A5060156097- Tuberculosis Research and Epidemiology
- Pneumonia and Respiratory Infections
- Mycobacterium research and diagnosis
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV/AIDS Research and Interventions
- Infectious Diseases and Tuberculosis
- HIV/AIDS Impact and Responses
- Diagnosis and treatment of tuberculosis
- HIV Research and Treatment
- Data-Driven Disease Surveillance
- Global Maternal and Child Health
- COVID-19 diagnosis using AI
- Antibiotic Use and Resistance
- Respiratory viral infections research
- Biosensors and Analytical Detection
- HIV, Drug Use, Sexual Risk
- Biosimilars and Bioanalytical Methods
- COVID-19 epidemiological studies
- HIV/AIDS drug development and treatment
- COVID-19 Clinical Research Studies
- Machine Learning in Healthcare
- Vaccine Coverage and Hesitancy
- Adolescent Sexual and Reproductive Health
- Data Analysis with R
- ICT in Developing Communities
Kamuzu University of Health Sciences
2022-2025
Kamuzu Central Hospital
2022-2025
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
2016-2025
University of Liverpool
2016-2025
University of Glasgow
2023-2025
University of Malawi
2018-2024
Malawi Epidemiology and Intervention Research Unit
2024
University of Health Science
2023-2024
London School of Hygiene & Tropical Medicine
2016-2023
Liverpool School of Tropical Medicine
2018-2023
SummaryBackgroundThe broad use of bedaquiline and pretomanid as the mainstay new regimens to combat tuberculosis is a risk due increasing resistance. We aimed assess safety, bactericidal activity, pharmacokinetics BTZ-043, first-in-class DprE1 inhibitor with strong activity in murine models.MethodsThis open-label, dose-expansion, randomised, controlled, phase 1b/2a trial was conducted two specialised sites Cape Town, South Africa. Adults aged 18–64 years newly diagnosed pulmonary sensitive...
Abstract The coronavirus disease (COVID-19) pandemic might affect tuberculosis (TB) diagnosis and patient care. We analyzed a citywide electronic TB register in Blantyre, Malawi interviewed officers. did not have an official COVID-19 lockdown but closed schools borders on March 23, 2020. In interrupted time series analysis, we noted immediate 35.9% reduction notifications April 2020; recovered to near prepandemic numbers by December However, 333 fewer cumulative were received than...
BackgroundChildhood tuberculosis remains a major cause of morbidity and mortality in part due to missed diagnosis. Diagnostic methods with enhanced sensitivity using easy-to-obtain specimens are needed. We aimed assess the diagnostic accuracy Cepheid Mycobacterium Host Response prototype cartridge (MTB-HR), candidate test measuring three-gene transcriptomic signature from fingerstick blood, children presumptive disease.MethodsRaPaed-TB was prospective study conducted at four sites African...
Suboptimal tuberculosis (TB) diagnostics and HIV contribute to the high global burden of TB. We investigated costs yield from systematic HIV-TB screening, including computer-aided digital chest X-ray (DCXR-CAD).In this open, three-arm randomised trial, adults (≥18 years) with cough attending acute primary services in Malawi were (1:1:1) standard care (SOC); oral testing (HIV screening) linkage care; or plus DCXR-CAD sputum Xpert for CAD4TBv5 scores (HIV-TB screening). Participants study...
Ratios of bacteriologically positive tuberculosis (TB) prevalence to notification rates are used characterise typical durations TB disease. However, this ignores the clinical spectrum disease and potentially long infectious periods with minimal or no symptoms prior care-seeking.
Current tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid cheaper diagnostic tests required for point of care use in low resource settings with high HIV prevalence.To investigate the sensitivity specificity, cost loop-mediated isothermal amplification (LAMP) assay diagnosis adults chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy.Between October 2013 March 2014, consecutive at a primary clinic were screened cough, offered testing...
A sizeable fraction of tuberculosis (TB) cases go undiagnosed. By analysing data from enhanced demographic, microbiological and geospatial surveillance TB registrations, we aimed to identify modifiable predictors inequitable access diagnosis care. Governmental community health workers (CHW) enumerated all households in 315 catchment areas during October–December 2015. From January 2015, government Officers routinely implemented at public private treatment registration centres within Blantyre...
Abstract Young People Living with HIV (YPLHIV, 15–24 years) are an important demographic of Persons (PLHIV) globally and in Southern Africa. However, YPLHIV experience poor outcomes across the diagnostic treatment cascade due to multiple factors. We estimated prevalence determinants viral suppression on antiretroviral therapy (ART) selected African countries. used publicly available data from Malawi, Zimbabwe, Mozambique, Lesotho, Eswatini collected during Population-based Impact Assessments...
Delays in identifying and treating individuals with infectious tuberculosis (TB) contribute to poor health outcomes allow ongoing community transmission of M. ( Mtb ). Current recommendations for screening specify characteristics (e.g., areas high local prevalence) that can be used target within the general population. However, higher burden are not necessarily rates transmission. We investigated using high-resolution surveillance data Blantyre, Malawi. extracted performed whole genome...
Abstract The World Health Organization End TB strategy aims for a 90% reduction of tuberculosis (TB) incidence by 2035. Systematic testing and treatment latent infection (LTBI) among contacts active patients is recommended as one the ways to curtail incidence. However, there shortage tools accurately diagnose LTBI. We assessed appropriateness whole blood host transcriptomic markers (TM) LTBI household bacteriologically confirmed index cases compared HIV negative healthy controls (HC)....
Abstract RNA sequencing and microarray analysis revealed transcriptional markers expressed in whole blood can differentiate active pulmonary TB (ATB) from other respiratory diseases (ORDs), latent infection (LTBI) healthy controls (HC). Here we describe a streamlined reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) assay that could be applied at near point-of-care for diagnosing distinguishing ATB ORDs LTBI HC. A literature review was undertaken to identify the most...
Recent evidence shows rapidly changing tuberculosis (TB) epidemiology in Southern and Eastern Africa, with need for subdistrict prevalence estimates to guide targeted interventions. We conducted a pulmonary TB survey estimate current burden Blantyre city, Malawi. From May 2019 March 2020, 115 households middle/high-density residential Blantyre, were randomly-selected from each of 72 clusters. Consenting eligible participants (household residents ≥ 18 years) interviewed, including cough (any...
Active case-finding (ACF) for tuberculosis can help find the “missing millions” with undiagnosed tuberculosis. In a cluster-randomised trial, we investigated impact of ACF on case-notifications in Blantyre, Malawi, where has been intensively implemented following 2014 estimates ~1,000 per 100,000 adults TB. Following pre-intervention prevalence survey (May 2019 to March 2020), constrained randomisation allocated neighbourhoods either door-to-door (sputum microscopy reported cough >2...
Tuberculosis case-finding interventions are critical to meeting World Health Organization End TB strategy goals. We investigated the impact of community-wide tuberculosis active case finding (ACF) alongside scale-up human immunodeficiency virus (HIV) testing and care on trends in adult notification rates (CNRs) Blantyre, Malawi. Five rounds ACF for (1-2 weeks leafleting, door-to-door enquiry cough sputum microscopy) were delivered neighborhoods ("ACF areas") North-West Blantyre between April...
A community-based HIV self-testing study in Blantyre, Malawi demonstrated that not all individuals living couples tested with their partner. We describe factors dissuading from Data were drawn qualitative exploring consequences of within couples. In-depth interviews conducted 33 who alone. Participants expressed fear dealing HIV-discordant relationships. Failure to self-test a partner was correlated gender, more men than women overtly declining or unconsciously unable have joint self-test....