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103. Omicron extensively but incompletely escapes Pfizer BNT162b2 neutralization

Author

Cele, Sandile, Jackson, Laurelle, Khoury, David S., Khan, Khadija, Moyo-Gwete, Thandeka, Tegally, Houriiyah, San, James Emmanuel, Cromer, Deborah, Scheepers, Cathrine, Amoako, Daniel G., Karim, Farina, Bernstein, Mallory, Lustig, Gila, Archary, Derseree, Smith, Muneerah, Ganga, Yashica, Jule, Zesuliwe, Reedoy, Kajal, Hwa, Shi Hsia, Giandhari, Jennifer, Blackburn, Jonathan M., Gosnell, Bernadett I., Abdool Karim, Salim S., Hanekom, Willem, Davies, Mary Ann, Hsiao, Marvin, Martin, Darren, Mlisana, Koleka, Wibmer, Constantinos Kurt, Williamson, Carolyn, York, Denis, Harrichandparsad, Rohen, Herbst, Kobus, Jeena, Prakash, Khoza, Thandeka, Kløverpris, Henrik, Leslie, Alasdair, Madansein, Rajhmun, Magula, Nombulelo, Manickchund, Nithendra, Marakalala, Mohlopheni, Mazibuko, Matilda, Moshabela, Mosa, Mthabela, Ntombifuthi, Naidoo, Kogie, Ndhlovu, Zaza, Ndung’u, Thumbi, Ngcobo, Nokuthula, Nyamande, Kennedy, and Patel, Vinod

Subjects
Multidisciplinary
Abstract

The emergence of the SARS-CoV-2 variant of concern Omicron (Pango lineage B.1.1.529), first identified in Botswana and South Africa, may compromise vaccine effectiveness and lead to re-infections1. Here we investigated Omicron escape from neutralization by antibodies from South African individuals vaccinated with Pfizer BNT162b2. We used blood samples taken soon after vaccination from individuals who were vaccinated and previously infected with SARS-CoV-2 or vaccinated with no evidence of previous infection. We isolated and sequence-confirmed live Omicron virus from an infected person and observed that Omicron requires the angiotensin-converting enzyme 2 (ACE2) receptor to infect cells. We compared plasma neutralization of Omicron relative to an ancestral SARS-CoV-2 strain and found that neutralization of ancestral virus was much higher in infected and vaccinated individuals compared with the vaccinated-only participants. However, both groups showed a 22-fold reduction in vaccine-elicited neutralization by the Omicron variant. Participants who were vaccinated and had previously been infected exhibited residual neutralization of Omicron similar to the level of neutralization of the ancestral virus observed in the vaccination-only group. These data support the notion that reasonable protection against Omicron may be maintained using vaccination approaches.

Published
2021

107. Higher mortality associated with the SARS-CoV-2 Delta variant in the Western Cape, South Africa, using RdRp target delay as a proxy: a cross-sectional study.

Author

Hussey, Hannah, primary, Davies, Mary-Ann, additional, Heekes, Alexa, additional, Williamson, Carolyn, additional, Valley-Omar, Ziyaad, additional, Hardie, Diana, additional, Korsman, Stephen, additional, Doolabh, Deelan, additional, Preiser, Wofgang, additional, Maponga, Tongai, additional, Iranzadeh, Arash, additional, Engelbrecht, Susan, additional, Wasserman, Sean, additional, Schrueder, Neshaad, additional, Boloko, Linda, additional, Symons, Greg, additional, Raubenheimer, Peter, additional, Viljoen, Abraham, additional, Parker, Arifa, additional, Cohen, Cheryl, additional, Jasat, Waasila, additional, Lessells, Richard, additional, Wilkinson, Robert J, additional, Boulle, Andrew, additional, and Hsiao, Marvin, additional

Published
2022
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109. The epidemiological and clinical characteristics of COVID-19 in a high HIV/TB burden district level hospital setting

Author

Mnguni, Ayanda Trevor, primary, Schietekat, Denzil, additional, Ebrahim, Nabilah, additional, Sonday, Nawhaal, additional, Boliter, Nicholas, additional, Schrueder, Neshaad, additional, Gabriels, Shiraaz, additional, Sigwadhi, Lovemore N., additional, Zemlin, Annalise E., additional, Chapanduka, Zivanai C., additional, Ngah, Vera, additional, Yalew, Anteneh, additional, Jalavu, Thumeka, additional, Abdullah, Ibtisam, additional, Tamuzi, Jacques L., additional, London, Leslie, additional, Naledi, Tracey, additional, Tembo, Yamanya, additional, Davies, Mary-Ann, additional, Nyasulu, Peter S., additional, and English, Rene, additional

Published
2022
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110. Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa

Author

Davies, Mary-Ann, primary, Morden, Erna, additional, Rosseau, Petro, additional, Arendse, Juanita, additional, Bam, Jamy-Lee, additional, Boloko, Linda, additional, Cloete, Keith, additional, Cohen, Cheryl, additional, Chetty, Nicole, additional, Dane, Pierre, additional, Heekes, Alexa, additional, Hsiao, Nei-Yuan, additional, Hunter, Mehreen, additional, Hussey, Hannah, additional, Jacobs, Theuns, additional, Jassat, Waasila, additional, Kariem, Saadiq, additional, Kassanjee, Reshma, additional, Laenen, Inneke, additional, Roux, Sue Le, additional, Lessells, Richard, additional, Mahomed, Hassan, additional, Maughan, Deborah, additional, Meintjes, Graeme, additional, Mendelson, Marc, additional, Mnguni, Ayanda, additional, Moodley, Melvin, additional, Murie, Katy, additional, Naude, Jonathan, additional, Ntusi, Ntobeko A. B., additional, Paleker, Masudah, additional, Parker, Arifa, additional, Pienaar, David, additional, Preiser, Wolfgang, additional, Prozesky, Hans, additional, Raubenheimer, Peter, additional, Rossouw, Liezel, additional, Schrueder, Neshaad, additional, Smith, Barry, additional, Smith, Mariette, additional, Solomon, Wesley, additional, Symons, Greg, additional, Taljaard, Jantjie, additional, Wasserman, Sean, additional, Wilkinson, Robert J., additional, Wolmarans, Milani, additional, Wolter, Nicole, additional, and Boulle, Andrew, additional

Published
2022
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111. Clinical severity of SARS-CoV-2 Omicron BA.4 and BA.5 lineages in South Africa

