A5086596808- Adolescent Sexual and Reproductive Health
- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Reproductive tract infections research
- Pneumocystis jirovecii pneumonia detection and treatment
- Global Maternal and Child Health
- HIV/AIDS Impact and Responses
- HIV Research and Treatment
- Poverty, Education, and Child Welfare
- Tuberculosis Research and Epidemiology
- HIV-related health complications and treatments
- ICT in Developing Communities
- Reproductive Health and Contraception
- Menstrual Health and Disorders
- Pneumonia and Respiratory Infections
- Mobile Health and mHealth Applications
- Syphilis Diagnosis and Treatment
- COVID-19 Impact on Reproduction
- Cytomegalovirus and herpesvirus research
- Mental Health and Patient Involvement
- Child Development and Digital Technology
- Blood Pressure and Hypertension Studies
- SARS-CoV-2 and COVID-19 Research
- Vaccine Coverage and Hesitancy
- HIV/AIDS drug development and treatment
Biomedical Research and Training Institute
2016-2025
University of KwaZulu-Natal
2023
Centre for Sexual Health and HIV AIDS Research
2022
Murdoch University
2019
University of Zimbabwe
2006-2015
Background HIV counselling and testing is a key component of both care prevention, but uptake currently low. We investigated the impact rapid at workplace on voluntary (VCT). Methods Findings The study was cluster-randomised trial two VCT strategies, with business occupational health clinics as unit randomisation. directly offered to all employees, followed by 2 y open access basic care. Businesses were randomised either on-site their clinic (11 businesses) or vouchers for off-site chain...
To investigate HIV incidence during a trial of two voluntary counselling and testing (VCT) strategies. Counselling may promote beneficial behavioural change, although knowledge negative status does not appear to contribute further benefit.The parent cluster-randomized demonstrated much greater uptake VCT when rapid were available on-site (intensive VCT) than through pre-paid vouchers an external provider (standard VCT). Anonymous tests had been requested from all employees at enrolment after...
Background There is a substantial burden of HIV infection among older children in sub-Saharan Africa, the majority whom are diagnosed after presentation with advanced disease. We investigated provision and uptake provider-initiated testing counselling (PITC) primary health care facilities, explored worker (HCW) perspectives on providing to children. Methods Findings Children aged 6 15 y attending six clinics Harare, Zimbabwe, were offered PITC, guardian consent child assent. The reasons why...
BackgroundHIV testing is the important entry point for HIV care and prevention service, but uptake of thus coverage antiretroviral therapy are much lower in older children adolescents than adults. We investigated effect economic incentives provided to caregivers aged 8–17 years on counselling Harare, Zimbabwe.MethodsThis randomised controlled trial was nested within a household prevalence survey Harare. Households with one or more participants whose status unknown were eligible participate...
<h2>Summary</h2><h3>Background</h3> Children and adolescents have poorer HIV treatment outcomes than adults. We aimed to assess the effect of community-based support for caregivers HIV-infected children adolescents, who are key mediators engaging with care, on outcomes. <h3>Methods</h3> In this open-label, randomised contolled trial, we recruited aged 6–15 years newly-diagnosed attending primary health-care clinics in Harare, Zimbabwe. were randomly assigned receive decentralised...
Objective To assess the diagnostic value of provider-initiated symptom screening for tuberculosis (TB) and how HIV status affects it.Methods We performed a secondary analysis randomly selected participants in community-based TB-HIV prevalence survey Harare, Zimbabwe.All completed five-symptom questionnaire underwent sputum TB culture testing.We calculated sensitivity, specificity, positive negative predictive values various symptoms used regression to investigate relationship between...
Reliance on community health workers (CHWs) for HIV care continues to increase, particularly in resource-limited settings. CHWs can improve service use and adherence treatment, but effectiveness of these programmes relies providing an enabling work environment CHWs, including reasonable workload, supportive supervision adequate training supplies. Although criteria effective CHW have been identified, rarely prospectively applied design evaluation new interventions. For the Zimbabwe study...
<ns3:p><ns3:bold>Background: </ns3:bold>Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) evaluate effectiveness of community-based, integrated HIV and sexual reproductive health services youth on outcomes.</ns3:p><ns3:p> </ns3:p><ns3:p> <ns3:bold>Protocol: </ns3:bold>The CHIEDZA is being conducted in three provinces Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters)...
<ns3:p>Background Youth have poorer HIV-related outcomes when compared to other age-groups. We describe the protocol for a cluster randomised trial (CRT) evaluate effectiveness of community-based, integrated HIV and sexual reproductive health services youth on outcomes. Protocol The CHIEDZA is being conducted in three provinces Zimbabwe, each with eight geographically demarcated areas (clusters) (total 24 clusters) 1:1 standard care (existing services) or intervention. intervention comprises...
Objective To qualitatively investigate reasons why individuals who reported chronic cough of 2 weeks or more in a cross-sectional prevalence survey had not accessed community-based outreach other diagnostic services. Methods This study was nested into cluster randomised trial comparing two methods providing community-level diagnosis for tuberculosis (TB). Twenty (12 males) with previously unreported cough, because undiagnosed pulmonary TB five cases, were interviewed. An additional 20...
