A5078658414- Tuberculosis Research and Epidemiology
- Health Systems, Economic Evaluations, Quality of Life
- Global Maternal and Child Health
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV/AIDS Impact and Responses
- Adolescent Sexual and Reproductive Health
- Healthcare Systems and Reforms
- Healthcare Policy and Management
- Interprofessional Education and Collaboration
- Primary Care and Health Outcomes
- Pneumonia and Respiratory Infections
- Cervical Cancer and HPV Research
- Reproductive tract infections research
- Pharmaceutical studies and practices
- Reproductive Health and Contraception
- Pharmaceutical Economics and Policy
- Hepatitis B Virus Studies
- Maternal and Perinatal Health Interventions
- Mycobacterium research and diagnosis
- Child and Adolescent Health
- Syphilis Diagnosis and Treatment
- HIV/AIDS Research and Interventions
- Diverse Scientific Research Studies
- HIV/AIDS drug development and treatment
- Childhood Cancer Survivors' Quality of Life
University of Cape Town
2016-2025
RELX Group (United Kingdom)
2015
RELX Group (United States)
2015
In South Africa, sputum smear microscopy has been replaced with Xpert MTB/RIF as the initial diagnostic test for tuberculosis. a pragmatic parallel cluster-randomised trial, we evaluated effect on patient and programme outcomes.We randomly allocated 20 laboratories (clusters) in medium-burden districts of Africa to either an (immediate Xpert) or (Xpert deferred) group (1:1), stratified by province. At two primary care clinics per laboratory, systematic sample adults giving tuberculosis...
Social protection against the cost of illness is a central policy objective Universal Health Coverage and post-2015 Global strategy for Tuberculosis (TB). Understanding economic burden associated with TB care key to identifying appropriate interventions towards achieving this target. The aims study were identify points in patient pathways from start symptoms treatment completion where could be targeted reduce impact on patients households, those most vulnerable these costs. Two cohorts...
Abstract Purpose Estimating the incremental costs of scaling‐up novel technologies in low‐income and middle‐income countries is a methodologically challenging substantial empirical undertaking, absence routine cost data collection. We demonstrate best practice pragmatic approach to estimate new countries, using example costing scale‐up Xpert Mycobacterium tuberculosis (MTB)/resistance riframpicin (RIF) South Africa. Materials methods costs, by applying two distinct approaches bottom‐up...
<h3>Background</h3> WHO recommends isoniazid preventive therapy (IPT) for young children in close contact with an infectious tuberculosis (TB) case. No models have examined the cost effectiveness of this recommendation. <h3>Methods</h3> A decision analysis model was developed to estimate health and economic outcomes five TB infection screening strategies household contacts. In no-testing strategy, received IPT based on age reported exposure. Other included testing a tuberculin skin test...
In 2010 a new diagnostic test for tuberculosis, Xpert MTB/RIF, received conditional programmatic recommendation from WHO. Several model-based economic evaluations predicted that would be cost-effective across sub-Saharan Africa. We investigated the cost-effectiveness of in real world during national roll-out South Africa.For this real-world cost analysis and evaluation, we applied extensive primary patient event data XTEND study, pragmatic trial examining introduction people tuberculosis 40...
South Africa is one of the world's 22 high tuberculosis (TB) burden countries, with second highest number notified rifampicin-resistant TB (R(R)-TB) and multidrug-resistant (MDR-TB) cases.To estimate patient costs associated diagnosis treatment R(R)-TB/MDR-TB in Africa.Patients diagnosed accessing care at government health facilities were surveyed using a structured questionnaire. Direct indirect estimated different durations for each patient.A total 134 patients surveyed: 84 intensive phase...
The evaluation of patient-reported health-related quality life (HRQOL) in pulmonary tuberculosis (TB) contributes to a comprehensive understanding the burden associated with this disease. aim study was assess overall impact TB on health status and single domains identified WHO definition health, including physical, mental social aspects.Four instruments for HRQOL were applied longitudinal multicentre during six-month standard treatment South Africa. These included generic SF-12 EQ-5D-5L,...
