Malaria: The Faculty of Tropical Medicine has provided a significant proportion of the biological, economic and clinical basis for the change in global antimalarial treatment recommendations to artemisinin combination treatments. We have been responsible for publishing 9.4% of all antimalarial trials since 1966, and enrolled 22% of all patients in such studies worldwide. Following a series of pharmacokinetic-pharmacodynamic (PK-PD) studies in severe malaria, and a pilot comparison, we conducted the largest ever trial in severe malaria, a multi-country, prospective study to compare mortality in patients treated with intravenous artesunate or intravenous or intravenous quinine. We have developed a mathematical-economic model of drug resistance, which has been influential in guiding international recommendations. Most recently, our attention has been focused on antimalarial drugs that can block malaria transmission effectively.
Melioidosis: The Faculty of Tropical Medicine has improved the accuracy and rapidity of the diagnosis of Burkholderia pseudomallei infection. Our studies on melioidosis treatment have provided the currently recommended acute and eradication treatments for this important cause of lethal community-acquired infection in this region. Significant progress has been made in understanding the biology of B.pseudomallei since the genome was fully sequenced. We demonstrated that horizontal gene acquisition was an important feature of its recent evolution and we have validated typing schemes based on MLST that will be essential for our understanding of disease epidemiology and pathogenesis. New projects include investigations of the potential community risk factors associated with the prevalence of melioidosis.
Leptospirosis and scrub typhus: In a large prospective stud, we identified scrub typhus (caused by Orientia tsutsugamushi) and leptospirosis as major causes of febrile illness leading to hospital admission in rural areas of Thailand and Laos. We have conducted the largest-ever randomized trial of antibiotic treatments for severe leptospirosis. We successfully improve the method of Leptospira isolation; hopefully, the measure will be practical and easy enough to be used routinely worldwide. The molecular tools for Leptospira and Oriential tsutsugamushi typing have been developed. We also conduct pathophysiological studies of leptospirosis and rickettsiosis, especially scrub typhus.
Last update: May 16, 2017