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Translational research in NDM has a truly worldwide impact, with scientists and clinicians investigating epidemiology, treatment, and prevention of disease on a global scale. Our podcasts on Global Health illuminate this work, and discuss research conducted in Oxford and around the world to better understand and manage emerging and endemic diseases.
57 Episodes
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Professor Sharon Brownie explains her research on nursing in LMICs Nurses are the largest part of the health care workforce an millions more will be needed in LMIC if high quality care is to be available to everyone. Research that addresses the consequences of the shortage of nurses but also helps generate ideas on solutions is important and should be conducted in partnership with the nursing profession.
Researcher Jalemba Aluvaala tells us about his work concerning newborn care in LMICs. Care for even the sickest newborns in many countries is limited by the resources available but there are some key interventions that can save lives. Delivering these interventions requires doctors and nurses to work together and often it is the continuous care provided by the nursing team together with families that is critical. Despite this a number of babies die and understanding risks is important to help provide information to families, to help plan care and should help us design better systems of care.
Jacob McKnight tells us about the challenges faced by nurses caring for newborns in Kenya. Caring for sick newborns in a poorly resourced hospital is a very challenging job. Yet this is not the only challenge many nurses face as they juggle supporting families and lives in a busy city. Some nurses have developed ways to cope in these difficult circumstances but for many the relentless pressure may cause them harm while upholding the ideals of nursing may seem impossible.
David Gathara tells us about his work leading nursing research Sick newborns require large amounts of nursing time, so what happens when nurses have to care for too many babies? By making direct observations of the care that is given this important new research identified how much care is missed. More care is missed when nurses have more babies to care for showing the direct consequences of health care worker shortages.
Social Scientist Jacinta Nzinga tell us about her research on the care of sick newborns. To really understand the work of nurses in very busy wards where care for sick newborns is provided, you have to be there. Using detailed observations, day, night and weekends, linked to narrative interviews, the routines, compromises and coping strategies that characterise the delivery of hospital care for newborns are brought to light providing critical information to understand why care is missed and to guide improvement efforts.
Professor Mike English tells us about the research project Health Services that Deliver for Newborns. Basic hospital care may be key to saving newborn lives. Professor Mike English, University of Oxford, outlines a multidisciplinary project engaging policy-makers and practitioners in Kenya. This project demonstrated poor coverage of Nairobi's 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.
Professor Tran Hien, founder member of our OUCRU unit in Vietnam tells us about the development of this very successful Clinical Research Unit. Although 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.
Professor Ronald Geskus from our OUCRU unit in Ho Chi Minh City, Vietnam, tells us about the contribution of biostatisticians to complex clinical research. The 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.
Dr Audrey Dubot-Peres from our LOMWRU unit in Laos and IRD (Institut de Recherche pour le Développement, Marseille, France) tells us about her research on viral infections in Laos. Infections 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.
Dr Juan Carrique-Mas from OUCRU, our Clinical Research Unit in Ho Chi Minh City, Vietnam, tell us about his research in the development of antimicrobial resistance in small-scale poultry production. 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.
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.
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