In northern Thailand, MORU researchers focus on scrub typhus, a disease transmitted by small bugs in rural environments. A simple diagnostic cartridge for rapid detection would avoid critical delays and issues of current antibody-based tests. If accessible in small hospitals, this improved diagnostics has the potential to save lives by providing timely treatment. Involving local communities is essential to address the endemic nature of scrub typhus in rural areas.

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I am research physician and head of CCRU (Chiangrai Clinical Research Unit), located in the north-east of Thailand and bordering Myanmar and Laos. The hilly patchwork of forests, fields, shrubs, orchards and streams of Chiangrai province is highly endemic for scrub typhus and, possibly, other tropical rickettsioses. CCRU, together with Chiangrai Prachanukroh Hospital and other local stakeholders, is involved in researching scrub typhus, acute febrile illness and antimicrobial resistance in the region. Another important focus of our work are the ethics of research in vulnerable populations such as hill tribes, who are disproportionally affected by infectious diseases but risk being underrepresented in research.

We also conduct scrub typhus public engagement activities with at-risk communities focused on prevention and raising awareness.

In the future we aim at expanding our network of stakeholders in order to obtain a better picture of health issues in rural communities. Among the questions our current and planned research projects aim to answer are:

• Compared efficacy of antibiotic treatments in scrub typhus
• Determinants and predictors of disease severity in scrub typhus
• Identifying the causes of acute febrile illness in rural communities
• Accuracy of rapid diagnostic tests (RDTs) in mild and moderate scrub typhus disease
• Prevalence of tropical rickettsioses other than scrub typhus in the area
• Feasibility, acceptability and efficacy of scrub typhus preventive measures

I am part of the Pint of Science Thailand team and collaborate with the rickettsia threat reduction network.