Author

Wolter, Nicole, primary, Jassat, Waasila, additional, Walaza, Sibongile, additional, Welch, Richard, additional, Moultrie, Harry, additional, Groome, Michelle, additional, Amoako, Daniel, additional, Everatt, Josie, additional, Bhiman, Jinal, additional, Scheepers, Cathrine, additional, Tebeila, Naume, additional, Chiwandire, Nicola, additional, du Plessis, Mignon, additional, Govender, Nevashan, additional, Ismail, Arshad, additional, Glass, Allison, additional, Mlisana, Koleka, additional, Stevens, Wendy, additional, Treurnicht, Florette, additional, Subramoney, Kathleen, additional, Makatini, Zinhle, additional, Hsiao, Marvin, additional, Parboosing, Raveen, additional, Wadula, Jeanette, additional, Hussey, Hannah, additional, Davies, Mary-Ann, additional, Boulle, Andrew, additional, von Gottberg, Anne, additional, and Cohen, Cheryl, additional

Published
2022
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112. Evaluation of a Public COVID-19 Dashboard in the Western Cape, South Africa: a tool for communication, trust, and transparency

Author

Ismail, Muzzammil, primary, Morden, Erna, additional, Hussey, Hannah, additional, Paleker, Masudah, additional, Jacobs, Theuns, additional, Laenen, Inneke, additional, Hunter, Mehreen, additional, Moodley, Melvin, additional, Smith, Mariette, additional, Mutemaringa, Themba, additional, Bam, Jamy-Lee, additional, Dane, Pierre, additional, Heekes, Alexa, additional, Boulle, Andrew, additional, and Davies, Mary-Ann, additional

Published
2022
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113. Cohort profile: the Western Cape Pregnancy Exposure Registry (WCPER)

Author

Kalk, Emma, primary, Heekes, Alexa, additional, Slogrove, Amy L, additional, Phelanyane, Florence, additional, Davies, Mary-Ann, additional, Myer, Landon, additional, Euvrard, Jonathan, additional, Kroon, Max, additional, Petro, Greg, additional, Fieggen, Karen, additional, Stewart, Chantal, additional, Rhoda, Natasha, additional, Gebhardt, Stefan, additional, Osman, Ayesha, additional, Anderson, Kim, additional, Boulle, Andrew, additional, and Mehta, Ushma, additional

Published
2022
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115. Effect of antiretroviral therapy care interruptions on mortality in children living with HIV: cohort study from Southern Africa

Author

Davies, Claire, Johnson, Leigh, Sawry, Shobna, Chimbetete, Cleophas, Eley, Brian, Vinikoor, Michael, Technau, Karl-G��nter, Ehmer, Jochen, Rabie, Helena, Phiri, Sam, Tanser, Frank, Malisita, Kennedy, Fatti, Geoffrey, Osler, Meg, Wood, Robin, Newton, Sam, Haas, Andreas, and Davies, Mary-Ann

Subjects
Adolescent, Databases, Factual, Anti-HIV Agents, Humans, HIV Infections, 610 Medicine & health, Child, 360 Social problems & social services, Article, Africa, Southern, Proportional Hazards Models
Abstract

OBJECTIVE To evaluate the characteristics and outcomes of HIV-infected children that have care interruptions, during which the child's health status and use of medication is unknown. DESIGN We included data on children initiating ART between 2004 and 2016 at 180���days. Children had a care interruption if they were classified as LTFU, and subsequently returned to care. Children who died within 180���days of ART start were excluded. METHODS The main outcome was all cause mortality. Two exposed groups were considered: those with a first care interruption within the first six months on ART, and those with a first care interruption after six months on ART. Adjusted hazard ratios were determined using a Cox regression model. RESULTS Among 53,674 children included, 23,437 (44%) had a care interruption, of which 10,629 (20%) had a first care interruption within six months on ART and 12,808 (24%) had a first care interruption after six months on ART. Increased mortality was associated with a care interruption within six months on ART (adjusted hazard ratio (AHR) = 1.52, 95% CI 1.12-2.04) but not with a care interruption after six months on ART (AHR = 1.05, 95% CI 0.77-1.44). CONCLUSIONS The findings suggest that strengthening retention of children in care in the early period after ART initiation is critical to improving paediatric ART outcomes.

Published
2022

116. Standardized Definitions of In Utero Human Immunodeficiency Virus and Antiretroviral Drug Exposure Among Children

Author

Slogrove, Amy A.L., Burmen, Barbara, Davies, Mary Ann, Edmonds, Andrew, Abrams, Elaine E.J., Chadwick, Ellen E.G., Goetghebuer, Tessa, Mofenson, Lynne L.M., Paul, Mary Elizabeth, Thorne, Claire, Williams, Paige P.L., Vicari, Marissa, Powis, Kathleen K.M., Slogrove, Amy A.L., Burmen, Barbara, Davies, Mary Ann, Edmonds, Andrew, Abrams, Elaine E.J., Chadwick, Ellen E.G., Goetghebuer, Tessa, Mofenson, Lynne L.M., Paul, Mary Elizabeth, Thorne, Claire, Williams, Paige P.L., Vicari, Marissa, and Powis, Kathleen K.M.

Abstract

In countries with high human immunodeficiency virus (HIV) prevalence, up to 30% of pregnant women are living with HIV, with fetal exposure to both HIV and antiretroviral therapy during pregnancy. In addition, pregnant women without HIV but at high risk of HIV acquisition are increasingly receiving HIV preexposure antiretroviral prophylaxis (PrEP). Investments are being made to establish and follow cohorts of children to evaluate the long-term effects of in utero HIV and antiretroviral exposure. Agreement on a key set of definitions for relevant exposures and outcomes is important both for interpreting individual study results and for comparisons across cohorts. Harmonized definitions of in utero HIV and antiretroviral drug (maternal treatment or PrEP) exposure will also facilitate improved classification of these exposures in future observational studies and clinical trials. The proposed definitions offer a uniform approach to facilitate the consistent description and estimation of effects of HIV and antiretroviral exposures on key child health outcomes., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2022

