Key research areas and achievements of the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme
The work of the Programme covers clinical research and aspects of improved diagnosis, pathogen population genetics, disease pathophysiology, drug resistance, clinical epidemiology and improved patient management.
Key research areas
Research focuses on several core areas:
- malaria - optimising the use of artemisinin-based therapies, understanding the biology and mechanisms of severe malaria and antimalarial resistance, and optimising treatments for pregnant women
- melioidosis - conducting clinical research to improve diagnosis and treatment
- pharmacology - determining the best dose regimens for drug treatments, the safety and efficacy of new treatments, and ways to prevent drug resistance
- poor-quality medicines - investigating the epidemiology of this neglected field of public health, assessing their impact and evaluating methods of detection
- other diseases of public health importance in the region - clinical and laboratory research into influenza, leptospirosis, typhus, beriberi (vitamin B1 deficiency), and staphylococcal (including MRSA) and pneumococcal infections.
Key achievements
The Programme has made major contributions to advancing the treatment of malaria worldwide. It has conducted more trials than any other centre in the world. The Shoklo Malaria Research Unit pioneered the development, evaluation and introduction of artemisinin combination therapy, now the frontline treatment for uncomplicated malaria. With drug resistance a rising concern, Programme researchers have documented the efficacy of the main antimalarial drugs in 15 000 patients, and have conducted a detailed clinical, pharmacological and parasitological assessment of newly emerging artemisinin resistance in western Cambodia.
The Programme's work on severe malaria has changed the World Health Organization's management guidelines. Researchers conducted the South-east Asian Quinine Artesunate Malaria Trial (SEAQUAMAT), demonstrating that the artemisinin drug artesunate reduced mortality by 35 per cent compared with quinine, the standard treatment for falciparum malaria. A larger-scale trial is now being conducted in African children. Programme researchers also provided the first detailed description of the effects of malaria during pregnancy in South-east Asia, showing that women in late pregnancy are systematically under-dosed with current antimalarial treatment regimes, and that it is safe to use artemisinin during pregnancy.
Outside of malaria, the Programme is responsible for most of the randomised controlled trials of melioidosis treatments in the world and has developed improved laboratory methods for diagnosis of the disease, now adopted internationally. Furthermore, the Programme has been instrumental in defining the extent of counterfeit and substandard drugs in Asia and Africa. This work, in collaboration with INTERPOL and the WHO Regional Office for the Western Pacific, has led to several arrests and prompted the establishment of the Counterfeit Drug Forensic Investigation Network (CODFIN).
