A5084914479- Infectious Diseases and Tuberculosis
- Tuberculosis Research and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- Orthopedic Infections and Treatments
- Bacterial Infections and Vaccines
- Sarcoidosis and Beryllium Toxicity Research
- Mycobacterium research and diagnosis
- HIV Research and Treatment
- Diagnosis and treatment of tuberculosis
- HIV/AIDS Research and Interventions
- Fungal Infections and Studies
- Long-Term Effects of COVID-19
- Myasthenia Gravis and Thymoma
- Neuroinflammation and Neurodegeneration Mechanisms
- Antifungal resistance and susceptibility
- Peripheral Neuropathies and Disorders
- Syphilis Diagnosis and Treatment
- HIV, Drug Use, Sexual Risk
- Parkinson's Disease Mechanisms and Treatments
- HIV-related health complications and treatments
- Pharmacological Effects and Toxicity Studies
- Botulinum Toxin and Related Neurological Disorders
- Inflammasome and immune disorders
- Autoimmune Neurological Disorders and Treatments
- Infectious Encephalopathies and Encephalitis
University of Cape Town
2014-2024
Groote Schuur Hospital
2003-2023
Wellcome Centre for Infectious Diseases Research in Africa
2012-2022
University of KwaZulu-Natal
2007-2021
The Francis Crick Institute
2015
GF Jooste Hospital
2009-2012
Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) tuberculosis on COVID-19 outcomes are unknown.We conducted a population cohort study using linked data from adults attending public-sector health facilities Western Cape, South Africa. We used Cox proportional hazards models, adjusted age, sex, location, comorbidities, to examine associations between HIV, tuberculosis, 1 March 9 June 2020 among (1) "active...
TB affects around 10.6 million people each year and there are now 155 survivors. its treatments can lead to permanently impaired health wellbeing. In 2019, representatives of affected communities attending the '1st International Post-Tuberculosis Symposium´ called for development clinical guidance on these issues. This statement post-TB wellbeing responds this call builds work symposium, which brought together survivors, healthcare professionals researchers. Our document offers expert...
Vitamin D deficiency is associated with susceptibility to tuberculosis (TB) in HIV-uninfected people Europe, but it not known whether such an association exists among HIV-infected subtropical Africa. We conducted a cross-sectional study determine vitamin was active TB ( n = 196) and 174) black Africans Cape Town, South also investigated there evidence of seasonal variation status notifications this setting over 8-y period. (serum 25-hydroxyvitamin [25(OH)D] <50 nmol/L) present 232 (62.7%)...
Paradoxical neurologic tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a potentially life-threatening condition that occurs within 3 months after starting combination antiretroviral therapy (ART). The reports in the published literature are anecdotal, and prevalence outcomes of TB-IRIS unknown.We prospectively assessed patients with suspected from June 2005 through October 2007 at our hospital Cape Town, South Africa. We defined paradoxical use consensus...
Tuberculosis immune reconstitution inflammatory syndrome (IRIS) is a common cause of deterioration in human immunodeficiency virus (HIV)-infected patients receiving tuberculosis treatment after starting antiretroviral therapy (ART). Potentially life-threatening neurological involvement occurs frequently and has been suggested as reason to defer ART.We conducted prospective study HIV-infected, ART-naive with tuberculous meningitis (TBM). At presentation, started prednisone; ART was initiated...
Mycobacterium tuberculosis is a common, devastating cause of meningitis in HIV-infected persons. Due to international rollout programs, access antiretroviral therapy (ART) increasing globally. Starting patients with HIV-associated tuberculous (TBM) on ART during (TB) treatment may increase survival these patients. We undertook this study describe causes at secondary-level hospital high HIV/TB co-infection setting and determine predictors mortality TBM.A retrospective review cerebrospinal...
Tuberculous meningitis (TBM) is the most severe form of tuberculous with substantial mortality. In May 2015, 54 researchers from 10 countries met in Da Lat, Vietnam, to discuss advances TBM. Among attendees were involved pivotal studies on use Xpert MTB/Rif for TBM diagnosis. Attendees discussed 2014 World Health Organization strong recommendation favoring "in preference conventional microscopy and culture as initial diagnostic test cerebrospinal fluid (CSF) if sample volume low or...
ObjectivesTuberculous meningitis (TBM) is the severest form of tuberculosis, but current diagnostic tests are insensitive. Recent reports suggest simple modifications to conventional cerebrospinal fluid (CSF) Ziehl–Neelsen (ZN) staining may greatly improve sensitivity. We sought define performance modified and ZN stain for TBM diagnosis.MethodsIn hospitals in Vietnam, South Africa Indonesia we conducted a prospective study with or without cytospin, smear, GeneXpert, culture on CSF adults...
