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1. Anthropometric and sociodemographic variables, but not preconception or prenatal maternal nutrition supplementation, predict neurodevelopment in offspring of the ‘Women First’ trial

Author: Stephanie Waldrop, Dhuly Chowdhury, Jamie E. Westcott, Fred Biasini, Ana Garcés, Lester Figueroa, Antoinette Tshefu, Adrien Lokangaka, Melissa Bauserman, Sarah Saleem, Sumera A. Ali, Robert L. Goldenberg, Shivaprasad S. Goudar, Sangappa M. Dhaded, Richard J. Derman, Jennifer F. Kemp, Marion Koso‐Thomas, Abhik Das, Michael Hambidge, Nancy F. Krebs, and The Women First Preconception Nutrition Trial Study Group
Subjects: infant neurodevelopment, linear growth, maternal nutrition supplement, nurturing care, preconception, SQ‐LNS, Pediatrics, RJ1-570, Gynecology and obstetrics, RG1-991, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Abstract Multiple factors influence infant and child neurodevelopment in low resource settings. In offspring of participants in the preconception maternal nutrition trial, Women First (WF), we examined the impact of providing a preconception (Arm 1) or prenatal (Arm 2) nutrient supplement (compared to controls, Arm 3) on neurodevelopmental outcomes at 24 months; predictors of neurodevelopment scores; and associations of infant anthropometrics with neurodevelopmental scores. Follow‐up visits for anthropometry were conducted at 6‐, 12‐, 18‐ and 24‐month of age. At 24‐months, in a randomized subset, the Bayley Scales of Infant Development, 3rd edition (BSID‐III), including cognitive, motor and social‐emotional subscales, and the Family Care Indicators (FCI) questionnaire, assessing family and home environment, were completed. Multiple covariates (intervention arm, site, maternal sociodemographic characteristics, FCI subscales, birthweight and 6–24 months' change in anthropometry z‐scores, (e.g., ΔLAZ6–24) were evaluated by linear regression to predict BSID‐III outcomes and to assess associations of anthropometric changes with BSID‐III scores. The analysis consisted of 1386 infants (n = 441, 486, 459 for Arms 1, 2 and 3, respectively). None of the domain‐specific BSID‐III subscale scores differed by maternal intervention arm. Four covariates significantly predicted (p ≤ 0.01) all 3 BSID‐III subscales: secondary maternal education, ΔLAZ6–24, birthweight >2500 g, and FCI play materials. Linear growth was associated with all domains of neurodevelopment. The results underscore the multi‐dimensional aspects of child development represented by the nurturing care framework, including prenatal maternal nutrition, post‐natal growth, maternal education for responsive caregiving and opportunities for early learning.
Published: 2024
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2. Diagnostic accuracy of ASQ for screening of neurodevelopmental delays in low resource countries.

Author: Manasyan, Albert, Salas, Ariel, Nolen, Tracy, Chomba, Elwyn, Mazariegos, Manolo, Tshefu Kitoto, Antoinette, Saleem, Sarah, Naqvi, Farnaz, Hambidge, K, Goco, Norman, McClure, Elizabeth, Biasini, Fred, Goldenberg, Robert, Bose, Carl, Koso-Thomas, Marion, Krebs, Nancy, Carlo, Waldemar, and Wallander, Jan
Subjects: community child health, developmental neurology & neurodisability, paediatric neurology, Child, Infant, Humans, Child, Preschool, Communication, Guatemala, Health Personnel, Income, Neurodevelopmental Disorders
Abstract: OBJECTIVE: The Bayley Scales of Infant Development (BSID) is the most used diagnostic tool to identify neurodevelopmental disorders in children under age 3 but is challenging to use in low-resource countries. The Ages and Stages Questionnaire (ASQ) is an easy-to-use, low-cost clinical tool completed by parents/caregivers that screens children for developmental delay. The objective was to determine the performance of ASQ as a screening tool for neurodevelopmental impairment when compared with BSID second edition (BSID-II) for the diagnosis of moderate-to-severe neurodevelopmental impairment among infants at 12 and 18 months of age in low-resource countries. METHODS: Study participants were recruited as part of the First Bites Complementary Feeding trial from the Democratic Republic of Congo, Zambia, Guatemala and Pakistan between October 2008 and January 2011. Study participants underwent neurodevelopmental assessment by trained personnel using the ASQ and BSID-II at 12 and 18 months of age. RESULTS: Data on both ASQ and BSID-II assessments of 1034 infants were analysed. Four of five ASQ domains had specificities greater than 90% for severe neurodevelopmental delay at 18 months of age. Sensitivities ranged from 23% to 62%. The correlations between ASQ communications subscale and BSID-II Mental Development Index (MDI) (r=0.38) and between ASQ gross motor subscale and BSID-II Psychomotor Development Index (PDI) (r=0.33) were the strongest correlations found. CONCLUSION: At 18 months, ASQ had high specificity but moderate-to-low sensitivity for BSID-II MDI and/or PDI
Published: 2023

3. Epidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo

Author: Sendor, Rachel, Banek, Kristin, Kashamuka, Melchior M., Mvuama, Nono, Bala, Joseph A., Nkalani, Marthe, Kihuma, Georges, Atibu, Joseph, Thwai, Kyaw L., Svec, W. Matthew, Goel, Varun, Nseka, Tommy, Lin, Jessica T., Bailey, Jeffrey A., Emch, Michael, Carrel, Margaret, Juliano, Jonathan J., Tshefu, Antoinette, and Parr, Jonathan B.
Published: 2023
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4. Assessing caregivers’ perceptions of treatment-seeking for suspected severe malaria in the Democratic Republic of the Congo

Author: Okitawutshu, Jean, Tshefu, Antoinette, Kalenga, Jean-Claude, Delvento, Giulia, Burri, Christian, Hetzel, Manuel W., Lengeler, Christian, and Signorell, Aita
Published: 2023
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5. Building a predictive model of low birth weight in low- and middle-income countries: a prospective cohort study

Author: Patterson, Jackie K., Thorsten, Vanessa R., Eggleston, Barry, Nolen, Tracy, Lokangaka, Adrien, Tshefu, Antoinette, Goudar, Shivaprasad S., Derman, Richard J., Chomba, Elwyn, Carlo, Waldemar A., Mazariegos, Manolo, Krebs, Nancy F., Saleem, Sarah, Goldenberg, Robert L., Patel, Archana, Hibberd, Patricia L., Esamai, Fabian, Liechty, Edward A., Haque, Rashidul, Petri, Bill, Koso-Thomas, Marion, McClure, Elizabeth M., Bose, Carl L., and Bauserman, Melissa
Published: 2023
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6. Prescription patterns and compliance with World Health Organization recommendations for the management of uncomplicated and severe malaria: A prospective, real-world study in sub-Saharan Africa

Author: Baraka, Vito, Nhama, Abel, Aide, Pedro, Bassat, Quique, David, Agatha, Gesase, Samwel, Gwasupika, Jonathan, Hachizovu, Sebastian, Makenga, Geofrey, Ntizimira, Christian Ruchaho, Obunge, Orikomaba, Tshefu, Kitoto Antoinette, Cousin, Marc, Otsyula, Nekoye, Pathan, Rashidkhan, Risterucci, Céline, Su, Guoqin, and Manyando, Christine
Published: 2023
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7. Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis

Author: Unger, Holger W., Hadiprodjo, Anastasia Jessica, Gutman, Julie R., Briand, Valerie, Fievet, Nadine, Valea, Innocent, Tinto, Halidou, D’Alessandro, Umberto, Landis, Sarah H., Ter Kuile, Feiko, Ouma, Peter, Oneko, Martina, Mwapasa, Victor, Slutsker, Laurence, Terlouw, Dianne J., Kariuki, Simon, Ayisi, John, Nahlen, Bernard, Desai, Meghna, Madanitsa, Mwayi, Kalilani-Phiri, Linda, Ashorn, Per, Maleta, Kenneth, Tshefu-Kitoto, Antoinette, Mueller, Ivo, Stanisic, Danielle, Cates, Jordan, Van Eijk, Anna Maria, Ome-Kaius, Maria, Aitken, Elizabeth H., and Rogerson, Stephen J.
Published: 2023
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8. Pre-referral rectal artesunate is no “magic bullet” in weak health systems

Author: Hetzel, Manuel W., Okitawutshu, Jean, Tshefu, Antoinette, Omoluabi, Elizabeth, Awor, Phyllis, Signorell, Aita, Kwiatkowski, Marek, Lambiris, Mark J., Visser, Theodoor, Cohen, Justin M., Buj, Valentina, Burri, Christian, and Lengeler, Christian
Published: 2023
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9. Junk food use and neurodevelopmental and growth outcomes in infants in low-resource settings

Author: Melody K. Chiwila, Nancy F. Krebs, Albert Manasyan, Elwyn Chomba, Musaku Mwenechanya, Manolo Mazariegos, Neelofar Sami, Omrana Pasha, Antoinette Tshefu, Adrien Lokangaka, Robert L. Goldenberg, Carl L. Bose, Marion Koso-Thomas, Norman Goco, Barbara T. Do, Elizabeth M. McClure, K. Michael Hambidge, Jamie E. Westcott, and Waldemar A. Carlo
Subjects: neonatology, infant nutrition, diet, low-income countries, complementary feeding, nutritional disorders, Public aspects of medicine, RA1-1270
Abstract: IntroductionFeeding infants a sub-optimal diet deprives them of critical nutrients for their physical and cognitive development. The objective of this study is to describe the intake of foods of low nutritional value (junk foods) and identify the association with growth and developmental outcomes in infants up to 18 months in low-resource settings.MethodsThis is a secondary analysis of data from an iron-rich complementary foods (meat versus fortified cereal) randomized clinical trial on nutrition conducted in low-resource settings in four low- and middle-income countries (Democratic Republic of the Congo, Guatemala, Pakistan, and Zambia). Mothers in both study arms received nutritional messages on the importance of exclusive breastfeeding up to 6 months with continued breastfeeding up to at least 12 months. This study was designed to identify the socio-demographic predictors of feeding infants’ complementary foods of low nutritional value (junk foods) and to assess the associations between prevalence of junk food use with neurodevelopment (assessed with the Bayley Scales of Infant Development II) and growth at 18 months.Results1,231 infants were enrolled, and 1,062 (86%) completed the study. Junk food feeding was more common in Guatemala, Pakistan, and Zambia than in the Democratic Republic of Congo. 7% of the infants were fed junk foods at 6 months which increased to 70% at 12 months. Non-exclusive breastfeeding at 6 months, higher maternal body mass index, more years of maternal and paternal education, and higher socioeconomic status were associated with feeding junk food. Prevalence of junk foods use was not associated with adverse neurodevelopmental or growth outcomes.ConclusionThe frequency of consumption of junk food was high in these low-resource settings but was not associated with adverse neurodevelopment or growth over the study period.
Published: 2024
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10. Epidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo

Author: Rachel Sendor, Kristin Banek, Melchior M. Kashamuka, Nono Mvuama, Joseph A. Bala, Marthe Nkalani, Georges Kihuma, Joseph Atibu, Kyaw L. Thwai, W. Matthew Svec, Varun Goel, Tommy Nseka, Jessica T. Lin, Jeffrey A. Bailey, Michael Emch, Margaret Carrel, Jonathan J. Juliano, Antoinette Tshefu, and Jonathan B. Parr
Subjects: Science
Abstract: Abstract Reports suggest non-falciparum species are an underappreciated cause of malaria in sub-Saharan Africa but their epidemiology is ill-defined, particularly in highly malaria-endemic regions. We estimated incidence and prevalence of PCR-confirmed non-falciparum and Plasmodium falciparum malaria infections within a longitudinal study conducted in Kinshasa, Democratic Republic of Congo (DRC) between 2015-2017. Children and adults were sampled at biannual household surveys and routine clinic visits. Among 9,089 samples from 1,565 participants, incidences of P. malariae, P. ovale spp., and P. falciparum infections by 1-year were 7.8% (95% CI: 6.4%-9.1%), 4.8% (95% CI: 3.7%-5.9%) and 57.5% (95% CI: 54.4%-60.5%), respectively. Non-falciparum prevalences were higher in school-age children, rural and peri-urban sites, and P. falciparum co-infections. P. falciparum remains the primary driver of malaria in the DRC, though non-falciparum species also pose an infection risk. As P. falciparum interventions gain traction in high-burden settings, continued surveillance and improved understanding of non-falciparum infections are warranted.
Published: 2023
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11. Assessing caregivers’ perceptions of treatment-seeking for suspected severe malaria in the Democratic Republic of the Congo

Author: Jean Okitawutshu, Antoinette Tshefu, Jean-Claude Kalenga, Giulia Delvento, Christian Burri, Manuel W. Hetzel, Christian Lengeler, and Aita Signorell
Subjects: Severe malaria, Malaria infection, Rectal artesunate, Treatment-seeking, Knowledge, attitude and practice, Democratic Republic of the Congo, Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background Malaria remains a major public health issue in the Democratic Republic of the Congo (DRC), accounting for 44% deaths among outpatient visits in children
Published: 2023
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12. Building a predictive model of low birth weight in low- and middle-income countries: a prospective cohort study

Author: Jackie K. Patterson, Vanessa R. Thorsten, Barry Eggleston, Tracy Nolen, Adrien Lokangaka, Antoinette Tshefu, Shivaprasad S. Goudar, Richard J. Derman, Elwyn Chomba, Waldemar A. Carlo, Manolo Mazariegos, Nancy F. Krebs, Sarah Saleem, Robert L. Goldenberg, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Rashidul Haque, Bill Petri, Marion Koso-Thomas, Elizabeth M. McClure, Carl L. Bose, and Melissa Bauserman
Subjects: Low birth weight, Preterm, Small for gestational age, Low-income country, Gynecology and obstetrics, RG1-991
Abstract: Abstract Background Low birth weight (LBW,
Published: 2023
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13. Prescription patterns and compliance with World Health Organization recommendations for the management of uncomplicated and severe malaria: A prospective, real-world study in sub-Saharan Africa

Author: Vito Baraka, Abel Nhama, Pedro Aide, Quique Bassat, Agatha David, Samwel Gesase, Jonathan Gwasupika, Sebastian Hachizovu, Geofrey Makenga, Christian Ruchaho Ntizimira, Orikomaba Obunge, Kitoto Antoinette Tshefu, Marc Cousin, Nekoye Otsyula, Rashidkhan Pathan, Céline Risterucci, Guoqin Su, and Christine Manyando
Subjects: Compliance, Diagnosis, Malaria, Prescription, Recommendations, Treatment, Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background This study aimed to evaluate the gap between guidelines and local clinical practice for diagnosis and treatment of uncomplicated and severe malaria, the patient characteristics, diagnostic approach, treatment, and compliance to standard guideline recommendations. Methods This was a multicentre, observational study conducted between October 2020 and March 2021 in which patients of all ages with symptoms suggestive of malaria and who visited a healthcare facility were prospectively enrolled in six countries in sub-Saharan Africa (The Democratic Republic of the Congo, Mozambique, Nigeria, Rwanda, The United Republic of Tanzania, and Zambia). Results Of 1001 enrolled patients, 735 (73.4%) patients had confirmed malaria (based on overall judgment by investigator) at baseline (uncomplicated malaria: 598 [81.4%] and severe malaria: 137 [18.6%]). Of the confirmed malaria patients, 533 (72.5%) were administered a malaria rapid diagnostic test. The median age of patients was 11 years (range: 2 weeks–91 years) with more patients coming from rural (44.9%) than urban (30.6%) or suburban areas (24.5%). At the community level, 57.8% of patients sought advice or received treatment for malaria and 56.9% of patients took one or more drugs for their illness before coming to the study site. In terms of early access to care, 44.1% of patients came to the study site for initial visit ≥ 48 h after symptom onset. In patients with uncomplicated malaria, the most prescribed treatments were artemisinin-based combination therapy (ACT; n = 564 [94.3%]), primarily using artemether-lumefantrine (82.3%), in line with the World Health Organization (WHO) treatment guidelines. In addition, these patients received antipyretics (85.6%) and antibiotics (42.0%). However, in those with severe malaria, only 66 (48.2%) patients received parenteral treatment followed by oral ACT as per WHO guidelines, whereas 62 (45.3%) received parenteral treatment only. After receiving ambulatory care, 88.6% of patients with uncomplicated malaria were discharged and 83.2% of patients with severe malaria were discharged after hospitalization. One patient with uncomplicated malaria having multiple co-morbidities and three patients with severe malaria died. Conclusions The findings of this study suggest that the prescribed treatment in most patients with uncomplicated malaria, but not of those with severe malaria, was in alignment with the WHO recommended guidelines.
Published: 2023
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14. Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis

