Research & Publications
My research is based in Uganda and uses translational methods to improve TB diagnosis and evaluation in high-burden, resource-constrained settings. Ongoing projects span two general areas: 1) discovery and validation of TB biomarkers using novel biotechnologies, and 2) translation of evidence-based TB diagnostic strategies into practice using implementation science through the Uganda TB Implementation Research Consortium (www.u-tirc.org). Training and capacity-building are an important aspect of my research activities, through the Fogarty Pulmonary Complications of AIDS Research-Training Program at Makerere University and Walimu (www.walimu.org), a non-profit that uses implementation science to improve care of severe acute illness in Uganda and other low-income countries.
Extensive Research Description
HIV-TB Household Contact Investigation in Kampala, Uganda – In collaboration with the Uganda TB Implementation Research Consortium (U-TIRC), we are carrying out two, separately NIH-funded randomized controlled trials, a community-based stepped wedge RCT, one evaluating a novel human-centered design informed strategy for household TB contact investigation, and the other a behaviorally-informed strategy design to reduce household HIV-TB stigma - and promote uptake of HIV testing funded by the National Institutes of Health NIH, revealed major barriers to uptake of household contact investigation.
Expression in HIV and Tuberculosis (eHAT) – In collaboration with collaborators at the University of Colorado and Stanford University, and the University of California San Francisco, we using novel host- and pathogen-targeted gene-expression profiling platforms to develop better biomarkers, therapeutic targets, and developmental models of the response to TB treatment in Haiti, Kenya, Peru, South Africa, Uganda, and Vietnam.
Xpert Omni Performance Evaluation for Linkage to Tuberculosis Care (XPEL TB) – In collaboration with colleagues from the University of California San Francisco, the Uganda TB Implementation Research Consortium recently completed a cluster-randomized trial showing that on-site TB testing using Xpert MTB Ultra devices increases the number of timely TB diagnoses and treatment initiations compared to widely used specimen-referral models.
Theory-informed Education and Counseling for HIV-TB (TEACH) - With support from the Center for Interdisciplinary Research on AIDS, we have recently completed a pre-post implementation study demonstrating that a structured, behaviorally informed TB education and counseling strategy using peer educators is superior to routine TB education and counseling among TB patients living with and without HIV in Kampala, Uganda.
Quality of Routine TB Diagnosis and Treatment in Kampala, Uganda - In collaboration with the Uganda TB Implementation Research Consortium (U-TIRC) and the Uganda National TB and Leprosy Programme (NTLP), we are developing a novel methodology for evaluating the quality of routine TB services using aggregated surveillance reporting data.
Implementation Science to Address Non-communicable Diseases in Uganda - In collaboration with the Uganda Initiative for Noncommunicable Diseases and the Uganda Heart Institute, we are evaluating digital health and other behaviorally informed approaches to improve the quality of care and self-management of hypertension and heart failure in Uganda.
Cali TB Contact Investigation Project - In collaboration with CIDEIM, the Cali Secretary of Health, Universidad Icesi, and Alianza TB, and with funding from Colciencias, we have identified barriers to household TB contract investigation in the City of Cali and are developing a novel design-thinking informed intervention for improving community-based active case-finding in Cali.
Mongolia Zero TB Initiative (ZTBI) - In collaboration with the Mongolia Health Initiative (MHI), the Yale Center for Methods in Implementation and Prevention Sciences (CMIPS) is evaluating the quality of routine TB care in four districts in Mongolia using the Zero TB Framework, an integrated approach to modeling the TB cascade.
Addressing Stigma as a barrier to household HIV-TB Case Finding - In collaboration with the Aurum Institute and with funding from the Yale Center for Interdisciplinary Research on AIDS (CIRA), we are evaluating barriers to household HIV and TB case finding in Gauteng Province, South Africa.
COVID-19 Contact Tracing - In collaboration with the New Haven Health Department and with support from the Yale School of Public Health Dean's COVID-19 Emergency Research Fund, we are carrying out a comprehensive mixed-methods analysis of COVID-19 contact tracing to improve the quality of the emergency public health response.
Critical Care; Tuberculosis; Global Health; Mobile Applications; COVID-19
Public Health Interests
Global Health; Health Care Quality, Efficiency; Respiratory Disease/Infections; COVID-19