Research areas: Helminths, Infectious disease, Malaria, Parasites, Surveillance.
Other keywords: Disease control, Programme evaluation.
Background
A Reader in Tropical Epidemiology and Disease Control at the London School of Hygiene and Tropical Medicine, I currrently hold a Wellcome Trust Research Career Development Fellowship, based full-time at the KEMRI-Wellcome Trust Collaborative Programme in Nairobi, Kenya.
I have a first degree in Human Sciences and a doctorate in Infectious Disease Epidemiology from the University of Oxford, and a Master's in Health Economics from City University, London. Before joining LSHTM in 2002, I held research appointments at the University of Oxford and Imperial College, London. My research has been based primarily in Africa, and I have lived and worked in Ghana, Kenya and Uganda; I have also worked in Brazil and parts of Asia.
I co-organize (with Jon Cox) the study unit Spatial Epidemiology in Public Health, and sit on the exam board for the MSc Control of Infectious Diseases. I also contribute to a number of other study units, including Parasitology and Entomology and Disease Agents and their Control.
I currently supervise two PhD students: Hugh Sturrock (spatial epidemiology of neglected tropical diseases); and Carol Gitonga (potential of school-based malaria surveillance).
Research
I have broad interests in tropical epidemiology, with particular emphasis upon identifying cost-effective intervention strategies against tropical diseases, and how they can be best targeted in geographical areas where they are needed most. I am interested in evaluating the impact of such interventions in resource-poor settings. Throughout his work, I place a strong emphasis on developing an evidence base that can be used by policy makers and programme implementers, and close involvement with national control programmes and international agencies helps ensure the effective translation of research findings into practical action.
My early research focused on the spatial epidemiology of human helminth infections and the use of geographical information systems and remote sensing to predict geographical distributions of infection to target control efforts. More recently, I investigated the spatial targeting and cost-effectiveness of schistosomiasis control in Africa.
My current research focuses on three main areas:
Epidemiology of malaria-helminth co-infection. Individuals living in the tropics are simultaneously infected with a variety of parasites, malaria and helminths, yet little is known about which individuals are most at-risk of co-infection, where they live and what factors determines risk at the community and population level. To address this, we are conducting a range of field studies in East Africa investigating the epidemiology of co-infection and its consequences for health.
Malaria control in school children in Africa. The risks and severity of clinical outcomes following exposure to Plasmodium falciparum increase among older children as transmission intensity declines. Malaria control in Africa has focused on pre-school children and pregnant women over the last decade, but as transmission intensity declines school-aged children will become an important risk group, warranting intervention. To help address this burden, we are undertaking randomized-controlled and plausibility trials of malaria prevention among school children in Kenya and Uganda, notably intermittent preventive treatment and the delivery of mosquito nets to children in schools.
A global atlas of helminth infection. Information about the distribution of helminth infection is central to the effectiveness of control efforts. We are developing a global atlas to help define the number of individuals at risk of infection and to determine areas requiring mass treatment. Our overall goal is to develop an open-access, global information resource on the distribution of soil-transmitted helminth infections and schistosomiasis: This Wormy World
I am also a member of the Human Hookworm Vaccine Initiative, with a current focus on the re-estimation of the disease burden of intestinal nematodes as part of the Global Burden of Disase study.