Dr. Kate Shearer [Researcher - Epidemiology]

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Dr. Kate Shearer

Dr. Shearer is an epidemiologist and faculty member in the Division of Medicine at the Johns Hopkins University School of Medicine. She completed her MPH in Global Epidemiology at Emory University’s Rollins School of Public Health and her PhD in Infectious Disease Epidemiology at the Johns Hopkins Bloomberg School of Public Health. Dr. Shearer is based in Johannesburg, South Africa and is involved in research projects in Ethiopia, Malawi, Mozambique, South Africa, and Zimbabwe. Her current research is primarily focused on uptake of TB preventive therapy.

Projects

  • Low Prevalence of Depressive Symptoms among Stable Patients on Antiretroviral Therapy in Johannesburg, South Africa

    Depression is a leading cause of morbidity worldwide. It affects more than 300 million individuals globally and depressive disorders are currently the 4th leading cause of Years Lived with Disability (YLD) in South Africa. People living with HIV are disproportionately affected by mental health disorders and while the lifetime prevalence of depression in the general population of South Africa is estimated as 9.7%, estimates from HIV-infected populations have ranged from 14-62%, with variability 

  • Using Routinely Collected Laboratory Data to Characterise Trends in the TB Epidemic

    The overall aim of this study is to harness routinely collected laboratory data to characterize the spatial distribution of tuberculosis in South Africa. In collaboration with partners at the University of the Witwatersrand and the National Health Laboratory Service, we are conducting retrospective analyses of de-identified data to highlight areas with greater burden of TB disease and investigate whether burden is changing over time. Results from this work will be informative for planning for 

  • Analysis of Drug Resistant Tuberculosis Population and Outcomes in South Africa, using the Electronic Drug Resistant Tuberculosis Register (EDRWeb)

    The South African Electronic Drug Resistant Tuberculosis Register (EDRWeb) is a national reporting database. We propose a retrospective analysis of this de-identified, established database of routinely reported patient-level data to describe the population and outcomes of drug-resistant TB as recorded within the EDRweb in order to inform treatment guidelines and practice for South Africa. Operational implementation across a broad number of sites is likely to differ from cohorts at 

  • The Costs and Outcomes of Tuberculosis Treatment at Primary Health Care Clinics in an Urban Township, South Africa

    The actual implementation of DOTS across South Africa varies widely. Implementation of DOTS may differ between the intensive phase of treatment (first 2-3 months, with daily injections for the retreatment regimen and a 4-drug fixed combination pill for both first-line regimens) and the continuation phase of treatment (consisting of a daily, 2-drug fixed combination pill). In either phase, the treatment supervisor may be a nurse or counselor at a healthcare facility, a lay healthworker from the 

  • 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, 

  • Second and Third-Line Antiretroviral Regimens

    As South Africa continues its rapid expansion of access to first-line antiretroviral therapy (ART), more patients will need to be switched to second-line therapy as these first-line regimens fail. However, with little experience with second-line treatments in resource-limited settings, it is not clear how well patients will do on these medications if their first regimen fails. As the cost of second-line medications is much higher than first-line, it is critical to evaluate whether these 

  • First Line Regimen Durability and Adverse Events

    Understanding the implications of the side effect profile of individual antiretroviral drugs as well as the durability of drug regimens has considerable significance in settings where resources and drug options for HIV remain limited. HE2RO has explored these questions through longitudinal patient datasets with a particular interest in the effects of tenofovir upon introduction into the national programme. These analyses are ongoing as guidelines continue to evolve and current projects include 

  • 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 

Publications