A5090518483- Malaria Research and Control
- Global Maternal and Child Health
- Mosquito-borne diseases and control
- Pregnancy and preeclampsia studies
- Travel-related health issues
- Hemoglobinopathies and Related Disorders
- Child Nutrition and Water Access
- Migration, Health and Trauma
- Preterm Birth and Chorioamnionitis
- Reproductive System and Pregnancy
- Pregnancy and Medication Impact
- Pharmacological Effects and Toxicity Studies
- Maternal and Perinatal Health Interventions
- Parasites and Host Interactions
- Drug-Induced Hepatotoxicity and Protection
- Neonatal Health and Biochemistry
- Assisted Reproductive Technology and Twin Pregnancy
- Insect Pest Control Strategies
- Cleft Lip and Palate Research
- Demographic Trends and Gender Preferences
- Research on Leishmaniasis Studies
- Fetal and Pediatric Neurological Disorders
- Gestational Diabetes Research and Management
- Microbial infections and disease research
- Oral Health Pathology and Treatment
Mahidol Oxford Tropical Medicine Research Unit
2016-2025
Shoklo Malaria Research Unit
2016-2025
Mahidol University
2016-2025
University of Calgary
2016-2018
Inserm
2018
Economic & Social Sciences, Health Systems & Medical Informatics
2018
University of California, Irvine
2018
University of Oxford
2018
Research Research (South Africa)
2017
The effects of malaria and its treatment in the first trimester pregnancy remain an area concern. We aimed to assess outcome malaria-exposed malaria-unexposed first-trimester pregnancies women from Thai-Burmese border compare outcomes after chloroquine-based, quinine-based, or artemisinin-based treatments.We analysed all antenatal records attending Shoklo Malaria Research Unit clinics May 12, 1986, Oct 31, 2010. Women without were compared with those who had a single episode trimester....
BackgroundPotentially untreatable Plasmodium falciparum malaria threatens the Greater Mekong subregion. A previous series of pilot projects in Myanmar, Laos, Cambodia, and Vietnam suggested that mass drug administration was safe, when added to provision early diagnosis treatment, could reduce reservoir P interrupts transmission. We examined effects a scaled-up programme this strategy four townships eastern Myanmar on incidence malaria.MethodsThe implemented Myawaddy, Kawkareik, Hlaingbwe,...
Background The Shoklo Malaria Research Unit has been working on the Thai–Myanmar border for 25 y providing early diagnosis and treatment (EDT) of malaria. Transmission Plasmodium falciparum declined, but resistance to artesunate emerged. We expanded malaria activities through EDT evaluated impact over a 12-y period. Methods Findings Between 1 October 1999 30 September 2011, increased number cross-border (Myanmar side) health facilities from two 11 recorded consultations. Changes in incidence...
Background The emergence and spread of multidrug-resistant Plasmodium falciparum in the Greater Mekong Subregion (GMS) threatens global malaria elimination efforts. Mass drug administration (MDA), presumptive antimalarial treatment an entire population to clear subclinical parasite reservoir, is a strategy accelerate elimination. We report cluster randomised trial assess effectiveness dihydroartemisinin-piperaquine (DP) MDA reducing incidence prevalence 16 remote village populations Myanmar,...
Intermittent preventive treatment (IPT), the main strategy to prevent malaria and reduce anaemia low birthweight, focuses on second half of pregnancy. However, intrauterine growth restriction may occur earlier in The aim this study was measure effects first pregnancy by comparing fetal biparietal diameter (BPD) infected uninfected women whose pregnancies had been accurately dated crown rump length (CRL) before 14 weeks gestation.In 3,779 living Thai-Myanmar border who delivered a normal...
Most evidence on the association between malaria in pregnancy and adverse outcomes focuses falciparum detected at birth. We assessed number timing of vivax episodes during small-for-gestational-age (SGA) preterm birth.We analysed observational data collected from antenatal clinics Thailand-Myanmar border (1986-2015). effects total SGA SGA, very birth, late by gestational age detection treatment using logistic regression models with time-dependent variables (monthly intervals). World Health...
<ns4:p><ns4:bold>Background: </ns4:bold>Artemisinin and partner drug-resistant falciparum malaria is expanding over the Greater Mekong Sub-region (GMS). Eliminating in GMS while drugs still retain enough efficacy could prevent global spread of antimalarial resistance. rapidly requires targeting reservoir asymptomatic parasite carriers.</ns4:p><ns4:p> This pilot trial aimed to evaluate acceptability, safety, feasibility effectiveness mass-drug administration (MDA) reducing four villages...
BackgroundArtemisinins, the most effective antimalarials available, are not recommended for falciparum malaria during first trimester of pregnancy because safety concerns. Therefore, quinine is used despite its poor effectiveness. Assessing artemisinin requires weighing risks and treatment. We aimed to assess effect first-trimester treatment on miscarriage major congenital malformations.MethodsIn this observational study, we assessed data from antenatal clinics Thai–Myanmar border between...
Background Primaquine is the only drug consistently effective against mature gametocytes of Plasmodium falciparum. The transmission blocking dose primaquine previously recommended was 0.75mg/kg (adult 45mg) but its deployment limited because concerns over haemolytic effects in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. G6PD deficiency an inherited X-linked enzymatic defect that affects estimated 400 million people around world high frequencies (15–20%) populations...
