Institute of Infection and Global Health, University of Liverpool, UK
LIV-TB Collaboration, Liverpool School of Tropical Medicine, UK
I am a physician and NIHR Academic Clinical Lecturer in Infectious Diseases. I completed medical training in Liverpool and have since worked as an infection physician and researcher in the UK, sub-saharan Africa, Latin America, and muddy fields at Glastonbury and Reading Festivals.
From February 2012-2015, I undertook a PhD entitled Preventing tuberculosis in high risk people with the Innovation For Health And Development team led by Dr Carlton Evans of Imperial College London, which works with 32 impoverished shantytown communities in north Lima, Peru, to improve TB prevention and control. During my time in Peru, I evaluated the economic effects of accessing “free” TB care, was part of the WHO task force on catastrophic costs of TB treatment, and led a Household Randomized-controlled Evaluation of a Socioeconomic Intervention to Prevent TB (HRESIPT). This research showed that socioeconomic support including conditional cash transfers improved rates of TB preventive therapy uptake and increased TB treatment success. We have recently completed the long-term follow-up and acceptability assessment from HRESIPT (manuscripts in press) and are continuing to evaluate the impact of the conditional cash transfers on TB control in the Community Randomised Evaluation of a Socioeconomic Intervention to Prevent Tuberculosis (CRESIPT) study.
In addition to ongoing work in Peru, I am expanding my research further as a post-doctoral investigator to evaluate the best methods of delivering socioeconomic support to TB-affected households in diverse low-resource settings through the following Wellcome Trust, Academy of Medical Sciences, and Swedish Health Research Council funded projects:
1. Developing a locally-appropriate socioeconomic support package for TB-affected households in Nepal: a Wellcome Trust Seed Research project to inform the BEYOND-TB trial (PI)
2. CHEST: Coordinating HEalth and Social care for TB patients in Mozambique (Co-investigator)
The projects above involve collaboration with multiple partners including: Karolinska Institutet, Liverpool School of Tropical Medicine (IMPACT TB, a Horizon 2020 EU funded study), University of Tampere Finland, the Birat Nepal Medical Trust, and national TB programs in Nepal and Mozambique.
I continue to be an active member of the Social Protection Action Research and Knowledge Sharing (SPARKS) network – a collaboration with Karolinska Institute, the World Health Organisation, and London School of Hygiene and Tropical Medicine), the WHO Task Force on Catastrophic Costs of TB, and run the (LIV-TB research collaborationhttps://www.lstmed.ac.uk/research/collaborations/liv-tb).
I am or have been funded by the Wellcome Trust, Academy of Medical Sciences, NIHR, Liverpool Glasgow Wellcome Centre for Global Health Research, University of Liverpool, Innovation For Health And Development, British Infection Association, International Union Against TB and Lung Disease, and American Society of Tropical Medicine and Hygiene.
I hope to apply for a Wellcome Trust Research Career Development Fellowship in 2019 to undertake the multi-centre “BEYOND TB” trial of socioeconomic support for TB-affected households in diverse settings.
1. Saunders MJ, Wingfield T, Tovar MA, et al. Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity – A prospective, observational cohort study in Peruvian shantytowns. Trop Med Int Health. 2018 Jun 4. doi: 10.1111/tmi.13087
2. Wingfield T, Tovar MA, Saunders MJ, et al. Addressing social determinants to end TB. Lancet. 2018 Mar 24;391(10126):1129-1132. doi: 10.1016/S0140-6736(18)30484-7
3. Saunders MJ, Tovar MA, Wingfield T, et al. Pragmatic tuberculosis prevention policies for primary care in low- and middle-income countries.Eur Respir J. 2018 Mar 22;51(3). pii: 1800315. doi: 10.1183/13993003.00315-2018
4. Wingfield T. Helping people with tuberculosis to avoid the medical poverty trap. The Conversation, March 2018
5. Garcia-Baena A, Siroka A, Collins A, Lonnroth K, Nishikiori N, Viney K, Weil D, Wingfield T. Tuberculosis patient cost surveys: a handbook. World Health Organisation, Geneva. ISBN 978-92-4-151352-4
6. Tucker A, Mithoo J, Wingfield T, et al. Quantifying the need for Enhanced Case Management for TB patients as part of TB Cohort Audit in the North West of England: a descriptive study. BMC Public Health. 2017 Nov 15;17(1):881. doi: 10.1186/s12889-017-4892-5.
