463 results on '"Mosepele, Mosepele"'
Search Results
102. How Applicable Is the Single-Dose AMBITION Regimen for Human Immunodeficiency Virus–Associated Cryptococcal Meningitis to High-Income Settings?
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Harrison, Thomas S, Lawrence, David S, Mwandumba, Henry C, Boulware, David R, Hosseinipour, Mina C, Lortholary, Olivier, Meintjes, Graeme, Mosepele, Mosepele, and Jarvis, Joseph N
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AMPHOTERICIN B ,DEVELOPED countries ,HETEROCYCLIC compounds ,MEDICAL protocols ,CRYPTOCOCCUS neoformans ,MENINGITIS ,FLUCONAZOLE ,HIV - Abstract
The AmBisome Therapy Induction Optimization (AMBITION-cm) trial, conducted in eastern and southern Africa, showed that a single, high dose (10 mg/kg) of liposomal amphotericin B, given with an oral backbone of fluconazole and flucytosine, was noninferior to the World Health Organization (WHO)–recommended regimen of 7 days of amphotericin B deoxycholate plus flucytosine for treatment of human immunodeficiency virus (HIV)–associated cryptococcal meningitis and has been incorporated into WHO treatment guidelines. We believe that the trial also has important implications for the treatment of HIV-associated cryptococcal meningitis in high-income settings. We advance the arguments, supported by evidence where available, that the AMBITION-cm trial regimen is likely to be as fungicidal as the currently recommended 14-day liposomal amphotericin–based treatments, better tolerated with fewer adverse effects, and confer significant economic and practical benefits and, therefore, should be included as a treatment option in guidance for HIV-associated cryptococcal treatment in high-income settings. [ABSTRACT FROM AUTHOR]
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- 2023
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103. Near-complete genome of SARS-CoV-2 Delta variant of concern identified in a symptomatic dog (Canis lupus familiaris) in Botswana
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Moyo, Sikhulile, primary, Choga, Wonderful T., additional, Letsholo, Samantha L., additional, Marobela-Raborokgwe, Chandapiwa, additional, Mazwiduma, Mbatshi, additional, Maruapula, Dorcas, additional, Rukuva, John, additional, Binta, Mary Gorettie, additional, Oarabile, Letlhogile, additional, Zuze, Boitumelo J. L., additional, Koopile, Legodile, additional, Seru, Kedumetse, additional, Motshosi, Patience, additional, Bareng, Ontlametse, additional, Radibe, Botshelo, additional, Lawrence-Smith, Pamela, additional, Macheke, Kutlo, additional, Kuate-Lere, Lesego, additional, Motswaledi, Modisa S., additional, Mbulawa, Mpaphi B., additional, Matshaba, Mogomotsi, additional, Masupu, Kereng V., additional, Lockman, Shahin, additional, Shapiro, Roger, additional, Makhema, Joseph, additional, Mosepele, Mosepele, additional, and Gaseitsiwe, Simani, additional
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- 2022
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104. A pragmatic approach to managing antiretroviral therapy-experienced patients diagnosed with HIV-associated cryptococcal meningitis: impact of antiretroviral therapy adherence and duration
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David R. Boulware, Henry C. Mwandumba, Thomas S. Harrison, Timothée Boyer-Chammard, Mosepele Mosepele, Chiratidzo E. Ndhlovu, Joshua Rhein, Síle F. Molloy, Lillian Tugume, Melanie Alufandika, Joseph N Jarvis, David S Lawrence, David B. Meya, Olivier Lortholary, Graeme Meintjes, Cecilia Kanyama, Charlotte Schutz, Conrad Muzoora, and Nabila Youssouf
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0301 basic medicine ,Antifungal ,Pediatrics ,medicine.medical_specialty ,Antifungal Agents ,medicine.drug_class ,Art initiation ,Immunology ,Human immunodeficiency virus (HIV) ,MEDLINE ,HIV Infections ,Meningitis, Cryptococcal ,medicine.disease_cause ,Medication Adherence ,law.invention ,03 medical and health sciences ,Viewpoint ,0302 clinical medicine ,Randomized controlled trial ,law ,Antiretroviral Therapy, Highly Active ,Humans ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,AIDS-Related Opportunistic Infections ,business.industry ,Antiretroviral therapy ,Discontinuation ,Treatment Outcome ,030104 developmental biology ,Infectious Diseases ,Anti-Retroviral Agents ,business ,Cryptococcal meningitis - Abstract
Cryptococcal meningitis accounts for 15% of all HIV-related deaths [1]. The overall number of cryptococcal meningitis cases has remained relatively stable in many low-to-middle income countries (LMICs) despite increasing roll-out of antiretroviral therapy (ART). Increasing numbers of patients are at risk of developing cryptococcal meningitis following ART failure or discontinuation, offsetting declines in those presenting for the first time with advanced HIV [2–4]. Over half of patients diagnosed with cryptococcal meningitis in recent studies in sub-Saharan Africa are ART-experienced (i.e. currently receiving or previously received ART) [5,6]. Although there is robust evidence from prospective randomized trials that ART initiation should be delayed until 4–6 weeks after starting antifungal therapy in ART-naive cryptococcal meningitis patients [7,8], the approach to ART management among ART-experienced cryptococcal meningitis patients lacks adequate evidence, with a paucity of published data.
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- 2020
105. Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa
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Raquel Viana, Sikhulile Moyo, Daniel G. Amoako, Houriiyah Tegally, Cathrine Scheepers, Christian L. Althaus, Ugochukwu J. Anyaneji, Phillip A. Bester, Maciej F. Boni, Mohammed Chand, Wonderful T. Choga, Rachel Colquhoun, Michaela Davids, Koen Deforche, Deelan Doolabh, Louis du Plessis, Susan Engelbrecht, Josie Everatt, Jennifer Giandhari, Marta Giovanetti, Diana Hardie, Verity Hill, Nei-Yuan Hsiao, Arash Iranzadeh, Arshad Ismail, Charity Joseph, Rageema Joseph, Legodile Koopile, Sergei L. Kosakovsky Pond, Moritz U. G. Kraemer, Lesego Kuate-Lere, Oluwakemi Laguda-Akingba, Onalethatha Lesetedi-Mafoko, Richard J. Lessells, Shahin Lockman, Alexander G. Lucaci, Arisha Maharaj, Boitshoko Mahlangu, Tongai Maponga, Kamela Mahlakwane, Zinhle Makatini, Gert Marais, Dorcas Maruapula, Kereng Masupu, Mogomotsi Matshaba, Simnikiwe Mayaphi, Nokuzola Mbhele, Mpaphi B. Mbulawa, Adriano Mendes, Koleka Mlisana, Anele Mnguni, Thabo Mohale, Monika Moir, Kgomotso Moruisi, Mosepele Mosepele, Gerald Motsatsi, Modisa S. Motswaledi, Thongbotho Mphoyakgosi, Nokukhanya Msomi, Peter N. Mwangi, Yeshnee Naidoo, Noxolo Ntuli, Martin Nyaga, Lucier Olubayo, Sureshnee Pillay, Botshelo Radibe, Yajna Ramphal, Upasana Ramphal, James E. San, Lesley Scott, Roger Shapiro, Lavanya Singh, Pamela Smith-Lawrence, Wendy Stevens, Amy Strydom, Kathleen Subramoney, Naume Tebeila, Derek Tshiabuila, Joseph Tsui, Stephanie van Wyk, Steven Weaver, Constantinos K. Wibmer, Eduan Wilkinson, Nicole Wolter, Alexander E. Zarebski, Boitumelo Zuze, Dominique Goedhals, Wolfgang Preiser, Florette Treurnicht, Marietje Venter, Carolyn Williamson, Oliver G. Pybus, Jinal Bhiman, Allison Glass, Darren P. Martin, Andrew Rambaut, Simani Gaseitsiwe, Anne von Gottberg, and Tulio de Oliveira
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Models, Molecular ,Recombination, Genetic ,Botswana ,Multidisciplinary ,SARS-CoV-2 ,COVID-19 ,610 Medicine & health ,Antibodies, Neutralizing ,South Africa ,360 Social problems & social services ,Mutation ,Spike Glycoprotein, Coronavirus ,Humans ,Phylogeny ,Immune Evasion - Abstract
The SARS-CoV-2 epidemic in southern Africa has been characterized by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, while the second and third waves were driven by the Beta (B.1.351) and Delta (B.1.617.2) variants, respectively1–3. In November 2021, genomic surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant associated with a rapid resurgence of infections in Gauteng province, South Africa. Within three days of the first genome being uploaded, it was designated a variant of concern (Omicron, B.1.1.529) by the World Health Organization and, within three weeks, had been identified in 87 countries. The Omicron variant is exceptional for carrying over 30 mutations in the spike glycoprotein, which are predicted to influence antibody neutralization and spike function4. Here we describe the genomic profile and early transmission dynamics of Omicron, highlighting the rapid spread in regions with high levels of population immunity.
