Faculty Member

Xiaolin Wei MD, MPH, PhD

Email Address(es)
xiaolin.wei@utoronto.ca
Office Phone
416 978 2020
Office Address
582-155 College Street, Toronto, ON M5T 3M7, Canada
Curriculum Vitae
Download
Division(s)/Office
Clinical Public Health Division
Office of Global Public Health Education & Training
Position
Associate Professor
SGS Status
Associate Member
Appointment Status
Contract

Research Interests

  • Global health, focusing on clinical public health interventions in prevention and control of antimicrobial resistance (AMR), tuberculosis (TB), and hypertension and diabetes in low and middle-income countries (LMICs)
  • Operations research, randomized controlled trials, cohort studies
  • Primary care reform and policy evaluation

Biography

As a physician, public health specialist, and public health researcher, I have trained and taught in China (including Hong Kong), the UK and Canada. For the past 20 years, I have helped lead a global team of scientists to successfully explore interventions that combine public health education and stewardship around TB, respiratory infections, hypertension and diabetes at the point of clinical care delivery. I also focus on combined strategies involving social inclusion, gender responsiveness and poverty reduction in China, the Philippines, Indonesia, Pakistan, Nepal, Bangladesh, Uganda, Ghana, and Swaziland.

At the University of Toronto, I am the Dalla Lana Chair in Global Health Policy and an associate professor at the Dalla Lana School of Public Health. I also serve as vice-president of the International Union Against Tuberculosis and Lung Disease.

Education & training history

  • 2012- Fellow, Faculty of Public Health, UK
  • 2004 – PhD, University of Toronto, Canada
  • 2001 – MPH, Peking University, China
  • 1998 – MD, Jining Medical School, China

Teaching responsibilities

Awards

  • 2017 – Diabetes Action Canada Mentorship Award
  • 2004 – Ted Goldenberg Award for Academic Excellence, Department of Health Policy, Management and Evaluation, University of Toronto
  • 2001 – Best Graduate Award, Peking University, Beijing, China

Research

I have published more than 100 papers, including in high-impact journals such as The Lancet, PLoS Med, and the Bulletin of the World Health Organization. As a principal investigator, I have received more than $5 million in funding for research into TB control.

Early in my career, I identified a need to better understand the epidemiology of TB — and its intersection with health service delivery — in many of the poorest countries of the world. The failure to control this highly treatable disease has been a puzzle, and a frustration.

As a researcher in both TB and health systems, I began to see that the guidelines devised by world health authorities often didn’t match the capacities of local health delivery systems, not just at the nation level, but within countries; and this was leading to underdiagnosis, underreporting of cases and poor treatment outcomes. To address this problem, I focused on research to identify undiagnosed TB while simultaneously researching primary care delivery in Asia and Africa.

At the same time, I began to conduct interventional studies that showed the efficacy of empowering local communities to treat TB, identifying new cases, using new technologies to improve treatment adherence and financial incentives to encourage treatment completion. My large-scale interventional studies of hypertension, diabetes and antibiotic overuse in China have enriched my understanding of the links between TB and other diseases of poverty — and the challenges of delivering complex health services in low-income localities. Traditional TB guidelines and interventions are often formulated a world away from the remote villages and poor inner cities where they’re most needed –where the shame and stigma of this disease of poverty, the lack of health delivery infrastructures, and a distrust of authority makes these well-intentioned guidelines difficult to implement.

After two decades of studying why traditional interventions fail, I began to work more closely with local authorities in China, the Philippines, Pakistan and other countries to devise a new way of thinking about treating TB that focuses on improving the conditions of poverty – crowded living conditions, poor nutrition, and overburdened local health delivery systems — but always taking into account the sociological and political realities on the ground. In doing so, I am identifying successes at the local level that can be scaled up. My goal is to formulate new examples of eliminating TB using combined health and social strategies, and stemming the growing crisis of antimicrobial resistance.

For more information of Ending TB in the Philippines

Selected publications in antimicrobial resistance for respiratory infections:

Wei X, Zhang Z, Hicks JP, Walley JD, King R, Newell JN, Yin, J., Zeng, J., Guo, Y., Lin, M., Upshur, R. E. G., Sun, Q. “Long-term outcomes of an educational intervention to reduce antibiotic prescribing for childhood upper respiratory tract infections in rural China: Follow-up of a cluster-randomised controlled trial”. PLoS Med. 2019;16(2):e1002733.

