A5052791763- HIV/AIDS Research and Interventions
- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- Malaria Research and Control
- Mosquito-borne diseases and control
- Insect Pest Control Strategies
- Adolescent Sexual and Reproductive Health
- Tuberculosis Research and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- Mycobacterium research and diagnosis
- Hepatitis B Virus Studies
- HIV-related health complications and treatments
- Hepatitis C virus research
- Diagnosis and treatment of tuberculosis
- Infectious Diseases and Tuberculosis
- Cytomegalovirus and herpesvirus research
- HIV, Drug Use, Sexual Risk
- Liver Disease Diagnosis and Treatment
- Breastfeeding Practices and Influences
- Parasites and Host Interactions
- Meat and Animal Product Quality
- Pneumonia and Respiratory Infections
- Identification and Quantification in Food
- HIV/AIDS Impact and Responses
- Hepatitis Viruses Studies and Epidemiology
Ifakara Health Institute
2011-2023
University of the Witwatersrand
2022-2023
Swiss Tropical and Public Health Institute
2017
University of Basel
2017
London School of Hygiene & Tropical Medicine
2013-2015
Current front line malaria vector control methods such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs), rely upon the preference of many primary vectors to feed and/or rest inside human habitations where they can be targeted with domestically-applied products. We studied biting behaviour Anopheles funestus Giles potential quadriannulatus Theobald in Luangwa valley, south-east Zambia. Mosquitoes were collected by landing catch blocks houses either combined use...
To investigate the prevalence and determinants of virologic failure acquired drug resistance-associated mutations (DRMs) in HIV-infected children adolescents rural Tanzania.Prospective cohort study with cross-sectional analysis.All 18 years or less attending paediatric HIV Clinic Ifakara on antiretroviral therapy (ART) for at least 12 months were enrolled. Participants tested HIV-DRM. Pre-ART samples used to discriminate transmitted resistances. Multivariate logistic regression analysis...
Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are commonly used together in the same households to improve malaria control despite inconsistent evidence on whether such combinations actually offer better protection than alone or IRS alone. Comparative tests were conducted using experimental huts fitted with LLINs, untreated nets, plus of LLINs IRS, an area where Anopheles arabiensis is predominant vector species. Three LLIN types, Olyset®, PermaNet 2.0® Icon Life®...
Abstract Background. Cryptococcal meningitis is a leading cause of death in people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome. The World Health Organizations recommends pre-antiretroviral treatment (ART) cryptococcal antigen (CRAG) screening persons CD4 below 100 cells/µL. We assessed the prevalence and outcome antigenemia rural southern Tanzania. Methods. conducted retrospective study including all ART-naive adults <150 cells/µL prospectively...
BACKGROUND The Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) is a single-site, open ongoing prospective cohort of people living with human immunodeficiency virus (PLWHIV) established in 2005 at the Chronic Diseases Clinic Ifakara (CDCI), within Saint Francis Referral Hospital (SFRH) Ifakara, Tanzania. objectives KIULARCO are to (i) provide patient cohort-level information on outcomes HIV treatment; (ii) opportunistic infections comorbidities; (iii) evaluate aspects (HIV) care...
In the Tanzanian city of Dar es Salaam, high coverage long-lasting insecticidal nets (LLINs), larvicide application (LA) and mosquito-proofed housing, was complemented with improved access to artemisinin-based combination therapy rapid diagnostic tests by end 2012. Three rounds city-wide, cluster-sampled cross-sectional surveys malaria parasite infection status, spanning 2010 2012, were two series high-resolution, longitudinal vector density. Larvicide using a granule formulation Bacillus...
Background Strategies to improve the uptake of Prevention Mother-To-Child Transmission HIV (PMTCT) are needed. We integrated and maternal, newborn child health services in a One Stop Clinic PMTCT cascade rural Tanzanian setting. Methods The Ifakara offers integral care HIV-infected pregnant women their families at one single place time. All HIV-exposed infants attended during first year Option B+ implementation (04/2014-03/2015) were included. was assessed antenatal clinic (ANC), labour...
Determining the age of malaria vectors is essential for evaluating impact interventions that reduce survival wild mosquito populations and estimating changes in vectorial capacity. Near infra-red spectroscopy (NIRS) a simple non-destructive method has been used to determine species Anopheles gambiae s.l. by analyzing differences absorption spectra. The spectra are affected biochemical occur during life could be influenced senescence also history mosquito, i.e., mating, blood feeding...
Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment cases. Progress excellent, but for long-term low-cost, sustainable tools that supplement existing programs are needed. Conventional such as indoor residual spraying house screening highly effective, difficult to deliver in rural areas. Therefore, an additional means reducing mosquito entry was evaluated: the points by planting tall densely foliated repellent plant Lantana camara L....
Near-infrared spectroscopy (NIRS) has been successfully used on fresh and RNAlater®-preserved members of the Anopheles gambiae complex to identify sibling species age. No preservation methods other than using RNAlater® have tested preserve mosquitoes for identification NIRS. However, is not most practical preservative field settings because it expensive, requires basic laboratory conditions storage widely available in sub-Saharan Africa. The aim this study was test several cheaper more...
Objectives To report on trends of tuberculosis ascertainment among HIV patients in a rural cohort Tanzania, and assessing the impact bundle services implemented December 2012, consisting three components:(i)integration services; (ii)GeneXpert for diagnosis; (iii)electronic data collection. Design Retrospective study enrolled Kilombero Ulanga Antiretroviral Cohort (KIULARCO), Tanzania.) Methods without prior history KIULARCO between 2005 2013 were included.Cox proportional hazard models used...
