2024
Prior tuberculosis, radiographic lung abnormalities and prevalent diabetes in rural South Africa
Castle A, Moosa Y, Claassen H, Shenoi S, Magodoro I, Manne-Goehler J, Hanekom W, Bassett I, Wong E, Siedner M. Prior tuberculosis, radiographic lung abnormalities and prevalent diabetes in rural South Africa. BMC Infectious Diseases 2024, 24: 690. PMID: 38992607, PMCID: PMC11238449, DOI: 10.1186/s12879-024-09583-8.Peer-Reviewed Original ResearchConceptsPrevalent diabetesChest X-rayChest X-ray abnormalitiesX-ray abnormalitiesOdds of prevalent diabetesHemoglobin A1c testingPost-TB lung diseaseHistory of TB diseaseAssociated with prevalent diabetesPulmonary abnormalitiesExposure of interestRural South AfricaPrevalence of diabetesTB diseaseCohort of peopleCAD4TBMethodsWe analyzed dataCross-sectional studyCompare groupsLogistic regression modelsIncidence of diabetesDiabetes prevalenceA1c testingConclusionsAmong peopleDigital chest X-ray
2023
Community health workers can be trained to identify patients eligible for tuberculosis preventive therapy, but encounter barriers to programme implementation in KwaZulu-Natal, South Africa
Norton S, Moll A, Madi J, Nkomo N, Brooks R, Andrews L, Shenoi S. Community health workers can be trained to identify patients eligible for tuberculosis preventive therapy, but encounter barriers to programme implementation in KwaZulu-Natal, South Africa. African Journal Of AIDS Research 2023, 22: 131-135. PMID: 37337826, DOI: 10.2989/16085906.2023.2213213.Peer-Reviewed Original ResearchConceptsTuberculosis preventive therapyCommunity health workersLargest HIV epidemicCause of deathNon-communicable diseasesHealth workersPreventive therapyRural resource-limited settingsHigh TB incidence ratesFurther implementation researchTB incidence rateRate of referralResource-limited settingsMedian ageTreatment initiationHIV epidemicIncidence rateRural South AfricaHIVInfectious diseasesTuberculosisImplementation researchScreening resultsDiseasePatientsPerceived stigma related to TB preventive therapy
Palacios C, Hough M, Shrestha R, Moll A, Kompala T, Andrews L, Shenoi S. Perceived stigma related to TB preventive therapy. The International Journal Of Tuberculosis And Lung Disease 2023, 27: 209-214. PMID: 36855038, DOI: 10.5588/ijtld.22.0570.Peer-Reviewed Original ResearchConceptsTB preventative therapyTB preventive therapyAnonymous cross-sectional surveyBurden of TBCommunity-dwelling adultsRural South African communityCross-sectional surveyPreventive therapyMean agePreventative therapyEndemic settingsPatient's familyKruskal-Wallis testStigma scoresRural South AfricaPoisson regressionNovel interventionsSouth African communityTherapyLess stigmaDescriptive statisticsFamily membersStigmaTBTwo-factor solution
2021
Feasibility of a community‐based delivery model for HIV pre‐exposure prophylaxis among bar patrons in rural South Africa
Grammatico MA, Moll AP, Choi K, Springer SA, Shenoi SV. Feasibility of a community‐based delivery model for HIV pre‐exposure prophylaxis among bar patrons in rural South Africa. Journal Of The International AIDS Society 2021, 24: e25848. PMID: 34826363, PMCID: PMC8625837, DOI: 10.1002/jia2.25848.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisAlcohol Use Disorders Identification TestLargest HIV epidemicCommunity-based delivery modelPrEP uptakeHIV testingOdds ratioOral tenofovir disoproxil fumarate/emtricitabineTenofovir disoproxil fumarate/emtricitabineRural South AfricaHazardous drinkingDisoproxil fumarate/emtricitabineHIV pre-exposure prophylaxisUptake of PrEPHIV care cascadeRapid HIV testingAdjusted odds ratioYoung menRural KwaZulu-Natal ProvinceAlcohol use disorderSexual risk behaviorsDisorders Identification TestBar patronsPrEP deliveryPrEP initiatorsStructural barriers to implementing recommended tuberculosis preventive treatment in primary care clinics in rural South Africa
