Neglected Tropical Diseases
I am a member of the World Health Organization Department of Control of Neglected Tropical Diseases Diagnostic Technical Advisory Group, 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. I was a lead investigator on a WHO sponsored trial of treatment of yaws in Ghana and Papua New Guinea and subsequently collaborated with Oriol Mitjà on studies to optimise community treatment strategies for yaws in PNG. Between 2020-2023 I was the principal investigator on a new EDCTP evaluation of a LAMP assay for yaws in Ghana, Cote d’Ivoire and Cameroon. I am currently collaborating on studies evaluating Linezolid as a new therapeutic agent for yaws.

Scabies: I have been involved in a number of studies on the epidemiology and control of scabies. These works contributed to WHO adopting scabies as an in 2017.  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 I am collaborating with colleagues on studies exploring the use of ivermectin in younger children. Between 2025-2029 I will be leading a project funded by the EDCTP focused on generating data on a novel paediatric formulation of ivermectin across Africa.

Leprosy: With Gabriele Pollara at UCL and Kidist Bobosha at AHRI I am collaborating on the Immuno-Lep study which aims to use tissue level transcriptomics to unpick immunological drivers of leprosy reactions and indentify novel therapeutic targets that may be more effective and have reduced side-effects compared to steroids.

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 (2019-2025) on integrated control strategies for NTDs of the skin including buruli ulcer, yaws, cutaneous leishmaniasis and leprosy in Ghana and Ethiopia. Building off the work of the SHARP project, we are establishing a new Multi-Arm-Multi-Stage trial of therapeutics for Cutaneous Leishmaniasis in Ethiopia funded by EDCTP. 

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 Nick Thomson and Mat Beale at the Sanger, 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.

A major stream of work is focused on therapeutic strategies for syphilis. I am the PI on a multi-country trial (2024-2028, Papua New Guinea and Zimbabwe) funded by the Gates foundation evaluating novel dosing of benzathine-penicillin to simplify treatment for pregnant women with syphilis. Alongside this I am one of the lead investigators on a second trial funded by the Gates foundation, evaluating oral drug regimens for infants with congenital syphilis in South Africa, Malawi and Indonesia. In the UK, in collaboration with Richard Gilson at UCL I have helped to establish 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.

I am currently funded by an NIHR Professorship (2024-2029) which will focus on applying these approaches to improve the control of syphilis in the UK. This work will integrate elements focused on genomic epidemiology, diagnostics and mathematical modelling. A key component is comprehensive patient and public engagement across all aspects of this project and I am working closely with the LoveTank to incorporate PPIE at every stage of the work. 

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.

STI Diagnostics: With Rashida Ferrand and the team at ThruZIM we are in the process of establishing the PROMISE trial which will evaluate the impact of implementing ANC testing for STIs on maternal and infant outcomes. This study will run for three years and take place across 15 antenatal clinics in Harare.

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 Streptotococcus
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.

Epidemiology: 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. With Ed Clarke at MRC Gambia we are now establishing further community and hospital based surveillance focused on GAS as part of the SAVAC consortium of sentinel sites.

Immunology: Our GAS work also includes a major focus on unpicking immune responses to GAS and attempting to identify correlates of protection. Our GAS team at MRC Gambia is part of the iSpy Network led by Shiranee Sriskandan which is focused on understanding protective immunity to GAS across the life course. In collaboration with Josh Osowicki and colleagues in Australia we have received funding from the Wellcome Trust to establish a controlled human infection model of Group A Strep infection in the Gambia and will be using this to try and understand correlates of protection and advance vaccine development. 

Respiratory Viruses and Emerging 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 was 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 the EDCTP funded CSIGN project which helped to strengthen surveillance of COVID-19 in Ghana.

MPOX: During the 2022 MPOX pandemic I established several studies in collaboration with Oriol Mitja which helped define the epidemiology of mpox as an emerging STI. We were one of the first groups to clearly demonstrate transmission linked to sexual activity, to clearly define periods of infectivity and understand the relationship between mpox and advanced HIV. We are now (2024-2026) running the EDCTP funded MOVIE-TRACE project  in collaboration with colleagues in DRC to better understand the transmission dynamics of the newly emerging 1b mpox clade. 

Emerging Zoonotic Infections: I am a co-investigator on the NIHR Health Protection Research Unit on Emerging Zoonotic Infections. At LSHTM out major focus will be on evaluating the role of novel strategies including metagenomics and phip-seq to improve diagnosis of fever in returning travellers.

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 or investigator on several other major trials including REMAP-CAP (Influenza), DURATIONS (pyelonephritis), ASPECT (Pneumonia) and RECOVERY-CAP (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