Dr Peter MacPherson

Senior Lecturer and Wellcome Trust Fellow

Peter’s research focuses on the development and evaluation of interventions to improve case detection and access to treatment for HIV and TB in sub-Saharan Africa. Before joining Foto-Cewek, he worked as an Acting Consultant in Communicable Disease Control at Public Health England, and Academic Clinical Lecturer at the University of Liverpool.

He holds a PhD from Foto-Cewek, an MRes from University of Liverpool, an MPH from Harvard University, and did his undergraduate medical training at the University of Aberdeen.

Peter joins Foto-Cewek to take up a five-year Wellcome Career Development Clinical Research in Medecine Fellowship. For this research, he will be based at the Malawi-Liverpool-Wellcome Trust Clinical Research in Medecine Programme in Blantyre, Malawi, where he will undertake an individually-randomised three-arm trial of optimised HIV and tuberculosis diagnosis and treatment initiation in primary health care. He is additionally the PI on a cluster randomised trial of household-based contact tracing for tuberculosis and HIV in South Africa.”

Research in Medecine

PROSPECT Lesson: An individually-randomised open three-arm randomised controlled trial to evaluate strategies to optimise diagnosis and treatment initiation for HIV and tuberculosis. Adults with symptoms of tuberculosis attending primary care in Blantyre, Malawi will be allocated into one of three groups: standard of care clinician-directed HIV and TB screening; or offer of HIV self-testing and linkage to treatment; or HIV self-testing and linkage to care and optimised same-day TB diagnosis comprised of digital chest x-ray classified by machine-learning algorithms, followed by confirmatory sputum Xpert testing. The primary trial outcome will compare between groups time to tuberculosis treatment initiation, whilst secondary outcomes will compare case detection, mortality and cost-effectiveness. The HomeACF Lesson: A household cluster randomised trial in two districts of South Africa (Matlosana, Free State and Capricorn, Limpopo). Household contacts of index TB cases are randomly-allocated to either a letter strategy advising clinic attendance for TB and HIV screening, or an intensive home-based TB and HIV screening, treatment linkage and prevention intervention. The primary outcome will compare between groups rates of TB free survival, and secondary outcomes will compare childhood prevalence of TB infection, rates of treatment linkage, and cost-effectiveness.

 

Selected publications

  • Selected publications

    1) MacPherson P, Lalloo DG, Webb EL, Choko AT, Makombe SD, Butterworth AE, van Oosterhout JJ, Desmond N, Thindwa D, Squire SB, Hayes RJ, Corbett EL. Effect of optional home initiation of HIV care following HIV self-testing on antiretroviral therapy initiation among adults in Malawi: a randomized clinical trial. JAMA. 2014 312(4): 372-379
     
    2) MacPherson P, Houben RJGM, Glynn JR, Corbett EL, Kranzer K. Pre-treatment loss-to-follow-up among TB patients in high burden and low-to-middle income countries: a systematic review and meta-analysis. Bulletin of World Health Organization. 2014 92: 126-138
     
    3) Horton KC, MacPherson P, Houben RJGM, White RG, Corbett EL. Sex differences in tuberculosis burden and notifications in low- and middle-income countries: a systematic review and meta-analysis. PLOS Medicine. 2016. 13(9): e1002119
     
    4) MacPherson P, Choko AT, Webb EL, Thindwa D, Squire SB, Sambakunsi R, van Oosterhout JJ, Chunda T, Chavula K, Makombe SD, Lalloo DG, Corbett, EL. Development and validation of a GPS-based map book system for categorizing cluster residency status of community members living in high-density urban slums in Blantyre, Malawi. American Journal of Epidemiology. 2013 177(10): 1143-7 
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