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Targeting interventions in outbreaks of sexually transmitted infections


About This PhD Project

Project Description

Queen Mary University of London is announcing an exciting opportunity for an allocated four-year PhD position in either the Earth Surface Science group in the School of Geography or the Evolution and Development group in the School of Biological and Chemical Sciences. The successful candidate will start their project in September 2019 and will participate in training and cohort activities of the London NERC DTP.

The London NERC Doctoral Training Partnership brings together eight of the world’s leading research centres in environmental science. Our partnership provides innovative doctoral training in a multidisciplinary research environment and fosters links between centres of research excellence, spanning NERC’s environmental science remit.

CASE partner: Barts Health NHS Trust

About the Project

Sexually transmitted infections (STIs) are a major problem around the world, with 499 million new cases diagnosed worldwide in 2008; in England alone there were 450,000 new cases in 20121,2. Spatial analysis of STIs is increasingly important as cases tend to be highly clustered and mapping them forms the basis for decisions on where to focus interventions.The WHO suggest that practitioners ask patients where they first met their recent partners to ‘help direct prevention efforts to epidemiologically important hotspots’3. Here, we test whether geographic profiling (GP) can identify specific sites for community level public health interventions without expensive and time-consuming interviews.

GP was developed in criminology to prioritise large lists of suspects in cases of serial crime. It uses locations of crime sites to create a probability surface that is overlaid on the study area to produce a geoprofile. Geoprofiles allow police to prioritise investigations by checking suspects associated with locations in descending order of their height on the geoprofile4. GP is highly successful in criminology, and is used by law enforcement worldwide. This success has led to its application to epidemiology, identifying disease sources from the addresses of infected individuals (eg identifying vector breeding sites during an outbreak of malaria in Cairo)5. Pilot studies with Chelsea & Westminster NHS Trust suggest that GP can be highly effective in identifying hotspots of STI transmission, and it is this work that we extend here.

This project asks if GP can locate places people meet sexual partners and contract STIs. This will help identify locations that are important for STI transmission so that prevention programs can be targeted to these. We ask (1) if maps produced by GP can improve the performance of questionnaires/interviews; (2) if GP can remove the need for questionnaires/interviews; (3) if socioeconomic/demographic information can improve model performance.

Methodology

The GP model is well established and runs in the open-source software. Patient data will be made available from Chelsea & Westminster and Barts NHS trusts. The model will use as input the postcodes of patients diagnosed with STIs (the project has passed C&W ethical review) to identify sites where sexual partners have been met.

The study that will form the first 2 chapters of the thesis has 3 phases. Phase 1 follows current best practice in that participants (excluding decliners) are given questionnaires asking where they have met recent partners. In Phase 2, Cohort 1 is divided into two groups. A control group (Group 1) is interviewed as normal, while in a second group (Group 2) interviews are supplemented with GP hotspot maps. Simultaneously, Cohort 2 is recruited, and participants given the questionnaire alone (the control group, Group 3) or the questionnaire plus GP map from Cohort 1 (Group 4). In Phase 3, GP of the full data set (Groups 1-4) will be used to see how well the model can identify locations highlighted in the questionnaire/interviews using addresses alone.

For further information about each topic please contact the relevant supervisor. Candidates are strongly advised to make contact with the potential supervisor to discuss these opportunities prior to application for funding.

Eligibility

Please note: NERC funding is subject to candidates meeting RCUK eligibility criteria and we encourage eligible students from the EU to apply. For details of eligibility please click here: https://london-nerc-dtp.org/apply-to-the-london-nerc-dtp/#eligibility

How to apply

Applicants should include a supporting statement, CV, transcripts and certificates, details of two referees, and indicate the relevant supervisor and project title in the application form. Shortlisted candidates will be invited to interview in March 2019.

To apply for a studentship being advertised by the School of Biological and Chemical Sciences (SBCS) please click here: https://mysis.qmul.ac.uk/urd/sits.urd/run/siw_ipp_lgn.login?process=siw_ipp_app&code1=RFQM-C1ZF-09&code2=0010

To apply for a studentship being advertised by the School of Geography please click here: https://mysis.qmul.ac.uk/urd/sits.urd/run/siw_ipp_lgn.login?process=siw_ipp_app&code1=RFQM-L8ZM-09&code2=0010&code3=GUEST

References

1 Public Health England. (2013). Shooting Up: Infections among people who inject drugs in the UK.

2 Public Health England. (2012). Sexually transmitted infections and chlamydia screening in England, 2012. Health Protection Report 7:23.

3 Steen., et al (2009). Bull. WHO 87:858-865.

4 Rossmo (2000) Geographic Profiling. CRC Press, New York.

5 Verity et al (2014). Methods in Ecol Evol 5:647–655.

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