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    John Metcalfe, MD

    TitleAssistant Professor
    SchoolUCSF School of Medicine
    DepartmentMedicine
    AddressSFGH, Bldg NH
    Phone415-596-9348

       Overview 
       Overview
      My decision to become a doctor evolved out of volunteering at a hospice with AIDS patients in the pre-HAART era, and was further strengthened by work in a rural, government clinic in eastern Honduras. Through grants received for financial need and academic excellence, I enrolled at Tufts University School of Medicine in 1998 as an MD/MPH candidate, where I was honored with a Massachusetts Medical Society Scholar Award for community service.

      Because of my commitment to work with critically underserved populations, I have been attracted to global health projects with programmatic relevance throughout my medical training. In Loreto, Peru, I worked on a project led by Dr. Bob Gilman (Johns Hopkins) using molecular diagnostics and active case finding to map unstable, seasonal malaria transmission. As a fourth year medical student I accepted an eight month field assignment in eastern Democratic Republic of Congo as an assistant epidemiologist with the International Rescue Committee. There, I applied probability sampling methods to measure health clinic utilization and mortality in a rural region of over 360,000 people, and managed a World Health Organization Roll Back Malaria field site enrolling 300 children in a prospective anti-malaria drug efficacy trial. During residency in Internal Medicine at UCSF, I designed a case-control study for the Brazilian Ministry of Health to investigate a sharp increase in severe leptospirosis associated with alveolar hemorrhage occurring in Brazilian slums.

      In 2003, drawn to the moral, economic and political issues surrounding provision of HIV care to Africans, I developed a clinical elective in Durban, South Africa, where I worked with Enhancing Care Initiative and the Harvard AIDS Institute to train healthcare workers on the eve of the public sector rollout of antiretrovirals. This experience played a critical role in my decision to approach my interests in infectious diseases and epidemiology from a pulmonary medicine perspective.
      In my second year of fellowship training in Pulmonary and Critical Care Medicine, I concurrently enrolled in the UC Berkeley doctoral program in epidemiology (2008-present) with tuition paid through a competitive Chancellor’s Fellowship for Graduate Study. Also concurrent with fellowship training, I worked as an international technical consultant to the Pan American Health Organization (PAHO), Program for Appropriate Technology in Health (PATH), and USAID in national TB program evaluations in three countries and an operational plan for scale-up of multidrug resistant tuberculosis management in Zimbabwe.

      I currently attend on the Pulmonary Consult Service and in the Intensive Care Unit at the San Francisco General Hospital. I am an Assistant Professor in the Division of Pulmonary and Critical Care Medicine at UCSF and a doctoral candidate in the Division of Epidemiology at the University of California, Berkeley. My research interests focus on the diagnosis, management, and transmission of drug resistant tuberculosis, domestically and in high HIV-burden settings. Further areas of specialization include diagnostic test evaluation, risk prediction, and causal inference. With collaborators at the Biomedical Research and Training Institute (http://www.brti.co.zw/) and the University of Zimbabwe/UCSF Clinical Trials Unit, we work to improve early detection of drug resistant TB, validate use of low cost, accelerated phenotypic assays, assess current international clinical care standards for persons at risk for drug resistant TB, and estimate the contribution of microbial and human genomic factors on drug resistant TB transmission in Harare, Zimbabwe.


       Bibliographic 
       Publications
      Publications by year:
      Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
      1. Metcalfe JZ, Cattamanchi A, McCulloch CE, Lew JD, Ha NP, Graviss EA. Test Variability of the QuantiFERON-TB Gold In-Tube Assay in Clinical Practice. Am J Respir Crit Care Med. 2013 Jan 15; 187(2):206-11.
        View in: PubMed
      2. Dantes R, Metcalfe J, Kim E, Kato-Maeda M, Hopewell PC, Kawamura M, Nahid P, Cattamanchi A. Impact of isoniazid resistance-conferring mutations on the clinical presentation of isoniazid monoresistant tuberculosis. PLoS One. 2012; 7(5):e37956.
        View in: PubMed
      3. Geng EH, Glidden DV, Bangsberg DR, Bwana MB, Musinguzi N, Nash D, Metcalfe JZ, Yiannoutsos CT, Martin JN, Petersen ML. A causal framework for understanding the effect of losses to follow-up on epidemiologic analyses in clinic-based cohorts: the case of HIV-infected patients on antiretroviral therapy in Africa. Am J Epidemiol. 2012 May 15; 175(10):1080-7.
        View in: PubMed
      4. Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang L, Hopewell PC, Pai M. Interferon-? release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis. J Infect Dis. 2011 Nov 15; 204 Suppl 4:S1120-9.
        View in: PubMed
      5. Brust JC, O'Donnell MR, Metcalfe JZ. TB/HIV: an orphan disease? Am J Respir Crit Care Med. 2011 Jun 1; 183(11):1441-2.
        View in: PubMed
      6. Cattamanchi A, Smith R, Steingart KR, Metcalfe JZ, Date A, Coleman C, Marston BJ, Huang L, Hopewell PC, Pai M. Interferon-gamma release assays for the diagnosis of latent tuberculosis infection in HIV-infected individuals: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2011 Mar; 56(3):230-8.
        View in: PubMed
      7. Kato-Maeda M, Metcalfe JZ, Flores L. Genotyping of Mycobacterium tuberculosis: application in epidemiologic studies. Future Microbiol. 2011 Feb; 6(2):203-16.
        View in: PubMed
      8. Metcalfe JZ, Kim EY, Lin SY, Cattamanchi A, Oh P, Flood J, Hopewell PC, Kato-Maeda M. Determinants of multidrug-resistant tuberculosis clusters, California, USA, 2004-2007. Emerg Infect Dis. 2010 Sep; 16(9):1403-9.
        View in: PubMed
      9. Davis JL, Worodria W, Kisembo H, Metcalfe JZ, Cattamanchi A, Kawooya M, Kyeyune R, den Boon S, Powell K, Okello R, Yoo S, Huang L. Clinical and radiographic factors do not accurately diagnose smear-negative tuberculosis in HIV-infected inpatients in Uganda: a cross-sectional study. PLoS One. 2010; 5(3):e9859.
        View in: PubMed
      10. Metcalfe JZ, Cattamanchi A, Vittinghoff E, Ho C, Grinsdale J, Hopewell PC, Kawamura LM, Nahid P. Evaluation of quantitative IFN-gamma response for risk stratification of active tuberculosis suspects. Am J Respir Crit Care Med. 2010 Jan 1; 181(1):87-93.
        View in: PubMed
      11. Cattamanchi A, Dantes RB, Metcalfe JZ, Jarlsberg LG, Grinsdale J, Kawamura LM, Osmond D, Hopewell PC, Nahid P. Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis. Clin Infect Dis. 2009 Jan 15; 48(2):179-85.
        View in: PubMed
      12. Gouveia EL, Metcalfe J, de Carvalho AL, Aires TS, Villasboas-Bisneto JC, Queirroz A, Santos AC, Salgado K, Reis MG, Ko AI. Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil. Emerg Infect Dis. 2008 Mar; 14(3):505-8.
        View in: PubMed
      13. Roshanravan B, Kari E, Gilman RH, Cabrera L, Lee E, Metcalfe J, Calderon M, Lescano AG, Montenegro SH, Calampa C, Vinetz JM. Endemic malaria in the Peruvian Amazon region of Iquitos. Am J Trop Med Hyg. 2003 Jul; 69(1):45-52.
        View in: PubMed
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