A5091815735- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- Adolescent Sexual and Reproductive Health
- COVID-19 epidemiological studies
- SARS-CoV-2 and COVID-19 Research
- SARS-CoV-2 detection and testing
- Global Maternal and Child Health
- HIV/AIDS Impact and Responses
- HIV/AIDS drug development and treatment
- Tuberculosis Research and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- COVID-19 Clinical Research Studies
- Health disparities and outcomes
- COVID-19 and healthcare impacts
- Mobile Health and mHealth Applications
- Sex work and related issues
- COVID-19 Impact on Reproduction
- Mycobacterium research and diagnosis
- Viral Infections and Outbreaks Research
- Influenza Virus Research Studies
- Intensive Care Unit Cognitive Disorders
- Pneumonia and Respiratory Infections
- Long-Term Effects of COVID-19
- HIV-related health complications and treatments
University of Amsterdam
2021-2025
Foundation for Innovative New Diagnostics
2022-2025
Boston University
2017-2025
Amsterdam University Medical Centers
2020-2025
Amsterdam Institute for Global Health and Development
2024-2025
University of the Witwatersrand
2017-2025
Department of Health
2024
Texas General Land Office
2024
Amsterdam UMC Location University of Amsterdam
2023
Digital Research Alliance of Canada
2023
New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended. Country decision makers must consider whether to further expand eligibility accordingly.We used multiple independent mathematical models in four settings-South Africa, Zambia, India, and Vietnam-to evaluate the potential health impact, costs, cost-effectiveness of different adult criteria under scenarios current expanded treatment...
The basic reproductive number (R0) is a function of contact rates among individuals, transmission probability, and duration infectiousness. We sought to determine the association between population density R0 SARS-CoV-2 across U.S. counties. conducted cross-sectional analysis using linear mixed models with random intercept fixed slopes assess R0, controlled for state-level effects intercepts. also assessed whether was differential county-level main mode transportation percentage as proxy...
Large-scale vaccination campaigns have prevented countless hospitalizations and deaths due to COVID-19. However, the emergence of SARS-CoV-2 variants that escape from immunity challenges effectiveness current vaccines. Given this continuing evolution, an important question is when how update vaccines antigenically match circulating variants, similarly seasonal influenza viruses where antigenic drift necessitates periodic vaccine updates. Here, we studied by assessing neutralizing activity...
Better access to tuberculosis testing is a key priority for fighting tuberculosis, the leading cause of infectious disease deaths in people. Despite roll-out molecular WHO-recommended rapid diagnostics replace sputum smear microscopy over past decade, large diagnostic gap remains. Of estimated 10·6 million people who developed globally 2022, more than 3·1 were not diagnosed. An exclusive focus on improving test accuracy alone will be sufficient close tuberculosis. Diagnostic yield, which we...
There are inefficiencies in current approaches to monitoring patients on antiretroviral therapy sub-Saharan Africa. Patients typically attend clinics every 1 3 months for clinical assessment. The clinic costs comparable with the of drugs themselves and CD4 counts measured 6 months, but rarely switched second-line therapies. To ensure sustainability treatment programmes, a transition more cost-effective delivery is needed. In contrast count, measurement level HIV RNA plasma (the viral load)...
BackgroundHIV self-testing increases testing uptake in sub-Saharan Africa but scale-up is challenging because of resource constraints. We evaluated an HIV intervention integrated into high-burden outpatient departments Malawi.MethodsIn this cluster-randomised trial, we recruited participants aged 15 years or older from at health facilities (including centres, mission hospitals, and district hospitals) central southern Malawi. The trial was clustered the facility level. used constrained...
Summary Large-scale vaccination campaigns have prevented countless hospitalizations and deaths due to COVID-19. However, the emergence of SARS-CoV-2 variants that escape from immunity challenges effectiveness current vaccines. Given this continuing evolution, an important question is when how update vaccines antigenically match circulating variants, similar seasonal influenza viruses where antigenic drift necessitates periodic vaccine updates. Here, we studied by assessing neutralizing...
The first step in SARS-CoV-2 genomic surveillance is testing to identify people who are infected. However, global rates falling as we emerge from the acute health emergency and remain low many low- middle-income countries (mean = 27 tests per 100,000 day). We simulated COVID-19 epidemics a prototypical country investigate how rates, sampling strategies sequencing proportions jointly impact outcomes, showed that spatiotemporal biases delay time detection of new variants by weeks months can...
