A5012574342- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- Global Maternal and Child Health
- HIV/AIDS Impact and Responses
- Poverty, Education, and Child Welfare
- Global Public Health Policies and Epidemiology
- Sex work and related issues
- Vaccine Coverage and Hesitancy
- Child Nutrition and Water Access
- HIV-related health complications and treatments
- HIV Research and Treatment
- Health disparities and outcomes
- Livestock and Poultry Management
- Mosquito-borne diseases and control
- Injury Epidemiology and Prevention
- Birth, Development, and Health
- Early Childhood Education and Development
- Syphilis Diagnosis and Treatment
- Reproductive Health and Technologies
- COVID-19 Impact on Reproduction
- Healthcare Systems and Reforms
- Viral gastroenteritis research and epidemiology
- Malaria Research and Control
- Respiratory viral infections research
World Health Organization
2023-2025
University of Cape Town
2018-2024
Epicentre (South Africa)
2018-2022
Médecins Sans Frontières
2022
Malawi Epidemiology and Intervention Research Unit
2011-2018
University of Liverpool
2016
Indepth Network
2014
African Population and Health Research Center
2014
Ministry of Health
2012
Ministry of Health
2012
The Karonga Health and Demographic Surveillance System (Karonga HDSS) in northern Malawi currently has a population of more than 35 000 individuals under continuous demographic surveillance since completion baseline census (2002–2004). system collects data on vital events migration for households. It also provides cause-specific mortality obtained by verbal autopsy all age groups, estimates rates disease specific presentations via linkage to clinical facility data. HDSS structure surveys...
Background School dropout has been linked to early pregnancy and marriage but less is known about the effect of school performance. We aimed assess whether performance influenced age at sexual debut, marriage, from what drop-out were associated with these later life events. Methods Data 2007–2016 a demographic surveillance site in northern Malawi annual updating schooling status grades, behaviour surveys, analysed associations age-specific (measured as age-for-grade) (in or out school) on...
Abstract Objective To provide a broad and up‐to‐date picture of the effect antiretroviral therapy (ART) provision on population‐level mortality in Southern East Africa. Methods Data all‐cause, AIDS non‐AIDS among 15–59 year olds were analysed from demographic surveillance sites (DSS) Karonga (Malawi), Kisesa (Tanzania), Masaka (Uganda) Africa Centre (South Africa), using Poisson regression. Trends over time up to 5 years prior ART roll‐out, 4–6 afterwards, are presented, overall by age sex....
BackgroundAs the HIV/AIDS pandemic has evolved over recent decades, Africa been most affected region, even though a large proportion of deaths have not documented at individual level. Systematic application verbal autopsy (VA) methods in defined populations provides an opportunity to assess mortality burden from data.Footnote ObjectiveTo present standardised comparisons HIV/AIDS-related sites across and Asia, including closely related causes death such as pulmonary tuberculosis (PTB)...
Background Malawi introduced pneumococcal conjugate vaccine (PCV13) and monovalent rotavirus (RV1) in 2011 2012 respectively, is planning the introduction of a second-dose measles (MV). We assessed predictors availability, uptake timeliness these vaccines rural Malawian setting. Methods Commencing on first date PCV13 eligibility we conducted prospective population-based birth cohort study 2,616 children under demographic surveillance Karonga District, northern who were eligible for PCV13, or...
To quantify refusal bias due to prior HIV testing, and its effect on prevalence estimates, in general-population surveys.Four annual, cross-sectional, house-to-house serosurveys conducted during 2006-2010 within a demographic surveillance population of 33 000 northern Malawi.The knowledge status test acceptance subsequent surveys was analysed. then estimated using ten adjustment methods, including age-standardization; multiple imputation missing data; conditional probability equations...
Abstract Objectives Developing countries are undergoing demographic transition with a shift from high mortality caused by communicable diseases (CD) to lower rates non‐communicable (NCD). HIV/AIDS has disrupted this trend in sub‐Saharan Africa. However, recent years, HIV‐associated been reduced the introduction of widely available antiretroviral therapy (ART). Side effects ART may lead increased risk cardiovascular diseases, raising prospects an accelerated towards NCD as primary cause...
The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network, http://alpha.lshtm.ac.uk/) brings together ten population-based HIV surveillance sites in eastern and southern Africa, is coordinated by the London School of Hygiene Tropical Medicine (LSHTM).It was established 2005 aims to (i) broaden evidence base epidemiology informing policy, (ii) strengthen analytical capacity research, (iii) foster collaboration between network members.All study sites, some...
Background: Despite substantial progress in antiretroviral therapy (ART) scale up, some people living with HIV (PLHIV) continue to present advanced disease, contributing ongoing HIV-related morbidity and mortality.Objective: We aimed quantify population-level estimates of from three high prevalence settings Sub-Saharan Africa.Methods: Three cross-sectional surveys were conducted (Ndhiwa (Kenya): September–November 2012), (Chiradzulu (Malawi): February–May 2013) (Eshowe (South Africa):...
Timely progression through school is an important measure for performance, completion and the onset of other life transitions adolescents. This study examines risk factors grade repetition establishes extent to which age-for-grade heterogeneity contributes subsequent at early later stages school. Using data from a demographic surveillance site in Karonga district, northern Malawi, cohort 8174 respondents (ages 5-24 years) primary was followed 2010 observed 2011. Grade more common among those...
Introduction High coverage of antiretroviral therapy (ART) in people living with HIV (PLHIV) increases viral suppression at population level and may reduce incidence. Médecins sans Frontières, collaboration the South African Department Health, has been working Eshowe/Mbongolwane (KwaZulu Natal) since 2011 to increase access quality services. Five years after an initial survey, we conducted a second survey measure progress diagnosis identify remaining gaps. Methods A cross-sectional,...