Author: Holger W. Unger, Anastasia Jessica Hadiprodjo, Julie R. Gutman, Valerie Briand, Nadine Fievet, Innocent Valea, Halidou Tinto, Umberto D’Alessandro, Sarah H. Landis, Feiko Ter Kuile, Peter Ouma, Martina Oneko, Victor Mwapasa, Laurence Slutsker, Dianne J. Terlouw, Simon Kariuki, John Ayisi, Bernard Nahlen, Meghna Desai, Mwayi Madanitsa, Linda Kalilani-Phiri, Per Ashorn, Kenneth Maleta, Antoinette Tshefu-Kitoto, Ivo Mueller, Danielle Stanisic, Jordan Cates, Anna Maria Van Eijk, Maria Ome-Kaius, Elizabeth H. Aitken, and Stephen J. Rogerson
Subjects: Medicine, Science
Abstract: Abstract In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.
Published: 2023
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15. A mixed methods study assessing the adoption potential of a saliva-based malaria rapid test in the Democratic Republic of Congo

Author: John Diaz, Cody Gusto, Kaci McCoy, Colby Silvert, Joseph A. Bala, Joseph Atibu, Antoinette Tshefu, Melchior Mwandagalirwa, and Rhoel R. Dinglasan
Subjects: Adoption, Malaria, Rapid diagnostic test, Saliva-based, Subclinical infection, Treatment, Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background The reliance on blood for thin and thick blood smear microscopy—using a relatively invasive procedure has presented challenges to the use of reliable diagnostic tests in non-clinical settings at the point-of-need (PON). To improve the capacity of non-blood-based rapid diagnostic tests to confirm subclinical infections, and thereby identify and quantify the human reservoir at the PON, a cross-sectoral collaboration between university researchers and commercial partners produced an innovative, non-invasive saliva-based RDT capable of identifying novel, non-hrp2/3 parasite biomarkers. While this new saliva-based malaria asymptomatic and asexual rapid test (SMAART-1) shows increased detection sensitivity and precision potential by identifying a new P. falciparum protein marker (PSSP17), appraising its utility in the field—particularly with respect to its adoption potential with children and adults in high risk, endemic regions—is necessary to warrant its continued development. Methods The purpose of this study was to assess the acceptability and adoption potential of the SMAART-1 at select PON sites in the Kinshasa Province. Teachers, community health workers, nurses, and laboratory technicians participated in data collection at three distinct community sites in Kinshasa Province, Democratic Republic of the Congo. Three data collection methods were utilized in this mixed methods study to provide an overarching acceptability evaluation of the SMAART-1 at PON field sites: observation checklists of SMAART-1 implementation, focus group discussions, and surveys with local health care practitioners—particularly teachers and community health workers. Results Findings indicate participants were interested in and supportive of the SMAART-1 protocol, with approximately 99% of the participants surveyed indicating that they either “agreed” or “strongly agreed” with the statement that they “would use the saliva-based malaria asymptomatic rapid test as part of a community malaria detection and treatment programme.” Data also suggest that the protocol was broadly appealing for its testing sensitivity and ease of use. Conclusions The SMAART-1 protocol’s clinically reliable results demonstrate a promising new level of sensitivity and precision for detecting parasite biomarkers. This study’s mixed-methods assessment of the protocol’s utility and adoption potential in the field, with a target user audience, advances its development and points to opportunities to formalize and expand evaluation efforts.
Published: 2023
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16. Pre-referral rectal artesunate is no 'magic bullet' in weak health systems

Author: Manuel W. Hetzel, Jean Okitawutshu, Antoinette Tshefu, Elizabeth Omoluabi, Phyllis Awor, Aita Signorell, Marek Kwiatkowski, Mark J. Lambiris, Theodoor Visser, Justin M. Cohen, Valentina Buj, Christian Burri, and Christian Lengeler
Subjects: Severe malaria, Rectal artesunate, Artesunate, Case management, Quality of care, Effectiveness, Medicine
Abstract: Abstract Severe malaria is a potentially fatal condition that requires urgent treatment. In a clinical trial, a sub-group of children treated with rectal artesunate (RAS) before being referred to a health facility had an increased chance of survival. We recently published in BMC Medicine results of the CARAMAL Project that did not find the same protective effect of pre-referral RAS implemented at scale under real-world conditions in three African countries. Instead, CARAMAL identified serious health system shortfalls that impacted the entire continuum of care, constraining the effectiveness of RAS. Correspondence to the article criticized the observational study design and the alleged interpretation and consequences of our findings. Here, we clarify that we do not dispute the life-saving potential of RAS, and discuss the methodological criticism. We acknowledge the potential for confounding in observational studies. Nevertheless, the totality of CARAMAL evidence is in full support of our conclusion that the conditions under which RAS can be beneficial were not met in our settings, as children often failed to complete referral and post-referral treatment was inadequate. The criticism did not appear to acknowledge the realities of highly malarious settings documented in detail in the CARAMAL project. Suggesting that trial-demonstrated efficacy is sufficient to warrant large-scale deployment of pre-referral RAS ignores the paramount importance of functioning health systems for its delivery, for completing post-referral treatment, and for achieving complete cure. Presenting RAS as a “magic bullet” distracts from the most urgent priority: fixing health systems so they can provide a functioning continuum of care and save the lives of sick children. The data underlying our publication is freely accessible on Zenodo.
Published: 2023
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17. The impact of risk factors on aspirin's efficacy for the prevention of preterm birth

Author: Nuss, Emily E., Hoffman, Matthew K., Goudar, Shivaprasad S., Kavi, Avinash, Metgud, Mrityunjay, Somannavar, Manjunath, Okitawutshu, Jean, Lokangaka, Adrien, Tshefu, Antoinette, Bauserman, Melissa, Tembo, Abigail Mwapule, Chomba, Elwyn, Carlo, Waldemar A., Figueroa, Lester, Krebs, Nancy F., Jessani, Saleem, Saleem, Sarah, Goldenberg, Robert L., Kurhe, Kunal, Das, Prabir, Hibberd, Patricia L., Achieng, Emmah, Nyongesa, Paul, Esamai, Fabian, Liechty, Edward A., Bucher, Sherri, Goco, Norman, Hemingway-Foday, Jennifer, Moore, Janet, McClure, Elizabeth M., Silver, Robert M., and Derman, Richard J.
Published: 2023
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18. Maternal age extremes and adverse pregnancy outcomes in low-resourced settings

Author: Paul Nyongesa, Osayame A. Ekhaguere, Irene Marete, Constance Tenge, Milsort Kemoi, Carla M. Bann, Sherri L. Bucher, Archana B. Patel, Patricia L. Hibberd, Farnaz Naqvi, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar, Richard J. Derman, Nancy F. Krebs, Ana Garces, Elwyn Chomba, Waldemar A. Carlo, Musaku Mwenechanya, Adrien Lokangaka, Antoinette K. Tshefu, Melissa Bauserman, Marion Koso-Thomas, Janet L. Moore, Elizabeth M. McClure, Edward A. Liechty, and Fabian Esamai
Subjects: pregnancy outcomes, low-and middle-income country, adolescent pregnancy, advanced maternal age pregnancy, maternal mortality ratio, neonatal mortality, Gynecology and obstetrics, RG1-991, Women. Feminism, HQ1101-2030.7
Abstract: IntroductionAdolescent (35 years) pregnancies carry adverse risks and warrant a critical review in low- and middle-income countries where the burden of adverse pregnancy outcomes is highest.ObjectiveTo describe the prevalence and adverse pregnancy (maternal, perinatal, and neonatal) outcomes associated with extremes of maternal age across six countries.Patients and methodsWe performed a historical cohort analysis on prospectively collected data from a population-based cohort study conducted in the Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia between 2010 and 2020. We included pregnant women and their neonates. We describe the prevalence and adverse pregnancy outcomes associated with pregnancies in these maternal age groups (35 years). Relative risks and 95% confidence intervals of each adverse pregnancy outcome comparing each maternal age group to the reference group of 20–24 years were obtained by fitting a Poisson model adjusting for site, maternal age, parity, multiple gestations, maternal education, antenatal care, and delivery location. Analysis by region was also performed.ResultsWe analyzed 602,884 deliveries; 13% (78,584) were adolescents, and 5% (28,677) were advanced maternal age (AMA). The overall maternal mortality ratio (MMR) was 147 deaths per 100,000 live births and increased with advancing maternal age: 83 in the adolescent and 298 in the AMA group. The AMA groups had the highest MMR in all regions. Adolescent pregnancy was associated with an adjusted relative risk (aRR) of 1.07 (1.02–1.11) for perinatal mortality and 1.13 (1.06–1.19) for neonatal mortality. In contrast, AMA was associated with an aRR of 2.55 (1.81 to 3.59) for maternal mortality, 1.58 (1.49–1.67) for perinatal mortality, and 1.30 (1.20–1.41) for neonatal mortality, compared to pregnancy in women 20–24 years. This pattern was overall similar in all regions, even in the
Published: 2023
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19. Can the date of last menstrual period be trusted in the first trimester? Comparisons of gestational age measures from a prospective cohort study in six low-income to middle-income countries

Author: Waldemar A Carlo, Archana Patel, Sowmya R Rao, Patricia L Hibberd, Fabian Esamai, Antoinette Tshefu Kitoto, Robert L Goldenberg, Elizabeth McClure, Sarah Saleem, Elwyn Chomba, Sherri Bucher, Carla M Bann, Richard Derman, Nancy F Krebs, Adrien Lokangaka, Melissa Bauserman, Lester Figueroa, Marion Koso-Thomas, Vanessa R Thorsten, and Shivaprasad Goudar
Subjects: Medicine
Abstract: Objectives We examined gestational age (GA) estimates for live and still births, and prematurity rates based on last menstrual period (LMP) compared with ultrasonography (USG) among pregnant women at seven sites in six low-resource countries.Design Prospective cohort studySetting and participants This study included data from the Global Network’s population-based Maternal and Newborn Health Registry which follows pregnant women in six low-income and middle-income countries (Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and Zambia). Participants in this analysis were 42 803 women, including their 43 230 babies, who registered for the study in their first trimester based on GA estimated either by LMP or USG and had a live or stillbirth with an estimated GA of 20–42 weeks.Outcome measures GA was estimated in weeks and days based on LMP and/or USG. Prematurity was defined as GA of 20 weeks+0 days through 36 weeks+6 days, calculated by both USG and LMP.Results Overall, average GA varied ≤1 week between LMP and USG. Mean GA for live births by LMP was lower than by USG (adjusted mean difference (95% CI) = −0.23 (–0.29 to –0.17) weeks). Among stillbirths, a higher GA was estimated by LMP than USG (adjusted mean difference (95% CI)= 0.42 (0.11 to 0.72) weeks). Preterm birth rates for live births were significantly higher when dated by LMP (adjusted rate difference (95% CI)= 4.20 (3.56 to 4.85)). There was no significant difference in preterm birth rates for stillbirths.Conclusion The small differences in GA for LMP versus USG in the Guatemalan and Indian sites suggest that LMP may be a useful alternative to USG for GA dating during the first trimester until availability of USG improves in those areas. Further research is needed to assess LMP for first-trimester GA dating in other regions with limited access to USG.Trial registration number NCT01073475.
Published: 2023
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20. Association between domesticated animal ownership and Plasmodium falciparum parasite prevalence in the Democratic Republic of the Congo: a national cross-sectional study

Author: Morgan, Camille E, Topazian, Hillary M, Brandt, Katerina, Mitchell, Cedar, Kashamuka, Melchior Mwandagalirwa, Muwonga, Jérémie, Sompwe, Eric, Juliano, Jonathan J, Bobanga, Thierry, Tshefu, Antoinette, Emch, Michael, and Parr, Jonathan B
Published: 2023
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21. Pre-referral rectal artesunate: no cure for unhealthy systems

Author: Hetzel, Manuel W, Awor, Phyllis, Tshefu, Antoinette, Omoluabi, Elizabeth, Burri, Christian, Signorell, Aita, Lambiris, Mark J, Visser, Theodoor, Cohen, Justin M, Buj, Valentina, and Lengeler, Christian
Published: 2023
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22. Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research

Author: Patterson, Jackie K, Neuwahl, Simon, Goco, Norman, Moore, Janet, Goudar, Shivaprasad S, Derman, Richard J, Hoffman, Matthew, Metgud, Mrityunjay, Somannavar, Manjunath, Kavi, Avinash, Okitawutshu, Jean, Lokangaka, Adrien, Tshefu, Antoinette, Bose, Carl L, Mwapule, Abigail, Mwenechanya, Musaku, Chomba, Elwyn, Carlo, Waldemar A, Chicuy, Javier, Figueroa, Lester, Krebs, Nancy F, Jessani, Saleem, Saleem, Sarah, Goldenberg, Robert L, Kurhe, Kunal, Das, Prabir, Patel, Archana, Hibberd, Patricia L, Achieng, Emmah, Nyongesa, Paul, Esamai, Fabian, Bucher, Sherri, Liechty, Edward A, Bresnahan, Brian W, Koso-Thomas, Marion, and McClure, Elizabeth M
Published: 2023
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23. Health system readiness and the implementation of rectal artesunate for severe malaria in sub-Saharan Africa: an analysis of real-world costs and constraints

Author: Lambiris, Mark J, Venga, Guy Ndongala, Ssempala, Richard, Balogun, Victor, Galactionova, Katya, Musiitwa, Michael, Kagwire, Fred, Olosunde, Oluseyi, Emedo, Emmanel, Luketa, Sylvie, Sangare, Moulaye, Buj, Valentina, Delvento, Giulia, Tshefu, Antoinette, Okitawutshu, Jean, Omoluabi, Elizabeth, Awor, Phyllis, Signorell, Aita, Hetzel, Manuel W, Lee, Tristan T, Brunner, Nina C, Cereghetti, Nadja, Visser, Theodoor, Napier, Harriet G, Burri, Christian, and Lengeler, Christian
Published: 2023
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24. Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda

Author: Phyllis Awor, Joseph Kimera, Proscovia Athieno, Gloria Tumukunde, Jean Okitawutshu, Antoinette Tshefu, Elizabeth Omoluabi, Aita Signorell, Nina Brunner, Jean-Claude Kalenga, Babatunde Akano, Kazeem Ayodeji, Charles Okon, Ocheche Yusuf, Giulia Delvento, Tristan Lee, Christian Burri, Christian Lengeler, and Manuel W. Hetzel
Subjects: Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background For children below 6 years with suspected severe malaria attending a health care provider unable to provide parenteral malaria treatment, pre-referral rectal artesunate (RAS) is recommended by the World Health Organization to prevent death and disability. A number of African countries are in the process of rolling out quality-assured RAS for pre-referral treatment of severe malaria at community-level. The success of RAS depends, among other factors, on the acceptability of RAS in the communities where it is being rolled-out. Yet to date, there is limited literature on RAS acceptability. This study aimed to determine the acceptability of RAS by health care providers and child caregivers in communities where quality assured RAS was rolled out. This study was nested within the comprehensive multi-country observational research project Community Access to Rectal Artesunate for Malaria (CARAMAL), implemented in the Democratic Republic of the Congo (DRC), Nigeria, and Uganda between 2018 and 2020. Data from three different sources were analysed to understand RAS acceptability: interviews with health workers during three health care provider surveys (N = 341 community health workers and 467 primary health facility workers), with caregivers of children
Published: 2022
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25. Effectiveness of rectal artesunate as pre-referral treatment for severe malaria in children under 5 years of age: a multi-country observational study

Author: Manuel W. Hetzel, Jean Okitawutshu, Antoinette Tshefu, Elizabeth Omoluabi, Phyllis Awor, Aita Signorell, Nina C. Brunner, Jean-Claude Kalenga, Babatunde K. Akano, Kazeem Ayodeji, Charles Okon, Ocheche Yusuf, Proscovia Athieno, Joseph Kimera, Gloria Tumukunde, Irene Angiro, Giulia Delvento, Tristan T. Lee, Mark J. Lambiris, Marek Kwiatkowski, Nadja Cereghetti, Theodoor Visser, Harriet G. Napier, Justin M. Cohen, Valentina Buj, Christian Burri, and Christian Lengeler
Subjects: Severe malaria, Malaria treatment, Rectal artesunate, Referral, Child mortality, Malaria mortality, Medicine
Abstract: Abstract Background To prevent child deaths from severe malaria, early parenteral treatment is essential. Yet, in remote rural areas, accessing facilities offering parenteral antimalarials may be difficult. A randomised controlled trial found pre-referral treatment with rectal artesunate (RAS) to reduce deaths and disability in children who arrived at a referral facility with delay. This study examined the effectiveness of pre-referral RAS treatment implemented through routine procedures of established community-based health care systems. Methods An observational study accompanied the roll-out of RAS in the Democratic Republic of the Congo (DRC), Nigeria and Uganda. Children
Published: 2022
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26. Key factors predicting suspected severe malaria case management and health outcomes: an operational study in the Democratic Republic of the Congo