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- 2022
106. Additional file 3 of Public and outpatients’ awareness of calling emergency medical services immediately by acute stroke in an upper middle-income country: a cross-sectional questionnaire study in greater Gaborone, Botswana
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Ookeditse, Ookeditse, Ookeditse, Kebadiretse K., Motswakadikgwa, Thusego R., Masilo, Gosiame, Bogatsu, Yaone, Lekobe, Baleufi C., Mosepele, Mosepele, Schirmer, Henrik, and Johnsen, Stein H.
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Additional file 3: eTable 1. Sources of stroke information among respondents.
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- 2022
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107. Additional file 4 of Public and outpatients’ awareness of calling emergency medical services immediately by acute stroke in an upper middle-income country: a cross-sectional questionnaire study in greater Gaborone, Botswana
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Ookeditse, Ookeditse, Ookeditse, Kebadiretse K., Motswakadikgwa, Thusego R., Masilo, Gosiame, Bogatsu, Yaone, Lekobe, Baleufi C., Mosepele, Mosepele, Schirmer, Henrik, and Johnsen, Stein H.
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Additional file 4: eTable 2. Mann-Whitney U/ Kruskal-Wallis H - Association of awareness of calling EMS, and seeking immediate medical assistance with sociodemographic factors among respondents.
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- 2022
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108. Additional file 2 of Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
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Malhotra, Akash, Thompson, Ryan R., Kagoya, Faith, Masiye, Felix, Mbewe, Peter, Mosepele, Mosepele, Phiri, Jane, Sambo, Jairos, Barker, Abigail, Cameron, Drew B., Davila-Roman, Victor G., Effah, William, Hutchinson, Brian, Laxy, Michael, Newsome, Brad, Watkins, David, Sohn, Hojoon, and Dowdy, David W.
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Additional file 2. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist.
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- 2022
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109. Additional file 1 of Public and outpatients’ awareness of calling emergency medical services immediately by acute stroke in an upper middle-income country: a cross-sectional questionnaire study in greater Gaborone, Botswana
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Ookeditse, Ookeditse, Ookeditse, Kebadiretse K., Motswakadikgwa, Thusego R., Masilo, Gosiame, Bogatsu, Yaone, Lekobe, Baleufi C., Mosepele, Mosepele, Schirmer, Henrik, and Johnsen, Stein H.
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Additional file 1: eFigure 1. Awareness of calling EMS by acute stroke study.
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- 2022
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110. Additional file 1 of Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
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Malhotra, Akash, Thompson, Ryan R., Kagoya, Faith, Masiye, Felix, Mbewe, Peter, Mosepele, Mosepele, Phiri, Jane, Sambo, Jairos, Barker, Abigail, Cameron, Drew B., Davila-Roman, Victor G., Effah, William, Hutchinson, Brian, Laxy, Michael, Newsome, Brad, Watkins, David, Sohn, Hojoon, and Dowdy, David W.
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Additional file 1. Protocol for scoping review.
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- 2022
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111. Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa
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Raquel Viana, Sikhulile Moyo, Daniel G Amoako, Houriiyah Tegally, Cathrine Scheepers, Christian L Althaus, Ugochukwu J Anyaneji, Phillip A Bester, Maciej F Boni, Mohammed Chand, Wonderful T Choga, Rachel Colquhoun, Michaela Davids, Koen Deforche, Deelan Doolabh, Susan Engelbrecht, Josie Everatt, Jennifer Giandhari, Marta Giovanetti, Diana Hardie, Verity Hill, Nei-Yuan Hsiao, Arash Iranzadeh, Arshad Ismail, Charity Joseph, Rageema Joseph, Legodile Koopile, Sergei L Kosakovsky Pond, Moritz UG Kraemer, Lesego Kuate-Lere, Oluwakemi Laguda-Akingba, Onalethatha Lesetedi-Mafoko, Richard J Lessells, Shahin Lockman, Alexander G Lucaci, Arisha Maharaj, Boitshoko Mahlangu, Tongai Maponga, Kamela Mahlakwane, Zinhle Makatini, Gert Marais, Dorcas Maruapula, Kereng Masupu, Mogomotsi Matshaba, Simnikiwe Mayaphi, Nokuzola Mbhele, Mpaphi B Mbulawa, Adriano Mendes, Koleka Mlisana, Anele Mnguni, Thabo Mohale, Monika Moir, Kgomotso Moruisi, Mosepele Mosepele, Gerald Motsatsi, Modisa S Motswaledi, Thongbotho Mphoyakgosi, Nokukhanya Msomi, Peter N Mwangi, Yeshnee Naidoo, Noxolo Ntuli, Martin Nyaga, Lucier Olubayo, Sureshnee Pillay, Botshelo Radibe, Yajna Ramphal, Upasana Ramphal, James E San, Lesley Scott, Roger Shapiro, Lavanya Singh, Pamela Smith-Lawrence, Wendy Stevens, Amy Strydom, Kathleen Subramoney, Naume Tebeila, Derek Tshiabuila, Joseph Tsui, Stephanie van Wyk, Steven Weaver, Constantinos K Wibmer, Eduan Wilkinson, Nicole Wolter, Alexander E Zarebski, Boitumelo Zuze, Dominique Goedhals, Wolfgang Preiser, Florette Treurnicht, Marietje Venter, Carolyn Williamson, Oliver G Pybus, Jinal Bhiman, Allison Glass, Darren P Martin, Andrew Rambaut, Simani Gaseitsiwe, Anne von Gottberg, and Tulio de Oliveira
- Abstract
SummaryThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in southern Africa has been characterised by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, whilst the second and third waves were driven by the Beta and Delta variants respectively1–3. In November 2021, genomic surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant associated with a rapid resurgence of infections in Gauteng Province, South Africa. Within three days of the first genome being uploaded, it was designated a variant of concern (Omicron) by the World Health Organization and, within three weeks, had been identified in 87 countries. The Omicron variant is exceptional for carrying over 30 mutations in the spike glycoprotein, predicted to influence antibody neutralization and spike function4. Here, we describe the genomic profile and early transmission dynamics of Omicron, highlighting the rapid spread in regions with high levels of population immunity.
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- 2021
112. Correction to: Strengthening medical training programmes by focusing on professional transitions: a national bridging programme to prepare medical school graduates for their role as medical interns in Botswana
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Michael J. Peluso, Rebecca Luckett, Savara Mantzor, Alemayehu G. Bedada, Paul Saleeb, Miriam Haverkamp, Mosepele Mosepele, Cecil Haverkamp, Rosa Maoto, Detlef Prozesky, Neo Tapela, Oathokwa Nkomazana, and Tomer Barak
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Special aspects of education ,LC8-6691 ,Medicine - Abstract
Correction Forllowing publication of the original article [1], the first author reported that there was a typographical error in the name of one of his co-authors. The correct spelling is Alemayehu Bedada, not Alemayhu Bedada.