Zhang Z, Dawkins B, Hicks JP, Walley JD, Hulme C, Elsey H., Deng SM., Lin M., Zeng J., Wei, X*. “Cost-effectiveness analysis of a multi-dimensional intervention to reduce inappropriate antibiotic prescribing for children with upper respiratory tract infections in China”. Tropical medicine & international health : TM & IH. 2018;23(10):1092-100.

Wei X, Zhang Z, Walley JD, Hicks JP, Zeng J, Deng S, Zhou Y, Yin J, Newell JN, Sun Q, Zou G, Guo Y, Upshur R, Lin M. “Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial”. Lancet Glob Health. 2017;5(12):e1258-e67.

Wei X, Yin J, Walley JD, Zhang Z, Hicks JP, Zhou Y, Sun Q, Zeng J., Lin M. “Impact of China’s essential medicines scheme and zero-mark-up policy on antibiotic prescriptions in county hospitals: a mixed methods study”. Tropical medicine & international health : TM & IH. 2017;22(9):1166-74.

Hu Y, Walley J, Chou R, Tucker JD, Harwell JI, Wu X, Yin J, Zou G, Wei X*. “Interventions to reduce childhood antibiotic prescribing for upper respiratory infections: systematic review and meta-analysis”. J Epidemiol Community Health. 2016;70:1162-70.

Zhang Z, Hu Y, Zou G, Lin M, Zeng J, Deng S,Deng S, Zachariah R, Walley J, Tucker JD, Wei X*. “Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions”. Glob Health Action. 2017;10(1):1287334.

Research advancing understanding of TB proliferation, diagnosis and treatment:

Walker IF, Shi OM, Hicks JP, Elsey H, Wei X., Menzies D., Falzon D, Migliori GB, Perez-Guzman C, Vargas MH, Garcia-Garcia L, Osornio JS, Ponce-De-Leon A, Van der Walt M, Newell JN. “Analysis of loss to follow up in 4,099 multidrug-resistant pulmonary tuberculosis patients”. European Respiratory Journal. 2019; 54(1)

Wei X, Hicks JP, Pande P, Zhang Z, Haldane V, Liu XQ, et al. “Protocol for a randomised controlled trial to evaluate the effectiveness of improving tuberculosis patients’ treatment adherence via electronic monitors and an app versus usual care in Tibet”. Trials. 2019;20(1):273

Li B, Zhang XL, Guo J, Wang J, Pianduo B, Wei XL, Ying TT, Hu J. “The Prevalence of pulmonary tuberculosis in Tibet Autonomous Region, China in 2014”. The international journal of tuberculosis and lung disease. 2019;23(6):735-740

Ge E, Li D, Luo M, Tsui KWS, Waye MMY, Shen X, Wei X*. “Transmission of multidrug-resistant tuberculosis in Shanghai: roles of residential status”. The international journal of tuberculosis and lung disease. 2018;22(12):1462-8.

Chen B, Gu H, Wang X, Wang F, Peng Y, Ge E, Wei X.* “Prevalence and determinants of latent tuberculosis infection among frontline tuberculosis healthcare workers in southeastern China: A multilevel analysis by individuals and health facilities”. Int J Infect Dis. 2018;79:26-33.

Yin, J.#, Wang, X., Zhou, L., Wei, X.*, 2018. “The relationship between social support, treatment interruption and treatment outcome in patients with multidrug-resistant tuberculosis in China: a mixed-methods study”. Trop Med Int Health. 23(6): 668-677

Yin, J.#, Yuan, J., Hu, Y., & Wei, X*. (2016). “Association between Directly Observed Therapy and Treatment Outcomes in Multidrug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis”. PloS One. 11(3), e0150511. Doi:10.1371/journal.pone.0150511

Ge, E., Zhang, X., Wang, X., & Wei, X*. (2016). “Spatial and temporal analysis of tuberculosis in Zhejiang Province, China, 2009-2012”. Infect Dis Poverty. 5(1), 11. Doi:10.1186/s40249-016-0104-2

