due to malaria declined from 78% (95% CI 76-80) (1,048/1Publication Open Access Efficacy and day 7 plasma piperaquine concentrations in African children treated for uncomplicated malaria with dihydroartemisinin-piperaquine.(2014-08-18) Zongo, Issaka; Some, Fabrice A.; Somda, Serge A. M.; Parikh, Sunil; Rouamba, Noel; Rosenthal, Philip J.; Tarning, Joel; Lindegardh, Niklas; Nosten, Franc¸ois; Oue´draogo, Jean Bosco; Oue´draogo, Jean Bosco; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit.; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit. Shoklo Malaria Research Unit.BACKGROUND: One promising new Artemisinin-based combination therapies (ACTs) is dihydroartemisinin-piperaquine (DHA-PQ). However, the pharmacokinetics of piperaquine and the relationship between drug levels and clinical efficacy are incompletely
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