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- 2018
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113. Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa
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Viana, Raquel, primary, Moyo, Sikhulile, additional, Amoako, Daniel G, additional, Tegally, Houriiyah, additional, Scheepers, Cathrine, additional, Althaus, Christian L, additional, Anyaneji, Ugochukwu J, additional, Bester, Phillip A, additional, Boni, Maciej F, additional, Chand, Mohammed, additional, Choga, Wonderful T, additional, Colquhoun, Rachel, additional, Davids, Michaela, additional, Deforche, Koen, additional, Doolabh, Deelan, additional, Engelbrecht, Susan, additional, Everatt, Josie, additional, Giandhari, Jennifer, additional, Giovanetti, Marta, additional, Hardie, Diana, additional, Hill, Verity, additional, Hsiao, Nei-Yuan, additional, Iranzadeh, Arash, additional, Ismail, Arshad, additional, Joseph, Charity, additional, Joseph, Rageema, additional, Koopile, Legodile, additional, Pond, Sergei L Kosakovsky, additional, Kraemer, Moritz UG, additional, Kuate-Lere, Lesego, additional, Laguda-Akingba, Oluwakemi, additional, Lesetedi-Mafoko, Onalethatha, additional, Lessells, Richard J, additional, Lockman, Shahin, additional, Lucaci, Alexander G, additional, Maharaj, Arisha, additional, Mahlangu, Boitshoko, additional, Maponga, Tongai, additional, Mahlakwane, Kamela, additional, Makatini, Zinhle, additional, Marais, Gert, additional, Maruapula, Dorcas, additional, Masupu, Kereng, additional, Matshaba, Mogomotsi, additional, Mayaphi, Simnikiwe, additional, Mbhele, Nokuzola, additional, Mbulawa, Mpaphi B, additional, Mendes, Adriano, additional, Mlisana, Koleka, additional, Mnguni, Anele, additional, Mohale, Thabo, additional, Moir, Monika, additional, Moruisi, Kgomotso, additional, Mosepele, Mosepele, additional, Motsatsi, Gerald, additional, Motswaledi, Modisa S, additional, Mphoyakgosi, Thongbotho, additional, Msomi, Nokukhanya, additional, Mwangi, Peter N, additional, Naidoo, Yeshnee, additional, Ntuli, Noxolo, additional, Nyaga, Martin, additional, Olubayo, Lucier, additional, Pillay, Sureshnee, additional, Radibe, Botshelo, additional, Ramphal, Yajna, additional, Ramphal, Upasana, additional, San, James E, additional, Scott, Lesley, additional, Shapiro, Roger, additional, Singh, Lavanya, additional, Smith-Lawrence, Pamela, additional, Stevens, Wendy, additional, Strydom, Amy, additional, Subramoney, Kathleen, additional, Tebeila, Naume, additional, Tshiabuila, Derek, additional, Tsui, Joseph, additional, van Wyk, Stephanie, additional, Weaver, Steven, additional, Wibmer, Constantinos K, additional, Wilkinson, Eduan, additional, Wolter, Nicole, additional, Zarebski, Alexander E, additional, Zuze, Boitumelo, additional, Goedhals, Dominique, additional, Preiser, Wolfgang, additional, Treurnicht, Florette, additional, Venter, Marietje, additional, Williamson, Carolyn, additional, Pybus, Oliver G, additional, Bhiman, Jinal, additional, Glass, Allison, additional, Martin, Darren P, additional, Rambaut, Andrew, additional, Gaseitsiwe, Simani, additional, von Gottberg, Anne, additional, and de Oliveira, Tulio, additional
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- 2021
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114. Feasibility of oral HIV self-testing in female sex workers in Gaborone, Botswana
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Shava, Emily, primary, Bogart, Laura M., additional, Manyake, Kutlo, additional, Mdluli, Charlotte, additional, Maribe, Kamogelo, additional, Monnapula, Neo, additional, Nkomo, Bornapate, additional, Mosepele, Mosepele, additional, Moyo, Sikhulile, additional, Mmalane, Mompati, additional, Bärnighausen, Till, additional, Makhema, Joseph, additional, and Lockman, Shahin, additional
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- 2021
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115. 743. Colonization with Extended-Spectrum Cephalosporin-Resistant Enterobacterales (ESCrE) in Healthcare and Community Settings in Botswana: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study
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Mannathoko, Naledi, primary, Mosepele, Mosepele, additional, Gross, Robert, additional, Smith, Rachel, additional, Alby, Kevin, additional, Glaser, Laurel, additional, Richard-Greenblatt, Melissa, additional, Sharma, Aditya, additional, Jaskowiak, Anne, additional, Sewawa, Kgotlaetsile, additional, Cowden, Laura, additional, Reesey, Emily, additional, Otukile, Dimpho, additional, Cressman, Leigh, additional, Paganotti, Giacomo, additional, Mokomane, Margaret, additional, and Lautenbach, Ebbing, additional
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- 2021
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116. 733. Carbapenem-Resistant Enterobacterales (CRE) Colonization Prevalence in Botswana: an Antibiotic Resistance in Communities and Hospitals (ARCH) Study
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Mannathoko, Naledi, primary, Mosepele, Mosepele, additional, Smith, Rachel, additional, Gross, Robert, additional, Glaser, Laurel, additional, Alby, Kevin, additional, Richard-Greenblatt, Melissa, additional, Sharma, Aditya, additional, Jaskowiak, Anne, additional, Sewawa, Kgotlaetsile, additional, Reesey, Emily, additional, Cowden, Laura, additional, Cressman, Leigh, additional, Otukile, Dimpho, additional, Paganotti, Giacomo, additional, Mokomane, Margaret, additional, and Lautenbach, Ebbing, additional
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- 2021
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117. Healthcare professionals' knowledge of modifiable stroke risk factors: A cross-sectional questionnaire survey in greater Gaborone, Botswana
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Baleufi Calstro Lekobe, Gosiame Masilo, Yaone Bogatsu, Henrik Schirmer, Kebadiretse K. Ookeditse, Stein Harald Johnsen, Mosepele Mosepele, Ookeditse Ookeditse, and Thusego R. Motswakadikgwa
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P, p-value ,Environmental health ,Diabetes mellitus ,Healthcare professionals ,LDL, low-density lipoprotein ,Health care ,medicine ,AHA/ASA, American Heart Association/American Stroke Association ,RC346-429 ,LMIC, low- and middle-income countries ,Stroke ,USA, United States of America ,ANOVA, analysis of variance ,Response rate (survey) ,Health professionals ,DALY, Disability-adjusted life-years ,business.industry ,HIC, high-income countries ,Questionnaire ,VDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710 ,Awareness ,medicine.disease ,Obesity ,VDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710 ,Modifiable stroke risk factors ,Knowledge ,Upper middle-income country ,SSA, Sub-Saharan Africa ,Neurology ,Low and middle-income countries ,Original Article ,Neurology. Diseases of the nervous system ,business ,SPSS, Statistical Package for the Social Sciences ,SD, standard deviation - Abstract
Background Stroke remains the second leading cause of deaths and disability globally, with highest mortality in Africa (low- and middle-income countries). It is crucial for healthcare professionals to have sufficient stroke risk factors' knowledge in order to reduce the stroke burden. Aims We investigated healthcare professionals' knowledge of modifiable stroke risk factors, and identified demographic factors influencing this knowledge. Methods In this cross-sectional survey study from Botswana (upper middle-income country), structured questionnaires reflecting recent stroke guidelines were administered to a representative selection of healthcare workers in greater Gaborone. The response rate was 61.4%, comprising 84 doctors, 227 nurses and 33 paramedics. Categorical data were described using percentages and Chi-square tests. Associations between stroke risk factors' knowledge and demographic factors were analyzed with one-way ANOVA using SPSS 25 statistical software. Results Awareness rate of individual stroke risk factors was highest for hypertension (96.5%), followed by obesity (93.3%), smoking (91.9%), elevated total cholesterol (91.0%), physical inactivity (83.4%), elevated low-density lipoprotein (LDL) cholesterol (81.1%), excessive alcohol drinking (77.0%), and lowest for diabetes (73.3%). For all-8 risk factors, doctors had the highest knowledge, followed by nurses and paramedics lowest (7.11 vs 6.85 vs 6.06, P, Highlights • This is the first study in Africa assessing knowledge of stroke risk factors among the three healthcare professions concurrently • Understanding stroke risk factors is crucial for healthcare professionals as counsellors and managers of stroke • Doctors had highest stroke knowledge, followed by nurses and lowest paramedics. • Low knowledge was associated with paramedics, private sector, 0–1 year’ clinical experience and female gender. • Continuing education on ischemic stroke risk factors is needed
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- 2021
118. High concordance in plasma and CSF HIV-1 drug resistance mutations despite high cases of CSF viral escape in individuals with HIV-associated cryptococcal meningitis in Botswana.
