Author: Elke Wynberg

Verbal autopsy research is vital for understanding community mortality, informing health interventions and policies in low- and middle-income countries. However, overlooking the community perspectives on deaths can undermine the ethical conduct and effectiveness of such research.

In this study, the authors explored community-based concepts of death, interpretations, and coping mechanisms in five Southeast Asian countries, with this manuscript highlighting key findings from the body mapping exercise that revealed diverse cultural and religious understandings on death. Participants’ views ranged from seeing death as a cessation to life’s struggles to an inevitable end, reflecting deep cultural and spiritual beliefs. Coping mechanisms, often grounded in religious practice and community support, played a crucial role in managing grief.

This study also underscores the importance of addressing emotional well-being for both participants and researchers. Recommendations include integrating mental health support into research protocols and tailoring practices to local cultural contexts. These findings inform the design of more ethically grounded verbal autopsy tools and procedures that are sensitive to local beliefs and emotional dynamics, ultimately improving data quality and community trust.

Text by Nan Shwe Nwe Htun

30 May 2025

In the remote corners of Chattogram Division in Bangladesh, a simple fever can be a death sentence. Limited access to care, delays in seeking help, and widespread self-medication are factors putting rural communities at risk. A new qualitative study dives deep into the challenges of managing acute febrile illness in these areas, drawing insights from interviews with local and international stakeholders.

The research reveals a fragile healthcare system strained by referral barriers, under-resourced emergency care, and reliance on community health workers who often lack the tools and training to respond to febrile illness beyond malaria. In the health centres, undiagnosed fevers are often treated with guesswork and unnecessary antibiotics, which fuels antimicrobial resistance.

This study makes the case for a more integrated approach – one that strengthens triage and referral systems, empowers frontline health workers with diagnostic tools and digital innovations, and removes the financial and logistical barriers that prevent timely care. As infectious disease patterns are shifting and rural health needs are evolving, we need to rethink how febrile illness in these communities is managed. Text: Marco Liverani

COMRU

4 June 2025

In May 2025, circus performances were used to educate Cambodian youth on the correct use of antibiotics. Misuse of antibiotics is a major driver of bacterial antimicrobial resistance (AMR) worldwide. The wide availability of antibiotics over the counter in Cambodia and linguistic issues make it difficult for younger Cambodians to understand when antibiotic use is appropriate.

Involving circus arts, storytelling and social media, the performances aimed to improve Cambodian youth’s awareness of the problem of AMR and its causes. Funded by a bursary from MORU Bioethics, the project is related to MORU’s ongoing research on AMR in Cambodia and complemented SEACTN’s Electronic clinical Decision support for management of Acute fever (EDAM) cluster-randomised trial in Battambang, which completed data collection in January 2025. The performances were part of a package of educational activities developed by MORU and the Cambodia-Oxford Medical Research Unit (COMRU) who teamed up with the Cambodian Ministry of Health (MoH), Action for Health Development (AHEAD), and Phare, the Cambodian Circus to educate Cambodian school children and youth groups on the correct use of antibiotics.

Delivered in Battambang on 19-20 May and Siem Reap on 22-23 May, the circus performances were extremely well received by a total audience of >1,200. Subsequent social media posts have been viewed >360,000 times to date. Next steps are to complete an educational video based on the circus performance and work with Cambodia MoH colleagues to integrate this into national AMR awareness activities.  – Text: Paul Turner.