BackgroundThere is concern over increasing prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) resistance in people initiating antiretroviral therapy (ART) low-income and middle-income countries. We assessed the effectiveness cost-effectiveness alternative public health responses countries sub-Saharan Africa where pretreatment drug to NNRTIs high.MethodsThe HIV Synthesis Model an individual-based simulation model sexual transmission, progression, effect ART adults, which...
Abstract The basic reproductive number (R 0 ) is a function of contact rates among individuals, transmission probability, and duration infectiousness. We sought to determine the association between population density R SARS-CoV-2 across U.S. counties, whether could be used as proxy for rates. conducted cross-sectional analysis using linear mixed models with random intercept fixed slopes assess . also assessed this was differential county-level main mode transportation-to-work percentage....
Many countries in Africa are scaling up differentiated service delivery (DSD) models for HIV treatment, but most existing data systems do not describe the use. We surveyed organizations that were supporting DSD 2019 Malawi, South Africa, and Zambia to diversity of being implemented at time.We interviewed model implementing descriptive information about each organization's care. described key characteristics model, including population patients served, location delivery, frequency...
BackgroundApproaches that allow easy access to pre-exposure prophylaxis (PrEP), such as over-the-counter provision at pharmacies, could facilitate risk-informed PrEP use and lead lower HIV incidence, but their cost-effectiveness is unknown. We aimed evaluate conditions under which cost-effective.MethodsWe applied a mathematical model of transmission simulate 3000 setting-scenarios reflecting range epidemiological characteristics communities in sub-Saharan Africa. The prevalence viral load...
Preexposure prophylaxis (PrEP) with tenofovir and emtricitabine can prevent new HIV-1 infections, but there is a concern that use of PrEP could increase HIV drug resistance resulting in loss treatment options. We compared standardized outcomes from three independent mathematical models simulating the impact on transmission sub-Saharan African countries.All assume people using receive an test every 3-6 months. The vary structure parameter choices for coverage, effectiveness (at different...
The aim is to determine the total annual cost per patient treated and retained on antiretroviral therapy in Zambia conventional care facilities across community-based differentiated service delivery (DSD) models.Economic evaluation was conducted using retrospective electronic record review.Twenty healthcare (13 with DSD models 7 as comparison sites) six of Zambia's 10 provinces were considered.All individuals (ART) >18 years old at study sites enrolled a model or by site type, respectively,...
Abstract Background Dexamethasone and remdesivir have the potential to reduce coronavirus disease 2019 (COVID)–related mortality or recovery time, but their cost-effectiveness in countries with limited intensive care resources is unknown. Methods We projected unit (ICU) needs capacity from August 2020 January 2021 using South African National COVID-19 Epi Model. assessed of (1) administration dexamethasone ventilated patients nonventilated patients, (2) alone both (3) only, (4) all relative...
Abstract Introduction Lesotho, the country with second‐highest HIV/AIDS prevalence (23.6%) in world, has made considerable progress towards achieving “95‐95‐95” UNAIDS targets, but recent success improving treatment access to all known HIV positive individuals severely strained existing healthcare infrastructure, financial and human resources. Lesotho also faces challenge of a largely rural population who incur significant time burden visit facilities. Using data from cluster‐randomized...
HIV is now considered a chronic condition, and people living with HIV, when treated, have similar life expectancy as compared to the general population. Consequently, improving ensuring good health-related quality of (HrQoL) among (people HIV) increasingly important has risen on global agenda in recent years. A 'fourth 90' 90% viral load suppression HrQoL should therefore be adopted alongside other 90-90-90 targets. This study aims report progress compare against population Netherlands...
Abstract Introduction Routine viral load testing is the WHO ‐recommended method for monitoring HIV ‐infected patients on ART , and many countries are rapidly scaling up capacity at centralized laboratories. Providing access to most remote populations facilities (the “last mile”) especially challenging. Using a geospatial optimization model, we estimated incremental costs of accessing 20% in Zambia by expanding transportation network required bring blood samples from clinics laboratories...
Increasing the availability of antigen rapid diagnostic tests (Ag-RDTs) in low- and middle-income countries (LMICs) is key to alleviating global SARS-CoV-2 testing inequity (median rate December 2021-March 2022 when Omicron variant was spreading multiple countries: high-income = 600 tests/100 000 people/day; LMICs 14 people/day). However, target levels effectiveness asymptomatic community screening impact transmission are unclear.