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Kelentse, Nametso, Moyo, Sikhulile, Choga, Wonderful T, Lechiile, Kwana, Leeme, Tshepo B, Lawrence, David S, Kasvosve, Ishmael, Musonda, Rosemary, Mosepele, Mosepele, Harrison, Thomas S, Jarvis, Joseph N, and Gaseitsiwe, Simani
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DRUG resistance ,HIV ,CEREBROSPINAL fluid examination ,GENETIC mutation ,MENINGITIS ,NUCLEOTIDE sequencing - Abstract
Objectives: We compared the patterns of HIV-1 drug resistance mutations between the CSF and plasma of individuals with HIV-associated cryptococcal meningitis.Methods: This is a cross-sectional study of archived CSF and plasma samples collected from ART-exposed participants recruited in the Phase 3 AmBisome Therapy Induction Optimisation randomized controlled trial (ISRCTN72509687) conducted in Botswana between 2018 and 2021. HIV-1 RT and protease genes were genotyped using next-generation sequencing and HIV-1 drug resistance mutations were compared between the CSF and plasma compartments stratified by thresholds of ≥20% and <20%.Results: Overall, 66.7% (16/24) of participants had at least one HIV-1 drug resistance mutation in the CSF and/or plasma. A total of 15/22 (68.2%) participants had HIV-1 drug resistance mutations at ≥20% threshold in the plasma and of those, 11 (73.3%) had been on ART longer than 6 months. HIV-1 drug resistance mutations were highly concordant between the CSF and plasma at ≥20% threshold despite a substantial number of individuals experiencing CSF viral escape and with only 54.5% with CSF WBC count ≥20 cells/mm3. Minority HIV-1 drug resistance mutations were detected in 20.8% (5/24) of participants. There were no mutations in the CSF that were not detected in the plasma.Conclusions: There was high concordance in HIV-1 drug resistance mutations in the CSF and plasma, suggesting intercompartmental mixing and possibly a lack of compartmentalization. Some individuals harboured minority HIV-1 drug resistance mutations, demonstrating the need to employ more sensitive genotyping methods such as next-generation sequencing for the detection of low-abundance mutations. [ABSTRACT FROM AUTHOR]- Published
- 2023
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119. Association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection With Maternal Mortality and Neonatal Birth Outcomes in Botswana by Human Immunodeficiency Virus Status.
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Jackson-Gibson, Maya, Diseko, Modiegi, Caniglia, Ellen C., Mayondi, Gloria K., Mabuta, Judith, Luckett, Rebecca, Moyo, Sikhulile, Lawrence, Pamela, Matshaba, Mogomotsi, Mosepele, Mosepele, Mmalane, Mompati, Banga, Jaspreet, Lockman, Shahin, Makhema, Joseph, Zash, Rebecca, and Shapiro, Roger L.
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- 2023
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120. HIV and coronary heart disease
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Mosepele, Mosepele, primary and Triant, Virginia, additional
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- 2015
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121. HIV self-testing may overcome stigma and other barriers to HIV testing among higher-socioeconomic status men in Botswana: A qualitative study
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Bogart, Laura M, primary, Kgotlaetsile, Keonayang, additional, Phaladze, Nthabiseng, additional, and Mosepele, Mosepele, additional
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- 2021
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122. Role of Support Reciprocity in HIV Viral Suppression Among People Living with HIV and Their Treatment Partners in Botswana
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Bogart, Laura M., primary, Phaladze, Nthabiseng, additional, Green, Harold D., additional, Klein, David J., additional, Kgotlaetsile, Keonayang, additional, Lekoko, Bright, additional, and Mosepele, Mosepele, additional
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- 2021
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123. May Measurement Month 2018: an analysis of blood pressure screening results from Botswana
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Xin Xia, Tiny Masupe, Thomas Beaney, Mary Banyana Tiro, Anca Chis Ster, Neil Poulter, Onalethata Lesetedi, Masego Kololo, Mosepele Mosepele, Orapeleng Phuswane, Obuile Makwati, John Thato Tlhakanelo, Amogelang Motlhagodi, Abraham Mamela, and Keneilwe Motlhatlhedi
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Physiology ,Cardiovascular risk factors ,030204 cardiovascular system & hematology ,Unit of alcohol ,03 medical and health sciences ,0302 clinical medicine ,Control ,Internal Medicine ,medicine ,AcademicSubjects/MED00200 ,030212 general & internal medicine ,Risk factor ,1102 Cardiorespiratory Medicine and Haematology ,Volunteer ,business.industry ,Mean age ,Articles ,medicine.disease ,Obesity ,Treatment ,Blood pressure ,Cardiovascular System & Hematology ,Hypertension ,Capital city ,Screening ,Cardiology and Cardiovascular Medicine ,business ,Demography - Abstract
During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure (BP) across different communities in Botswana. Study sites included four large villages and Gaborone (capital city). Screening sites were shopping malls, train stations, churches, and workplaces. Individuals aged ≥18 years were recruited through fliers, word of mouth, and as volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three BP readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used and was estimated using multiple imputation where missing. Amongst 4599 participants whose BPs were measured, 54.5% were female, while mean age was 35.9 years. A total of 1510 (32.8%) participants were hypertensive and of those, 712 (47.1%) were aware of the hypertension. Only 35.2% of hypertensives were on antihypertensive treatment with 54.4% had controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Risk factors associated with higher BP included obesity, more than 1 unit of alcohol/week and BP measured on Sunday. Less than half (47.1%) of those identified as having hypertension during MMM18 were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
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- 2020
124. 733. Carbapenem-Resistant Enterobacterales (CRE) Colonization Prevalence in Botswana: an Antibiotic Resistance in Communities and Hospitals (ARCH) Study
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Naledi Mannathoko, Mosepele Mosepele, Rachel Smith, Robert Gross, Laurel Glaser, Kevin Alby, Melissa Richard-Greenblatt, Aditya Sharma, Anne Jaskowiak, Kgotlaetsile Sewawa, Emily Reesey, Laura Cowden, Leigh Cressman, Dimpho Otukile, Giacomo Paganotti, Margaret Mokomane, and Ebbing Lautenbach
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Infectious Diseases ,AcademicSubjects/MED00290 ,Oncology ,Poster Abstracts - Abstract
Background Although CRE are a global threat, data in low- and middle-income countries are scarce. Colonization data are vital for informing antibiotic resistance strategies. We characterized the colonization prevalence of CRE in various settings in Botswana. Methods This study was conducted in 3 districts in Botswana (1 hospital and 2 clinics per district). Adult inpatients and clinic patients were randomly selected for enrollment. Community subjects were enrolled by inviting each enrolled clinic subject to refer up to 3 adults. Each adult clinic or community subject was also asked to refer their children. All subjects had rectal swabs obtained and inoculated on selective chromogenic media for preliminary identification of CRE. Final identification and susceptibility testing were performed using MALDI-TOF MS and VITEK-2, respectively. CRE underwent genotyping for carbapenemase genes. Results Subjects were enrolled from 1/15/20-9/4/20 with a pause from 4/2/20-5/21/20 due to a countrywide COVID lockdown. Of 5,088 subjects approached, 2,469 (49%) participated. Enrollment by subject type was: hospital – 469 (19%); clinic – 959 (39%); community adult – 477 (19%); and community child – 564 (23%). Of 2,469 subjects, the median (interquartile range) age was 32 years (19-44) and 1,783 (72%) were female. 42 (1.7%) subjects were colonized with at least one CRE; 10 subjects were colonized with multiple strains. E. coli (n=17), K. pneumoniae (n=20), and E. cloacae complex (n=11) were most common. CRE colonization prevalence was 6.8% for hospital subjects, 0.7% for clinic subjects, 0.2% for adult community subjects, and 0.5% for child community subjects (p< 0.001)). CRE prevalence varied across regions (Figure 1) and was significantly higher pre- vs post-lockdown (Figure 2). VIM and NDM were the most common carbapenemase genes (Figure 3). Figure 1. CRE Colonization - Study Sites Figure 2. CRE Colonization - Temporal Trends FIgure 3. CRE Genotypic Analyses Conclusion CRE colonization was significantly higher in hospital vs community settings in Botswana. CRE prevalence varied by region and decreased significantly following a countrywide lockdown. With CRE prevalence still modest, elucidating risk factors for CRE colonization holds promise in developing strategies to curb further emergence of CRE. Additional investigation of the CRE isolates without identified resistance genes is warranted. Disclosures Robert Gross, MD, MSCE, Pfizer (Other Financial or Material Support, Serve on DSMB for drug unrelated to HIV) Ebbing Lautenbach, MD, MPH, MSCE, Merck (Other Financial or Material Support, Member of Data and Safety Monitoring Board (DSMB))
