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Child Health Research in Cambodia

Embedded within the Angkor Hospital for Children (AHC) in Siem Reap, Cambodia, the Cambodia-Oxford Medical Research Unit (COMRU) was established in 2006 as a collaboration between MORU and AHC, a non-profit paediatric healthcare organisation. AHC comprises a tertiary level teaching hospital, a clinical training site for Cambodian healthcare workers and a comprehensive community outreach and engagement programme.

Giving Cambodian children a voice in healthcare and research
Giving Cambodian children a voice in healthcare and research.

Research at COMRU is focused around the important causes of morbidity and mortality in Cambodian children. Despite recently graduating to lower middle-income status, Cambodia remains one of the poorest nations in Southeast Asia with high rates of neonatal, infant and childhood mortality.

Reflecting the unit’s major research focus on bacterial infection and antimicrobial resistance (AMR), COMRU has a well-equipped diagnostic and research microbiology laboratory onsite at AHC, including facilities for bacterial culture, molecular pathogen identification / characterisation by PCR and whole genome sequencing (WGS), and serological testing. The unit also carries out research in the community of Siem Reap Province. AHC's neonatal research programme takes place in the nearby province of Preah Vihear.

Research at COMRU has defined the epidemiology of some of the key infectious diseases affecting Cambodian children. We have contributed to development of the Cambodia National Antimicrobial Resistance Surveillance System and helped revise the country’s National Action Plan for Antimicrobial Resistance. Locally, we have implemented an electronic antibiotic prescription guideline app at AHC and led development of a comprehensive hospital antimicrobial stewardship programme.

COMRU’s significant recent achievements include:

  • Quantified the burden of antimicrobial resistant infections in hospitalised Cambodian children over a ten-year period and lead a general review on AMR in Cambodia, in collaboration with the Ministry of Health AMR Technical Working Group.
  • Determined the impact of PCV13 on Streptococcus pneumoniae colonisation and invasive disease in the three years following vaccine introduction, in collaboration with the World Health Organization (WPRO), US Centers for Disease Control and Prevention, and the bacterial microarray group at St George's, University of London
  • Estimated the likely coverage of prototype group A streptococcal vaccines in Cambodian children, in collaboration with the Murdoch Children’s Research Institute, Australia.
  • Mapped the burden of paediatric melioidosis in Siem Reap province, to inform future intervention studies.
  • Contributed to Oxford Tropical Network and Wellcome Sanger Institute whole genome sequencing projects on Salmonella Typhi, Shigella sonnei, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae epidemiology and population biology.
  • Identified key beliefs and practices occurring in the newborn period in rural Cambodia, to inform future intervention studies around neonatal care.
  • Commenced a programme of implementation research based around delivery of paediatric healthcare in Cambodia.
  • Hosted the 2015 Oxford Tropical Network Meeting, attended by over 300 researchers from Asia, Africa and Oxford.

Contact

Email:     pault@tropmedres.ac

Twitter:  @PaulTurnerMicro

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