Research Articles (Internal Medicine)http://hdl.handle.net/2263/28182024-03-29T11:45:52Z2024-03-29T11:45:52ZHealthcare deliverySchneider, H.Kredo, T.Odendaal, W.A.Abdullah, Fareedhttp://hdl.handle.net/2263/944162024-02-09T22:47:14Z2023-02-01T00:00:00ZHealthcare delivery
Schneider, H.; Kredo, T.; Odendaal, W.A.; Abdullah, Fareed
We report here on the process and findings of a research prioritisation exercise for universal health coverage (UHC) in South Africa,
conducted during the course of 2019. As plans to roll out National Health Insurance (NHI) gather momentum and we transition into a
pandemic recovery phase, we believe that it is now time to revisit these priorities, while recognising that experiences with the COVID‑19
pandemic have revealed new system challenges and strengths and introduced new priorities. The UHC research priority-setting
methodology followed a stepwise process of collation of evidence, expert brainstorming and the development of a survey completed by
68 members of the Public Health Association of South Africa. Themes related to leadership and governance were ranked most highly, and
with other priorities generated, provide an initial road map of knowledge needs that could guide individual institutions and commissioning
by funding bodies. We further reflect on the importance of researcher-decision-maker dialogue and strengthening the contribution of
health policy and systems research to policy and practice, especially as new reforms are implemented.
2023-02-01T00:00:00ZProfile of human papillomavirus genotypes in breast and oesophageal cancer patients in Pretoria, South AfricaMaroga, N.Mokoena, TaoleMusekiwa, AlfredBida, MeshackKgomo, Mpho K.Lebelo, R.http://hdl.handle.net/2263/942012024-01-31T22:48:05Z2023-07-01T00:00:00ZProfile of human papillomavirus genotypes in breast and oesophageal cancer patients in Pretoria, South Africa
Maroga, N.; Mokoena, Taole; Musekiwa, Alfred; Bida, Meshack; Kgomo, Mpho K.; Lebelo, R.
BACKGROUND : The association between human papillomavirus (HPV) and cervical cancer is well established, and cervical cancer can be prevented through HPV vaccination. Little has been reported on the association between HPV and breast carcinoma (BC) or oesophageal squamous cell carcinoma (OSCC) in Africa. It is possible that use of appropriate HPV vaccines against genotypes responsible for these cancers may also prevent their development. OBJECTIVES : To investigate HPV genotype prevalence in BC and OSCC patients in Pretoria, South Africa (SA). METHODS : A retrospective cross-sectional study of BC and OSCC patients managed at Steve Biko Academic Hospital from 2015 to 2019 was undertaken. Patient medical records were analysed, and DNA was extracted from their archived pathology material and amplified by polymerase chain reaction before hybridisation for HPV genotypes. RESULTS : There were 101 patients with BC and 50 with OSCC. The prevalence of HPV infection in BC patients was 77.2%, with 35.6% highrisk (HR) genotypes, and that in OSCC patients 90.0%, with 56.0% HR genotypes. The most prevalent HPV genotypes (>20% each) were HPV 16, 70 and 51 for BC and HPV 51, 70, 16 and 82 for OSCC, with 31.7% and 60.0% of patients, respectively, having co-infection with ≥2 genotypes. CONCLUSION : The high prevalence of infection with multiple HPV genotypes in BC and OSCC patients, with HPV 16, 51, 70, 35 and 82 the most common genotypes in these cancers, warrants expansion of the current SA bivalent HPV 16/18 vaccine for girls to include boys, and inclusion of HPV 51, 70, 35 and 82, in order to prevent BC and OSCC as well as cervical cancer.
2023-07-01T00:00:00ZWhat are health policy and systems research priorities for universal health coverage in South Africa?Schneider, H.Kredo, T.Odendaal, W.A.Abdullah, Fareedhttp://hdl.handle.net/2263/941972024-01-31T22:48:50Z2023-02-01T00:00:00ZWhat are health policy and systems research priorities for universal health coverage in South Africa?
