South and Southeast Asian Community-based Trials Network MORU
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Progress updates

SEACTN-Work Package A team say goodbye to Savannakhet colleagues 

Having overseen recruitment of an astounding 25,000 patients by our partners from Savannakhet Health Centres in Atsaphangthong, Phalanxay and Phin District Health Centres as part of Work Package A of the multi-country SEACTN project (improving management of febrile illnesses in rural areas), as well as conducting more than 1400 verbal autopsies, the LOMWRU Work Package A team packed up to return to Vientiane last week (week of 3 July). We visited the district hospitals with Provincial Health Office Director Dr Tiengkham Pongvongsa (bottom photo, left) who has overseen numerous research projects in Savannakhet Province over the years. Dr Koukeo Phommasone, who has coordinated all the work packages in Laos since the beginning of the project, gave very preliminary results to the heads of the District Health Offices, who eagerly await full results from MORU in Bangkok at a later date. We also caught up with Dr Chanthala Phamisith, Director of Savannakhet Provincial Hospital where Work Package B of SEACTN is being conducted with more than 1000 patients included so far (WP-B team is Dr Xaykhamphet, Dr Khanxayaphone, Dr Sengdavanh and Mr Bank).

The LOMWRU WP-A team are shown above on a previous visit, from left: Mr Souksavanh Simanivong (logistician), Mr Somdy Xayalath (VA project), Dr Nongneth Khambounheuan (Director of Atsaphangthong District Hospital), Dr Souphap Inxyxiengma (Head of Atsaphangthong District Health Office), Dr Xaipasong Xaiyaphet (site coordinator), Dr Khambang Seevanhthong, and Dr Aitlada Soulivong. 

– Text courtesy of Liz Ashley, with thanks to Dr Xaipasong Xaiyaphet for photos.

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Progress updates

Chiangrai SEACTN team visits SMRU

From DATES, to exchange experiences and learn from the colleagues in Mae Sot, a delegation from the CCRU SEACTN team visited study sites managed by SMRU as part of the rural febrile illness project of the South and Southeast Asia Community Trials Network (SEACTN). We visited Mae Ramat hospital, Mae Tao clinic and Mawker Tai clinic. Due to the unstable situation on the border, it was not safe to visit malaria posts, but we got very close to the border! Pictured: Community advisory board interview at Hai Moo’s house, from left: Nattida Toonin, Nipaphan Kanthawang, Carlo Perrone, Hai Moo and Primpraporn Thongdee.

– With thanks to Carlo Perrone for all text and photos

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Progress updates

SEACTN monitoring and site visit!

As part of the work for the South and South East Asia Community Trials Network (SEACTN), Jaruwan Tubprasert and Akanittha Poonchai visited CCRU to monitor the work package B, which will find out the causes of acute febrile illness and its outcomes in people presenting to hospitals in the region, and the household survey, which will define a picture of the health status of communities in the network. Their precious feedback will help us improve the quality of our work, Thank you Jaruwan and Akanittha!

Together with the monitoring team, Dr Aninda Sen, Dr Sharmin Ahmed and Dr Nawrin Kabir came from BRAC University, Bangladesh to exchange experiences on the project, as they will soon start the household survey and have only recently started with work package B. Meiwen Zhang, Watcharintorn Thongpiam, SEACTN PI Prof Yoel Lubell and Chris Chew completed the visiting party. Together, we visited Chiangrai Prachanukroh and Mae Chan Hospitals together, met local partners and household survey fieldworkers, and discussed issues related to the projects.

Pictured during a lunch break at Mae Chan, clockwise from left: Dr Sharmin Ahmed, Laphaphat Naruesornsiri, Jaruwan Tubprasert, Akanittha Poonchai, Yoel Lubell, Dr Aninda Sen, Carlo Perrone, Chris Chew, Benjamas Nuangkanta, Dr Nawrin Kabir, Nidanuch Tasak and Areerat Thaiprakhong,

We all thank our visitors for their company and help. Unfortunately, the dry-season wildfires have made the air hazardously polluted so outdoor activities had to be kept to a minimum. We hope in future visits to show them Chiangrai’s wonderful outdoors. 

– Thank you, Carlo Perrone, for text and Benjamas Nuangkanta for photo.

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Progress updates

SEACTN recruitment tops 20,000!

Congratulations are in order as our amazing SEACTN-Work package A team, from left, Souksavanh Simanivong (logistician), Dr Aitlada Soulivong, Dr Khambang Seevanhthong and site coordinator Dr Xaipasong Xaiyaphet and the Savannakhet provincial and District health staff led by Dr Tiengkham Pongvongsa (not pictured), enrolled more than their target of 20,000 consultations in health centres in Atsaphangthong, Phalanxay and Phin by end Feb. This is a massive achievement and the Laos site is the first to reach its target. Taking place in Bangladesh, Thailand, Myanmar and Cambodia and Laos, SEACTN (Southeast Asia Community Trials Network) aims to improve the management of febrile illness in rural areas. There are other work packages such as WP-B studying patients presenting to Savannakhet Provincial Hospital with febrile illness, and a verbal autopsy sub-study. Dr Koukeo Phommasone, Deputy Head of Mahosot Hospital Microbiology and Clinician Scientist, manages the Lao SEACTN programme of research, and Prof Yoel Lubell, based in MORU, Bangkok, is overall SEACTN PI.  

– Thank you, Liz Ashley, for text and Dr Xaipasong Xaiyaphet for photo.