Author: Jean Okitawutshu, Aita Signorell, Jean-Claude Kalenga, Eric Mukomena, Giulia Delvento, Christian Burri, Fatou Mwaluke, Valentina Buj, Moulaye Sangare, Sylvie Luketa, Nina Brunner, Tristan Lee, Manuel Hetzel, Christian Lengeler, and Antoinette Tshefu
Subjects: Democratic Republic of the Congo, iCCM, IMCI, Severe malaria, Rectal artesunate, Injectable artesunate, Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background Evidence suggests that pre-referral Rectal Artesunate (RAS) can be a life-saving intervention for severe malaria in remote settings in Africa. Recognition of danger signs indicative of severe malaria is critical for prompt and appropriate case management. Methods This was an observational study conducted in three Health Zones of the Democratic Republic of the Congo to determine the distribution of dangers signs for severe malaria and assess their impact on RAS use, referral completion, injectable treatment and ACT provision, and health outcomes including death. An individual-level analysis was carried out, using multilevel-mixed effects logistic regression models. Severely ill febrile children
Published: 2022
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27. Prevention of maternal and neonatal death/infections with a single oral dose of azithromycin in women in labour in low-income and middle-income countries (A-PLUS): a study protocol for a multinational, randomised placebo-controlled clinical trial

Author: Osayame A Ekhaguere, William A Petri, Rashidul Haque, Waldemar A Carlo, Archana Patel, Patricia L Hibberd, Sk Masum Billah, Fabian Esamai, Antoinette Tshefu Kitoto, Robert L Goldenberg, Elizabeth McClure, Sarah Saleem, Carl Bose, Musaku Mwenechanya, Elwyn Chomba, Prabir Kumar Das, Shivaprasad S Goudar, Kunal Kurhe, Tracy Nolen, Richard Derman, Avinash Kavi, Nancy F Krebs, Adrien Lokangaka, Melissa Bauserman, Lester Figueroa, Marion Koso-Thomas, Manolo Mazariegos, Jennifer Hemingway-Foday, Alan Tita, Trecious Mweemba, Gustave Lomendje, Mrityunjay Metgud, Shiyam S Tikmani, Paul Nyongesa, Amos Sagwe, Md Shahjahan Siraj, and Edward A Liechty
Subjects: Medicine
Abstract: Introduction Maternal and neonatal infections are among the most frequent causes of maternal and neonatal mortality, and current antibiotic strategies have been ineffective in preventing many of these deaths. A randomised clinical trial conducted in a single site in The Gambia showed that treatment with an oral dose of 2 g azithromycin versus placebo for all women in labour reduced certain maternal and neonatal infections. However, it is unknown if this therapy reduces maternal and neonatal sepsis and mortality. In a large, multinational randomised trial, we will evaluate the impact of azithromycin given in labour to improve maternal and newborn outcomes.Methods and analysis This randomised, placebo-controlled, multicentre clinical trial includes two primary hypotheses, one maternal and one neonatal. The maternal hypothesis is to test whether a single, prophylactic intrapartum oral dose of 2 g azithromycin given to women in labour will reduce maternal death or sepsis. The neonatal hypothesis will test whether this intervention will reduce intrapartum/neonatal death or sepsis. The intervention is a single, prophylactic intrapartum oral dose of 2 g azithromycin, compared with a single intrapartum oral dose of an identical appearing placebo. A total of 34 000 labouring women from 8 research sites in sub-Saharan Africa, South Asia and Latin America will be randomised with a one-to-one ratio to intervention/placebo. In addition, we will assess antimicrobial resistance in a sample of women and their newborns.Ethics and dissemination The study protocol has been reviewed and ethics approval obtained from all the relevant ethical review boards at each research site. The results will be disseminated via peer-reviewed journals and national and international scientific forums.Trial registration number NCT03871491 (https://clinicaltrials.gov/ct2/show/NCT03871491?term=NCT03871491&draw=2&rank=1).
Published: 2023
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28. WED-451-YI Characterizing hepatitis B virus infection in children and household contacts in the Democratic Republic of Congo to inform elimination efforts in a resource-limited setting

Author: Morgan, Camille, primary, Powers, Kimberly, additional, Edwards, Jessie, additional, Yotebieng, Marcel, additional, Emch, Michael, additional, Biju, Stane, additional, Devkota, Upasana, additional, Cloherty, Gavin, additional, Lin, Feng-Chang, additional, Muwonga, Jérémie, additional, Kashamuka, Melchior, additional, Tshefu, Antoinette, additional, Becker-Drepps, Sylvia, additional, Parr, Jonathan B., additional, and Thompson, Peyton, additional
Published: 2024
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29. Diagnostic accuracy of ASQ for screening of neurodevelopmental delays in low resource countries

Author: Waldemar A Carlo, Fred J Biasini, Antoinette Tshefu Kitoto, Robert L Goldenberg, Carl L Bose, Albert Manasyan, Sarah Saleem, Elwyn Chomba, Ariel A Salas, Tracy Nolen, Elizabeth M McClure, Nancy F Krebs, Marion Koso-Thomas, K Michael Hambidge, Manolo Mazariegos, Farnaz Naqvi, Norman Goco, and Jan L Wallander
Subjects: Medicine
Abstract: Objective The Bayley Scales of Infant Development (BSID) is the most used diagnostic tool to identify neurodevelopmental disorders in children under age 3 but is challenging to use in low-resource countries. The Ages and Stages Questionnaire (ASQ) is an easy-to-use, low-cost clinical tool completed by parents/caregivers that screens children for developmental delay. The objective was to determine the performance of ASQ as a screening tool for neurodevelopmental impairment when compared with BSID second edition (BSID-II) for the diagnosis of moderate-to-severe neurodevelopmental impairment among infants at 12 and 18 months of age in low-resource countries.Methods Study participants were recruited as part of the First Bites Complementary Feeding trial from the Democratic Republic of Congo, Zambia, Guatemala and Pakistan between October 2008 and January 2011. Study participants underwent neurodevelopmental assessment by trained personnel using the ASQ and BSID-II at 12 and 18 months of age.Results Data on both ASQ and BSID-II assessments of 1034 infants were analysed. Four of five ASQ domains had specificities greater than 90% for severe neurodevelopmental delay at 18 months of age. Sensitivities ranged from 23% to 62%. The correlations between ASQ communications subscale and BSID-II Mental Development Index (MDI) (r=0.38) and between ASQ gross motor subscale and BSID-II Psychomotor Development Index (PDI) (r=0.33) were the strongest correlations found.Conclusion At 18 months, ASQ had high specificity but moderate-to-low sensitivity for BSID-II MDI and/or PDI
Published: 2023
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30. Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research

Author: Jackie K Patterson, MD, Simon Neuwahl, MSPH, Norman Goco, MHS, Janet Moore, MS, Shivaprasad S Goudar, ProfMD, Richard J Derman, ProfMD, Matthew Hoffman, ProfMD, Mrityunjay Metgud, ProfMD, Manjunath Somannavar, MD, Avinash Kavi, MD, Jean Okitawutshu, MD, Adrien Lokangaka, MD, Antoinette Tshefu, ProfMD, Carl L Bose, ProfMD, Abigail Mwapule, RN, Musaku Mwenechanya, MD, Elwyn Chomba, MD, Waldemar A Carlo, ProfMD, Javier Chicuy, MD, Lester Figueroa, MD, Nancy F Krebs, ProfMD, Saleem Jessani, MBBS, Sarah Saleem, ProfMD, Robert L Goldenberg, ProfMD, Kunal Kurhe, MD, Prabir Das, MD, Archana Patel, ProfMD, Patricia L Hibberd, ProfMD, Emmah Achieng, MPH, Paul Nyongesa, MMed, Fabian Esamai, MBChB, Sherri Bucher, PhD, Edward A Liechty, ProfMD, Brian W Bresnahan, PhD, Marion Koso-Thomas, MD, and Elizabeth M McClure, PhD
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Premature birth is associated with an increased risk of mortality and morbidity, and strategies to prevent preterm birth are few in number and resource intensive. In 2020, the ASPIRIN trial showed the efficacy of low-dose aspirin (LDA) in nulliparous, singleton pregnancies for the prevention of preterm birth. We sought to investigate the cost-effectiveness of this therapy in low-income and middle-income countries. Methods: In this post-hoc, prospective, cost-effectiveness study, we constructed a probabilistic decision tree model to compare the benefits and costs of LDA treatment compared with standard care using primary data and published results from the ASPIRIN trial. In this analysis from a health-care sector perspective, we considered the costs and effects of LDA treatment, pregnancy outcomes, and neonatal health-care use. We did sensitivity analyses to understand the effect of the price of the LDA regimen, and the effectiveness of LDA in reducing both preterm birth and perinatal death. Findings: In model simulations, LDA was associated with 141 averted preterm births, 74 averted perinatal deaths, and 31 averted hospitalisations per 10 000 pregnancies. The reduction in hospitalisation resulted in a cost of US$248 per averted preterm birth, $471 per averted perinatal death, and $15·95 per disability-adjusted life year. Interpretation: LDA treatment in nulliparous, singleton pregnancies is a low-cost, effective treatment to reduce preterm birth and perinatal death. The low cost per disability-adjusted life year averted strengthens the evidence in support of prioritising the implementation of LDA in publicly funded health care in low-income and middle-income countries. Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Published: 2023
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31. Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda

Author: Awor, Phyllis, Kimera, Joseph, Athieno, Proscovia, Tumukunde, Gloria, Okitawutshu, Jean, Tshefu, Antoinette, Omoluabi, Elizabeth, Signorell, Aita, Brunner, Nina, Kalenga, Jean-Claude, Akano, Babatunde, Ayodeji, Kazeem, Okon, Charles, Yusuf, Ocheche, Delvento, Giulia, Lee, Tristan, Burri, Christian, Lengeler, Christian, and Hetzel, Manuel W.
Published: 2022
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32. Impact of extractive industries on malaria prevalence in the Democratic Republic of the Congo: a population-based cross-sectional study

Author: Mitchell, Cedar L., Janko, Mark M., Mwandagalirwa, Melchior K., Tshefu, Antoinette K., Edwards, Jessie K., Pence, Brian W., Juliano, Jonathan J., and Emch, Michael
Published: 2022
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33. Key factors predicting suspected severe malaria case management and health outcomes: an operational study in the Democratic Republic of the Congo

Author: Okitawutshu, Jean, Signorell, Aita, Kalenga, Jean-Claude, Mukomena, Eric, Delvento, Giulia, Burri, Christian, Mwaluke, Fatou, Buj, Valentina, Sangare, Moulaye, Luketa, Sylvie, Brunner, Nina, Lee, Tristan, Hetzel, Manuel, Lengeler, Christian, and Tshefu, Antoinette
Published: 2022
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34. Effectiveness of rectal artesunate as pre-referral treatment for severe malaria in children under 5 years of age: a multi-country observational study

Author: Hetzel, Manuel W., Okitawutshu, Jean, Tshefu, Antoinette, Omoluabi, Elizabeth, Awor, Phyllis, Signorell, Aita, Brunner, Nina C., Kalenga, Jean-Claude, Akano, Babatunde K., Ayodeji, Kazeem, Okon, Charles, Yusuf, Ocheche, Athieno, Proscovia, Kimera, Joseph, Tumukunde, Gloria, Angiro, Irene, Delvento, Giulia, Lee, Tristan T., Lambiris, Mark J., Kwiatkowski, Marek, Cereghetti, Nadja, Visser, Theodoor, Napier, Harriet G., Cohen, Justin M., Buj, Valentina, Burri, Christian, and Lengeler, Christian
Published: 2022
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35. Anthropometric and sociodemographic variables, but not preconception or prenatal maternal nutrition supplementation, predict neurodevelopment in offspring of the 'Women First' trial.

Author: Waldrop, Stephanie, Chowdhury, Dhuly, Westcott, Jamie E., Biasini, Fred, Garcés, Ana, Figueroa, Lester, Tshefu, Antoinette, Lokangaka, Adrien, Bauserman, Melissa, Saleem, Sarah, Ali, Sumera A., Goldenberg, Robert L., Goudar, Shivaprasad S., Dhaded, Sangappa M., Derman, Richard J., Kemp, Jennifer F., Koso‐Thomas, Marion, Das, Abhik, Hambidge, Michael, and Krebs, Nancy F.
Abstract: Multiple factors influence infant and child neurodevelopment in low resource settings. In offspring of participants in the preconception maternal nutrition trial, Women First (WF), we examined the impact of providing a preconception (Arm 1) or prenatal (Arm 2) nutrient supplement (compared to controls, Arm 3) on neurodevelopmental outcomes at 24 months; predictors of neurodevelopment scores; and associations of infant anthropometrics with neurodevelopmental scores. Follow‐up visits for anthropometry were conducted at 6‐, 12‐, 18‐ and 24‐month of age. At 24‐months, in a randomized subset, the Bayley Scales of Infant Development, 3rd edition (BSID‐III), including cognitive, motor and social‐emotional subscales, and the Family Care Indicators (FCI) questionnaire, assessing family and home environment, were completed. Multiple covariates (intervention arm, site, maternal sociodemographic characteristics, FCI subscales, birthweight and 6–24 months' change in anthropometry z‐scores, (e.g., ΔLAZ6–24) were evaluated by linear regression to predict BSID‐III outcomes and to assess associations of anthropometric changes with BSID‐III scores. The analysis consisted of 1386 infants (n = 441, 486, 459 for Arms 1, 2 and 3, respectively). None of the domain‐specific BSID‐III subscale scores differed by maternal intervention arm. Four covariates significantly predicted (p ≤ 0.01) all 3 BSID‐III subscales: secondary maternal education, ΔLAZ6–24, birthweight >2500 g, and FCI play materials. Linear growth was associated with all domains of neurodevelopment. The results underscore the multi‐dimensional aspects of child development represented by the nurturing care framework, including prenatal maternal nutrition, post‐natal growth, maternal education for responsive caregiving and opportunities for early learning. Key messages: Preconception and prenatal maternal nutrition is important to ensure adequate fetal growth and healthy birthweight.Preconception and prenatal maternal nutritional supplementation was not associated with young child neurodevelopment but has been shown to improve post‐natal growth.Post‐natal linear growth is consistently associated with offspring neurodevelopment at 24 months.Maternal education to foster responsive caregiving, and opportunities for early learning in the home also positively impact offspring neurodevelopmental outcomes.These findings underscore the importance of multi‐dimensional aspects essential for children to reach their full developmental potential. [ABSTRACT FROM AUTHOR]
Published: 2024
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36. Development of new real-time PCR assays for detection and species differentiation of Plasmodium ovale.

Author: He, Wenqiao, Sendor, Rachel, Potlapalli, Varun R., Kashamuka, Melchior M., Tshefu, Antoinette K., Phanzu, Fernandine, Kalonji, Albert, Ngasala, Billy, Thwai, Kyaw Lay, Juliano, Jonathan J., Lin, Jessica T., and Parr, Jonathan B.
Subjects: WHOLE genome sequencing, NUCLEOTIDE sequencing, CONFIDENCE intervals, PLASMODIUM, DETECTION limit
Abstract: Background: The parasite species formerly known as Plasmodium ovale, Plasmodium ovalecurtisi (P. ovalecurtisi) and Plasmodium ovalewallikeri (P. ovalewallikeri), are endemic across multiple African countries. These species are thought to differ in clinical symptomatology and latency, but only a small number of existing diagnostic assays can detect and distinguish them. In this study, we sought to develop new assays for the detection and differentiation of P. ovalecurtisi and P. ovalewallikeri by leveraging recently published whole-genome sequences for both species. Methods: Repetitive sequence motifs were identified in available P. ovalecurtisi and P. ovalewallikeri genomes and used for assay development and validation. We evaluated the analytical sensitivity of the best-performing singleplex and duplex assays using synthetic plasmids. We then evaluated the specificity of the duplex assay using a panel of samples from Tanzania and the Democratic Republic of the Congo (DRC), and validated its performance using 55 P. ovale samples and 40 non-ovale Plasmodium samples from the DRC. Results: The best-performing P. ovalecurtisi and P. ovalewallikeri targets had 9 and 8 copies within the reference genomes, respectively. The P. ovalecurtisi assay had high sensitivity with a 95% confidence lower limit of detection (LOD) of 3.6 parasite genome equivalents/μl, while the P. ovalewallikeri assay had a 95% confidence LOD of 25.9 parasite genome equivalents/μl. A duplex assay targeting both species had 100% specificity and 95% confidence LOD of 4.2 and 41.2 parasite genome equivalents/μl for P. ovalecurtisi and P. ovalewallikeri, respectively. Conclusions: We identified promising multi-copy targets for molecular detection and differentiation of P. ovalecurtisi and P. ovalewallikeri and used them to develop real-time PCR assays. The best performing P. ovalecurtisi assay performed well in singleplex and duplex formats, while the P. ovalewallikeri assay did not reliably detect low-density infections in either format. These assays have potential use for high-throughput identification of P. ovalecurtisi, or for identification of higher density P. ovalecurtisi or P. ovalewallikeri infections that are amenable to downstream next-generation sequencing. Author summary: Non-falciparum malaria appears to be on the rise, especially in settings where P. falciparum transmission is declining. Plasmodium ovalecurtisi and Plasmodium ovalewallikeri are neglected parasites that can cause relapsing malaria and are thought to differ in clinical symptomatology and latency. However, only few existing diagnostic assays can detect and distinguish them. Most target the 18S rRNA gene of both P. ovalecurtisi and P. ovalewallikeri with potential for cross-reactivity at higher parasite densities, and are not well-suited for high-throughput use, hindering our understanding of their epidemiology. Mining recently available P. ovalecurtisi and P. ovalewallikeri reference genomes, we identify new multi-copy targets for molecular detection and develop novel singleplex and duplex real-time PCR assays capable of species differentiation. These assays are highly specific and require short turn-around time. The P. ovalecurtisi assay performed well, while the P. ovalewallikeri assay did not reliably detect low-density infections. These assays provide new options for high-throughput studies of P. ovalecurtisi infection, as well as identification of higher density infections amenable to next-generation sequencing of both species. [ABSTRACT FROM AUTHOR]
Published: 2024
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37. Impact of extractive industries on malaria prevalence in the Democratic Republic of the Congo: a population-based cross-sectional study

Author: Cedar L. Mitchell, Mark M. Janko, Melchior K. Mwandagalirwa, Antoinette K. Tshefu, Jessie K. Edwards, Brian W. Pence, Jonathan J. Juliano, and Michael Emch
Subjects: Medicine, Science
Abstract: Abstract Extraction of natural resources through mining and logging activities provides revenue and employment across sub-Saharan Africa, a region with the highest burden of malaria globally. The extent to which mining and logging influence malaria transmission in Africa remains poorly understood. Here, we evaluate associations between mining, logging, and malaria in the high transmission setting of the Democratic Republic of the Congo using population-representative malaria survey results and geographic data for environmental features and mining and logging concessions. We find elevated malaria prevalence among individuals in rural areas exposed to mining; however, we also detect significant spatial confounding among locations. Upon correction, effect estimates for mining and logging shifted toward the null and we did not find sufficient evidence to detect an association with malaria. Our findings reveal a complex interplay between mining, logging, space, and malaria prevalence. While mining concessions alone may not drive the high prevalence, unobserved features of mining-exposed areas, such as human migration, changing vector populations, or parasite genetics, may instead be responsible.
Published: 2022
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38. Health worker compliance with severe malaria treatment guidelines in the context of implementing pre-referral rectal artesunate in the Democratic Republic of the Congo, Nigeria, and Uganda: An operational study.

