Professor David Moore
MBChB MD DTM&H MSc (Epi) FRCP
of Infectious Diseases and Tropical Medicine
In my current position I have three roles - I lead a TB research group centred primarily in Lima, Peru; I am Course Director for the DTM&H; and I am Consultant in Infectious Diseases and Tropical Medicine at the Hospital for Tropical Diseases in London.
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 2001/02 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 in the laboratory of JHU Professor Bob Gilman at Universidad Peruana Caytano Heredia.
Through enhanced MDRTB diagnosis we became interested in exposed household contacts and the challenge of understanding latent TB infection. Our recent work suggests that perhaps only one third of people labelled as having "LTBI" by tuberculin skin test or IGRA actually have viable infection and thus true latency. Future work aims to define this more clearly.
My main teaching responsibility at LSHTM is as Course Director for the Diploma in Tropical Medicine and Hygiene (DTM&H); I am also a tutor and on the exam board for the MSc in Tropical Medicine and International Health (MSc TMIH).
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 drug-susceptible and drug-resistant active TB disease, and institutional and domestic TB infection control.
MODS delivers rapid, low-cost diagnosis of MDR-TB but important by-products of this enhanced diagnostic testing include identification of a large number of MDR-exposed household contacts and individuals with isoniazid resistant (non-MDR) TB.
We are interested in an experimental medicine approach exploring transcriptomic responses to preventive therapy for contacts exposed to drug-susceptible TB with an eye to future evaluations of preventive therapy for MDR-exposed contacts.
We believe we have demonstrated that subjects with evidence of TB sensitisation (positive IGRA or TST) can be separated into those who still have viable TB infection capable of future reactivation and those who do not, through observing their transcriptomic response to TB preventive therapy - explained in this short animation and the linked publication.
We have also developed a DHIS-2 MDR-TB contact registry module to enhance capacity of programmes to identify and track MDR contacts and to create a ready-to-go line list of individuals eligible for MDR preventive therapy in the event that current ongonig trials identify an efficacious regimen.
In London, aligned with my clinical tropical medicine practice at the Hospital for Tropical Diseases (UCLH), we are leading operational research into implementation of screening for Chagas disease in Latin American migrants now living in the UK. We have established a UK Chagas Hub for clinicians, scientists and members of the Latin American community to come together to explore ways to optimise clinical pathways, raise awareness and undertake research, with a YouTube channel, Facebook and Twitter presence, @ukchagashub
As our clinical cohort of patients under follow-up for Chagas disease continues to grow we are embarking upon longitudinal studies in this diverse population.