Healthcare workers in South Africa, and elsewhere, may face a high risk of Mycobacterium tuberculosis (Mtb) infection and DR-TB disease, indicating a high force of infection in clinics to both health care workers and patients. Interventions such as cough screening or improved ventilation have the potential to reduce transmission of Mtb in clinics, reducing TB morbidity. However, it is currently unclear which infection control (IC) approaches will be most cost-effective, and be feasible in low and middle-income country settings.

The PhD research is part of a wider project, that uses a multi-disciplinary approach to inform, develop and predict the potential impact of a health systems intervention to improve IC for DR-TB within health facilities in the Western Cape and KwaZulu-Natal provinces of South Africa. The aim of the PhD project is to examine the interaction between building design and use and Mtb transmission risk, and inform interventions to interrupt transmission. The student will develop an individual-based mathematical model of clinic structure and ventilation, the movement of staff and visitors through clinics, and Mtb transmission. The model will be used to estimate the proportion of transmission to different groups that occurs in different parts of the clinics, and at different times of day. The model will then be used to estimate the impact of different interventions on transmission.

The project will involve some primary data collection in 12 clinics in South Africa, including ventilation measurements, and documentation of patient and healthcare worker movement within facilities.

Applicants should have a strong quantitative background, with an interest in developing core skills in infectious disease modelling. Experience of infectious disease modelling/epidemiology or buildings science will be advantageous. The successful candidate will be enrolled in the MRC London Intercollegiate Doctoral Training Programme which will provide additional training and local student cohort activity opportunities.