Dr. Ribka Berhanu [Assistant Professor]

T: +27100600026  
Dr. Ribka Berhanu

Ribka Berhanu is an infectious diseases physician and clinical TB researcher. She is an assistant professor in the department of medicine at the Vanderbilt University Medical Centre and divides her time between Johannesburg and Nashville. She works closely with both the Health Economics and Epidemiology Research Office and the Perinatal HIV Research Unit of the Wits Health Consortium. Her clinical work in the US and in South Africa is focused on the care of hospitalized patients with HIV and complex infectious diseases. Ribka’s research is centered on TB transmission and new TB diagnostics in high burden countries. She is funded through an NIH K08 training grant to study the application of network analysis, geo-spatial analysis, and whole genome sequencing to understand non-household transmission of TB in South Africa.

Projects

  • Rewards for TB Contact Screening (RECON)

    Because of the high risk of both TB and HIV among the household contacts of TB patients and the importance of early case detection for both diseases and especially for DR-TB, improving TB case finding is a high priority. Recent studies have shown that having healthcare workers make multiple visits to the homes of TB patients in order to screen household contacts is a logistically challenging and resource- intensive strategy, and it is not routinely undertaken in most public sector settings in 
  • 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 
  • Adverse Events of Treatment in a Decentralized Drug-Resistant Tuberculosis Clinic in Johannesburg, South Africa

    The overall aim of this study is to review adverse events of decentralized, ambulatory drug-resistant TB (DR-TB) among a high proportion of rifampicin monoresistant TB patients at an outpatient specialized clinic in Johannesburg, South Africa. The study is a retrospective study and differs in two significant ways from previous studies of DR-TB in South Africa.  Firstly, a large proportion of the patients receiving decentralized care have rifampicin mono-resistant TB. All the previous studies 
  • Costs and Outcomes Analysis of Decentralized, Deinstitutionalized Drug-Resistant Tuberculosis Management at a Johannesburg Hospital

    The overall aim of this medical record review observational cohort study is to analyse the cost and outcomes of decentralized, deinstitutionalized drug-resistant TB (DR-TB) management at an outpatient specialized clinic in Johannesburg. In August 2011, the South African National Department of Health adopted guidelines regarding MDR-TB treatment, “Decentralised Management of Multidrug-Resistant Tuberculosis: A Policy Framework for South Africa.” These guidelines recommend that acid fast 
  • Linkages to Care for Patients Diagnosed with Drug-Resistant Tuberculosis within the City of Johannesburg

    Nationally, in the most recently reported cohort of patients (2011), only 56% of patients with laboratory-confirmed MDR-TB initiated 2nd line TB treatment. The National Strategic Plan for HIV, TB, and STIs 2012-2016 set an ambitious target of 100% initiation. Because of the complexity of the referral and linkage process and the fragmentation of the records amongst various registers, the proportion of patients completing each step (sample collection, diagnosis of resistance, reporting of 
  • Remote Electronic Treatment Adherence Monitoring of Patients on Antiretroviral Therapy in South Africa: A Pilot Study

    Electronic patient adherence monitoring is a novel method for improving adherence to HIV treatment. This pilot study aimed to generate preliminary data for a larger trial. We determine the effectiveness and cost-effectiveness of using electronic patient adherence monitoring in patients at high risk of failing second-line antiretroviral therapy (ART) at Themba Lethu HIV clinic in Johannesburg, South Africa compared to the standard of care, which involves optimized adherence counseling. 
  • 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 

Publications