49 results on '"Dorrington, Rob E."'
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2. Rapid mortality surveillance using a national population register to monitor excess deaths during SARS-CoV-2 pandemic in South Africa
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Dorrington, Rob E., Moultrie, Tom A., Laubscher, Ria, Groenewald, Pam J., and Bradshaw, Debbie
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- 2021
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3. Modelling of HIV prevention and treatment progress in five South African metropolitan districts
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van Schalkwyk, Cari, Dorrington, Rob E., Seatlhodi, Thapelo, Velasquez, Claudia, Feizzadeh, Ali, and Johnson, Leigh F.
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- 2021
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4. Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
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Kassebaum, Nicholas J, Bertozzi-Villa, Amelia, Coggeshall, Megan S, Shackelford, Katya A, Steiner, Caitlyn, Heuton, Kyle R, Gonzalez-Medina, Diego, Barber, Ryan, Huynh, Chantal, Dicker, Daniel, Templin, Tara, Wolock, Timothy M, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C, Agardh, Emilie E, Akena, Dickens, Alasfoor, Deena, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Al Kahbouri, Mazin J, Alla, François, Allen, Peter J, AlMazroa, Mohammad A, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzmán, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Amini, Hassan, Ammar, Walid, Antonio, Carl AT, Anwari, Palwasha, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Ali, Asad, Majed Masoud, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Badawi, Alaa, Balakrishnan, Kalpana, Basu, Arindam, Basu, Sanjay, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Bernabe, Eduardo, Beyene, Tariku J, Bhutta, Zulfiqar, Bin Abdulhak, Aref, Blore, Jed D, Basara, Berrak Bora, Bose, Dipan, Breitborde, Nicholas, Cárdenas, Rosario, Castañeda-Orjuela, Carlos A, Castro, Ruben Estanislao, Catalá-López, Ferrán, Cavlin, Alanur, Chang, Jung-Chen, Che, Xuan, Christophi, Costas A, Chugh, Sumeet S, Cirillo, Massimo, Colquhoun, Samantha M, Cooper, Leslie Trumbull, Cooper, Cyrus, da Costa Leite, Iuri, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Degenhardt, Louisa, De Leo, Diego, del Pozo-Cruz, Borja, Deribe, Kebede, Dessalegn, Muluken, deVeber, Gabrielle A, Dharmaratne, Samath D, Dilmen, Uğur, Ding, Eric L, Dorrington, Rob E, Driscoll, Tim R, Ermakov, Sergei Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A, Farzadfar, Farshad, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, and de Lima, Graça Maria Ferreira
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2.4 Surveillance and distribution ,Aetiology ,Infection ,Reproductive health and childbirth ,Good Health and Well Being ,Age Distribution ,Cause of Death ,Female ,Global Health ,HIV Infections ,Humans ,Maternal Mortality ,Models ,Statistical ,Organizational Objectives ,Pregnancy ,Pregnancy Complications ,Infectious ,Risk Factors ,Socioeconomic Factors ,Time Factors ,Medical and Health Sciences ,General & Internal Medicine - Abstract
BackgroundThe fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.MethodsWe used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.Findings292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.InterpretationGlobal rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FundingBill & Melinda Gates Foundation.
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- 2014
5. Sexual behaviour patterns in South Africa and their association with the spread of HIV : Insights from a mathematical model
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Johnson, Leigh F., Dorrington, Rob E., Bradshaw, Debbie, Pillay-Van Wyk, Victoria, and Rehle, Thomas M.
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- 2009
6. The impact of child mortality on fertility in South Africa: Do child support grants and antiretroviral treatment matter?
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Bidzha, Mashudu Lucas, primary, Johnson, Leigh F., additional, Dorrington, Rob E., additional, Ngepah, Nicholas, additional, and Greyling, Talita, additional
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- 2023
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7. Steep Declines in Pediatric AIDS Mortality in South Africa, Despite Poor Progress Toward Pediatric Diagnosis and Treatment Targets
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Johnson, Leigh F., Patrick, Mark, Stephen, Cindy, Patten, Gabriela, Dorrington, Rob E., Maskew, Mhairi, Jamieson, Lise, and Davies, Mary-Ann
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- 2020
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8. Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study
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Pillay-van Wyk, Victoria, Msemburi, William, Laubscher, Ria, Dorrington, Rob E, Groenewald, Pam, Glass, Tracy, Nojilana, Beatrice, Joubert, Jané D, Matzopoulos, Richard, Prinsloo, Megan, Nannan, Nadine, Gwebushe, Nomonde, Vos, Theo, Somdyala, Nontuthuzelo, Sithole, Nomfuneko, Neethling, Ian, Nicol, Edward, Rossouw, Anastasia, and Bradshaw, Debbie
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- 2016
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9. Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era
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Eaton, Jeffrey W, Bacaër, Nicolas, Bershteyn, Anna, Cambiano, Valentina, Cori, Anne, Dorrington, Rob E, Fraser, Christophe, Gopalappa, Chaitra, Hontelez, Jan A C, Johnson, Leigh F, Klein, Daniel J, Phillips, Andrew N, Pretorius, Carel, Stover, John, Rehle, Thomas M, and Hallett, Timothy B
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- 2015
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10. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
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Wang, Haidong, Liddell, Chelsea A, Coates, Matthew M, Mooney, Meghan D, Levitz, Carly E, Schumacher, Austin E, Apfel, Henry, Iannarone, Marissa, Phillips, Bryan, Lofgren, Katherine T, Sandar, Logan, Dorrington, Rob E, Rakovac, Ivo, Jacobs, Troy A, Liang, Xiaofeng, Zhou, Maigeng, Zhu, Jun, Yang, Gonghuan, Wang, Yanping, Liu, Shiwei, Li, Yichong, Ozgoren, Ayse Abbasoglu, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Alemu, Zewdie Aderaw, Allen, Peter J, AlMazroa, Mohammad AbdulAziz, Alvarez, Elena, Amankwaa, Adansi A, Amare, Azmeraw T, Ammar, Walid, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Asad, Majed Masoud, Assadi, Reza, Banerjee, Amitava, Basu, Sanjay, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Bhutta, Zulfiqar, Blore, Jed D, Basara, Berrak Bora, Boufous, Soufiane, Breitborde, Nicholas, Bruce, Nigel G, Bui, Linh Ngoc, Carapetis, Jonathan R, Cárdenas, Rosario, Carpenter, David O, Caso, Valeria, Castro, Ruben Estanislao, Catalá-Lopéz, Ferrán, Cavlin, Alanur, Che, Xuan, Chiang, Peggy Pei-Chia, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting-Wu, Cirillo, Massimo, da Costa Leite, Iuri, Courville, Karen J, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Deribe, Kebede, Dharmaratne, Samath D, Dherani, Mukesh K, Dilmen, Uğur, Ding, Eric L, Edmond, Karen M, Ermakov, Sergei Petrovich, Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fijabi, Daniel Obadare, Foigt, Nataliya, Forouzanfar, Mohammad H, Garcia, Ana C, Geleijnse, Johanna M, Gessner, Bradford