Chandra DK, Moll AP, Altice FL, Didomizio E, Andrews L, Shenoi SV. Structural barriers to implementing recommended tuberculosis preventive treatment in primary care clinics in rural South Africa. Global Public Health 2021, 17: 555-568. PMID: 33650939, PMCID: PMC8410883, DOI: 10.1080/17441692.2021.1892793.Peer-Reviewed Original ResearchConceptsTuberculosis preventive treatmentPrimary healthcare clinicsTPT initiationWorld Health OrganizationAntiretroviral therapyPreventive treatmentRural South AfricaHIV/TB servicesBurden of HIVOnly independent correlatePrimary care clinicsClinic-level factorsPatient-level characteristicsPrimary care providersHealth Services frameworkEvidence-based strategiesQuality improvement strategiesTB servicesClinical factorsCare clinicsIndependent correlatesMedical recordsPromoting ActionCare providersHealthcare clinicsFactors associated with low tuberculosis preventive therapy prescription rates among health care workers in rural South Africa
Ahmed AA, Grammatico M, Moll AP, Malinga S, Makhunga P, Charalambous S, Ladines-Lim JB, Jones J, Choi K, Shenoi SV. Factors associated with low tuberculosis preventive therapy prescription rates among health care workers in rural South Africa. Global Health Action 2021, 14: 1979281. PMID: 34652990, PMCID: PMC8525921, DOI: 10.1080/16549716.2021.1979281.Peer-Reviewed Original ResearchConceptsTuberculosis preventive therapyHealth care workersPrimary healthcare clinicsLower prescription ratesPrescription ratesRural South AfricaCare workersIsoniazid preventative therapyIncidence of tuberculosisCross-sectional studyGovernment district hospitalsPreventive therapyMedian ageMultivariable analysisPreventative therapyDistrict hospitalHealthcare clinicsHCW trainingPatient disclosureTPT useConsolidated FrameworkLogistic regressionImplementation researchSelf-reported dataPrescribers
2020
1656. Factors associated with low TB preventative therapy prescription rates among healthcare workers in rural South Africa
Ahmed A, Grammatico M, Malinga S, Makhunga P, Moll A, Ladines-Lim J, Jones J, Choi K, Shenoi S. 1656. Factors associated with low TB preventative therapy prescription rates among healthcare workers in rural South Africa. Open Forum Infectious Diseases 2020, 7: s816-s817. PMCID: PMC7778258, DOI: 10.1093/ofid/ofaa439.1834.Peer-Reviewed Original ResearchPrimary care clinicsLower prescription ratesPrescription ratesHealthcare workersPatients' nondisclosureRural South AfricaConclusions Healthcare workersIsoniazid preventive therapyProfessional nursesRural district hospitalMedical officersCross-sectional surveyEligible patientsMortality benefitPreventive therapyMedian ageCare clinicsPreventative therapyTuberculosis incidenceDistrict hospitalSelf-reported knowledgePatientsHCW trainingMultivariate analysisPrescribers102. Improving Implementation of HIV Pre-exposure Prophylaxis: Lessons Learned from Young Women in Rural South Africa
Hannaford A, Khumalo N, Norton S, Moll A, Shenoi S. 102. Improving Implementation of HIV Pre-exposure Prophylaxis: Lessons Learned from Young Women in Rural South Africa. Open Forum Infectious Diseases 2020, 7: s180-s181. PMCID: PMC7777701, DOI: 10.1093/ofid/ofaa439.412.Peer-Reviewed Original ResearchPrEP delivery modelsPre-exposure prophylaxisYoung womenPrEP initiationHIV pre-exposure prophylaxisSexual activityCommunity health workersInconsistent condom useHIV prevention programsMale sexual partnersCommunity-based deliveryPrEP deliveryMedication refillsPrEP implementationPrEP useDelivery modelPrEP educationHIV stigmaHealth workersHigh riskPrEP disclosureProgrammatic conditionsClinic facilitiesRural South AfricaCondom use1031. Mobility and Structural Barriers Contribute to Loss to Follow up from HIV Care in Rural South Africa
Hannaford A, Moll A, Madondo T, Khoza B, Shenoi S. 1031. Mobility and Structural Barriers Contribute to Loss to Follow up from HIV Care in Rural South Africa. Open Forum Infectious Diseases 2020, 7: s546-s546. PMCID: PMC7776485, DOI: 10.1093/ofid/ofaa439.1217.Peer-Reviewed Original ResearchHIV careHIV transmissionRural South AfricaLongitudinal HIV careViral load suppressionRisk of tuberculosisRural settingsPatient-centered careStructural barriersART discontinuationPill fatigueART prescriptionMedian durationART accessPrimary careHIV knowledgeChronic careHealthcare workersHIV stigmaHigh riskPatient motivationSpecific clinicPrevents transmissionMajor precipitantSexual partnersMobility and structural barriers in rural South Africa contribute to loss to follow up from HIV care
