Recent Publications

Association of maternal age with utilization of antenatal care services and knowledge of child development in rural Limpopo, South Africa

Early pregnancy access to prenatal care is essential Research has linked a lack of antenatal services to a  risk of maternal mortality Younger women typically share traits such as low socioeconomic position, lack of spousal support, work obligations, and unexpected pregnancies During focused group discussions (FGD) with CHWs they stated that young women had poorer 

Dietary Diversity Among HIV-exposed and Uninfected Compared to HIV-unexposed and Uninfected Children Aged 32-59 Months in Gauteng, South Africa

The principles of infant and young child nutrition apply to all children, despite their HIV status. From the age of 6 months, breastfeeding is no longer able to meet all of the nutritional requirements of a developing child The nutritional status of children is influenced chiefly by caregivers Caregivers need to be able to provide adequate (in quantity and diversity) and frequent feedings 45% of children (8.9 million) were poor in 2018, and 33% (6.4 million) were below the food 

Predicted effects of the introduction of long-acting injectable cabotegravir pre-exposure prophylaxis in sub-Saharan Africa: a modelling study

Summary Background: Long-acting injectable cabotegravir pre-exposure prophylaxis (PrEP) is recommended by WHO as an additional option for HIV prevention in sub-Saharan Africa, but there is concern that its introduction could lead to an increase in integrase-inhibitor resistance undermining treatment programmes that rely on dolutegravir. We aimed to project the health benefits and risks of cabotegravir-PrEP introduction in settings in sub-Saharan Africa. Methods: With HIV Synthesis, an 

The costs of interventions for type 2 diabetes mellitus, hypertension and cardiovascular disease in South Africa – a systematic literature review

Background In the context of a move to universal health coverage, three separate systematic reviews were conducted to summarise available evidence on the direct costs of interventions for type 2 diabetes mellitus, hypertension, and cardiovascular disease in South Africa. Methods PubMed® and Web of Science was searched for literature published between 01 and 1995 and 27 October 2022. Additionally, reference and citations lists of retrieved articles and experts were consulted. We also 

The household economic burden of drug-susceptible TB diagnosis and treatment in The Gambia

OBJECTIVE: To determine the costs and catastrophic costs incurred by drug-susceptible (DS) pulmonary TB patients in The Gambia. METHODS: This observational study collected cost and socio-economic data using a micro-costing approach from the household perspective from 244 adult DS-TB patients with pulmonary TB receiving treatment through the national treatment programme in The Gambia. We used data collected between 2017 and 2020 using an adapted version of the WHO generic patient cost 

Monitoring for Advanced Disease in the UTT Era: Trends in CD4 Count Testing Volumes Among Patients Presenting for HIV Care in South Africa

Background: South Africa eliminated CD4 criteria for ART eligibility in 2016 under its Universal Test and Treat (UTT) policy In September 2017, the general UTT policy was updated with a directive to initiate ART on the day of HIV diagnosis (same-day initiation—SDI) However, CD4 count at entry into care remains an important marker of disease progression. National guidelines specify patients should still have a CD4 count done at enrolment into HIV 

RECORD LINKAGE WITHOUT PATIENT IDENTIFIERS: A PROOF OF CONCEPT USING LABORATORY AND CLINICAL DATA FROM SOUTH AFRICA’S HIV PROGRAM

Background and Objective Linkage of health databases traditionally requires personal identifiers such as names and personal identification (ID) numbers, which may not be accessible for research purposes due to data privacy concerns (1). The National Health Laboratory Service (NHLS) database contains CD4 count and viral load laboratory records used to assess patient health at presentation, monitor response to ART, track viral suppression, and detect treatment failure. Facility-based 

Quasi-experimental evaluation of a financial incentive for first-dose COVID-19 vaccination among adults aged ≥60 years in South Africa

Introduction: COVID-19 vaccination coverage in South Africa (RSA) remains low despite increased access to vaccines. On 1 November 2021, RSA introduced the Vooma Voucher programme which provided a small guaranteed financial incentive, a Vooma Voucher redeemable at grocery stores, for COVID-19 vaccination among older adults, a population most vulnerable to serious illness, hospitalisation and death. However, the association of financial incentives with vaccination coverage remains 

Progress towards unique patient identification and case-based surveillance within the Southern African development community

Population mobility makes patient-tracking and care linkage in the South African Development Community (SADC) challenging. Case-based surveillance (CBS) through individual-level clinical data linked with a unique patient-identifier (UPI) is recommended. We conducted a mixedmethods landscape analysis of UPI and CBS implementation within selected SADC countries, this included: (1) SADC UPI implementation literature review; (2) assessment of UPI and CBS implementation for high HIV-prevalence SADC 

Relative cost-effectiveness of long-acting injectable cabotegravir versus oral pre-exposure prophylaxis in South Africa based on the HPTN 083 and HPTN 084 trials: a modelled economic evaluation and threshold analysis

Long-acting injectable cabotegravir, a drug taken every 2 months, has been shown to be more effective at preventing HIV infection than daily oral tenofovir disoproxil fumarate and emtricitabine, but its cost-effectiveness in a high-prevalence setting is not known. We aimed to estimate the incremental cost-effectiveness of long-acting injectable cabotegravir compared with tenofovir disoproxil fumarate and emtricitabine in South Africa, using methods standard to government planning, and to 

Similar costs and outcomes for differentiated service delivery models for HIV treatment in Uganda

This cost-outcome study estimated, from the perspective of the service provider, the total annual cost per client on antiretroviral therapy (ART) and total annual cost per client virally suppressed (defined as < 1000 copies/ml at the time of the study) in Uganda in five ART differentiated service delivery models (DSDMs). These included both facility- and community-based models and the standard of care (SOC), known as the facility-based individual management (FBIM) model. The Ministry of 

HE²RO Joins The Union World Conference

HE²RO is happy to be part of the virtual Union World Conference. This year's conference aims to urge our communities toward inclusive policies that is supported by data, ensure the best evolution of care, and prevention against existing disease, while averting future