Ashton Hall

Ashton is a fourth-year medical student at the University of Cincinnati College of Medicine. He studied microbiology and history at Miami University (Oxford, Ohio). Ashton was first exposed to tropical medicine through a medical mission trip to Ecuador in 2018, where he visited remote communities in the Andean highlands in which most children had gastrointestinal parasites. He then undertook a month-long observership at St. John's Medical College in Bangalore, India, where he witnessed how certain infectious diseases are exacerbated by social and political exclusion. This interest in tropical medicine led him to the London School of Hygiene and Tropical Medicine, where he completed a Master's degree in medical microbiology. His year abroad was cut short due to the COVID-19 pandemic, which precluded him from traveling to The Gambia to study the effectiveness of prophylactic azithromycin for group B streptococcus colonization in pregnancy. Ashton matriculated to medical school in 2021 with his eyes set on a career in infectious diseases. He spent significant time on the pediatric and adult infectious disease consult services during medical school. He also authored case reports in AJTMH on disseminated tuberculosis, blastomycosis, and strongyloidiasis. He planned to apply to internal medicine residency programs in fall 2024 as a stepping stone to infectious disease fellowship. Beyond the classroom, Ashton enjoys reading about medical history, working out at the Cincinnati Athletic Club, and watching the New York Yankees.

What does the Kean Fellowship mean to you?
It's an incredible honor to be a 2024 recipient of the Benjamin H. Kean Travel Fellowship in Tropical Medicine. With this award, I will pursue an international research elective to supplement my fourth and final year of medical school. I will be traveling to Peru to learn about the magnitude of tuberculosis and gastrointestinal parasite infections. For five weeks, I will be immersed in Peruvian/Andean culture, learning more about their culture, history, and healthcare system. The Kean Fellowship also promotes professional mentorship at my home and overseas institutions, which is invaluable for students like myself who are interested in pursuing a career in infectious diseases and tropical medicine.

What do you anticipate learning?
Tuberculosis (TB) is a leading infectious killer worldwide that is estimated to infect one-fourth of the world's population. Across the globe but particularly in developing countries, up to one-third of TB patients are co-infected with at least one intestinal parasite, including Strongyloides stercoralis, Giardia lamblia, Ascaris lumbricoides, and two species of hookworms. This co-infection is particularly problematic, as intestinal parasites shift the host immune response away from cell-mediated (Th1 predominant) pathways and toward humoral pathways. Patients with TB-intestinal parasite coinfections may have difficulty clearing the infection as quickly as those with mono-infections and thus requiring prolonged courses of antibiotics, predisposing patients and community members to antibiotic resistance. My Kean Project will look at the burden of intestinal parasitosis among patients with known TB disease in Lima, Peru.

What interests you about tropical medicine and what problems are you interested in solving?
Engraved into the side of LSHTM's Keppel Street building are 26 names of prominent physicians, public health officers, and microbiologists who had outsized contributions to the field of tropical medicine. Several noteworthy examples include Ronald Ross, William Gorgas, Walter Reed, Louis Pasteur, Robert Koch and Patrick Manson. Walking to class each morning and looking up at those names, I remember feeling inspired by the indelible impact that a few scientists and physicians had on millions of people worldwide.

Although tropical medicine began as a colonial mission in places like Antwerp, Liverpool, and London, the field has refocused itself in the last century to diagnose and treat neglected diseases in developed and developing countries. While the United States may be an exceptional country, American exceptionalism often prevents us from recognizing and addressing inconvenient truths, such as the estimated 12 million Americans suffering from a neglected parasitic infection. I am interested tropical medicine because it allows me to advocate for the forgotten faces of neglected tropical diseases.

Strongyloidiasis is a soil-transmitted helminth thought to infect 30-100 million people worldwide and is endemic to Northern Kentucky. We have seen several cases in the last few years at the University of Cincinnati Medical Center and Cincinnati Children's Hospital Medical Center. I am interested in developing more comprehensive screening guidelines for at-risk patients such as transplant candidates/recipients, patients with hematologic malignancies, and patients receiving prolonged immunosuppressive medications to more adequately diagnose and treat this underrecognized parasite.