A5103055692- HIV/AIDS Research and Interventions
- Global Maternal and Child Health
- HIV-related health complications and treatments
- SARS-CoV-2 and COVID-19 Research
- HIV, Drug Use, Sexual Risk
- COVID-19 epidemiological studies
- HIV/AIDS Impact and Responses
- COVID-19 Clinical Research Studies
- Autopsy Techniques and Outcomes
- HIV Research and Treatment
- Child Nutrition and Water Access
- Vaccine Coverage and Hesitancy
- HIV/AIDS drug development and treatment
- Adolescent Sexual and Reproductive Health
- Pneumocystis jirovecii pneumonia detection and treatment
- Healthcare Systems and Reforms
- Emergency and Acute Care Studies
- Food Security and Health in Diverse Populations
- Fungal Infections and Studies
- Advanced Causal Inference Techniques
- COVID-19 Pandemic Impacts
- Pregnancy and preeclampsia studies
- Healthcare cost, quality, practices
- Medical Coding and Health Information
- Cytomegalovirus and herpesvirus research
Emory University
2023-2025
South African Medical Research Council
2020-2024
University of the Witwatersrand
2020-2024
National Research Foundation
2021
Respiratory and Meningeal Pathogens Research Unit
2020
University College London
2010-2015
University of KwaZulu-Natal
2010-2015
National Institute for Communicable Diseases
2015
Institute for Security Studies
2014
Africa Health Research Institute
2011-2013
The B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified on November 25, 2021, in Gauteng province, South Africa. Data regarding the seroprevalence SARS-CoV-2 IgG before fourth wave disease 2019 (Covid-19), which omicron dominant, are needed.
When patients receive an intervention based on whether they score below or above some threshold value a continuously measured random variable, the will be randomly assigned for close to threshold. The regression discontinuity design exploits this fact estimate causal treatment effects. In spite of its recent proliferation in economics, has not been widely adopted epidemiology. We describe discontinuity, implementation, and assumptions required inference. show that is generalizable survival...
Importance The number of deaths children younger than 5 years has been steadily decreasing worldwide, from more 17 million annual in the 1970s to an estimated 5.3 2019 (with 2.8 occurring those aged 1-59 months [53% all <5 years]). More detailed characterization childhood could inform interventions improve child survival. Objective To describe causes postneonatal across 7 mortality surveillance sentinel sites Africa and Asia. Design, Setting, Participants Child Health Mortality...
To determine retention in HIV care for individuals not yet eligible antiretroviral therapy (ART) and to explore factors associated with a rural public health program.
The Child Health and Mortality Prevention Surveillance (CHAMPS) Network programme undertakes post-mortem minimally invasive tissue sampling (MITS), together with collection of ante-mortem clinical information, to investigate causes childhood deaths across multiple countries. We aimed evaluate the overall contribution pneumonia in causal pathway death causative pathogens fatal children aged 1-59 months enrolled CHAMPS Network.
Malaria is a leading cause of childhood mortality worldwide. However, accurate estimates malaria prevalence and causality among patients who die at the country level are lacking due to limited specificity diagnostic tools used attribute etiologies. Accurate crucial for prioritizing interventions resources aimed reducing malaria-related mortality.
Objective To assess whether treatment outcomes vary with age for adults receiving antiretroviral therapy (ART) in a large rural HIV cohort. Design Retrospective cohort analysis using data from public Treatment & Care Programme. Methods Adults initiating ART 1st August 2004 - 31st October 2009 were stratified by at initiation: young (16–24 years) mid-age (25–49 and older (≥50 adults. Kaplan-Meier survival was used to estimate mortality rates person-time Cox regression determine factors...
ciencies in programme performance, and viral load monitoring may provide warning of adherence problems possible development acquired antiretroviral resistance. 19o evaluate a decentralized model ART delivery rural community, we analysed the scale-up our explored trends characteristics individuals accessing treatment their outcomes within first year treatment. Methods SettingThe Hlabisa HIV Treatment Care Programme is partnership between local Department Health Africa Centre for Population...
Little is known about depression in older people sub-Saharan Africa, the associated impact of HIV, and influence on health perceptions.Examine prevalence correlates depression; explore relationship between perceptions HIV-infected -affected people.In 2010, 422 participants aged 50+ were recruited into a cross-sectional study. Nurse professionals interviewed diagnosis depressive episode was derived from Composite International Diagnostic Interview (Depression module) using Classification...
ABSTRACT Background We conducted a seroepidemiological survey from October 22 to December 9, 2021, in Gauteng Province, South Africa, determine SARS-CoV-2 immunoglobulin G (IgG) seroprevalence primarily before the fourth wave of coronavirus disease 2019 (Covid-19), which B.1.1.529 (Omicron) variant was dominant. evaluated epidemiological trends case rates and severe through January 12, 2022, Gauteng. Methods contacted households previous November 2020 plus an additional 10% using same...
Abstract Background Limitations in laboratory testing capacity undermine the ability to quantify overall burden of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Methods We undertook a population-based serosurvey for SARS-CoV-2 infection 26 subdistricts, Gauteng Province (population 15.9 million), South Africa, estimate infection, fatality rate (IFR) triangulating seroprevalence, recorded COVID-19 deaths and excess-mortality data. employed three-stage random...
