Cohort Profile Update: Africa Centre Demographic Information System (ACDIS) and population-based HIV survey

Gareta, Dickman; Mngomezulu, Thobeka; Smit, Theresa; Khoza, Thandeka; Nxumalo, Siyabonga; Dreyer, Jaco; Dube, Sweetness; Majozi, Nomathamsanqa; Ording-Jesperson, Gregory; Ehlers, Eugene; Harling, Guy; Shahmanesh, Maryam; Siedner, Mark J.; Hanekom, Willem A.; Herbst, Kobus

doi:10.1093/ije/dyaa264

Cited by 78 publications

(109 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The district is typical of rural South Africa, with approximately 100% of individuals of Black African descent, 58% of adults unemployed, and 66% with access to piped water in their home ( appendix 2 p 7 ). 14 The University of KwaZulu-Natal Biomedical Research Ethics Committee, the London School of Hygiene & Tropical Medicine Ethics Committee, and the Partners Institutional Review Board approved the study protocol. All participants provided informed consent.…”

Section: Methodsmentioning

confidence: 99%

Convergence of infectious and non-communicable disease epidemics in rural South Africa: a cross-sectional, population-based multimorbidity study

Modise

Bucibo

Wong

et al. 2021

The Lancet Global Health

Self Cite

View full text Add to dashboard Cite

Summary Background There has been remarkable progress in the treatment of HIV throughout sub-Saharan Africa, but there are few data on the prevalence and overlap of other significant causes of disease in HIV endemic populations. Our aim was to identify the prevalence and overlap of infectious and non-communicable diseases in such a population in rural South Africa. Methods We did a cross-sectional study of eligible adolescents and adults from the Africa Health Research Institute demographic surveillance area in the uMkhanyakude district of KwaZulu-Natal, South Africa. The participants, who were 15 years or older, were invited to participate at a mobile health camp. Medical history for HIV, tuberculosis, hypertension, and diabetes was established through a questionnaire. Blood pressure measurements, chest x-rays, and tests of blood and sputum were taken to estimate the population prevalence and geospatial distribution of HIV, active and lifetime tuberculosis, elevated blood glucose, elevated blood pressure, and combinations of these. Findings 17 118 adolescents and adults were recruited from May 25, 2018, to Nov 28, 2019, and assessed. Overall, 52·1% (95% CI 51·3–52·9) had at least one active disease. 34·2% (33·5–34·9) had HIV, 1·4% (1·2–1·6) had active tuberculosis, 21·8% (21·2–22·4) had lifetime tuberculosis, 8·5% (8·1–8·9) had elevated blood glucose, and 23·0% (22·4–23·6) had elevated blood pressure. Appropriate treatment and optimal disease control was highest for HIV (78·1%), and lower for elevated blood pressure (42·5%), active tuberculosis (29·6%), and elevated blood glucose (7·1%). Disease prevalence differed notably by sex, across age groups, and geospatially: men had a higher prevalence of active and lifetime tuberculosis, whereas women had a substantially high prevalence of HIV at 30–49 years and an increasing prevalence of multiple and poorly controlled non-communicable diseases when older than 50 years. Interpretation We found a convergence of infectious and non-communicable disease epidemics in a rural South African population, with HIV well treated relative to all other diseases, but tuberculosis, elevated blood glucose, and elevated blood pressure poorly diagnosed and treated. A public health response that expands the successes of the HIV testing and treatment programme to provide multidisease care targeted to specific populations is required to optimise health in such settings in sub-Saharan Africa. Funding Wellcome Trust, Bill & Melinda Gates Foundation, the South African Department of Science and Innovation, South African Medical Research Council, and South African Population Research Infrastructure Network. Translation For the isiZulu translation of the abstract see Supplementary Materials section.

show abstract

Section: Methodsmentioning

confidence: 99%

Convergence of infectious and non-communicable disease epidemics in rural South Africa: a cross-sectional, population-based multimorbidity study