Author: Aita Signorell, Phyllis Awor, Jean Okitawutshu, Antoinette Tshefu, Elizabeth Omoluabi, Manuel W Hetzel, Proscovia Athieno, Joseph Kimera, Gloria Tumukunde, Irene Angiro, Jean-Claude Kalenga, Babatunde K Akano, Kazeem Ayodeji, Charles Okon, Ocheche Yusuf, Giulia Delvento, Tristan T Lee, Nina C Brunner, Mark J Lambiris, James Okuma, Nadja Cereghetti, Valentina Buj, Theodoor Visser, Harriet G Napier, Christian Lengeler, and Christian Burri
Subjects: Medicine
Abstract: BackgroundFor a full treatment course of severe malaria, community-administered pre-referral rectal artesunate (RAS) should be completed by post-referral treatment consisting of an injectable antimalarial and oral artemisinin-based combination therapy (ACT). This study aimed to assess compliance with this treatment recommendation in children under 5 years.Methods and findingsThis observational study accompanied the implementation of RAS in the Democratic Republic of the Congo (DRC), Nigeria, and Uganda between 2018 and 2020. Antimalarial treatment was assessed during admission in included referral health facilities (RHFs) in children under 5 with a diagnosis of severe malaria. Children were either referred from a community-based provider or directly attending the RHF. RHF data of 7,983 children was analysed for appropriateness of antimalarials; a subsample of 3,449 children was assessed additionally for dosage and method of ACT provision (treatment compliance). A parenteral antimalarial and an ACT were administered to 2.7% (28/1,051) of admitted children in Nigeria, 44.5% (1,211/2,724) in Uganda, and 50.3% (2,117/4,208) in DRC. Children receiving RAS from a community-based provider were more likely to be administered post-referral medication according to the guidelines in DRC (adjusted odds ratio (aOR) = 2.13, 95% CI 1.55 to 2.92, P < 0.001), but less likely in Uganda (aOR = 0.37, 95% CI 0.14 to 0.96, P = 0.04) adjusting for patient, provider, caregiver, and other contextual factors. While in DRC, inpatient ACT administration was common, ACTs were often prescribed at discharge in Nigeria (54.4%, 229/421) and Uganda (53.0%, 715/1,349). Study limitations include the unfeasibility to independently confirm the diagnosis of severe malaria due to the observational nature of the study.ConclusionsDirectly observed treatment was often incomplete, bearing a high risk for partial parasite clearance and disease recrudescence. Parenteral artesunate not followed up with oral ACT constitutes an artemisinin monotherapy and may favour the selection of resistant parasites. In connection with the finding that pre-referral RAS had no beneficial effect on child survival in the 3 study countries, concerns about an effective continuum of care for children with severe malaria seem justified. Stricter compliance with the WHO severe malaria treatment guidelines is critical to effectively manage this disease and further reduce child mortality.Trial registrationClinicalTrials.gov (NCT03568344).
Published: 2023
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39. Pf7: an open dataset of Plasmodium falciparum genome variation in 20,000 worldwide samples [version 1; peer review: 2 approved]

Author: Mohamed Hassan Abdelraheem, Sonia Goncalves, Lemu Golassa, Tim Anderson, Desmond Omane Acheampong, Enoch Aninagyei, Ifeyinwa Aniebo, Patrick O Ansah, Felix Ansah, Gordon A Awandare, Paulo Arnaldo, Maciej F Boni, Gwladys I Bertin, Peter C Bull, Marielle Bouyou-Akotet, Keobouphaphone Chindavongsa, Edwin Kamau, Huch Cheah, Claire Kamaliddin, Vladimir Corredor, David J Conway, Nicholas Day, Abibatou Konaté, Erin Courtier, Theerarat Kochakarn, Arjen Dondorp, Abdoulaye Djimde, Diego F Echeverry, Seydou Doumbia, Mara Lawniczak, Pharath Lim, Sonia Maria Mauricio Enosse, Oumou Maïga-Ascofaré, Thomas G Egwang, Aung Myint Thu, Mark Fleharty, Jutta Marfurt, Caterina A Fanello, Mark Fukuda, Victor Mobegi, Matthew Forbes, Sara Anne Healy, G L Abby Harrison, Anastasia Hernandez-Koutoucheva, Jason A Hendry, Ivo Mueller, Francis Hombhanje, Harald Noedl, Catherine A Hill, Thuy-Nhien Nguyen, Mazza Hussein, Amanda Hott, Rintis Noviyanti, Scott A Jackson, Abraham Oduro, Deus Ishengoma, Harold Ocholla, Julia Jeans, Jean-Bosco Ouedraogo, Chris G Jacob, Drissa S Konate, Jon Keatley, Francois Nosten, Kolapo Oyebola, Myat P Kyaw, Aminatou Kone, Norbert Peshu, Samuel K Lee, Dennis Kyle, Kovana M Loua, Milijaona Randrianarivelojosia, Martha Lemnge, Sasithon Pukrittayakamee, Richard James Maude, Pascal Ringwald, Celine I Mandara, Abdelrahim Osman Mohamed, Toshihiro Mita, Jaqui Montgomery, Julian C Rayner, David Saunders, Olugbenga A Mokuolu, Lastenia Ruiz, Kathryn Murie, Peter Siba, Collins Misita Morang’a, Alex Shayo, Tuyen Nguyen Thi Kim, Thang Ngo Duc, Vincent Ntui-Njock Ntui, Colin Sutherland, Hong Nguyen Van, Xin-zhuan Su, Marie A Onyamboko, Livingstone Tavul, Irene Omedo, Richard Pearson, Antoinette Tshefu, Wellington Aghoghovwia Oyibo, Vandana Thathy, Chris Drakeley, Huynh Hong Quang, Joseph Vinetz, Christopher V Plowe, Federica Verra, Eduard Rovira-Vallbona, Jason Wendler, Anna Rosanas-Urgell, Teun Bousema, Thuy Nguyen, Mahamadou S. Sissoko, Valentin Ruano-Rubio, Alexis Nzila, Shannon Takala-Harrison, Christen Smith, William Yavo, Ngo Viet Thanh, Arthur Talman, Georgia Whitton, Mahamoudou Toure, Rob W van der Pluijm, Sarah Auburn, Antoine Claessens, Mahamadou Diakite, Kesinee Chotivanich, Mehul Dhorda, Olivo Miotto, Mallika Imwong, Mayfong Mayxay, Alfred Amambua-Ngwa, Philip Bejon, Elizabeth Ashley, Alyssa Barry, Rick M. Fairhurst, Ye Htut, Tran Tinh Hien, Kimberly J Johnson, Dominic P Kwiatkowski, Umberto D'Alessandro, Chanthap Lon, Paul N Newton, Aung P Phyo, Ric N Price, Victoria J Simpson, Kevin Marsh, Nicholas J White, Thomas E Wellems, Lynette Isabella Ochola-Oyier, Mozam Ali, Ambroise Ahouidi, Jacob Almagro-Garcia, Ben Andagalu, Lucas Amenga-Etego, Voahangy Andrianaranjaka, Tobias Apinjoh, Vito Baraka, Hampate Ba, Steffen Borrmann, Oralee Branch, Thanat Chookajorn, Souleymane Dama, Chanaki Amaratunga, Alister Craig, Brigitte Denis, Eleanor Drury, Christiane Dolecek, Patrick Duffy, Berhanu Erko, Abdul Faiz, Muzamil Mahdi Abdel Hamid, Anita Ghansah, and Dionicia Gamboa
Subjects: malaria, plasmodium falciparum, genomics, data resource, genomic epidemiology, eng, Medicine, Science
Abstract: We describe the MalariaGEN Pf7 data resource, the seventh release of Plasmodium falciparum genome variation data from the MalariaGEN network. It comprises over 20,000 samples from 82 partner studies in 33 countries, including several malaria endemic regions that were previously underrepresented. For the first time we include dried blood spot samples that were sequenced after selective whole genome amplification, necessitating new methods to genotype copy number variations. We identify a large number of newly emerging crt mutations in parts of Southeast Asia, and show examples of heterogeneities in patterns of drug resistance within Africa and within the Indian subcontinent. We describe the profile of variations in the C-terminal of the csp gene and relate this to the sequence used in the RTS,S and R21 malaria vaccines. Pf7 provides high-quality data on genotype calls for 6 million SNPs and short indels, analysis of large deletions that cause failure of rapid diagnostic tests, and systematic characterisation of six major drug resistance loci, all of which can be freely downloaded from the MalariaGEN website.
Published: 2023
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40. Drug-Resistance and Population Structure of Plasmodium falciparum Across the Democratic Republic of Congo Using High-Throughput Molecular Inversion Probes

Author: Aydemir, Ozkan, Janko, Mark, Hathaway, Nick J, Verity, Robert, Mwandagalirwa, Melchior Kashamuka, Tshefu, Antoinette K, Tessema, Sofonias K, Marsh, Patrick W, Tran, Alice, Reimonn, Thomas, Ghani, Azra C, Ghansah, Anita, Juliano, Jonathan J, Greenhouse, Bryan R, Emch, Michael, Meshnick, Steven R, and Bailey, Jeffrey A
Subjects: Vector-Borne Diseases, Antimicrobial Resistance, Vaccine Related, Prevention, Infectious Diseases, Emerging Infectious Diseases, Malaria, Genetics, Rare Diseases, Biodefense, 2.1 Biological and endogenous factors, 2.2 Factors relating to the physical environment, Aetiology, Infection, Good Health and Well Being, Child, Democratic Republic of the Congo, Drug Resistance, Female, High-Throughput Nucleotide Sequencing, Humans, Malaria, Falciparum, Male, Microsatellite Repeats, Mutation, Plasmodium falciparum, Population Surveillance, Sulfadoxine, Surveys and Questionnaires, malaria, drug resistance, molecular inversion probe, targeted sequencing, Biological Sciences, Medical and Health Sciences, Microbiology
Abstract: A better understanding of the drivers of the spread of malaria parasites and drug resistance across space and time is needed. These drivers can be elucidated using genetic tools. Here, a novel molecular inversion probe (MIP) panel targeting all major drug-resistance mutations and a set of microsatellites was used to genotype Plasmodium falciparum infections of 552 children from the 2013-2014 Demographic and Health Survey conducted in the Democratic Republic of the Congo (DRC). Microsatellite-based analysis of population structure suggests that parasites within the DRC form a homogeneous population. In contrast, sulfadoxine-resistance markers in dihydropteroate synthase show marked spatial structure with ongoing spread of double and triple mutants compared with 2007. These findings suggest that parasites in the DRC remain panmictic despite rapidly spreading antimalarial-resistance mutations. Moreover, highly multiplexed targeted sequencing using MIPs emerges as a cost-effective method for elucidating pathogen genetics in complex infections in large cohorts.
Published: 2018

41. Junk food use and neurodevelopmental and growth outcomes in infants in low-resource settings

Author: Chiwila, Melody K., primary, Krebs, Nancy F., additional, Manasyan, Albert, additional, Chomba, Elwyn, additional, Mwenechanya, Musaku, additional, Mazariegos, Manolo, additional, Sami, Neelofar, additional, Pasha, Omrana, additional, Tshefu, Antoinette, additional, Lokangaka, Adrien, additional, Goldenberg, Robert L., additional, Bose, Carl L., additional, Koso-Thomas, Marion, additional, Goco, Norman, additional, Do, Barbara T., additional, McClure, Elizabeth M., additional, Hambidge, K. Michael, additional, Westcott, Jamie E., additional, and Carlo, Waldemar A., additional
Published: 2024
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42. Population genomics ofPlasmodium ovalespecies in sub-Saharan Africa

Author: Carey-Ewend, Kelly, primary, Popkin-Hall, Zachary R., additional, Simkin, Alfred, additional, Muller, Meredith, additional, Hennelly, Chris, additional, He, Wenqiao, additional, Moser, Kara A., additional, Gaither, Claudia, additional, Niaré, Karamoko, additional, Aghakanian, Farhang, additional, Feleke, Sindew, additional, Brhane, Bokretsion G., additional, Phanzu, Fernandine, additional, Mwandagalirwa, Kashamuka, additional, Aydemir, Ozkan, additional, Sutherland, Colin, additional, Ishengoma, Deus S., additional, Ali, Innocent M., additional, Ngasala, Billy, additional, Kalonji, Albert, additional, Tshefu, Antoinette, additional, Parr, Jonathan, additional, Bailey, Jeffrey A., additional, Juliano, Jonathan J., additional, and Lin, Jessica T., additional
Published: 2024
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43. Risk factors for COVID-19-related in-hospital mortality in a high HIV and tuberculosis prevalence setting in South Africa: a cohort study