Wei X, Yin J, Zhang ZT, Walley J, Harwell J, Li H, Li R, Wang L, Sun Q, and Zhang XL, (2015), “Treatment Interruptions and Provision of Directly Observed Treatment of Multidrug Resistant Tuberculosis Patients in China”. Journal of International Union against TB and Lung Disease. 19(4):413–419

Zhang XL, Li SG, Li HT, Li GX, Guo XY, Wang Y, Li R, Yin J, Zou GY, Wei X*. “Integrating tuberculosis screening into annual health examinations for the rural elderly improves case detection”. Journal of International Union against TB and Lung Disease. 2015;19(7):787-91. Doi: 10.5588/ijtld.14.0617.

Wei, X., Zou, G., Chong, M. K., & Xu, L. (2015). “An intervention of active TB case finding among smokers attending routine primary care facilities in China: an exploratory study”. Trans R Soc Trop Med Hyg. 109(9), 545-552.

Wei X, Zou G, Yin J, Walley J, Zhang X, Li R, Sun Q. “Effective reimbursement rates of the rural health insurance among uncomplicated tuberculosis patients in China”. Trop Med Int Health. 2015;20(3):304-11.

Wei X, Zou, G, Walley, J, Yin, J, Lonroth K, Uplekar M, Wang W, Sun Q. “China Tuberculosis Policy at Crucial Crossroads: Comparing the practice of different hospital and tuberculosis control collaboration models using survey data”. PLoS One. 2014,9,3, e90596 DOI:10.1371/journal.pone.0090596

Wei X, Zhang X, Yin J, Walley J, Beanland R, Zou G, Zhang H, Li F, Liu Z, Zee BCY, Griffiths SM. “Changes in pulmonary tuberculosis prevalence: evidence from the 2010 population survey in a populous province of China”. BMC Infectious Diseases. 2014, 14:21

Ansa, G#. A., Walley, J. D., Siddiqi, K., & Wei, X. (2014). “Delivering TB/HIV services in Ghana: a comparative study of service delivery models”. Trans R Soc Trop Med Hyg. Doi: 10.1093/trstmh/tru110

Wei X, Zou G, Yin J, Walley J and Sun Q. (2013). “Comparing patient care seeking pathways in three models of hospital and TB programme collaboration in China”. BMC Infectious Diseases 13:93

Zou G#, Wei X*, Witter S, Yin J, Walley J, Liu S, Yang H, Chen J, Tian G and Mei J (2013) “Incremental cost-effectiveness of two interventions to improve treatment completion among rural-to-urban migrant TB patients in Shanghai”. International Journal of Tuberculosis and Lung Disease. 17(8): 1056-1064

Wei X, Zou G, Yin J, Walley J, Yang H, Kliner M, Mei J. (2012). “Providing financial incentives to rural-to-urban TB migrants in Shanghai: an intervention study”. Infectious Disease of Poverty 1:9

Research advancing primary care, health service delivery and tobacco cessation:

Su Min, Haldane V, Upshur R, Sullivan F, Legare F, Greiver M, Wei X*. “The impact of treatment adherence for patients with diabetes and hypertension on cardiovascular disease risk: a protocol for a retrospective cohort study, 2008-2018”. JMIR Research Protocols. 2019 accepted

Su, M.#, Si, Y., Zhou, Z., Shen, C., Dong, W., Fan, X., Wang, X., Wei, X.*, 2018. “Comparing the income-related inequity of tested prevalence and self-reported prevalence of hypertension in China”. Int J Equity Health. 17, 82.

Wei, X., Walley, J.D., Zhang, Z., Zou, G., Gong, W., Deng, S., Harries, A.D., Hicks, J.P., Chong, M.K.C., Newell, J.N., Zhong, J., Yu, M. 2017. “Implementation of a comprehensive intervention for patients at high risk of cardiovascular disease in rural China: A pragmatic cluster randomized controlled trial”. PLoS One. 12, e0183169.

Wei X*, Yin J, Wong SY, Griffiths SM, Zou G, Shi L. “Private ownership of primary care providers associated with patient perceived quality of care: A comparative cross-sectional survey in three big Chinese cities”. Medicine 2017; 96(1): e5755.

