SMRU annual report
Progress Report for the fiscal year 2007-2008

Prof. F. Nosten
Shoklo Malaria Research Unit
Faculty of Tropical Medicine, Mahidol University

 

Background to the Research Programme

The malaria research programme of the SMRU started in 1986. The research unit is a field station of the Faculty of Tropical Medicine, Mahidol University, Bangkok. It is part of the Oxford Mahidol University Tropical Medicine Research Programme funded by the Wellcome Trust of Great Britain. The main objectives are to establish the appropriate strategy for treatment and prevention of malaria in the communities living along the Thai-Myanmar border.(http://www.shoklo-unit.com/)

Main research Areas

  1. Treatment of malaria: During this fiscal year SMRU in Maela camp (population >45,000) has treated 2,588 cases of malaria (1075 falciparum and 1483 of vivax, 14 ovale and 16 malariae).  As shown previously the majority of cases of malaria treated in Maela camp (85%) is found in patients who work or live outside the camp perimeter (see report attached).
  2. Malaria in pregnancy: in the antenatal clinics of SMRU, the majority of pregnant women from Maela camp continued to be seen on a weekly basis. Those who have travelled outside the camp in the previous 2 months get tested for malaria. All cases of malaria (43 falciparum, 129 vivax) were treated according to SMRU protocols.  In the ANC facilities, 1252 women delivered under supervision of SMRU midwives and doctors.   97 cases of complicated delivery were transferred to Mae Sot hospital via AMI. SMRU has issued 1,268 delivery certificates since Jan  2007.
  3. Collaboration with the Ministry of Health:  The joined antenatal consultations in Muluchai, Mawkertai and Wang Pa continue, to facilitate the access to malaria diagnosis and treatment to patients from the migrant workers population in the remote areas of the province. There were 2,160 pregnant women who attended the migrant workers consultations during Oct 2007- Sep-2008 and 1,120 were treated for malaria including 327 for P.falciparum. In our clinics of Mawker Tai and Murunchai (in Phop Pra district) and Wang Pha (Mae Ramat district), and in Mae Kon Ken (Mae Sot district) 27,605 cases of malaria including 13,067 falciparum, 6,659 cases of vivax confirmed malaria in migrant workers were treated. This very high numbers in the migrants, compare to the larger population in Maela and other camps is explained by the rains and the absence of malaria control in Myanmar.
  4. Prevention of mother to child HIV: We are now concentrating on the prevention of vertical transmission in pregnant women (PMCT).  The PMTCT in Mae La camp has started in since May, 2002. Migrant PMTCT program started in July 2008.   From July –September the number of up-taking women from ML camp were 465 and post test counselling was done for 429 women. There are 2 HIV screening positive and one was confirmed HIV positive.  In migrant, the PMTCT program is conducting in three sites (MKT, MRC and WP).  The total number of women who up take the PMTCT are 664, Screening positive.  Post test counselling have done to 651 women.  There are 19 HIV screening positive and   6  out of 19 are HIV ser- positive.
  5. Study on nutrient deficiency in pregnancy: this follow up of the pregnant women in Maela and their infants is focusing on the impact of micronutrient deficiency and of DDT exposure on the neurological development of the babies.  500 infant (and their mother) have been followed from birth until 12 months of age and we expect the first results to be available during 2009
  6. Malaria Control Programme: (collaboration with NGOs) SMRU continues to assist the medical NGOs working in camps for displaced people, with their malaria programmes. SMRU continues to provide a quality control service for the laboratories of the NGOs.
  7. Epidemiology of respiratory infections in infants: this project takes place in Maela and involves the infants born to mothers who were followed in SMRU ANC. The objective of the study is to look at the epidemiology and treatment of pneumonia in the under two population. Recruitment has now finished with 999 pregnant women having agreed to participate. 846 infants have been born since the start of the project in September 2007. Infants are asked to attended SMRU’s clinic at Maela every month (98% of infants attended their follow up) as well as during an illness episode.  From October 2007 – September 2008: 118 infants were treated for pneumonia.  There were 274 inpatient admissions and 1605 outpatient consultations for study infants during this time period.

    Conclusion: This quarterly report and the attached data, indicates that SMRU has carried out the planned activities, without encountering any significant difficulty.  The main problem facing us is the departure of our staff to a third country. This the rainy season has seen a slight increase in malaria cases mainly in people (adults) working in the fields and commuting back and forth to Myanmar.

 

 

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