Research Projects

SELECTED RESEARCH PROJECTS

2020-2022

The spatiotemporal trends of HIV prevalence in the southern African sub-region

This study plan to evaluate the spatiotemporal trends in HIV prevalence in southern African sub-region. We planned to use HIV and geospatial datasets obtained from the three countries’ demographic and health surveys to analyse the spatial dependence in HIV prevalence, spatial interpolation, and spatiotemporal trends. The use of geospatial coordinates in communities to map prevalence of HIV infection and exploring several additional geographic variables that are related to HIV risk is essential for understanding the HIV epidemics in these countries. Exploring the geographic variables in conjunction with behavioral and demographic characteristics is critical for improved surveillance systems in these countries. This study also has the potential for better understanding of HIV prevalence spatial patterns and will impact resource allocation for targeted public health interventions in the future.

Roles and responsibilities

Principal investigator; developed the concept for this study; produced metadata; data cleaning; formal analysis; interpretation of the data; funding acquisition; methodology; project administration; project resources; visualization; writing – original draft preparation; and writing – review & editing.


Funding

Young researchers Grant, Sub-Committee B, Stellenbosch University, South Africa.


Output

Distribution and determinants of HIV prevalence in South Africa

2020-2021

The usage and impact of insecticide treated nets in sub-Saharan Africa high burden settings

This study provided a comprehensive overview of current evidence from available primary and systematic reviews about the usage, factors associated with the use of insecticide-treated mosquito nets and the impacts of the net usage on malaria incidence in sub-Saharan African countries. The findings will help researchers, policymakers, of insecticide-treated mosquito nets manufacturers and relevant stakeholders to identify the level of usage and key factors that are critical for net use. The broad outline will also showcase the reduction in malaria cases, deaths due to malaria and the number of lives saved secondary to insecticide-treated nets.

Roles and responsibilities

Principal investigator; developed the concept for this study; protocol development; study identification and selection; data extraction; quality assessment; data synthesis; and report writing.

Funding

Vestergaard Sàrl, Switzerland.


Outputs

Undergoing peer reviewing.

2020-2021

Classification schemes of COVID-19 high risk areas and resulting policies (CSP): Evidence mapping

The policy to reduce human mobility in controlling the spread of COVID-19 especially in the initial stage of the outbreak was popular in many countries; although the relationship between mobility, policy implementation, and virus spread remains contentious. This study determined country classification schemes for high-risk COVID-19 areas and associated policies and provided clear information for the scientific community, healthcare practitioners, decision-makers, and stakeholders.

Roles and responsibilities

Co-investigator; co-developed the concept for this study; protocol development; study identification and selection; data extraction; quality assessment; data synthesis; and report writing.


Funding

Robert Koch Institute, Germany.


Outputs

Undergoing peer reviewing.

2020

Community-based interventions targeting female sex workers along the HIV care cascade in sub-Saharan Africa

This review assessed the effect of FSW-targeted community interventions on the improvement of HIV services access along the treatment cascade and described community-based interventions that positively affect continuation in HIV care across the HIV treatment cascade for FSWs in sub-Saharan Africa. This study shows that the effect of community-based interventions varies across the different stages of HIV care cascade. A broad package of interventions including a combination of behavioral, biomedical, and structural, designed with specific strategies, unique to each cascade stage appears to be more effective.

Roles and responsibilities

Co-investigator; protocol development; study identification and selection; data extraction; quality assessment; data synthesis; and report writing.

Outputs

1. Effect of community-based interventions targeting female sex workers along the HIV care cascade in sub-Saharan Africa: a systematic review and meta-analysis. Systematic Reviews. 2021;10(1):1-20. https://doi.org/10.1186/s13643-021-01688-4

2. Effect of female sex work-targeted community-based interventions along the HIV treatment cascade in sub-Saharan Africa: a systematic review protocol. BMJ Open 2020;10:e039495. https://doi.org/10.1136/bmjopen-2020-039495

2019

Implementation of community linked maternal and neonatal death review process in a South African urban community

Engaging community health workers in a formalized death review process through verbal and social

autopsy has been utilized in different settings to estimate the burden and causes of mortality, where civil registration and vital statistics systems are weak. This method has not been widely adopted. We piloted the use of trained community health workers (CHW) to investigate the extent of unreported maternal and infant deaths in Khayelitsha and explored requirements of such a program and the role of CHWs in bridging gaps. This was a mixed methods study, incorporating both qualitative and quantitative methods. CHWs can conduct verbal and social autopsy for maternal and infant deaths to complement formal vital registration systems. Capacity development, stakeholder’s engagement, supervision, and support are essential for a community-linked death review system.