D, Goginashvili, Ketevan, Gona, Philimon, Goto, Atsushi, Gouda, Hebe N, Green, Mark A, Greenwell, Karen Fern, Gugnani, Harish Chander, Gupta, Rahul, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Harb, Hilda L, Hay, Simon, Hedayati, Mohammad T, Hosgood, H Dean, Hoy, Damian G, Idrisov, Bulat T, Islami, Farhad, Ismayilova, Samaya, Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B, Juel, Knud, Kabagambe, Edmond Kato, Kazi, Dhruv S, Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khang, Young-Ho, Kim, Daniel, Kinfu, Yohannes, Kinge, Jonas M, Kokubo, Yoshihiro, Kosen, Soewarta, Defo, Barthelemy Kuate, Kumar, G Anil, Kumar, Kaushalendra, Kumar, Ravi B, Lai, Taavi, Lan, Qing, Larsson, Anders, Lee, Jong-Tae, Leinsalu, Mall, Lim, Stephen S, Lipshultz, Steven E, Logroscino, Giancarlo, Lotufo, Paulo A, Lunevicius, Raimundas, Lyons, Ronan Anthony, Ma, Stefan, Mahdi, Abbas Ali, Marzan, Melvin Barrientos, Mashal, Mohammad Taufiq, Mazorodze, Tasara T, McGrath, John J, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Miller, Ted R, Mills, Edward J, Mohammad, Karzan Abdulmuhsin, Mokdad, Ali H, Monasta, Lorenzo, Montico, Marcella, Moore, Ami R, Moschandreas, Joanna, Msemburi, William T, Mueller, Ulrich O, Muszynska, Magdalena M, Naghavi, Mohsen, Naidoo, Kovin S, Narayan, KM Venkat, Nejjari, Chakib, Ng, Marie, de Dieu Ngirabega, Jean, Nieuwenhuijsen, Mark J, Nyakarahuka, Luke, Ohkubo, Takayoshi, Omer, Saad B, Caicedo, Angel J Paternina, Wyk, Victoria Pillay-van, Pope, Dan, Pourmalek, Farshad, Prabhakaran, Dorairaj, Rahman, Sajjad UR, Rana, Saleem M, Reilly, Robert Quentin, Rojas-Rueda, David, Ronfani, Luca, Rushton, Lesley, Saeedi, Mohammad Yahya, Salomon, Joshua A, Sampson, Uchechukwu, Santos, Itamar S, Sawhney, Monika, Schmidt, Jürgen C, Shakh-Nazarova, Marina, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S, Sposato, Luciano A, Stathopoulou, Vasiliki Kalliopi, Stroumpoulis, Konstantinos, Tabb, Karen M, Talongwa, Roberto Tchio, Teixeira, Carolina Maria, Terkawi, Abdullah Sulieman, Thomson, Alan J, Thorne-Lyman, Andrew L, Toyoshima, Hideaki, Dimbuene, Zacharie Tsala, Uwaliraye, Parfait, Uzun, Selen Begüm, Vasankari, Tommi J, Vasconcelos, Ana Maria Nogales, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Waller, Stephen, Wan, Xia, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Westerman, Ronny, Wilkinson, James D, Williams, Hywel C, Yang, Yang C, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Younis, Mustafa, Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhu, Shankuan, Vos, Theo, Lopez, Alan D, and Murray, Christopher J L
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- 2014
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11. Maternal mortality in South Africa: lessons from a case study in the use of deaths reported by households in censuses and surveys. [Paper in special issue: Measuring Maternal Mortality Through Census Data. Leone, Tiziana (ed.)]
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Dorrington, Rob E. and Bradshaw, Debbie
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- 2011
12. The Effect of HIV Programs in South Africa on National HIV Incidence Trends, 2000–2019
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Johnson, Leigh F., primary, Meyer-Rath, Gesine, additional, Dorrington, Rob E., additional, Puren, Adrian, additional, Seathlodi, Thapelo, additional, Zuma, Khangelani, additional, and Feizzadeh, Ali, additional
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- 2022
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13. The effect of syndromic management interventions on the prevalence of sexually transmitted infections in South Africa
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Johnson, Leigh F., Dorrington, Rob E., Bradshaw, Debbie, and Coetzee, David J.
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- 2011
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14. Modelling the demographic impact of HIV/AIDS in South Africa and the likely impact of interventions
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Johnson, Leigh F. and Dorrington, Rob E.
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- 2006
15. Estimating the impact of antiretroviral treatment on adult mortality trends in South Africa: A mathematical modelling study
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Johnson, Leigh F., May, Margaret T., Dorrington, Rob E., Cornell, Morna, Boulle, Andrew, Egger, Matthias, and Davies, Mary-Ann
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Highly active antiretroviral therapy -- Patient outcomes ,Biological sciences - Abstract
Background Substantial reductions in adult mortality have been observed in South Africa since the mid-2000s, but there has been no formal evaluation of how much of this decline is attributable to the scale-up of antiretroviral treatment (ART), as previous models have not been calibrated to vital registration data. We developed a deterministic mathematical model to simulate the mortality trends that would have been expected in the absence of ART, and with earlier introduction of ART. Methods and findings Model estimates of mortality rates in ART patients were obtained from the International Epidemiology Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaboration. The model was calibrated to HIV prevalence data (1997-2013) and mortality data from the South African vital registration system (1997-2014), using a Bayesian approach. In the 1985-2014 period, 2.70 million adult HIV-related deaths occurred in South Africa. Adult HIV deaths peaked at 231,000 per annum in 2006 and declined to 95,000 in 2014, a reduction of 74.7% (95% CI: 73.3%-76.1%) compared to the scenario without ART. However, HIV mortality in 2014 was estimated to be 69% (95% CI: 46%-97%) higher in 2014 (161,000) if the model was calibrated only to HIV prevalence data. In the 2000-2014 period, the South African ART programme is estimated to have reduced the cumulative number of HIV deaths in adults by 1.72 million (95% CI: 1.58 million-1.84 million) and to have saved 6.15 million life years in adults (95% CI: 5.52 million-6.69 million). This compares with a potential saving of 8.80 million (95% CI: 7.90 million-9.59 million) life years that might have been achieved if South Africa had moved swiftly to implement WHO guidelines (2004-2013) and had achieved high levels of ART uptake in HIV-diagnosed individuals from 2004 onwards. The model is limited by its reliance on all-cause mortality data, given the lack of reliable cause-of-death reporting, and also does not allow for changes over time in tuberculosis control programmes and ART effectiveness. Conclusions ART has had a dramatic impact on adult mortality in South Africa, but delays in the rollout of ART, especially in the early stages of the ART programme, have contributed to substantial loss of life. This is the first study to our knowledge to calibrate a model of ART impact to population-level recorded death data in Africa; models that are not calibrated to population-level death data may overestimate HIV-related mortality., Author(s): Leigh F. Johnson 1,*, Margaret T. May 2, Rob E. Dorrington 3, Morna Cornell 1, Andrew Boulle 1, Matthias Egger 1,4, Mary-Ann Davies 1 Introduction Substantial declines in adult [...]
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- 2017
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16. Safety evaluation of the single-dose Ad26.COV2.S vaccine among healthcare workers in the Sisonke study in South Africa: A phase 3b implementation trial.
