Shunmay Yeung

Shunmay Yeung
London School of Hygiene and Tropical Medicine | LSHTM · Department of Global Health and Development

Doctor of Philosophy

About

153
Publications
23,569
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
9,193
Citations
Introduction
Dr Shunmay Yeung is an Associate Professor at the London School of Hygiene and Tropical Medicine where she co-leads the MARCH centre of Maternal, Adolescent, Reproductive and Child Health - Child theme. She is an Honorary Consultant in Paediatric Infectious Disease at St Mary's Hospital London. She is active in research in global child health and infectious disease, with particular expertise on malaria, economic evaluation, and the diagnosis and case management of children with acute infections in both high, and low and middle income settings.

Publications

Publications (153)
Article
Full-text available
In many countries, community pharmacies have played an important role during the COVID-19 pandemic, providing essential medicines and personal protective equipment (PPE), disseminating information on disease prevention and management, and referring clients to health facilities. In recognition of this, there are increasing calls for an improved unde...
Article
Full-text available
Background Pharmacists have been at the frontline of the COVID-19 response in Indonesia, providing medicines, advice, and referral services often in areas with limited healthcare access. This study aimed to explore their knowledge, attitudes, and practices during the pandemic, so that we can be better prepared for future emergencies. Methods A cro...
Article
Background Overuse of antibiotics is one of the main drivers for antimicrobial resistance (AMR). Globally, most antibiotics are prescribed in the outpatient setting. This survey aimed to explore attitudes and practices with regards to microbiology tests, AMR and antibiotic prescribing among healthcare providers at public primary health clinics in H...
Article
Full-text available
Background As concerns about the prevalence of infections that are resistant to available antibiotics increase, attention has turned toward the use of these medicines both within and outside of formal healthcare settings. Much of what is known about use beyond formal settings is informed by survey-based research. Few studies to date have used compa...
Article
Full-text available
Background Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the int...
Article
Full-text available
Introduction: The aim of this mixed-method study was to determine the extent and determinants of inappropriate dispensing of antibiotics by licensed private drug retail outlets in Indonesia. Methods: Standardised patients (SPs) made a total of 495 visits to 166 drug outlets (community pharmacies and drug stores) between July and August 2019. The...
Article
Full-text available
Background Selectively targeting and treating malaria-infected individuals may further decrease parasite carriage in low-burden settings. Using a trans-disciplinary approach, a reactive treatment strategy to reduce Plasmodium falciparum prevalence in participating communities was co-developed and tested. Methods This is a 2-arm, open-label, cluste...
Preprint
Full-text available
Background Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the int...
Article
Full-text available
Background Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is promoted by multiple drivers, including antibiotic use in the livestock sector. Thus, understanding factors influencing antibiotic use in livestock production is essential to the design and implementation of effective interventions to reduce A...
Preprint
Full-text available
Background: Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is driven by antibiotic use. Understanding factors influencing antibiotic use is essential to design and implement effective interventions to reduce unnecessary antibiotic use and AMR. This study aims to explore the practices and views of the ke...
Article
Full-text available
Background Rising global concern about antimicrobial resistance has drawn attention to the use of antibiotics in livestock. Understanding the current usage of antibiotics in these animals is essential for effective interventions on the optimisation of antibiotic use. However, to date few studies have been conducted in low- and middle-income countri...
Article
Full-text available
Background: Malaria control activities can have a disproportionately greater impact on Plasmodium falciparum than on P. vivax in areas where both species are coendemic. We investigated temporal trends in malaria-related morbidity and mortality in Papua, Indonesia, before and after introduction of a universal, artemisinin-based antimalarial treatme...
Article
Full-text available
