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Institute for Global Health

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The impact

Our research is multidisciplinary and multi-professional and aims to underpins national and global policy on infectious disease control. Much of our research involves epidemiological studies ranging from clinical trials to observational studies, record linkage, modelling and the analysis of routinely collected data to inform policy. Nationally, our work has informed the development of the collaborative TB strategy which was published by Public Health England in January 2015 (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61638-X/abstract).

Examples of the national and international impact of the work from CIDE includes: 

  • Tuberculosis in hard to reach groups

Our evaluation of the Find and Treat Service demonstrated that this intervention is cost effective and led to the commissioning of the service. See http://www.bmj.com/content/343/bmj.d5376.long and accompanying videohttps://www.youtube.com/watch?v=H01jCZAbKbE. This evaluation is widely cited and has informed NICE guidelines and European recommendations on control of TB in hard to reach groups.

  • Molecular epidemiology of tuberculosis

The analysis of molecular epidemiological data has provided insights into the spread of tuberculosis and multi drug resistant tuberculosis in the UK (Anderson et al) demonstrating limited transmission in the UK and showing opportunities exist to improve contact investigation. In collaboration with Dr Pam Sonnenberg, we have also recently shown that use of MIRU-VNTR to inform the prospective investigation of clusters is not cost effective (http://thorax.bmj.com/content/early/2015/04/16/thoraxjnl-2014-206480.long). Previous work include contrasting the impact of Beijing strain on TB epidemiology in Peru and the UK (http://erj.ersjournals.com/content/43/2/632.long).

  • BCG vaccine

Our review of BCG vaccination effectiveness (http://www.journalslibrary.nihr.ac.uk/hta/volume-17/issue-37#abstract) , led to a joint case control study with LSHTM, which should provide useful data to inform future BCG vaccination policy. More recently, we have demonstrated that BCG can protect against tuberculosis infection (http://www.ncbi.nlm.nih.gov/pubmed/25097193), in addition to its proven effect on severe forms of tuberculosis disease.

  • Latent tuberculosis infection

We reviewed the evidence for latent TB treatment, which informed global guidelines for preventative therapy (http://annals.org/article.aspx?articleid=1895308) and undertaken analysis to inform the targeting of latent TB screening (http://www.ncbi.nlm.nih.gov/pubmed/23828120). In collaboration with Public Health England, we are leading the largest cohort study evaluating the prognostic value of interferon gamma release assays compared to the tuberculin skin test, which has completed enrolment.

  • Tuberculosis and air travel

Our work on tuberculosis and air travel has informed national and European guidelines (http://www.sciencedirect.com/science/article/pii/S1473309910700281).

  • HIV and tuberculosis

In a randomised controlled trial using a step wedge design, we were able to show that an educational intervention can impact HIV testing in TB clinics (http://erj.ersjournals.com/content/41/3/627.long). We identified the increased risk of tuberculosis and HIV infection in health care workers http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8678341&fileId=S0950268811002445)

Tuberculosis in pregnancy

Through a case-case analysis and a cohort study using primary care data, we demonstrated an increased risk of tuberculosis in the post partum period (http://www.atsjournals.org/doi/abs/10.1164/rccm.201106-1083OC?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&#.VWHCpFlViko)