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Takuva, Simbarashe, Takalani, Azwidhwi, Seocharan, Ishen, Yende-Zuma, Nonhlanhla, Reddy, Tarylee, Engelbrecht, Imke, Faesen, Mark, Khuto, Kentse, Whyte, Carmen, Bailey, Veronique, Trivella, Valentina, Peter, Jonathan, Opie, Jessica, Louw, Vernon, Rowji, Pradeep, Jacobson, Barry, Groenewald, Pamela, Dorrington, Rob E., Laubscher, Ria, and Bradshaw, Debbie
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MEDICAL personnel ,PEDICULOSIS ,COVID-19 ,BREAKTHROUGH infections ,VACCINE safety ,VACCINES - Abstract
Background: Real-world evaluation of the safety profile of vaccines after licensure is crucial to accurately characterise safety beyond clinical trials, support continued use, and thereby improve public confidence. The Sisonke study aimed to assess the safety and effectiveness of the Janssen Ad26.COV2.S vaccine among healthcare workers (HCWs) in South Africa. Here, we present the safety data. Methods and findings: In this open-label phase 3b implementation study among all eligible HCWs in South Africa registered in the national Electronic Vaccination Data System (EVDS), we monitored adverse events (AEs) at vaccination sites through self-reporting triggered by text messages after vaccination, healthcare provider reports, and active case finding. The frequency and incidence rate of non-serious and serious AEs were evaluated from the day of first vaccination (17 February 2021) until 28 days after the final vaccination in the study (15 June 2021). COVID-19 breakthrough infections, hospitalisations, and deaths were ascertained via linkage of the electronic vaccination register with existing national databases. Among 477,234 participants, 10,279 AEs were reported, of which 138 (1.3%) were serious AEs (SAEs) or AEs of special interest. Women reported more AEs than men (2.3% versus 1.6%). AE reports decreased with increasing age (3.2% for age 18–30 years, 2.1% for age 31–45 years, 1.8% for age 46–55 years, and 1.5% for age > 55 years). Participants with previous COVID-19 infection reported slightly more AEs (2.6% versus 2.1%). The most common reactogenicity events were headache (n = 4,923) and body aches (n = 4,483), followed by injection site pain (n = 2,767) and fever (n = 2,731), and most occurred within 48 hours of vaccination. Two cases of thrombosis with thrombocytopenia syndrome and 4 cases of Guillain-Barré Syndrome were reported post-vaccination. Most SAEs and AEs of special interest (n = 138) occurred at lower than the expected population rates. Vascular (n = 37; 39.1/100,000 person-years) and nervous system disorders (n = 31; 31.7/100,000 person-years), immune system disorders (n = 24; 24.3/100,000 person-years), and infections and infestations (n = 19; 20.1/100,000 person-years) were the most common reported SAE categories. A limitation of the study was the single-arm design, with limited routinely collected morbidity comparator data in the study setting. Conclusions: We observed similar patterns of AEs as in phase 3 trials. AEs were mostly expected reactogenicity signs and symptoms. Furthermore, most SAEs occurred below expected rates. The single-dose Ad26.COV2.S vaccine demonstrated an acceptable safety profile, supporting the continued use of this vaccine in this setting. Trial registration: ClinicalTrials.gov NCT04838795; Pan African Clinical Trials Registry PACTR202102855526180. Saimbarashe Takuva, Azwi Takalani, and colleagues investigate the frequency and incidence of adverse events reported after receipt of a single dose of the Ad26.COV2.S COVID-19 vaccine among health care workers in South Africa. Author summary: Why was this study done?: While the safety of the Ad26.COV2.S vaccine was established in phase 3 clinical trials, continuous evaluation of safety in expanded populations is crucial. The Sisonke phase 3b implementation study enrolled almost half a million healthcare workers, providing an opportunity to further evaluate the safety of the single-dose Ad26.COV2.S vaccine. What did the researchers do and find?: A total of 477,234 healthcare workers across all South African provinces received the Ad26.COV2.S vaccine between 17 February 2021 and 17 May 2021. Through self-reports and active case finding, adverse events, serious adverse events, and adverse events of special interest were identified. Overall occurrence of adverse events was low. The majority of adverse events reported were common reactogenicity signs and symptoms. Most serious adverse events and adverse events of special interest, including vascular events, immune system disorders, and deaths, occurred at lower than the expected population rates. What do these findings mean?: The single-dose Ad26.COV2.S vaccine had an acceptable safety profile. This supports continued use of this vaccine in large rollout programmes. [ABSTRACT FROM AUTHOR]
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- 2022
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17. South African child deaths 1990–2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?
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Kerber, Kate J., Lawn, Joy E., Johnson, Leigh F., Mahy, Mary, Dorrington, Rob E., Phillips, Heston, Bradshaw, Debbie, Nannan, Nadine, Msemburi, William, Oestergaard, Mikkel Z., Walker, Neff P., Sanders, David, and Jackson, Debra
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- 2013
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18. HIV/AIDS vaccination in adolescents would be efficient and practical when vaccine supplies are limited
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Johnson, Leigh F., Bekker, Linda-Gail, and Dorrington, Rob E.
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- 2007
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19. The role of sexually transmitted infections in the evolution of the South African HIV epidemic
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Johnson, Leigh F., Dorrington, Rob E., Bradshaw, Debbie, and Coetzee, David J.
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- 2012
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20. A Bayesian approach to uncertainty analysis of sexually transmitted infection models
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Johnson, Leigh F, Alkema, Leontine, and Dorrington, Rob E
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- 2010
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21. The effect of educational attainment and other factors on HIV risk in South African women: results from antenatal surveillance, 2000–2005
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Johnson, Leigh F, Dorrington, Rob E, Bradshaw, Debbie, Plessis, Hendrika du, and Makubalo, Lindiwe
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- 2009
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22. A comparison of death recording by health centres and civil registration in south Africans receiving antiretroviral treatment
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Johnson, Leigh F., Dorrington, Rob E., Laubscher, Ria, Hoffmann, Christopher J., Wood, Robin, Fox, Matthew P., Cornell, Morna, Schomaker, Michael, Prozesky, Hans, Tanser, Frank, Davies, Mary-Ann, and Boulle, Andrew
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Mortality -- Analysis -- Research -- Risk factors -- South Africa ,Highly active antiretroviral therapy -- Analysis -- Research -- Health aspects ,HIV infections -- Research -- Care and treatment -- Complications and side effects ,Medical records -- Analysis -- Usage ,Health - Abstract
Introduction: There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART). Methods: Completeness of death recording was estimated using a capture-recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes. Results: After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3-94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2-35.8%) were recorded in patient files, with this proportion dropping from 60% in 2004-2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults). Conclusions: South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records. Keywords: antiretroviral therapy; HIV; vital statistics registration; South Africa. To access the supplementary material to this article please see Supplementary Files under Article Tools online., Introduction Antiretroviral treatment (ART) has had a significant impact on AIDS mortality in developing countries [1-4]. However, most of what is known regarding mortality after ART initiation in developing countries [...]
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- 2015
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23. Acknowledging uncertainty about maternal mortality estimates
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Dorrington, Rob E. and Bradshaw, Debbie
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Mothers -- Patient outcomes ,Health ,World Health Organization - Abstract
Differences between estimates of maternal mortality from different research groups have been much debated. (1-3) The data that are included or omitted and the choice of models have been discussed, [...]
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- 2016
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24. Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies
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Johnson, Leigh F., Mossong, Joel, Dorrington, Rob E., Schomaker, Michael, Hoffmann, Christopher J., Keiser, Olivia, Fox, Matthew P., Wood, Robin, Prozesky, Hans, Giddy, Janet, Garone, Daniela Belen, Cornell, Morna, Egger, Matthias, and Boulle, Andrew
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Antiviral agents -- Dosage and administration ,Drug interactions -- Research ,HIV patients -- Physiological aspects ,Biological sciences - Abstract
Background: Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults. Methods and Findings: Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV- positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2) at age 20 y and 10.1 y (95% CI: 9.3-10.8) at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7) and 14.4 y (95% CI: 13.3-15.3), respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0) if her baseline CD4 count was [greater than or equal to] 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0) if her baseline CD4 count was Conclusions: South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well., Introduction Estimates of life expectancies of HIV-infected individuals are important in providing information to patients about their long-term prognosis, in projecting the future costs of HIV-related care, and in forecasting [...]