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- 2021
125. Patient Socioeconomic and Cultural Factors Associated With Fidelity to Guideline-Concordant Breast Cancer Therapy Delivery in Botswana
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Lebogang T. Mokokwe, Modesty Obasohan, Tlotlo Ralefala, Frances Barg, Mosepele Mosepele, Robert Gross, and Yehoda M. Martei
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Cancer Research ,Oncology - Abstract
PURPOSE Breast cancer patients, including patients living with HIV (PLWH), in sub-Saharan Africa experience a disproportionate burden of mortality. Adherence to treatment guidelines improves quality of care and survival outcomes. We therefore sought to study patient socioeconomic and cultural factors associated with treatment fidelity and how this may differ for PLWH in Botswana. METHODS This was a qualitative study design with deviance sampling of high and low fidelity patients who initiated treatment for stage I-III breast cancer. One-on-one phone interviews were conducted using semi-structured interviews, guided by the Theory of Planned Behavior. The final sample size was determined by thematic saturation. Transcribed interviews were double-coded and analyzed in NVivo using an integrated analysis approach. We maintained a kappa statistic of 0.8 between coders. RESULTS Fifteen high and 15 low fidelity patients were enrolled from August 25-December 15, 2020. Ten out of 30 of the cohort were PLWH. Barriers to treatment adherence included concerns about safety and efficacy of chemotherapy, lack of trust in the care team, lack of psychosocial support, financial toxicity, geographical inaccessibility, and other health-system barriers. Drivers and manifestations of stigma, including intersectional stigma of cancer fatalism in PLWH were identified as prominent barriers. Conversely, self-acceptance and de-stigmatization were identified as facilitators of treatment initiation. Additional facilitators included knowledge of curative intent, anticipated management of side effects, self-motivation, social support, and peer support. COVID-19 pandemic amplified existing socioeconomic barriers especially for patients with food insecurity and geographic inaccessibility. CONCLUSION The study identified multi-level modifiable patient and related health-system factors associated with treatment initiation and adherence. PLWH experienced unique barriers including intersectional stigma, which is a critical finding and warrants further evaluation. The facilitators in this study provide opportunities for leveraging existing strengths within the specific context to design multilevel implementation strategies to increase treatment fidelity of guideline concordant breast cancer therapy.
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- 2022
126. Modest reduction in adverse birth outcomes following the COVID-19 lockdown
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Caniglia, Ellen C., primary, Magosi, Lerato E., additional, Zash, Rebecca, additional, Diseko, Modiegi, additional, Mayondi, Gloria, additional, Mabuta, Judith, additional, Powis, Kathleen, additional, Dryden-Peterson, Scott, additional, Mosepele, Mosepele, additional, Luckett, Rebecca, additional, Makhema, Joseph, additional, Mmalane, Mompati, additional, Lockman, Shahin, additional, and Shapiro, Roger, additional
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- 2021
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127. Equity in clinical trials for HIV-associated cryptococcal meningitis: A systematic review of global representation and inclusion of patients and researchers
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Lawrence, David S., primary, Leeme, Tshepo, additional, Mosepele, Mosepele, additional, Harrison, Thomas S., additional, Seeley, Janet, additional, and Jarvis, Joseph N., additional
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- 2021
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128. sj-pdf-1-qhr-10.1177_10497323211001361 – Supplemental material for Identifying 'What Matters Most' to Men in Botswana to Promote Resistance to HIV-Related Stigma
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Supriya Misra, Haitisha T. Mehta, Eschliman, Evan L., Shathani Rampa, Ohemaa B. Poku, Wei-Qian Wang, Ho-Foster, Ari R., Mosepele Mosepele, Becker, Timothy D., Patlo Entaile, Arscott-Mills, Tonya, Opondo, Phillip R., Blank, Michael B., and Yang, Lawrence H.
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111099 Nursing not elsewhere classified ,111799 Public Health and Health Services not elsewhere classified ,160807 Sociological Methodology and Research Methods ,FOS: Health sciences ,FOS: Sociology - Abstract
Supplemental material, sj-pdf-1-qhr-10.1177_10497323211001361 for Identifying “What Matters Most” to Men in Botswana to Promote Resistance to HIV-Related Stigma by Supriya Misra, Haitisha T. Mehta, Evan L. Eschliman, Shathani Rampa, Ohemaa B. Poku, Wei-Qian Wang, Ari R. Ho-Foster, Mosepele Mosepele, Timothy D. Becker, Patlo Entaile, Tonya Arscott-Mills, Phillip R. Opondo, Michael B. Blank and Lawrence H. Yang in Qualitative Health Research
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- 2021
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129. Feasibility of oral HIV self-testing in female sex workers in Gaborone, Botswana
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Till Bärnighausen, Kutlo Manyake, Charlotte Mdluli, Laura M. Bogart, Shahin Lockman, Neo Monnapula, Emily Shava, Sikhulile Moyo, Mosepele Mosepele, Mompati Mmalane, Kamogelo Maribe, Joseph Makhema, and Bornapate Nkomo
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RNA viruses ,Epidemiology ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Pathology and Laboratory Medicine ,Geographical Locations ,Immunodeficiency Viruses ,Medicine and Health Sciences ,Virus Testing ,Multidisciplinary ,Botswana ,Female sex ,virus diseases ,HIV diagnosis and management ,Middle Aged ,Negative HIV ,Professions ,Medical Microbiology ,Research Design ,Viral Pathogens ,Viruses ,Medicine ,Female ,Pathogens ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Female Sex Workers ,Science ,HIV prevention ,Research and Analysis Methods ,Microbiology ,Young Adult ,Initial visit ,Diagnostic Medicine ,Retroviruses ,medicine ,Humans ,Microbial Pathogens ,Preventive medicine ,Sex Workers ,business.industry ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,Pilot Studies ,Family member ,Public and occupational health ,Family medicine ,Medical Risk Factors ,People and Places ,Africa ,Population Groupings ,business - Abstract
Background Oral HIV self-testing (HIVST) may be useful for increasing testing in persons at elevated risk of acquiring HIV. Methods We conducted a pilot study to evaluate the feasibility (defined by uptake) of HIVST among FSW in Gaborone, Botswana. FSW age 18 years and above were recruited through a non-governmental organization serving FSW. FSW with unknown or negative HIV status at screening performed HIVST in the study clinic following brief training. FSW testing HIV-negative were each given two test kits to take home: one kit to perform unassisted HIVST and another to share with others. Feasibility (use) of HIVST (and sharing of test kits with others) was assessed in these women at a study visit four months later. Results Two hundred FSW were screened. Their average age was 34 years (range 18–59), and 115 (58%) were HIV-positive. Eighty-five (42%) tested HIV-negative at entry and were eligible to take part in the HIVST pilot study. All 85 (100%) agreed to take home HIVST kits. Sixty-nine (81%) of these 85 participants had a follow-up visit, 56 (81%) of whom reported performing HIVST at a mean of three and half months after the initial visit. All 56 participants who performed HIVST reported negative HIVST results. Fifty (73%) of the 69 participants who took HIVST kits home shared them with others. Of the 50 women sharing HIVST kits, 25 (50%) shared with their non-client partners, 15 with a family member, 8 with friends, and 3 with a client. One participant did not test herself but shared both her test kits. Most participants 53/56 (95%) found oral HIVST very easy to use whilst 3/56 (5%) felt it was fairly easy. Conclusion Oral HIVST is feasible among FSW in Gaborone, Botswana. The majority of FSW used the HIVST kits themselves and also shared extra HIVST kits with other individuals.
