Open communication has always been at the heart of the SACEMA Quarterly. Ever since the first issue of the magazine, in March 2009, the aim of the Quarterly has been to provide regular updates, articles, and reviews of developments in the world of quantitative epidemiology. This issue will be the last SACEMA Quarterly. We are thankful for your interest in our work through the years.
Rooftop solar could be used as an ideal solution to the multiple problems which remain unsolved in low-income areas (LIAs), including the big four of economic development, employment, municipal debt and energy justice. Although this claim sounds preposterous, given how wicked these problems have been shown to be, and how many other approaches have been tried, but have failed, it is made without any presumption or disingenuity. Rarely is an opportunity presented in a way which allows multiple objectives to be achieved with a single instrument. Rooftop solar is one such opportunity; it should not be ignored.
Incidence is the most sensitive indicator of epidemiological trends, but it is hard to estimate for HIV. Epidemic surveillance therefore largely relies on population-level prevalence surveys, antenatal clinic surveys and various forms of routine data. A range of methods are used to estimate HIV incidence, but no single approach attains the levels of precision one might hope for with the data available. To help address this, we developed an approach that implements an optimal weighting of a biomarker-based incidence estimator and an incidence estimator based on estimates of age-specific prevalence and excess mortality.
In epidemiology, mathematical models are widely used to simulate progression, transmission, prevention and treatment of infectious diseases. Individual-based models (IBMs) keep track of the events that happen to each individual separately and are therefore able to take into account various sources of individual heterogeneity. SimpactCyan is conceived as a multipurpose model-building tool to address research questions in HIV epidemiology at the intersection of network and social epidemiology, computational biology, public health and policy modelling. With SimpactCyan we aim to overcome some of the limitations of current software for implementing IBMs in HIV epidemiology.
Malawi has developed an excellent, nation-wide system for monitoring HIV patients and keeping track of key epidemic markers. The success of the Malawi system lies in two things: the focus on simplicity and the use of the data collection process not only to track the epidemic and identify problems to be dealt with but also to give regular feedback and support to every clinic in the country. We in South Africa have much to learn from them.
The prevalence of Foetal Alcohol Spectrum Disorder (FASD) recorded on farms and in rural towns in the Western and Northern Cape is much higher than anywhere else in the world. FASD is generally agreed to be an outcome of women drinking when they are pregnant. Conceptions of FASD and interpretations of its consequences continue to be controversial.
Among the three greatest pandemics in history are the Black Death, the Spanish Flu and now HIV. The Spanish Flu was caused by a virulent strain of the H5N1 virus and killed up to fifty million people, or 2% of the world’s population, most of them in less than one month in 1918. We should study the history of past epidemics and learn how to avoid, manage and control them. South Africa is still struggling to contain the epidemic of HIV and manage the epidemic of TB, now being primarily driven by HIV.
The HIVR4P conference is a global scientific conference focusing on biomedical HIV prevention research. HIVR4P 2018 supported research on HIV vaccines, microbicides, PrEP, treatment as prevention, and other biomedical prevention approaches. Numerous presentations highlighted the growing knowledge of HIV immune responses, HIV vaccine approaches, the impact of PrEP in HIV prevention, new PrEP drugs and diverse potential delivery options.
Formal scientific experimental investigations tend to rely on comparing situations where differences are to some extend directly controlled, or at least known. However, it is clearly impossible to investigate, in such a manner, every detail of life, or even a slightly narrower aspect like ‘healthcare’ – by examining each choice and evaluating its role in a ‘total package’ of ‘lifestyle’, ‘care’ or ‘policy’. The current edition of the SACEMA Quarterly features several pieces grappling explicitly with this challenge of understanding a bigger picture than any particular ‘scientific investigation’ can formally take on.
Intimate partner violence (IPV) is a worldwide epidemic. Physical and sexual violence are the most well-studied forms of IPV from an epidemiological point of view. Both of these have serious implications for other aspects of physical and mental health. In particular, women who have experienced IPV are more likely to be HIV-positive. In a modelling study we investigated some closely related questions about HIV and IPV in South Africa.