A5066253506- HIV/AIDS Research and Interventions
- HIV/AIDS Impact and Responses
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- Global Maternal and Child Health
- HIV/AIDS drug development and treatment
- Adolescent Sexual and Reproductive Health
- Tuberculosis Research and Epidemiology
- Poverty, Education, and Child Welfare
- HIV-related health complications and treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Pneumonia and Respiratory Infections
- Health Systems, Economic Evaluations, Quality of Life
- Sex work and related issues
- Hepatitis C virus research
- Hepatitis B Virus Studies
- Diabetes Management and Education
- Adolescent and Pediatric Healthcare
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Chinese history and philosophy
- Blood Pressure and Hypertension Studies
- Liver Disease Diagnosis and Treatment
- Air Quality and Health Impacts
- Global Health Care Issues
- Primary Care and Health Outcomes
University of the Witwatersrand
2016-2025
Boston University
2016-2025
The Ohio State University
2022-2024
Office Of Health Economics
2012-2023
Colorado State University
2022
Africa Health Research Institute
2007-2021
Section27
2021
Right to Care
2021
Education Labour Relations Council
2017
Center for Global Health
2009-2016
Many countries use the cost-effectiveness thresholds recommended by World Health Organization's Choosing Interventions that are Cost-Effective project (WHO-CHOICE) when evaluating health interventions. This sets threshold for as cost of intervention per disability-adjusted life-year (DALY) averted less than three times country's annual gross domestic product (GDP) capita. Highly cost-effective interventions defined meeting a DALY once GDP We argue reliance on these reduces value analyses and...
High rates of patient attrition from care between HIV testing and antiretroviral therapy (ART) initiation have been documented in sub-Saharan Africa, contributing to persistently low CD4 cell counts at treatment initiation. One reason for this is that starting ART many countries a lengthy burdensome process, imposing long waits multiple clinic visits on patients. We estimated the effect uptake viral suppression an accelerated algorithm allowed treatment-eligible patients be dispensed their...
Antiretroviral therapy (ART) for human immunodeficiency virus (HIV) prevents illness and death from HIV disease transmission of infection.To encourage global scale-up ART, the Joint UN Program on HIV/AIDS (UNAIDS) issued "95-95-95" targets "cascade care."These state that by 2030, 95% individuals living with will know their status, people diagnosed infection receive those taking ART have achieved suppression virus.• While tremendous progress has been made toward achieving these targets,...
Summary Objectives To estimate the impact of HIV/AIDS on individual labour productivity during disease progression. Methods We used a retrospective cohort design to study and attendance tea estate workers who died or were medically retired because AIDS‐related causes between 1997 2002 in western Kenya. compared daily output kilograms leaves plucked, use paid unpaid leave assignment less strenuous tasks by 54 AIDS those comparison workers, matched time field using longitudinal regression....
To better understand the reasons why patients default from antiretroviral treatment (ART) programmes to help design interventions that improve retention and ultimately, patient outcomes.Prospective cohort study at two sites in South Africa followed by qualitative interviews with had defaulted.Respondents overwhelmingly reported ART improved their health status quality of life. Nevertheless, despite taking worse when is stopped, serious barriers remained: transport costs, time needed for...
Objective We estimated the incremental cost and impact on diagnosis treatment uptake of national rollout Xpert MTB/RIF technology (Xpert) for pulmonary TB above current guidelines years 2011 to 2016 in South Africa. Methods parameterised a population-level decision model with data from national-level databases (n = 199,511) implementation studies. The follows cohorts suspects under diagnostic or an algorithm that includes Xpert. Assumptions include number suspects, symptom prevalence 5.5%,...
Background Women have better patient outcomes in HIV care and treatment than men sub-Saharan Africa. We assessed—at the population level—whether to what extent mass is associated with changes sex disparities adult life expectancy, a summary metric of survival capturing mortality across full cascade care. also determined sex-specific trends distribution HIV-related deaths women prior at each stage clinical cascade. Methods Findings Data were collected on all occurring from 2001 2011 large...
Summary The scale‐up of antiretroviral therapy (ART) has been one the success stories sub‐Saharan Africa, where coverage increased from about 2% in 2003 to more than 40% 5 years later. However, tempering this is a growing concern patient retention (the proportion patients who are alive and remaining on ART health system). Based personal experience authors, 10 key interventions presented discussed that might help improve retention. These (1) need for simple standardized monitoring systems...
<h3>Introduction</h3> Hypertension has become a major cause of morbidity and premature mortality in South Africa, but population-wide estimates prevalence access to care are scarce. Using data from the African National Health Nutrition Examination Survey (2011–2012), this analysis evaluates national hypertension uses cascade examine unmet need for care. <h3>Methods</h3> was defined as blood pressure over 140/90 mm Hg or use antihypertensive medication. We constructed by decomposing...
Background Differentiated antiretroviral therapy (ART) delivery models, in which patients are provided with care relevant to their current status (e.g., newly initiating, stable on treatment, or unstable treatment) has become an essential part of patient-centered health systems. In 2015, the South African government implemented Chronic Disease Adherence Guidelines (AGLs), involved five interventions: Fast Track Initiation Counseling for initiating patients, Enhanced unsuppressed viral load,...
Lawrence Long and colleagues report that "down-referring" stable HIV patients from a doctor-managed, hospital-based ART clinic to nurse-managed primary health facility provides good outcomes cost-effective treatment for patients.
South Africa faces an epidemic of chronic non-communicable diseases (NCDs), yet national surveillance is limited due to the lack recent data. We used data from first comprehensive survey on NCDs-the African National Health and Nutrition Examination Survey (SANHANES-1 (2011-2012))-to evaluate prevalence health system response diabetes through a care cascade. defined as Hemoglobin A1c equal or above 6.5% currently treatment for diabetes. constructed cascade by categorizing population with into...
Facility-based, multimonth dispensing of antiretroviral therapy (ART) for HIV could reduce burdens on patients and providers improve retention in care. We assessed whether 6-monthly ART was non-inferior to standard care 3-monthly dispensing.We did a pragmatic, cluster-randomised, unblinded, non-inferiority trial (INTERVAL) at 30 health facilities Malawi Zambia. Eligible participants were aged 18 years or older, HIV-positive, clinically stable ART. Before randomisation, (clusters) matched the...
Retention on antiretroviral therapy (ART) during the early treatment period is one of most serious challenges facing HIV programs, but timing and patterns disengagement from care remain poorly understood. We describe engagement in first year after initiation. analysed retrospective datasets routinely collected electronic medical register (EMR) data for ≥18-year-old clients who initiated ART at public sector clinics South Africa 01/01/2018 had ≥14 months potential follow-up. Using scheduled...
Summary Objective To estimate loss to follow up (LTFU) between initial enrolment and the first scheduled return medical visit of a pre‐antiretroviral therapy (ART) care program for patients not eligible ART. Methods The study was conducted at public‐sector HIV clinic in Johannesburg. We reviewed records all newly enrolled pre‐ART yet ART January 2007 February 2008. Crude proportions completing their stratified by patient characteristics were calculated. A modified‐Poisson approach used...