Background The current burden of >5 million deaths yearly is the focus Sustainable Development Goal (SDG) to end preventable newborns and children under 5 years old by 2030. To accelerate progression toward this goal, data are needed that accurately quantify leading causes death, so interventions can target common causes. By adding postmortem pathology microbiology studies other available data, Child Health Mortality Prevention Surveillance (CHAMPS) network provides comprehensive...
Delays in illness recognition, healthcare seeking, and the provision of appropriate clinical care are common resource-limited settings. Our objective was to determine frequency delays “Three Delays-in-Healthcare”, factors associated with delays, among deceased infants children seven countries high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies medical records for aged 1–59 months who died between December 2016 February 2022 six sites...
Objectives. To explore linkage to and retention in HIV care after an episode of cryptococcal meningitis (CM) rural South Africa. Design. A retrospective case series adult individuals (≥16 years old) with laboratory-confirmed CM from January - December 2007 at Hlabisa Hospital – a district hospital northern KwaZulu-Natal. Outcome measures. Inpatient mortality associated risk factors were analysed. The proportion alive on antiretroviral therapy (ART) 2 was determined by the treatment...
South Africa remains the country with greatest burden of HIV-infected individuals and second highest estimated TB incidence per capita worldwide. Within Africa, KwaZulu-Natal has one rates an emerging epidemic drug-resistant tuberculosis.
Abstract Objective To determine rates of, and factors associated with, disengagement from care in a decentralised antiretroviral programme. Methods Adults (≥16 years) who initiated therapy ( ART ) the Hlabisa HIV Treatment Care Programme August 2004–March 2011 were included. Disengagement was defined as no clinic visit for 180 days, after adjustment mortality. Cumulative incidence functions care, stratified by year of initiation, obtained; competing‐risks regression used to explore with...
To describe and compare the health status, emotional wellbeing, functional status of older people in Uganda South Africa who are HIV infected or affected by their families.Data came from general population cohort Entebbe Medical Research Council/Uganda Virus Institute, Centre Demographic Information System through cross-sectional surveys 2009/10 using instruments adapted World Health Organization (WHO) Study on Global Ageing Adult (SAGE). Analysis was based 932 aged 50 years (510 Uganda, 422...
To explore the impact of expanded eligibility criteria for antiretroviral therapy (ART) on median CD4⁺ cell count at ART initiation and early mortality ART.Analyses included all adults (≥16 years) initiated first-line between August 2004 July 2012. threshold 350 cells per microliter was implemented in 2011. Early defined as any death within 91 days initiation. Trends baseline were examined by year (August to July) Competing risks analysis used examine mortality.A total 19,080 (67.6% female)...
Abstract Background There is paucity of information on the role cytomegalovirus (CMV) infection as a cause stillbirths or childhood deaths in low-and middle-income countries (LMICs). We investigated attribution CMV-disease causal pathway to and children <5 years age seven LMICs participating Child Health Mortality Prevention Surveillance (CHAMPS) network. Methods analyzed decedents enrolled between December 2016 July 2023. Deaths were using post-mortem minimally invasive tissue...
Healthcare and social needs for mature adults aged 50 years or older differ from those of younger due to stigma concerning HIV in people, beliefs that engagement sexual activity no longer applies, age driven comorbidities responses antiretroviral treatment, which complicate diagnosis management. In the face a growing epidemic adults, mostly infected people aging with HIV, but also new infections this group, services, cater young children, education messages interventions, mainly target leave...
Invasive Group B Streptococcus (GBS) is a common cause of early-onset neonatal sepsis and also associated with stillbirth. This study aimed to determine the proportion stillborn infants who died between 0 90 days attributable GBS using postmortem minimally invasive tissue sampling (MITS) in 7 low- middle-income countries (LMICs) participating Child Health Mortality Prevention Surveillance (CHAMPS). Deaths that occurred December 2016 2021 were investigated MITS, including culture for bacteria...
We conducted an epidemiologic survey to determine the seroprevalence of SARS-CoV-2 anti-nucleocapsid (anti-N) and anti-spike (anti-S) protein IgG from 1 March 11 April 2022 after BA.1-dominant wave had subsided in South Africa prior another dominated by BA.4 BA.5 (BA.4/BA.5) sub-lineages. also analysed trends Gauteng Province for cases, hospitalizations, recorded deaths, excess deaths were evaluated inception pandemic through 17 November 2022. Despite only 26.7% (1995/7470) individuals...
Cryptococcal meningitis (CM) remains a leading cause of death for HIV-infected individuals in sub-Saharan Africa. Improved treatment strategies are needed if to benefit from the increasing availability antiretroviral therapy. We investigated factors associated with mortality routine care KwaZulu-Natal, South Africa.A prospective year long, single-center, consecutive case series diagnosed cryptococcal 190 patients were culture positive meningitis, whom 186 included study. 52/186 (28.0%) died...
In many resource-limited settings monitoring of combination antiretroviral therapy (cART) is based on the current CD4 count, with limited access to HIV RNA tests or laboratory diagnostics. We examined whether count slope over 6 months could provide additional prognostic information.We analyzed data from a large multicohort study in South Africa, where routinely monitored. Adult HIV-positive patients initiating cART between 2003 and 2010 were included. Mortality was Cox models; by level...