Laos has a population of 5.2 million, the majority of whom are rural rice farmers, and life expectancy in the country is 54 years. Prior to the study, which was funded by the UK's Wellcome Trust, little was known about the causes and distribution of bacterial disease in the country, which is a major killer of children and adults. The research involved a major collaboration between scientists from Laos, the UK, Thailand and Vietnam.
"This is the first description of the causes of bacteraemia in Laos, and Lao colleagues expect that it will have an important impact on health policy," says Dr Paul Newton, a University of Oxford researcher based at Mahosot Hospital, Vientiane, Laos. "It will influence what the Ministry of Health and international organisations recommend as therapy and how individual doctors treat patients with these conditions.
"Before this information was available, Lao doctors had to extrapolate from the evidence from Vietnam, Thailand and elsewhere. Not surprisingly, the Lao data suggests that this may not be appropriate and that local knowledge is crucial. This is particularly significant in a country whose health care system is under-resourced. In Laos, there is a great need for clinical research to develop the most locally appropriate, least expensive, but effective public health interventions. The Government of the Laos is actively encouraging such research."
The most common cause of bacteraemia found in children and adults alike was Salmonella enterica serovar typhi, the cause of typhoid fever. In fact, almost half of all children (44%) with community-acquired bacteraemia were found to have typhoid.
Unlike elsewhere in south-east Asia, the researchers found few cases of multi-drug resistant typhoid. Use of fluoroquinolone antibiotics in other countries is thought to have led to bacteria, such as those causing typhoid, to become less sensitive to treatment by first line drugs.
"The relative susceptibility of typhoid bacteria to antibiotics found in our study suggests that short courses of fluoroquinolone antibiotics can safely be used, which is different from the current situation in Vietnam where typhoid is usually resistant to commonly used, inexpensive antibiotics," says Dr Rattanaphone Phetsouvanh of the Mahosot Hospital.
However, there is no place for complacency, warns Professor Chanpheng Thammavong, Director of Mahosot Hospital,
"Public health measures to reduce the incidence of typhoid, such as improved sanitation and vaccination, may have a significant impact on morbidity and mortality in Laos, as it appears to have done in Thailand. However, vaccination is relatively expensive in Laos and may not be affordable. With improved trans-border communications between Laos and its neighbours, there is a real risk that the prevalence of multi-drug resistant typhoid may increase in Laos."
Amongst infants, the most significant cause of bacteraemia was Staphylococcus aureus, which can also cause pneumonia and skin infections. Over two-thirds of infants with clinically-significant bacteria in their blood were found to have the S. aureus infection.
"Our research found that S. aureus bacteraemia has a very high mortality rate amongst infants in Laos, killing one in four infected children," explains Dr Newton. "This means that we should seriously consider giving infants, especially newborn babies, anti-staphylococcal antibiotics, which can treat the infection."
Craig Brierley | alfa
The balancing act: An enzyme that links endocytosis to membrane recycling
07.12.2016 | National Centre for Biological Sciences
Transforming plant cells from generalists to specialists
07.12.2016 | Duke University
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
07.12.2016 | Health and Medicine
07.12.2016 | Life Sciences
07.12.2016 | Health and Medicine