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New SEACTN site at Mae Chan Hospital 

On 3 Jan, from left, Lapaphat (Porn) Naruesornsiri, Suwaphat (Fern) Nuangkanta and Nidanuch (Pui) Tasak (not shown) recruited the first SEACTN Work Package-B patient at Mae Chan Hospital. Located in the foothills of the northern part of the Khun Tan mountain range, close to the Myanmar border and not far from Laos, the hospital serves a large Hill tribe and migrant population. Work Package B will help define the infectious causes of fever in these and other rural population so we can plan targeted interventions in the future. We hope to recruit many more patients and increase CCRU’s work with the hospital in the future. 

– Thank you, Carlo Perrone, for all text and Nidanuch Tasak for image. 

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SEACTN verbal autopsy PE workshop

On 29 Nov-1 Dec, Dr Nan Shwe Htun and Watcharintorn Thongpian, from MORU MAEMOD’s Economics & Implementation Research Group (EIRG), visited LOMWRU and SEACTN sites in Laos to do public engagement on verbal autopsy using body mapping, an art-based research tool to gather qualitative data about study participants physical and emotional experiences. Pictured, from left: Dr Aitlada Soulivong (site research physician), Dr Khambang Seevanhthong (site research physician), Dr Xaipasong Xaiyaphet (site coordinator and research physician), Watcharintorn Thongpian, and Dr Nan Shwe Htun. 

– With thanks to Dr Koukeo Phommasone for words and photo.

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Understanding local death and mourning practices 

On Fri 25 Nov, a public engagement session was conducted as part of the SEACTN verbal autopsy project. The verbal autopsy project seeks to understand the causes of death in South and SE Asia and the public engagement activities will help us understand local cultures, practices and beliefs on death and mourning, to make sure our project respects local customs and culture. Members of the Lahu, Hmong, Jin Hor (Chinese Yunnan) and K’Mu met us at Wiang Khean Public Health Office. Through focus group discussions and body mapping activities we learned a lot from participants and are confident that the verbal autopsy project in Chiangrai will greatly benefit. (Photo: Participants involved in the body mapping activity, from left: Mr. Dechtrit Boonma , Mr. Yong-An Saefoo and Mrs. Phoothai Srisat.)

– Text and photo courtesy of Carlo Perrone.

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New site for SEACTN WP B

The site initiation visit for work package B, a project aiming to find out the causes of febrile illness in healthcare facilities of the South and Southeast Asian Community Trials Network (SEACTN), took place at Mae Chan hospital on November 29th. The CCRU team was welcomed enthusiastically, we are all very excited to expand our activities at this new site in the beginning of 2023. (Photo: CCRU and Mae Chan Hospital teams discussing the SEACTN WPB project.)

– Thank you, Carlo Perrone, for text, and Benjamas Nuangkanta for photo.

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Progress updates

SEACTN Bangkok meeting discusses next phase funding

After a hiatus of two years due to the pandemic, MORU hosted on 20-21 Oct an in-person meeting of South and Southeast Asia Community-based Trials Network (SEACTN) investigators and collaborators (some joining online) from all study sites. Investigators and collaborators from Thailand, Cambodia, Laos, Bangladesh, Canada, and the USA met at the Hospital for Tropical Diseases in Bangkok to provide updates on progress, and discuss opportunities, challenges and future projects, and exchange ideas on moving the network forward as it looks toward seeking funding for the next phase commencing in 2024. The two days of brainstorming and networking proved very fruitful, resulting in several novel research ideas on how to leverage and use the infrastructure provided by the network. SEACTN seeks to understand the burden of febrile illness in rural areas in the tropics. Full results are expected in 2024.

– With thanks to Chris Chew for story and image.

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Grant to use metagenomics to determine febrile illness causes in South and SE Asia

On 24 Oct, Liz Batty, Senior Bioinformatician and co-Head of the Molecular Microbiology group in MORU Microbiology, was awarded U$200,000 by the Chan Zuckerberg Initiative (CZI) with the Bill & Melinda Gates Foundation (BMGF) to use metagenomic sequencing to define the causes of febrile illness in remote and rural areas of South and Southeast Asia. 

Liz’s grant will analyse samples from South and Southeast Asia Community-based Trials Network (SEACTN) work package B (WP-B) sites, in Laos, Thailand and Bangladesh via collaborations with LOMWRU, SMRU, and the Bangladesh Rural Advancement Committee (BRAC]. Led by Prof Yoel Lubell, and supported by the Wellcome Innovations Flagship Programme, SEACTN seeks to ascertain the incidence, causes and outcome of febrile illness in SE Asia.

By enabling scientists to analyse all nucleic acids in a sample, metagenomic next-generation sequencing (mNGS) can be used to detect novel pathogens in outbreaks and investigate diseases with complex etiology, such as encephalitis and antimicrobial resistance. 

“This metagenomic work will help us define the burden of febrile illness by identifying pathogens causing febrile illness that are novel, or missed by traditional diagnostics,” said Liz. “It will improve our understanding of the causes of febrile illness and how we choose target diagnostics for febrile illness.”

Accurately determining which infection is causing fever could have a significant impact on health in South and Southeast Asia, where febrile illness contributes substantially to morbidity and mortality. 

With the decline of malarial illness and mortality in this region, the burden has shifted to non-malarial causes of fever. However, the causes of non-malarial fever remain unknown in many patients – and febrile patients are incorrectly treated as if they had malaria. 

Liz’s grant was part of U$2 million awarded by CZI and BMGF to researchers investigating novel, emerging pathogens with a focus on building metagenomics capacity in high-potential countries that have been historically under-resourced in SE Asia and elsewhere.  

– Text contributions by Liz Batty and John Bleho.