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Jo Middleton

Jo Middleton BSc MRes MRSB

Research Fellow
E: J.Middleton@bsms.ac.uk
T: +44 (0)1273 641025
Location: Department of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Room 319, Watson Building, Falmer BN1 9PH

Areas of expertise: Parasitology (particularly acarine: scabies. Lyme disease etc.); planetary health; sustainability; outbreak research; disease ecology; zoonotic diseases; Rapid anthropological Assessment Procedures for health; systematic reviews; remote pre-hospital care; Papua New Guinea.

Research areas: Infection and immunology; primary care and health services.

Other Roles: BSMS institutional liaison with the Planetary Health Alliance

Biography

Jo Middleton is a Research Fellow in the Department of Primary Care and Public Health in a team led by Professor Jackie Cassell. Jo works across BSMS host institutions, with research in Life Sciences at University of Sussex, and Pharmacy and Biomolecular Sciences at University of Brighton. Much of Jo’s research and teaching involves interrelated work at two very different scales, that of microscopic parasites (specifically acarines) and that of Planetary Health, an emerging field which aims to safeguard both human health and the natural systems that underpin it.

Before joining BSMS Jo worked in the ambulance service and taught courses for Brighton and Sussex University Hospitals staff and those travelling to remote areas. They have a long term commitment to biodiversity conservation, with a particular focus on forest preservation and indigenous health in Oceania. 

Jo is a peer reviewer for the Department of Health (UK government), evidence mapping for policy and the Health Research Board (Irish government grant body), as well as the following journals: Epidemiology and Infection; BMJ Open; PLOS Neglected Tropical Diseases; British Journal of General Practice; P J Acarology, Planetary Health Alliance 2018/The Lancet Planetary Health.

Research

Surfaces: an interdisciplinary project to understand and enhance health in the vulnerable rainforests of Papua New Guinea (PNG) (UK; Papua New Guinea)

Jo is a Co-I on Surfaces. PNG’s globally important rainforests are threatened by logging, and its health-related Sustainable Development Goal indicators are worse than all but two countries outside sub-Saharan Africa. Surfaces is mapping evidence on integrated health and conservation projects worldwide, and aims to provide a practical example in PNG’s rainforests, focusing first on neglected tropical skin diseases (specifically scabies and fungal diseases). [PI: Dr Alan Stewart. Funder: Sussex Sustainability Research Programme]. Read more >

Scabies Research Project (UK; Europe; Papua New Guinea; Ethiopia; Ghana)

Jo came to BSMS in January 2014 to work on the Scabies Research Project, a collaboration between BSMS, London School of Hygiene & Tropical Medicine, and Public Health England (PHE). The project carried out the first UK study into scabies outbreaks in care homes for the elderly, which are a considerable public health burden and highly distressing for residents (see the cover story in Lancet Infectious Diseases. The team is now developing national outbreak guidelines, and working on novel scabies diagnostics. Scabies is also a WHO Neglected Tropical Disease and Jo is  now engaged in international projects in Papua New Guinea, Ghana, and Ethiopia. He have also studied outbreaks in refugee/migrant camps across Europe. [Funders: Public Health England, British Skin Foundation, Economic Social Research Council, National Institute of Healthcare Research].

Ecology of Lyme disease (South Downs and Forest of Dean National Parks)

Jo is investigating ecological determinants of Lyme disease hazard in the South Downs National Park and potential One Health based interventions. This involves field collection of ticks, acarine taxonomy, real-time PCR pathogen identification, and a systematic review to determine if interventions that aim to decrease Lyme disease hazard at non-domestic sites can be effective without negatively affecting ecosystem health. [Funders: British Ecological Society, Royal Society of Biology, British Deer Society, Nineveh Charitable Trust].

Novel tests for infectious diseases to reduce hospital admissions (UK)

On behalf of i-sense Jo is exploring health and social care worker’s views on novel point-of-care diagnostics. The capability to detect infections and wirelessly connect results to healthcare systems may help patients gain faster access to treatment, and support public health efforts to map indicators of emerging infections in real-time. [Funder: Engineering and Physical Sciences Research Council].

Teaching

Jo teaches at Brighton and Sussex Medical School and the School of Life Sciences at University of Sussex, primarily on topics related to parasites, planetary health, and disease ecology. I presently contribute to the following degree courses:

  • Bachelor Medicine Bachelor of Surgery (BSMS)
  • BSc Ecology and Conservation (University of Sussex)
  • MPH Public Health (BSMS)
  • MSc Conservation Biology (University of Sussex)

Jo is the lead within the Planetary Health Alliance of an international working group developing curriculum across member medical and nursing schools, from Sydney to Yale.

Selected publications

Article

Middleton, Jo (2018) A conversation with… Jo Middleton. Pulse (8). pp. 12-13. 

Middleton J, Cassell JA, Jones C, Lanza S, Head MG and Walker SL (2018) Scabies control: the forgotten role of personal hygiene- Authors reply. [http://sro.sussex.ac.uk/78707/] The Lancet Infectious Diseases, 18 (10). pp. 1068-1069. ISSN 1473-3099 

Cassell JA, Middleton J, Nalabanda A, Lanza S, Head MG, Bostock, J, Hewitt K, Jones C, Darley C, Karir S and Walker SL. (2018) Scabies outbreaks in ten care homes for the elderly: a prospective study of clinical features, epidemiology, and treatment outcomes. [http://sro.sussex.ac.uk/75896/] The Lancet Infectious Diseases. ISSN 1473-3099

Stone S, Myers SS, Golden C and the Planetary Health Education Brainstorm Group* [*136 inc. Middleton J] Cross-cutting principles for planetary health education. [http://sro.sussex.ac.uk/65880/] The Lancet Planetary Health, 2 (5). e192-e193. ISSN 2542-5196 

Kinyanjui T, Middleton J, Güttel S, Cassell JA, Ross J and House T (2018) Scabies in residential care homes: modelling, inference and interventions for well-connected population sub-units. [http://sro.sussex.ac.uk/73765/] PLOS Computational Biology, 14 (3). e1006046. ISSN 1553-7358 

Middleton J, Cooper I, Rott AS (2016) Can interventions that aim to decrease Lyme disease hazard at non-domestic sites be effective without negatively affecting ecosystem health? A systematic review protocol. Environmental Evidence, 5 (23). ISSN 2047-2382  

Conferences or workshop item

Middleton J, Cassell JA, Rott AS, Cooper I and Stewart A (2018) Win-win interventions for health and conservation from Papua New Guinea’s rainforests to the UK’s National Parks. [http://sro.sussex.ac.uk/78795/] In: Tulsicon2018 Conference: Impact of One Health on Conservations, 14 September 2018, London Wetland Centre, London, UK.

Middleton J, Cassell JA, Novotny V, Colthart G, Peck M, Fairhead J, Walker SL, Head MG, Macgregor H, Inacio J and Stewart A (2017) Surfaces: An interdisciplinary project to understand and enhance health in the vulnerable rainforests of Papua New Guinea. Inaugural Planetary Health / GeoHealth Annual Meeting, 28-30 April 2017, Harvard Medical School, Boston, USA. 

Middleton J, Cooper I and Rott AS (2017) An on-going investigation into the ecological determinants of Lyme disease in the South Downs National Park, South East England: the potential for 'One Health' based interventions. Microbiology Society Annual Conference 2017, 3-6 April 2017, Edinburgh, UK.

Middleton J, Head MG and Cassell JA (2017) Scabies: diagnostic challenges of neglected tropical skin disease, existing tools, future developments. Diagnostics and the Developing World Conference 2017, 24 Jan 2017, Brunel University, London. 

Read more >