117. Omicron extensively but incompletely escapes Pfizer BNT162b2 neutralization

Author

Cele, Sandile, Jackson, Laurelle, Khoury, David S., Khan, Khadija, Moyo-Gwete, Thandeka, Tegally, Houriiyah, San, James Emmanuel, Cromer, Deborah, Scheepers, Cathrine, Amoako, Daniel G., Karim, Farina, Bernstein, Mallory, Lustig, Gila, Archary, Derseree, Smith, Muneerah, Ganga, Yashica, Jule, Zesuliwe, Reedoy, Kajal, Hwa, Shi Hsia, Giandhari, Jennifer, Blackburn, Jonathan M., Gosnell, Bernadett I., Abdool Karim, Salim S., Hanekom, Willem, Davies, Mary Ann, Hsiao, Marvin, Martin, Darren, Mlisana, Koleka, Wibmer, Constantinos Kurt, Williamson, Carolyn, York, Denis, Harrichandparsad, Rohen, Herbst, Kobus, Jeena, Prakash, Khoza, Thandeka, Kløverpris, Henrik, Leslie, Alasdair, Madansein, Rajhmun, Magula, Nombulelo, Manickchund, Nithendra, Marakalala, Mohlopheni, Mazibuko, Matilda, Moshabela, Mosa, Mthabela, Ntombifuthi, Naidoo, Kogie, Ndhlovu, Zaza, Ndung’u, Thumbi, Ngcobo, Nokuthula, Nyamande, Kennedy, Patel, Vinod, Cele, Sandile, Jackson, Laurelle, Khoury, David S., Khan, Khadija, Moyo-Gwete, Thandeka, Tegally, Houriiyah, San, James Emmanuel, Cromer, Deborah, Scheepers, Cathrine, Amoako, Daniel G., Karim, Farina, Bernstein, Mallory, Lustig, Gila, Archary, Derseree, Smith, Muneerah, Ganga, Yashica, Jule, Zesuliwe, Reedoy, Kajal, Hwa, Shi Hsia, Giandhari, Jennifer, Blackburn, Jonathan M., Gosnell, Bernadett I., Abdool Karim, Salim S., Hanekom, Willem, Davies, Mary Ann, Hsiao, Marvin, Martin, Darren, Mlisana, Koleka, Wibmer, Constantinos Kurt, Williamson, Carolyn, York, Denis, Harrichandparsad, Rohen, Herbst, Kobus, Jeena, Prakash, Khoza, Thandeka, Kløverpris, Henrik, Leslie, Alasdair, Madansein, Rajhmun, Magula, Nombulelo, Manickchund, Nithendra, Marakalala, Mohlopheni, Mazibuko, Matilda, Moshabela, Mosa, Mthabela, Ntombifuthi, Naidoo, Kogie, Ndhlovu, Zaza, Ndung’u, Thumbi, Ngcobo, Nokuthula, Nyamande, Kennedy, and Patel, Vinod

Abstract

The emergence of the SARS-CoV-2 variant of concern Omicron (Pango lineage B.1.1.529), first identified in Botswana and South Africa, may compromise vaccine effectiveness and lead to re-infections1. Here we investigated Omicron escape from neutralization by antibodies from South African individuals vaccinated with Pfizer BNT162b2. We used blood samples taken soon after vaccination from individuals who were vaccinated and previously infected with SARS-CoV-2 or vaccinated with no evidence of previous infection. We isolated and sequence-confirmed live Omicron virus from an infected person and observed that Omicron requires the angiotensin-converting enzyme 2 (ACE2) receptor to infect cells. We compared plasma neutralization of Omicron relative to an ancestral SARS-CoV-2 strain and found that neutralization of ancestral virus was much higher in infected and vaccinated individuals compared with the vaccinated-only participants. However, both groups showed a 22-fold reduction in vaccine-elicited neutralization by the Omicron variant. Participants who were vaccinated and had previously been infected exhibited residual neutralization of Omicron similar to the level of neutralization of the ancestral virus observed in the vaccination-only group. These data support the notion that reasonable protection against Omicron may be maintained using vaccination approaches.

Published
2022

122. Has the phasing out of stavudine in accordance with changes in WHO guidelines led to a decrease in single-drug substitutions in first-line antiretroviral therapy for HIV in sub-Saharan Africa?

Author

Brennan, Alana T., Davies, Mary-Ann, Bor, Jacob, Wandeler, Gilles, Stinson, Kathryn, Wood, Robin, Prozesky, Hans, Tanser, Frank, Fatti, Geoffrey, Boulle, Andrew, Sikazwe, Izukanji, Wools-Kaloustian, Kara, Yiannoutsos, Constantin, Leroy, Valériane, de Rekeneire, Nathalie, and Fox, Matthew P.

Published
2017
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124. Implementation of 'Treat‐all' at adult HIV care and treatment sites in the Global IeDEA Consortium: results from the Site Assessment Survey

