A5020061458- Cervical Cancer and HPV Research
- Prostate Cancer Diagnosis and Treatment
- Global Cancer Incidence and Screening
- Prostate Cancer Treatment and Research
- Health Systems, Economic Evaluations, Quality of Life
- Mental Health Treatment and Access
- Health disparities and outcomes
- HIV/AIDS Research and Interventions
- Chronic Disease Management Strategies
- Genital Health and Disease
- Family Caregiving in Mental Illness
- Genetic factors in colorectal cancer
- Cardiac Health and Mental Health
- HIV/AIDS Impact and Responses
- Primary Care and Health Outcomes
- Health, psychology, and well-being
- Global Health Care Issues
- Viral-associated cancers and disorders
- Colorectal Cancer Screening and Detection
- Adolescent Sexual and Reproductive Health
- COVID-19 Pandemic Impacts
- Employment and Welfare Studies
- Statistical Methods in Clinical Trials
- Global Health and Surgery
- HIV Research and Treatment
University of Cape Town
2015-2024
South African Tuberculosis Vaccine Initiative
2015-2020
Groote Schuur Hospital
2016
Lung Institute
2016
City, University of London
2013
Goldsmiths University of London
2012
Development Agency of Serbia
2012
Background In many low-income countries, care for patients with non-communicable diseases (NCDs) and mental health conditions is provided by nurses. The benefits of nurse substitution supplementation in NCD high-income settings are well recognised, but evidence from low- middle-income countries limited. Primary Care 101 (PC101) a programme designed to support expand nurses' role care, comprising educational outreach nurses clinical management tool enhanced prescribing provisions. We...
Abstract We followed adolescents and adults living with HIV aged older than 15 years who enrolled in a South African private-sector programme to examine adherence viral non-suppression (viral load > 400 copies/mL) of participants (20,743, 38%) without (33,635, 62%) mental health diagnoses. Mental diagnoses were associated unfavourable patterns. The risk was higher among patients organic disorders [adjusted ratio (aRR) 1.55, 95% confidence interval (CI) 1.22–1.96], substance use (aRR 1.53,...
Background. South Africa (SA) is facing a heavy burden of non-communicable diseases (NCDs). Few studies address multimorbidity, control and treatment NCDs in patients attending primary healthcare (PHC) clinics. Objectives. To describe related risk factors, disease severity status with four important public sector PHC clinics two districts SA. Methods. A cross-sectional sample completed baseline data collection for randomised controlled trial health systems intervention. The study population...
The scale-up of antiretroviral treatment (ART) programmes has seen HIV/AIDS transition to a chronic condition characterised by high rates comorbidity with tuberculosis, non-communicable diseases (NCDs) and mental health disorders. Depression is one such disorder that associated higher non-adherence, progression AIDS greater mortality. Detection comorbid depression critical achieve viral load suppression in more than 90% those on ART line the recent 90-90-90 Joint United Nations Programme...
Socioeconomic predictors and consequences of depression its treatment were investigated in 4393 adults with specified non-communicable diseases attending 38 public sector primary care clinics the Eden Overberg districts Western Cape, South Africa. Participants interviewed at baseline 2011 14 months later, as part a randomised controlled trial guideline-based intervention to improve diagnosis management chronic diseases. The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10)...
The high co-morbidity of mental disorders, particularly depression, with non-communicable diseases (NCDs) such as cardiovascular disease (CVD), is concerning given the rising burden NCDs globally, and role depression plays in confounding prevention treatment NCDs. objective this randomised control trial (RCT) to determine real-world effectiveness strengthened identification management on outcomes hypertensive patients attending primary health care (PHC) facilities South Africa (SA). study...
We tested the real-world effectiveness of a collaborative task-sharing model on depressive symptom reduction in hypertensive Primary Health Care (PHC) patients South Africa.A pragmatic parallel cluster randomised trial 20 clinics Dr Kenneth Kaunda district, North West province. PHC were stratified by sub-district and 1:1 ratio. Control received care as usual (CAU), involving referral to doctors and/or mental health specialists. Intervention CAU plus enhanced training lay counselling service....