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- 2013
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25. GBD 2016 estimates problematic for South Africa
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Dorrington, Rob E, primary and Bradshaw, Debbie, additional
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- 2018
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26. Editorial: Persistent burden from non-communicable diseases in South Africa needs strong action
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Nojilana, Beatrice, Bradshaw, Debbie, Pillay-van Wyk, Victoria, Msemburi, William, Somdyala, Nontuthuzelo, Joubert, Jané D., Groenewald, Pam, Laubscher, Ria, and Dorrington, Rob E.
- Abstract
No Abstract
- Published
- 2016
27. HIV epidemic drivers in South Africa: A model-based evaluation of factors accounting for inter-provincial differences in HIV prevalence and incidence trends
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Johnson, Leigh F., primary, Dorrington, Rob E., additional, and Moolla, Haroon, additional
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- 2017
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28. Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa
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Johnson, Leigh F., primary, Dorrington, Rob E., additional, and Moolla, Haroon, additional
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- 2017
- Full Text
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29. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
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Amankwaa, Adansi A, Wang, Yanping, Apfel, Henry, Iannarone, Marissa, Abera, Semaw Ferede, Liddell, Chelsea A, Zhou, Maigeng, Alvarez, Elena, Coates, Matthew M, Li, Yichong, Zhu, Jun, Lofgren, Katherine T, Dorrington, Rob E, Jacobs, Troy A, AlMazroa, Mohammad AbdulAziz, Phillips, Bryan, Achoki, Tom, Allen, Peter J, Adelekan, Ademola, Mooney, Meghan D, Ozgoren, Ayse Abbasoglu, Rakovac, Ivo, Alemu, Zewdie Aderaw, Abubakar, Ibrahim, Yang, Gonghuan, Liang, Xiaofeng, Schumacher, Austin E, Liu, Shiwei, Levitz, Carly E, Wang, Haidong, Sandar, Logan, and Ademi, Zanfina
- Subjects
parasitic diseases - Abstract
Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.
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- 2014
- Full Text
- View/download PDF
30. Prospects for HIV control in South Africa: a model-based analysis
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Johnson, Leigh F., primary, Chiu, Calvin, additional, Myer, Landon, additional, Davies, Mary-Ann, additional, Dorrington, Rob E., additional, Bekker, Linda-Gail, additional, Boulle, Andrew, additional, and Meyer-Rath, Gesine, additional
- Published
- 2016
- Full Text
- View/download PDF
31. Persistent burden from non-communicable diseases in South Africa needs strong action
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Nojilana, Beatrice, primary, Bradshaw, Debbie, additional, Pillay-van Wyk, Victoria, additional, Msemburi, William, additional, Somdyala, Nontuthuzelo, additional, Joubert, Jané D, additional, Groenewald, Pamela, additional, Laubscher, Ria, additional, and Dorrington, Rob E, additional
- Published
- 2016
- Full Text
- View/download PDF
32. Emerging trends in non-communicable disease mortality in South Africa, 1997 - 2010
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Nojilana, Beatrice, primary, Bradshaw, Debbie, additional, Pillay-van Wyk, Victoria, additional, Msemburi, William, additional, Laubscher, Ria, additional, Somdyala, Nontuthuzelo I M, additional, Joubert, Jane D, additional, Groenewald, Pamela, additional, and Dorrington, Rob E, additional
- Published
- 2016
- Full Text
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33. Acknowledging uncertainty about maternal mortality estimates
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Dorrington, Rob E, primary and Bradshaw, Debbie, additional
- Published
- 2015
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34. An investigation into the extent of uncertainty surrounding estimates of the impact of HIV/AIDS in South Africa
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Johnson, Leigh F., Dorrington, Rob E., Matthews, Alan P., Centre for Actuarial Research (CARE), and Faculty of Commerce
- Abstract
HIV / AIDS statistics have been the source of much controversy in South Africa, but often the extent of uncertainty around these estimates is ignored. There is need for an assessment of the range of uncertainty around often-quoted HIV / AIDS statistics. This analysis determines ranges of uncertainty around the inputs and outputs of the ASSA2002 AIDS and Demographic model of the South African HIV / AIDS epidemic, using a generalized likelihood uncertainty estimation approach. A sample of 500 parameter combinations was drawn by weighting randomly generated parameter combinations by likelihood functions defined on the basis of four South African HIV / AIDS data sets. The estimated number of HIV infections in mid-2005 was 5.1 million (95% prediction interval: 4.2-6.0 million), equivalent to an HIV prevalence rate of 11.1% (9.1-13.1%). Between mid-2004 and mid-2005, the estimated number of new HIV infections was 490 000 (370 000-590 000) and the estimated number of AIDS deaths was 320 000 (270 000-380 000). The posterior mean HIV survival time was estimated to be 11.5 years (95% credibility interval: 10.0-12.9 years), longer than estimated for elsewhere in the developing world. This analysis confirms that South Africa is experiencing a severe HIV / AIDS epidemic, and suggests that HIV / AIDS epidemiology in the country probably differs from that elsewhere in Africa.
- Published
- 2007
35. Further response to Govinder et al. (2014): Flaws in the Equity Index
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Moultrie, Tom A., primary and Dorrington, Rob E., additional
- Published
- 2014
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36. Flaws in the approach and application of the Equity Index: Comments on Govinder et al. (2013)
- Author
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Moultrie, Tom, primary and Dorrington, Rob E., additional
- Published
- 2014
- Full Text
- View/download PDF
37. Second National Burden of Disease Study South Africa: national and subnational mortality trends, 1997–2009
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Wyk, Victoria Pillay-van, primary, Msemburi, William, additional, Laubscher, Ria, additional, Dorrington, Rob E, additional, Groenewald, Pam, additional, Matzopoulos, Richard, additional, Prinsloo, Megan, additional, Nojilana, Beatrice, additional, Nannan, Nadine, additional, Gwebushe, Nomonde, additional, Vos, Theo, additional, Somdyala, Nontuthuzelo, additional, Sithole, Nomfuneko, additional, Neethling, Ian, additional, Nicol, Edward, additional, Joubert, Janetta, additional, Rossouw, Anastasia, additional, and Bradshaw, Debbie, additional
- Published
- 2013
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38. Characteristics, availability and uses of vital registration and other mortality data sources in post-democracy South Africa
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Joubert, Jané, primary, Rao, Chalapati, additional, Bradshaw, Debbie, additional, Dorrington, Rob E., additional, Vos, Theo, additional, and Lopez, AlanD, additional
- Published
- 2012
- Full Text
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39. Used for ill; used for good: a century of collecting data on race in South Africa
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Moultrie, Tom A., primary and Dorrington, Rob E., additional
- Published
- 2012
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40. The Effect of Early Initiation of Antiretroviral Treatment in Infants on Pediatric AIDS Mortality in South Africa
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Johnson, Leigh F., primary, Davies, Mary-Ann, additional, Moultrie, Harry, additional, Sherman, Gayle G., additional, Bland, Ruth M., additional, Rehle, Thomas M., additional, Dorrington, Rob E., additional, and Newell, Marie-Louise, additional
- Published
- 2012
- Full Text
- View/download PDF
41. The Contribution of Maternal HIV Seroconversion During Late Pregnancy and Breastfeeding to Mother-to-Child Transmission of HIV
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Johnson, Leigh F., primary, Stinson, Kathryn, additional, Newell, Marie-Louise, additional, Bland, Ruth M., additional, Moultrie, Harry, additional, Davies, Mary-Ann, additional, Rehle, Thomas M., additional, Dorrington, Rob E., additional, and Sherman, Gayle G., additional
- Published
- 2012
- Full Text
- View/download PDF
42. Progress towards Millennium Development Goal 4
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Kerber, Kate, primary, Tuaone-Nkhasi, Maletela, additional, Dorrington, Rob E, additional, Nannan, Nadine, additional, Bradshaw, Debbie, additional, Jackson, Debra, additional, and Lawn, Joy E, additional
- Published
- 2012
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43. The effect of changes in condom usage and antiretroviral treatment coverage on human immunodeficiency virus incidence in South Africa: a model-based analysis
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Johnson, Leigh F., primary, Hallett, Timothy B., additional, Rehle, Thomas M., additional, and Dorrington, Rob E., additional
- Published
- 2012
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44. The role of sexually transmitted infections in the evolution of the South African HIV epidemic
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Johnson, Leigh F., primary, Dorrington, Rob E., additional, Bradshaw, Debbie, additional, and Coetzee, David J., additional
- Published
- 2011
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45. Maternal mortality ratio - trends in the vital registration data.