Author

Brazier, Ellen, Maruri, Fernanda, Duda, Stephany N., Tymejczyk, Olga, Wester, C William, Somi, Geoffrey, Ross, Jeremy, Freeman, Aimee, Cornell, Morna, Poda, Armel, Musick, Beverly S., Zhang, Fujie, Althoff, Keri N., Mugglin, Catrina, Kimmel, April D., Yotebieng, Marcel, Nash, Denis, Karminia, Azar, Sohn, Annette H., Allen, Debbie, Bloch, Mark, Boyd, Susan, Brown, Katherine, Costa, Jess, Donohue, William, Gunathilake, Manoji, Hoy, Jennifer, Macrae, Karen, Moore, Richard, Roth, Norman, Rowling, Diane, Silvers, Julie, Smith, David J., Sowden, David, Templeton, David, Varma, Rick, Woolley, Ian, Youds, David, Meng, Somanithd Chhay, Vannary, Bun, Chan, Yun Ting, Lam, Wilson, Lee, Man Po, Ning, Han, Pansy, Yu Po Chu, Kumarasamy, N., Pujari, Sanjay, Kurniati, Nia, Merati, Tuti Parwati, Muktiarti, Dina, Parwata, Wayan Sandhi, Ratni, Made, Sukmawati, Ni Made Dewi Dian, Vedaswari, Dian Sulistya Putu Diah, Wati, Ketut Dewi Kumara, Yunihastuty, Evy, Tanuma, Junko, Mills, Graham, Raymond, Nigel, Ditangco, Rossana, Papa, Ohnmar Seinn, Tek, Ng Oon, Azwa, Raja, Daud, Fauziah, Juin, Wong Ke, Kamarulzaman, Adeeba Binti, Khairulddin, Nik, Li, Chong Meng, Moy, Fong Siew, Shah, Raja Iskandar, Shyan, Wong Peng, Sim, Benedict, Thahira, Jamal Mohamed, Tuang, Koh Mia, Yusoff, Nik, Choi, Jun Yong, Chan, Yu?Jiun, Huang, Chih?Sheng, Wing?Wai, Wong, Avihingsanon, Anchalee, Chokephaibulkit, Kulkanya, Hansudewechakul, Rawiwan, Khumcha, Benjhawan, Khusuwan, Suwimon, Kiertiburanakul, Sasisopin, Lumbiganon, Pagakrong, Maleesatharn, Alan, Praparattanapan, Jutarat, Puthanakit, Thanyawee, Sricharoenchai, Sirintip, Sudjaritruk, Tavitiya, Watanaporn, Suporn, An, Vu Thien, Cuong, Do Duy, H?ng, Bùi Thu, Huy, Bùi V?, Quy, Du Tuan, Van, Lam Nguyen, Baragunzwa, Agathomfue, Gakima, Dévote, Ingabire, Gloria, Kankinoi, Floride, Manyundo, Risase Scholastique, Misago, Celestin, Nahimana, Thierry, Nimbona, Pélagie, Ntirampeba, Felicite, Twizere, Christella, Ajeh, Rogers, Djenabou, Amadou, Dzudie, Anastase, Ewanoge, Alice Ndelle, Tchassem, Edmond, Bampapa, Therese, Lelo, Patricia, Kitetele, Faustin, Paul, Marie, Tytyna, Amida, Akolbout, Maryse, Bitsindou, Parfait, Diafouka, Merlin, Mafoua, Adolphe, Mahinga, Nadine, Moudila, Ella, Moutoula, Antoinette, Ndala, Ulrich, Nsonde, Dominique Mahambou, Ayinkamiye, Josephine, Dusabe, Chantal, Hakizimana, Theogene, Mbaraga, Gilbert, Mukamana, Joyce, Mukantwali, Sandrine, Munyaneza, Athanase, Murangwa, Anthere, Musenguwera, J. Claude, Ngutegure, Marie Immanculee, Ntarambirwa, Fidele, Nyiransabimana, Diane, Sinayobye, Jean D'Amour, Tuyishimire, Yvonne, Uwamahoro, Olive, Viateur, Habumuremyi, Vincent, Sugira, Kuhn, Yee Yee, Musick, Beverly, Rodriguez, Israel, Wools?Kaloustian, Kara, Yiannoutsos, Constantin, Akajoroit, Esinasi, Ariya, Peter, Atsimale, Meshack, Barua, Zeruya, Busaka, Oscar, Bukusi, Elizabeth, Chebor, Valentine, Chemweno, Timothy, Chirchir, John, Esendi, Lameck Diero Sagida, Fwamba, Aisha, Mmella, Anne, Githumbi, Eunice, Hussein, Marcia Nasimiyu, Kandie, Xavier, Kemunto, Martha, Khaemba, Elizabeth, Kipchumba, Mary, Koech, Emily, Kosgei, Caroline, Laundrick, Barasa, Merongo, Ruth, Mochotto, Patricia, Munyisi, Consolata, Ndakalu, Lilian, Ochieng, William Okoth, Odalo, Paul, Okumu, Wicklife, Omari, Lilian, Omondi, Alphoce, Osia, Lydia, Owino, Magret, Oyoo, Maureen, Pepela, Doris, Rono, Millicent, Simon, Omar, Tenge, Angie, Too, Mary, Toto, Modesta, Towett, Cathrine, Wawire, Kennedy, Kimambo, Mensaria, Kinyota, Ester, Lyamuya, Rita, Mathias, Julia, Mfuko, Athuman Ramadhan, Michael, Denna, Ngonyani, Kapella Zacharia, Nyaga, Charles, Somi, G.R., Urassa, Mark S., Batte, James, Bwana, Mwebesa Bosco, Castelnuovo, Barbara, Kanyesigye, Michael, Kisakye, Alice, Nalugoda, Fred, Semuwemba, Haruna, Ssali, John, Ssemakadde, Matthew, Castilho, Jessica, Cesar, Carina, De Alencastro, Paulo Ricardo, Barbosa, Eduardo Luiz, Brites, Carlos, Caricol, Renata, Carmo, Fabiana Bononi Do, Coelho, Lara Esteves, Escuder, Maria Mercedes, Estevam, Denize Lotufo, Ferreira, Flavia Gomes Faleiro, Gonçalves, Alexandre, Gouvêa, Aída Barbosa, Ikeda, Maria Leticia Rodrigues, Kalichman, Artur O., Machado, Daisy Maria, Queiroz, Simone, Souza, Rosa, Succi, Regina Célia, Trindade, Kátia Valeska, Tupinambás, Unai, Wolff, Marcelo, Rouzier, Vanessa, Padgett, Denis, Crabtree, Brenda, Martin, Carlos Eduardo Verne, Mejia, Fernando, Chang, Benny, Done, Brenda, Gabe, Larry, Gill, John, Gough, Kevin, Howlett, Gail, Klein, Marin, Latendre?Paquette, Judy, Leung, Victor, Macphee, Paul, Macpherson, P., Maharaj, Raj, Medina, Lorna Carrasco, Page, Suzanne, Pexos, Costas, Rachlis, Anita, Salters, Kate, Sterling, Sherine, Boswell, Stephen, Burkholder, Greer, Cesteros, Gisela, Chagaris, Kalliope, Franklin, Rosa, Fuhrer, Jack, Gilbert, Cynthia L., Goetz, Matthew, Grasso, Chris, Horberg, Michael, Hunter?Mellado, Robert F., Kell, Rita, Kitahata, Mari, Klein, Daniel, Levine, Ken, Marconi, Vincent, Mathews, Christopher, Mayor, Angel M., Mcgowan, Catherine, Napravnik, Sonia, Novak, Richard, Oursler, Kris Ann, Ramos, Shellier, Rodriguez, Benigno, Rodriguez, Maria C., Silverberg, Michael, Simberkoff, Michael S., Varshney, Mohit, Ward, Douglas, Widick, Barb, Yangco, Bienvenido G., Davies, Mary?Ann, Smith, Lilian, Von Groote, Per Maximilian, Muhairwe, Josephine, Balakasi, Steve, Banda, Quietus, Kalepa, Getrude, Bello, Andrew, Bulla, J.W., Chigeda, Maria, Chikaphupha, Joyce, Chikwekwere, Flora, Kachoka, Jack, Kapito, Allan, Katondo, Alinafe Nathan, Kumwenda, Molly, Labein, Felix Phewa, Magombo, Ronald, Malumbe, Bridget, Makuwira, I., Marico, Patricia, Masangale, Betha, Mchiela, Angella, Midian, Dan, Phiri, Kezia, Tambe, Mary, Thomas, Baid, Thomson, Charles, Hector, Jonas, Cross, Anna, Dlamini, Siphephelo, Eley, Brian, Euvrard, Jonathan, Fatti, Geoffrey, Hilderbrand, Katherine, Hsiao, Marvin, Mpye, Michael, Prozesky, Hans, Reubenson, Gary, Rose, Lesley, Sawry, Shobna, Sibambo, Nosisa, Technau, Karl, Vinikoor, Michael, Chimbetete, Cleophas, Kamenova, Kamelia, Balestre, Eric, Leroy, Valeriane, Malasteste, Karen, Djimon, Marcel Zannou, D' Almeida, Marcelline, Hounhoui, Ghislaine, Assogba, Michee, Zoungrana, Jacques, Yaméogo, Issouf, Tapsoba, Achille, Abdelh, Sidibé, Bosse, Clarisse Amani, Diabaté, Mamoudou, Eboua, Tanoh Kassi François, Folquet, Madeleine Amorissani, Hawelander, Denise, Konaté, Mamadou, Kouakou, Kouadio, Lambert, Dohoun, Minga, Albert Kla, N'Gbeche, Marie Sylvie, Tanon, Aristophane, Yao, Abo, Renner, Lorna, N'Diaye, Clémentine, Berthé, Mme Alima, Seydi, Moussa, Tine, Judicaël, Elom, Takassi Ounoo, Kariylare, Benjamin, and Patassi, Akessiwe

