NEGLECTED TROPICAL DISEASES

I am a member of the World Health Organization Department of Control of Neglected Tropical Diseases Diagnostic Technical Advisory Group, am on the steering committee of the London Centre for NTD Research, am the current Chair of the International Alliance for the Control of Scabies and sit on the technical advisory group for the World Scabies Program.

Yaws: My Phd, which was funded by the Wellcome Trust, focused on understanding the impact of azithromycin mass administration on treponemal infections as part of a strategy to eliminate yaws in the Solomon Islands including work on disease mapping and the evaluation of diagnostic tests. I was a lead investigator on a WHO sponsored trial of treatment of yaws in Ghana and Papua New Guinea and collaborate with Oriol Mitjà on studies to optimise community treatment strategies for yaws in PNG. I am the principal investigator on a new EDCTP evaluation of a LAMP assay for yaws (2020-2022) in Ghana, Cote d’Ivoire and Cameroon and am collaborating on studies evaluating Linezolid as a new therapeutic agent for yaws.

Scabies: I am involved in a number of studies on the epidemiology and control of scabies, which is endemic in the Pacific region and has recently been adopted as an NTD by the World Health Organization. I collaborate with Andrew Steer, in Melbourne, and John Kaldor, in Sydney, on a number of studies to better understand the use of mass treatment strategies to control scabies in endemic communities and in the Gambia am collaborating with colleagues on studies exploring the use of ivermectin in younger children.

Integrated NTD control: As well as work on these specific NTDs I am interested in strategies for the integrated control of neglected tropical diseases. I was the lead investigator on several studies exploring the possibility of combining MDA programmes for multiple NTDs into a single intervention in Ethiopia and Papua New Guinea. Along with Rachel Pullan, Steve Walker and others I am a lead investigator on the NIHR funded SHARP project (2019-2023) on integrated control strategies for NTDs of the skin including buruli ulcer, yaws, cutaneous leishmaniasis and leprosy in Ghana and Ethiopia.

SEXUALLY TRANSMITTED INFECTIONS

At LSHTM I am a member of the steering committee of the STI Research Interest Group and a member of the WHO Collaborating Centre on STIs.

Syphilis: In collaboration with Professor Nick Thomson a major area of interest has been the application of next-generation sequencing approaches to better understand the epidemiology of syphilis. This has included conducting the largest multi-country whole genome sequencing study of syphilis to date. We have now expanded this work to include a focus on genital ulcer disease across Botswana, Ghana, Uganda and Zimbabwe funded by the Gates Foundation which will provide vital data on global genomic diversity of this important sexually transmitted pathogen. A further Gates grant is focused on identifying potential targets for syphilis vaccine development and makes use of the treponema-cell culture model established at the Sanger.

In many LMICs syphilis testing remains limited to the antenatal setting and key groups such as men who have sex with men (MSM) are often unable to access testing. In order to improve outcomes for marginalised groups I work with Joe Tucker to evaluate innovative strategies, such as self-testing, to improve syphilis testing rates amongst high risk groups in China and Zimbabwe.

In collaboration with Richard Gilson at UCL I am helping to setup UK sites for a study evaluating Linezolid as a new oral therapy for syphilis as part of a multi-centre study led by my long term collaborator Oriol Mitjà.

STI Diagnostics: With Rashida Ferrand and Katharina Kranzer I am currently supervising a Wellcome Trust funded PhD on integrating near-patient molecular diagnostics for STIs into antenatal care in Zimbabwe.

Sexual & Reproductive Health: I am a member of the I-SHARE consortium. I-SHARE examines the impact of the COVID-19 crisis on sexual and reproductive health across a diverse range of low-income, middle-income, and high-income countries.

GROUP A STREPTOCOCCUS:

My work on scabies has led on to a broader research interest in Group A Streptococcal (GAS) disease which is a major cause of morbidity and mortality worldwide.

In collaboration with Thushan de Silva at the University of Sheffield and MRC Unit the Gambia we have established a series of studies focused on understanding the epidemiology and control of GAS. These have included the SpyCATS study, led by Edwin Armitage, which is the most detailed household transmission study of GAS conducted worldwide and the PharynGAS Study evaluating near-patient diagnostic tests. Building off these studies we are part of the iSpy Network led by Shiranee Sriskandan which is focused on unpicking immune responses to GAS across the life course.

RESPIRATORY VIRUS INFECTIONS:

Winter Pressures: Funded by NIHR I am an investigator on a large study, led by Roz Eggo, which is using electronic health records and modelling to investigate the impacts of respiratory viruses and other drivers of increased health service pressure during the winter on both primary and secondary care.

Post-COVID: I am a member of the national management committee of PHOSP, a large UK cohort study exploring long-term outcomes of patients who were hospitalised with COVID-19. Linked to this I am a co-investigator on a grant led by Andy Briggs evaluating health system pathways and the economic impact on patients hospitalised with COVID and on the OpenPROMPT study led by Roz Eggo on the economic impact on patients with COVID managed in the community.

COVID Transmission: I was the PI on an MRC/NIHR funded study which has taken a multi-disciplinary approach to understanding transmission of COVID in minority populations in the UK and how public health responses can best be contexualised to the needs of these groups. Alongside this I was also the co-ordinator of an EDCTP funded project looking to strengthen surveillance of COVID-19 in Ghana.

UK PRAGMATIC INFECTIOUS DISEASES TRIALS:

I am a founding member of the ULCH Clinical Infection Research Committee helping oversee a portfolio of research at University College London Hospital. I am a co-investigator on the SNAP trial, the worlds largest RCT on the treatment of Staphylococcus aureus bacteraemia. This multi-centre study is currently funded in Australia, New Zealand, Canada, Singapore, Israel and the United Kingdom. I am a member of the UK regional steering committee and the global early oral switch and adjunctive-therapies working groups. At UCLH I am also a site PI on several other major trials including REMAP-CAP (Influenza), DURATIONS (pyelonephritis) and ASPECT (Pneumonia).

OTHER ACTIVITIES

Alongside my research work at LSHTM, I worked with Chrissy Roberts to establish and run the ODK@LSHTM service which supports the uptake of the ODK electronic data collection platform in research projects run by LSHTM worldwide. Our Emergency Data Kit project supported the role out of Ebola Vaccination in the DRC

Details of grants and work I have been involved in are also available on ORC-ID