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Bradshaw, Debbie and Dorrington, Rob E.
- Subjects
- *
MATERNAL mortality , *MORTALITY of AIDS patients , *PANDEMICS , *PREVENTION of communicable diseases , *RESEARCH methodology - Abstract
Background. The paucity of quality data on maternal deaths and possible mis-specification of models have resulted in a range of estimates of the maternal mortality ratio (MMR) for South Africa. Objectives. This paper contrasts the estimates from multi-country models for estimating the MMR with the South African data from vital registration. Method. A literature review was undertaken to identify estimates of the MMR for South Africa and methodologies used. In addition, cause of death data from Statistics SA were analysed for trends. Results. In contrast to prediction models used by international agencies, the Health Data Advisory and Co-ordinating Committee (HDACC) recommended the use of the vital registration data adjusted for under-registration and misclassification of causes to monitor maternal mortality. HDACC also recommended that, as is done by the Maternal Mortality Estimation Interagency Group (MMEIG), the number of maternal deaths identified be scaled up by 50% to account for the general under-reporting of maternal deaths. Based on this approach, the baseline MMR in 2008 was estimated to be 310 per 100 000 live births. From vital statistics, the indications are that by 2009, South Africa had not yet managed to reverse the upward trend in MMR. The increase is largely a result of an increase in the number of maternal deaths from indirect causes, as might be expected in the context of the HIV pandemic. However, the number of indirect maternal deaths increased markedly only since 2003, a few years later than the rapid increase in AIDS mortality. Conclusions. There are opportunities to improve monitoring maternal mortality, including strengthening the information systems (vital registration, the confidential enquiry and the routine health information system) and exploring opportunities for linking data from different sources. Better data on the role of HIV in maternal mortality are needed. [ABSTRACT FROM AUTHOR]
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- 2012
46. Estimating the impact of antiretroviral treatment on adult mortality trends in South Africa: A mathematical modelling study
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Johnson, Leigh F, May, Margaret T, Dorrington, Rob E, Cornell, Morna, Boulle, Andrew, Egger, Matthias, and Davies, Mary-Ann
- Subjects
610 Medicine & health ,360 Social problems & social services ,3. Good health - Abstract
BACKGROUND Substantial reductions in adult mortality have been observed in South Africa since the mid-2000s, but there has been no formal evaluation of how much of this decline is attributable to the scale-up of antiretroviral treatment (ART), as previous models have not been calibrated to vital registration data. We developed a deterministic mathematical model to simulate the mortality trends that would have been expected in the absence of ART, and with earlier introduction of ART. METHODS AND FINDINGS Model estimates of mortality rates in ART patients were obtained from the International Epidemiology Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaboration. The model was calibrated to HIV prevalence data (1997-2013) and mortality data from the South African vital registration system (1997-2014), using a Bayesian approach. In the 1985-2014 period, 2.70 million adult HIV-related deaths occurred in South Africa. Adult HIV deaths peaked at 231,000 per annum in 2006 and declined to 95,000 in 2014, a reduction of 74.7% (95% CI: 73.3%-76.1%) compared to the scenario without ART. However, HIV mortality in 2014 was estimated to be 69% (95% CI: 46%-97%) higher in 2014 (161,000) if the model was calibrated only to HIV prevalence data. In the 2000-2014 period, the South African ART programme is estimated to have reduced the cumulative number of HIV deaths in adults by 1.72 million (95% CI: 1.58 million-1.84 million) and to have saved 6.15 million life years in adults (95% CI: 5.52 million-6.69 million). This compares with a potential saving of 8.80 million (95% CI: 7.90 million-9.59 million) life years that might have been achieved if South Africa had moved swiftly to implement WHO guidelines (2004-2013) and had achieved high levels of ART uptake in HIV-diagnosed individuals from 2004 onwards. The model is limited by its reliance on all-cause mortality data, given the lack of reliable cause-of-death reporting, and also does not allow for changes over time in tuberculosis control programmes and ART effectiveness. CONCLUSIONS ART has had a dramatic impact on adult mortality in South Africa, but delays in the rollout of ART, especially in the early stages of the ART programme, have contributed to substantial loss of life. This is the first study to our knowledge to calibrate a model of ART impact to population-level recorded death data in Africa; models that are not calibrated to population-level death data may overestimate HIV-related mortality.
47. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
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Haidong Wang, Liddell, Chelsea A., Coates, Matthew M., Mooney, Meghan D., Levitz, Carly E., Schumacher, Austin E., Apfel, Henry, lannarone, Marissa, Phillips, Bryan, Lofgren, Katherine T., Sandar, Logan, Dorrington, Rob E., Rakovac, Ivo, Jacobs, Troy A., Xiaofeng Liang, Maigeng Zhou, Jun Zhu, Gonghuan Yang, Yanping Wang, and Shiwei Liu
- Subjects
- *
CHILD mortality , *INFANT mortality , *NEONATAL mortality , *CHILDBIRTH - Abstract
The article discusses a study which examined global trends in neonatal, infant and under-5 mortality from 1990 to 2013. Topics discussed include a reduction in child mortality rate, an increase in the number of child births in 2013 as compared to 1990, and developing countries expected to achieve the Millennium Development Goal 4 (MDG 4).
