Luke Davis, MD

Associate Professor of Epidemiology (Microbial Diseases); Associate Professor of Medicine (Pulmonary, Critical Care, and Sleep Medicine)

Research Departments & Organizations

School of Public Health: Center for Methods in Implementation and Prevention Science (CMIPS) | Epidemiology of Microbial Diseases | YSPH Global Health Concentration

Internal Medicine: Pulmonary, Critical Care & Sleep Medicine

Yale Institute for Global Health

Research Interests

Critical Care; Global Health; Mobile Applications; Tuberculosis

Research Summary

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

Current Projects:

mHealth for Home Contact Investigation in Kampala, Uganda – This community-based household RCT, funded by the National Institutes of Health NIH), revealed major barriers to uptake of household contact investigation, even after implementation of short-messaging services (SMS)-supported, home-based TB and HIV testing services. We are currently piloting the use of human-centered design and communities of practice to improve delivery and sustainability of TB 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 identify better biomarkers, therapeutic targets, and developmental models of the response to TB treatment in Haiti, Kenya, Peru, South Africa, Uganda, and Vietnam.

Exosomes for Discovery of Novel TB Biomarkers – In collaboration with colleagues at Notre Dame, Colorado State, and the University of California San Francisco, and with support from NIH, we are leading a discovery effort to identify and isolate novel proteomic targets on human exosomes as the basis for a future point of care TB diagnostic test.

Pediatric TB Guideline Implementation in Uganda – In collaboration with colleagues from Makerere University in Uganda, and with support from USAID and NIH, we are using mixed methods to collect data on common barriers and enablers to uptake of and adherence to consensus guidelines on pediatric TB evaluation and management in Uganda. We will then apply evidence-based theories of behavior change to categorize these barriers and enablers and design targeted interventions to improve quality of care.

Xpert Omni Performance Evaluation for Linkage to Tuberculosis Care: The XPEL TB Trial – In collaboration with colleagues from the University of California San Francisco and the London School of Hygiene and Tropical Medicine, and with support from the Wellcome Trust and NIH, we will be designing and implementing a cluster-randomized trial comparing to single-specimen microscopy within an SMS-assured Xpert MTB/RIF referral network to conventional microscopy and Xpert MTB/RIF algorithms.

Xpert TB Caring Wisely in the US – In collaboration with colleagues at the San Francisco Department of Public Health, we implemented Xpert MTB/RIF as a test to guide triage of patients out of airborne infection isolation rooms, replacing the conventional strategy of using serial smear microscopy. Using multiple data collection approaches and a pragmatic design, we demonstrated the molecular testing to guide triage improved the patient and provider experience and lowered costs dramatically, without jeopardizing the safety of other patients.

Severe Illness Management System (SIMS) – With support from international agencies and private foundations, Walimu is adapting novel approaches from the field of implementation science to improve the identification and management of severe illness in hospitals in Uganda.

Theory-informed Education and Counseling for HIV-TB (TEACH) - With support from the Center for Interdisciplinary Research on AIDS, we are evaluating the scope and effectiveness of routine TB counseling among persons living with HIV and those without in Kampala, Uganda, and adapting clinical practice guidelines on TB treatment adherence counseling to fit the challenges and opportunities of the local setting.

Activities

  • TB Education and Counseling in HIV-prevalent settings (TEACH) Tugela Ferry, South Africa; Kampala, Uganda (2017 - 2018)

    This preliminary study will use implementation science to adapt and introduce a intervention to improve uptake of guidelines on education and counseling among HIV-TB co-infected patients initiating TB treatment in South Africa and Uganda.

  • Severe Illness Management Support (SIMS) Kasese, Uganda (2014)

    Prospective pragmatic trial of a complex implementation intervention to improve health worker uptake of WHO severe illness guidelines at multiple general hospitals in Western Uganda

  • Pulmonary Complications of AIDS Research Training (PART) Program Kampala, Uganda (2013)

    Research training program for Ugandan junior investigators interested in applying translational research methods to the study of TB and other pulmonary complications of HIV/AIDS

  • Uganda TB Implementation Research Consortium (U-TIRC) Kampala, Uganda (2008)

    Implementation research to improve diagnosis and treatment of tuberculosis (TB) in partnership with the Uganda National TB Programme and Makerere University. Ongoing projects focus on contact investigation, pediatric TB diagnosis and management, single-specimen microscopy, and Xpert MTB/RIF...

  • Mulago Inpatient Novel Diagnosis of Pneumonia (MIND) Study Kampala, Uganda (2005)

    A cross-sectional study examining the diagnosis of tuberculosis (TB) and other pulmonary complications of HIV at Mulago Hospital

Selected Publications

See list of PubMed publications

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Contact Info

Luke Davis, MD
Office Location
Room 62060 College Street
New Haven, CT 06510
Mailing Address
Epidemiology of Microbial DiseasesP.O. Box 208034
New Haven, CT 06520-8034
The long road to tuberculosis diagnosis. Lake Victoria, Entebbe, Uganda.

Patients seeking evaluation for cough and other symptoms of tuberculosis in low-income countries like Uganda take long and often circuitous journeys to access basic diagnostic services.