Schneider, H.; Kredo, T.; Odendaal, W.A.; Abdullah, Fareed
We report here on the process and findings of a research prioritisation exercise for universal health coverage (UHC) in South Africa,
conducted during the course of 2019. As plans to roll out National Health Insurance (NHI) gather momentum and we transition into a
pandemic recovery phase, we believe that it is now time to revisit these priorities, while recognising that experiences with the COVID‑19
pandemic have revealed new system challenges and strengths and introduced new priorities. The UHC research priority-setting
methodology followed a stepwise process of collation of evidence, expert brainstorming and the development of a survey completed by
68 members of the Public Health Association of South Africa. Themes related to leadership and governance were ranked most highly, and
with other priorities generated, provide an initial road map of knowledge needs that could guide individual institutions and commissioning
by funding bodies. We further reflect on the importance of researcher-decision-maker dialogue and strengthening the contribution of
health policy and systems research to policy and practice, especially as new reforms are implemented.
2023-02-01T00:00:00ZCOVID-19 severity and in-hospital mortality in an area with high HIV prevalenceBoswell, MichaelMaimela, T.C.R. (Tshegofatso)Hameiri-Bowen, DanRiley, GeorgeMalan, AlbertusSteyn, NickiettaNolutshungu, NomondeDe Villiers, Talita R.De Beer, ZeldaMathabathe, JohnTshabalala, KhanyisileAbdullah, FareedRamlall, RajievHeystek, Marthinus J.Basu, DebashisRheeder, PaulUeckermann, VeronicaVan Hougenhouck-Tulleken, W.G. (Wesley)http://hdl.handle.net/2263/941242024-02-16T11:19:11Z2023-01-27T00:00:00ZCOVID-19 severity and in-hospital mortality in an area with high HIV prevalence
Boswell, Michael; Maimela, T.C.R. (Tshegofatso); Hameiri-Bowen, Dan; Riley, George; Malan, Albertus; Steyn, Nickietta; Nolutshungu, Nomonde; De Villiers, Talita R.; De Beer, Zelda; Mathabathe, John; Tshabalala, Khanyisile; Abdullah, Fareed; Ramlall, Rajiev; Heystek, Marthinus J.; Basu, Debashis; Rheeder, Paul; Ueckermann, Veronica; Van Hougenhouck-Tulleken, W.G. (Wesley)
BACKGROUND : HIV infection causes immune dysregulation affecting T-cell and monocyte
function, which may alter coronavirus disease 2019 (COVID-19) pathophysiology.
OBJECTIVES : We investigated the associations among clinical phenotypes, laboratory
biomarkers, and hospitalisation outcomes in a cohort of people hospitalised with COVID-19 in
a high HIV prevalence area.
METHOD : We conducted a prospective observational cohort study in Tshwane, South Africa.
Respiratory disease severity was quantified using the respiratory oxygenation score. Analysed
biomarkers included inflammatory and coagulation biomarkers, CD4 T-cell counts, and HIV-1
viral loads (HIVVL).
RESULTS : The analysis included 558 patients, of whom 21.7% died during admission. The mean
age was 54 years. A total of 82 participants were HIV-positive. People living with HIV (PLWH)
were younger (mean age 46 years) than HIV-negative people; most were on antiretroviral
treatment with a suppressed HIVVL (72%) and the median CD4 count was 159 (interquartile
range: 66–397) cells/μL. After adjusting for age, HIV was not associated with increased risk of
mortality during hospitalisation (age-adjusted hazard ratio = 1.1, 95% confidence interval:
0.6–2.0). Inflammatory biomarker levels were similar in PLWH and HIV-negative patients.
Detectable HIVVL was associated with less severe respiratory disease. In PLWH, mortality
was associated with higher levels of inflammatory biomarkers. Opportunistic infections, and
other risk factors for severe COVID-19, were common in PLWH who died.
CONCLUSION : PLWH were not at increased risk of mortality and those with detectable HIVVL
had less severe respiratory disease than those with suppressed HIVVL.
DATA AVAILABILITY : Complete individual patient data and the analysis code in R are available to researchers on reasonable request from the corresponding author, M.T.B.
2023-01-27T00:00:00Z