Modise

Bucibo

Wong

et al. 2021

The Lancet Global Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…The South African Population Research Infrastructure Network (SAPRIN)—an initiative that is hosted by the South African Medical Research Council and receives long-term from the National Department of Science and Innovation—integrates three Health and Demographic Surveillance System (HDSS) nodes for population and health surveillance: (1) the Medical Research Council (MRC)/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) in Ehlanzeni district, Mpumalanga [ 34 ]; (2) the Dikgale-Mamabolo-Mothiba (DIMAMO) Population Health Research Centre in Capricorn district, Limpopo [ 35 ]; and (3) the Africa Health Research Institute (AHRI) in uMkhanyakude district, KwaZulu-Natal [ 36 ]. Other urban nodes are under development.…”

Section: Methodsmentioning

confidence: 99%

“…The [35]; and (3) the Africa Health Research Institute (AHRI) in uMkhanyakude district, KwaZulu-Natal [36]. Other urban nodes are under development.…”

Section: Study Sitementioning

confidence: 99%

Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study

Harling¹,

Gómez‐Olivé²,

Tlouyamma³

et al. 2021

JMIR Public Health Surveill

Self Cite

View full text Add to dashboard Cite

Background In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited. Objective We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave. Methods The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics: COVID-19–related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics. Results In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents’ self-reported satisfaction with their COVID-19–related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often. Conclusions South Africans complied with stringent, COVID-19–related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples’ income and access to basic services.

show abstract

“…Eligible participants were all individuals aged 15 years and older and resident within the geographic boundaries of the Africa Health Research Institute (AHRI) population intervention program surveillance area (see ref. 41 for the cohort profile). Individuals who had died or outmigrated before the surveillance visit were no longer eligible.…”

Section: Methodsmentioning

confidence: 99%

Deep learning of HIV field-based rapid tests

Turbé

Herbst

Mngomezulu

et al. 2021

Nat Med

Self Cite

View full text Add to dashboard Cite

Although deep learning algorithms show increasing promise for disease diagnosis, their use with rapid diagnostic tests performed in the field has not been extensively tested. Here we use deep learning to classify images of rapid human immunodeficiency virus (HIV) tests acquired in rural South Africa. Using newly developed image capture protocols with the Samsung SM-P585 tablet, 60 fieldworkers routinely collected images of HIV lateral flow tests. From a library of 11,374 images, deep learning algorithms were trained to classify tests as positive or negative. A pilot field study of the algorithms deployed as a mobile application demonstrated high levels of sensitivity (97.8%) and specificity (100%) compared with traditional visual interpretation by humansexperienced nurses and newly trained community health worker staff-and reduced the number of false positives and false negatives. Our findings lay the foundations for a new paradigm of deep learning-enabled diagnostics in low-and middle-income countries, termed REASSURED diagnostics 1 , an acronym for real-time connectivity, ease of specimen collection, affordable, sensitive, specific, user-friendly, rapid, equipment-free and deliverable. Such diagnostics have the potential to provide a platform for workforce training, quality assurance, decision support and mobile connectivity to inform disease control strategies, strengthen healthcare system efficiency and improve patient outcomes and outbreak management in emerging infections.Rapid diagnostic tests (RDTs) save lives by informing case management, treatment, screening, disease control and elimination programs 1 . Lateral flow tests are among the most common RDTs, and hundreds of millions of these tests are performed worldwide each year. They have the potential to support near-person testing and decentralized management of a range of clinically important diseases (including malaria, HIV, syphilis, tuberculosis, influenza and noncommunicable diseases 2 ), making it convenient for the end user and more affordable for health systems 3 . However, RDTs also present some issues, namely: errors in performing the test and interpreting the result 4,5 , quality control and lack of electronic data capture records of the test and results within health systems and surveillance. Many of these would be overcome with the real-time connectivity associated with REASSURED-the new criterion for an ideal test to reflect the importance of digital connectivity, coined by Peeling and coworkers 1 . Real-time connectivity involves the use of mobile-phone-connected RDTs. To date there have been few peer-reviewed studies or evaluations of the effectiveness of connected lateral flow tests at scale in populations in low-and middle-income countries.

show abstract

Cohort Profile Update: Africa Centre Demographic Information System (ACDIS) and population-based HIV survey

Cited by 78 publications

References 32 publications

Convergence of infectious and non-communicable disease epidemics in rural South Africa: a cross-sectional, population-based multimorbidity study

Convergence of infectious and non-communicable disease epidemics in rural South Africa: a cross-sectional, population-based multimorbidity study

Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study

Deep learning of HIV field-based rapid tests

Contact Info

Product

Resources

About