Subjects
Public health administration -- Evaluation, HIV infection -- Diagnosis -- Drug therapy, Health
Abstract

: Introduction: Since 2015, the World Health Organization (WHO) has recommended that all people living with HIV (PLHIV) initiate antiretroviral treatment (ART), irrespective of CD4+ count or clinical stage. National adoption of universal treatment has accelerated since WHO's 2015 “Treat All” recommendation; however, little is known about the translation of this guidance into practice. This study aimed to assess the status of Treat All implementation across regions, countries, and levels of the health care delivery system. Methods: Between June and December 2017, 201/221 (91%) adult HIV treatment sites that participate in the global IeDEA research consortium completed a survey on capacity and practices related to HIV care. Located in 41 countries across seven geographic regions, sites provided information on the status and timing of site‐level introduction of Treat All, as well as site‐level practices related to ART initiation. Results: Almost all sites (93%) reported that they had begun implementing Treat All, and there were no statistically significant differences in site‐level Treat All introduction by health facility type, urban/rural location, sector (public/private) or country income level. The median time between national policy adoption and site‐level introduction was one month. In countries where Treat All was not yet adopted in national guidelines, 69% of sites reported initiating all patients on ART, regardless of clinical criteria, and these sites had been implementing Treat All for a median period of seven months at the time of the survey. The majority of sites (77%) reported typically initiating patients on ART within 14 days of confirming diagnosis, with 60% to 62% of sites implementing Treat All in East, Southern and West Africa reporting same‐day ART initiation for most patients. Conclusions: By mid‐ to late‐2017, the Treat All strategy was the standard of care at almost all IeDEA sites, including rural, primary‐level health facilities in low‐resource settings. While further assessments of site‐level capacity to provide high‐quality HIV care under Treat All and to support sustained viral suppression after ART initiation are needed, the widespread introduction of Treat All at the service delivery level is a critical step towards global targets for ending the HIV epidemic as a public health threat., Introduction WHO's 2015 recommendation for immediate treatment of all PLHIV, regardless of CD4+ cell count, represented a paradigm shift in HIV care and treatment. By preventing morbidity and mortality among [...]

Published
2019
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125. Changes in rapid HIV treatment initiation after national 'treat all' policy adoption in 6 sub-Saharan African countries: Regression discontinuity analysis

Author

Tymejczyk, Olga, Brazier, Ellen, Yiannoutsos, Constantin T., Vinikoor, Michael, van Lettow, Monique, Nalugoda, Fred, Urassa, Mark, Sinayobye, Jean d'Amour, Rebeiro, Peter F., Wools-Kaloustian, Kara, Davies, Mary-Ann, Zaniewski, Elizabeth, Anderegg, Nanina, Liu, Grace, Ford, Nathan, and Nash, Denis

Subjects
Sub-Saharan Africa -- Health policy, HIV patients -- Drug therapy -- Demographic aspects, Antiretroviral agents -- Dosage and administration -- Laws, regulations and rules, Regulatory compliance -- Analysis, Databases, HIV, Consortia, Women's health, AIDS (Disease), AIDS treatment, Highly active antiretroviral therapy, Epidemiology, Elderly patients, Public health, Government regulation, Biological sciences
Abstract

Background Most countries have formally adopted the World Health Organization's 2015 recommendation of universal HIV treatment ('treat all'). However, there are few rigorous assessments of the real-world impact of treat all policies on antiretroviral treatment (ART) uptake across different contexts. Methods and findings We used longitudinal data for 814,603 patients enrolling in HIV care between 1 January 2004 and 10 July 2018 in 6 countries participating in the global International epidemiology Databases to Evaluate AIDS (IeDEA) consortium: Burundi (N = 11,176), Kenya (N = 179,941), Malawi (N = 84,558), Rwanda (N = 17,396), Uganda (N = 96,286), and Zambia (N = 425,246). Using a quasi-experimental regression discontinuity design, we assessed the change in the proportion initiating ART within 30 days of enrollment in HIV care (rapid ART initiation) after country-level adoption of the treat all policy. A modified Poisson model was used to identify factors associated with failure to initiate ART rapidly under treat all. In each of the 6 countries, over 60% of included patients were female, and median age at enrollment ranged from 32 to 36 years. In all countries studied, national adoption of treat all was associated with large increases in rapid ART initiation. Significant increases in rapid ART initiation immediately after treat all policy adoption were observed in Rwanda, from 44.4% to 78.9% of patients (34.5 percentage points [pp], 95% CI 27.2 to 41.7; p < 0.001), Kenya (25.7 pp, 95% CI 21.8 to 29.5; p < 0.001), Burundi (17.7 pp, 95% CI 6.5 to 28.9; p = 0.002), and Malawi (12.5 pp, 95% CI 7.5 to 17.5; p < 0.001), while no immediate increase was observed in Zambia (0.4 pp, 95% CI -2.9 to 3.8; p = 0.804) and Uganda (-4.2 pp, 95% CI -9.0 to 0.7; p = 0.090). The rate of rapid ART initiation accelerated sharply following treat all policy adoption in Malawi, Uganda, and Zambia; slowed in Kenya; and did not change in Rwanda and Burundi. In post hoc analyses restricted to patients enrolling under treat all, young adults (16-24 years) and men were at increased risk of not rapidly initiating ART (compared to older patients and women, respectively). However, rapid ART initiation following enrollment increased for all groups as more time elapsed since treat all policy adoption. Study limitations include incomplete data on potential ART eligibility criteria, such as clinical status, pregnancy, and enrollment CD4 count, which precluded the assessment of rapid ART initiation specifically among patients known to be eligible for ART before treat all. Conclusions Our analysis indicates that adoption of treat all policies had a strong effect on increasing rates of rapid ART initiation, and that these increases followed different trajectories across the 6 countries. Young adults and men still require additional attention to further improve rapid ART initiation., Author(s): Olga Tymejczyk 1,2,*, Ellen Brazier 1,2, Constantin T. Yiannoutsos 3, Michael Vinikoor 4,5, Monique van Lettow 6,7, Fred Nalugoda 8, Mark Urassa 9, Jean d'Amour Sinayobye 10, Peter F. [...]