This review assesses the evidence for patterns of antibiotic use in pig on the basis of papers published in peer-reviewed journals in English between 2000 and 2017. Thirty-six articles were identified and reviewed, of which more than 85% of studies were conducted in Europe and North America. Penicillins and Tetracyclines groups were the most common...
Article
Full-text available
Typhoid fever is a common cause of fever in Cambodian children but diagnosis and treatment are usually presumptive owing to the lack of quick and accurate tests at an initial consultation. This study aimed to evaluate the cost-effectiveness of using a rapid diagnostic test (RDT) for typhoid fever diagnosis, an immunoglobulin M lateral flow assay (I...
Data
Supplier costs (excluding 10% of shipping cost) US$, 2015. (PDF)
Data
ICER change by two-way sensitivity analysis. (TIF)
Data
Effect of varying specificity of tests and probability of treatment success. (TIF)
Data
Probability of treatment success. (TIF)
Article
Background: Overuse of antimicrobials in both humans and animals is recognized as one of the main drivers of Antimicrobial Resistance (AMR); and the optimisation of their use has been advocated as a key strategy for dealing with AMR. The measurement of antimicrobial use is vital for the design, monitoring and evaluation of such strategies. This sys...
Conference Paper
Background Antibiotic resistance is a global threat that is both harmful to patients and costly for healthcare services. It is exacerbated by the unnecessary prescription of antibiotics for viral infections. One suggested intervention to help reduce inappropriate prescriptions is point-of-care-testing (POCT) for biomarkers. This systematic review a...
Article
Full-text available
Background Systematic treatment of all individuals living in the same compound of a clinical malaria case may clear asymptomatic infections and possibly reduce malaria transmission, where this is focal. High and sustained coverage is extremely important and requires active community engagement. This study explores a community-based approach to trea...
Article
Full-text available
Artemisinin combination therapy is recommended for the treatment of multidrug resistant Plasmodium falciparum and Plasmodium vivax. In March 2006, antimalarial policy in Indonesia was changed to a unified treatment with dihydroartemisinin-piperaquine for all species of malaria because of the low efficacy of previous drug treatments. In 2013, a rand...
Article
Full-text available
We compared children who were positive for Ebola virus disease (EVD) with those who were negative to derive a pediatric EVD predictor (PEP) score. We collected data on all children <13 years of age admitted to 11 Ebola holding units in Sierra Leone during August 2014-March 2015 and performed multivariable logistic regression. Among 1,054 children,...
Article
Full-text available
Objective To analyse how antibiotics are imported, manufactured, distributed and regulated in Thailand. Methods We gathered information, on antibiotic distribution in Thailand, in in-depth interviews – with 43 key informants from farms, health facilities, pharmaceutical and animal feed industries, private pharmacies and regulators– and in database...
Data
Technical Appendix. Additional information about Ebola infection in children and the development of the Pediatric Ebola Predictive Score (PEP score).
Article
Full-text available
Background Large-scale use of insecticide-treated nets and indoor residual spraying have contributed to a significant decrease in malaria transmission worldwide. Further reduction and progress towards elimination, however, require complementary control measures which can address the remaining gaps in protection from mosquito bites. Following the de...
Article
Full-text available
Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended t...
Article
Full-text available
We collected data on 1054 children admitted to Ebola Holding Units in Sierra Leone and describe outcomes of 697/1054 children testing negative for Ebola virus disease (EVD) and accompanying caregivers. Case-fatality was 9%; 3/630 (0.5%) children discharged testing negative were readmitted EVD-positive. Nosocomial EVD transmission risk may be lower...
Article
Full-text available
We collected data on 1054 children admitted to Ebola Holding Units in Sierra Leone and describe outcomes of 697/1054 children testing negative for Ebola virus disease (EVD) and accompanying caregivers. Case-fatality was 9%; 3/630 (0.5%) children discharged testing negative were readmitted EVD-positive. Nosocomial EVD transmission risk may be lower...
Article
Full-text available
Background: Primaquine is the only licensed antimalarial for the radical cure of Plasmodium vivax infections. Many countries, however, do not administer primaquine due to fear of hemolysis in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency. In other settings, primaquine is given without G6PD testing, putting patients at risk of hemo...
