I am a physician and NIHR Academic Clinical Lecturer in Infectious Diseases. I completed medical training in Liverpool and have since worked as an infection physician and researcher in the UK, sub-saharan Africa, Latin America, and muddy fields at Glastonbury and Reading Festivals. From February 2012-2015, I undertook a PhD entitled Preventing tuberculosis in high risk people with the Innovation For Health And Development team led by Dr Carlton Evans of Imperial College London, which works with 32 impoverished shantytown communities in north Lima, Peru, to improve TB prevention and control. During my time in Peru, I evaluated the economic effects of accessing "free" TB care, was part of the WHO task force on catastrophic costs of TB treatment, and led a Household Randomized-controlled Evaluation of a Socioeconomic Intervention to Prevent TB (HRESIPT). This research showed that socioeconomic support including conditional cash transfers improved rates of TB preventive therapy uptake and increased TB treatment success. We have recently completed the long-term follow-up and acceptability assessment from HRESIPT (manuscripts in press) and are continuing to evaluate the impact of the conditional cash transfers on TB control in the Community Randomised Evaluation of a Socioeconomic Intervention to Prevent Tuberculosis (CRESIPT) study.
In addition to ongoing work in Peru, I am expanding my research further as a post-doctoral investigator to evaluate the best methods of delivering socioeconomic support to TB-affected households in diverse low-resource settings through the following Wellcome Trust, Academy of Medical Sciences, NIHR, and Swedish Health Research Council funded projects:
- Developing a locally-appropriate socioeconomic support package for TB-affected households in Nepal: a Wellcome Trust Seed Research project to inform the BEYOND-TB trial (PI)
- CHEST: Coordinating HEalth and Social care for TB patients in Mozambique (Co-investigator)
- IMPALA: https://www.lstmed.ac.uk/impala
I hope to apply for a Wellcome Trust Research Career Development Fellowship in 2019 to undertake the multi-centre "BEYOND TB" trial of socioeconomic support for TB-affected households in diverse settings.
The projects above involve collaboration with multiple partners including: Karolinska Institutet, Liverpool School of Tropical Medicine (IMPACT TB, a Horizon 2020 EU funded study), University of Tampere Finland, the Birat Nepal Medical Trust, and national TB programs in Nepal and Mozambique.
I continue to be an active member of the Social Protection Action Research and Knowledge Sharing (SPARKS) network - a collaboration with Karolinska Institute, the World Health Organisation, and London School of Hygiene and Tropical Medicine), the WHO Task Force on Catastrophic Costs of TB, and run the LIV-TB research collaboration.
1) Addressing the social determinants of health – see www.ifhad.org
2) Evaluating the impact of socioeconomic support on health outcomes including tuberculosis - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30412-9/abstract and http://theconversation.com/how-to-help-people-with-tuberculosis-avoid-the-medical-poverty-trap-91634
3) Assessing catastrophic costs of accessing TB and health services in diverse low- and medium-income settings - http://apps.who.int/iris/bitstream/handle/10665/259701/9789241513524-eng.pdf;jsessionid=C0E5A4C6DA9F33DF559C3DAFB530365F?sequence=1
Dr Maxine Caws, Professor Bertie Squire, Professor Jason Madan, and Dr Noemia Siqueira. Project: IMPACT-TB study. Liverpool School of Tropical Medicine. IMPACT-TB is an EU Horizon 2020 funded project to implement proven active case finding interventions in Nepal and Vietnam. I have developed a Wellcome Trust funded seed project nested within IMPACT-TB to characterise the socioeconomic impact on TB-affected households and create a shortlist of locally-appropriate socioeconomic interventions to mitigate this impact. The project will be ongoing until 2019 and will directly inform the design of the larger multi-centre BEYOND-TB trial as part of a Research Career Development Fellowship.
Dr Salla Atkins and Professor Knut Lonnroth. Project: CHEST study. University of Tampere, Finland, Karolinska Institutet, Sweden, and National TB Programme of Mozambique. CHEST: Coordinating HEalth and Social care for TB patients in Mozambique. The aim of this study is to develop and evaluate a bi-directional referral system for TB patients between the health and social care services in Mozambique to enhance access to social protection and TB services and hence improve TB case finding and treatment outcomes while reducing the economic impact of TB for patients and their households.
Professor Carlton Evans. Innovation For Health And Development, Peru. Imperial College London and Universidad Peruana Cayetano Heredia. Professor Evans has led the way in research into socioeconomic support for TB-affected households. He was my PhD supervisor and we continue to work together addressing the social determinants of TB. Most recently, we have completed final follow-up of a cohort of TB-affected households in impoverished shantytowns of Lima, Peru, to assess the feedback on acceptability of a socioeconomic intervention in which they participated. Professor Evans continues to be a close friend, collaborator, and source of inspiration as do his Innovation For Health And Development team (including Sumona Datta, Rosario Montoya, Matt Saunders, and Eric Ramos).
Dr Delia Boccia.Project: SPARKS and LSHTM London School of Hygiene and Tropical Medicine
I have worked closely with Dr Boccia of the London School for over 7 years. We have worked together as part of the HRESIPT and CRESIPT studies in Peru (see research) and as part of the Social Protection Action Research and Knowledge Sharing (SPARKS) network - a collaboration between LSHTM, Karolinska Institutet and WHO. I also teach on the TB week of the Social Epidemiology course, organised by Dr Boccia.
Professor Knut Lonnroth Project: Strengthening social protection for TB-affected people Department of Public Health Sciences, Karolinska Institutet
I work with Professor Knut Lonnroth and his team (including Dr Kerri Viney and Ms Olivia Biermann) at Karolinska Institutet through the Social Protection Action Research and Knowledge Sharing (SPARKS) network of international collaborators. We also work together on my Wellcome Trust funded research and the CHEST study, amongst other projects.
I coordinate and lead LIV-TB. LIV-TB is a cross-campus collaboration between the Liverpool School of Tropical Medicine and the University of Liverpool. We hold a monthly seminar with a presentation on a TB related theme by members of the group or visiting researchers in the field, followed by wide-ranging discussion and update. To find out more, visit: https://www.lstmed.ac.uk/research/collaborations/liv-tb I am also a member of UK Academics and Professionals and TB (www.ukaptb.org). We are a group of academics and clinicians working together to eliminate TB. We joined forces in early 2018 so that we could combine our research and experience to inform the UN General Assembly meeting that is being organised specifically to tackle this worldwide issue.