Published
2019
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128. Reduced amplification efficiency of the RNA-dependent-RNA-polymerase target enables tracking of the Delta SARS-CoV-2 variant using routine diagnostic tests

Author

Valley-Omar, Ziyaad, Marais, Gert, Iranzadeh, Arash, Naidoo, Michelle, Korsman, Stephen, Maponga, Tongai, Hussey, Hannah, Davies, Mary-Ann, Boulle, Andrew, Doolabh, Deelan, Laubscher, Mariska, Wojno, Justyna, Deetlefs, J.D., Maritz, Jean, Scott, Lesley, Msomi, Nokukhanya, Naicker, Cherise, Tegally, Houriiyah, de Oliveira, Tulio, Bhiman, Jinal, Williamson, Carolyn, Preiser, Wolfgang, Hardie, Diana, and Hsiao, Nei-yuan

Published
2022
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129. Mental health, longitudinal ART adherence, and viral suppression among adolescents and adults living with HIV in South Africa: a cohort study

Author

Haas, Andreas D, primary, Lienhard, Raphael, additional, Didden, Christiane, additional, Cornell, Morna, additional, Folb, Naomi, additional, Boshomane, Tebatso M G, additional, Salazar-Vizcaya, Luisa D, additional, Ruffieux, Yann, additional, Nyakato, Patience, additional, Wettstein, Anja E, additional, Tlali, Mpho, additional, Davies, Mary-Ann, additional, Von Groote, Per, additional, Wainberg, Milton, additional, Maartens, Gary, additional, and Joska, John A, additional

Published
2022
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132. The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time series analysis

Author

Wettstein, Anja Elisabeth, primary, Tlali, Mpho, additional, Joska, John A, additional, Cornell, Morna, additional, Skrivankova, Veronika W, additional, Seedat, Soraya, additional, Mouton, Johannes P, additional, van den Heuvel, Leigh L, additional, Maxwell, Nicola, additional, Davies, Mary-Ann, additional, Maartens, Gary, additional, Egger, Matthias, additional, and Haas, Andreas D, additional

Published
2022
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133. Effectiveness of the Ad26.COV2.S vaccine in health-care workers in South Africa (the Sisonke study): results from a single-arm, open-label, phase 3B, implementation study

Author

Bekker, Linda-Gail, primary, Garrett, Nigel, additional, Goga, Ameena, additional, Fairall, Lara, additional, Reddy, Tarylee, additional, Yende-Zuma, Nonhlanhla, additional, Kassanjee, Reshma, additional, Collie, Shirley, additional, Sanne, Ian, additional, Boulle, Andrew, additional, Seocharan, Ishen, additional, Engelbrecht, Imke, additional, Davies, Mary-Ann, additional, Champion, Jared, additional, Chen, Tommy, additional, Bennett, Sarah, additional, Mametja, Selaelo, additional, Semenya, Mabatlo, additional, Moultrie, Harry, additional, de Oliveira, Tulio, additional, Lessells, Richard John, additional, Cohen, Cheryl, additional, Jassat, Waasila, additional, Groome, Michelle, additional, Von Gottberg, Anne, additional, Le Roux, Engelbert, additional, Khuto, Kentse, additional, Barouch, Dan, additional, Mahomed, Hassan, additional, Wolmarans, Milani, additional, Rousseau, Petro, additional, Bradshaw, Debbie, additional, Mulder, Michelle, additional, Opie, Jessica, additional, Louw, Vernon, additional, Jacobson, Barry, additional, Rowji, Pradeep, additional, Peter, Jonny G, additional, Takalani, Azwi, additional, Odhiambo, Jackline, additional, Mayat, Fatima, additional, Takuva, Simbarashe, additional, Corey, Lawrence, additional, Gray, Glenda E, additional, Brumskine, William, additional, Naicker, Nivashnee, additional, Makhaza, Disebo, additional, Naicker, Vimla, additional, Naidoo, Logashvari, additional, Spooner, Elizabeth, additional, van Nieuwenhuizen, Elane, additional, Mngadi, Kathryn, additional, Nchabeleng, Maphoshane, additional, Innes, James Craig, additional, Gill, Katherine, additional, Petrick, Friedrich Georg, additional, Barnabas, Shaun, additional, Badal-Faesen, Sharlaa, additional, Kassim, Sheetal, additional, Mahoney, Scott Hayden, additional, Lazarus, Erica, additional, Nana, Anusha, additional, Maboa, Rebone Molobane, additional, Kotze, Philip, additional, Lombaard, Johan, additional, Malan, Daniel Rudolf, additional, Kotze, Sheena, additional, Mohlala, Phuthi, additional, Ward, Amy, additional, Meintjes, Graeme, additional, Urbach, Dorothea, additional, Patel, Faeezah, additional, Diacon, Andreas, additional, Ahmed, Khatija, additional, Grobbelaar, Coert, additional, Mda, Pamela, additional, Dubula, Thozama, additional, Luabeya, Angelique, additional, Mamba, Musawenkosi Bhekithemba, additional, Burgess, Lesley, additional, and Dawson, Rodney, additional

Published
2022
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135. Promise and Practice of Professional Portfolios.

Author

Willis, Elizabeth M. and Davies, Mary Ann

Abstract

Surveyed preservice elementary teachers regarding their perceptions of the impact of portfolios on professional development and the transition from school to work. Results indicated that the process promoted reflective practice, increased self-confidence, prepared respondents for the job search, and heightened awareness of professional standards. Student feedback offered suggestions for making portfolios an integral part of teacher education programs. (SM)

Published
2002

137. Through the Looking Glass...Preservice Professional Portfolios.

Author

Davies, Mary Ann and Willis, Elizabeth

Abstract

Shares one institution's experiences using professional portfolios to help future teachers become effective practitioners and transition from school to work, describing the portfolio development process and exit presentations. Feedback from student questionnaires indicated that students overwhelmingly considered the invested time worthwhile, saw the process as an appropriate program exit assessment, and recommended its continuation. (SM)

Published
2001

139. Learning...The Beat Goes On.

Author

Davies, Mary Ann

Abstract

Discusses how music enhances learning by facilitating brain growth and integration, evoking emotions, and addressing learners' needs. Suggests ways to use music to create a positive learning environment by reducing stress, increasing productivity, and regulating energy. Presents suggestions for incorporating music at elementary/secondary levels, and includes a bibliography of songs related to diversity, peace, environmental awareness, and U.S. history. (KB)

Published
2000

140. Mentors and School-Based Partnership: Ingredients for Professional Growth.

Author

Davies, Mary Ann, Brady, Martha, Rodger, Emilie, and Wall, Pat

Abstract

Investigated the impact of a school-based teacher-education partnership on the professional development of elementary mentor teachers. Analysis of two mentor-teacher surveys indicated that mentors perceived benefits in the areas of teaching style, addressing student needs, and program influences. Mentor teachers became more self-confident, self-reflective, and collegial as a result of the experience. (SM)