Author: Abdullah, Shaina, Abrahams, Fiona, Adams, Vincentius, Adnane, Fhima, Adoni, Sonia, Adoons, Dieketso Melitta, Africa, Veronique, Aguinaga, D, Akach, Susan, Alakram Khelawon, Prisha, Aldrich, George, Alesinloye, Olatunde, Aletta, Mathale Biniki, Alice, Mametja, Aphane, Tebogo, Archary, Moherndran, Arends, Felicity, Arends, Shireen, Aser, Munonde, Asmal, T, Asvat, Mohammed, Avenant, Theunis, Avhazwivhoni, Muvhali, Azuike, Magnolia, Baartman, Johanna, Babalwa, Dlava, Badenhorst, Johan, Badenhorst, Miranda, Badripersad, Bianca, Badul, Lalihla, Bagananeng, M, Bahle, Mncedisi, Balfour, Liezl, Baloyi, T C, Baloyi, S, Baloyi, Tinyiko, Baloyi, Tshepo Mpho, Banda, Thokozani, Barit, Shimon, Bartsch, Nicole, Bayat, Junaid, Bazana, Siyabulela, Beetge, Marlene, Bekapezulu, Nosindiso, Belebele, Rammala, Bella, Phala, Belot, Zanenkululeko, Bembe, Lindi Gladys, Bensch, Sonja, Beukes, Gishma, Bezuidenhout, Karla, Bhembe, Themba, Bikisha, N A, Bilenge, Ben, Bishop, Leesa, Biyela, Baphamandla, Blaauw, Cyntheola, Blaylock, Mark, Bodley, Nicola, Bogale, Power, Bokolo, Sibongile, Bolon, Stefan, Booysen, Mary, Booysen, Eldereze, Boretti, Lia, Borges, Paula, Boshoga, Millicent, Bosman, Natasha, Bosvark, Lucinda, Botes, Nicky, Botha, Adele, Botha, Chantall, Botha, Jana, botha, Chantall, Botha, Mandlakayise Irvin, Botha, Alet, Bradbury, Janet, Breakfast, Zandisile, Breed, Maria, Brenda, Molele, Brice, Moshito, Britz, Jolene, Brown, Amanda, Buchanan, T, Bucwa, Thozama, Burger, Crystelle, Busakwe, Ziyanda, Bushula, Nosiviwe, Buthelezi, Zinhle, Buthelezi, Dumsile, Buthelezi, Thubelihle, Buthelezi, Mpumelelo Basil, Buthelezi, Fundiswa Lidwina, Bux, Nadia, Buys, Christoff, Buys, Anneline, Caka, Ernestina, Canal, Armando Sanchez, Caroline, Sithole, Casper, Monrick, Cawood, Shannon, Cebisa, Oratile, Cele, Nothando, Cele, Sboniso, Cele, Sthembile Goodness, Chauke, Mkhacani, Chauke, Pinkie, Chelin, Nevil, Chen, Xiaohui, Chetty, Venmalla, Chetty, Kerisse, Cheu, Christinah, Chibabhai, Vindana, Chirima, Takudzwa, ChisaleMabotja, Mantwa, Chivenge, Charity, Choene, Ngoasheng, Choko, Mbali Nosisa, Choshi, Martin, Chowdhury, Sabbir, Christoforou, Anastacia, Chuene, S L S, Chueu, T S, Cilliers, Dale, Cilliers, Vanessa, Claassen, Marcel, Cloete, Jeané, Coelho, Chantelle, Coetzee, Carol, Coetzee, Hans Jurgens, Coetzee, Christine, Coetzee, Marelize, Coetzer, Dane, Coka, Sizwe, Colane, M, Combrink, Herkulaas, Conjwa, Songezo, Contrad, Colleen, Cornelissen, Faith, Cronje, Leezelle, Crouse, Christine, Dabi, Tshidi, Dandala, Ziyanda, Dangor, Ziyaad, Daniel, Gildenhuys, Daniel, Ngwana, Daumas, Alfred, Dauth, Madelein, David, Mongalo, Davids, Wayne, Daweti, Nozuko, Dawood, Halima, Dayile, Wandisa, De Bruin, B, De Klerk, Karin, De la Rosa, Tanya, de Nysschen, Marice, De vos, Marie, De Wet, Darien, Debising, Mohith, Deenadayalu, Darshan, Dekeda, Babalwa, Desiree, Mofokeng, Deysel, Annelise, Dhlamini, Abram, Diala, Makgethwa Dhlala, Diale, Mathapelo, Diketane, Bella, Dingani, Nosisa, Diniso, Siyabonga, Diphatse, Lesego, Diya, Anele, Dladla, Zihloniphile, Dladla, Nompumelelo, Dladla, Mlungisi, Dladla, Patience, Dlamini, Baphilie, Dlamini, Nonhlanhla, Dlamini, Linda, Dlamini, Nonzwakazi, Dlamini, Wendy, Dlamini, Ncomeka, Dlamini, Siyabonga, Dlamini, Nicodemus, Dlamini, Lebohang, Dlamini, Motshedise, Dlava, Babalwa Christine, Dlova, Phikiwe, Dlozi, Lindiwe, Doreen, Maenetja, Doyi, Vumile, Doyi, Athini, Du Plessis, Belinda, du Plessis, Johanna Aletta, du Plessis, Eddie, du Plessis, Nicolette, du Plessis, Karin, du Toit, Briette, du Toit, Narissa, Dube, Jabulile, Dubula, Athayanda, Duduzile, Msomi, Duiker, Sechaba, Duma, Unati Bongile, Duma, Kholiwe, Dunne, Kella, Dyantyi, Kholeka, Dyantyi, Avile, Dyasi, Simphiwe, Dyondzo, Chauke, Dyubhele, Phelisa, Dywili, B J, Edwards, Letitia, Eksteen, Madie, Ellis, Tersia, Ellis, Tia, Emmerson, Glenda, Enslin, Theusia, Epule, Odimula, Erasmus, Lana, Erick, Mathonsi, Etsane, Lerato, Eunice, Shimange, Fani, Zanele, Ferreira, Mariette, Finger-Motsepe, K L, Floris, Fabion, Fobo, Tseko, Fokotsane, Keresemetse, Fokwana, Duduzile Emmelda, Fords, Genevieve Marion, Fortein, Juanita, Fouche, Christine, Fourie, Rulandi, Frean, Andrew, Fredericks, Ludwig, Funda, Wandile, funjwa, kabelo, Futhane, Martha, Futuse, Amanda, Gabaediwe, Dora, Gabuza, Nonhlanhla, Galant, Janycke, Gama, Zanele, Gano, Thobile, Gardiner, Emma Cora, Gastrow, Henri, Gate, Kelly, Gaunt, Ben, Gavaza, Rikhotso, Gayi, Thapelo, Gcakasi, Nkosinathi, Gcobo, Nomusa, Geffen, Leon, Geldenhuys, S, George, Jenny, Gerber, Martha, Getyengana, Zolisa, Gigi, Nkululo, Gihwala, Radha, Gilliland, Mitchell, Gloria, Zandile, Glover, Elitia, Gokailemang, Ellen, Goosen, Suseth, Gopane, Maria, Gosa-Lufuta, Thandazile, Gosnell, Bernadett, Gouws, Sharleen, Govender, Christina, Govender, Raksha, Govender, Pearl, Govender, Sally, Govender, Roxanne, Govender, K, Govender, Savie, Govinden, Rashika, Gqabuza, Luphumlo, Gqaji, Nomthandazo, Gqetywa, Maneo, Green, Caroline, Green, Nathan, Green, Neera, Grobler, Hendrik, Groenwald, Pamela, Grootboom, Daniel, Gumede, Beatrice, Gumede, Nomonde, Gumede, Simphiwe, Gumede, Slindile, Gumede, Ntombikayise, Gumede, Zenande, Gxotiwe, Thandiswa, H L, Makhubela, Hadebe, Nonhlanhla, Hadebe, Skhumbuzo, Halkas, Christos, Hamer, Ansie, Hamida, Ebrahim, Hammond, Juan, Haniff, Sumayia, Hare, Annelise, Hattingh, lorinda, Hendricks, Thenjiwe, Henecke, Philip-George, Henly-Smith, Brends, Herselman, Glynis, Heymans, Ansie, Heyns, Chantel, Hlabahlaba, Golekane, Hlabangwane, Lucky, Hlamarisa, Simango, Hlanzi, Ntokozo, Hlela, Hlengiwe, Hlokwe, Katlego, Hlongwa, Thembinkosi, Hlongwana, Anele, Hlubi, Themba, Hobo, Tozama, Hopane, Nare Nathaniel, House, Mariska, Hudson, Catharina, Huysamen, Marinda, Indheren, Jezreen, Ingle, Samantha, Isaacs, Gavin, Isaacs, T S Thekiso, Itumeleng, Maringa, J van Rensburg, Karien, Jackson, Saloshni, Jacob, Neziswa, Jacobs, Burton, Jacobs, Tshireletso, Jacobs, Gugulethu, Jaftha, Mesadi, Jaji, Zimkhitha, Jali, Sibusiso, James, Gcobisa, January, Gillian, Jeke, Andiswa, Jeremiah, Laurent, Jeremiah, L S, Jhetam, Mubeen, John, Maureen, John, Chuene, Jola, Thandiwe, Jonas, Yolande, Jonas, Anovick, Juggernath, Amilcar, Kaba, Eileen, Kabo, Venetia, Kadi, Disebo, Kaizer, Karabo, Kambule, Moshaya Peter, Kapp, Lorraine, Kau, Tshepo, Keneth, Nchabeleng, Kgabi, O, Kgafela, Tebogo Audrey, Kgakgadi, Vincent, Kgaswe, Isabella, Kgathlane, Tsholofelo, Kgetha, Vuyelwa Julia, Kgomojoo, Mmaselloane, Kgoro, B, Kgosiemang, Christinah, Kgosiencho, Gloria, Khambula, Stephen, Khan, Ariffa, Khanare, Refemetswe, Khanyase, Ncamsile, Khanyile, Nokwethemba, Kharatsi, Fillip, Khawula, Simangele, Khohlakala, Themba, Khomo, Letitia, Khoza, Isabel, Khoza, Sinethemba, Khukule, Nombulelo, Khumalo, Busisiwe, Khumalo, Tracy, khumalo, Zinhle, Khumalo, Vuyelwa, Khumalo, Delisile, Khumalo, Lebohang, Khumalo, Boitumelo, Khumalo, Thuli, Khumalo, Gugu, Khuzwayo, Bongiwe, Khuzwayo, Thembhelihle, Kidson, Hennie, Kistan, Jesne, Klaas, Gugu, Klassen, Marilyn, Koeberg, Josehine, Koen, Marizel, Koena, Simphiwe, Kok, Ina, Kola, Imraan, Kolokoto, Karabo, Konar, Ramachandra, Kotsedi, Dr, Kotze, Jaline, Koupis, Martins, Kritzinger, Helen, Kruger, Marlize, Kruger, Henk, Kubayi, Tlangelani, Kubeka, Thabisile, Kubheka, Nonjabulo, Kubheka, Melusi, Kubheka, Sibusiso Clifford, Kubheka, Erol, Kumalo, Monica, Kunene, Thulani, Kunene, Siphilile Candy, Kunneke, Yvette, Kupa, R P, Kutama, Rachel, Kwakwazi, Nompumelelo, Kweyama, Lwanele, Labuschagne, Maureen, Labuschagne, Marina, Lakshman, Prabha, Lamani, Lungelo, Lamani, Thembela, Langa, Naomi, Langeni, Khangelani, Langeni, Aphelele, Langeni, Nwabisa Hazel, Langeveldt, Gena, Laubscher, Anchen, Le Roux, Laetitia, Leah, Magagane, Lebea, Collen, Lebea, Sello, Lebenya, Viyella Phumla Cynthia, Lebogang, Lorraine, Leboho, P K, Lee, Chantel, Lefakane, Kelebogile Rejoice, Legoabe, Zandile, Lekala, Patrick, Lekhoaba, Motsitsi, Lekunutu, Tanki Shadrack, Lerefolo, Galaletsang, Letebele, N, Lethoba, Tsepo Patric, Letlalo, Emission, Letlhage, Ofentse, Letshufi, D S V, Letsoalo, Dineo Fiona, Letsoalo, Seleka Jones, Letsoalo, Pennelope, Letwaba, Getrude, Linda, Sobekwa, Lipholo, Katleho, Litabe, Sabata, Lochan, Harsha, Lomax, Linda, Lombaard, Francina, Loots, Elmarie, Lourens, Ariana, Louw, Celeste, Louw, Rianna, Lubambo, Zikhona, Lubambo, Msebenzi Moises, Ludada, Gregory, Lukas, Michael, Lungu, Thembela, Lupindo, Nomvume, Lusenga, Emmah, Luthuli, Happiness, Luvuno, Zoleka Sylvia, M H, Gwangwa, Maarman, Mustafa, Mabaso, Buyisiwe, Mabaso, Cynthia, Mabitle, Morena, Mabogoane, Grace, Mabone, Kgakgamatso, Mabuza, Rueben, Mabuza, Velaphi, Madiseng, Mogantla, Madlala, Thobile, Madolo, Mashooase, Madonsela, Thabiso, Madubanya, Lesetsa, Maepa, Amukelani, Mafumana, Namhla, Mafumo, Caroline, Magadla, Pumeza, Magale, Viscah, Magaqa, Nompumelelo, Magda, Oberholzer, Magdeline, Rakgoale, Maggie, Tswai, Maginxa, Bongeka, Magoba, Cathrine Maite, Magongwa, Caroline, Magubane, Agretia, Magubane, Agretia Ntombizodwa, Magwai, R, Mahabane, D I, Mahabeer, Padmini, Mahadulula, Elsie, Mahanjana, Lungiswa, Maharaj, Amy, Mahlambi, Qedusiza, Mahlangu, Yvonne, Mahlangu, Lerato, Mahlangu, Ntombifikile, Mahlangu, Makhosazana, Mahlangu, Mahlatsi, Mahlasela, Penelope, Mahlatse, Thosago, Mahlobo, Regina, Mahole, Dikhing, Mahomed, Adam, Mahubane, Mapeu Debora, Mahume, Peter, Maifo, Lehlogonolo, Maimane, Vincent, Maimele, Petunia, Maine, Phakoe, Mainongwane, Patricia Senyanyathi, Majamani, Nomalungisa, Majozini, Amahle, Makalima, Noluthando, Makam, Nomfundo, Makamba, Khanyisa, Makan, R, Makarapa, Mashiane, Makgahlela, Malesela, Makgisa, Mogoiwa David, Makgomo, Makgoba, Makgopa, M A, Makhalema, Mabone, Makhanya, Lindokuhle Lizo, Makhanya, Philile Valentia, Makharaedzha, Tolerance, Makhathini, Nathi, Makhesi, Elizabeth, Makhubela, Cinile, Makhunga, Nkululeko Freedom, Makhupula, Nomalinge, Makhura, R R, Makola, Rangwato, Makuba, Zingisa, Makubalo, Asanda, Makumsha, Lonwabo, Makuya, George, Malaka, Levy Mmachuene, Malangeni, Themba, Malatji, M L, Malebana-Metsing, Pelonomi, Malek, Malek, Malevu, Luthando, Malgas, Juanita, Malgas, Dimakatso, Malope, Paul Makgasane, Malose, Monyeki, Maluleke, Katekani, Mambane, Kato, Mamorobela, Nthabiseng, Manamela, Kukami, Manana, Tshepo, Maneto, Sathiel, Manganye, Aron Kabelo, Mangena, Pheto, Mangoale, Anna, Mangozho, Tinotenda Florence, Manickchund, Pariva, Mankayi, Zandisile, Manning, Arthur, Manyaapelo, Kelebogile Manyaapelo, Manyane, Tabea, Manzana, Zoliswa, Manzini, Milton, Mapasa-Dube, Busisiwe, Maphumulo, Siboniso, Maphumulo, Ntombifuthi, Maponya, Sindy, Maponya, Khomotso Mumsy, Maponya, Napjadi, Maqubela, Lami, Maqubela, Lizeka, Maqungo, Vuyo, Marais, Marisa, Marais, Chantal, Maramba, Nondumiso, Mare, Annelize, Maredi, Madumetsa, Martins, Afikile, Marule, Johanna, Marumo, Refilwe, Masakona, N N, Masehla, Kedibone Vincentia, Maseko, Eric, Maselesele, Tshilidzi, Maselo, Mojalefa, Maseloa, M, Masemola, M E, Masemola, Thembi, Mashaba, Bella, Mashangwane, James, Mashao, Mantebele, Mashego, Shalom, Mashele, Lerato, Mashiane, Ester, Mashibini, Joyce, Mashilo, J, Mashiloane, Tumi, Mashishi, Charity, Mashiyi, Ngazibini, Mashudu, Khomola, Masindi, Aluwani, Maslo, Caroline, Masondo, Nduduzo, Masuku, Dumisile, Matamela, Cry, Matandela, Mirriam, Mathabela, Nontokozo, Mathabi, T, Mathe, Keitumetse, Mathebula, Mathabo, Mathebula, Catherine, Mathebula, Mdungazi Andres, Mathenjwa, Nqobizwe, Mathibe, Jane, Mathibela, Lebohang, Mathilda, Makwela, Mathiva, Khakhu, Mathobela, Mokgadi Alinah, Mathonsi, Fikile Pearl, Mathonsi, K P, Mathosa, Katlego, Matiwane, Noluvo, Matjeke, Emma, Matjiane, Bella, Matjila, Thabang, Matlala, Chidi, Matome, Petlo, Matoti, Nolusindiso, Matseliso, C, Matsemela, Dineo, Matsha, Phumeza, Matshediso, Gaalebale Prudence, Matshediso, Motsumi, Matshela, Esther, Mavuma, Bongeka, Mavundla, Pearl, Mavuso, Nomthandazo, Mawasha, Lovender, Mawelela, Rebecca, Mazibuko, Nelisiwe, Mazibuko, Phumlani, Mazubane, Lindiwe, Mbanjwa, Bavumile, Mbasa, Ayanda, Mbatha, Nosimilo, Mbatha, Zanele, Mbatha, Rudolph Zenzele, Mbedzi, Gift, Mbizi, Tatenda Trevor, Mbonambi, Khumbulani, Mboniswa, Nondumiso, Mbonisweni, Nomfanelo, Mbuilu, Jody, Mbulawa, Siyabonga, Mbutho, Zama, Mbuzi, Natasha, Mchunu, Nonkululeko, Mchunu, Cyprian, Mchunu, Nokuzola, Mchunu, Masesi Thandeka, Mciteka, Vuyokazi, Mdaka, Solly, Mdakane, Neho, Mdediswa, Siyabonga, Mdima, Melusi, Mdima Masondo, Nozipho, Mdindana, Siviwe, Mdleleni, Ntombizikhona, Mdletshe, Sibusiso, Mdoda, Gcobisa Precious, Mdolo, Ntombi, Mdontsane, Anele, Mehta, Ruchikas, Memela, Philile Rittah, Methuse, Masande, Metshile, Keatlaretse, Metuse, Pheliswa, Meyer, Anton, Meyer, Gavin, Meyer, Cameron, Mfazwe, Sisonke, Mfecane, Andiswa, Mfecane, Bongeka, Mfeka, Nelisiwe, Mgaga, Busisiwe, Mgauli, Thandiwe Portia, Mgedezi, Thembekile, Mgedezi, Vuyokazi, Mgevane, Kalipile, Mgiba, Bongni, Mgoduka, Babalwa, Mhlaba, Patrick, Mhlaba, Zeldah, Mhlanga, Ntombizodwa, Mhlinza, Vangile, 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Strydom, Riaan, Adelekan, Tsholofelo, Mdlovu, Bhekizizwe, Moodley, Nirvasha, Namavhandu, Eunice L, Venturas, Jacqueline, Magula, Nombulelo, and Blumberg, Lucille
Published: 2021
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44. Difference in mortality among individuals admitted to hospital with COVID-19 during the first and second waves in South Africa: a cohort study

