A5047534279- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- HIV, Drug Use, Sexual Risk
- Genital Health and Disease
- Sex work and related issues
- Global Maternal and Child Health
- Ethics and Legal Issues in Pediatric Healthcare
- Economic and Financial Impacts of Cancer
- Urological Disorders and Treatments
- HIV/AIDS Impact and Responses
- HIV-related health complications and treatments
- Female Genital Mutilation/Cutting Issues
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare cost, quality, practices
- Autopsy Techniques and Outcomes
- Intimate Partner and Family Violence
- HIV Research and Treatment
- Viral Infections and Outbreaks Research
- Poverty, Education, and Child Welfare
- Influenza Virus Research Studies
- Migration, Health and Trauma
- Prenatal Substance Exposure Effects
- Healthcare Systems and Reforms
- Alcohol Consumption and Health Effects
- Hepatitis C virus research
Rakai Health Sciences Program
2014-2024
London School of Hygiene & Tropical Medicine
2023-2024
QIMR Berghofer Medical Research Institute
2022-2023
Uganda Virus Research Institute
2013-2021
Makerere University
2014
University of the Witwatersrand
2013
Background: The rollout of antiretroviral therapy (ART) is one the largest public health interventions in Eastern and Southern Africa recent years. Its impact well described clinical cohort studies, but population-based evidence rare. Methods: We use data from seven demographic surveillance sites that also conduct community-based HIV testing collect information on uptake services. present crude death rates adults (aged 15–64) for period 2000–2011 by sex, status, treatment status. Parametric...
BackgroundInternational and global organisations advocate targeting interventions to areas of high HIV prevalence (ie, hotspots). To better understand the potential benefits geo-targeted control, we assessed extent which hotspots along Lake Victoria sustain transmission in neighbouring populations south-central Uganda.MethodsWe did a population-based survey Rakai, Uganda, using data from Rakai Community Cohort Study. The study surveyed all individuals aged 15–49 years four high-prevalence...
BackgroundAs the HIV epidemic in sub-Saharan Africa matures, evidence about age distribution of new infections and how this has changed over is needed to guide prevention. We aimed assess trends age-specific incidence six population-based cohort studies eastern southern Africa, reporting changes mean at infection, infections, birth cumulative incidence.MethodsWe used a Bayesian model reconstruct from repeated observations individuals' serostatus survival collected among population cohorts...
Although fishing communities have a significantly higher HIV prevalence than the general population, there is paucity of data on burden and service utilization, particularly among youth. We assessed utilization prevention treatment services youth in Kasensero community neighboring communities.Data were derived from Rakai Community Cohort Study (RCCS) surveys conducted between 2013 2014. The RCCS population-based household survey that collects annually individuals aged 15-49 years, resident...
Abstract To prevent new infections with human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa, UNAIDS recommends targeting interventions to populations that are at high risk of acquiring and passing on the virus. Yet it is often unclear who where these ‘source’ are. Here we demonstrate how viral deep-sequencing can be used reconstruct HIV-1 transmission networks infer direction networks. We able deep-sequence from a large population-based sample infected individuals Rakai...
Abstract HIV prevalence varies markedly throughout Africa, and it is often presumed areas of higher (i.e., hotspots) serve as sources infection to neighboring lower prevalence. However, the small-scale geography migration networks movement HIV-positive individuals between communities poorly understood. Here, we use population-based data from ~22,000 persons known status characterize migratory patterns their relationship among 38 in Rakai, Uganda with ranging 9 43%. We find that migrants...
The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network, http://alpha.lshtm.ac.uk/) brings together ten population-based HIV surveillance sites in eastern and southern Africa, is coordinated by the London School of Hygiene Tropical Medicine (LSHTM).It was established 2005 aims to (i) broaden evidence base epidemiology informing policy, (ii) strengthen analytical capacity research, (iii) foster collaboration between network members.All study sites, some...
Abstract Purpose To qualitatively explore Australian healthcare professionals’ perspectives on how to improve the care and management of cancer-related financial toxicity, including relevant practices, services, unmet needs. Methods We invited professionals (HCP) who currently provide people with cancer within their role complete an online survey, which was distributed via networks clinical oncology professional associations/organisations. The survey developed by Clinical Oncology Society...
Introduction Uganda has one of the highest rates alcohol use in sub-Saharan Africa but prevalence and correlates drinking are undocumented Rakai region, earliest epicenters HIV/AIDS epidemic East Africa. Methods We analyzed cross-sectional data from 18,700 persons (8,690 men, 10,010 women) aged 15–49 years, living agrarian, trading fishing communities participating Community Cohort Study (RCCS) between March 2015 September 2016. Logistic regression models assessed associations past year...
The efficacy of voluntary male medical circumcision (VMMC) for human immunodeficiency virus (HIV) prevention in men was demonstrated 3 randomized trials. This led to the adoption VMMC as an integral component United States President's Emergency Plan AIDS Relief (PEPFAR) combination HIV program sub-Saharan Africa. However, evidence on individual-level effectiveness programs real-world, programmatic settings is limited.