Background: To what extent antiretroviral therapy (ART) reduces mother-to-child HIV transmission (MTCT) during breastfeeding remains unclear. We assessed the MTCT risk from mothers on ART to their infants breastfeeding. Setting: Ifakara, rural Tanzania. Methods: included born between January 2013 and May 2016 who initiated before delivery, had a negative DNA polymerase chain reaction at 4–12 weeks exclusively breastfed for ≥6 months. Mothers' plasma HIV-RNA viral loads (VLs) were measured up...
Abstract Background. We evaluated the prevalence of chronic hepatitis B virus (HBV) infection and liver fibrosis/cirrhosis in human immunodeficiency (HIV)-infected individuals enrolled a rural Tanzanian prospective cohort assessed hepatic fibrosis progression 12–24 months after antiretroviral treatment (ART) initiation. Methods. All ART-naive HIV-infected adults ≥15-year-old Kilombero Ulanga Antiretroviral Cohort who started ART between 2005 2015 were included. Pre-ART factors associated...
Abstract Introduction Monitoring HIV viral load (HVL) in people living with (PLHIV) on antiretroviral therapy (ART) is recommended by the World Health Organization. Implementation of HVL testing programs have been affected logistic and organizational challenges. Here we describe monitoring cascade a rural setting Tanzania compare turnaround times (TAT) between an on-site referral laboratory. Methods In nested study prospective Kilombero Ulanga Antiretroviral Cohort (KIULARCO) included PLHIV...
ObjectivesThe epidemiological and clinical determinants of hepatitis delta virus (HDV) infection in Sub-Saharan Africa are ill-defined. The prevalence HDV was determined HIV/hepatitis B (HBV) co-infected individuals rural Tanzania.MethodsAll HBV-infected adults under active follow-up the Kilombero Ulanga Antiretroviral Cohort (KIULARCO) were screened for anti-HDV antibodies. For positive samples, a second serological test nucleic acid amplification performed. Demographic characteristics at...
Strategies to improve HIV diagnosis and linkage into care, antiretroviral treatment coverage, outcomes of mothers children are urgently needed in sub-Saharan Africa.From December 2012, we implemented an intervention package prevention mother-to-child transmission (PMTCT) pediatric care our rural Tanzanian clinic, consisting of: (1) creation a PMTCT unit integrated within the reproductive child health clinic; (2) implementation electronic medical records; (3) provider-initiated testing...
Poor adherence to antiretroviral drugs and viral resistance are the main drivers of treatment failure in HIV-infected patients. In sub-Saharan Africa, avoidance on second-line protease inhibitor therapy is critical as options limited.In prospective observational study Kilombero & Ulanga Antiretroviral Cohort rural Tanzania, we assessed virologic (viral load ≥1,000 copies/mL) drug mutations bio-banked plasma samples 6-12 months after initiation a inhibitor-based regimen. Additionally, was...
Virological outcome data after programmatic transition from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based to dolutegravir (DTG)-based antiretroviral therapy (ART) regimens in sub-Saharan Africa (SSA) outside of clinical trials are scarce. We compared viral suppression and associated factors treatment-naïve people living with HIV (PLHIV) starting DTG- based versus NNRTI-based ART. virological at 12 months, treatment initiation the two cohorts participants aged ≥15 years,...
Objectives: To assess viral suppression rates, to prevalence of acquired HIV drug resistance and characterize the spectrum HIV-1 mutations (HIV-DRM) in HIV-1-infected patients a rural Tanzanian cohort. Methods: This was cross-sectional study nested within Kilombero Ulanga Antiretroviral Cohort. Virological failure defined as RNA ≥50 copies/mL. Risk factors associated with virological development HIV-DRM were assessed using logistic regression. Results: included 304 participants median time...
Abstract Background We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania. Methods In a cohort PLWHIV aged ≥15 years enrolled from January 2013 to June 2016, we association between (estimated glomerural filtration rate < 90 mL/min/1.73 m2) at enrollment during follow-up demographic clinical characteristcis using logistic regression Cox proportional hazards models. Results Of 1093 PLWHIV, 172 (15.7%) had...
Background It has been hypothesized that schistosomiasis negatively influences immune reconstitution in people living with HIV starting antiretroviral therapy (ART). In this study, we investigated the effect of on course infection patients ART a rural part Tanzania. Methodology Retrospective study including prospectively enrolled cohort Ifakara, south-central Tanzania between January 1, 2013 and April 2015. Schistosomal circulating anodic antigen (CAA) was assessed pre-ART cryopreserved...
Abstract The acquisition of drug-resistance mutations among African children living with in human immunodeficiency virus on antiretroviral treatment has been scarcely reported. This threatens the overall success programs and clinical outcomes care. We present a well characterized series from rural Tanzania acquired to contribute better understanding this emerging public health concern.
The extent to which drug-drug interactions (DDIs) between antiretrovirals (ARVs) and co-medications are recognized managed has not been thoroughly evaluated in limited-resource settings.This prospective questionnaire-based study aimed determine the prevalence risk factors for unrecognized/incorrectly DDIs people living with HIV followed-up at Chronic Diseases Clinic of Ifakara (CDCI) enrolled Kilombero Ulanga Antiretroviral Cohort (KIULARCO).We prospectively included ARV-treated adults...
A 9-year-old HIV-infected child previously treated with inadequate doses of antitubercular drugs based on weight was admitted 5 months after initial tuberculosis (TB) diagnosis acute hemiplegia and inguinal lymphadenopathies in a rural hospital Tanzania. He diagnosed TB meningitis lymphadenitis using Xpert Mycobacterium /rifampicin (MTB/RIF) assay. Rifampicin resistance detected the lymph node aspirate but not cerebrospinal fluid. His therapy optimised available medications antiretroviral...