Published
1999

141. Effect of antiretroviral therapy care interruptions on mortality in children living with HIV

Author

Davies, Claire, primary, Johnson, Leigh, additional, Sawry, Shobna, additional, Chimbetete, Cleophas, additional, Eley, Brian, additional, Vinikoor, Michael, additional, Technau, Karl-Günter, additional, Ehmer, Jochen, additional, Rabie, Helena, additional, Phiri, Sam, additional, Tanser, Frank, additional, Malisita, Kennedy, additional, Fatti, Geoffrey, additional, Osler, Meg, additional, Wood, Robin, additional, Newton, Sam, additional, Haas, Andreas, additional, and Davies, Mary-Ann, additional

Published
2022
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142. Assessing the clinical severity of the Omicron variant in the Western Cape Province, South Africa, using the diagnostic PCR proxy marker of RdRp target delay to distinguish between Omicron and Delta infections – a survival analysis

Author

Hussey, Hannah, primary, Davies, Mary-Ann, additional, Heekes, Alexa, additional, Williamson, Carolyn, additional, Valley-Omar, Ziyaad, additional, Hardie, Diana, additional, Korsman, Stephen, additional, Doolabh, Deelan, additional, Preiser, Wolfgang, additional, Maponga, Tongai, additional, Iranzadeh, Arash, additional, Wasserman, Sean, additional, Boloko, Linda, additional, Symons, Greg, additional, Raubenheimer, Peter, additional, Viljoen, Abraham, additional, Parker, Arifa, additional, Schrueder, Neshaad, additional, Solomon, Wesley, additional, Rousseau, Petro, additional, Wolter, Nicole, additional, Jassat, Waasila, additional, Cohen, Cheryl, additional, Lessells, Richard, additional, Wilkinson, Robert J, additional, Boulle, Andrew, additional, and Hsiao, Nei-yuan, additional

Published
2022
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144. Outcomes of laboratory-confirmed SARS-CoV-2 infection in the Omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa

Author

Davies, Mary-Ann, primary, Kassanjee, Reshma, additional, Rousseau, Petro, additional, Morden, Erna, additional, Johnson, Leigh, additional, Solomon, Wesley, additional, Hsiao, Nei-Yuan, additional, Hussey, Hannah, additional, Meintjes, Graeme, additional, Paleker, Masudah, additional, Jacobs, Theuns, additional, Raubenheimer, Peter, additional, Heekes, Alexa, additional, Dane, Pierre, additional, Bam, Jamy-Lee, additional, Smith, Mariette, additional, Preiser, Wolfgang, additional, Pienaar, David, additional, Mendelson, Marc, additional, Naude, Jonathan, additional, Schreuder, Neshaad, additional, Mnguni, Ayanda, additional, Le Roux, Susan, additional, Murie, Katie, additional, Prozesky, Hans, additional, Mahomed, Hassan, additional, Rossouw, Liezel, additional, Wasserman, Sean, additional, Maughan, Deborah, additional, Boloko, Linda, additional, Smith, Barry, additional, Taljaard, Jantjie, additional, Symons, Greg, additional, Ntusi, Ntobeko, additional, Parker, Arifa, additional, Wolter, Nicole, additional, Jassat, Waasila, additional, Cohen, Cheryl, additional, Lessells, Richard, additional, Wilkinson, Robert, additional, Arendse, Juanita, additional, Kariem, Saadiq, additional, Moodley, Melvin, additional, Vallabhjee, Krish, additional, Wolmarans, Milani, additional, and Boulle, Andrew, additional

Published
2022
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145. The Association of SARS-CoV-2 Infection and Tuberculosis Disease with Unfavorable Treatment Outcomes: A Systematic Review

Author

Vadlamudi, Nirma, primary, Basham, C. Andrew, additional, Johnston, James, additional, Ahmad Khan, Faiz, additional, Battista Migliori, Giovanni, additional, Centis, Rosella, additional, D&apos;Ambrosio, Lia, additional, Jassat, Waasila, additional, Davies, Mary-Ann, additional, Schwartzman, Kevin, additional, and Campbell, Jonathon, additional

Published
2022
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146. The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time-series analysis

Author

Wettstein, Anja, primary, Tlali, Mpho, additional, Joska, John A., additional, Cornell, Morna, additional, Skrivankova, Veronika W., additional, Seedat, Soraya, additional, Mouton, Johannes P., additional, van den Heuvel, Leigh L., additional, Maxwell, Nicola, additional, Davies, Mary-Ann, additional, Maartens, Gary, additional, Egger, Matthias, additional, and Haas, Andreas D., additional

Published
2022
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147. Early assessment of the clinical severity of the SARS-CoV-2 Omicron variant in South Africa

Author

Wolter, Nicole, primary, Jassat, Waasila, additional, Walaza, Sibongile, additional, Welch, Richard, additional, Moultrie, Harry, additional, Groome, Michelle, additional, Amoako, Daniel Gyamfi, additional, Everatt, Josie, additional, Bhiman, Jinal N., additional, Scheepers, Cathrine, additional, Tebeila, Naume, additional, Chiwandire, Nicola, additional, du Plessis, Mignon, additional, Govender, Nevashan, additional, Ismail, Arshad, additional, Glass, Allison, additional, Mlisana, Koleka, additional, Stevens, Wendy, additional, Treurnicht, Florette K., additional, Makatini, Zinhle, additional, Hsiao, Nei-yuan, additional, Parboosing, Raveen, additional, Wadula, Jeannette, additional, Hussey, Hannah, additional, Davies, Mary-Ann, additional, Boulle, Andrew, additional, von Gottberg, Anne, additional, and Cohen, Cheryl, additional

Published
2021
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149. Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa

