Lymphatic Filariasis (LF): The tremendously debilitating neglected tropical disease (NTD) lymphatic filariasis (LF) is the world’s second leading cause of long-term disability. LF is spread by mosquitoes that carry immature forms of parasitic worms; once inserted into humans, these worms grow and reproduce, eventually blocking the lymphatic drainage systems of their human hosts. Nearly 120 million people in over 80 countries are infected with the parasitic worms that cause LF; of these, over 40 million are permanently disfigured (e.g., elephantiasis- swelling of the limbs with thick, rough, folded skin) and 80 million suffer “silent” infections and internal damage. An estimated 1.2 billion people – one fifth of the world’s population – are at risk for acquiring LF. Along with trachoma, LF is one of two diseases that the global health community aims to eliminate by the year 2020, via The Global Program to Eliminate Lymphatic Filariasis (GPELF).

Development of Xenomonitoring System for Lymphatic Filariasis Elimination in Recife, Brazil: This 3 year project, conducted in collaboration with the Ministry of Health’s Centro de Pesquisas Aggeu Magalhaes (CPqAM/FIOCRUZ), the Filariasis Control Program of Recife (FCPR) and the City of Recife’s Environmental Health Agency, aims to develop a Culex quinquefasciatus-based xenomonitoring (XM) system for guiding the elimination of urban LF in terms of sampling for monitoring and mass drug administration (MDA). It will:  (i) Develop a Culex quinquefasciatus-based XM system to measure adult mosquito density –including pilot projects to determine the spatial framework for collections; (ii) Analyze collected C. quinquefasciatus samples to assess W. bancrofti infection and infectivity; (iii) Create spatial models to determine the ideal parameters (optimization) for collection, including spatial issues discretely related to mosquitoes; (iv) Collect human LF outcomes of circulating filarial antigen (CFA) and microfilariae (mf) to establish corresponding human prevalence in the areas being xenomonitored for comparison with sensitivity of XM system; (5) Evaluate how associated human LF (socio-economic, behavioral) and environmental (e.g., water) factors may influence the XM system’s ability to predict human infection as detected via CFA and mf. Funding: ‘Bright Young Talent’ Fellowship, Science without Borders (Brazilian Ministry of Science, Innovation, and Technology and The British Council), 2015-18. Collaborators: Dr. Neal Alexander (IDE/EPH/LSHTM), Dr. Cynthia Braga (CPqAM/FIOCRUZ/FCPR), and Dr. Mary Cameron (DCD/ITD/LSHTM).

The Role Of Residential Proximity To Public And Private Water Sources In Lymphatic Filariasis (LF): Doctoral research conducted in Recife, Brazil involved: i) a systematic literature review; ii) a case-control study [surveys; household inspections; geo-referencing each person, house, and feature (e.g., water source of interest]; and iii) an ecological study [interpolating missing census data via Bayesian (Markov Chain Monte Carlo, MCMC) methods]. Funding: UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR); Infectious Disease Epidemiology Unit (IDEU/EPH/LSHTM); Director’s Office and Department of Parasitology (CPqAM/FIOCRUZ). Supervision: Dr. Neal Alexander (IDE/EPH/LSHTM) and Dr. Cynthia Braga (CPqAM/FIOCRUZ/FCPR).

Investigation Of HEV Transmission Dynamics And Epidemic Evolution To Improve Outbreak Control Efforts Among Emergency Affected Populations: Rapid response project to determine the epidemiologic and environmental characteristics that lead to severe, protracted hepatitis e virus (HEV) outbreaks among displaced populations. Specific objectives include: (i) Describe the sequential spatial spread of HEV infection throughout the camp population from onset to conclusion of an outbreak; (ii) Describe the risk factors for HEV acquistion by epidemiologic and environmental investigations; (iii) Determine  seroprevalence of HEV  early in the outbreak and sero-conversion at mid and late points;  (iv) Determine  incidence of HEV infection and maternal and neonatal health outcomes among pregnant women; (v) Determine susceptibility of HEV to chlorine at standard drinking water concentrations; (vi) Develop recommendations to control HEV transmission among displaced populations. Funding: UK Department for International Development (DfID) and The Wellcome Trust via Enhanced Learning and Research for Humanitarian Assistance (ELRHA). LSHTM partners: Centers for Disease Control and Prevention (CDC); United Nations High Commission for Refugees (UNHCR).

An Evidence Review Of Research On Health Interventions In Humanitarian Crises: Evidence review consisting of systematic literature reviews and expert consultation to review evidence on public health interventions and assessments of their impacts over the last 30 years of humanitarian crises (natural disasters, armed conflict) in order to help prioritize global research and funding needs. It covered the following health topics: communicable disease; water, sanitation and hygiene (WASH); nutrition; sexual and reproductive health (SRH), including gender-based violence (GBV); mental and psychosocial health; non-communicable disease; injury and physical rehabilitation; served as lead investigator on: i) communicable disease and ii) WASH. Research also considered contextual factors influencing health delivery: health services and systems; access to health services; health assessment methods; coordination; accountability; health worker security; and urbanisation. Funding: DfID and The Wellcome Trust via ELRHA. LSHTM partners: Harvard University, Overseas Development Institute (ODI).

Other Interests: NTDs (LF, dengue), arboviruses (e.g., dengue, chikungunya and Zika); water/sanitation/hygiene (WASH); surveillance, entomology, urbanisation; environmental risk factors.