Hannaford A, Moll AP, Madondo T, Khoza B, Shenoi SV. Mobility and structural barriers in rural South Africa contribute to loss to follow up from HIV care. AIDS Care 2020, 33: 1436-1444. PMID: 32856470, PMCID: PMC8043244, DOI: 10.1080/09540121.2020.1808567.Peer-Reviewed Original ResearchConceptsHIV careRural South AfricaHIV transmissionLongitudinal HIV careViral load suppressionRisk of tuberculosisRural settingsStructural barriersART discontinuationPill fatigueMedian durationMixed-methods evaluationART accessMajor precipitantFuture interventionsCareDistant clinicsPLWHFamily needsConvenience samplingSocial supportMethods evaluationLTFUDiscontinuationMajor contributor‘PrEP should be for men only’: Young heterosexual men’s views on PrEP in rural South Africa
Hannaford A, Lim J, Moll AP, Khoza B, Shenoi SV. ‘PrEP should be for men only’: Young heterosexual men’s views on PrEP in rural South Africa. Global Public Health 2020, 15: 1337-1348. PMID: 32207661, DOI: 10.1080/17441692.2020.1744680.Peer-Reviewed Original ResearchConceptsRural South AfricaSouth AfricaYoung men's perspectivesHeterosexual menCommunity-based servicesYoung heterosexual menMen's perspectivesPrevention servicesService delivery modelsMen's viewsHIV prevention servicesStructural barriersFemale partnersKey themesHIV prevention knowledgeGender-specific interventionsCasual sexual partnersDifferentiated service delivery modelsGaps persistHigh HIV risk behaviorHIV-negative heterosexual menHigh-risk sexual behaviorPre-exposure prophylaxisHigh attributable mortalityHIV risk behaviors
2019
1673. Gendered Patterns of HIV, TB, and Other Primary Care Referrals in Rural South Africa
Choi K, Moll A, Shenoi S. 1673. Gendered Patterns of HIV, TB, and Other Primary Care Referrals in Rural South Africa. Open Forum Infectious Diseases 2019, 6: s612-s613. PMCID: PMC6809581, DOI: 10.1093/ofid/ofz360.1537.Peer-Reviewed Original ResearchPrimary care servicesRural South AfricaHazardous drinkingPositive screeningHealth concernIsoniazid preventive therapyLast clinic visitPrimary care referralsMultivariable logistic regressionHealth careCommunity health workersHealth-seeking behaviourCommunity-based servicesCare referralClinic visitsPreventive therapyMedian ageClinical outcomesSaharan AfricaHealthcare useHealth workersHIV effortsMore referralsCare servicesHIV
2018
1300. Young Heterosexual Men in Rural South Africa Want Access to PrEP
Hannaford A, Khoza B, Moll A, Shenoi S. 1300. Young Heterosexual Men in Rural South Africa Want Access to PrEP. Open Forum Infectious Diseases 2018, 5: s397-s397. PMCID: PMC6253012, DOI: 10.1093/ofid/ofy210.1133.Peer-Reviewed Original ResearchHIV prevention servicesHIV risk behaviorsHIV statusPrevention servicesRural South AfricaFemale partnersCondom useHIV pre-exposure prophylaxisRisk behaviorsHigh HIV risk behaviorHIV-negative menPre-exposure prophylaxisHistory of STIHIV prevention knowledgeInconsistent condom useSexual risk behaviorsHeterosexual menRural KwaZulu-NatalMultiple sexual relationshipsNegative menHIV preventionPrevention knowledgeTreatment servicesCommunity settingsHIV
2017
Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa
Arnesen R, Moll AP, Shenoi SV. Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa. PLOS ONE 2017, 12: e0177168. PMID: 28542309, PMCID: PMC5443492, DOI: 10.1371/journal.pone.0177168.Peer-Reviewed Original ResearchConceptsPrimary health clinicsPredictors of lossART clinicsSouth African HIV clinicAntiretroviral therapy accessInadequate medical recordsCells/μLART initiationLow CD4LTFU ratesCD4 countHIV careHIV clinicHIV outcomesRetrospective reviewMedical recordsHealth clinicsTherapy accessHigh riskLTFUPatientsRural hospitalsRural South AfricaNovel interventionsClinicIntegrated Tuberculosis/Human Immunodeficiency Virus Community-Based Case Finding in Rural South Africa: Implications for Tuberculosis Control Efforts