Introduction Children living with HIV experience particular challenges in accessing care. usually rely on adult caregivers for access to care, including timely diagnosis, initiation of treatment and sustained engagement services. The aim this study was inform the design a community‐based intervention support HIV‐positive children increase children's retention care as part programme introducing decentralized primary health facilities. Methods Using an existing conceptual framework, we...
Substantial numbers of children with HIV present to health care services in older childhood and adolescence, previously undiagnosed. These "slow-progressors" may experience considerable chronic ill health, which is not well characterized. We investigated the prevalence morbidity among aged 6-15 years at diagnosis infection.A cross-sectional study was performed 7 primary clinics Harare, Zimbabwe. Children who tested positive following provider-initiated testing counseling were recruited. A...
BackgroundThe prevalence of sexually transmitted infections (STIs) among youth is high in sub-Saharan Africa. We investigated the uptake testing for and Chlamydia trachomatis (chlamydia) Neisseria gonorrhoeae (gonorrhoea) community-based settings Zimbabwe, explored facilitators barriers to testing.MethodsThis study was nested within a cluster randomised trial delivery integrated HIV sexual reproductive health services aged 16–24 years. gonorrhoea via urine samples using Xpert CT/NG test...
Hazardous drinking (HD) and substance use (SU) can lead to disinhibited behaviour are both growing public health problems among Southern African youths. We investigated the prevalence of SU HD their association with risky sexual youth in Zimbabwe. Data analysis from a population-based survey conducted between October 2021 June 2022 ascertain outcomes cluster randomised trial (CHIEDZA: Trial registration number:NCT03719521). Stage: Post-results. 24 communities three provinces Youth aged 18-24...
Introduction Obtaining informed consent for research includes the use of information sheets, which are often long and may be difficult participants to understand. We conducted a trial investigate whether procedures using study video coupled with electronic were non-inferior standard participant sheets (PIS) among youth aged 18–24 years in Zimbabwe. Methods The was nested within an endline population-based survey cluster-randomised from October 2021 June 2022. Randomisation or paper-based at...
Affordable, easy-to-use and rapid diagnostics may support a move away from syndromic management for sexually transmitted infections (STIs) in resource-constrained settings. A lateral flow assay Neisseria gonorrhoeae (NG-LFA) has shown high sensitivity specificity (>90%) symptomatic individuals. We investigated the performance acceptability of this as screening tool NG among pregnant women. This evaluation was embedded within prospective study evaluating point-of-care STI women attending...
Genomic pathogen surveillance is a powerful tool for public health and research, but costly unachievable in low-resource settings. Most sub-genomic typing methods sacrifice resolution whilst remaining costly. We developed "Phylo-Plex", novel approach that identifies information-rich genomic regions to maximise phylogenetic information minimising the number of regions. Applied Treponema pallidum, we designed high-resolution multiplex PCR sequencing scheme lineage tracking. Using MinION...
Community Health Worker (CHW) programmes are increasingly important in HIV service delivery. CHWs' familiarity with the local context can improve intervention acceptability and sustainability but concerns have been raised about potential exploitation "burnout" of CHWs as they become emotionally involved clients' lives. Little attention has paid to what happens at end time-limited CHW interventions. This study aimed examine experience withdrawal from clients their families. We conducted a...
Objective: We previously proposed a simple tool consisting of five items to screen for risk HIV infection in adolescents (10–19 years) Zimbabwe. The objective this study is validate the performance screening children aged 6–15 years attending primary healthcare facilities Methods: Children who had not been tested underwent testing with caregiver consent. was modified include four original be appropriate younger age range, and administered. A receiver operator characteristic analysis...
Children living with HIV who are not diagnosed in infancy often remain undiagnosed until they present advanced disease. Provider-initiated testing and counselling (PITC) health facilities is recommended for high-HIV-prevalence settings, but it unclear whether this approach sufficient to achieve universal coverage of testing. We aimed investigate the change community burden infection among older children adolescents following implementation PITC Harare, Zimbabwe.Over course 2 years (January...
Background Mobile phones may help young people (YP) access health information and support service engagement. However, in low-income settings there is limited knowledge on YP’s phone internet to inform the feasibility of implementing digital interventions. Objective We investigated communication technologies among adolescents adults Zimbabwe. Methods A cross-sectional population-based survey was conducted from October December 2018 YP aged 13-24 years 5 communities urban peri-urban Harare...
Mobile technology is increasingly being used to widen access and support the delivery of public health interventions. Human immunodeficiency viruses (HIV) self-testing (HIVST) enables individuals have autonomy. We evaluated feasibility a novel application called ITHAKA HIVST among youth aged 16-24 years in Zimbabwe.
BackgroundHypertension is the greatest driver of cardiovascular mortality and onset might be in youth. We aimed to investigate prevalence risk factors for elevated blood pressure (hypertension ≥140 mm Hg systolic, ≥90 diastolic, or both) high-normal (130–139 85–89 among youth Zimbabwe.MethodsA population-based, cross-sectional survey randomly sampled aged 18–24 years from 24 urban peri-urban communities three provinces (Harare, Bulawayo, Mashonaland East) Zimbabwe was conducted between Oct...