Abstract Aims Prior research, largely focused on US male veterans, indicates an increased risk of cardiovascular disease among individuals with post-traumatic stress disorder (PTSD). Data from other settings and populations are scarce. The objective this study is to examine PTSD as a factor for incident major adverse events (MACEs) in South Africa. Methods We analysed reimbursement claims (2011–2020) cohort African medical insurance scheme beneficiaries aged 18 years or older. calculated...
There is convincing evidence that lower socioeconomic position associated with increased risk of mental disorders. However, the mechanisms involved are not well understood. This study aims to elucidate causal pathways between and depression symptoms in South African adults. Two possible theories examined: social causation, which suggests poor conditions cause ill health; drift, those health more likely drift into circumstances.The used longitudinal cross-sectional observational data on 3904...
The treatment gap for mental health services is a growing public concern. A lay-counselling service located at primary care (PHC) level could potentially help to close the large common disorders in South Africa. aim of this study was understand multilevel factors contributing implementation and potential dissemination such depression PHC level.Process qualitative data patients with depressive symptoms collected alongside pragmatic randomized controlled trial evaluating collaborative model...
People with mental illness have a reduced life expectancy, but the extent of mortality gap and contribution natural unnatural causes to excess among people in South Africa are unknown.
Background The development of strategies to better detect and manage patients with multiple long-term conditions requires estimates the most prevalent condition combinations. However, standard meta-analysis tools are not well suited synthesising heterogeneous multimorbidity data. Methods We developed a statistical model synthesise data on associations between diseases nationally representative prevalence applied South Africa. Published unpublished were reviewed, meta-regression analysis was...
Several studies have found lower prostate cancer diagnosis rates among men with human immunodeficiency virus (HIV; MWH) than without HIV but reasons for this finding remain unclear.
Background: The increased prevalence of physical diseases among individuals with mental illness contributes to their risk mortality. However, the mediating role specific in effect on mortality is not well understood. Method: We conducted a longitudinal causal mediation analysis using data from beneficiaries South African medical insurance scheme 2011 2020. estimated overall major depressive disorder (MDD) and evaluated reductions this through hypothetical interventions risks an...
Background. Low socioeconomic status is associated with the risk of hypertension. There are few reports effect and potentially modifiable factors on control hypertension in South Africa (SA). Objectives. To investigate associations between patients’ socioeconomic characteristics primary healthcare facilities, treatment blood pressure hypertensive patients. Methods. We enrolled patients attending 38 public sector care clinics Western Cape, SA, 2011, followed them up 14 months later as part a...
<p>Table S10 shows hazard ratios for prostate cancer diagnosis, restricting to men with at least one specific antigen test.</p>
<p>Table S6 shows rate ratios for prostate specific antigen (PSA) testing and biopsies, excluding HIV positive men not in Aid AIDS registration.</p>
<p>Hazard ratios for the association of different factors with an incident prostate cancer diagnosis.</p>
<p>Cohort characteristics by HIV status and overall.</p>
<div>AbstractBackground:<p>Several studies have found lower prostate cancer diagnosis rates among men with human immunodeficiency virus (HIV; MWH) than without HIV but reasons for this finding remain unclear.</p>Methods:<p>We used claims data from a South African private medical insurance scheme (July 2017– July 2020) to assess aged ≥ 18 years and HIV. Using flexible parametric survival models, we estimated hazard ratios (HR) the association between incident...
<p>Table S8 shows hazard ratios for prostate cancer diagnosis, excluding men with HIV without Aid AIDS registration.</p>
<p>Table S5 shows characteristics at diagnosis of prostate cancer, by population group.</p>
<p>Selection of study population. The flow diagram shows the number individuals who were excluded from analysis and reasons for exclusion.</p>