A5066823889- HIV/AIDS Research and Interventions
- HIV/AIDS Impact and Responses
- Adolescent Sexual and Reproductive Health
- Tuberculosis Research and Epidemiology
- HIV, Drug Use, Sexual Risk
- COVID-19 epidemiological studies
- Global Maternal and Child Health
- HIV-related health complications and treatments
- Vaccine Coverage and Hesitancy
- HIV Research and Treatment
- COVID-19 Impact on Reproduction
- Chronic Disease Management Strategies
- COVID-19 and Mental Health
- COVID-19 and healthcare impacts
- Pneumocystis jirovecii pneumonia detection and treatment
- Global Health and Surgery
- Food Security and Health in Diverse Populations
- Mobile Health and mHealth Applications
- Health, Environment, Cognitive Aging
- HIV/AIDS drug development and treatment
- Survey Sampling and Estimation Techniques
- Electronic Health Records Systems
- COVID-19 diagnosis using AI
- Data Quality and Management
- Blood Pressure and Hypertension Studies
Africa Health Research Institute
2016-2025
Human Sciences Research Council
2023
University of Cape Town
2022-2023
Desmond Tutu HIV Foundation
2022
University of KwaZulu-Natal
2017-2022
University of the Witwatersrand
2022
London School of Hygiene & Tropical Medicine
2022
University of Kinshasa
2020
Lighthouse Trust
2010-2012
Kamuzu Central Hospital
2012
Background Sexually transmitted infections (STIs) and bacterial vaginosis (BV) are associated with increased transmission of HIV, poor reproductive sexual health. The burden STIs/BV among young people is unknown in many high HIV prevalence settings. We conducted an acceptability, feasibility, study home-based sampling for men women aged 15–24 years old a health demographic surveillance site (HDSS) rural KwaZulu-Natal, South Africa. Methods findings A total 1,342 people, stratified by age...
Objectives We evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation rural Kwa-Zulu Natal (KZN). Design Observational cohort Setting Data were analysed from 11 primary healthcare clinics northern KZN. Participants A total 46 523 individuals made 89 476 visits during the observation period. Exposure interest conducted an interrupted time series analysis to estimate changes with a focus on transitions prelockdown level 5, 4 and 3 periods....
BackgroundThere has been remarkable progress in the treatment of HIV throughout sub-Saharan Africa, but there are few data on prevalence and overlap other significant causes disease endemic populations. Our aim was to identify infectious non-communicable diseases such a population rural South Africa.MethodsWe did cross-sectional study eligible adolescents adults from Africa Health Research Institute demographic surveillance area uMkhanyakude district KwaZulu-Natal, Africa. The participants,...
The Africa Centre Demographic Information System (ACDIS) cohort in rural KwaZulu Natal, South Africa, was established 2000.In 2017, the expanded and renamed Population Intervention Platform (PIP). Public health priorities have changed over past 20 years, with widespread availability of ART a growing burden non-communicable disease (NCD).AHRI's research programme has shifted to address these new priorities, deliver evaluate interventions. In mid-2018, had approximately 140,000 individuals...
Summary Objectives To determine the proportion of patients returning to antiretroviral treatment (ART) and factors associated with their return in a resource‐limited setting. Methods Between September 2006 March 2009, at two ART‐providing facilities Lilongwe, Malawi, we identified who had missed clinic appointments by more than 3 weeks therefore would have run out drugs. We traced these individuals, documented reasons for and, where appropriate, arranged another ART appointment. Results...
Adolescent girls and young women (AGYW) bear the brunt of HIV epidemic in South Africa. 'DREAMS' aims to reduce incidence through multi-level combination prevention. We describe uptake sexual reproductive health (SRH) by AGYW KwaZulu-Natal (KZN), prior DREAMS.
Objective To assess the effect of lockdown during 2020 COVID-19 pandemic on daily all-cause admissions, and by age diagnosis subgroups, odds mortality in a hospital rural KwaZulu-Natal (KZN). Design Observational cohort. Setting Referral for 17 primary care clinics uMkhanyakude District. Participants Data collected Africa Health Research Institute all admissions from 1 January to 20 October: 5848 patients contributed 6173 admissions. Exposure Five levels national South 27 March 2020, with...
Computer-aided digital chest radiograph interpretation (CAD) can facilitate high-throughput screening for tuberculosis (TB), but its use in population-based active case-finding programs has been limited. In an HIV-endemic area rural South Africa, we used a CAD algorithm (CAD4TBv5) to interpret x-rays (CXR) as part of mobile health effort. Participants with TB symptoms or CAD4TBv5 score above the triaging threshold were referred microbiological sputum assessment. During initial pilot phase,...
Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation the association between adiposity and cardiometabolic disease availability data African populations. We aimed derive a SSA-specific optimal WC cut-point for identifying individuals at increased risk.