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- 2014
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48. Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013
- Author
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Carl Abelardo T. Antonio, Rob E. Dorrington, Belinda K Lloyd, Elisabete Weiderpass, Kovin Naidoo, Leslie T. Cooper, Sandra Nolte, Eduardo A. Undurraga, Mohammad A. AlMazroa, R. Kumar, Xiaofeng Liang, Amanda J. Mason-Jones, Kazem Rahimi, Sanjay Basu, Vasiliy Victorovich Vlassov, André Karch, Dipan Bose, Vivekanand Jha, Adansi A. Amankwaa, Kaire Innos, Ione Jayce Ceola Schneider, Itamar S. Santos, Anwar Rafay, Bolajoko O. Olusanya, Tommi Vasankari, Nana Kwaku Mainoo, Saleem M Rana, Wagner Marcenes, Fortuné Gbètoho Gankpé, Rana J. Asghar, Lela Sturua, Nicholas J K Breitborde, Corine Karema, Charles R. Newton, Uche S. Uchendu, Jongmin Lee, Inga Dora Sigfusdottir, Harish Chander Gugnani, Kaushalendra Kumar, Reza Assadi, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Timothy M. Wolock, Ronny Westerman, Samath D Dharmaratne, Katya Anne Shackelford, Anders Larsson, Jeffrey A. Towbin, Jixiang Ma, Lynne Gaffikin, Konstantin Kazanjan, Mohammad Ali Sahraian, Mohammad H. Forouzanfar, Yichong Li, Felix Sayinzoga, Daniel Dicker, Philimon Gona, Maurice Giroud, Maysaa El Sayed Zaki, Shiwei Liu, Lorenzo Monasta, Chantal Huynh, Abdullatif Husseini, Ted R. Miller, Solomon Meseret Woldeyohannes, D. Alex Quistberg, Justin Beardsley, Majed Asad, Uʇur Dilmen, Alaa Badawi, Hsien-Ho Lin, Haidong Kan, Vinod K. Paul, Mitsuru Mukaigawara, James Leigh, Xiao Nong Zou, Sajjad Ur Rahman, Valentina Arsić Arsenijević, Gokalp Kadri Yentur, Man Mohan Mehndiratta, Murugesan Raju, Stephanie J. London, Kingsley N. Ukwaja, Young-Ho Khang, Knud Juel, Mohsen Naghavi, Rasmus Havmoeller, Gelin Xu, Semaw Ferede Abera, Devina Nand, Norito Kawakami, Neil Pearce, Elisabeth Barboza França, Ferrán Catalá-López, Ketevan Goginashvili, Vegard Skirbekk, Neeraj Bedi, Barthelemy Kuate Defo, Andrew H. Kemp, H. Dean Hosgood, Vafa Rahimi-Movaghar, Konrad Pesudovs, Linhong Wang, Xiao Rong Wang, Alan D. Lopez, Ademola Lukman Adelekan, Joshua A. Salomon, Walter Mendoza, Aref A. Bin Abdulhak, Ivy Shiue, G Anil Kumar, Yuichiro Yano, Luke D. Knibbs, Jung-Chen Chang, Yousef Khader, Caitlyn Steiner, Selen Begüm Uzun, Luciano A. Sposato, Gabrielle deVeber, Raghib Ali, Andre Pascal Kengne, Chakib Nejjari, Rafael Alfonso-Cristancho, Tania Georgina Sánchez Pimienta, Roberto Tchio Talongwa, Hilda L Harb, Ali H. Mokdad, Edward J Mills, Angel J Paternina Caicedo, Xiaohong Li, Luke Nyakarahuka, Diego De Leo, Rashmi Gupta, Robert G. Weintraub, Tim Driscoll, Sun Ha Jee, Carolina Maria Teixeira, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hwashin Hyun Shin, Palwasha Anwari, Daniel Pope, Hassan Amini, Jae-Hyun Park, Saad B. Omer, Eric L. Ding, Narayanaswamy Venketasubramanian, Juan Liang, Tara Templin, Arindam Basu, Farshad Farzadfar, Yang Yang, Xuan Che, Scott Weichenthal, Jeyaraj D Pandian, David L. Tirschwell, Adrian Davis, Hilton Lam, Feng Tan, Stephen S Lim, Soewarta Kosen, Atsushi Goto, Ratilal Lalloo, Yanping Wang, Glen Mola, Paulo A. Lotufo, Dhruv S. Kazi, Jose C. Adsuar, Amany H Refaat, Ruben Castro, Gene F. Kwan, Johanna M. Geleijnse, Emerito Jose A. Faraon, Costas A. Christophi, Theo Vos, Sara Sheikhbahaei, Guilherme V. Polanczyk, Jed D. Blore, Azmeraw T. Amare, Kyle R. Heuton, Walid Ammar, Louisa Degenhardt, Andrew Vallely, Guohong Jiang, Ricky Leung, Jasvinder A. Singh, Zewdie Aderaw Alemu, A Artaman, Steven E. Lipshultz, Carlos A Castañeda-Orjuela, Seyed-Mohammad Fereshtehnejad, Sadaf G. Sepanlou, Mark J. Nieuwenhuijsen, John Q. Wong, Manami Inoue, Coen H. Van Gool, James D. Wilkinson, Ejaz Ahmad Khan, Yoshihiro Kokubo, Manuela Mendonca Felicio, Farshad Pourmalek, Boris I. Pavlin, Karen Sliwa, Robert G. Nelson, Tom Achoki, Edmond K. Kabagambe, Orish Ebere Orisakwe, Christopher J L Murray, In-Hwan Oh, Uchechukwu K.A. Sampson, Ulrich O Mueller, Austin E Schumacher, Edson Serván-Mori, Berrak Bora Basara, Simon I. Hay, Anil Kaul, Foad Abd-Allah, Takayoshi Ohkubo, Kim Yun Jin, Abdullah Sulieman Terkawi, Mall Leinsalu, Sergei Petrovich Ermakov, Marek Majdan, Ileana B. Heredia Pi, Christina Papachristou, Scott B. Patten, Rajeev Gupta, Kalpana Balakrishnan, Mustafa Z. Younis, Kenji Shibuya, Graça Maria Ferreira De Lima, Andrea P. Silva, Maziar Moradi-Lakeh, Anand Dayama, Eiman Jahangir, Stefan Ma, Karen M. Tabb, Nicholas J Kassebaum, Shams Eldin Ali Hassan Khalifa, Mazin J. Al Kahbouri, Nadim E. Karam, Jun Zhu, Chandrashekhar T Sreeramareddy, Dinorah González-Castell, Diego Gonzalez-Medina, Aliya Naheed, Ryan M Barber, Salvador Villalpando, Yang Liu, Chanda Kulkarni, Vinay Nangia, Haidong Wang, Yongmei Li, Rosario Cárdenas, Randah R. Hamadeh, Suzanne Polinder, Van C. Lansingh, François Alla, Max Petzold, Bryan L. Sykes, Ubai Alsharif, Chuanhua Yu, Francesco Saverio Violante, Monika Sawhney, Ayse Abbasoglu Ozgoren, Graeme J. Hankey, Mouhanad Hammami, Iuri da Costa Leite, Dickens Akena, Rintaro Mori, Alanur Çavlin, Maia Kereselidze, Jonathan de la Cruz Monis, Deena Alasfoor, Taavi Lai, Eric Y. Tenkorang, Cyrus Cooper, Sudan Prasad Neupane, Dan Poenaru, Veena S. Kulkarni, Naohiro Yonemoto, Elizabeth Glaser, Sergey Soshnikov, Ziad A. Memish, Paul N. Jensen, Fabiola Mejía-Rodríguez, Ana C. Garcia, Rakhi Dandona, Emilie Agardh, Katherine B Gibney, Vasco Manuel Pedro Machado, Michelle L. Bell, David M. Pereira, Muluemebet Abera Wordofa, Samantha M. Colquhoun, Elena Alvarez, Stephen G. Waller, Ketevan Gambashidze, Eduardo Bernabé, Rafael Lozano, Damian G Hoy, Miltiadis K. Tsilimbaris, Hebe N. Gouda, Muhammad Imran Nisar, Zanfina Ademi, Andrew L. Thorne-Lyman, Denis Nash, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Donald H. Silberberg, Monica S. Vavilala, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Lalit Dandona, Borja del Pozo-Cruz, Sumeet S. Chugh, Johan Ärnlöv, Tariku Jibat Beyene, Melvin Barrientos Marzan, Ami R. Moore, Marie Ng, Maigeng Zhou, Samia Alhabib, Massimo Cirillo, Soraya Seedat, Paul S. F. Yip, Nima Hafezi-Nejad, Amelia Bertozzi-Villa, Kebede Deribe, John Nelson Opio, Peter J. Allen, Marina Shakh-Nazarova, Bach Xuan Tran, Arsène Kouablan Adou, Yingfeng Zheng, Julio Cesar Montañez Hernandez, Yong Zhao, Nelson Alvis-Guzman, Bulat Idrisov, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. Jacobsen, Kassebaum, Nicholas J., Bertozzi-Villa, Amelia, Coggeshall, Megan S., Shackelford, Katya A., Steiner, Caitlyn, Heuton, Kyle