John Metcalfe, MD, PhD, MPH

Professor In Residence
M_MED-ZSFG-PULM

My research focuses on fundamental questions in the tracking and early identification of drug-resistant tuberculosis (DR-TB) to better target and evaluate control interventions. I have specialized training in clinical research methods, statistical prediction, repeated measures, and causal inference through doctoral work in the Division of Epidemiology, UC Berkeley. I have served as a consultant to the WHO, USAID, and PAHO for the development of regional and national TB management guidelines. Because of my commitment to work with critically underserved populations, I have been attracted to global health projects with strong programmatic relevance throughout my career. I have experience conducting prospective studies in challenging environments, including a one-year field assignment in eastern D.R. Congo, and in Zimbabwe, where we oversaw treatment of the first cohort of drug-resistant TB patients (2011), undertook the first modern characterization of DR-TB in the country (2014), carried out a pragmatic diagnostic RCT of GeneXpert MTB/RIF (2014), and consulted on national TB (2014) and DR-TB (2016) prevalence surveys.

Within the NIH Division of AIDS Clinical Trials Group, I lead an ACTG phase IIc trial (protocol A5362) examining the sterilizing activity of the repurposed agent clofazimine and rifapentine. My work also focuses on determining mechanisms of M. tuberculosis clonal evolution under treatment, the longitudinal clinical significance of micro-heteroresistance, and on developing assays for non-invasive therapeutic drug monitoring. Collectively, these experiences provide distinct perspectives on keystone problems with high clinical impact, bench-to-bedside translation barriers, and scientific conduct in a variety of international settings.

Publications

TB prevalence in Zimbabwe: a national cross-sectional survey, 2014.

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

Chipinduro M, Timire C, Chirenda J, Matambo R, Munemo E, Makamure B, Nhidza AF, Tinago W, Chikwasha V, Ngwenya M, Mutsvangwa J, Metcalfe JZ, Sandy C

Xpert MTB/RIF-detected Rifampicin Resistance is a Sub-Optimal Surrogate for Multidrug Resistant Tuberculosis in Eastern Democratic Republic of the Congo: Diagnostic and Clinical Implications.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Bisimwa BC, Nachega JB, Warren RM, Theron G, Metcalfe JZ, Shah M, Diacon AH, Sam-Agudu NA, Yotebieng M, Bulabula ANH, Katoto PDMC, Chirambiza JP, Nyota R, Birembano FM, Musafiri EM, Byadunia S, Bahizire E, Kaswa MK, Callens S, Kashongwe ZM