In 2020, it was estimated that there were 155 million survivors of TB alive, all at risk possible post disability. The 2 nd International Post-Tuberculosis Symposium (Stellenbosch, South Africa) held to increase global awareness and empower TB-affected communities play an active role in driving the agenda. We aimed update knowledge on post-TB life illness, identify research priorities, build collaborations highlight need embed lung health outcomes clinical trials programmatic care services....
Confirming the clinical suspicion of tuberculous meningitis (TBM) has always been problematic. Whilst smear and culture positivity are diagnostic, these tests have low sensitivity. The polymerase chain reaction (PCR) assay given variable results.This study attempted to improve diagnostic yield by: (a) increasing cerebrospinal fluid (CSF) volumes; (b) testing from three specimens CSF assumed represent lumbar, cervico-thoracic cord, base brain samples; (c) undertaking PCR assays using multiple...
Abstract Patients with HIV-associated tuberculosis (TB) initiating antiretroviral therapy (ART) may develop immune reconstitution inflammatory syndrome (TB-IRIS). No biomarkers for TB-IRIS have been identified and the underlying mechanisms are unclear. Here we perform transcriptomic profiling of blood samples patients TB. We identify differentially abundant transcripts as early week 0.5 post ART initiation that predict downstream activation proinflammatory cytokines in who progress to...
The immunopathogenesis of tuberculosis-associated immune reconstitution inflammatory syndrome (IRIS) remains incompletely understood, and we know only 1 disease site-specific study the underlying immunology; recently showed that Mycobacterium tuberculosis culture positivity increased neutrophils in cerebrospinal fluid (CSF) patients with tuberculous meningitis (TBM) are associated TBM-IRIS. In this investigated mediators at site TBM-IRIS.We performed lumbar puncture 3-5 time points human...
Tuberculous meningitis (TBM) is a frequent cause of in individuals with human immunodeficiency virus (HIV) infection, resulting death approximately 40% affected patients. A severe complication antiretroviral therapy (ART) these patients neurological tuberculosis-immune reconstitution inflammatory syndrome (IRIS), but its underlying remains poorly understood. To investigate the pathogenesis TBM-IRIS, we performed longitudinal whole-blood microarray analysis HIV-infected TBM and reflected...
To describe the spectrum of central nervous system (CNS) disease during first year antiretroviral therapy (ART) and to determine contribution neurological immune reconstitution inflammatory syndrome (IRIS).A prospective observational cohort study conducted over a 12-month period at public sector referral hospital in South Africa.HIV-seropositive patients who developed new or recurrent psychiatric symptom(s) sign(s) within starting ART were enrolled. We used number area preceding as...
Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in settings with high prevalence tuberculosis/human immunodeficiency virus (HIV) coinfection. However, paucity publications exists on the spectrum neurological magnetic resonance (MR) imaging findings spinal these populations.We conducted retrospective study adults at referral center South Africa for patients disease without bony involvement seen plain film radiography. We report clinical, laboratory MR findings,...
HIV cerebrospinal fluid (CSF) escape, where is suppressed in blood but detectable CSF, occurs when persists the CNS despite antiretroviral therapy (ART). To determine virus producing cell type and whether lowered CSF ART levels are responsible for we collected from 156 neurosymptomatic participants Durban, South Africa. We observed that 28% of with an undetectable viral load showed escape. detected host surface markers on envelope to cellular source first line regimen efavirenz,...
Abstract The delayed diagnosis of tuberculous meningitis (TBM) leads to poor outcomes, yet the current diagnostic methods for identifying Mycobacterium tuberculosis in cerebrospinal fluid (CSF) are inadequate. first comparative study new GeneXpert MTB/RIF Ultra (Xpert Ultra) TBM suggested increased sensitivity Xpert Ultra. Two subsequent studies have shown has improved sensitivity, but insufficient negative predictive value exclude TBM. Collecting and processing large volumes CSF...
Background. G F Jooste Hospital (GFJH) is a secondary-level referral hospital in high HIV and tuberculosis (TB) co-infection setting. Aims. To assess the proportion of significant drug-induced liver injury (DILI) due to treatment (TBT) and/or antiretroviral therapy (ART) among patients presenting with dysfunction at GFJH describe management outcomes. Methods. A retrospective observational study was performed all cases referred from 1 January 30 June 2009. Significant defined by alanine...
Background In the developing world, principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation antiretroviral therapy (ART) during TB significantly improves survival, however it not known which barriers prevent eligible from initiating life-saving ART. Method Setting. A South African township clinic with integrated and HIV services. Design. Logistic regression analyses a prospective cohort HIV-1 infected adults (≥18 years) who commenced therapy, were for ART,...