R., Gonzalez-Medina, Diego, Barber, Ryan, Huynh, Chantal, Dicker, Daniel, Templin, Tara, Wolock, Timothy M., Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw Ferede, Abubakar, Ibrahim, Achoki, Tom, Adelekan, Ademola, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie E., Akena, Dicken, Alasfoor, Deena, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Al Kahbouri, Mazin J., Alla, Françoi, Allen, Peter J., Almazroa, Mohammad A., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzmán, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Antonio, Carl A.T., Anwari, Palwasha, Ärnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Ali, Asad, Majed Masoud, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Basu, Arindam, Basu, Sanjay, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku J., Bhutta, Zulfiqar, Abdulhak, Aref Bin, Blore, Jed D., Basara, Berrak Bora, Bose, Dipan, Breitborde, Nichola, Cárdenas, Rosario, Castañeda-Orjuela, Carlos A., Castro, Ruben Estanislao, Catalá-López, Ferrán, Cavlin, Alanur, Chang, Jung-Chen, Che, Xuan, Christophi, Costas A., Chugh, Sumeet S., Cirillo, Massimo, Colquhoun, Samantha M., Cooper, Leslie Trumbull, Cooper, Cyru, Da Costa Leite, Iuri, Dandona, Lalit, Dandona, Rakhi, Davis, Adrian, Dayama, Anand, Degenhardt, Louisa, De Leo, Diego, Del Pozo-Cruz, Borja, Deribe, Kebede, Dessalegn, Muluken, Deveber, Gabrielle A., Dharmaratne, Samath D., Dilmen, Uʇur, Ding, Eric L., Dorrington, Rob E., Driscoll, Tim R., Ermakov, Sergei Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Felicio, Manuela Mendonca, Fereshtehnejad, Seyed-Mohammad, De Lima, Graça Maria Ferreira, Forouzanfar, Mohammad H., França, Elisabeth B., Gaffikin, Lynne, Gambashidze, Ketevan, Gankpé, Fortuné Gbètoho, Garcia, Ana C., Geleijnse, Johanna M., Gibney, Katherine B., Giroud, Maurice, Glaser, Elizabeth L., Goginashvili, Ketevan, Gona, Philimon, González-Castell, Dinorah, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rahul, Gupta, Rajeev, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Havmoeller, Rasmu, Hay, Simon I., Pi, Ileana B. Heredia, Hoek, Hans W., Hosgood, H Dean, Hoy, Damian G., Husseini, Abdullatif, Idrisov, Bulat T., Innos, Kaire, Inoue, Manami, Jacobsen, Kathryn H., Jahangir, Eiman, Jee, Sun Ha, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kabagambe, Edmond Kato, Kan, Haidong, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazanjan, Konstantin, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Knibbs, Luke, Kokubo, Yoshihiro, Kosen, Soewarta, Defo, Barthelemy Kuate, Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. Anil, Kumar, Kaushalendra, Kumar, Ravi B., Kwan, Gene, Lai, Taavi, Lalloo, Ratilal, Lam, Hilton, Lansingh, Van C., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Xiaohong, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., London, Stephanie J., Lotufo, Paulo A., Ma, Jixiang, Ma, Stefan, Machado, Vasco Manuel Pedro, Mainoo, Nana Kwaku, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Mason-Jones, Amanda J., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, De La Cruz Monis, Jonathan, Hernandez, Julio Cesar Montañez, Moore, Ami R., Moradi-Lakeh, Maziar, Mori, Rintaro, Mueller, Ulrich O., Mukaigawara, Mitsuru, Naheed, Aliya, Naidoo, Kovin S., Nand, Devina, Nangia, Vinay, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nieuwenhuijsen, Mark J., Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Park, Jae-Hyun, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pesudovs, Konrad, Petzold, Max, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pope, Dan, Pourmalek, Farshad, Qato, Dima, Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Ur Rahman, Sajjad, Raju, Murugesan, Rana, Saleem M., Refaat, Amany, Ronfani, Luca, Roy, Nobhojit, Pimienta, Tania Georgina Sánchez, Sahraian, Mohammad Ali, Salomon, Joshua A., Sampson, Uchechukwu, Santos, Itamar S., Sawhney, Monika, Sayinzoga, Felix, Schneider, Ione J.C., Schumacher, Austin, Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Shakh-Nazarova, Marina, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soshnikov, Sergey S., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stroumpoulis, Konstantino, Sturua, Lela, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tan, Feng, Teixeira, Carolina Maria, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thorne-Lyman, Andrew L., Tirschwell, David L., Towbin, Jeffrey A., Tran, Bach X., Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Undurraga, Eduardo A., Uzun, Selen Begüm, Vallely, Andrew J., Van Gool, Coen H., Vasankari, Tommi J., Vavilala, Monica S., Venketasubramanian, N., Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vos, Theo, Waller, Stephen, Wang, Haidong, Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wong, John Q., Wordofa, Muluemebet Abera, Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., Naghavi, Mohsen, Murray, Christopher J.L., Lozano, Rafael, Kassebaum, Nj, Bertozzi-Villa, A, Coggeshall, M, Shackelford, Ka, Steiner, C, Heuton, Kr, Gonzalez-Medina, D, Barber, R, Huynh, C, Dicker, D, Templin, T, Wolock, Tm, Ozgoren, Aa, Abd-Allah, F, Abera, Sf, Achoki, T, Adelekan, A, Ademi, Z, Adou, Ak, Adsuar, Jc, Agardh, Ee, Akena, D, Alasfoor, D, Alemu, Za, Alfonso-Cristancho, R, Alhabib, S, Ali, R, Al Kahbouri, Mj, Alla, F, Allen, Pj, Almazroa, Ma, Alsharif, U, Alvarez, E, Alvis-Guzmán, N, Amankwaa, Aa, Amare, At, Amini, H, Ammar, W, Antonio, Ca, Anwari, P, Arnlöv, J, Arsenijevic, V, Artaman, A, Asad, Mm, Asghar, Rj, Assadi, R, Atkins, L, Badawi, A, Balakrishnan, K, Basu, A, Basu, S, Beardsley, J, Bedi, N, Bekele, T, Bell, Ml, Bernabe, E, Beyene, Tj, Bhutta, Z, Bin Abdulhak, A, Blore, J, Basara, Bb, Bose, D, Breitborde, N, Cárdenas, R, Castañeda-Orjuela, Ca, Castro, Re, Catalá-López, F, Cavlin, A, Chang, Jc, Che, X, Christophi, Ca, Chugh, S, Cirillo, M, Colquhoun, Sm, Cooper, Lt, Cooper, C, da Costa Leite, I, Dandona, L, Dandona, R, Davis, A, Dayama, A, Degenhardt, L, De Leo, D, Del Pozo-Cruz, B, Deribe, K, Dessalegn, M, Deveber, Ga, Dharmaratne, Sd, Dilmen, U, Ding, El, Dorrington, Re, Driscoll, Tr, Ermakov, Sp, Esteghamati, A, Faraon, Ej, Farzadfar, F, Felicio, Mm, Fereshtehnejad, Sm, de