Author: Abdullah, Shaina, Abrahams, Fiona, Adams, Vincentius, ADNANE, FHIMA, Adoni, Sonia, Adoons, Dieketso Melitta, Africa, Veronique, Aguinaga, Dr, Akach, Susan, Alakram Khelawon, Prisha, Aldrich, George, Alesinloye, Olatunde, Aletta, Mathale Biniki, Alice, Mametja, Aphane, Tebogo, Archary, Moherndran, Arends, Felicity, Arends, Shireen, Aser, Munonde, Asmal, T, Asvat, Mohammed, Avenant, Theunis, Avhazwivhoni, Muvhali, Azuike, Magnolia, Baartman, Johanna, Babalwa, Dlava, Badenhorst, Johan, Badenhorst, Miranda Badenhorst, Badripersad (CEO), Bianca, Badul, Lalihla, Bagananeng, M, Bahle, Mncedisi, Balfour, Liezl, Baloyi, TC, Baloyi, S, Baloyi, Tinyiko, Baloyi, Tshepo Mpho, Banda, Thokozani, Barit, Shimon, Bartsch, Nicole, Bayat, Junaid, Bazana, Siyabulela, Beetge, Marlene, Bekapezulu, Nosindiso, Belebele, Rammala, Bella, Phala, Belot, Zanenkululeko, Bembe, Lindi Gladys, Bensch, Sonja, Beukes, Gishma, Bezuidenhout, Karla, Bhembe, Themba, BIKISHA, N.A, Bilenge, Ben, Bishop, Leesa, Biyela, Baphamandla, Blaauw, Cyntheola, Blaylock, Mark, Bodley, Nicola, Bogale, Power, Bokolo, Sibongile, Bolon, Stefan, Booysen, Mary, Booysen, Eldereze, Boretti, Lia, Borges, Paula, Boshoga, Millicent, Bosman, Natasha, Bosvark, Lucinda, Botes, Nicky, Botha, Adele, BOTHA, CHANTALL, Botha, Jana, BOTHA, MANDLAKAYISE IRVIN, Botha, Alet, Bradbury, Janet, Breakfast, Zandisile, Breed, Maria, Brenda, Molele, Brice, Moshito, Britz, Jolene, brown, Amanda, Buchanan, Ms T, Bucwa, Thozama, Burger, Crystelle, Busakwe, Ziyanda, Bushula, Nosiviwe, Buthelezi, Zinhle, Buthelezi, Dumsile, Buthelezi, Thubelihle, Buthelezi, Mpumelelo Basil, Buthelezi, Fundiswa Lidwina, Bux, Nadia, Buys, Christoff, Buys, Anneline, Caka, Ernestina, Canal, Armando Sanchez, Caroline, Sithole, Casper, Monrick, Cawood, Shannon, Cebisa, Oratile, Cele, Nothando, Cele, Sboniso, Cele, Sthembile Goodness, Chauke, Mkhacani, Chauke, Pinkie, Chelin, Nevil, Chen, Xiaohui, Chetty, Venmalla, Chetty, Kerisse, Cheu, Christinah, Chibabhai, Vindana, Chirima, Takudzwa, ChisaleMabotja, Mantwa, CHIVENGE, CHARITY, Choene, Ngoasheng, Choko, Mbali Nosisa, Choshi, Martin, Chowdhury, Sabbir, Christoforou, Anastacia, Chuene, S.L.S, Chueu, T.S, Cilliers, Dale, Cilliers, Vanessa, Claassen, Marcel, Cloete, Jeané, Coelho, Chantelle, Coetzee, Carol, Coetzee, Hans Jurgens, Coetzee, Christine, Coetzee, Marelize, Coetzer, Dane, Coka, Sizwe, Colane, Mr M, Combrink, Herkulaas, Conjwa, Songezo, Contrad, Colleen, Cornelissen, Faith, Cronje, Leezelle, Crouse, Christine, D.A, Moshai, D.I, Ms Mahabane, Dabi, Tshidi, Dandala, Ziyanda, Dangor, Ziyaad, Daniel, Gildenhuys, Daniel, Ngwana, Daumas, Alfred, Dauth, Madelein, David, Mongalo, Davids, Wayne, Daweti, Nozuko, Dawood, Halima, Dayile, Wandisa, DE BRUIN, B, De Klerk, Karin, De la Rosa, Tanya, de Nysschen, Marice, De vos, Marie, De Wet, Darien, Debising, Mohith, Deenadayalu, Darshan, Dekeda, Babalwa, Desiree, Mofokeng, Deysel, Annelise, Dhlamini, Abram, Diala, Makgethwa Dhlala, Diale, Mathapelo, Diketane, Bella, Dingani, Nosisa, Diniso, Siyabonga, Diphatse, Lesego, Diya, Anele, Dladla, Zihloniphile, Dladla, Nompumelelo, Dladla, Mlungisi, Dladla, Patience, Dlamini, Baphilie, DLAMINI, NONHLANHLA, Dlamini, Linda, Dlamini, Nonzwakazi, Dlamini, Wendy, Dlamini, Ncomeka, Dlamini, Siyabonga, Dlamini, Nicodemus, Dlamini, Lebohang, Dlamini, Motshedise, Dlava, Babalwa Christine, Dlova, Phikiwe, Dlozi, Lindiwe, Doreen, Maenetja, Doyi, Vumile, Doyi, Athini, Du Plessis, Belinda, du Plessis, Johanna Aletta, du Plessis, Mr. Eddie, du Plessis, Nicolette, du Plessis, Karin, du Toit, Briette, du Toit, Narissa, Dube, Jabulile, Dubula, Athayanda, Duduzile, Msomi, Duiker, Sechaba, Duma, Unati Bongile, Duma, Kholiwe, Dunne, Kella, Dyantyi, Kholeka, Dyantyi, Avile, Dyasi, Simphiwe, DYONDZO, CHAUKE, Dyubhele, Phelisa, Dywili, B.J, Edwards, Letitia Edwards, Eksteen, Madie, Ellis, Tersia, Ellis, Tia, Emmerson, Glenda, Enslin, Theusia, EPULE, ODIMULA, Erasmus, Lana, Erick, Mathonsi, Etsane, Lerato, Eunice, Shimange, Fani, Zanele, Ferreira, Mariette, Finger-Motsepe, K.L, Floris, Fabion, Fobo, Tseko, Fokotsane, Keresemetse, Fokwana, Duduzile Emmelda, Fords, Genevieve Marion, Fortein, Juanita, Fouche, Christine, Fourie, Rulandi, Frean, Andrew, Fredericks, Ludwig, Funda, Wandile, Funjwa, Kabelo, Futhane, Martha, Futuse, Amanda, Gabaediwe, Dora, Gabuza, Nonhlanhla, Galant, Janycke, Gama, Zanele, Gano, Thobile, Gardiner, Emma Cora, Gastrow, Henri, Gate, Kelly, Gaunt, Ben, Gavaza, Rikhotso, Gayi, Thapelo, Gcakasi, Nkosinathi, Gcobo, Nomusa, Geffen, Leon, Geldenhuys, S, George, Jenny, Gerber, Martha, Getyengana, Zolisa, Gigi, Nkululo, Gihwala, Radha, Gilliland, Mitchell, Gloria, Zandile, Glover, Elitia, Gokailemang, Ellen, Goosen, Suseth, Gopane, Maria, Gosa - Lufuta, Thandazile, Gosnell, Bernadett, Gouws, Sharleen, Govender, Christina, Govender, Raksha, Govender, Pearl, Govender, Sally, Govender, Roxanne, Govender, K, Govender, Mrs Savie, Govinden, Rashika, Gqabuza, Luphumlo, Gqaji, 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Jacobs, Gugulethu, Jaftha, Mesadi, Jaji, Zimkhitha, Jali, Sibusiso, James, Gcobisa, January, Gillian, Jeke, Andiswa, Jeremiah, Laurent, Jeremiah, LS, Jhetam, Mubeen, John, Maureen, John, Chuene, Jola, Thandiwe, Jonas, Yolande, Jonas, Anovick, Juggernath, Amilcar, kaba, eileen, Kabo, Venetia, Kadi, Disebo, Kaizer, Karabo, Kambule, Moshaya Peter, Kapp, Lorraine, Kau, Tshepo, Keneth, Nchabeleng, Kgabi, O, Kgafela, Tebogo Audrey, Kgakgadi, Vincent, Kgaswe, Isabella, Kgathlane, Tsholofelo, Kgetha, Vuyelwa Julia, Kgomojoo, Mmaselloane, Kgoro, MR B, Kgosiemang, Christinah, Kgosiencho, Gloria, Khambula, Stephen, Khan, Ariffa, Khanare, Refemetswe, Khanyase, Ncamsile, Khanyile(Data Capturer), Nokwethemba, Kharatsi, Fillip, Khawula, Simangele, Khohlakala, Themba, Khomo, Letitia, khoza, Isabel, Khoza, Sinethemba, Khukule, Nombulelo, Khumalo, Busisiwe, Khumalo, Tracy, khumalo, Zinhle, Khumalo, Vuyelwa, Khumalo, Delisile, Khumalo, Lebohang, Khumalo, Boitumelo, Khumalo, Thuli, Khumalo, Gugu, 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Lekhoaba, Motsitsi, Lekunutu, Tanki Shadrack, Lerefolo, Galaletsang, Letebele, Mrs N, Lethoba, Tsepo Patric, Letlalo, Emission, Letlhage, Ofentse, Letshufi, D.S.V, Letsoalo, Dineo Fiona, Letsoalo, Seleka Jones, Letsoalo, Pennelope, Letwaba, Getrude, Linda, Sobekwa, Lipholo, Katleho, Litabe, Sabata, Lochan, Harsha, Lomax, Linda, Lombaard, Francina, Loots, Elmarie, Lourens, Ariana, Louw, Celeste, Louw, Rianna, Lubambo, Zikhona, Lubambo, Msebenzi Moises, Ludada, Gregory, Lukas, Michael, Lungu, Thembela, Lupindo, Nomvume, Lusenga, Emmah, Luthuli, Happiness, Luvuno, Zoleka Sylvia, M.H, Sr Gwangwa, Maarman, Mustafa, Mabaso, Buyisiwe, Mabaso, Cynthia, Mabitle, Morena, Mabogoane, Grace, Mabone, Kgakgamatso, Mabuza, Rueben, Mabuza, Velaphi, Madiseng, Mogantla, Madlala, Thobile, Madolo, Mashooase, Madonsela, Thabiso, Madubanya, Lesetsa, Maepa, Amukelani, Mafumana, Namhla, Mafumo, Caroline, Magadla, Pumeza, Magale, Viscah, Magaqa, Nompumelelo, Magda, Oberholzer, Magdeline, Rakgoale, Maggie, Tswai, Maginxa, Bongeka, Magoba, Cathrine Maite, Magongwa, Caroline, MAGUBANE, AGRETIA, Magubane, Agretia Ntombizodwa, Magwai, R, Mahabeer, Padmini, Mahadulula, Elsie, Mahanjana, Lungiswa, Maharaj, Amy, Mahlambi, Qedusiza, Mahlangu, Yvonne, Mahlangu, Lerato, Mahlangu, Ntombifikile, Mahlangu, Makhosazana, Mahlangu, Mahlatsi, Mahlasela, Penelope, Mahlatse, Thosago, Mahlobo, Regina, Mahole, Dikhing, Mahomed, Adam, Mahubane, Mapeu Debora, Mahume, Peter, Maifo, Lehlogonolo, Maimane, Vincent, Maimele, Petunia, Maine, Phakoe, Mainongwane, Patricia Senyanyathi, Majamani, Nomalungisa, Majozini, Amahle, Makalima, Noluthando, Makam, Nomfundo, Makamba, Khanyisa, Makan, R, Makarapa, Mashiane, Makgahlela, Malesela, Makgisa, Mogoiwa David, Makgomo, Makgoba, Makgopa, MA, Makhalema, Mabone, Makhanya, Lindokuhle Lizo, Makhanya, Philile Valentia, Makharaedzha, Tolerance, Makhathini, Nathi, Makhesi, Elizabeth, Makhubela, Cinile, Makhunga, Nkululeko Freedom, Makhupula, Nomalinge, Makhura, RR, Makola, Rangwato, Makuba, Zingisa, Makubalo, Asanda, Makumsha, Lonwabo, Makuya, George, Malaka, Levy Mmachuene, Malangeni, Themba, MALATJI, ML, Malebana-Metsing, Pelonomi, Malek, Malek, Malevu, Luthando, Malgas, Juanita, Malgas, Dimakatso, Malope, Paul Makgasane, Malose, Monyeki, Maluleke, Katekani, Mambane, Kato, Mamorobela, Nthabiseng, Manamela, Kukami, Manana, Tshepo, Maneto, Sathiel, Manganye, Aron Kabelo, Mangena, Pheto, Mangoale, Anna, MANGOZHO, TINOTENDA FLORENCE, Manickchund, Pariva, Mankayi, Zandisile, Manning, Arthur, Manyaapelo, Kelebogile Manyaapelo, Manyane, Tabea, Manzana, Zoliswa, Manzini, Milton, Mapasa-Dube, Busisiwe, Maphumulo, Siboniso, Maphumulo, Ntombifuthi, Maponya, Sindy, Maponya, Khomotso Mumsy, Maponya, Napjadi, Maqubela, Lami, Maqubela, Lizeka, Maqungo, Vuyo, Marais, Marisa, Marais, Chantal, Maramba, Nondumiso, Mare, Annelize, Maredi, Madumetsa, Martins, Afikile, Marule, Johanna, Marumo, Refilwe, Masakona, NN, MASEHLA, KEDIBONE VINCENTIA, Maseko, Eric, Maselesele, Tshilidzi, Maselo, Mojalefa, Maseloa, M, Masemola, M.E, Masemola, Thembi, Mashaba, Bella, Mashangwane, James, Mashao, Mantebele, Mashego, Shalom, Mashele, Lerato, Mashiane, Ester, Mashibini, Joyce, Mashilo, J, Mashiloane, Tumi, Mashishi, Charity, Mashiyi, Ngazibini, Mashudu, Khomola, masindi, aluwani, Maslo, Caroline, Masondo, Nduduzo, Masuku, Dumisile, Matamela, Cry, Matandela, Mirriam, Mathabela, Nontokozo, Mathabi, T, Mathe, Keitumetse, Mathebula, Mathabo, Mathebula, Catherine, Mathebula, Mdungazi Andres, Mathenjwa, Nqobizwe, Mathibe, Jane, Mathibela, Lebohang, MATHILDA, MAKWELA, Mathiva, Khakhu, Mathobela, Mokgadi Alinah, Mathonsi, Fikile Pearl, Mathonsi, KP, Mathosa, Katlego, Matiwane, Noluvo, Matjeke, Emma, Matjiane, Bella, Matjila, Thabang, Matlala, Sr Chidi, Matome, Petlo, Matoti, Nolusindiso, Matseliso, C., Matsemela, Dineo, Matsha, Phumeza, Matshediso, Gaalebale Prudence, Matshediso, Motsumi, Matshela, Esther, Mavuma, Bongeka, Mavundla, Pearl, Mavuso, Nomthandazo, Mawasha, Lovender, Mawelela, Rebecca, Mazibuko, Nelisiwe, Mazibuko, Phumlani, Mazubane, Lindiwe, Mbanjwa, Bavumile, Mbasa, Ayanda, Mbatha, Nosimilo, MBATHA, ZANELE, Mbatha, Rudolph Zenzele, Mbedzi, Gift, Mbizi, Tatenda Trevor, Mbonambi, Khumbulani, Mboniswa, Nondumiso, Mbonisweni, Nomfanelo, Mbuilu, Jody, Mbulawa, Siyabonga, Mbutho, Zama, Mbuzi, Natasha, Mchunu, Nonkululeko, Mchunu, Cyprian, Mchunu, Nokuzola, Mchunu, Masesi Thandeka, Mciteka, Vuyokazi, Mdaka, Solly, Mdakane, Neho, Mdediswa, Siyabonga, Mdima, Melusi, Mdima Masondo, Nozipho, Mdindana, Siviwe, Mdleleni, Ntombizikhona, Mdletshe, Sibusiso, Mdoda, Gcobisa Precious, Mdolo, Ntombi, Mdontsane, Anele, Mehta, Ruchikas, Memela, Philile Rittah, Methuse, Masande, Metshile, Keatlaretse, Metuse, Pheliswa, Meyer, Anton, Meyer, Gavin, Meyer, Cameron, Mfazwe, Sisonke, Mfecane, Andiswa, Mfecane, Bongeka, Mfeka, Nelisiwe, Mgaga, Busisiwe, Mgauli, Thandiwe Portia, Mgedezi, Thembekile, Mgedezi, Vuyokazi, Mgevane, Kalipile, Mgiba, Bongni, Mgoduka, Babalwa, MHLABA, PATRICK, Mhlaba, Zeldah, Mhlanga, Ntombizodwa, Mhlinza, Vangile, Mhlongo, Nokuthula, Mhlongo, sibongiseni, Mhlotshana, Unamandla, Mikateko, Mabaso, Minnie, Helena, Mintoor, Karen, Miyeni, Bongi, MJ, Mabelane, Mjethu, Rosy, Mkhize, Gloria, Mkhize, Mvuselelo, Mkhize, Ntokozo Siyabonga, Mkhize, Victoria, Mkhize, Nomkhosi, Mkhize, Nokuthula, Mkhwanazi, Mathini, Mkile, Nolwandle, Mkise, Kholofelo, Mkiya, Nokwandiso, Mkongi, Pearl, Mkungeka, Mnonopheli, Mlahleki, Hlomile, Mlibali, Nolukholo, mlungwana, Sakhumzi, Mmachele, Jonas, Mmateka, Mashatole, Mmokwa, Molebatsi, Mmutlane, Thembisa, Mndebele, Zanele Olive, mngomezulu, nonhlanhla, Mnguni, Noluthando Millicent, Mngunyana, Pumza, Mngunyana, Nomxolisi, Mngxekeza, Ntombebongo, MNISI, ZENZELE, Mnqayi, Hlengiwe Precious, MNQAYI, PHUMZILE, Mntungwa, Thabiso, Mnyaka, Siya, Mnyakeni, Ntombikayise, Mnyamana, Vuyani, Mnyipika, Nomzingisi, Moabelo, Koena, Moatshe, Mmakgoshi Alseria, Mochaki-Senoge, Jennifer Mochaki-Senoge, Moche, Sharon, Mocwagae, Tebello, Modibane, Koeikantse, Modimoeng, Tebogo godfrey, Modisa, Obakeng, Modisane, Itumeleng, Modise, Olebogeng, Modjadji, Makaepeaa Flovia, Modupe, Sharon, Moeketsi, Maja, Moeketsi, Ntswaki, Moeng, Kereditse Kingsley, Mofamere, Naledi Nthabiseng, Mofokeng, Samuel, Mofokeng, Thabo, Mofomme, Jonas, MOGAKANE, VICKY, Mogale, Lehlohonolo, Mogapi, Audrey, Mogashoa, Thomas, Mogatla, Mphaka James, Mogoale, Kgaladi, Mohajane, Dikeledi Maggie, Mohapi, Nkuba, Mohatsela, Mthoamihla, Mohlala, Irene, Mohlala, Daphney, Mohlamonyane, Mpho, Mohutsiwa, Bonolo Millord, Moipone, Selemela, Moisi, Tshepang, Mojalefa, Nelly, Moji, Vuyo, Mokangwana, Buhle, Mokgabo, Matloa, Mokgaetji, Manaka, Mokgaotsi, Jane, Mokgoro, Neo Theodore, Mokhatla, Thalitha, Mokhele, Lerato Lovedalia, Mokhema, Sheila, Mokoena, Mamoya, Mokoena, Mojalefa, Mokome, Lleka, Mokone, Cynthia, Mokono, Ipeleng, Mokonyama, Thabiso, Mokori, Josiah, Mokuena, Dolores, Mokumo, Danny, Mokwena, Oddy, Mokwena, Kgaogelo, Mokwena, 