1. Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine,
   Mahidol University, Bangkok, Thailand
2. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine,
   University of Oxford, Oxford, United Kingdom
3. Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
4. The Royal Society of Thailand, Dusit, Bangkok, Thailand

Correspondence to Weerapong Phumratanaprapin (MD),
Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Ratchathewi, Bangkok, 10400, Thailand. Email: weerapong.phu@mahidol.ac.th

Abstract

Newspapers have a responsibility to report the truth to their readers, and the trustworthiness of the print media remains crucial in our age of decentralized, social media and online commentary. Honest reporting of the evidence and the uncertainties around health claims are especially important as there may be serious consequences if incorrect information is disseminated. Letters to the Editor can fall into a grey area where the responsibility for statements are unclear.

Recently there have been examples of misleading claims printed in letters appearing in many local and English language newspapers in many countries. One letter to a newspaper in Thailand made incorrect statements about vaccine safety which, if believed, could potentially discourage infant vaccination and thereby place children at risk of preventable infectious diseases. Another letter contradicted Thailand’s national policy for malaria treatment with artemisinin combination therapies and advocated instead the use of unlicensed, unproven herbal remedies, which if followed could result in the mismanagement of a potentially fatal disease. Both articles risked causing harm and should not have been printed without qualification.

Improved editorial guidelines may help avoid such oversights in future. Such guidelines might include additional steps prior to publication to verify and fact-check health claims, the adoption of a risk-based approach before deciding whether the public interest is best served by publication, and consultation with relevant medical experts. The public deserve to read a range of opinions from readers, including on health matters, but there is an editorial responsibility to ensure in as far as is reasonable, that such claims are evidence-based, appropriately referenced, and accountable.

Keywords: Ethics, evidence-based medicine, malaria, media, Thailand, vaccination

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1. Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
2. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
3. Shoklo Malaria Research Unit, Mae Sot, Thailand
4. Ingvartsen Arkitekter, København K, Denmark
5. Det Kongelige Danske Kunstakademis Skoler for Arkitektur, Design og Konservering—Arkitektskolen, Copenhagen, Denmark
6. CSK Research Solutions, Dar es Salam, Tanzania
7. Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines

Correspondence to Lorenz von Seidlein (MD, PhD),
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. Email: lorenz@tropmedres.ac

Abstract

Traditional, rural homes in tropical sub-Saharan Africa are often ground floor, waddle and daub structures and differ from the Asian elevated, air-permeable houses even though the climate zones are similar. We assessed the relative comfort of living in a Thai-style bamboo house compared with a traditional African mud house in a hot and humid zone in Africa.

A team of Thai craftsmen built a bamboo house in Magoda. Tanzania. The bamboo was locally sourced. We compared the relative comfort of living in a Thai style house with a traditional African house using temperature and humidity recordings over 4 months, particularly between 19:00 to 22:00 when decisions are made where to sleep and assessed acceptability of the Thai house to local residents.

The construction of a Thai-style bamboo house took two weeks after the construction materials were in-site. The indoor climate assessment of the house indicated that residents in the bamboo house are likely to feel comfortable 85% of the time while the residents in the mud house would only feel comfortable 34% during that time between 19:00 to 22:00. The bamboo house was well accepted by the villagers and has served as accommodation for the residents since hand-over in 2015.

The typical Thai bamboo house in Tanzania provided a substantially more comfortable indoor climate compared to the traditional African mud house. The residents were happy with the house design and continue to use the Thai bamboo house. Novel designs hold considerable promise as a sustainable approach to provide housing for the rapidly expanding population of Africa and may carry health benefits.

Keywords: malaria, vector borne diseases, mosquitoes, respiratory tract infections.

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1. The Royal Society of Thailand, Dusit, Bangkok, Thailand
2. Department of Clinical Tropical Medicine. Faculty of Tropical Medicine. Mahidol Oxford Tropical Medicine Research Unit (MORU). Mahidol University. Thailand

Correspondence to: Borimas Hanboonkunupakarn (MD-PhD),
Department of Clinical Tropical Medicine. Faculty of Tropical Medicine. Mahidol Oxford Tropical Medicine Research Unit (MORU). Mahidol University. Thailand. Email: borimas.han@mahidol.ac.th

Abstract

Malaria is one of the most important tropical diseases with 200 million cases worldwide. The malaria control and elimination programmes, initiated by WHO in 2005, have been adopted by more than 50 countries. Thailand has aimed to eliminate malaria in 2030. A key strategy to eliminate malaria is “to reduce malaria transmission” including transmission of the infection between the human host and the vector. Ivermectin, an old anthelmintic drug, is known to have a mosquito-cidal effect. Mosquitoes will die after biting people who have ingested ivermectin. Ivermectin is, therefore, a potential new tool for the control and eventual elimination of mosquito vectors. Ivermectin has been used in mass drug administrations for example for the control of lymphatic filariasis but there is currently no consensus on the usefulness and the most appropriate regimen for ivermectin in malaria control. The Faculty of Tropical Medicine, Mahidol University recently conducted two phase1 clinical trials on ivermectin. This review describes the results of recent studies on pharmacokinetic properties and mosquito-cidal effects of ivermectin, conducted in the Faculty of Tropical Medicine, Mahidol University.

Keywords: malaria, ivermectin, malaria elimination,

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Abstract

Quinine and Quin-Ghao (artemisinins) both have a centuries old medical history as effective anti-ague remedies and remain natureûs two most important anti-malarial drugs. From ancient records of early discovery, it took less than a decade for quinine to be widely used in Europe in the 17th century. In contrast, it took over a thousand years until the 20th century for Quin Ghao (artemisinin) to become known and accepted outside China. These divergent timelines of the two drugs, partly reflect differences in the scientific heritage between the two civilizations i.e general publication in the West versus confidential ownership in the East. Quinine, but especially artemisinin derivatives, still play an important role in malaria control and treatment as witnessed in the WHO malaria treatment guidelines. Recent evidence shows that artesunate is superior to quinine in preventing death from severe falciparum malaria. Quinine is more wildly available and has remained the first line anti-malarial regimen for first trimester pregnant women.

Key words: malaria, quinine, Quin-Ghao, artesunate

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Abstract

Malaria infection is a major global health problem causing at least 1 million deaths per year. P. falciparm parasite in many areas has developed resistance to antimalarial monotherapy. The use of antimalarial combinations will delay the onset and slow the rate of spread of resistance. WHO recommends that all countries experiencing resistance to conventional monotherapies, such as chloroquine, quinine, amodiaquine or sulfadoxine–pyrimethamine, should use combination therapies, preferably those containing artemisinin derivatives or artemisinin-based combination therapies. Other alternative combination therapies are artesunate plus tetracycline or doxycycline or clindamycin and quinine plus tetracycline or doxycycline or clindamycin.

Key words: Malaria, Combination therapy

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