7. Rudgard WE, Evans CA, Sweeney S, Wingfield T, et al. Preventing catastrophic costs for poor TB-affected households in low- and middle-income countries: An economic modelling study of the impact of TB-specific and TB-sensitive cash transfers. PLOS Med. 2017 Nov 7;14(11):e1002418. doi: 10.1371/journal.pmed.1002418. eCollection 2017 Nov
8. Wingfield T, Macpherson P, Cleary P, Ormerod P. High prevalence of TB disease in contacts of adults with extra-pulmonary TB. Thorax. 2017 Nov 16. pii: thoraxjnl-2017-210202. doi: 10.1136/thoraxjnl-2017-210202
9. Wingfield T. Mitigating the financial impact of tuberculosis requires more than expansion of TB services. Lancet Global Health, 2017 Nov;5(11):e1056-e1057. doi: 10.1016/S2214-109X(17)30368-6
10. Saunders MJ, Wingfield T, Tovar MA, et al. A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: a prospective derivation and external validation cohort study. Lancet Infect Dis. 2017 Aug 18. pii: S1473-3099(17)30447-4.
11. Wingfield T, Tovar MA, Huff D, et al. Socioeconomic support to improve initiation of tuberculosis preventive therapy and increase tuberculosis treatment success in Peru: a household-randomised, controlled evaluation. Academy of Medical Sciences Young Investigator Award. Lancet 2017; 389(6)
12. Wingfield T, Tovar MA, Huff D, et al. A household-randomized controlled evaluation of socioeconomic support to improve tuberculosis preventive therapy initiation and increase tuberculosis treatment success, Peru. Bull World Health Organ. 2017 Apr 1;95(4):270-280. doi: 10.2471/BLT.16.170167
13. Wingfield T, Tovar MA, Huff D, et al. Beyond pills and tests: addressing the social determinants of tuberculosis. Clin Med 2016;16:s79-s91; doi:10.7861/clinmedicine.16-6-s79
14. Wingfield T, Tovar MA, Huff D, et al. The economic effects of supporting TB-affected households, Peru. Eur Respir J. 2016 Sep 22. pii: ERJ-00066-2016. doi: 10.1183/13993003.00066-2016
15. Wingfield T. Viral arthritis. Clin Med. 2016 Aug;16(4):399 doi: 10.7861/clinmedicine.16-4-399a
16. Boccia D, Pedrazzoli D, Wingfield T, et al. Towards cash transfer interventions for tuberculosis prevention, care and control: key operational challenges and research priorities. BMC Infect Dis. 2016 Jun 21;16:307. doi: 10.1186/s12879-016-1529-8
17. Wingfield T, Boccia D, Tovar M, et al. Designing and implementing a socioeconomic intervention to enhance TB control: operational evidence from the CRESIPT project in Peru. BMC Public Health 2015 Aug 21;15(1):810 DOI: 10.1186/s12889-015-2128-0
18. Wingfield T, Boccia D, Tovar M, et al. Defining catastrophic costs and comparing their importance for adverse tuberculosis outcomes with multi-drug resistance: A prospective cohort study, Peru. PLOS Med. 2014 Jul 15;11(7):e1001675. doi: 10.1371/journal.pmed.1001675.
19. Wingfield T, Schumacher SG, Sandhu G, et al. The Seasonality of Tuberculosis, Sunlight, Vitamin D, and Household Crowding. J Infect Dis. 2014 Sep 1;210(5):774-83. doi: 10.1093/infdis/jiu121.
20. Williamson J, Ramirez R, Wingfield T. Health, healthcare access, and use of traditional versus modern medicine in remote Peruvian Amazon communities: a descriptive study of knowledge, attitudes and practices. Am J Trop Med Hyg 2015 Jan doi:10.4269/ajtmh.14-0536
Research keywords: Clinical infectious diseases; epidemiology; health economic analysis; socioeconomic support; randomised controlled trials