The World Health Organization (WHO) recommendation for regular tuberculosis (TB) screening of HIV-positive individuals with Xpert MTB/RIF as the first diagnostic test has major resource implications.To develop a prediction model TB, symptomatic adults attending routine HIV care, to prioritise TB investigation.Cohort study exploring testing algorithm.HIV clinics, South Africa.Representative sample adult clinic attendees; data from participants reporting ≥1 symptom on WHO tool were split 50:50...
Maximising the efficiency of national tuberculosis programmes is key to improving service coverage, outcomes, and progress towards End TB targets. We aimed determine overall spending investigate associated factors in 121 low-income middle-income countries between 2010 2019.In this data envelopment stochastic frontier analysis, we used from WHO Global report series on as input treatment coverage output estimate efficiency. investigated associations 25 independent variables efficiency.We...
The treatment of chronic myeloid leukemia through tyrosine kinase inhibitors (TKIs) has achieved promising efficacy and safety outcomes, however the costs are associated with a substantial economic burden. objective this study was to develop Markov model 20-year time horizon assess cost effectiveness TKIs from public healthcare system perspective in South Africa. We constructed compare three strategies which initiated either imatinib, nilotinib, or dasatinib. Treatment switched another TKI...
In resource-limited environments, setting priorities for leukemia care becomes essential to ensure effective and efficient use of available resources. This study aimed identify the key areas services by determining their prioritization within South African healthcare system developing a set improvement research priorities. A two-round modified Delphi method was used rank management Healthcare professional experts comprised Clinical Hematologists Hematopathologists. round 1, participants...
SETTING-The cost of multidrug-resistant tuberculosis (MDR-TB) treatment is a major barrier to scale-up in South Africa.OBJECTIVE-To estimate and compare the for rifampicin-resistant (RR-TB) Africa different models care settings.DESIGN-We estimated costs with varying levels hospitalisation.These were used calculate total treating all diagnosed cases RR-TB Africa, budget impact adopting fully or partially decentralised model vs. hospitalised model. RESULTS-The was 42% more costly than (US$13...
Abstract Background The World Health Organization (WHO) recommends that the cost effectiveness of introducing human papillomavirus (HPV) vaccination is considered before such a strategy implemented. However, developing countries often lack technical capacity to perform and interpret results economic appraisals vaccines. To provide information about feasibility using models in country setting, we evaluated HPV terms their capacity, requirements, limitations comparability. Methods A literature...
The high cost of rifampicin-resistant tuberculosis (RR-TB) treatment hinders access. South Africa has a RR-TB burden, and national policy outlines decentralisation to improve access reduce costs. We analysed health system costs associated with by drug resistance profile outcome in decentralised programme.Retrospective, routinely collected patient-level data were combined unit determine for each patient cohort treated between January 2009 December 2011. Drug based on recommended regimens...
Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge many National TB Programmes, health systems, and patients. There is increasing investment the development of shortened regimens with number candidates phase 3 trials. We developed an individual-based decision analytic model to assess cost-effectiveness hypothetical four-month first-line TB, assuming non-inferiority duration. The was populated using extensive,...
Abstract Background Public-private partnerships (PPP) could be effective in scaling up services. We estimated cost and cost-effectiveness of different PPP arrangements the provision tuberculosis (TB) treatment, financing required for models from perspective provincial TB programme, provider, patient. Methods Two provider are evaluated, relative to sole public provision: public-private workplace (PWP) non-government (PNP). Cost effectiveness data were collected at six sites providing directly...
According to the World Health Organization, South Africa ranks as one of highest burden TB, TB/HIV co-infection, and drug-resistant TB (DR-TB) countries. DR-TB treatment is complicated administer relies on use multiple toxic drugs, with potential for severe adverse drug reactions. We report occurrence events (AEs) during a standardised regimen at two outpatient, decentralized, public-sector sites in Johannesburg, Africa. reviewed medical records six-month intensive phase rifampicin-resistant...
Background: Health-related quality of life (HRQOL) and adherence to treatment are two often inter-related concepts that have implications for patient management care. Tuberculosis (TB) its present a major public health concern in South Africa. The study aimed evaluate the association between HRQOL TB patients Methods: Four self-reported one measures were used an observational longitudinal multicentre during six-month standard treatment. These included generic Short-Form 12 items (SF-12)...