Lima, Gm, Forouzanfar, Mh, França, Eb, Gaffikin, L, Gambashidze, K, Gankpé, Fg, Garcia, Ac, Geleijnse, Jm, Gibney, Kb, Giroud, M, Glaser, El, Goginashvili, K, Gona, P, González-Castell, D, Goto, A, Gouda, Hn, Gugnani, Hc, Gupta, R, Hafezi-Nejad, N, Hamadeh, Rr, Hammami, M, Hankey, Gj, Harb, Hl, Havmoeller, R, Hay, S, Pi, Ib, Hoek, Hw, Hosgood, Hd, Hoy, Dg, Husseini, A, Idrisov, Bt, Innos, K, Inoue, M, Jacobsen, Kh, Jahangir, E, Jee, Sh, Jensen, Pn, Jha, V, Jiang, G, Juel, K, Kabagambe, Ek, Kan, H, Karam, Ne, Karch, A, Karema, Ck, Kaul, A, Kawakami, N, Kazanjan, K, Kazi, D, Kemp, Ag, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khan, Ea, Khang, Yh, Knibbs, L, Kokubo, Y, Kosen, S, Defo, Bk, Kulkarni, C, Kulkarni, V, Kumar, Ga, Kumar, K, Kumar, Rb, Kwan, G, Lai, T, Lalloo, R, Lam, H, Lansingh, Vc, Larsson, A, Lee, Jt, Leigh, J, Leinsalu, M, Leung, R, Li, X, Li, Y, Liang, J, Liang, X, Lim, S, Lin, Hh, Lipshultz, Se, Liu, S, Liu, Y, Lloyd, Bk, London, Sj, Lotufo, Pa, Ma, J, Ma, S, Machado, Vm, Mainoo, Nk, Majdan, M, Mapoma, Cc, Marcenes, W, Marzan, Mb, Mason-Jones, Aj, Mehndiratta, Mm, Mejia-Rodriguez, F, Memish, Za, Mendoza, W, Miller, Tr, Mills, Ej, Mokdad, Ah, Mola, Gl, Monasta, L, de la Cruz Monis, J, Hernandez, Jc, Moore, Ar, Mori, R, Mueller, Uo, Mukaigawara, M, Naheed, A, Naidoo, K, Nand, D, Nangia, V, Nash, D, Nejjari, C, Nelson, Rg, Neupane, Sp, Newton, Cr, Ng, M, Nieuwenhuijsen, Mj, Nisar, Mi, Nolte, S, Norheim, Of, Nyakarahuka, L, Oh, Ih, Ohkubo, T, Olusanya, Bo, Omer, Sb, Opio, Jn, Orisakwe, Oe, Pandian, Jd, Papachristou, C, Park, Jh, Caicedo, Aj, Patten, Sb, Paul, Vk, Pavlin, Bi, Pearce, N, Pereira, Dm, Pesudovs, K, Petzold, M, Poenaru, D, Polanczyk, Gv, Polinder, S, Pope, D, Pourmalek, F, Qato, D, Quistberg, Da, Rafay, A, Rahimi, K, Rahimi-Movaghar, V, Ur Rahman, S, Raju, M, Rana, Sm, Refaat, A, Ronfani, L, Roy, N, Pimienta, Tg, Sahraian, Ma, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Sayinzoga, F, Schneider, Ij, Schumacher, A, Schwebel, Dc, Seedat, S, Sepanlou, Sg, Servan-Mori, Ee, Shakh-Nazarova, M, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shiue, I, Sigfusdottir, Id, Silberberg, Dh, Silva, Ap, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Sreeramareddy, Ct, Stroumpoulis, K, Sturua, L, Sykes, Bl, Tabb, Km, Talongwa, Rt, Tan, F, Teixeira, Cm, Tenkorang, Ey, Terkawi, A, Thorne-Lyman, Al, Tirschwell, Dl, Towbin, Ja, Tran, Bx, Tsilimbaris, M, Uchendu, U, Ukwaja, Kn, Undurraga, Ea, Uzun, Sb, Vallely, Aj, van Gool, Ch, Vasankari, Tj, Vavilala, M, Venketasubramanian, N, Villalpando, S, Violante, F, Vlassov, Vv, Vos, T, Waller, S, Wang, H, Wang, L, Wang, Sx, Wang, Y, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Woldeyohannes, Sm, Wong, Jq, Wordofa, Ma, Xu, G, Yang, Yc, Yano, Y, Yentur, Gk, Yip, P, Yonemoto, N, Yoon, Sj, Younis, Mz, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhao, Y, Zheng, Y, Zhou, M, Zhu, J, Zou, Xn, Lopez, Ad, Naghavi, M, Murray, Cj, Lozano, R, Cell biology, Epidemiology, Public Health, Erasmus MC other, Cardiothoracic Surgery, and Pathology
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Pediatrics ,Time Factors ,Nutrition and Disease ,hiv-infection ,immunodeficiency virus-1 infection ,peripartum cardiomyopathy ,Poison control ,HIV Infections ,IMMUNODEFICIENCY VIRUS-1 INFECTION ,Socioeconomic Factor ,Global Health ,0302 clinical medicine ,PERIPARTUM CARDIOMYOPATHY ,pregnancy-related mortality ,Risk Factors ,Pregnancy ,Voeding en Ziekte ,Cause of Death ,Global health ,HIV Infection ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,10. No inequality ,Cause of death ,030219 obstetrics & reproductive medicine ,south-africa ,Medicine (all) ,1. No poverty ,WOMEN ,PREGNANCY-RELATED MORTALITY ,health initiatives ,General Medicine ,SOUTH-AFRICA ,3. Good health ,Maternal Mortality ,World Health ,CHILD SURVIVAL ,Female ,Maternal death ,women ,Human ,medicine.medical_specialty ,Time Factor ,DEATHS ,child survival ,Article ,adult mortality ,03 medical and health sciences ,Age Distribution ,HEALTH INITIATIVES ,SDG 3 - Good Health and Well-being ,HIV-INFECTION ,ADULT MORTALITY ,Injury prevention ,medicine ,Organizational Objectives ,Organizational Objective ,Humans ,VLAG ,Models, Statistical ,business.industry ,Risk Factor ,medicine.disease ,deaths ,Standardized mortality ratio ,Socioeconomic Factors ,Relative risk ,Pregnancy Complications, Infectiou ,business ,Demography - Abstract
BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.FUNDING: Bill & Melinda Gates Foundation.
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- 2016
49. The Effect of HIV Programs in South Africa on National HIV Incidence Trends, 2000-2019.
- Author
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Johnson LF, Meyer-Rath G, Dorrington RE, Puren A, Seathlodi T, Zuma K, and Feizzadeh A
- Subjects
- Adolescent, Anti-Retroviral Agents therapeutic use, Bayes Theorem, Female, Humans, Incidence, Male, Pregnancy, South Africa epidemiology, Circumcision, Male, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections prevention & control
- Abstract
Background: Recent studies have shown HIV incidence declines at a population level in several African countries. However, these studies have not directly quantified the extent to which incidence declines are attributable to different HIV programs., Methods: We calibrated a mathematical model of the South African HIV epidemic to age- and sex-specific data from antenatal surveys, household surveys, and death registration, using a Bayesian approach. The model was also parameterized using data on self-reported condom use, voluntary medical male circumcision (VMMC), HIV testing, and antiretroviral treatment (ART). Model estimates of HIV incidence were compared against the incidence rates that would have been expected had each program not been implemented., Results: The model estimated incidence in 15-49 year olds of 0.84% (95% CI: 0.75% to 0.96%) at the start of 2019. This represents a 62% reduction (95% CI: 55% to 66%) relative to 2000, a 47% reduction (95% CI: 42% to 51%) relative to 2010, and a 73% reduction (95% CI: 68% to 77%) relative to the incidence that would have been expected in 2019 in the absence of any interventions. The reduction in incidence in 2019 because of interventions was greatest for ART and condom promotion, with VMMC and behavior change after HIV testing having relatively modest impacts. HIV program impacts differed significantly by age and sex, with condoms and VMMC having greatest impact in youth, and overall incidence reductions being greater in men than in women., Conclusions: HIV incidence in South Africa has declined substantially since 2000, with ART and condom promotion contributing most significantly to this decline., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
- Full Text
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