Abstract Objectives Public health interventions designed to interrupt COVID-19 transmission could have deleterious impacts on primary healthcare access. We sought identify whether implementation of the nationwide lockdown (shelter-in-place) order in South Africa affected ambulatory clinic visitation rural Kwa-Zulu Natal (KZN). Design Prospective, longitudinal cohort study Setting Data were analyzed from Health Research Institute and Demographic Surveillance System, which includes prospective...
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...
Significance HIV incidence has recently been in decline across some of the most intense epidemics sub-Saharan Africa due to scale-up prevention and transmission-blocking treatments. Understanding whether declines are being felt equally age gender can help prioritize demographic groups where more effort is needed lower transmission. We found that declined disproportionately youngest men women a population with highest prevalence world. Shifts distribution risk may be consequence aging...
Unlocking the potential of telehealth in Africa for HIV: opportunities, challenges, and pathways to equitable healthcare delivery
Under South Africa's Universal Test and Treat (UTT) policy, CD4 counts are no longer required to determine HIV treatment eligibility. However, count at presentation remains an important marker of disease progression. We assessed whether testing declined in the UTT era and, if so, by how much. analysed data from National Health Laboratory Service (NHLS) Cohort TIER.Net database for individuals care across five African provinces. "First count" was defined as first test recorded each patient....
Abstract Mycobacterium tuberculosis ( Mtb ) transmission is driven by variable social, environmental, and biological factors, including the number duration of indoor contacts. Social contact data can provide information on potential patterns, but underutilised outside field mathematical modelling. We explore three contexts where valuable insights: 1) household tracing; 2) infection prevention control measures (IPC) in congregate settings; 3) contamination cluster randomised trials (CRTs). A...
Rapid Diagnostic Tests (RDTs) are affordable tools for disease diagnosis and surveillance. There is growing evidence of the benefits Machine Learning models to aid accurate decision making through classification test results, improving sensitivity specificity reducing risk false positives/negatives. Yet date these have relied on large, clinically sensitive, costly, time-intensive real-world image training libraries. Herein, we present SynSight: a pipeline RDTs trained using mechanistically...
Background Young men are less likely than young women to engage with HIV prevention and care, their HIV-related mortality is higher. We describe incidence uptake of services in 20–29 years(y) rural KwaZulu-Natal, South Africa, before the roll-out DREAMS. Methods used data from a population-based demographic surveillance cohort. was estimated anonymised testing an annual serosurvey. Service assessed 2011 2015, through two self-reported outcomes: 1) past 12 months(m); 2) voluntary medical male...
Abstract Introduction HIV elimination requires innovative approaches to ensure testing and immediate treatment provision. We investigated the effectiveness of conditional financial incentives on increasing linkage care in a 2×2 factorial cluster randomized controlled trial-Home-Based Intervention Test Start (HITS) - rural South Africa. Methods Of 45 communities uMkhanyakude, KwaZulu-Natal, 16 were randomly assigned arms receive for home-based counseling (HBHCT) within 6 weeks (R50 [US$3]...
Objectives The aim of the study was to estimate rates linkage HIV care and antiretroviral treatment ( ART ) initiation after introduction home‐based counselling testing HBHCT telephone‐facilitated support for in rural South Africa. Methods A population‐based prospective cohort carried out KwaZulu Natal, All residents aged ≥ 15 years were eligible . Those who tested positive not referred at one 11 public‐sector clinics. Individuals did attend clinic within 2 weeks sent a short message service...
In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over subsequent 5 months, NPI policies were eased in stages according a national strategy. COVID-19 throughout country heterogeneously; disease reached rural areas by July and case numbers peaked from August. A second wave began late 2020. Data on impact social economic well-being access health care are limited.We aimed determine how residents three African provinces...
BackgroundThe convergence of infectious diseases and non-communicable in South Africa is challenging to health systems. In this analysis, we assessed the multimorbidity needs individuals communities rural KwaZulu-Natal established a framework quantify met unmet for living with diseases.MethodsWe analysed data collected between May 25, 2018, March 13, 2020, from participants large, community-based, cross-sectional survey (Vukuzazi) that offered community-based HIV, hypertension, diabetes...
Men in sub-Saharan Africa are less likely to accept HIV testing and link care than women. We conducted a trial investigate the impact of conditional financial incentives decision support application, called EPIC-HIV, on linkage care. report findings process evaluation explore whether interventions were delivered as intended, identify mechanisms any contextual factors that may have impacted outcomes. Between August 2018 March 2019, we in-depth interviews focus group discussions with...
Summary Objectives To describe the development and operation of integrated tuberculosis (TB) HIV care at Martin Preuss Centre, a multipartner organization bringing together governmental non‐governmental providers TB services in Lilongwe, Malawi. Methods We used case study approach to TB/HIV service illustrate successes challenges faced by providers. quantified effective integration using indicators defined World Health Organization. Results The custom‐designed building facilitates patient...