Data
P. vivax recurrence data. (XLSX)
Data
Study description for determining G6PD activity in females. (PDF)
Data
One-way sensitivity analysis results on costs and disability-adjusted life-years (DALYs). (PDF)
Article
Full-text available
Background There is growing interest in the expansion of community health workers programmes in low- and middle-income countries as a cost-effective approach to address shortages of health professionals. However, our understanding of the reception of large-scale programmes and how to improve them remains limited, with knowledge gaps about factors t...
Article
Full-text available
Objectives To examine the impact of use of rapid diagnostic tests for malaria on prescribing of antimicrobials, specifically antibiotics, for acute febrile illness in Africa and Asia. Design Analysisof nine preselected linked and codesigned observational and randomised studies (eight cluster or individually randomised trials and one observational s...
Article
Full-text available
Background Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal access to prompt parasite-based diagnosis, many malaria-endemic countri...
Article
Background The case definition for suspected Ebola virus disease is broad, so many negative children are isolated for testing, risking nosocomial infection. We collected data on children admitted to Ebola holding units in Sierra Leone to refine the case definition and describe outcomes of admitted children. Methods All children aged less than 13 y...
Article
Full-text available
Background Malaria remains a significant public health issue in Eastern Indonesia, where multidrug resistant Plasmodium falciparum and Plasmodium vivax are highly prevalent. The objective of this study was to describe treatment-seeking behaviour and household costs prior to a change to a unified treatment policy of dihydroartemisinin-piperaquine in...
Article
The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review...
Article
Full-text available
Little is known about potentially modifiable factors in Ebola virus disease in children. We undertook a retrospective cohort study of children <13 years old admitted to 11 Ebola holding units in the Western Area, Sierra Leone, during 2014-2015 to identify factors affecting outcome. Primary outcome was death or discharge after transfer to Ebola trea...
Article
Little is known about potentially modifiable factors in Ebola virus disease in children. We undertook a retrospective cohort study of children <13 years old admitted to 11 Ebola holding units in the Western Area, Sierra Leone, during 2014–2015 to identify factors affecting outcome. Primary outcome was death or discharge after transfer to Ebola trea...
Article
Full-text available
Background Most malarious countries outside of Africa are co-endemic for Plasmodium falciparum and Plasmodium vivax. The comparative burden of anaemia in the community caused by these two species is incompletely characterized. Methods A three-stage, cross-sectional, community survey was used to determine the proportion of moderate or severe anaemi...
Article
Objectives: To identify and discuss the main ethical challenges related to the conduct of surveys and make suggestions on how to address them. Method: Most evidence-based information regarding medicine quality derives from surveys. However, existing research ethical guidelines do not provide specific guidance for medicine quality surveys. Hence,...
Article
Full-text available
Rigorous evidence of ‘what works’ to improve health care is in demand, but methods for the development of interventions have not been scrutinized in the same ways as methods for evaluation. This paper presents and examines intervention development processes of eight malaria health care interventions in East and West Africa. A case study approach wa...
Article
Background The Ebola virus disease (EVD) outbreak in West Africa has claimed over 11000 lives with >27000 cases. Infected children <5 years have a high mortality rate but little is known about disease manifestations and possible predictors of outcome. The impact of epidemiological, clinical and operational factors on mortality is unknown. Method A...
Article
Background The West African Ebola virus disease (EVD) outbreak decimated fragile health systems. The paediatric case definition of EVD is broad, and the symptoms non-specific meaning many children are admitted to Ebola Holding Units (EHUs) as suspect cases who subsequently test negative. Little is known about the characteristics or outcome of these...
Article
Background The outbreak of Ebola virus disease in West Africa has claimed more than 11 200 lives with more than 28 000 cases. Infected children under the age of 5 years have a high mortality rate but little is known about disease progression and possible predictors of outcome. Circumstantial factors such as transfer distances from Ebola holding uni...