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A.M., Mosana, Thabo, Mosase, Alice, Mose, Yolanda, Mosehlo, Maponya, Moseki, Mothusi, Moshabe, Mojalefa David, Moshani, Mbulelo, Moshani, Pelisa, Mosima, Ledwaba, Mosima, Ezrom, Mosoma, M.P, Motaung, Lebohang, Motaung, Mokete, Motaung Xhama, Thozama Charmain, Motha, Purine Khethiwe, Motimele, Lerato, Motimeng, Boitumelo, Motladiile, Shirley, Motlhabane, otsile, Motlhamme, Joshua, Motloba, Mandla, Motse, Kagiso, Motshegoa, Sophia, Moutlana, Edward, Mouton, Irma, Moya, Zanele, Moyake, Nomonde, MP, Maja, Mpete, Jenny, Mpfuni, Luamba Meltha, Mphahlele, Seputule Mphahlele, Mphake, Mashadi, Mphanya, Ephraim Letlhogonolo, Mphaphuli, Mashudu, Mphela, Tebogo Chwene, Mpontshane, MS, Mqotyana, Thabile, Mqungquthu, Babalwa, Msane, Noluthando Busane, Mseleku, Malusi, Msibi, Sibusiso, Msibi, Mancele, Msibi, Thulisile, Msibi, Siyabonga Linda, Msiza, Clement Nhlanhla, Msomi, Lungelo, Mtatambi, Mandlenkosi, Mthathambi, Thembisa, Mthembu, December, Mthembu, Nhlahla, Mthembu, Fezile Mbali, Mthembu, Lungiswa, Mthethwa, Nompumelelo Petunia, Mthimkhulu, Khulekani, Mthuli, Lungani Percival, Mthunzi, Ashley, Mtolo, Xolani Sydney, Mtolo, Nomonde Precious, Mtshali, Linda, Mtwa, Neliswa, Mtyobile, Fezeka, Mtyobile, Kanyisa, Mudau, Mpfariseni, Muemeleli, Magwabeni, Mulaudzi, Isaac, Mulaudzi, Rebecca, Mulaudzi, Mhlelekedzeni, Muligwe, Dakalo Rejoyce, Muponda, Blessing, Mushadi, Mmbangiseni Stella, Mushid, M, Muthaphuli, Konanani, Muthavhine, J, Muthika, Mpho, Mvelase, Samkelisiwe, Mvelase, Vusi, MWEHU, LAURENT KAYUMBA, Myaka, Thabile, myburgh, Magriet, Mzamo, Zimkhitha, Mzawuziwa, Fezeka, Mzini, Mfundo Lunga, Mzizana, Oscar, Mzobe, Ntokozo, Mzobe, Thokozile, Mzobe, Zamaswazi, Mzwandile, Mtimkulu, Naby, Fathima, NAICKER, KESHNEE, Naicker, Pregashnie, Naicker, Saroja, Naicker, Pershen, Naicker, Saiyen Virgil, NAIDOO, RIA, Naidoo, Sam, Naidoo, Mergan, NAIDOO, KAMALAMBAL, Naidoo, Aroomugam, Naku, Sivuyile, Nakwa, Firdose, Nancy, Masoga, Nathan, Rita, Naude, Maritsa, Ncaza, Gcobisa, Ncaza, Aviwe, Ncha, Relebohile, Ncoyini, Yanelisa, Ncube, Snothile, Ndaba, Mrs, NDABA, VUSUMUZI, Ndaba, Mmapula, Ndawonde, Siziwe, Ndevu, Ziphozihle, NDHLOVU, NONHLANHLA FAITH, Ndima, Simphiwe, Ndlela, Sindisiwe, Ndlela, Thobsile P, Ndlovu, Nobuhle, Ndlovu, Nwabisa, Ndlovu, Virginia Dipuo, Ndlumbini, Sombekhaya, Nduli, Khululiwe, Nduli, Priscilla Nontokozo, Ndwambi, Michael, Nel, Jeremy, Nel, Rina, Nel, Lizelle, Nemanashi, Ntsundeni florah, Nemudivhiso, Usinkhangwe Nyaphophi, Nemutavhanani, Joyce Nemutavhanani, Nene, Jabu, Nene, Xolani, Netshilonga, David, Netsianda, Rendani, Newton, Charmaine, Ngalo, Vuyo Leroy, Ngani, Ncumisa, Ngcakaza, Thabisa Monica, Ngcobo, Thamela, Ngcobo, Trulove Nonhlanhla, Ngcobo, Richards, Ngcobo, Gcinile, Ngcobo, Guguletu, Ngetu, Thozama, Ngewu, Pinkie, Ngobeni, Tshepo, Ngobeni, Providence, Ngobeni, Khanyisile, Ngobeni, Prudence, Ngobese, Thembisile, Ngomane, Tracy, Ngondo, Nolusindiso, Ngubane, Nokukhanya, Ngubane, Sithembiso, Nguse, Ntombizodwa Praxedise, Ngwane, Tholakele, Ngwasheng, Elizabeth, Ngwenya, Siphamandla, Ngwenya, Gugu, Ngwenya, Nomthandazo, Ngwenya, Themba, Ngwenya, Eva, Ngxola, Zintlanu, Nhabe, Tshegofatso, Nhlabathi, Jabulile, Nhlangwana, Ishmael, Nhlapo, Sithembile, nick, Matlala, Niemand, Vicky, Nienaber, Carina, Nix, Louise, Njikelana, Chumisa, Njomi, Masiza, Nkabinde, Lucia, NKABINDE, M, Nkabiti, Boitumelo, Nkabule, Gugu, Nkadimeng, Mankopodi, Nkanjeni, Nonkanyiso, Nkatlo, Palesa Portia, Nkewana, Bongani, Nkhwashu, Audrey, Nkoana, Ngokoana, Nkoane, Mmathapelo, Nkogatse, M, Nkomo, Fezile, Nkomo, Ntando, Nkonyane, Nontobeko, Nkosi, Sydney, Nkosi, Ntombikayise, Nkosi, Phumzile, Nkosi, Ntombifuthi, NKOSI, TINTSWALO, Nkosi, ML, Nkosi, Godfrey, Nkosi, Amukelani, Nkosi, Fikile Vinoliah, Nkosi, Mbali, Nkosi, Nomcebo Lucia, Nkosi, Siphokazi, Nkuhlu, Amanda, Nkumane, Phumzile, Nkuna, Malebo, Nkwakwha, Wendy, Noge, Sesi, Nolte, Elizabeth, Nomawabo, Peko, Nombita, Malibongwe, Nophale, Nandipha, Nothnagel, Jeanetta, Novokoza, Bongiwe, Nqaphi, Zanele, Nqondo, Thobekile, Nqwelo, Siphokazi, NS, Nkoana, Ntabeni, Sindiswa, Ntabeni, Mr, Ntampula, mawethu, Ntebe, Mthutuzeli, NTELA, MOKWABO, Ntimbane, Hezekiah, Ntintsilana, Xolisa, Ntleki, Patrick, Ntobela, Zanele, Ntombela, Bandile, Ntombela, Zamaswazi, Ntombela, Khonelihle Zandile, Ntombela, Praisegod Samkelo Thobani, Ntonintshi, Lindiwe, Ntseane, Dipuo, Ntseane, Thobeka, Ntsham, Xolelwa, Ntshele, Mbalenhle, Ntshewula, Amanda, Ntsoko, Zinzi, Ntsoto, Athini, Ntuli, Nomsa, Ntuli, Nokwazi, Ntuli, Nomvula, Ntuli, Andrew Diffar, Ntuli, Faith, Nurnberger, Margrit, Nxala, Ntsikelelo, Nxasane, Sithandiwe, Nxumalo, Mr Thanda, Nyathi, Xolani, Nyawula, Nontobeko, Nzama, Nhlakanipho, Obed, Maila Nkuneng, Ogwal, Florence, Olifant, Maureen, Oliphant, Mr B, Olive, Monota, Olyn, Kagisho, Omoighe, Raymond, One, Phumeza, Oscar, Ratombo, Owen, Nkuna, P, Mailula, Padayachee, Nalini, Padayachy, Vasaily, Pakade, Ntombizakhe, Palime, Mosiuoa, Palisa, Jane, Parker, Arifa, Parkies, Lesenyeho, Parrish, Andy, Patel, Nilesh, Pather, Anastasia, Patience, Mkhombo Tsakani, Patzke, Marisa, Pawuli, Akhumzi, Pelako, Ntandokazi, Penrose, Phaswana Sibasa, Peppeta, Litha, Pershad, Santosh, Pertunia, Makheda, Pertunia, Nkuna, Perumal, Dane, Peter, Mongameli, Peters, Justin, Petlane, Vatiswa, Petrus, Harideen, Phahladira, Kgomotso, Phakisa, Matebesi John, Phale, R, Phathela, Livhuwani, Phillip, Sekate Daniel, Phiri, Beverly, Phiri, Mapule Precious, Phokane, Thapelo, Phokoane, Frank, Pholosho, Moele, Phooko, Sekoro, Phooko, Sekodi Geoffrey, Phutiane, Maponya, Pillay, Faiza, Pillay, Melanie, Pillay, Sayuri, Pillay, CR, Plaatjie, Zikhona, Pootona, James, Potgieter, Samantha, Potgieter, Marius, Precious, Mulaudzi Mulatedzi, Pretorius, Paul Janus, Prozesky, Hans, Pule, Mokhethi, Punwasi, Jayshina, Putzier, Dot, Qankqiso, Lutho, Qebedu, Siphokazi, Qhola, Phozisa, Qotoyi, Ntombesithathu, Qotso, Sipho Victor, Qwabe, Zanele, Rabie, Helena, Rabothata, Phoebe, Rachoene, Christina, Radana, Mteteleli, Radebe, Maria, Radebe, Dr. Valentino, Radebe, Nonkululeko, Radinne, Ella, Raduvha, Sherly, Raghunath, Shamintha, Rajagopaul, Claudine, Rakgwale, Mary, Ralethe, Malumbete Michael, ralimo, Kenneth, Ramafoko, Motlalepule, Ramagoma, Maduvhahafani, Raman, Charlotte, Ramavhuya, Dr, Rambally, Molly, Ramdeen, Nivasha, Ramdin, Tanusha, Rameshwarnath, Sharita, Ramkillawan, Yeishna, Ramotlou, Rampedi, Faith, Rampersad, Vijayluxmi, Ramuima, Avhashoni, Ranone, Noluthando, Rapasa, Mabohlale Portia, rapelang, Mpharoane, Raphaely, Nika, Rashokeng, Lesiba, Rashopola, Caroline, Ratau, Tebogo, RATAU, M, Ratshili, Mpfariseni David, Rautenbach, Elmari, Ravele, Rofhiwa, Reachable, Johannes, Rebecca, Peta Mmalahla, Reddy, Kessendri, Redfern, Andrew, Reed, Robertha, Rees, Mumsy, Reji, Dr, Reubenson, Gary, Rewthinarain, Veena, Rheeder, Paul, Rhulani, Nkonayani, Richard, Mufamadi, Rikhotso, J.S, Rikhotso, Shatimone Beverley, Robert, Lavhelani Ndivhaleni, Roto, Noncedo, Ruder, Gideon, Rugnath, Kapil, Ruiters, Lizette, Ruiters, Mina, Russell, Sue, Ruwiza, Lynn, RY, Molokoane, Saaiman, Mandy, Sabela, Emmanuel, Sadiq, Lerato, Saki, Litha, SALAMBWA, HYPPOLITE, Samjowan, Menitha, Samodien, Nazlee, Samuel, Rakgolele, Sandile, Fakudze, Sanelisiwe, Cekuse, Sani, Mandlankosi, Sawuka, Simangele, Schoeman, Lelani, Scholts, Magriet, Schroder, Ronel, Sebalabala, Mamotetekoane, Sebati, Selwalenkwe Collet, Seboko, Jacoline, Sebuthoma, Wilheminah, Segami, Annah, Segokotlo, Ruth, Sehloho, MR, Seisa, Khutjo, Sekgobela, Antony, Sekhosana, Monica, Sekonyela, John, Sekoto, Mpho, Sekulisa, Naledi, Sekwadi, Mokgadi Vanessa, Selaelo, Lebogo, Selatlha, Johannes, Selekolo, Kgomotso, Selfridge, William, Semenya, Lucy, Sengakane, Ivy, Sengata, Masabata, Sentle, Petronella, Seoketsa, Malebo, Seonandan, Pratheesha, Serumula, Thomas Mambushi, Setheni, Nkululeko, Setlale, Refiloe, Setlhodi, Tumediso, Setlhodi, Barbara, Setloghele, Robert, Sewpersad, Aarthi, Sewpersadh, Ryan, Shabalala, Phumlile, Shabangu, Owen, Shabangu, Kungesihe, Shabangu, Harriet Sbonangaye, Shabangu, Doctor Thokozani, Shadi, Clifford, Shaik, Hasifa, Shale, Tseliso, Shandu, Qedani, Shandu, Nomvelo, Shange, Ntswaki Marcia, Shenxane, Abongile, Sherriff, A, Shezi, Sebenzile, Shezi, Thenjiwe, Shihangule, Scally, Shikwambana, Cheyeza, Shoba, Lungisani, shokane, Kamogelo, Sibande, Nora, Sibeko, Lydia, Sibeko, Xolani, Sibiya, Zanele, Sibiya, Mncedisi, Sibuta, Sphamandla, Sifumba, Thembakazi, Sigcau, Sipho, Sigila, Lutho, Sihentshe, Kayakazi, Sihlangu, Bongani, Sikhakhane, Daisy, Sikhakhane, Shaun Nhlanhla, Siko, Mbali, Sikonje, Sipho, Simanga, Khumbulekile, Simango, Nomsa, Simela, Thulisile, Simelane, Ntombikayise, Singh, Sashah, Singh, Marjorie, Singh, Mrs Ragani, Singh, Shash, Singh, Anita, Sithole, Hitekani, Sithole, Senzekile, Sithole, Ntokozo Danielle, Sithole, Koketso Maxwell, Situma, Jonnie, Sivraman, Annie, Siwela, Katekani, Siyewuyewu, Nonqubela, Sizeka, Maweya, Siziba, Nonceba, Skhosana, Andrew, Skhosana, Khanyisile, SKHOSANA, RORISANG, Skoko, Tandiwe, Slabbert, Sunet, Smangaliso, Ntombela, Smedley, Christine, Smit, Lydia, Smit, Natassia, Smit, Lizelle, Smit, Michelle, Smith, Fasie, Smith, Lizzie, Smith, Sunell, Smith, Cassius, Smuts, Stefan, Sofe, Ayanda, Solomon, Khobane, Solomon, LJ, Sombani, chauke, SONGCA, RICHARD, Sontamo, Anga, Soorju, Supriya, Sopazi, Zubenathi, Soqasha, Brian, Sosibo, Bongiwe, Sotsaka, Ntsika, Soula, Mandy, Spoor, Simon, Stacey, Sarah, Stali, Asanda, Stephina, Mutele Mmboniseni, Steup, Myra, Steven, Sinoxolo, Stevens, AW, Stevens, Vincent, Steyn, Dewald, Steyn, Bianca, Stocks, Pat, Stolk, Henk, Stoltz, Alida, Strehlau, Renate, Stroebel, Anneke, Strydom, Loraine, Strydom, Jean-Marie, Strydom, Anton, Strydom, Ursula, Sunnyraj, Midhu, Swana, Nwabisa, Swanepoel, Winnie, Swanepoel, Suzan, Swartbooi, Elsie, Swartz, Estley Swartz, Syce, Casandra, T.E, Shihambi, Tabane, Joyce, Tabane, NE, Tawana, Mrs, Tebello, Ntene, Tembe, Siphosetu Wiseman, Terblanche, Samantha, Thabede, Ntombifuthi, Thabelo, Nkhumeleni, Thabethe, Sibusiso, Thabo George, Lekhanya, Thare, Keorapetse, Thebogo, Makofane, Thekiso, Lerato, Theko, Lloyd, Themba, Celimphilo Zandi, Theron, Danie, Theron, Henda, Theron, Ilze, Thingathinga, Thandiwe, THLABADIRA, M.M, Thoka, Dikeledi, Thokwana, Zanele, Thom, Gustav, Thubakgale, Mamphot Joel, Thwala, Theodora, Thys, P, Tieho, Monethi, Timothy, Matodzi, Tintswalo, Ndlovu, Tivana, Babalwa, Tladi, Molefi, Tokota, Bongiwe, Toni, Simthandile, Torres, Ariel, Toubkin, Mande, Tsatsi, Marinda, Tshabalala, Khanyisile, Tshamase, Nozibele, Tshefu, Gontse, Tshegofatjo, Makgoga, Tshikomba, Given, Tshilo, Thapelo, Tshira, Lerato, Tshirado, S.T, Tshisikule, Maipfi, Tsoke, G, TSOKE, N, Tsoko, Alatha, Tsotetsi, Mosele, TSUBELLA, SANDEVA, Tuswa, Noxolo, Tutse, Maipato, Tutu, Nomayenzeke, Twala, Sphephelo, Twala, Nhlanhla, Twala, Simphiwe, Ubisi, John, Unathi, Tefo, Van Aswegen, A, van der Merwe, Marietjie, van der Merwe, Trudie, van der Plank, Patience, van der Spuy, Elmarie, Van Der Westhuizen, Linda, Van Der Westhuizen, Adele, van der Westhuizen, Talana, van der Westhuyzen, Mene, Van Dyk, Thea, van Heerden, Ingrid, van Jaarsveld, Ryno, Van Lill, M, van Niekerk, Heidi, van Niekerk, Ben, van Rensburg, Amanda, van Schallwyk, Judy, Van Sensie, Zeitschke Yarnrich, van Vuuren, Magda, van Vuuren, Cloete, Vandu, Olga Funiswa, Vane, Mandisa, VanZyl, Lucia, Variava, Ebrahim, Veerus, Mariam, Velapi, Nokhwezi, Veleko, Sebina, Velezantsi, Z., Venter, Retha, Vergottini, Corlia, Vermeulen, Inga, Vidah, Liabara Lufuluvhi, Vilakazi, Bongani, Vilakazi, Treasure N, Vilakazi, Mbalenhle Precious, Viljoen, Karen, Viljoen, Werner, Volschenk, Zuretha, Vos, Angelo, VV, Matlala, Walters, Jacques, Webb, Kate, Welsh, John, WESSELS, D, Wheller, Judy, White, Fundile, White, Priscilla, Whyte, Carmen, Willemse, Ansie, William, Sape, Williams, Daniel, Williams, Kamielah, Williams, Mercia, Williamson, Anne, Wilson, Cherade, Wolff, Boipelo, Wray, Michelle, Xaba, Ntombizonke B, Xaba, Thabang Jabulani, Xiniwe, Thanks, Xoliswa, Mtshali, Xulu, Funokwakhe, Xulu, Gibson, Yam, Sandlakazi, Zakhura, NM, Zareloa, Mashela, Zinto, Sive, Zinziswa, Dyibeni, Ziselo, Lulamile, Zitha, Zakhele, Zitha, Emmanuel, Zokufa, Anele, Zondi, Innocent, Zondi, Sikhumbuzo Bernard, Zondi, Sbuyi, Zondi, Thulani, Zongola, Wandiswa, Zühlke, Liesl, Zulu, Zandile, ZULU, LUNGELO, Zulu, Thandeka, Zulu, Slindili, Zulu, Nkosinathi, Zuma, Angel, Zungu, precious, Zungu, Pamela, Zungu, Melusi, Zungu, Priscilla, Zwakala, Bongo Lihle, Zwane, Antonia, Zwane, Promise, Zwane, Muziwendoda, Zwane, Hlengiwe Priscila, Zwane, Nomgcobo, Jassat, Waasila, Mudara, Caroline, Ozougwu, Lovelyn, Tempia, Stefano, Blumberg, Lucille, Davies, Mary-Ann, Pillay, Yogan, Carter, Terence, Morewane, Ramphelane, Wolmarans, Milani, von Gottberg, Anne, Bhiman, Jinal N, Walaza, Sibongile, and Cohen, Cheryl
Published: 2021
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45. Correction: Health worker compliance with severe malaria treatment guidelines in the context of implementing pre-referral rectal artesunate in the Democratic Republic of the Congo, Nigeria, and Uganda: An operational study

