John Metcalfe, MD, PhD, MPH
|School||UCSF School of Medicine|
|Address||1001 Potrero Ave, SFGH 5|
San Francisco CA 94143
|University of California, San Francisco||Residency ||Internal Medicine|
I am an Assistant Professor in the Division of Pulmonary and Critical Care Medicine and the Curry International Tuberculosis Center, both at the University of California, San Francisco. My research interests focus on the diagnosis, management, and transmission of tuberculosis and other pulmonary infectious diseases, domestically and in high HIV-burden settings. I have specialized training in clinical research methods, statistical prediction, repeated measures, and causal inference through a Ph.D. obtained within the Division of Epidemiology at UC Berkeley.
Domestic collaborations with the Tuberculosis Control Branch of the California Department of Public Health have resulted in publications on state-wide epidemiologic trends in TB/HIV co-morbidity and its changing relationship among immigrants, as well as the molecular epidemiology of drug-resistant TB. Application of specialized statistical techniques to analyze the clinical utility of interferon-gamma release assays (IGRAs) has led to two first-author publications in the American Journal of Respiratory and Critical Care Medicine. Internationally, I have worked as a technical consultant to the Pan American Health Organization (PAHO), Program for Appropriate Technology in Health (PATH), and USAID in national TB program evaluation, programmatic guidelines, and multidrug resistant tuberculosis operational plan development, including in Zimbabwe. Since 2011, I have enrolled over 400 individuals at risk for drug-resistant TB (K23 AI094251, Transmission and Pathogenesis of MDR-TB (Trap MDR-TB)) in Harare, Zimbabwe. Here, we produced the first population-based estimate of MDR-TB since 1995, improved time to diagnosis for MDR-TB from over one year to nine days, and validated low-cost diagnostic platforms for local use. Within this cohort, an unusual number of HIV-infected individuals, especially adolescents, were noted to have chronic respiratory symptoms in absence of TB or other apparent etiology. In collaboration with world-class UCSF researchers, we now aim to characterize the clinical manifestations, immune ontogeny, and microbiome (the ecological community of microorganisms) of this unique patient group. Finally, through a recently funded NIH/Fogarty award (D43 TW009539), we have begun to strengthen the capacity of the UZ College of Health Sciences (UZCHS) to replenish its ranks of high-quality junior faculty and to conduct high quality, innovative, and locally relevant TB and HIV/AIDS research. I currently hold an appointment as Lecturer within the University of Zimbabwe, and act as consultant to the NIH Division of AIDS UZ/UCSF Clinical Trials Unit.
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