Chloroquine has been recommended for Plasmodium vivax infections >60 years, but resistance is increasing. To guide future therapies, the cumulative benefits of using slowly eliminated (chloroquine) vs rapidly (artesunate) antimalarials, and risks adding radical cure (primaquine) were assessed in a 3-way randomized comparison conducted on Thailand-Myanmar border.
In the Greater Mekong Subregion in Southeast Asia, malaria elimination strategies need to target all Plasmodium falciparum parasites, including those carried asymptomatically. More than 70% of asymptomatic carriers are not detected by current rapid diagnostic tests (RDTs) or microscopy. An HRP2-based ultrasensitive RDT (uRDT) developed improve detection low-density infections was evaluated during prevalence surveys within a program low-transmission area eastern Myanmar. Surveys were...
Chloroquine or dihydroartemisinin-piperaquine with either 7- 14-day primaquine regimens provided highly effective radical cure of vivax malaria on the Thailand-Myanmar border. Short course higher dose for may improve efficacy by improving adherence.
The objective of mass antimalarial drug administration (MDA) is to eliminate malaria rapidly by eliminating the asymptomatic parasite reservoirs and interrupting transmission. In Greater Mekong Subregion, where artemisinin-resistant Plasmodium falciparum now widespread, MDA has been proposed as an elimination accelerator, but contribution infections transmission questioned. impact on entomological indices not characterized previously.MDA was conducted in 4 villages Kayin State (Myanmar)....
Malaria in pregnancy is preventable and contributes significantly to the estimated 5.5 million stillbirths neonatal deaths that occur annually. The contribution of malaria areas low transmission has not been quantified, roles maternal anaemia, small-for-gestational-age status, preterm birth mediating effect on stillbirth death are poorly elucidated.We analysed observational data routinely collected at antenatal clinics Thai-Myanmar border (1986-2015). We used Cox regression sequential...
The association between malaria during pregnancy and low birth weight (LBW) is well described. This manuscript aims to quantify the relative contribution of small-for-gestational-age (SGA) infants preterm (PTB) in pregnancies accurately dated by ultrasound on Thai-Myanmar border at Shoklo Malaria Research Unit. From 2001 2010 a population cohort prospectively followed pregnancies, we analyzed all singleton newborns who were live born, normal, weighed first hour life with gestational age (GA)...
A targeted malaria elimination project, including mass drug administrations (MDA) of dihydroartemisinin/piperaquine plus a single low dose primaquine is underway in villages along the Thailand Myanmar border. The intervention has multiple components but success project will depend on participation entire communities. Quantitative surveys were conducted to study reasons for or non-participation campaign with aim identify factors associated acceptance and administrations. household heads four...
Estimating gestational age in resource-limited settings is prone to considerable inaccuracy because crown-rump length measured by ultrasound before 14 weeks gestation, the recommended method for estimating age, often unavailable. Judgements regarding provision of appropriate obstetric and neonatal care are dependent on accurate estimation age. We determined accuracy Dubowitz Gestational Age Assessment, a population-specific symphysis-fundal height formula, biometry performed between 16 40...
Abstract Background Antenatal care and skilled childbirth services are important interventions to improve maternal health lower the risk of poor pregnancy outcomes mortality. A growing body literature has shown that geographic distance clinics can be a disincentive towards seeking during pregnancy. On Thailand-Myanmar border antenatal serving migrant populations have found high rates loss follow-up 17.4%, but decades civil conflict made underlying factors difficult investigate. Here we...
Tak Province, at the Thai–Myanmar border, is one of three high malaria incidence areas in Thailand. This study aimed to describe and identify possible factors driving spatiotemporal trends disease from 2012 2015. Climate variables forest cover were correlated with using Pearson's r. Statistically significant clusters (hot spots) low (cold annual parasite per 1000 population (API) identified Getis-Ord Gi* statistic. The total number confirmed cases declined by 76% 2015 (Plasmodium falciparum...
Background In low- and middle-income countries twin births have a high risk of complications partly due to barriers accessing hospital care. This study compares pregnancy outcomes, maternal neonatal morbidity mortality singleton in refugee migrant clinics on the Thai Myanmar border. Methods A retrospective review medical records all pregnancies delivered or followed at antenatal Shoklo Malaria Research Unit from 1986 2020, with known outcome estimated gestational age. Logistic regression was...
Eight manuscripts have specifically examined the effects of areca (betel) nut use in pregnant women, seven which documented adverse on birth weight, newborn neurological status, gender ratio and pregnancy outcomes such as anaemia miscarriage following during pregnancy. A retrospective cohort analysis migrant refugee women attending antenatal clinics along Thai-Myanmar border (July 1997 to November 2006) was conducted examine routinely recorded enrolment. Of 7685 2284 (29.7%) never used or...
Background Antenatal ultrasound suits developing countries by virtue of its versatility, relatively low cost and safety, but little is known about women's or local provider's perspectives this upcoming technology in such settings. This study was undertaken to better understand how routine obstetric experienced a displaced Burmese population identify barriers acceptance patients providers. Methodology/Principal Findings Qualitative (30 observations, 19 interviews, seven focus group...
Improving access to early diagnosis and treatment (EDT) has increasingly proven be a major contributor decreasing malaria incidence in low-transmission settings. The Malaria Elimination Task Force (METF) deployed posts set up Eastern Myanmar, providing free uninterrupted community-based EDT more than 1200 villages. Ensuring high quality services are provided by these is essential reaching elimination targets. present study aimed determine the functionality of METF programme. This report...