ObjectiveTo determine causes of death and associated risk factors in women reproductive age rural South Africa.MethodsDeaths person-years observation (pyo) were determined for females (aged 15–49 years) resident 15,526 households a African Demographic Health Surveillance site from 2000 to 2009. Cause was ascertained by verbal autopsy ICD-10 coded; categorized as HIV/TB, non-communicable, communicable/maternal/perinatal/nutrition, injuries, undetermined (unknown). Characteristics obtained...
To understand the opinions and current practices of health professionals on topic addressing cancer-related financial toxicity among patients.A cross-sectional online survey was distributed through Australian clinical oncology professional organizations/networks. The multidisciplinary Clinical Oncology Society Australia Financial Toxicity Working Group developed 25 questions relating to frequency comfort levels patient-clinician discussions, about their role, strategies used, barriers...
Summary Background Despite numerous risk factors and serious consequences, little is known about metabolic dysfunction‐associated steatotic liver disease (MASLD) at population level in Africa. Aim The aim of the study was to estimate prevalence MASLD people living with without HIV Uganda. Methods We collected data from 37 communities South Central Uganda between May 2016 2018. estimated using fatty index advanced fibrosis dynamic aspartate‐to‐alanine aminotransferase ratio. additional on...
Objectives To assess the safety and acceptability of early infant circumcision ( EIC ) provided by trained clinical officers CO s) registered nurse midwives RNMW in rural Uganda. Subjects Methods We conducted a randomised trial using Mogen clamp newly s four health centres Rakai, The was with clinicaltrials.gov # NCT 02596282. In all, 501 healthy neonates aged 1–28 days normal birth weight gestational age were to n = 256) 245) for , followed‐up at 1, 7 28 days. Results 701 mothers directly...
There are limited data on the impact of antiretroviral therapy (ART) population-level adult mortality in sub-Saharan Africa. We analysed for 2000–14 from Rakai Community Cohort Study (RCCS) Uganda, where free ART was scaled up after 2004. Using non-parametric and parametric (Weibull) survival analysis, we estimated trends average person-years lived between exact ages 15 50, per capita life-years lost to HIV, hazards people living with HIV (PLHIV). Between 2000 2014, before age 50 increased...
Objective This study aimed to quantify the out-of-pocket (OOP) costs and perceived financial burden among Australian men with localised prostate cancer in first 6 months after diagnosis, by primary management option. Methods cost-analysis quantified OOP using administrative claims data self-reported survey data. Financial was assessed COmprehensive Score for Toxicity–Functional Assessment of Chronic Illness Therapy (COST-FACIT) tool. Participants were recruited into a randomised control...
Monitoring and evaluation of clinical programs requires assessing patient outcomes. Numerous challenges complicate these efforts, the most insidious which is loss to follow-up (LTFU). LTFU a composite outcome, including individuals out care, undocumented transfers, unreported deaths. Incorporation vital status information from routine outreach may improve mortality estimates for those LTFU.
Timely progression of people living with HIV (PLHIV) from the point infection through pathway diagnosis to treatment is important in ensuring effective care and preventing HIV-related deaths onwards transmission infection. Reliable, population-based estimates new infections are difficult obtain for generalised epidemics sub-Saharan Africa. Mortality data indicate disease burden and, if disaggregated along continuum treatment, can also reflect coverage quality different services. Neither...
Introduction Antenatal alcohol use is linked to adverse maternal and neonatal outcomes. Uganda has one of the highest rates in sub-Saharan Africa, but prevalence antenatal not been reported Rakai region. Methods We used cross-sectional data from pregnant women Community Cohort Study between March 2017 September 2018. Using bivariate multivariable analyses, we assessed associations self-reported sociodemographic characteristics, intimate partner violence (IPV), HIV status. Results Among 960...
Objective: To determine whether circumcision of HIV-positive men is associated with increased subsequent sexual risk behaviors which may place their female partners at risk.Methods: Newly circumcised and uncircumcised in the Rakai Community Cohort Study were followed from baseline (July 2013–January 2015) to trend association follow up (February 2015–September 2016). Risk included activity, alcohol before sex, transactional multiple sex partners, casual inconsistent condom use partners. The...
Objective To assess acquisition of knowledge and competence in performing Early Infant Male Circumcision (EIMC) by non‐physicians trained using a structured curriculum. Subjects Methods Training provision EIMC the Mogen clamp was conducted for 10 Clinical Officers ( CO s) Registered Nurse Midwives RNMW s), Rakai, Uganda. Healthy infants whose mothers consented to study participation were assigned trainees, each whom performed at least s. Ongoing assessment feedback competency done, safety...
There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated level and trends mortality, overall by different causes, rural Rakai, Uganda, age, sex, HIV status.
Globally, intimate partner violence (IPV) is highly prevalent, with adolescents being particularly vulnerable, especially during pregnancy. This study examines the prevalence and severity of physical IPV among pregnant in sub-Saharan Africa (SSA). We analyzed data from Demographic Health Surveys collected between 2017-2021 eight SSA countries, involving 2,289 ever-pregnant aged 15-19. Physical pregnancy was defined as experiencing harm while by a husband, former partner, current boyfriend,...