A5090980774- Tuberculosis Research and Epidemiology
- HIV/AIDS Research and Interventions
- Pneumocystis jirovecii pneumonia detection and treatment
- Pharmaceutical studies and practices
- Adolescent Sexual and Reproductive Health
- HIV/AIDS Impact and Responses
- Adolescent and Pediatric Healthcare
- Pneumonia and Respiratory Infections
- Child and Adolescent Health
- Mental Health Treatment and Access
- HIV, Drug Use, Sexual Risk
- Immunodeficiency and Autoimmune Disorders
- Mobile Health and mHealth Applications
- Infectious Diseases and Tuberculosis
- Human Rights and Development
- Bipolar Disorder and Treatment
- Emergency and Acute Care Studies
- Early Childhood Education and Development
- Pharmaceutical Economics and Policy
- Children's Rights and Participation
- Respiratory viral infections research
- Chronic Disease Management Strategies
- Patient-Provider Communication in Healthcare
- ICT in Developing Communities
- Vaccine Coverage and Hesitancy
Stellenbosch University
2016-2025
Desmond Tutu HIV Foundation
2019-2025
Universidad de Londres
2023
University of Oxford
2023
Hadassah Medical Center
2023
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....
<sec><title>BACKGROUND</title>TB preventive treatment (TPT) prevents the development of TB disease in individuals at risk progression from infection to disease. However, implementation TPT for children is poor most high-burden settings. The long duration and pill burden 6-month once-daily isoniazid regimen (6H) pose significant barriers completion. We aimed understand children’s, caregivers’, healthcare providers’ experiences 12-week once-weekly rifapentine (3HP) using a...
BACKGROUND: Persistent respiratory symptoms and lung function deficits are common after patients with TB. We aimed to define the burden of post-TB disease (PTLD) assess associations between impairment in two high TB incidence communities.METHODS: This was a cross-sectional survey adults Cape Town, South Africa who completed treatment 1-5 years previously. Questionnaires, spirometry 6-minute walking distance (6MWD) were used relationships outcome measures associated factors.RESULTS: Of 145...
Though tuberculosis (TB)-related stigma is a recognized barrier to care, interventions are lacking, and gaps remain in understanding the drivers experiences of TB-related stigma. We undertook community-based mixed methods assessments inform intervention design.
Current antiretroviral therapy (ART) adherence monitoring is premised on patients' self-reported behaviour (prone to recall error) and verified by blood viral load measurement (which can delay results). A newly developed Urine Tenofovir Rapid Assay (UTRA) assesses tenofovir in urine at point-of-care a novel tool test immediately respond levels of people living with HIV (PLHIV). We explored PLHIV health workers' initial perceptions about integrating the UTRA into routine medical care for...
<sec id="st1"><title>BACKGROUND</title>We evaluated the palatability and acceptability of a 100 mg dispersible non-dispersible 250 levofloxacin (LVX) tablet formulation in children.</sec><sec id="st2"><title>METHODS</title>Perform was randomised, open-label, cross-over trial relative bioavailability LVX vs. crushed tablets children aged <6 years routinely receiving TB preventive treatment. Children caregivers completed Likert- ranking-type...
SETTING: We conducted a qualitative exploration into the palatability and acceptability of novel fixed-dose combination (FDC) anti-tuberculosis drug. This study was nested in SHINE (Shorter treatment for minimal TB children) trial, which compares safety efficacy treating non-severe drug-susceptible tuberculosis (TB) with 6 vs. 4 months regimen children aged 0–16 years. Participants were recruited Cape Town, South Africa. OBJECTIVE: To describe FDC rifampicin, isoniazid pyrazinamide among...
Abstract Introduction Differentiated models of care that include referral antiretroviral treatment ( ART ) clients to adherence clubs are an important strategy help clinics manage increased number living with HIV in resource‐constrained settings. This study reported on (i) clinical outcomes among attending community‐based and (ii) experiences perceptions factors key successful club implementation healthcare workers. Methods A retrospective cohort analysis routine data a descriptive collected...
BACKGROUND: South Africa has one the highest TB and HIV burdens globally. preventive therapy (TPT) reduces risk of disease TB-related mortality in adults children living with is indicated for use TB-exposed HIV-negative individuals children. TPT implementation remains suboptimal. METHODS: We conducted a pragmatic review using multiple data sources, including informant interviews ( n = 134), semi-structured observations 93) patient folder reviews 31 health facilities purposively selected...
BACKGROUND: TB preventive therapy (TPT) is critical for ending TB, yet implementation remains poor. With new global guidelines expanding TPT eligibility and regimens, we aimed to understand preferences among children, adolescents caregivers.METHODS: We undertook a discrete choice experiment 131 170 173 caregivers, conducted 17 in-depth interviews in 25 clinics Cape Town, South Africa. The design included attributes location, waiting time, treatment duration, dosing frequency,...
