A5041701454- Reproductive Health and Contraception
- HIV/AIDS Research and Interventions
- Maternal and fetal healthcare
- Maternal and Perinatal Health Interventions
- Adolescent Sexual and Reproductive Health
- Global Maternal and Child Health
- Pregnancy and preeclampsia studies
- Sexual function and dysfunction studies
- Maternal Mental Health During Pregnancy and Postpartum
- Reproductive tract infections research
- Emergency and Acute Care Studies
- Pregnancy-related medical research
- COVID-19 epidemiological studies
- HIV-related health complications and treatments
- Cytomegalovirus and herpesvirus research
- HIV Research and Treatment
- SARS-CoV-2 and COVID-19 Research
- HIV/AIDS drug development and treatment
- Pregnancy and Medication Impact
- Hormonal and reproductive studies
- HIV, Drug Use, Sexual Risk
- COVID-19 Clinical Research Studies
- Metabolism and Genetic Disorders
- Sex work and related issues
- Trauma and Emergency Care Studies
University of the Witwatersrand
2020-2025
Walter Sisulu University
2021-2025
Western Cape Department of Health
2014-2024
South African Medical Research Council
2020-2024
University of Fort Hare
2016-2024
ECRI Institute
2023
East London NHS Foundation Trust
2023
Royal London Hospital
2023
Cecilia Makiwane Hospital
2019-2021
Frere Hospital
2021
BackgroundObservational and laboratory studies suggest that some hormonal contraceptive methods, particularly intramuscular depot medroxyprogesterone acetate (DMPA-IM), might increase women's susceptibility to HIV acquisition. We aimed compare DMPA-IM, a copper intrauterine device (IUD), levonorgestrel (LNG) implant among African women seeking effective contraception living in areas of high incidence.MethodsWe did randomised, multicentre, open-label trial across 12 research sites eSwatini,...
Delays in the detection or treatment of postpartum hemorrhage can result complications death. A blood-collection drape help provide objective, accurate, and early diagnosis hemorrhage, delayed inconsistent use effective interventions may be able to addressed by a bundle.
BackgroundReducing deaths from hypertensive disorders of pregnancy is a global priority. Low dietary calcium might account for the high prevalence pre-eclampsia and eclampsia in low-income countries. Calcium supplementation second half known to reduce serious consequences pre-eclampsia; however, effect during placentation not known. We aimed test hypothesis that before early (up 20 weeks' gestation) prevents development pre-eclampsiaMethodsWe did multicountry, parallel arm, double-blind,...
This study assesses the perceptions and acceptance of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination. It also examines its influencing factors among healthcare workers (HCWs) in Eastern Cape, South Africa.In this cross-sectional performed November December 2020, a total 1308 HCWs from two large academic hospitals participated Cape Healthcare Workers Acquisition SARS-CoV-2 (ECHAS) study. Validated measures vaccine hesitancy were explored using questionnaire. Logistic...
Abstract Background Postpartum haemorrhage (PPH) is the leading cause of global maternal deaths, accounting for 30–50% deaths in sub-Saharan Africa. Most PPH-related are preventable with timely detection and initiation care, which may be facilitated by using a clinical care bundle. We explore influences on current PPH management future implementation new bundle (E-MOTIVE) low-resource, high-burden settings. Methods Semi-structured qualitative interviews based Theoretical Domains Framework...
Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. Most PPH deaths can be avoided with timely detection and management; however, critical challenges persist. A multi-country cluster-randomised trial (E-MOTIVE) will introduce a clinical care bundle for early first-response management in hospital settings. This formative qualitative study aimed to explore healthcare providers' knowledge practices after vaginal birth, inform design implementation E-MOTIVE.
The copper intrauterine device (IUD) is under-utilised in South Africa, where injectable progestin contraception (IPC) dominates usage. There a lack of robust comparative data on these contraceptive options to inform policy, programs, clinical counseling, and women's choices. Within the context African program increase access IUD, we conducted pragmatic, open-label, parallel-arm, randomised controlled trial IUD versus IPC at two hospitals. target sample size was 7,000 women randomisation...
