the hospital for tropical diseases

I'm about to start my new job in the excitingly named hospital for tropical diseases. It should be an interesting place to be working and it has good links with all the research world that I'm hoping to go into.

The "hospital" mainly consists of a floor (8th) in the swanky new UCH building on the Euston Road. Struggling to get blogger to upload a photo at the moment.

It's also good for going to the London School of Tropical Medicine - just across the road - for lectures / library / meetings in setting up the PhD I'm hoping to do in 2008/2009 ish, though LSHTM has the downside of being toxic territory! Well... like the Chernobyl site, the fallout there will fade away with time.

I'm really excited to have got this job : it is probably one of the premiere institutions in the world for dealing with tropical infections, it serves the whole of the south east as a referal centre, and what with London being the multi-ethnic place that it is, gets diseases from all over the world. It's also going to be a good spot because it is close to my house (or my parents house at least) and lots of my friends are living/ working nearby. So everything looking sweet as. And not "sweet Asbo" as it has been in Manchester !

outcomes from Gambia : job and paper

Well, my good news is that the whole working in Gambia thing has been bearing some fruits in professional life : I've got a highly prestigious job at the hospital for tropical diseases in UCH in London to start in August, and I've had my first first-author publication recently done (in March).

Here is the (rather wordy) abstract from the site (see www.biomedcentral.com for full article)

Background

New tools are required to improve tuberculosis (TB) diagnosis and treatment, including enhanced ability to compare new treatment strategies. The ELISPOT assay uses Mycobacterium tuberculosis-specific antigens to produce a precise quantitative readout of the immune response to pathogen. We hypothesized that TB patients in The Gambia would have reduced ELISPOT counts after successful treatment.

Methods

We recruited Gambian adults with sputum smear and culture positive tuberculosis for ELISPOT assay and HIV test, and followed them up one year later to repeat testing and document treatment outcome. We used ESAT-6, CFP-10 and Purified Protein Derivative (PPD) as stimulatory antigens. We confirmed the reliability of our assay in 23 volunteers through 2 tests one week apart, comparing within and between subject variation.

Results

We performed an ELISPOT test at diagnosis and 12 months later in 89 patients. At recruitment, 70/85 HIV-negative patients (82%) were ESAT-6 or CFP-10 (EC) ELISPOT positive, 77 (90%) were PPD ELISPOT positive. Eighty-two cases (96%) successfully completed treatment: 44 (55%; p<0.001) were EC ELISPOT negative at 12 months, 17 (21%; p=0.051) were PPD ELISPOT negative. Sixty (73%) cured cases had a CFP-10 ELISPOT count decrease, 64 (78%) had an ESAT-6 ELISPOT count decrease, 58 (70%) had a PPD ELISPOT count decrease. There was a mean decline of 25, 44 and 47 SFU/2x105 cells for CFP-10, ESAT-6 and PPD respectively (p<0.001 for all). Three of 4 HIV positive patients were cured, all 3 underwent ELISPOT reversion; all 4 not cured subjects (3 HIV-negative, 1 HIV positive) were ESAT-6, CFP-10 and PPD ELISPOT positive at 12 months.

Conclusions

Successful tuberculosis treatment is accompanied by a significant reduction in the M. tuberculosis-specific antigen ELISPOT count. The ELISPOT has potential as a proxy measure of TB treatment outcome. Further investigation into the decay kinetics of T-cells with treatment is warranted.


Kind of hard to believe that I produced this actually. After 6 months working in A+E I think I must have lost all abilities to write senisble prose, without loading it with abreviations and jargon ...

So professionally speaking, it has been a big success to gamble on going to Gambia. I'm now planning to head back there in a couple of years to do a PhD in a related health topic ... should be good.