A5005008137- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- COVID-19 epidemiological studies
- Adolescent Sexual and Reproductive Health
- Healthcare Systems and Reforms
- HIV/AIDS Impact and Responses
- Global Maternal and Child Health
- COVID-19 and healthcare impacts
- Healthcare Policy and Management
- HIV Research and Treatment
- Viral Infections and Outbreaks Research
- Traffic and Road Safety
- COVID-19 Clinical Research Studies
- Health and Conflict Studies
- SARS-CoV-2 and COVID-19 Research
- Injury Epidemiology and Prevention
- Census and Population Estimation
- Global Health Care Issues
- Global Public Health Policies and Epidemiology
- Wildlife Ecology and Conservation
- SARS-CoV-2 detection and testing
- Nasal Surgery and Airway Studies
- HIV-related health complications and treatments
- COVID-19 Pandemic Impacts
- Genital Health and Disease
Imperial College London
2015-2024
Medical Research Council
2020-2024
Institute for Disease Modeling
2018-2021
University of California, Berkeley
2017-2021
Bellevue Hospital Center
2018-2021
London Centre for Neglected Tropical Disease Research
2020-2021
University of California, San Francisco
2018
San Francisco General Hospital
2018
Minnesota Department of Health
2007
Cambridge University Press
1975-1977
SummaryBackgroundCOVID-19 has the potential to cause substantial disruptions health services, due cases overburdening system or response measures limiting usual programmatic activities. We aimed quantify extent which services for HIV, tuberculosis, and malaria in low-income middle-income countries with high burdens of these diseases could lead additional loss life over next 5 years.MethodsAssuming a basic reproduction number 3·0, we constructed four scenarios possible responses COVID-19...
The COVID-19 pandemic could lead to disruptions provision of HIV services for people living with and those at risk acquiring in sub-Saharan Africa, where UNAIDS estimated that more than two-thirds the approximately 38 million resided 2018. We aimed predict potential effects such on HIV-related deaths new infections Africa.In this modelling study, we used five well described models epidemics (Goals, Optima HIV, Synthesis, an Imperial College London model, Epidemiological MODeling software...
This Viewpoint discusses the challenges of accurately modeling COVID-19 pandemic and reviews principles that will make some models more useful than others, such as use granular local data when available, regular updating revision, specification uncertainty around estimates.
Abstract Objective To understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during first epidemic wave on west coast United States. Design Prospective cohort study. Setting Kaiser Permanente integrated healthcare delivery systems serving populations in northern California, southern Washington state. Participants 1840 people with a acute hospital admission for confirmed covid-19 by 22 April 2020, among 9 596 321 plan enrollees. Analyses length stay clinical...
Ideas and Opinions14 April 2020Caution Warranted: Using the Institute for Health Metrics Evaluation Model Predicting Course of COVID-19 PandemicFREENicholas P. Jewell, PhD, Joseph A. Lewnard, Britta L. PhDNicholas PhDLondon School Hygiene & Tropical Medicine, London, United Kingdom, University California, Berkeley, California (N.P.J.)Search more papers by this author, PhDUniversity (J.A.L.)Search PhDImperial College Kingdom (B.L.J.)Search authorAuthor, Article, Disclosure...
There is concern that the COVID-19 pandemic could severely disrupt HIV services in sub-Saharan Africa. However, it difficult to determine priorities for maintaining different elements of existing given widespread uncertainty.We explore impact disruptions on outcomes South Africa, Malawi, Zimbabwe, and Uganda using a mathematical model, examine how affected by model assumptions, compare potential deaths those may be caused same settings.The most important determinant HIV-related mortality an...
Abstract Introduction Geographic and transportation barriers are associated with poorer HIV ‐related health outcomes in sub‐Saharan Africa, but data on the impact of these prevention interventions limited. We estimated association between distance to clinic other transportation‐related pre‐exposure prophylaxis (Pr EP ) uptake initial visit attendance a rural community southwestern Uganda enrolled ongoing SEARCH study ( NCT 01864603). Methods Community‐wide testing was conducted offered adult...
