Dr. William Macleod [Assistant Professor]

T: +27 (0) 10 001 0635  
Dr. William Macleod

William “Bill” MacLeod is an International Health Demographer at Boston University with 20 years of experience working in sub-Saharan Africa utilising his expertise in study design, data management, and statistical analysis.  Bill has conducted research in interdisciplinary teams to conduct surveys, and clinical and community trials focused primarily on infectious diseases (pneumonia, malaria, and HIV) in children, infants and neonates.  He has participated in Data Safety and Management Boards and on Technical Steering Committees for WHO sponsored pneumonia trials.  Bill joined HE2RO in August 2010.  His work has been published in the Lancet, BMJ, and Tropical Medicine and International Health.  Prior to joining Boston University, Bill was a Peace Corps Volunteer in Honduras.

Projects

  • Analysis of National Lab Database to evaluate the HIV treatment rollout in South Africa

    By linking lab tests on detailed patient identifiers, a national, patient-level longitudinal cohort is being developed, which contains over 3 million ART initiators and over 23 million observations. This “NHLS Patient Cohort” will enable us to evaluate the national ART program using data that are nationally representative and robust to self-transfer across care settings. Through a partnership between Wits University in South Africa and Boston University in the U.S., this project will 

  • Analysing the Impact and Cost of Scaling up Xpert MTB/RIF Technology for TB Diagnosis: The National TB Cost Model (NTCM)

    In the South African context, smear microscopy and other conventional TB diagnostic technologies that have been used for decades, are no longer reliable, because many HIV-positive tuberculosis patients are smear-negative, and the long time to diagnosis means that many patients die without having started TB treatment. In December 2010 the GeneXpert System using the Xpert MTB/RIF assay received a strong recommendation from the World Health Organization as the initial test in individuals with HIV 

  • Investigating the Feasibility of Implementation of Multi-Disciplinary Point-of-Care Testing in an HIV Treatment Clinic Using a Randomised Controlled Trial

    A major challenge to successful implementation of both antiretroviral and anti-tuberculosis therapy in low-resource settings remains the ability to diagnose and monitor the progress of both infections, a process that is hampered by lack of laboratory infrastructure, technical skill and poor integration of HIV and TB services. Recent technological innovations in the Point of Care (POC) testing arena promises to alleviate the problem by providing access to on-site laboratory tests with the future 

  • Retention and Attrition from HIV Care

    With the rapid expansion of access to antiretroviral therapy (ART) in sub-Saharan Africa, the number of HIV-positive people on treatment has increased dramatically. In South Africa, scale-up of services has put pressure on the ability of treatment programs to maintain care for existing patients while continuing to expand access to new patients. With increased demand and limited capacity, many HIV-positive patients never access care, and many who do discontinue treatment. HE2RO staff, 

  • Linkage to National Databases to Enhance Programme Evaluation

    HIV care involves a web of local clinics and laboratories throughout South Africa. In the emergency phase of the epidemic, monitoring and evaluation took a backseat to HIV care. Currently HIV care takes place at over 3,000 local clinics throughout South Africa. Laboratory test from the labs and patient records from the clinics provide potentially useful sources of data for monitoring and evaluation of the National treatment programme currently and historically. Linkage of patient records to the 

  • Paediatric and Adolescent Populations

    Children and adolescents have been identified as priority populations with the greatest potential impact on the development of the HIV epidemic. HE2RO has used multiple sources of data to evaluate the outcomes of children and adolescents initiating ART at multiple clinics across Gauteng and Mpumalanga. We also utilize prospective cohorts to identify factors associated with treatment adherence and missed clinic visits among adolescents and plan to use national level laboratory data to produce 

  • Adult Treatment Outcomes and Opportunistic Infections

    As the HIV epidemic matured in South Africa and the national treatment programme reached 10 years since inception, the team at HE2RO has used longitudinal patient databases to evaluate treatment outcomes among adults initiating ART. We consider diverse factors that may influence the effect of ART and also the impact of changing national guidelines in an on-going