Roles and responsibilities

Co-investigator; project management; data collection; data cleaning; formal analysis; interpretation of the data; methodology; visualization; writing – original draft preparation; and writing – review & editing.


Funding

mothers2mothers/Johnson & Johnson


Output

Engaging community health workers in maternal and infant death identification in Khayelitsha, South Africa: a pilot study

2016-2019

Understanding the relationship between vaccination, vaccine-preventable diseases, and HIV infection among sub-Saharan African children

This study shed light on the mediators of vaccine protection, adverse effects and fundamental aspects of the epidemiology of various vaccine-preventable diseases among HIV-infected population. It also evaluated the determinants of vaccine non-uptake, and the association between maternal HIV status and the vaccination status of HIV-exposed child. We completed evidence synthesis of existing studies and secondary analyses of existing data sets using different research methods such as systematic review, meta-analysis, meta-regression and multivariable logistic regression models. We found that the burden of vaccine-preventable diseases was still high among HIV-infected and HIV-exposed children in sub-Saharan Africa. HIV-infected children were less likely to be protected against vaccine-preventable diseases when compared to non-exposed children. Vaccination coverage for both HIV-exposed children and non-exposed children was still sub-optimal. Furthermore, individual and contextual factors such as maternal age, educational level, unemployment, and adult literacy level contributed significantly to non-uptake of DTP3 among the children of HIV-infected women across sub-Saharan Africa. Residency in communities with high unemployment was an independent predictor of acute respiratory infections among immunized and HIV-exposed children while those born to women aged 15-24 or 25-34 years old were significantly more likely to develop diarrheal diseases.


Roles and responsibilities

Principal investigator; conceptualization; produced metadata; data cleaning; formal analysis; interpretation of the data; funding acquisition; methodology; project administration; project resources; visualization; writing – original draft preparation; and writing – review & editing.

Funding

National Research Foundation, South Africa.


Outputs

1. Vaccination among HIV–infected, HIV-exposed uninfected and HIV-uninfected children: A systematic review and meta-analysis of evidence related to vaccine efficacy and effectiveness. Human Vaccines & Immunotherapeutics. 2019;15(11):2578-89. https://doi.org/10.1080/21645515.2019.1599677

2. The burden of vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa: a systematic review and meta-analysis. Human Vaccines & Immunotherapeutics. 2019; 15(11), pp.2590-2605. https://doi.org/10.1080/21645515.2019.1599676

3. Non-specific effects of childhood vaccines on acute childhood morbidity among HIV-exposed children in sub-Saharan Africa: a multilevel analysis. Human Vaccines & Immunotherapeutics. 2018;14(10):2382-2390. https://doi.org/10.1080/21645515.2018.1516490

4. Morbidity benefit conferred by childhood immunisation in relation to maternal HIV status: a meta-analysis of demographic and health surveys. Human Vaccines & Immunotherapeutics. 2018;14(10):2414-2426. https://doi.org/10.1080/21645515.2018.1515453

5. Non-uptake of childhood vaccination among the children of HIV-infected mothers in sub-Saharan Africa: A multilevel analysis. Human Vaccines & Immunotherapeutics. 2018;14(10):2405-2413. https://doi.org/10.1080/21645515.2018.1502524

6. Effect of maternal HIV status on vaccination coverage among sub-Saharan African children: A socio-ecological analysis. Human Vaccines & Immunotherapeutics. 2018;14(10):2373-2381. https://doi.org/10.1080/21645515.2018.1467204

7. Children and HIV: what we found about vaccine-preventable diseases. The Conversation. December 2019. https://theconversation.com/children-and-hiv-what-we-found-about-vaccine-preventable-diseases-127838

8. Non-uptake of Childhood Vaccination among the Children of HIV-infected Mothers in Sub-Saharan Africa: A Multilevel Analysis. The Communication Initiative Network. August 2019. https://www.comminit.com/hiv-aids-africa/content/non-uptake-childhood-vaccination-among-children-hiv-infected-mothers-sub-saharan-africa-

The burden of vaccine-preventable diseases among sub-Saharan African HIV-infected children

2017

Systematic reviews on effectiveness and safety of bacille Calmette-Guerin vaccine


Roles and responsibilities

Co-investigator; protocol development; study identification and selection; data extraction; quality assessment; data synthesis; and report writing.