Gong W, Wei X*, Liang Y, Zou G, Hu R, Deng S, Zhang Z, Pan J, Choi BC, Yu M. “Urban and Rural Differences of Acute Cardiovascular Disease Events: A Study from the Population-Based Real-Time Surveillance System in Zhejiang, China in 2012”. (equal contribution with GW) PloS one 2016; 11(11): e0165647.

Hu Y#, Walley J, Chou R, Tucker JD, Harwell JI, Wu X, Yin J, Zou G, Wei X*. “Interventions to reduce childhood antibiotic prescribing for upper respiratory infections: systematic review and meta-analysis”. Journal of Epidemiology and Community Health 2016; 70: 1162-70

Wei X*, Li H, Yang N, Wong YSS, Chong MCK, Shi, L, Wong MCS, Xu J, Zhang D, Tang J, Li DKT, Meng Q, Griffiths S, (2015). “Changes of primary care quality in two megacities of China between 2011 and 2013: a multivariate difference-in-difference analysis”, Bulletin of the World Health Organization 93:407-16

Li H#, Wei X*, Wong MC, Yang N, Wong SY, Lao X, et al. “A Comparison of the Quality of Hypertension Management in Primary Care Between Shanghai and Shenzhen: A Cohort Study of 3196 Patients”. Medicine. 2015;94(5): e455.

Wei X, Li H, Yang N, Wong YSS, Owolabi O, Xu, J, Shi, L, Li K, Tang J, Griffiths S, (2015) “Comparing quality of public primary care between Hong Kong and Shanghai using validated patient assessment tools”. PLOS One, 2015;10(3): e0121269.

Wei X*, Yang N, Zhang Z, Li H, Wong YS, Gao Y, Wong C, Wang J, Wang H, Li K, Tang J, Griffiths S (2015). “Comparison of three models of ownership of community health centers in China: a qualitative study”. Journal of Health Service Research and Policy, 20(3), 162-9

Zou G#, McPake B, Wei X*. (2014) “Chinese health foreign aid and policy: beyond medical aid”. The Lancet. 2014, 383(9927):1461-1462.

Wei X, Zhang Z, Song X, Xu Y, Wu W, Lao X, Ma W. “Household smoking restrictions related to secondhand smoke exposure in Guangdong, China: a population representative survey”. Nicotine & tobacco research: official journal of the Society for Research on Nicotine and Tobacco 2014, 16(4):390-396

Wei X, Zou G, Gong W, Yin J, Yu Y, Walley J, et al. “Cardiovascular disease risk reduction in rural China: a clustered randomized controlled trial in Zhejiang”. Trials. 2013; 14: 354.

Wei X, Zou G, Yin J, Walley J, Zhou B, Yu YX, Tian LW, Chen K (2013). “Characteristics of High Risk People with Cardiovascular Disease in Chinese Rural Areas: Clinical Indicators, Disease Patterns and Drug Treatment”. PLoS One. 2013, 8(1): e54169 http://dx.doi.org/10.1371/journal.pone.0054169

Wang HH#, Wong SY, Wong MC, Wei XL, Wang JJ, Li DK, et al. “Patients’ experiences in different models of community health centers in southern China”. Ann Fam Med. 2013 Nov-Dec;11(6):517-26 doi: 10.1370/afm.1545.

Walley J, Graham K, Wei X, Kain K, Weston R (2012). “Getting research into practice: primary care management of noncommunicable disease in low-and middle-income counties”. Bulletin of World Health Organization. 90:402 http://www.idpjournal.com/content/1/1/9

Wei X*, Barnsley J, Zakus D, Cockerill R, Glazier R and Sun X (2008). “Evaluation of a diabetes management program in China demonstrated association of improved continuity of care with clinical outcomes”. Journal of Clinical Epidemiology. 61(9): 932-39  http://dx.doi.org/doi: 10.1016/j.jclinepi.2007.12.013

* denotes as corresponding author, # denotes students or trainee first authored papers.

Full publication list available at: https://www.researchgate.net/profile/Xiaolin_Wei2

Google Scholar at: https://scholar.google.com/citations?user=oyiAgloAAAAJ&hl=en

News Articles

U of T Researchers Receive Grant to Increase Tuberculosis Treatment Adherence in Tibet

U of T study finds long-term success in reducing unnecessary antibiotics prescriptions in China