Author

Boulle, Andrew, Davies, Mary-Ann, Hussey, Hannah, Ismail, Muzzammil, Morden, Erna, Vundle, Ziyanda, Zweigenthal, Virginia, Mahomed, Hassan, Paleker, Masudah, Pienaar, David, Tembo, Yamanya, Lawrence, Charlene, Isaacs, Washiefa, Mathema, Hlengani, Allen, Derick, Allie, Taryn, Bam, Jamy-Lee, Buddiga, Kasturi, Dane, Pierre, Heekes, Alexa, Matlapeng, Boitumelo, Mutemaringa, Themba, Muzarabani, Luckmore, Phelanyane, Florence, Pienaar, Rory, Rode, Catherine, Smith, Mariette, Tiffin, Nicki, Zinyakatira, Nesbert, Cragg, Carol, Marais, Frederick, Mudaly, Vanessa, Voget, Jacqueline, Davids, Jody, Roodt, Francois, van Zyl Smit, Nellis, Vermeulen, Alda, Adams, Kevin, Audley, Gordon, Bateman, Kathleen, Beckwith, Peter, Bernon, Marc, Blom, Dirk, Boloko, Linda, Botha, Jean, Boutall, Adam, Burmeister, Sean, Cairncross, Lydia, Calligaro, Gregory, Coccia, Cecilia, Corin, Chadwin, Daroowala, Remy, Dave, Joel A, De Bruyn, Elsa, De Villiers, Martin, Deetlefs, Mimi, Dlamini, Sipho, Du Toit, Thomas, Endres, Wilhelm, Europa, Tarin, Fieggan, Graham, Figaji, Anthony, Frankenfeld, Petro, Gatley, Elizabeth, Gina, Phindile, Govender, Evashan, Grobler, Rochelle, Gule, Manqoba Vusumuzi, Hanekom, Christoff, Held, Michael, Heynes, Alana, Hlatswayo, Sabelo, Hodkinson, Bridget, Holtzhausen, Jeanette, Hoosain, Shakeel, Jacobs, Ashely, Kahn, Miriam, Kahn, Thania, Khamajeet, Arvin, Khan, Joubin, Khan, Riaasat, Khwitshana, Alicia, Knight, Lauren, Kooverjee, Sharita, Krogscheepers, Rene, Kruger, Jean Jacque, Kuhn, Suzanne, Laubscher, Kim, Lazarus, John, Le Roux, Jacque, Lee Jones, Scott, Levin, Dion, Maartens, Gary, Majola, Thina, Manganyi, Rodgers, Marais, David, Marais, Suzaan, Maritz, Francois, Maughan, Deborah, Mazondwa, Simthandile, Mbanga, Luyanda, Mbatani, Nomonde, Mbena, Bulewa, Meintjes, Graeme, Mendelson, Marc, Möller, Ernst, Moore, Allison, Ndebele, Babalwa, Nortje, Marc, Ntusi, Ntobeko, Nyengane, Funeka, Ofoegbu, Chima, Papavarnavas, Nectarios, Peter, Jonny, Pickard, Henri, Pluke, Kent, Raubenheimer, Peter J, Robertson, Gordon, Rozmiarek, Julius, Sayed, A, Scriba, Matthias, Sekhukhune, Hennie, Singh, Prasun, Smith, Elsabe, Soldati, Vuyolwethu, Stek, Cari, van den berg, Robert, van der Merwe, Le Roux, Venter, Pieter, Vermooten, Barbra, Viljoen, Gerrit, Viranna, Santhuri, Vogel, Jonno, Vundla, Nokubonga, Wasserman, Sean, Zitha, Eddy, Lomas-Marais, Vanessa, Lombard, Annie, Stuve, Katrin, Viljoen, Werner, Basson, De Vries, Le Roux, Sue, Linden-Mars, Ethel, Victor, Lizanne, Wates, Mark, Zwanepoel, Elbe, Ebrahim, Nabilah, Lahri, Sa’ad, Mnguni, Ayanda, Crede, Thomas, de Man, Martin, Evans, Katya, Hendrikse, Clint, Naude, Jonathan, Parak, Moosa, Szymanski, Patrick, Van Koningsbruggen, Candice, Abrahams, Riezaah, Allwood, Brian, Botha, Christoffel, Botha, Matthys Henndrik, Broadhurst, Alistair, Claasen, Dirkie, Daniel, Che, Dawood, Riyaadh, du Preez, Marie, Du Toit, Nicolene, Erasmus, Kobie, Koegelenberg, Coenraad F N, Gabriel, Shiraaz, Hugo, Susan, Jardine, Thabiet, Johannes, Clint, Karamchand, Sumanth, Lalla, Usha, Langenegger, Eduard, Louw, Eize, Mashigo, Boitumelo, Mhlana, Nonte, Mnqwazi, Chizama, Moodley, Ashley, Moodley, Desiree, Moolla, Saadiq, Mowlana, Abdurasiet, Nortje, Andre, Olivier, Elzanne, Parker, Arifa, Paulsen, Chané, Prozesky, Hans, Rood, Jacques, Sabela, Tholakele, Schrueder, Neshaad, Sithole, Nokwanda, Sithole, Sthembiso, Taljaard, Jantjie J, Titus, Gideon, Van Der Merwe, Tian, van Schalkwyk, Marije, Vazi, Luthando, Viljoen, Abraham J, Yazied Chothia, Mogamat, Naidoo, Vanessa, Wallis, Lee Alan, Abbass, Mumtaz, Arendse, Juanita, Armien, Rizqa, Bailey, Rochelle, Bello, Muideen, Carelse, Rachel, Forgus, Sheron, Kalawe, Nosi, Kariem, Saadiq, Kotze, Mariska, Lucas, Jonathan, McClaughlin, Juanita, Murie, Kathleen, Najjaar, Leilah, Petersen, Liesel, Porter, James, Shaw, Melanie, Stapar, Dusica, Williams, Michelle, Aldum, Linda, Berkowitz, Natacha, Girran, Raakhee, Lee, Kevin, Naidoo, Lenny, Neumuller, Caroline, Anderson, Kim, Begg, Kerrin, Boerlage, Lisa, Cornell, Morna, de Waal, Renée, Dudley, Lilian, English, René, Euvrard, Jonathan, Groenewald, Pam, Jacob, Nisha, Jaspan, Heather, Kalk, Emma, Levitt, Naomi, Malaba, Thoko, Nyakato, Patience, Patten, Gabriela, Schneider, Helen, Shung King, Maylene, Tsondai, Priscilla, Van Duuren, James, van Schaik, Nienke, Blumberg, Lucille, Cohen, Cheryl, Govender, Nelesh, Jassat, Waasila, Kufa, Tendesayi, McCarthy, Kerrigan, Morris, Lynn, Hsiao, Nei-yuan, Marais, Ruan, Ambler, Jon, Ngwenya, Olina, Osei-Yeboah, Richard, Johnson, Leigh, Kassanjee, Reshma, and Tamuhla, Tsaone

Subjects
sub-Saharan Africa, 0301 basic medicine, Microbiology (medical), Adult, Male, Tuberculosis, antiretroviral, 030106 microbiology, Population, HIV Infections, HIV Infections/complications, Cohort Studies, South Africa, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Major Article, Medicine, Humans, 030212 general & internal medicine, education, Proportional Hazards Models, education.field_of_study, South Africa/epidemiology, business.industry, Proportional hazards model, SARS-CoV-2, Hazard ratio, HIV, Correction, COVID-19, medicine.disease, Confidence interval, AcademicSubjects/MED00290, Infectious Diseases, Standardized mortality ratio, tuberculosis, Attributable risk, business, Viral load, Demography
Abstract

Background Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates. Results Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1). Conclusions While our findings may overestimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both living with HIV and having current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex, and other comorbidities and COVID-19 mortality were similar to those in other settings.

Published
2021

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