A5086247381- Tuberculosis Research and Epidemiology
- HIV/AIDS Research and Interventions
- HIV/AIDS Impact and Responses
- Global Maternal and Child Health
- Bipolar Disorder and Treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV, Drug Use, Sexual Risk
- Healthcare Systems and Reforms
- Pneumonia and Respiratory Infections
- HIV Research and Treatment
- Evaluation and Performance Assessment
- Medication Adherence and Compliance
- Healthcare Policy and Management
- Child Nutrition and Water Access
- HIV/AIDS drug development and treatment
- Interprofessional Education and Collaboration
- Adolescent and Pediatric Healthcare
- Community Development and Social Impact
- Public-Private Partnership Projects
- Viral Infections and Outbreaks Research
- Health Systems, Economic Evaluations, Quality of Life
- Adolescent Sexual and Reproductive Health
- Health Policy Implementation Science
Aurum Institute
2012-2024
BackgroundThe post-2015 End TB Strategy proposes targets of 50% reduction in tuberculosis incidence and 75% mortality from by 2025. We aimed to assess whether these are feasible three high-burden countries with contrasting epidemiology previous programmatic achievements.Methods11 independently developed mathematical models transmission projected the epidemiological impact currently available interventions for prevention, diagnosis, treatment China, India, South Africa. Models were calibrated...
BackgroundThe post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality 75% 2025. We aimed to assess resource requirements cost-effectiveness strategies achieve these in China, India, South Africa.MethodsWe examined intervention scenarios developed consultation with country stakeholders, which scaled up existing interventions high but feasible coverage Nine independent modelling groups collaborated estimate policy outcomes, we estimated the cost...
This study describes the post-diagnosis care-seeking costs incurred by people living with TB and/or HIV and their households, in order to identify potential benefits of integrated care. We conducted a cross-sectional 454 participants or both public primary health care clinics Ekurhuleni North Sub-District, South Africa. collected information on visits facilities, direct indirect for guardians caregivers. define 'integration' as receipt services at same facility, day. Costs were presented...
National Tuberculosis Programmes (NTPs) require specialist input to support the development of policy and practice informed by evidence, typically against tight deadlines.To describe lessons learned from establishing a dedicated tuberculosis (TB) think tank advise South African NTP on TB policy.A national was established in evidence-informed policy. Support provided for activities, including meetings, modelling regular telephone calls, with wider network unpaid expert advisers under an...
Background: Digital adherence technologies have gained traction recently, with medication monitors showing improved in large trials China. Data on long term TB outcomes following use of digital tools is lacking.Methods: We conducted a cluster randomized trial 18 primary health clinics South Africa. measured and 18-month clinical amongst people drug-susceptible (DS-TB) supported by monitor differentiated care approach (intervention) versus standard (SoC). Adherence was calculated as days the...
Evidence on the relative costs and effects of interventions that do not consider 'real-world' constraints implementation may be misleading. However, in many low- middle-income countries, time data scarcity mean incorporating health system priority setting can challenging. We developed a 'proof concept' method to empirically estimate for inclusion model-based economic evaluations, using intensified case-finding strategies (ICF) tuberculosis (TB) South Africa as an example. As part strategic...
Mathematical models are increasingly being used to compare strategies for tuberculosis (TB) control and inform policy decisions. Models often do not consider financial other constraints on implementation may overestimate the impact that can be achieved. We developed a pragmatic approach incorporating resource into mathematical of TB. Using TB transmission model calibrated South Africa, we estimated epidemiologic requirements (financial, human (HR), diagnostic) 9 case-finding interventions....
We evaluated a novel on-site antiretroviral therapy (ART) programme in South African correctional facility using routinely collected data, from retrospective cohort of adult inmates starting ART between 03/2007 and 03/2009 followed-up to 09/2009. report (1) mortality (using survival analysis); (2) retention the (to 09/2009); (3) virological suppression at six 12 months (<400 copies/ml) following initiation. In total, 404 started (median age 33 years; 91.3% men; median baseline CD4 cell count...
Objectives The extent of the HIV epidemic in South Africa may render public sector capacity inadequate to manage all patients requiring antiretroviral treatment (ART). Private practitioners are an underutilised resource. Methods authors developed a model care using 72 private five provinces urban and rural areas with centralised clinical support, training, pharmacy control data management. describe programme, its quality measures patient outcomes cohort analysis. Results Between January 2005...
To evaluate the effect of an intervention to optimize TB/HIV integration on patient outcomes.Cluster randomised control trial at 18 primary care clinics in South Africa. The was placement a nurse (TB/HIV officer) facilitate provision integrated services, and lay health worker (TB screening TB for 24 months. Primary outcomes were i) incidence hospitalisation/death among individuals newly diagnosed with HIV, ii) iii) proportion HIV-positive who retained HIV 12 months after enrolment.Of 3328...
South Africa has the highest tuberculosis (TB) disease incidence rate in world, and TB is leading infectious cause of death. Decisions on, funding for, prevention care policies are decentralised to provincial governments therefore, tools inform policy need operate at this level. We describe use a mathematical model planning tool level high HIV burden country, estimate impact on achieving 90-(90)-90 targets Stop Partnership Global Plan End TB. “TIME Impact” freely available, user-friendly...
In South Africa, Community Caregivers (CCGs) visit households to provide basic healthcare services including those for tuberculosis and HIV. However, CCG workloads, costs, time burden are largely unknown. Our objective was assess the workloads operational costs teams operating in different settings Africa.Between March October 2018, we collected standardized self-reported activity forms from 11 pairs working at two public health clinics Ekurhuleni district, Africa. were assessed based on...
Abstract Background Each year, 1 million children develop TB resulting in over 200,000 child deaths. preventive treatment (TPT) is highly effective preventing but remains poorly implemented for household contacts. Home-based contact management and TPT services may improve access to care. In this study, we aim evaluate the effectiveness cost-effectiveness of home-based with initiation two high-burden African countries, Ethiopia South Africa. Methods This pragmatic cluster randomized trial...
Abstract Background Suboptimal adherence to tuberculosis (TB) treatment is common and puts individuals at increased risk of failure. Identifying factors for poor may help better target improve resource allocations. We assessed specific determinants adherence: HIV status; antiretroviral therapy; time clinical care access; perceived stigma, among adults with drug-sensitive TB. Methods This a secondary analysis the “TB Mate'' cluster-randomised trial, which implemented TB intervention in 18...
Objectives: Targeted universal tuberculosis (TB) testing can improve TB detection among people with HIV. This approach is being scaled up in South Africa through Xpert MTB/RIF Ultra for individuals starting antiretroviral therapy and annually thereafter. Clarity needed on how Universal may affect preventive treatment (TPT) provision, whether TPT should be delayed until ruled out. Design: State-transition microsimulation. Methods: We simulated a cohort of African patients screened while...