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- 2021
130. Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
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Professur für Public Health und Prävention, Malhotra, Akash;Thompson, Ryan R.;Kagoya, Faith;Masiye, Felix;Mbewe, Peter;Mosepele, Mosepele;Phiri, Jane;Sambo, Jairos;Barker, Abigail;Cameron, Drew B.;Davila-Roman, Victor G.;Effah, William;Hutchinson, Brian;Laxy, Michael;Newsome, Brad;Watkins, David;Sohn, Hojoon;Dowdy, David W., Professur für Public Health und Prävention, and Malhotra, Akash;Thompson, Ryan R.;Kagoya, Faith;Masiye, Felix;Mbewe, Peter;Mosepele, Mosepele;Phiri, Jane;Sambo, Jairos;Barker, Abigail;Cameron, Drew B.;Davila-Roman, Victor G.;Effah, William;Hutchinson, Brian;Laxy, Michael;Newsome, Brad;Watkins, David;Sohn, Hojoon;Dowdy, David W.
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- 2021
131. Developing an interprofessional transition course to improve team-based HIV care for Sub-Saharan Africa
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S. Martin, E. Chilemba, Abigail Kazembe, Jehan Z Budak, M. de Villiers, D. Von Zinkernagel, J. Khanyola, C. Haruruvizhe, Michael J. A. Reid, Elsie Kiguli-Malwadde, Fred C. Semitala, Hoffie Conradie, and Mosepele Mosepele
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Interprofessional ,medicine.medical_specialty ,Quality management ,020205 medical informatics ,Service delivery framework ,Health Personnel ,Interprofessional Relations ,education ,lcsh:Medicine ,02 engineering and technology ,Education ,03 medical and health sciences ,0302 clinical medicine ,Health care ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Curriculum development ,Humans ,030212 general & internal medicine ,Quality improvement ,Sub Saharan Africa ,Curriculum ,health care economics and organizations ,Africa South of the Sahara ,lcsh:LC8-6691 ,Medical education ,lcsh:Special aspects of education ,business.industry ,Public health ,lcsh:R ,HIV ,General Medicine ,Interprofessional education ,Faculty ,Health Occupations ,Needs assessment ,business ,Psychology ,Research Article - Abstract
Background With funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice. Methods Ten faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. Results Between April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5027 learners trained between September 2019 and September 2020. Conclusions To our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.
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- 2020
132. Depression Among HIV-Positive Individuals in Botswana: A Behavioral Surveillance
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Lawler, Kathy, Mosepele, Mosepele, Seloilwe, Esther, Ratcliffe, Sarah, Steele, Katherine, Nthobatsang, Rudo, and Steenhoff, Andrew
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- 2011
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133. Neurocognitive impairment among HIV‐positive individuals in Botswana: a pilot study
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Lawler, Kathy, Mosepele, Mosepele, Ratcliffe, Sarah, Seloilwe, Esther, Steele, Katherine, Nthobatsang, Rudo, and Steenhoff, Andrew
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Nervous system diseases -- Statistics -- Risk factors ,HIV seropositivity -- Statistics -- Psychological aspects -- Complications and side effects ,Cognition disorders -- Statistics -- Risk factors ,Health - Abstract
Background: The primary objective of this study was to determine the prevalence of neurocognitive impairment among HIV‐positive individuals in Botswana, using the International HIV Dementia Scale (IHDS). We also compared performance on the IHDS with performance on tests of verbal learning/memory and processing speed, and investigated the association between performance on the IHDS and such variables as depression, age, level of education and CD4 count. Methods: We conducted a cross‐sectional study of 120 HIV‐positive individuals randomly selected from an outpatient HIV clinic in Gaborone, Botswana. Patients provided a detailed clinical history and underwent neuropsychological testing; measures of depression, daily activities and subjective cognitive complaints were recorded. Results: Despite the fact that 97.5% of subjects were receiving highly active antiretroviral therapy (HAART), 38% met criteria for dementia on the IHDS, and 24% were diagnosed with major depressive disorder. There was a significant association between neurocognitive impairment as measured by the IHDS and performance on the other two cognitive measures of verbal learning/memory and processing speed. Level of education significantly affected performance on all three cognitive measures, and age affected processing speed and performance on the IHDS. Depression and current CD4 count did not affect performance on any of the cognitive measures. Conclusions: The prevalence of neurocognitive impairment in HIV‐positive individuals in Botswana is higher than expected, especially since almost all of the subjects in this study were prescribed HAART. This suggests the need to reconsider the timing of introduction of antiretroviral therapy in developing countries where HAART is generally not administered until the CD4 cell count has dropped to 200/mm[sup.3] or below. The contribution of other factors should also be considered, such as poor central nervous system penetration of some antiretrovirals, drug resistance, potential neurotoxicity, and co‐morbidities. Memory impairment and poor judgment may be underlying causes for behaviours that contribute to the spread of HIV and to poor adherence. It is important to identify these neurobehavioural complications of HIV so that effective treatments can be developed., Background Individuals with HIV infection often experience neurological complications, including cognitive deficits, referred to as HIV‐associated neurocognitive disorders (HAND). The specific pattern of neuropsychological deficits is attributed to damage to [...]
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- 2010
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134. Current co-morbidities burden in patients living with HIV in low- and middle-income countries
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Ponatshego, Ponego Lloyd, primary, Youssouf, Nabila Farah, additional, and Mosepele, Mosepele, additional
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- 2021
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135. MAY MEASUREMENT MONTH 2018: AN ANALYSIS OF BLOOD PRESSURE SCREENING RESULTS FROM BOTSWANA
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Masupe, Tiny, primary, Tlhakanelo, John Thato, additional, Tiro, Mary Banyana, additional, Motlhatlhedi, Keneilwe, additional, Mamela, Abraham, additional, Makwati, Obuile, additional, Kololo, Masego, additional, Phuswane, Orapeleng, additional, Lesetedi, Onalethata, additional, Motlhagodi, Amogelang, additional, Beaney, Thomas, additional, Ster, Ancha Chis, additional, Poulter, Neil R, additional, Xia, Xin, additional, and Mosepele, Mosepele, additional
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- 2021
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136. Identifying “What Matters Most” to Men in Botswana to Promote Resistance to HIV-Related Stigma
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Misra, Supriya, primary, Mehta, Haitisha T., additional, Eschliman, Evan L., additional, Rampa, Shathani, additional, Poku, Ohemaa B., additional, Wang, Wei-Qian, additional, Ho-Foster, Ari R., additional, Mosepele, Mosepele, additional, Becker, Timothy D., additional, Entaile, Patlo, additional, Arscott-Mills, Tonya, additional, Opondo, Phillip R., additional, Blank, Michael B., additional, and Yang, Lawrence H., additional
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- 2021
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137. An Evaluation of Baseline Kidney Function in the REPRIEVE Trial of Pitavastatin in Human Immunodeficiency Virus
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Lerato Mohapi, Heather J. Ribaudo, Pamela S. Douglas, Kathleen V. Fitch, Steven K. Grinspoon, Edgar T. Overton, Amy Kantor, Mosepele Mosepele, Sandra W. Cardoso, Khuanchai Supparatpinyo, Sandesh Patil, Judith A. Aberg, Marcus V. G. Lacerda, Christina M. Wyatt, Paul Muntner, and Grace A. McComsey
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Male ,medicine.medical_specialty ,030232 urology & nephrology ,Renal function ,HIV Infections ,Supplement Articles ,Comorbidity ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Epidemiology ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Renal Insufficiency, Chronic ,Tenofovir ,Body surface area ,Creatinine ,business.industry ,Middle Aged ,medicine.disease ,Infectious Diseases ,chemistry ,Cohort ,Quinolines ,Median body ,Female ,business ,Body mass index ,Kidney disease ,Glomerular Filtration Rate ,Statistical Distributions - Abstract
BackgroundChronic kidney disease is a common comorbid condition among persons living with human immunodeficiency virus (PWH). We characterized baseline kidney function in the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) trial cohort.MethodsREPRIEVE enrolled PWH with low to moderate cardiovascular risk based on traditional risk factors to evaluate the effect of statin therapy on cardiovascular events. We determined baseline estimated glomerular filtration rate (eGFR) with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease, and Cockcroft-Gault equations, and we evaluated baseline factors associated with eGFR ResultsAmong 7770 participants enrolled, the median age was 50 years, 31% were female (natal sex), 43% black or African American and 15% Asian, the median body mass index (calculated as calculated as weight in kilograms divided by height in meters squared) was 25.8, and the median CD4 cell count 620/µL. The median CKD-EPI eGFR was 97 mL/min/1.73 m2, and 38% had an eGFR ConclusionsREPRIEVE enrolled a diverse cohort including a substantial number of PWH with reduced kidney function. Factors associated with reduced eGFR included traditional risk factors and tenofovir disoproxil fumarate exposure. Three commonly used equations have only fair agreement, with potential implications for both clinical care and epidemiologic studies.Clinical Trials RegistrationNCT02344290.
