Scientists offering papers for publication will be becoming increasingly aware of a significant change in the attitude of journals to the publication of the data used to reach conclusions drawn in their manuscript. New regulations are moving rapidly and uncompromisingly towards a policy where all of the data, and related metadata, required to replicate the reported findings must be made freely available to the world at large. There is much to be said in favour of this argument, but one wonders whether journals have thought through some of the ramifications of the new policy.
Africa and Asia have the highest prevalence of Hepatitis B virus (HBV) worldwide. Mother-to-child transmission (MTCT) is the most common route of transmission in high prevalence areas. There are three different prevention strategies available to prevent HBV MTCT: Vaccine, Hepatitis B Immunoglobulin and Antiviral therapy during pregnancy. Strategic investment now could see the eradication of HBV MTCT in Africa and ultimately potentially the elimination of this major public health problem.
As coverage of paediatric ART increases and guidelines for ART initiation change, it will be necessary to determine how best to monitor ART. Routine monitoring of HIV viral load is common practice in ART programmes in high-income countries, but, in sub-Saharan Africa, most ART programmes rely on CD4 cell measurements or clinical monitoring to detect treatment failure. We conducted a computer simulation of HIV-positive children to predict the effect of different ART monitoring strategies.
Individuals across Africa may have changed their sexual behaviour following the visibility of AIDS in the public sphere in the mid to late 1990s. Though each change in behaviour may have been small, the changes affected simultaneously different aspects of individual sexuality, and added up cumulatively into a moderate reduction in sexual behaviour at the individual level. In turn, this change in individual behaviour was translated into massive disruption of sexual networks at the population level. This made it difficult for HIV to propagate in the population leading to large declines in HIV incidence and prevalence.
Concurrent partnerships have been suggested as a possible driver of the HIV epidemic in Southern Africa. To date, estimates of concurrency in published literature have been problematic due to poor definitions and measurement. We conducted a sexual behaviour survey in Cape Town that characterized concurrency by estimating the point prevalence, cumulative prevalence, incidence and degree distribution of concurrent partnerships. We also described the duration of overlaps for relationships begun in the previous year and the relative risk of having concurrent partnerships for different race and sex groups.
Household contacts of active TB cases are at increased risk of TB infection and several studies have measured TB prevalence in this key population. The study described here not only measured TB prevalence, but also measured TB and HIV incidence in the household contacts of 729 TB index cases in the Matlosana sub-district in North West Province. We concluded that the efficacy of contact tracing for TB control purposes might be improved by a second intensified case finding visit and by providing preventive treatment against TB for both HIV-infected and HIV-seronegative household contacts of TB cases.
We would like to invite you to the Results Showcase for the Sexual Behavior Survey on Friday, 27 March, 2015 from 11am – 3pm at the Blue Hall in Khayelitsha.
2015 signifies the deadline for the Millennium Development Goals (MDGs) which include reduction of the under-five mortality rate by two-thirds, reduction of the maternal mortality ratio by three quarters (both relative to the 1990 figures), and universal access to reproductive health. This issue of the SACEMA Quarterly focuses on various aspects of maternal and child health, and the role of statistical and mathematical modelling techniques in this area of research.
While in the past antiretroviral treatment (ART) for children aged 2-5 years was started only when the CD4 count or CD4% fell below a critical threshold, or a clinically severe event occurred, the new WHO 2013 guidelines recommend immediate treatment initiation regardless of the child’s immune status. Scientific evidence which can guide policies is sparse and conducting trials on the optimal timing of ART initiation is lengthy, costly, and ethically difficult. Instead, routinely captured observational data can be used to answer this question if the statistical analysis makes use of methods which allow a causal interpretation. One of these methods which allows causal interpretations is called “g-computation”.
King James VI of Scotland, I of England, (1567−1625) commissioned the most influential book ever to be written in English. While the language of the King James Bible has done much to define modern English, it can be argued that the Bible also developed, for the first time, the notion of peer-review which is at the very heart of modern science. And one may argue further that the way in which he organized the writing of the new Bible holds lessons for how we should organize our scientific lives today.