Author: Signorell, Aita, Awor, Phyllis, Okitawutshu, Jean, Tshefu, Antoinette, Omoluabi, Elizabeth, Hetzel, Manuel W., Athieno, Proscovia, Kimera, Joseph, Tumukunde, Gloria, Angiro, Irene, Kalenga, Jean-Claude, Akano, Babatunde K., Ayodeji, Kazeem, Okon, Charles, Yusuf, Ocheche, Delvento, Giulia, Lee, Tristan T., Brunner, Nina C., Lambiris, Mark J., Okuma, James, Cereghetti, Nadja, Buj, Valentina, Visser, Theodoor, Napier, Harriet G., Lengeler, Christian, and Burri, Christian
Subjects: Biological sciences
Abstract: Author(s): Aita Signorell, Phyllis Awor, Jean Okitawutshu, Antoinette Tshefu, Elizabeth Omoluabi, Manuel W. Hetzel, Proscovia Athieno, Joseph Kimera, Gloria Tumukunde, Irene Angiro, Jean-Claude Kalenga, Babatunde K. Akano, Kazeem Ayodeji, Charles [...]
Published: 2023
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46. Perceptions and experiences of Congolese midwives implementing a low-cost battery-operated heart rate meter during newborn resuscitation

Author: Madeline Thornton, Daniel Ishoso, Adrien Lokangaka, Sara Berkelhamer, Melissa Bauserman, Joar Eilevstjønn, Pooja Iyer, Beena D. Kamath-Rayne, Eric Mafuta, Helge Myklebust, Janna Patterson, Antoinette Tshefu, Carl Bose, and Jackie K. Patterson
Subjects: neonatal resuscitation, Helping Babies Breathe, electronic heart rate monitoring, low-income countries (LMICs), stillbirth, Pediatrics, RJ1-570
Abstract: Background900,000 newborns die from respiratory depression each year; nearly all of these deaths occur in low- and middle-income countries. Deaths from respiratory depression are reduced by evidence-based resuscitation. Electronic heart rate monitoring provides a sensitive indicator of the neonate's status to inform resuscitation care, but is infrequently used in low-resource settings. In a recent trial in the Democratic Republic of the Congo, midwives used a low-cost, battery-operated heart rate meter (NeoBeat) to continuously monitor heart rate during resuscitations. We explored midwives' perceptions of NeoBeat including its utility and barriers and facilitators to use.MethodsAfter a 20-month intervention in which midwives from three facilities used NeoBeat during resuscitations, we surveyed midwives and conducted focus group discussions (FGDs) regarding the incorporation of NeoBeat into clinical care. FGDs were conducted in Lingala, the native language, then transcribed and translated from Lingala to French to English. We analyzed data by: (1) coding of transcripts using Nvivo, (2) comparison of codes to identify patterns in the data, and (3) grouping of codes into categories by two independent reviewers, with final categories determined by consensus.ResultsEach midwife from Facility A used NeoBeat on an estimated 373 newborns, while each midwife at facilities B and C used NeoBeat an average 24 and 47 times, respectively. From FGDs with 30 midwives, we identified five main categories of perceptions and experiences regarding the use of NeoBeat: (1) Providers' initial skepticism evolved into pride and a belief that NeoBeat was essential to resuscitation care, (2) Providers viewed NeoBeat as enabling their resuscitation and increasing their capacity, (3) NeoBeat helped providers identify flaccid newborns as liveborn, leading to hope and the perception of saving of lives, (4) Challenges of use of NeoBeat included cleaning, charging, and insufficient quantity of devices, and (5) Providers desired to continue using the device and to expand its use beyond resuscitation and their own facilities.ConclusionMidwives perceived that NeoBeat enabled their resuscitation practices, including assisting them in identifying non-breathing newborns as liveborn. Increasing the quantity of devices per facility and developing systems to facilitate cleaning and charging may be critical for scale-up.
Published: 2022
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47. Individual, household and neighborhood risk factors for malaria in the Democratic Republic of the Congo support new approaches to programmatic intervention

Author: Carrel, Margaret, Kim, Seungwon, Mwandagalirwa, Melchior Kashamuka, Mvuama, Nono, Bala, Joseph A., Nkalani, Marthe, Kihuma, Georges, Atibu, Joseph, Diallo, Alpha Oumar, Goel, Varun, Thwai, Kyaw L., Juliano, Jonathan J., Emch, Michael, Tshefu, Antoinette, and Parr, Jonathan B.
Published: 2021
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48. The epidemiology of Plasmodium vivax among adults in the Democratic Republic of the Congo

Author: Nicholas F. Brazeau, Cedar L. Mitchell, Andrew P. Morgan, Molly Deutsch-Feldman, Oliver John Watson, Kyaw L. Thwai, Pere Gelabert, Lucy van Dorp, Corinna Y. Keeler, Andreea Waltmann, Michael Emch, Valerie Gartner, Ben Redelings, Gregory A. Wray, Melchior K. Mwandagalirwa, Antoinette K. Tshefu, Joris L. Likwela, Jessie K. Edwards, Robert Verity, Jonathan B. Parr, Steven R. Meshnick, and Jonathan J. Juliano
Subjects: Science
Abstract: Plasmodium vivax generally accounts for a low proportion of malaria cases in Africa, but population-level data on the distribution of infections is limited. Here, the authors use data from the Democratic Republic of the Congo and show that the prevalence is low (~3%) and diffusely spread.
Published: 2021
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49. ESSAI DE GESTION ET VOIES DE VALORISATION DES DECHETS MENAGERS SOLIDES POUR LA SALUBRITE DURABLE DE LA VILLE DE KINSHASA. CAS DU QUARTIER MBANZA-LEMBA DANS LA COMMUNE DE LEMBA

Author: Olivier LOKANGO OKINTAMBOLO, Christian SAMBA LOKOMBE, Jiton BOSOMBO MBENGI, Keziah BINTI FATAKI, Michel MBAMBU BAMBUTA, Joél-Andre OPEY AMBUR, Blaise KALUNGA MUKUWA, Charmante MBAYA LUKEBA, Lambert TSHEFU LOKANGU, Olivier LOKANGO OKINTAMBOLO, Christian SAMBA LOKOMBE, Jiton BOSOMBO MBENGI, Keziah BINTI FATAKI, Michel MBAMBU BAMBUTA, Joél-Andre OPEY AMBUR, Blaise KALUNGA MUKUWA, Charmante MBAYA LUKEBA, and Lambert TSHEFU LOKANGU
Abstract: Après avoir observé le phénomène et analysé le contexte général de la gestion des déchets dans toutes les villes de l’Afrique et à Kinshasa en particulier dans les quartier Mbanza-Lemba dans la commune Lemba , nous avons trouvé que cette problématique de la ville comme pour les citadins , nous avons constaté l’existence de deux systèmes de gestion dans le monde , à savoir : l’un « moderne » utilisé par des pays industriellement développés, réalisé tant bien que mal par la municipalité, et l’autre « communautaire » réalisé par les pays en voie de développement qui se définit comme système pris en charge par les usagers, cas de notre pays RDC. La singulière mise en évidence de deux systèmes qui cohabitent, met en lumière les problèmes rencontrés dans la maitrise de la croissance de la ville et surtout des problèmes financiers qu’a connu et que continue de connaitre la municipalité. Après l’étude comparative de ces deux systèmes qui fait apparaitre des différences et des insuffisances notoires au niveau de l’organisation du service et du rôle des auteurs, nous avons trouvé qu’à Mbanza-Lemba ce sont des individus qui se débrouillent pour gérer leurs déchets et cette gestion aboutit très mal car la destination des déchets est dans des ravins ou érosions, décharges publiques brutes, caniveaux, rivières, à même dans les avenues ou rues.. Pour remédier à cette situation, un schéma résumant des mécanismes à mettre en œuvre pour une gestion intégrée et durable des déchets ménagers solides au quartier a été proposé comme étant un projet. . Cette gestion ne sera possible qu’avec l’instauration de la taxe sur l’assainissement.
Published: 2024

50. CONNAISSANCES, ATTITUDES ET PRATIQUES (CAP) DES ÉTUDIANTS EN RAPPORT AVEC LA GESTION DES DÉCHETS SOLIDES SUR LE SITE DE L’UNIVERSITE DE KINSHASA (UNIKIN)

Author: Jeff Eyala Ndjondjo, Olivier Lokango Okintambolo, Joel-André Opey Ambur, Keziah Binti Fataki, Christian Samba Lokombe, Jiton Bosombo Mbengi, Joseph Mafuta Wa Mafuta, Berka Jimy Musitu, Christian Ngudjolo Tangali, Lambert Tshefu Lokangu, Albert Mbata Muliwavyo, Jeff Eyala Ndjondjo, Olivier Lokango Okintambolo, Joel-André Opey Ambur, Keziah Binti Fataki, Christian Samba Lokombe, Jiton Bosombo Mbengi, Joseph Mafuta Wa Mafuta, Berka Jimy Musitu, Christian Ngudjolo Tangali, Lambert Tshefu Lokangu, and Albert Mbata Muliwavyo
Abstract: Le choix porté sur ce sujet s’explique par la mégestion des déchets solides dans l’Université de Kinshasa qui constitue un problème majeur pour cette dernière. C’est ainsi que nous avons évalué les connaissances, attitudes et pratiques (CAP) des étudiants en rapport avec la gestion des déchets solides sur le site de l’Université de Kinshasa et dont les objectifs consistaient à décrire les caractéristiques sociodémographiques des étudiants, déterminer le niveau des connaissances et la perception des étudiants à la gestion des déchets. Pour y parvenir, nous avons fait recours au questionnaire d’enquête adressé aux étudiants. Nous avons donc décidé de mener une étude descriptive transversale sur un échantillon (384 étudiant) dont la taille minimale a été calculée par la formule de Ficher. Cette étude nous a permis de constater que les déchets solides produits à l’université sont mal gérés avec des risques importants pour la santé des étudiants. Ces étudiants, étant les premiers producteurs des déchets sur le site universitaire, jettent leurs déchets à l’air libre et laissent le service de ramassage se charger du balayage et de l’évacuation des déchets. La production des déchets sans destination véritables se trouve également au chapitre nuisances hygiénique et esthétique. Pour remédier à cette situation, un schéma résumant le système à mettre en œuvre pour une gestion intégrée et durable des déchets ménagers solides à l’Université de Kinshasa a été proposé comme étant un projet.
Published: 2024

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