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- 2020
138. Utility of CD4 count measurement in the era of universal antiretroviral therapy: an analysis of routine laboratory data in Botswana
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Julia Ngidi, Mosepele Mosepele, T Mphoyakgosi, Mark W Tenforde, Bornapate Nkomo, Kwana Lechiile, M Tau, Richard J. Hayes, Charles Muthoga, Fredah Mulenga, Madisa Mine, Joseph N Jarvis, Tshepo B Leeme, and Dinah Ramaabya
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Anti-HIV Agents ,Population ,HIV Infections ,Logistic regression ,Article ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Antiretroviral Therapy, Highly Active ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,education ,education.field_of_study ,Botswana ,business.industry ,Health Policy ,Routine laboratory ,virus diseases ,Odds ratio ,Middle Aged ,Viral Load ,medicine.disease ,030112 virology ,Antiretroviral therapy ,Confidence interval ,CD4 Lymphocyte Count ,Infectious Diseases ,Female ,business ,Viral load - Abstract
OBJECTIVES National guidelines in Botswana recommend baseline CD4 count measurement and both CD4 and HIV viral load (VL) monitoring post-antiretroviral therapy (ART) initiation. We evaluated the utility of CD4 count measurement in Botswana in the era of universal ART. METHODS CD4 and VL data were analysed for HIV-infected adults undergoing CD4 count measurement in 2015-2017 at the Botswana Harvard HIV-Reference Laboratory. We determined (1) the proportion of individuals with advanced HIV disease (CD4 count
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- 2020
139. Bartonella Infection in Immunocompromised Hosts: Immunology of Vascular Infection and Vasoproliferation
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Mosepele Mosepele, Dana Mazo, and Jennifer Cohn
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Most infections by genus Bartonella in immunocompromised patients are caused by B. henselae and B. quintana. Unlike immunocompetent hosts who usually develop milder diseases such as cat scratch disease and trench fever, immunocompromised patients, including those living with HIV/AIDS and posttransplant patients, are more likely to develop different and severe life-threatening disease. This paper will discuss Bartonella's manifestations in immunosuppressed patients and will examine Bartonella's interaction with the immune system including its mechanisms of establishing infection and immune escape. Gaps in current understanding of the immunology of Bartonella infection in immunocompromised hosts will be highlighted.
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- 2012
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140. Four-class drug-resistant HIV-1 subtype C in a treatment experienced individual on dolutegravir-based antiretroviral therapy in Botswana
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Ava Avalos, Christopher F. Rowley, Tendani Gaolatlhe, Mosepele Mosepele, Simani Gaseitsiwe, Sikhulile Moyo, Kaelo K Seatla, Dinah Ramaabya, Madisa Mine, Ishmael Kasvosve, Thabo Diphoko, and Joseph N Jarvis
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Male ,0301 basic medicine ,Genotype ,Anti-HIV Agents ,Pyridones ,030106 microbiology ,Immunology ,Mutation, Missense ,Human immunodeficiency virus (HIV) ,HIV Infections ,Drug resistance ,medicine.disease_cause ,Article ,Piperazines ,Treatment experienced ,03 medical and health sciences ,chemistry.chemical_compound ,Pharmacotherapy ,ANTIRETROVIRAL AGENTS ,Drug Resistance, Multiple, Viral ,Oxazines ,Humans ,Immunology and Allergy ,Medicine ,Botswana ,business.industry ,Middle Aged ,Raltegravir ,Antiretroviral therapy ,Virology ,Infectious Diseases ,chemistry ,Dolutegravir ,HIV-1 ,business ,Heterocyclic Compounds, 3-Ring ,medicine.drug - Abstract
There are limited data on the effectiveness of dolutegravir (DTG)-based combination antiretroviral therapy (ART) in real-life settings in southern Africa where HIV-1 subtype C predominates. We report a patient infected with HIV-1 subtype C on DTG-based ART previously exposed to raltegravir who developed multidrug resistance mutations to four antiretroviral classes. There is need for drug resistance monitoring and clinical vigilance to ensure effectiveness of HIV treatment programs even in the era of DTG-based ART.
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- 2018
141. HIV disease is associated with increased biomarkers of endothelial dysfunction despite viral suppression on long-term antiretroviral therapy in Botswana
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Linda C. Hemphill, Virginia A. Triant, Shahin Lockman, Lucy Mupfumi, Terence Mohammed, Mosepele Mosepele, Sikhulile Moyo, and Kara Bennett
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Male ,Oncology ,Time Factors ,Sustained Virologic Response ,HIV Infections ,Disease ,030204 cardiovascular system & hematology ,human immune deficiency virus ,endothelial dysfunction ,0302 clinical medicine ,Risk Factors ,cardiovascular disease ,Clinical endpoint ,Medicine ,030212 general & internal medicine ,Endothelial dysfunction ,Botswana ,biology ,General Medicine ,Middle Aged ,Viral Load ,Intercellular Adhesion Molecule-1 ,3. Good health ,Treatment Outcome ,medicine.anatomical_structure ,Cardiovascular Diseases ,Female ,Inflammation Mediators ,medicine.symptom ,E-Selectin ,Cardiology and Cardiovascular Medicine ,Viral load ,Adult ,medicine.medical_specialty ,Endothelium ,Anti-HIV Agents ,Antigens, Differentiation, Myelomonocytic ,Vascular Cell Adhesion Molecule-1 ,Receptors, Cell Surface ,Inflammation ,monocyte activation ,03 medical and health sciences ,Antigens, CD ,Internal medicine ,Humans ,Interleukin 6 ,Interleukin-6 ,business.industry ,Cardiovascular Topics ,Case-control study ,HIV ,medicine.disease ,Cross-Sectional Studies ,inflammation ,Case-Control Studies ,Africa ,biology.protein ,Endothelium, Vascular ,atherosclerosis ,business ,Cell Adhesion Molecules ,Biomarkers - Abstract
Summary Background Untreated HIV infection is associated with increased biomarkers of endothelial dysfunction. However, the predictors and degree of endothelial dysfunction among virally suppressed HIV–infected adults on long–term antiretroviral therapy (ART) have not been well studied in sub– Saharan Africa (SSA). Methods We enrolled 112 HIV–infected adults with virological suppression on long–term ART and 84 HIV–uninfected controls in Botswana. We measured plasma levels of markers of endothelial injury [soluble vascular adhesion molecule 1 (VCAM–1), intercellular adhesion molecule 1 (ICAM–1) and E–selectin] and plasma levels of biomarkers of inflammation [interleukin 6 (IL–6)] and monocyte activation (sCD163). Baseline traditional cardiovascular disease (CVD) risk factors and bilateral common carotid intima–media thickness (cIMT) were also available for all participants. We assessed whether HIV status (despite virological suppression on ART) was associated with biomarkers of endothelial dysfunction after controlling for traditional CVD risk factors in linear regression models. We additionally assessed the association between IL–6, sCD163 and cIMT with endothelial dysfunction in separate multivariate linear regression models, controlling for cIMT, among virally suppressed HIV–infected participants only. Results In multivariate analysis, HIV infection was significantly associated with increased VCAM–1 (p < 0.01) and ICAM–1 (p = 0.03) but not E–selectin (p = 0.74) levels. Within the HIV–positive group, higher sCD163 levels were associated with decreased ICAM–1 and E–selectin (p < 0.01 and p = 0.01, respectively) but not VCAM–1 (p = 0.13) levels. IL–6 was not associated with any of the biomarkers of endothelial dysfunction. Conclusion HIV disease was associated with biomarkers of endothelial dysfunction among virally suppressed adults in Botswana on long–term ART after controlling for traditional CVD risk factors. Future work should explore the clinical impact of persistent endothelial dysfunction following longterm HIV viral suppression on the risk of CVD clinical endpoints among HIV–infected patients in this setting.