Outputs

1. Report on BCG vaccine use for protection against mycobacterial infections including tuberculosis, leprosy, and other nontuberculous mycobacteria (NTM) infections. Prepared by the SAGE Working Group on BCG Vaccines and WHO Secretariat. September 2017. https://www.who.int/immunization/sage/meetings/2017/october/1_BCG_report_revised_version_online.pdf

2. Systematic review on safety of BCG vaccination. World Health Organization commissioned report. September 2017.

3. Systematic review on efficacy and effectiveness of BCG vaccination. World Health Organization commissioned report. September 2017.


Funding

World Health Organization

Outputs

Other outputs

1. Systematic review on safety of BCG vaccination. World Health Organization commissioned report. September 2017.

2. Systematic review on efficacy and effectiveness of BCG vaccination. World Health Organization commissioned report. September 2017.

WHO report on BCG vaccine use

2015-2016

South-to-South eMTCT Quality Improvement Collaborative

South Africa has made substantial improvements in prevention of mother-to-child transmission (PMTCT) services in South Africa as demonstrated by a reduction in vertical transmission in the recent past. We describe impact and determinants for successful implementation of a quality improvement collaborative (QIC) approach as a method to accelerate the achievements of elimination of mother-to-child transmission (eMTCT) goals in South Africa. In partnership with the Department of Health, we implemented a QIC in 55 health facilities in three provinces over two phases. The collaborative approach achieved rapid improvements in eMTCT programme outcomes in a wide range of facilities across South Africa. Performance variability may be attributed to contextual, organizational and system factors.


Roles and responsibilities

Co-investigator; field work; data collection; data synthesis; and report writing.


Funding

USAID/PEPFAR


Outputs

1. Chirowodza A, Williams D, Diergaardt C, Adetokunboh O. et al. The effectiveness of a quality improvement collaborative to accelerate elimination of mother to child transmission (eMTCT): key outcomes and determinants from a demonstration phase collaborative implemented in South Africa, 2012-2015. Journal of the International Aids Society. 2016 Jul 1 (Vol. 19). https://onlinelibrary.wiley.com/doi/epdf/10.7448/IAS.19.6.21264

SOME OTHER VITAL PROJECTS

  1. HIV testing and counselling among South African female adolescents and young women. 2022 - 2023. Co-Investigator

  2. Investigating social and structural determinants of health inequities in HIV prevention and care among farmworkers in South Africa. 2021 - 2024. Co-Investigator

  3. Male partner unknown HIV status’ -risk factor for HIV incidence and clinical outcomes in PMTCT programmes in Africa. 2021 - 2022. Co-Investigator

  4. Missed opportunities for vaccination in Africa. 2021. Co-Investigator

  5. African based researchers’ output on models for the transmission dynamics of infectious diseases and public health interventions. 2019 - 2021. Principal Investigator

  6. Predictors of post-operative outcomes in patients with peripheral arterial disease and critical limb ischaemia: a systematic review and meta-analysis. 2016 - 2019. Co-Investigator

  7. The Impact of Rubella Vaccine Introduction on Rubella Infection and Congenital Rubella Syndrome

Implications of COVID-19 in high burden countries for HIV/TB. 2016 - 2019. Co-Investigator

  1. Projected early spread of COVID-19 in Africa through 1 June 2020. 2020. Co-Investigator

  2. Immunogenicity and safety of fractional dose yellow fever vaccination. 2018 - 2019. Co-Investigator

  3. A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria. 2018 - 2019. Co-Investigator

  4. Children who have received no routine polio vaccines in Nigeria: Who are they and where do they live? 2017. Co-Investigator

  5. Shifting tasks from pharmacy to non-pharmacy personnel for providing antiretroviral therapy to people living with HIV. 2015 - 2018. Co-Investigator

  6. Eliminating mother-to-child transmission of the human immunodeficiency virus in sub-Saharan Africa: The journey so far and what remains to be done. 2013 - 2015. Principal Investigator

  7. Community-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Middle- and Low-Income Countries. 2015 - 2016. Co-Investigator

  8. Efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV infected children and adolescents. 2013 - 2015. Principal Investigator

  9. Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children. 2015 - 2017. Principal Investigator