Page 52 - The lraternational Journal of the Royal Society of Thailand.indd

The International Journal of the Royal Society of Thailand
Volume XV-2023

was spread and on how best people could best protect themselves, staff were advised
to reduce their work hours in the office, use hand gel and masks, and if they
experienced cough or fever they were to self-isolate at home for 14 days. At the same
time, MORU researchers based in Bangkok were advised to work from home, further
fragmenting the oversight of the research in Cambodia. This was followed by The
University of Oxford issuing guidance “to pause or postpone all non-essential
research involving face-to-face interactions (unless arrangements can be made for
it to be conducted remotely or online), unless it was related to COVID-19 or was

clinical research vital for patient care or safety.”

As approval processes for non-COVID-19 research ground to a halt in the UK
following a tsunami of COVID-19 studies requiring ethics approval (research
undertaken by MORU requires Ethics approval from The University of Oxford, UK
[OxTREC]), a Vivax Malaria Project (EFFORT) that was to be undertaken in
Cambodia by MORU and Menzies, Australia, switched to firstly apply for Australian-IRB
approvals (granted May 2020), in an effort to avoid protracted delays to study
approval.

With future studies and funding for the study sites expected to be delayed,
support for the study staff in Kravanh, west Cambodia, who had only recently
completed another MORU malaria research project, was required. This proved

problematic given the limited funding available however researchers were successful
in supporting the staff through this period.
Given the relatively low number of cases of COVID-19, the vital nature of

the research and the trust built up during previous engagement activities, the team
in Siam Pang were able to restart recruitment into the PAL trial from the end of
April 2020. There were a number of adaptions to manage the risk of COVID-19, i.e.
conducting recruitment at the health centre were infection control measures could
be more easily implemented. However, due to border restrictions, the team faced
delays receiving study supplies and were unable to ship study blood samples for
processing in Bangkok.

By the end of July, cases of COVID-19 were increasing in Cambodia, however,
with local authorities’ permission the team were able to continue working in the
community whilst adhering to strict COVID-19 prevention measures i.e. mask

wearing. There did not appear to be any local transmission, only imported cases
from Malaysia and Indonesia which were mainly confined to Phnom Penh. There was,
however, further uncertainty with the sole Cambodian-based MORU researcher
requiring a visa renewal. Given the restrictions on entry visas for foreigners there
was a risk that no MORU researcher would remain in Cambodia, thankfully this
was not the case.

Sustaining Health Research During the COVID-19 Pandemic:
44 Lessons from Field Sites in Rural Cambodia