Background Depot medroxyprogesterone acetate (DMPA) is the most commonly used hormonal contraceptive method in South Africa. It frequently administered immediate postnatal period, yet it unclear whether affects risk of depression (PND). Aim To determine DMPA increases PND compared with copper-containing intrauterine device (IUD) when after delivery. Design and setting A single-blind randomised controlled trial conducted at two teaching hospitals East London, Methods Eligible, consenting...
Abstract Objective To compare low‐cost “Suction Tube Uterine Tamponade” (STUT) treatment for refractory postpartum hemorrhage (PPH) with uterine balloon tamponade (UBT) using a randomized feasibility study. Methods After verbal assent, we allocated participants PPH by randomly ordered envelopes to STUT or routine UBT at 10 hospitals in South Africa and one tertiary referral center Colombia between January 10, 2020, May 3, 2024. In the group, inserted 24 FG Levin stomach tube into cavity...
Abstract Objective To check the quality of oxytocin and tranexamic acid—two recommended products for prevention treatment postpartum hemorrhage (PPH)—used in facilities taking part an implementation research project to improve PPH diagnosis management. Methods Between September 2020 August 2021, acid used study Kenya, Nigeria, South Africa, Tanzania were collected transported cold storage analysis. Samples analyzed according International (oxytocin) British Pharmacopeia (tranexamic acid)...
Abstract Background Robust information on relative effects of hormonal contraceptives endogenous androgens is important for understanding beneficial and adverse effects, method choice development new methods. Methods In this ancillary study at the East London, South Africa site ECHO multicentre randomized trial, we compared three contraceptive methods serum androgen levels among users aged 18 to 35 years. Participants were allocated by centrally-managed randomization open label depot...
Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality. A new clinical intervention (E-MOTIVE) holds potential to improve early PPH detection and management. We aimed develop pilot implementation strategies support uptake this in Kenya, Nigeria, South Africa, Tanzania.
This study assesses the cumulative incidence of SARS-CoV-2 infection among healthcare workers (HCWs) during South Africa's first wave and examines associated demographic, health-related occupational risk factors for infection. Multistage cluster sampling was used in a cross-sectional to recruit 1309 HCWs from two academic hospitals Eastern Cape, Africa over 6 weeks November December 2020. Prior test results PCR participants' characteristics were recorded while blood sample drawn detection...
Background Evidence from observational studies suggests an increased risk of HIV acquisition among women using depot medroxyprogesterone acetate (DMPA) contraception. Methods Within the context a South African programme to increase women's access intrauterine contraceptive device (IUD), we conducted pragmatic, open-label, parallel-arm, randomised controlled trial (RCT) IUD versus injectable progestogen contraception (IPC) at two hospitals. The primary outcome was pregnancy; secondary...
Uterine balloon tamponade (UBT) is widely used to treat postpartum haemorrhage (PPH). Randomised trials of UBT are scarce: those improvised condom in low-resource settings found more harm than good. suction (UST) aligned with the physiological mechanism uterine haemostasis (contraction), but purpose-designed devices may be unaffordable or unavailable when needed. We describe a technique UST using an inexpensive Levin catheter. Use described as last resort three cases life-threatening PPH...
To compare the effects of depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel (LNG) implant, and copper intrauterine device (IUD) on mood sexual function.At Effective Care Research Unit in South Africa, women already randomized ECHO Trial to three methods were asked participate this study. Participants interviewed at 3 12 months after enrollment using Beck Depression Inventory Arizona Sexual Experiences Scale, WHO-5 Wellbeing Index Patient Global Impression scale.A total 605...
Postpartum haemorrhage is the leading cause of preventable maternal mortality in South Africa. In a significant breakthrough management PPH, E-MOTIVE trial found that multifaceted health service intervention reduced severe PPH after vaginal delivery by 60% 78 hospitals Nigeria, Kenya, Tanzania and SA. The approach comprises objective blood loss measurement monitored every 15 minutes during first hour to detect early trigger bundle first-line treatments, including massaging uterus, oxytocin...
Background Observational data suggest lower HIV risk with norethisterone enanthate (NET-EN) than depo-medroxyprogesterone acetate intramuscular (DMPA-IM) injectable contraceptives. If confirmed, a switch between these similar methods would be programmatically feasible and could impact the trajectory of epidemic. We aimed in this paper to investigate effects DMPA-IM NET-EN on estradiol levels, measures depression sexual activity menstrual effects, relevant risk; ascertain whether are...