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.
Evidence that age-disparate relationships (ADR) between young women and older men are an important route of transmission of HIV infection is limited. The results from recent studies indicate that heterosexual relationships between young women and older men may help sustain the epidemic within some populations of South Africa and Malawi. However, the way in which age differences serve to sustain the epidemic of HIV may be different than what has been previously described in observational studies. This article proposes several public health intervention recommendations in relation to ADR and the epidemic of HIV.
Planet Earth has been here for over 4.5 billion years, but in just two human generations we have managed to place our only “home” at great risk. Given today’s uncertainties – social, economic, geopolitical, and environmental, it is clear that many lessons from history have not yet been learned and new lessons may prove equally, if not more, difficult to take on board as we head deeper into this century. My new book seeks to raise awareness about major global issues we face, stimulate discussion or debate and find ways forward to ensure planet and people sustainability.
There have been numerous papers and books on South Africa’s catastrophic era of AIDS denialism. There is much less known and written about the “when-to-start antiretrovirals (ARVs)” debate. This debate offers a fascinating look at how scientific disagreements between reasonable people, who are experts in the field, work, and how consensus evolves as evidence accumulates.
HIV and human papillomavirus (HPV) are two heavy hitting sexually transmitted infections (STIs). Meta-analyses of the association between HPV prevalence and HIV acquisition and the association between HIV prevalence and new HPV detection have estimated a two-fold increased risk in both directions, after adjusting for individual-level (sexual behavioural) factors. The studies argue that biological mechanisms may be responsible for these increased risks, but they also concur that residual confounding due to behaviour at the sexual network level cannot be ruled out. We used an individual based model to shed some light on the matter.
On 18 April 2018, Venetia Karamitsou, PhD student in the Disease Dynamics group at the University of Cambridge, held a talk at SACEMA on modelling the evolution of influence. Given that vaccination is the main control strategy against influenza outbreaks, it is worrisome that influenza mutates often, making reinfection possible even for vaccinated individuals. Existing models regarding the evolution of influenza focus on either changes within hosts or between hosts. The main motivation behind the current research is to find out how both types of models can be combined. The results from the study can be useful in reassessing vaccination policies.
Models of HIV and TB are well established and it is tempting to model the combination of HIV and TB by repeating a suitable TB model a number of times corresponding to the various states of HIV. This can, however, lead to a very complex model with tens, if not hundreds of parameters, requiring considerable computing power to run. Fortunately, the time scales over which the two infections progress are very different, allowing us to greatly simplify the problem.