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- 2018
142. Polymorphisms in Cytochrome P450 are associated with Extensive Efavirenz Pharmacokinetics and CNS Toxicities in an HIV Cohort in Botswana
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Scarlett L. Bellamy, Robert E. Gross, Marc R. Gastonguay, Mosepele Mosepele, Xiaoyan Han, Marijana Vujkovic, Ganesh S. Moorthy, Athena F. Zuppa, Brian L. Strom, Bakgaki Ratshaa, Gregory P. Bisson, Richard Aplenc, and Andrew P. Steenhoff
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0301 basic medicine ,Adult ,Central Nervous System ,Cyclopropanes ,Male ,Efavirenz ,CYP2B6 ,Genotype ,030106 microbiology ,Single-nucleotide polymorphism ,HIV Infections ,Pharmacology ,030226 pharmacology & pharmacy ,Polymorphism, Single Nucleotide ,Article ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pharmacokinetics ,Cytochrome P-450 Enzyme System ,Genetics ,Medicine ,Humans ,Alleles ,Botswana ,biology ,business.industry ,Cytochrome P450 ,Benzoxazines ,chemistry ,Alkynes ,Toxicity ,Cohort ,biology.protein ,Molecular Medicine ,Reverse Transcriptase Inhibitors ,Female ,business - Abstract
Inter-individual variability in efavirenz (EFV) pharmacokinetics and dynamics are dominantly driven by the polymorphism in cytochrome P450 (CYP) isoenzyme 2B6 516G>T. We hypothesized that additional CYP polymorphisms mediate the relationship between CYP2B6 516G>T, EFV metabolism, and clinical events. We investigated 21 SNPs in 814 HIV-infected adults initiating EFV-based therapy in Botswana for population pharmacokinetics, CNS toxicities, and treatment outcomes. Two SNPs (rs28399499 and rs28399433) showed reduced apparent oral EFV clearance. Four SNPs (rs2279345, rs4803417, rs4802101, and rs61663607) showed extensive clearance. Composite CYP2B-mediated EFV metabolism was significantly associated with CNS toxicity (p=0.04), with extensive metabolizers reporting more and slow and very slow metabolizers reporting less toxicity after one month compared to intermediate metabolizers. Composite CYP2B6 metabolism was not associated with composite early treatment failure. In conclusion, our data suggest that CNS-related toxicities might not be solely the result of super-therapeutic parent EFV concentrations in HIV-infected individuals in patients of African ancestry.
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- 2018
143. Neurobehavioral effects in HIV-positive individuals receiving highly active antiretroviral therapy (HAART) in Gaborone, Botswana.
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Kathy Lawler, Kealeboga Jeremiah, Mosepele Mosepele, Sarah J Ratcliffe, Catherine Cherry, Esther Seloilwe, and Andrew P Steenhoff
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Medicine ,Science - Abstract
ObjectiveTo explore the prevalence and features of HIV-associated neurocognitive disorders (HANDS) in Botswana, a sub-Saharan country at the center of the HIV epidemic.Design and methodsA cross sectional study of 60 HIV-positive individuals, all receiving highly active antiretroviral therapy (HAART), and 80 demographically matched HIV-seronegative control subjects. We administered a comprehensive neuropsychological test battery and structured psychiatric interview. The lowest 10(th) percentile of results achieved by control subjects was used to define the lower limit of normal performance on cognitive measures. Subjects who scored abnormal on three or more measures were classified as cognitively impaired. To determine the clinical significance of any cognitive impairment, we assessed medication adherence, employment, and independence in activities of daily living (ADL).ResultsHIV+ subjects were impaired for all cognitive-motor ability areas compared with matched, uninfected control subjects. Thirty seven percent of HIV+ patients met criteria for cognitive impairment.ConclusionThese findings indicate that neurocognitive impairment is likely to be an important feature of HIV infection in resource-limited countries; underscoring the need to develop effective treatments for subjects with, or at risk of developing, cognitive impairment.
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- 2011
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144. Developing an interprofessional transition course to improve team-based HIV care for Sub-Saharan Africa
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Kiguli-Malwadde, Elsie, primary, Budak, Jehan Z, additional, Chilemba, Evelyn, additional, Semitala, Fred, additional, Von Zinkernagel, Deborah, additional, Mosepele, Mosepele, additional, Conradie, Hoffie, additional, Khanyola, J, additional, Haruruvizhe, Clara, additional, Martin, Shayanne, additional, Kazembe, Abigail, additional, De Villiers, M, additional, and Reid, Michael J A, additional
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- 2020
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145. Developing an inter-professional transition course to improve team-based HIV care for Sub-Saharan Africa
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Kiguli-Malwadde, Elsie, primary, Budak, Jehan Z, additional, Chilemba, Evelyn, additional, Semitala, Fred, additional, Von Zinkernagel, Deborah, additional, Mosepele, Mosepele, additional, Conradie, Hoffie, additional, Khanyola, J, additional, Haruruvizhe, Clara, additional, Martin, Shayanne, additional, Kazembe, Abigail, additional, De Villiers, M, additional, and Reid, Michael J A, additional
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- 2020
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146. Colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in hospitalized patients in Botswana.
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Mannathoko, Naledi Betsi, Mosepele, Mosepele, Gross, Robert, Smith, Rachel, Styczynski, Ashley, Cressman, Leigh, Richard-Greenblatt, Melissa, Glaser, Laurel, Alby, Kevin, Jaskowiak, Anne, Sewawa, Kgotlaetsile, Cowden, Laura, Otukile, Dimpho, Paganotti, Giacomo, Mokomane, Margaret, Bilker, Warren, and Lautenbach, Ebbing
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- 2024
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147. May Measurement Month 2018: an analysis of blood pressure screening results from Botswana
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Masupe, Tiny, primary, Tlhakanelo, John Thato, additional, Tiro, Mary Banyana, additional, Motlhatlhedi, Keneilwe, additional, Mamela, Abraham, additional, Makwati, Obuile, additional, Kololo, Masego, additional, Phuswane, Orapeleng, additional, Lesetedi, Onalethata, additional, Motlhagodi, Amogelang, additional, Beaney, Thomas, additional, Ster, Anca Chis, additional, Poulter, Neil R, additional, Xia, Xin, additional, and Mosepele, Mosepele, additional
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- 2020
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148. Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
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Shava, Emily, primary, Manyake, Kutlo, additional, Mdluli, Charlotte, additional, Maribe, Kamogelo, additional, Monnapula, Neo, additional, Nkomo, Bornapate, additional, Mosepele, Mosepele, additional, Moyo, Sikhulile, additional, Mmalane, Mompati, additional, Bärnighausen, Till, additional, Makhema, Joseph, additional, Bogart, Laura M., additional, and Lockman, Shahin, additional
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- 2020
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149. An Evaluation of Baseline Kidney Function in the REPRIEVE Trial of Pitavastatin in Human Immunodeficiency Virus
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Overton, Edgar T, primary, Kantor, Amy, primary, Fitch, Kathleen V, primary, Muntner, Paul, primary, Supparatpinyo, Khuanchai, primary, Mosepele, Mosepele, primary, Mohapi, Lerato, primary, Cardoso, Sandra Wagner, primary, Patil, Sandesh, primary, de Lacerda, Marcus V G, primary, McComsey, Grace, primary, Aberg, Judith A, primary, Douglas, Pamela S, primary, Grinspoon, Steven K, primary, Ribaudo, Heather, primary, and Wyatt, Christina M, primary
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- 2020
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150. Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey
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Tapela, Neo M., primary, Clifton, Lei, additional, Tshisimogo, Gontse, additional, Gaborone, Moagi, additional, Madidimalo, Tebogo, additional, Letsatsi, Virginia, additional, Masupe, Tiny, additional, Mosepele, Mosepele, additional, Makhema, Joseph, additional, Lockman, Shahin, additional, and Hunter, David J., additional
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- 2020
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