Mr Michael D French

 

Research Assistant

Schistosomiasis Control Initiative

The Schistosomiasis Control Initiative (SCI) is a collaborative project to assist countries in sub Saharan Africa control schistosomiasis, intestinal helminths and other Neglected Tropical Diseases (NTDs).  The SCI was created in 2002 and is directed by Prof. Alan Fenwick OBE.

The SCI has been supported by the Bill and Melinda Gates Foundation, through several grants since 2002, for work in six countries, Burkina Faso, Mali, Niger, Tanzania (including Zanzibar), Uganda and Zambia. In 2007, Geneva Global awarded funds for control work in Rwanda and Burundi. SCI works in partnership with the World Health Organisation, and the DBL-Institute for Health Research and Development (responsible for in-country training and operational research), and participates in the USAID/NTD control project as country managers for Burkina Faso, Niger and Uganda.

Further information on this project and the Global Network for NTD control can be found on the SCI website at www.sci-ntds.org and at www.gnntdc.org

Mathematical Modelling

Alongside my role as a research assistant for the SCI, I am studying for my PhD. in the mathematical modelling of transmission dynamics of NTDs, with particular emphasis on schistosomiasis.

I have three internal supervisors within the department:

Dr. Maria Gloria Basáñez Reader in Parasite Epidemiology

Prof. Joanne Webster Professor in Parasite Epidemiology

Dr. Tom Churcher Post-doctoral Research Associate

In conjunction with my supervisors, I develop mathematical models of the transmission dynamics of neglected tropical diseases (NTDs), with a particular emphasis on schistosomiasis, in order to understand the effect of current control programmes and to evaluate the most effective control strategies for the future.

The tools exist to treat the majority of the so-called neglected tropical diseases (NTDs) using a safe, effective and cheap approach of mass drug administration.  Mathematical models provide a means of helping to optimise the control strategy, in terms of treatment algorithms, frequency, duration, and populations targeted in order to reduce infection and disease markers. Models also help to set realistic and achievable programme goals to monitor and evaluate control programmes, and to highlight potential issues once they arise.

The SCI incorporates a comprehensive monitoring and evaluation module into its control programmes. Its extensive longitudinal cohorts in each country provides a unique opportunity to fit models to both pre-treatment baseline data, and also successive years of post-treatment follow-up data from the same individuals, the first time this has been done.

Models are be validated against field data, and subject to sensitivity analyses, with the aim of identifying where they can be put to best use to help guide policy-decisions for NTD control programmes.

Research is designed to follow several strands and is aimed at helping answer the following policy-relevant questions:

 Estimating the reduction in overall transmission that follows mass drug administration

Many control programmes, including schistosomiasis, are aimed at controlling morbidity rather than halting transmission.  The effect, if any, of mass drug administration on reductions in environmental transmission, or force of infection (FOI), have not received much attention.  Our work aims to quantify these reductions with subsequent rounds of treatment in areas of differing intensity, and to predict the effect on transmission of differing future control strategies.

Reduction in force of infection when treatment is targeted at school children compared to MDA

As a natural extension of the above aim, the reduction in FOI can be compared between mass drug administration to the entire community and targeted control of school children. After the initial burst of mass treatment, there could be a programmatic change towards targeted treatment if it can be shown that this shift can be effective in achieving the anticipated endpoints. As the SCI achieves its primary morbidity control aims in some countries, this research theme becomes increasingly policy-relevant.

 Estimation of the impact of treatment frequency on infection and morbidity markers

Early success in SCI programmes has indicated that it may be possible to control morbidity by chemotherapy treatment every other year, as subsequent yearly treatment is predicted to result in diminishing returns of disease reduction. The effects of differing treatment frequency and target populations are being investigated in areas of varying endemicity.

 Design of sampling protocols to maximise the probability of detecting chemotherapy-induced selective pressures or anthelmintic resistance if these were operating

Detecting anthelmintic/antibiotic resistance if and when they occur will be extremely important given the lack of viable alternatives to current first-line treatments. This will be especially relevant to the integration of NTD control where treatment coverage for individual diseases is expected to increase which may increase the selective pressure for pathogens to develop resistance

Helminth Research Group

I am a member of the Helminth Research Group, based in the Department, which provides a forum for discussion of research in the area, with internal and external speakers invited to present their work. The Helminth Research Group was established by Dr. Maria Gloria Basáñez

Other Responsibilities

 I lecture and demonstrate in practicals to both undergraduate and postgraduate students, including the MSc in Modern Epidemiology (of which I am an alumnus), the 3rd year Epidemiology module as part of the BSc Biology course, Imperial College's professional short course on the Epidemiology and Control of Infectious Diseases which is aimed at public health professionals, policy-makers and researchers,  and to the new Global Health Short Course aimed at medical students and early-career researchers, convened by Dr. Yaobi Zhang.