ABSTRACT Background The United States is now the country reporting highest number of 2019 coronavirus disease (COVID-19) cases and deaths. However, little known about epidemiology burden severe COVID-19 to inform planning within healthcare systems modeling intervention impact. Methods We assessed incidence, duration hospitalization, clinical outcomes acute inpatient admissions in a prospectively-followed cohort 9,596,321 individuals enrolled comprehensive, integrated delivery plans from...
In all health-care systems, decisions need to be made regarding allocation of available resources. Evidence is needed for these decisions, especially in low-income countries. We aimed estimate how resources provided by the public sector were used Malawi during 2015-19 and effects strengthening services.
From the Introduction: The course of COVID-19 [coronavirus disease 2019] epidemic in Low- and Middle-Income Countries (LMICs) will be determined by actions that countries take coming weeks months It is clear taken to reduce size epidemic, delay, or flatten its peak, could lead substantial reductions deaths if doing so allows more patients with severe conditions benefit from supportive care hospital However, impact response it have far reaching consequences - including on other diseases,...
Introduction To be used most effectively, pre‐exposure prophylaxis (PrEP) should prioritized to those at high risk of acquisition and would ideally aligned with time periods increased exposure. Identifying such is not always straightforward, however. Gaza Province in southern Mozambique characterized by levels HIV transmission circular labour migration mines South Africa. A strong seasonal pattern births observable, reflecting an increase conception December. Given the potential for between...
<title>Abstract</title> <bold>Background: </bold>To make the best use of health resources, it is crucial to understand healthcare needs a population – including how will evolve and respond changing epidemiological context patient behaviour this compares capabilities deliver with existing workforce. Existing approaches planning either rely on using observed demand from fixed historical period or models estimate within narrow domain (e.g., specific diease area programme). A new data-grounded...
Objective To estimate the cost-effectiveness of daily oral tenofovir-based PrEP, with a protective effect against HSV-2 as well HIV-1, among HIV-1 serodiscordant couples in South Africa. Methods We incorporated acquisition, transmission, and interaction into microsimulation model heterosexual Africa, use PrEP for uninfected partner prior to ART initiation 1infected partner, one year thereafter. Results cost per disability-adjusted life-year (DALY) averted two scenarios, which has no on...
Western Kenya suffers a highly endemic and also very heterogeneous epidemic of human immunodeficiency virus (HIV). Although female sex workers (FSW) their male clients are known to be at high risk for HIV, HIV prevalence across regions in is not strongly correlated with the fraction women engaged commercial sex. An agent-based network model transmission, geographically stratified county level, was fit epidemic, scale-up interventions, populations FSW under two assumptions about potential...
Summary The numbers of deaths caused by HIV could increase substantially if the COVID-19 epidemic leads to interruptions in availability services. We compare publicly available scenarios for mortality with predicted additional HIV-related based on assumptions about possible programs. An interruption supply ART 40% those 3 months cause a number same order magnitude as that are anticipated be saved from through social distancing measures. In contrast, disruption can managed such and usage is...
Abstract Background Road traffic injuries are a significant cause of death and disability globally. However, in some countries the exact health burden caused by road is unknown. In Malawi, there no central reporting mechanism for so extent hard to determine. A limited number models predict incidence mortality due injury Malawi. These estimates vary greatly, owing differences assumptions, on population remains unclear. Methods We use an individual-based model combine epidemiological with...
Assessment of the extent civilian casualties during times conflict presents significant challenges in data collection, quantitative methods, interpretation, and presentation. In this article, we briefly consider motivation use casualty accounting review historical approaches to these questions with illustrative comments on US Civil War, World War I, II, other conflicts. We provide an overview several methodologies including excess mortality, epidemiologic surveys, direct indirect counts,...
Background: Consumable stock-outs negatively affect health outcomes not only by impeding or delaying the effective delivery of services but also discouraging patients from seeking care. Consequently, supply chain strengthening is being adopted as a key component national strategies. However, evidence on factors associated with limited.Methods: In this study, we use facility census data Malawi to identify consumables stock-outs. We estimate multilevel logistic regression model binary outcome...
Abstract Background Decisions need to be made in all healthcare systems about the allocation of available resources with aim improving population health. Evidence is needed for these decisions, which can have enormous consequences health, especially lower-income settings. Methods We address this using an individual-based simulation model and service delivery that we developed Malawi, drawing on demographic, epidemiological routine system data (on facilities, staff, consumables). compare...