Dr Anna Last
Clinical Associate Professor
United Kingdom
I have been working on the epidemiology and control and elimination of malaria and neglected tropical diseases (NTDs) at LSHTM since 2010. I completed a Wellcome Trust Clinical PhD Fellowship at LSHTM on the molecular epidemiology of trachoma and ocular Chlamydia trachomatis infection on the Archipelago of Guinea Bissau between 2011-2014. I continued my research in trachoma in Guinea Bissau through an NIHR Clinical Lectureship at LSHTM between 2015-2017. Following my appointment as an Associate Professor, from 2017-2019 I led a network of integrated studies on NTDs (including soil-transmitted helminths, lymphatic filariasis, schistosomiasis, yaws and scabies) and malaria in Guinea Bissau through an MRC Global Challenges Research Foundation Award. I continue my involvement in trachoma research as a Co-investigator on a Wellcome Trust Collaborative research programme towards the elimination of trachoma in Ethiopia (Stronger-SAFE) and as PI for a study evaluating the impact of ivermectin on the putatitve trachoma vector, Musca sorbens. I am currently working with LSHTM and international collaborators to establish a consortium towards the development and evaluation of a vaccine for sustainable trachoma elimination. I was PI for the recently completed MATAMAL, a Joint Global Health Trials Scheme-funded cluster randomised placebo-controlled trial to evaluate the impact of mass administered ivermectin for malaria control on the Archipelago of Guinea Bissau. Following the successful administration of MDA in this context, I am now working towards future projects to evaluate interventions for malaria elimination in this setting. I am also working towards similar trials in Zanzibar with colleagues at LSHTM and Tanzania. I have continued research interests in malaria and NTD elimination in East and West Africa.
I have directly influenced the delivery of interventions and their evaluation through participation in working groups such as the Bill and Melinda Gates Foundation funded multidisciplinary group ‘The Ivermectin Roadmappers’, following a World Health Organization (WHO) technical consultation on ivermectin for malaria control. I contribute to MESA (originally the Malaria Eradication Scientific Alliance),
hosted by the WHO Collaborating Centre for Malaria Control, Elimination and Eradication at IS Global (Barcelona) to strengthen the evidence base through research into malaria control interventions. I have been an active member of the London Centre for Neglected Tropical Diseases Research (LCNTDR), launched in 2013 following the London Declaration in 2012, with a focus on operational research in NTDs and have participated in the WHO Alliance for the Global Elimination of Trachoma (GET2020) for the last decade. I am currently a technical adviser to the WHO for the consultation on Trachoma End-Game Challenges and am involved in discussions related to access and implementation of interventions towards the elimination of NTDs as well as being a core member of a WHO guideline development group for integrated mass drug treatments for NTDs. I have supported national trachoma control programmes in Guinea Bissau, The Gambia and Ethiopia through research and capacity strenghthening throughout my research career.
Over the last seven years, with my field team and colleagues in Guinea Bissau, MRC The Gambia and at LSHTM, we have established research infrastructure including an experienced field research team, social science researchers, field laboratory technicians and field entomologists on the remote Bijagós Archipelago of Guinea Bissau. We continue to work with the National Malaria Control Programme and the Global Fund to undertake malaria surveillance activities following successful intervention through MATAMAL.
I hold an Honorary Consultant position at the Hospital for Tropical Diseases, where I have a weekly outpatient clinic and look after inpatients with infectious and tropical diseases.
Affiliations
Centres
Teaching
Tropical Medicine in International Health MSc (LSHTM): I am Co-Module Organiser (since 2021) for the TMIH module 3462 (Practical Skills in Clinical Research). I am a Personal Tutor, involved in teaching, marking, exam setting, Exam Board and Programme Committee. We are currently in the process of offering the TMIH module 3462 as a stand-alone module to add on for DTMH candidates following the diploma, and in discussion with the Clinical Trials Network and the directors of the DL-MSc Health in Humanitarian Crises and the MSc in Climate Change and Planetary Health to explore offering our module as a recommended core module for these courses.
I have supervised over 25 MSc students' summer projects (students from the MSc TMIH, CID and medical entomology) at our field site on the Archipelago to date and several additional others per year from TMIH with a variety of summer projects based in London and elsewhere.
Diploma of Tropical Medicine and Hygiene (LSHTM) (Personal Tutor, Teaching, Marking, Exam Setting and Exam Board)
Undergraduate Medical Students (UCL) and doctors in training (UCLH)
Examiner for the Diploma of Tropical Medicine and Hygiene (Worshipful Society of the Apothecaries)
Research
Clinical tropical medicine
Malaria
Neglected Tropical Diseases
Disease elimination
Clinical trials
Since 2010 my research has focused on malaria and neglected tropical diseases (NTDs).
I have coordinated a series of trachoma research projects based at our field site on the Bijagós Archipelago of Guinea Bissau looking at host-pathogen interactions, pathogen genomics, molecular and spatial epidemiology of ocular Chlamydia trachomatis infection and its control and elimination. This research has directly contributed to the elimination of trachoma as a public health problem in this region. My continued interest in trachoma elimination is realised through my involvement with Stronger-SAFE, a Wellcome Trust-funded research programme which aims to develop novel WASH and fly-control interventions to be used in combination with antibiotic mass drug administration towards the elimination of trachoma in Ethiopia, and the establishment of an international consortium towards developing a vaccine for sustainable trachoma elimination.
Following on from my trachoma research in West Africa, in 2017 we conducted a network of vector and disease mapping studies on the Bijagós Archipelago (DTNMaPa Bijagós: Mapeamento de Doenças Tropicais Negligenciadas e Paludísmo no Archipelago Bijagós) to characterise the epidemiology of malaria and other co-endemic NTDs (lymphatic filariasis, schistosomiasis, soil-transmitted helminths, yaws and scabies) with a view to developing and testing diagnostics and interventions towards the elimination of these diseases as public health problems. This has been followed with our recent cluster randomised placebo-controlled trial (MATAMAL) which evaluated the impact of seasonal ivermectin mass drug administration on malaria and ivermectin-susceptible NTDs. I continue to work on malaria elimination, with plans to conduct trials in Guinea Bissau and Tanzania (Zanzibar).
I have worked with colleagues at LSHTM to develop and evaluate novel molecular diagnostics for use in NTD research. The multidisciplinary approach we have made has led to local and international collaborations. In Guinea Bissau I have strong collaborative relationships with the directors of the National Programme for Eye Health (Programa Nacional de Saúde de Visão (PNSV)), the National Program for Malaria Control (Programa Nacional de Luta Contra Paludísmo (PNLCP)) and the National Program for NTDs (Programa Nacional de Doenças Tropicais Neglegenciadas (PNDTNs). I also work closely with programme implementing partners (Sightsavers International in Guinea Bissau and The Fred Hollows Foundation in Ethiopia).
I am currently involved in collaborations with the Wellcome Trust Sanger Institute for pathogen genomic work from our trachoma studies (Ethiopia), Imperial College London for mathematical modelling work from our malaria studies (Guinea Bissau), the University of Trento (Italy) for metagenomic studies and NIH/NIAID (USA) for planned clinical trials.