In the June 2010 issue of the SACEMA Quarterly, Steve Bellan reported on the 2009 and 2010 Clinics on the Meaningful Modelling of Epidemiological Data (MMED) that were given at the African Institute for Mathematical Sciences (1). This clinic continues to be given annually and in April 2012 an article has been published in PLOS Read More
There are few students in epidemiological modeling and analysis who can resist the temptation to fit a theoretical disease model to real epidemic data. A recent DNA fingerprinting project from Masiphumelele, a township near Cape Town, offered such a temptation. The result is a short journey into the world of statistically rare events, in this case brought about by the relatively small size of Masiphumele and by the slow reactivation rates of TB.
After two decades of setbacks with microbicide trials, recently two studies demonstrated a proof of concept for microbicides for the first time. With now a demonstrated proof of concept, understanding the potential cost-effectiveness of vaginal microbicides within the currently existing set of HIV prevention interventions becomes crucial. As there it not yet a safe and effective microbicide available, the challenge is to evaluate the potential of the microbicide technology for a hypothetical intervention. Results are reported of a recent study that looked at a potential 1-year intervention targeting a population of women in reproductive age in South Africa and estimated the incremental cost-effectiveness over a year of microbicides when distributed in conjunction with condoms.
In recent years there has been a dramatic increase in treatment demand for abuse of drugs including methamphetamine (MA) in the Western Cape Province (WCP) of South Africa. MA use has been linked to risky sexual behaviour and sexually transmitted infections including HIV. Thus, MA use has immense public health implications. It is against this background that a model was formulated to study the dynamics of treatment use for MA abuse in the WCP, with the aim of providing a predictive tool for the prevalence of drug use. The results of this study are presented in this article.
Given the enormous burden that the current HIV/AIDS and TB epidemics have imposed on rural areas in the eastern and central provinces of South Africa, how much attention should the National and Provincial governments be paying to zoonotic diseases such as bovine TB (BTB) in these areas? The answer lies not only in the extent to which BTB posses an additional burden on human health in the region, but also on the degree to which it threatens food security, exacerbates poverty, and threatens conservation and green tourism.
Mathematical modelling is valuable in public health because it for example provides a way to evaluate strategies for controlling disease before actually trying such strategies in the field. By varying the values of model parameters, it is possible to ask questions such as: “How will the number of people getting sick during an influenza outbreak in Cape Town be affected if we give half of all sick people a drug that reduces their infectiousness by 50%?”. In May 2009, the first annual clinic on the Meaningful Modelling of Biological Data was organised at the African Institute for Mathematical Sciences (AIMS) in Muizenberg, South Africa.
The article from Tony Davies in this issue of the Quarterly, gives a historical overview on occupational lung disease in South Africa. Recently a report was published by the Health Systems Trust, which highlights the actuality of this topic (2). The aim of the research presented in the report was to investigate health systems surveillance Read More
In July 2009 Dr Gavin Hitchcock reported on the Training and Capacity Building at SACEMA. In the prologue of the report he highlighted the importance of effective multi-disciplinary training in meaningful epidemiological modelling: “The human tragedies associated with disease in Africa and elsewhere continue to appeal our sensibilities and drain our resources: TB, malaria, trypanosomiasis, Read More
South Africa is faced with a public health catastrophe due, in part at least, to the mining activity, which laid the foundation of our economy. In the mines millions of men have worked in dangerous and dusty conditions. There have been three very high risk exposures in South African workplaces: silica, asbestos and tuberculosis, all resulting in serious lung problems. This article gives an historical perspective on the causes of occupational lung disease and what should have been done to lower the risks.
Since 1990 the pre-eminent factor contributing to the current massive TB epidemic in South Africa is HIV infection. But the risk of TB in HIV-infected adults and children can be reduced by taking HAART. The WHO Stop TB Department now proposes the 3I’s strategy (Intensified Case Finding, Isoniazid preventive treatment, and TB Infection Control) to halt the rise of the TB epidemic. However, the 3I’s strategy has some pitfalls.