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Nhiếp ảnh gia đặc trú của OUCRU (khách đặc biệt công tác nội trú), cô Pearl Gan, đã được trao tặng giải thưởng tại Triển Lãm của Hiệp Hội Quốc Tế về Bệnh Nhiệt Đới Bị Lãng Quên (ISNTD) cho các tác phẩm gửi trưng bày trong triển lãm này. Các tác phẩm đã nộp của Pearl bao gồm 7 tấm ảnh và đã được công nhận có sức ảnh hưởng đến các bệnh nhiệt đới và được công nhận về các mục tiêu phát triển rộng hơn.

Nhân vật chính trong các tấm ảnh của Pearl là những bệnh nhân bị ảnh hưởng bởi bệnh nhiệt đới ở Bangladesh, Thái Lan, Central Timor, Pakistan và Indonesia. Bạn có thể xem tất cả tác phẩm trên trang web trưng bày của triển lãm.

We recently reported the exciting findings published in eLife, from a phase II clinical trial led by Professor Guy Thwaites which showed that aspirin help increase survival from TB meningitis by reducing brain inflammation and preventing the disease from blocking blood vessels in the brain that cause parts of the brain to die (commonly called ‘stroke’).

With funding from the Wellcome Trust, OUCRU researchers  investigated whether the addition of aspirin at low (81mg/day) or high (1000mg/day) dose, or placebo, to the first 60 days of current standard TB meningitis treatment (anti-TB drugs and steroids) was safe and reduced new strokes or death from this severe disease.

Professor Thwaites was recently interviewed about this work for the eLife podcast, and you can listen that interview here: eLife podcast

eLife have also published an insight article, which discusses this study and its results, available online here.

Sepsis is a huge problem worldwide: There are about 20 million cases of sepsis, leading to more than 5 million deaths annually, with much of the burden in low- and middle-income countries (LMICs) such as Vietnam.

There is currently no reference standard that allows easy, accurate diagnosis of sepsis. Louise Thwaites, Duong Bich Thuy and other researchers from OUCRU have been contributing to a collaborative project across 10 countries to test the predictability of a clinical scoring method which could be used to identify patients with sepsis. The study, the Sepsis Assessment and Identification in Low Resource Settings (SAILORS) collaboration, was led by Dr. Kristina E. Rudd, MD, MPH, at the University of Washington (Seattle, Washington, USA). The results of this study have been published in an article in JAMA this week which is available as an open-access publication.

In 2016, the Sepsis-3 Task Force proposed that, for patients with suspected infection outside of the intensive care unit (ICU), a combination of respiratory rate, mental status, and systolic blood pressure, named ‘quick’ Sequential (Sepsis-related) Organ Failure Assessment (qSOFA), could be used to help identify patients with sepsis. This study was a test of the predictive validity of qSOFA, which is one of the main ways to identify patients with sepsis. Identification of patients with sepsis in an accurate and rapid manner is important, as studies show that prompt and appropriate treatment (with antibiotics, organ support, etc) within the first hour is critical to improve outcomes and reduce mortality.

This study is the largest and most robust study of the performance of the qSOFA in LMICs to date. This is extremely important, as the patients, pathogens, and clinical capacity to manage sepsis differ considerably between high-income and LMIC settings and, as pointed out above, the majority of sepsis cases occur in LMICs. The study found that for hospitalized adults with suspected infection, a qSOFA score greater than or equal to 2 was significantly associated with increased likelihood of excess hospital death compared with a lower score. The study also found that a moderate qSOFA score of just one point also is associated with increased risk of excess mortality compared to a score of zero. This means that the aSOFA score may help identify patients at higher risk for excess hospital mortality among adults with suspected infection in LMICs.

The 10 countries represented in the 9 data sets in this study are: Bangladesh, Haiti, India, Indonesia, Myanmar, Rwanda, Sierra Leone, Sri Lanka, Thailand, and Vietnam. The success of this project is the result of incredible international collaboration between the researchers who performed the original 9 studies and contributed their data for analysis in the study.

A first of its kind study into the population and spread of tuberculosis-causing (TB) bacteria in Ho Chi Minh City, Vietnam, has found that more than half of cases can be attributed to one particular strain of the bacteria.

Using state-of-the-art genomics technology, a Melbourne-led international collaboration, including researchers from OUCRU in Vietnam and Singapore, sequenced the DNA from bacteria isolated from the lungs of 1635 TB patients located in outpatient clinics in eight districts of Ho Chi Minh City. The findings, published in Nature Genetics this week, concluded that the strain of TB-causing bacteria known as the Beijing lineage, was responsible for 59 per cent of infections, and even more (75%) of those diagnosed in younger people.

TB is the leading cause of death globally from a single infectious agent – Mycobacterium tuberculosis – that typically affects the lungs, but can also infect other sites of the body. Multiple antibiotics are used to treat TB, however treatment is long (six months), and the emergence of drug-resistant bacteria is a considerable threat to global health.

Vietnam is one of the WHO High Burden Countries for TB and multi drug-resistant TB, and in 2016 there were an estimated 126,000 cases and 13,850 deaths in the South East Asian country. Co-lead Investigator of the study and a Senior Research Fellow, Dr Sarah Dunstan from the Peter Doherty Institute for Infection and Immunity (a joint venture of The University of Melbourne and The Royal Melbourne Hospital), said within the Beijing lineage they found a mutation, which likely bolsters the bacteria’s ability to spread. “Combating and managing TB spread requires new strategies to diagnose, treat and protect against emerging and evolving strains of the bacteria,” said Dr Dunstan. “Armed with an understanding of how the disease is spread in Ho Chi Minh City could allow more targeted local TB control, and this knowledge could potentially be applied to other settings given the Beijing lineage is found worldwide, predominantly in Asia.”

First author on the paper describing the study, Associate Professor Kathryn Holt from the University of Melbourne’s Bio21 Molecular Science and Biotechnology Institute, said the study shows the Beijing lineage of TB bacteria spreads more easily from person-to-person than other strains of the bacteria. “Contact tracing – looking for early signs of TB infection in people who have been in close contact with TB patients, and treating them before they can spread the disease further – is an important part of TB control, but it takes a lot of resources,” said Associate Professor Holt. “All TB patients have the potential to transmit the TB bacteria to others when they cough, but our data indicates this is more likely to result in new disease cases if the infection is caused by the Beijing lineage. So if resources are limited, it would make sense to prioritise contact tracing for Beijing lineage TB cases.”

Co-author Dr Nguyen T. T. Thuong, head of OUCRU’s TB group in Ho Chi Minh City, comments: “TB treatment fails in many patients infected with multidrug resistant strains, which are then passed on, increasing the number of resistant cases in the community. My team in Vietnam now is running a pilot study in early diagnosis of drug resistant TB cases using whole genome sequencing. The findings from this publication can be applied concurrently to identify those carrying the easily-spread-mutation. If this test becomes a bedside diagnostic tool, it will allow not only early diagnosis of drug resistance and more precise treatment but also better management against disease transmission.”

The study was funded by the National Health and Medical Research Council in Australia, Wellcome Trust UK and A*STAR Biomedical Research Council Singapore.