Research

MAM conducts research in conjunction with Myanmar Oxford Clinical Research Unit (MOCRU). https://www.tropicalmedicine.ox.ac.uk/research/mocru-myanmar-moru-network

The main aim of the research is to improve the diagnosis and treatment of diseases – current research areas are:

  • Determining predictors of mortality and loss to- follow-up in HIV clinics in Myanmar
  • A multi-centre observational study to describe the prevalence of scrub typhus defined as a positive rapid diagnostic test among selected patients presenting with fever to clinics in Myanmar
  • Environmental sampling and mapping of the geographic distribution of Burkholderia pseudomallei, the cause of melioidosis, in Myanmar
  • Cross-sectional study investigating the causes of pneumonia in two community clinics in two Yangon townships, Myanmar
  • Public engagement activities: Form theatre as a tool for public engagement on Fever and Antibiotic use in Myanmar
  • Studies of malaria treatment combinations (just finished TRAC II, preparing for DeTACT)
  • Determining the factors associated with severe rickets in Nagaland, Northern Myanmar.
  • Determining the aetiology of fever and improved ways to manage fever in resource poor settings and in remote communities.
  • Malaria elimination strategies in hard to reach areas investigating a variety of community based strategies

MAM Academic Scientific Posters Submitted and Accepted at Medical Conferences

Click on them to enlarge:

Talaromycosis in HIV Patients Poster

CMV Retinitis Strategy Poster

CMV Strategy Poster

FEVER STUDIES

Fever is the most common reason for attending health care. The problem is that we often don’t know what is causing it. Clinical diagnosis are usually difficult, and a wrong diagnosis results in a wrong treatment.

Two fever diseases, Typhus and Melioidosis, common during ‘the British times’ are largely forgotten these days, partly due to the lack of laboratory tests. We explored if these diseases are still common.

Typhus; We tested 128 fever patients with a newly developed rapid test for scrub typhus. 15 (12%) patients tested positive. This indicates that typhus might be a common causes of febrile illnesses. This is important for clinicians to know; only if you are aware of a disease, you can diagnose and treat it! 

Melioidosis; is an often fatal disease caused by a bacteria that lives in the mud. It was discovered in 1911 by a British doctor in Yangon (!), but since the 2nd World War the disease has been rarely diagnosed. It is hard to believe that it left with the British!

We took 3,870 mud samples from 387 sites all over the country. 31 sites had one or more positives samples.

Mud samples taken for melioidosis culture at specific depths

This study confirmed the common presence of melioidosis in Myanmar and now, clinicians can consider melioidosis as one of the differential causes of pneumonia and sepsis, in particular for rice farmers!

TRACKING RESISTENCE TO MALARIA

Malaria treatment is failing across South-east Asia. Further spreading of this resistance could result in catastrophic consequences in both Asia to Africa.
To investigate the spread of resistance, MAM & MOCRU cooperated in a large study implemented in 8 tropical countries. They enrolled 1,110 patients with 115 from Myanmar. Myanmar showed no resistance and treatment was still effective. However in all other countries, resistance was very high and it is possible that it will spread to Myanmar.

The next step will be to investigate if this bacterium is a common cause of death in hospitals at these locations.

CAUSES OF PNEUMONIA STUDIES

To effectively treat pneumonia, we need to know its causes. We studied 299 patients with acute pneumonia, to identify the bacterial and viral causes. Surprisingly, the results showed 95 (32%) patients had lung-TB, which is generally only considered in patients with chronic complaints of pneumonia. This is very important for the management of patients with signs and symptoms of acute pneumonia in the future.

PENCILLIOSIS PAPER

Published in British HIV Medicine 2020

http://www.mam.org.mm/wp-content/uploads/2020/08/Penicilliosis-Paper__Nini_2020.pdf