BackgroundMortality from external causes, of all kinds, is an important component overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented individual Overviews the state cause Asia therefore based uncertain information. The INDEPTH Network maintains longitudinal surveillance, including death, at population sites across which offers opportunities to document level range settings.ObjectiveTo describe patterns causes...
Introduction Ghana is working towards achieving the 95-95-95 targets for its HIV response. One challenge has been low linkage to care rates, possibly due high rates of retesting among people living with who are already aware their status. This leads an overestimation first 95 and a subsequent underestimation second 95. study aimed measure prevalence PLHIV in status explore reasons retesting. Methods was facility-based cross-sectional conducted three ecological zones Ghana. A total 11,145...
Objective The study aims to assess whether unintended children experience slower growth than intended children. Methods We analysed longitudinal data linked the Karonga Health and Demographic Surveillance Site collected over three rounds between 2008 2011 on women's fertility intentions anthropometric of Using prospective information intention we assessed are more likely be stunted applied Propensity Score Matching technique control for endogenous factors affecting both probability that a...
BackgroundWomen continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly sub-Saharan Africa and Asia. Part problem is lack accurate, population-based information characterising issues informing solutions. Population surveillance sites, such those operated within INDEPTH Network, have potential contribute bridging gaps. ObjectiveTo describe patterns pregnancy-related mortality at Network Health Demographic Surveillance System sites southeast Asia...
Background: Improved life expectancy in high HIV prevalence populations has been observed since antiretroviral therapy (ART) scale-up. However, it is unclear if the benefits are sustained, and mortality among HIV-positive individuals not (yet) on ART well described. We assessed temporal change over 9 years rural Malawi. Methods: Within a demographic surveillance site northern Malawi, we combined demographic, uptake data. calculated using Kaplan-Meier estimates, compared rates rate ratios...
Little is known about the pattern or risk factors for deaths from external causes in sub-Saharan Africa: there a lack of reliable data, and public health priorities have been focussed on other causes. This study assessed prevalence factor rural Malawi. We analysed data 2002–2012 Karonga demographic surveillance site which covers ~35,000 people northern Verbal autopsies with clinician coding are used to assign cause death. Repeated annual surveys capture socio-economic factors. Using Poisson...
Latest WHO guidelines recommend starting HIV-positive individuals on antiretroviral therapy treatment (ART) regardless of CD4 count. We assessed additional impact adopting new guidelines.We used data aged 15-59 years from three HIV population surveys conducted in 2012 (Kenya) and 2013 (Malawi South Africa). Individuals were interviewed at home followed by rapid testing if tested HIV-positive. classified as "eligible for ART" (i) had ever been initiated ART or (ii) not yet but met the...
BackgroundVerbal autopsy could be more widely used if interpretation by computer algorithm relied on. We assessed how InterVA-4 results compared with clinician review in diagnosing HIV/AIDS-related deaths over the period of antiretroviral (ART) roll-out.DesignIn Karonga Prevention Study demographic surveillance site northern Malawi, all are followed verbal using a semi-structured questionnaire. Cause death is assigned two clinicians third as tie-breaker. The diagnosis was InterVA same...
Abstract Introduction Gutu, a rural district in Zimbabwe, has been implementing comprehensive HIV care with the support of Médecins Sans Frontières (MSF) since 2011, decentralizing testing and treatment services to all healthcare facilities. We evaluated prevalence, incidence cascade care, Gutu District five years after MSF began its activities. Methods A cross‐sectional study was implemented between September December 2016. Using multistage cluster sampling, individuals aged ≥15 living...
Background: Under-five mortality is decreasing but with little change in neonatal rates. We examined the effect of maternal HIV status on under-five and cause death since widespread availability antiretroviral therapy rural Malawi. Methods: Children born 2006–2011 Karonga demographic surveillance area were included. Maternal was available from serosurveys. Age-specific rate ratios for children to HIV-positive HIV-negative mothers obtained by fitting a Poisson model accounting child...
Background Coronavirus disease 2019 (COVID-19) is caused by a virus called severe acute respiratory syndrome coronavirus. As countries struggled to control the spread of through among other measures closure health facilities, repurposing care workers, and restrictions on people's movement, HIV service delivery was affected.Objectives To assess impact COVID-19 in Zambia comparing uptake services before during COVID-19.Methods We used repeated cross-sectional quarterly monthly data testing,...
HIV-serodiscordant couples are at high risk of HIV transmission. In sub-Saharan Africa, contribute ~30% all new infections in the region.To quantify prevalence and evaluate steps cascade care among people living with serodiscordant relationships four high-prevalence settings Africa. Four surveys were conducted: Ndhiwa (Kenya) 2012, Chiradzulu (Malawi) 2013, Gutu (Zimbabwe) Nsanje 2016. Eligible individuals aged 15 - 59 years asked to participate voluntary rapid testing. Viral load CD4 counts...
Abstract Background Rapid diagnostic tests (RDT) for malaria are the primary tool diagnosis in sub-Saharan Africa but utility of most commonly used histidine-rich protein 2 (HRP2) antigen-based is limited high transmission settings due to long duration positivity after successful treatment. HRP2 also threatened by emergence Plasmodium that do not carry pfhrp or 3 genes. lactate dehydrogenase (pLDH)-based promising alternatives, less available. This study assessed performances and pLDH(pan)...
Female Sex Workers (FSWs) are a hard-to-reach and understudied population, especially those who begin selling sex at young age. In one of the most economically disadvantaged regions in Malawi, large population women is engaged work surrounding predominantly male sites transport routes. A cross-sectional study February April 2019 Nsanje district used respondent driven sampling (RDS) to recruit ≥13 years had sexual intercourse (with someone other than their main partner) exchange for money or...