To describe an early-stage holistic framework towards evaluating factors that impact the overall acceptability of TB treatment along care cascade in children. We developed a conceptual utilising theory generative approach. Domains were through review existing definitions and analysis qualitative data undertaken studies Clarity domain was achieved iterative refinement among research team. Three domains, each comprising several dimensions, identified to holistically evaluate acceptability: (1)...
Tuberculosis is the number one infectious cause of death globally. Young children, generally those younger than 5 years, are at highest risk progressing from tuberculosis infection to disease and developing most severe forms tuberculosis. Most current drug formulations have poor acceptability among children require consistent adherence for prolonged periods time. These challenges complicate children’s treatment caregivers’ daily administration drugs. Rapid developments in mobile technologies...
A considerable burden of the tuberculosis (TB) epidemic is found in adolescents. The reasons for increased susceptibility to TB infection and higher incidence disease adolescence, compared with 5-10 years old age group, are incompletely understood. Despite pressing clinical public health need better understand address adolescent TB, research this field remains limited.Teen an ongoing prospective observational cohort study that aims biology, morbidity social context TB. plans recruit 50...
Drug-resistant tuberculosis (TB) is threatening global TB control. Although formulations designed for children are a priority, adult levofloxacin widely used in treatment and prevention. TB-CHAMP was cluster-randomised, placebo-controlled trial evaluating the efficacy safety of 24 weeks daily to prevent child adolescent household contacts adults with infectious multidrug-resistant TB. Nested in-depth longitudinal qualitative work conducted subset their caregivers understand broader...
The global expansion of HIV testing, prevention and treatment services is necessary to achieve epidemic control promote individual population health benefits for people living with (PLHIV) in sub-Saharan Africa. Community-based workers (CHWs) could play a key role supporting implementation at scale. In the HPTN 071 (PopART) trial Zambia South Africa, cadre 737 study-specific CHWs, working closely government-employed CHW, were deployed deliver 'universal' door-to-door package, including an...
BACKGROUND: Brazil, India and South Africa are among the top 30 high TB burden countries globally experienced rates of SARS-CoV-2 infection mortality. The COVID-19 response in each country was unprecedented complex, informed by distinct political, economic, social health systems contexts. While responses have set back control efforts, they also hold lessons to inform future programming services. METHODS: This a qualitative exploratory study involving interviews with stakeholders ( n = 76) 2...
The WHO estimates 58 million people experienced one or more TB disease episodes between 2000 and 2018. These 'former patients' are at greater risk of future infection death than naïve people. Additionally, former patients experience social, psychological, physiological difficulties after microbiological cure. Drawing on semi-structured interviews collected with 28 from communities in Zambia (n = 8) South Africa 2) October 2018 March 2019, we describe their perceptions having two episodes....
South Africa currently sustains the largest antiretroviral treatment (ART) programme in world. The number of people on ART is set to grow even more coming years as incidence remains stable, stay healthy, and guidelines for initiation become increasingly inclusive. African public health sector has relied community- home-based lay professional "carers" carry out everyday tasks rolling programme. Drawing ethnographic research one locality Western Cape, paper explores care practices two such...
Drug-resistant (DR) strains of Mycobacterium tuberculosis (M. tb) are increasingly recognised as a threat to global (TB) control efforts. Identifying people with DR-TB exposure/ infection and providing TB preventive therapy (TPT) is public health priority. guidelines advise the evaluation household contacts newly diagnosed cases, provision TPT vulnerable populations, including young children (<5 years). Many become infected through exposure in their household. Levofloxacin under exposed M....
Background: Public health programming often frames HIV status disclosure as a means to negotiate condom- and abstinence-based prevention or involve intimate partners in care garner treatment adherence support. can be used ensure viral suppression prevent onward transmission, which provides strong evidence encourage disclosure. The ideological shift towards is expected facilitate Purpose: There lack of research on how the scale-up universal testing influences practices high burden settings....
BACKGROUND: Multidrug-resistant TB (MDR-TB) treatment for children frequently includes unpalatable drugs with low overall acceptability. This can negatively impact and their caregivers´ experiences is an important contributor to poor adherence, potentially, outcomes. Children preferences MDR-TB are not well documented. We describe priorities inform future regimens.METHODS: conducted a cross-sectional qualitative study at hospital in South Africa using semi-structured interviews participatory...
The global COVID-19 pandemic has reversed many of the hard-won gains made in TB programmes and associated reduction number deaths, case notifications incidence over last three decades. Modelling estimates show that impact will be lasting. There are calls to recover shortfalls along care cascade have resulted from COVID-19, with recognition response holds lessons inform more robust comprehensive services.To explore measures two high burden South African provinces.This was an exploratory...