Dr David Moore MBChB MD DTM&H MSc (Epi) FRCP
- Room 308
- LSHTM
- Keppel Street
- London
- WC1E 7HT
- T: +44 (0)20 7612 7805
- F: +44 (0)20 7637 4314
Four years after graduating from Birmingham Medical School in 1989 I found myself working at Hlabisa Hospital in rural Kwazulu-Natal in South Africa. It was here that my eyes were opened to tropical medicine and public health. On returning to the UK I was fortunate to get onto the North Thames ID training rotation culminating in a year at the Hospital for Tropical Diseases.
After a 2001/2002 Masters in Epidemiology at the school we moved to Lima, Peru with a Wellcome Trust Research Training Fellowship in Clinical Tropical Medicine to evaluate the rapid TB and MDRTB diagnostic test MODS (www.modsperu,org) in the laboratory of JHU Professor Bob Gilman (http://faculty.jhsph.edu/default.cfm?faculty_id=261) at Universidad Peruana Caytano Heredia (http://www.upch.edu.pe/).
With a few minor tweaks MODS has been transformed from an interesting research observation into a formally recognised rapid diagnostic test endorsed by WHO in 2010 and with further Wellcome support through a Career Development Fellowship we were able to evaluate the process of implementation of MODS into the Peruvian National TB Control Programme (NTP) and Regional Reference Laboratory Network. At $3.50 for an TB detection and MDR test available within 7 days MODS represents good value for money in this MDR high-burden setting.
However, diagnosing MDRTB rapidly with MODS (or indeed any new rapid diagnostic) is a big step forward but it asks more questions than it answers - thus we are now starting to address the issues that arise as a consequence of earlier detection of DR-TB, such as (1) what should be/can be done for household contacts of MDRTB patients? (2) what should be/can be done for patients with isoniazid-resistant non-MDR disease?
The success of our research effort in Peru is largely a result of excellent collaborative links with the Peruvian NTP and with ID and chest physicians in the major Lima hospitals. Thus our work is integrated from the outset and only follows an agenda that is acceptable and prioritised in-country, maximising the likelihood of policy adoption at the end of the process.
I relocated to the UK with my family in August 2009 but have regular contact with my field and laboratory team in Lima every week and visit frequently. Our research programme continues to develop and I have both Peruvian and British Wellcome Fellows working in my group.
Affiliation
Teaching
My main teaching responsibility at LSHTM is as Course Director for the DTM&H (http://www.lshtm.ac.uk/prospectus/short/stmh.html); I also teach on the Diploma in Tropical Nursing and am a tutor for the MSc in Tropical Medicine and International Health.
During my 7 years in Lima I was privileged to supervise and mentor a large number of extremely talented and dynamic science and medical undergraduates and postgraduates from the UK, Peru and the US who passed through our research unit. Their names are too numerous to mention but most of them feature on at least one and often two of the publications on our publication list. My research group in Lima remains active and postgraduate students from LSHTM and elsewhere are welcomed, though a good command of Spanish is a prerequisite.
Research
My primary research interest is in control of tuberculosis and drug-resistant tuberculosis through innovative strategies for diagnosis of adult and paediatric TB, management of latent TB infection and active TB disease (drug-susceptible and drug-resistant), and institutional and domestic TB infection control. We also have a growing interest in development of laboratory capacity through innovative laboratory design and application of portable containerized laboratories.
An expanding area of interest is control of bartonellosis (Oroya fever, Verruga Peruana) due to Bartonella bacilliformis; knowledge gaps in diagnosis, natural history, epidemiology, vector biology and therapeutics are amongst the major challenges for this neglected disease affecting impoverished Andean communities.
Research areas
- Diagnostics
- Health services research
- Pharmacokinetics
Disciplines
- Epidemiology
- Microbiology
- Operational research
Disease and Health Conditions
- Infectious disease
- Tuberculosis
Regions
- Latin America & Caribbean (developing only)
Countries
- India
- Peru
- Somalia
- South Africa
Other interests
- Clinical Tropical Medicine
- MDR TB
- TB Centre
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Selected publications
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Microscopic observation drug susceptibility assay for tuberculosis screening before isoniazid preventive therapy in HIV-infected persons
Reddy, K.P.; Brady, M.F.; Gilman, R.H.; Coronel, J.; Navincopa, M.; Ticona, E.; Chavez, G.; Sanchez, E.; Rojas, C.; Solari, L.; Valencia, J.; Pinedo, Y.; Benites, C.; Friedland, J.S.; Moore, D.A.
Clinical Infectious Diseases, 2010; 50(7):988-96
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The MIT D-lab electricity-free PortaTherm(TM) incubator for remote testing with the QuantiFERON (R)-TB Gold In-Tube assay
Dominguez, M.; Smith, A.; Luna, G.; Brady, M.F.; Austin-Breneman, J.; Lopez, S.; Yataco, R.; Moore, D.A.J.
International Journal of Tuberculosis and Lung Disease, 2010; 14(11):1468-1474
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MODS accreditation process for regional reference laboratories in Peru: validation by GenoType (R) MTBDRplus
Coronel, J.; Roper, M.; Mitchell, S.; Castillo, E.; Gamarra, N.; Drobniewski, F.; Luna, G.; Mendoza, A.; Moore, D.A.J.
International Journal of Tuberculosis and Lung Disease, 2010; 14(11):1475-1480
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Prolonged infectiousness of tuberculosis patients in a DOTS programme with standardized therapy
Fitzwater, S.P.; Caviedes, L.; Gilman, R.H.; Coronel, J.; Lachira, D.; Salazar, C.; Saravia, J.C.; Reddy, K.P.; Friedland, J.S.; Moore, D.A.J.
Clin Infect Diseases, 2010; in press
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Upper-room ultraviolet light and negative air ionization to prevent tuberculosis transmission
Escombe, A.R.; Moore, D.A.; Gilman, R.H.; Navincopa, M.; Ticona, E.; Mitchell, B.; Noakes, C.; Martinez, C.; Sheen, P.; Ramirez, R.; Quino, W.; Gonzalez, A.; Friedland, J.S.; Evans, C.A.
PLoS Med, 2009; 6(3):e43
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Infrequent MODS TB culture cross-contamination in a high-burden resource-poor setting
Moore, D.A.; Caviedes, L.; Gilman, R.H.; Coronel, J.; Arenas, F.; Lachira, D.; Salazar, C.; Carlos Saravia, J.; Oberhelman, R.A.; Hollm-Delgado, M.G.; Escombe, A.R.; Evans, C.A.; Friedland, J.S.
Diagnostic Microbiology and Infectious Disease, 2006; 56(1):35-43
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Microscopic-observation drug-susceptibility assay for the diagnosis of TB
Moore, D.A.; Evans, C.A.; Gilman, R.H.; Caviedes, L.; Coronel, J.; Vivar, A.; Sanchez, E.; Pinedo, Y.; Saravia, J.C.; Salazar, C.; Oberhelman, R.; Hollm-Delgado, M.G.; Lachira, D.; Escombe, A.R.; Friedland, J.S.
New England Journal of Medicine, 2006; 355(15):1539-50
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Diagnosis of sputum-scarce HIV-associated pulmonary tuberculosis in Lima, Peru
Vargas, D.; Garcia, L.; Gilman, R.H.; Evans, C.; Ticona, E.; Navincopa, M.; Luo, R.F.; Caviedes, L.; Hong, C.; Escombe, R.; Moore, D.A.
Lancet, 2005; 365(9454):150-2
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