Shenoi SV, Moll AP, Brooks RP, Kyriakides T, Andrews L, Kompala T, Upadhya D, Altice FL, Eksteen FJ, Friedland G. Integrated Tuberculosis/Human Immunodeficiency Virus Community-Based Case Finding in Rural South Africa: Implications for Tuberculosis Control Efforts. Open Forum Infectious Diseases 2017, 4: ofx092. PMID: 28695145, PMCID: PMC5499582, DOI: 10.1093/ofid/ofx092.Peer-Reviewed Original ResearchHuman immunodeficiency virusIntensive case findingCase findingResistant TBTB casesHIV testingRural South AfricaOverall case notification rateConcurrent HIV testingHIV coinfection rateHIV-negative tuberculosisMedian CD4 countCD4 cell countHIV/TBDrug-resistant TBCase notification ratesCase-finding strategyHIV-positive individualsHigh-risk populationTB symptom screeningPopulation-level ratesCD4 countTuberculosis symptomsSymptom screeningTB elimination“It’s about my life”: facilitators of and barriers to isoniazid preventive therapy completion among people living with HIV in rural South Africa
Jacobson KB, Niccolai L, Mtungwa N, Moll AP, Shenoi SV. “It’s about my life”: facilitators of and barriers to isoniazid preventive therapy completion among people living with HIV in rural South Africa. AIDS Care 2017, 29: 936-942. PMID: 28147705, PMCID: PMC5545149, DOI: 10.1080/09540121.2017.1283390.Peer-Reviewed Original ResearchMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsAmbulatory Care FacilitiesAntitubercular AgentsCounselingFemaleHealth Knowledge, Attitudes, PracticeHealth Services AccessibilityHIV InfectionsHumansIncidenceInterviews as TopicIsoniazidMalePatient ComplianceQualitative ResearchRural PopulationSocial StigmaSouth AfricaTrustTuberculosisConceptsIsoniazid preventive therapyIPT completionPreventive roleAbsence of symptomsHealth care workersKnowledge of TBHealth service deliveryResource-limited settingsHealth care systemRural KwaZulu-NatalAntiretroviral therapyHIV patientsHIV diagnosisPreventive therapyTherapy completionTB incidenceAppropriate counselingHealthcare workersIndividual patientsCare workersRural South AfricaHIVPatientsUnrelated conditionsIndividual semi-structured interviews
2016
Cost-Effectiveness of Community-Based TB/HIV Screening and Linkage to Care in Rural South Africa
Gilbert JA, Shenoi SV, Moll AP, Friedland GH, Paltiel AD, Galvani AP. Cost-Effectiveness of Community-Based TB/HIV Screening and Linkage to Care in Rural South Africa. PLOS ONE 2016, 11: e0165614. PMID: 27906986, PMCID: PMC5131994, DOI: 10.1371/journal.pone.0165614.Peer-Reviewed Original ResearchConceptsTB/HIVTB/HIV controlHIV screeningHIV controlRural South AfricaLife yearsMonths of IPTMost life yearsHigh-incidence settingsWidespread prevalenceCost-effectiveness resultsProbabilistic sensitivity analysesHIV transmissionHigh burdenTreatment coverageUnknown patientsHIVHealthcare accessDrug resistanceActive casesMonthsLifetime usePatientsYearsScreeningImpact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa
Kompala T, Moll AP, Mtungwa N, Brooks RP, Friedland GH, Shenoi SV. Impact of nurse-delivered community-based CD4 services on facilitating pre-ART care in rural South Africa. BMC Health Services Research 2016, 16: 374. PMID: 27515233, PMCID: PMC4982129, DOI: 10.1186/s12913-016-1627-8.Peer-Reviewed Original ResearchConceptsPre-ART careAntiretroviral treatmentCD4 testingCBVCT servicesTreatment cascadeRural South AfricaLocal primary care clinicsCD4 count resultsCommunity-based voluntary counselingPrimary care clinicsHIV-positive clientsPhlebotomy servicesResource-limited settingsART initiationHIV careART eligibilityCare cascadeCare clinicsHIV-positiveVoluntary counselingTreatment eligibilityCD4 resultsResult notificationResultsBetween 2010Nurse presence“I Have to Push Him with a Wheelbarrow to the Clinic”: Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa
Loeliger KB, Niccolai LM, Mtungwa LN, Moll A, Shenoi SV. “I Have to Push Him with a Wheelbarrow to the Clinic”: Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa. AIDS Patient Care And STDs 2016, 30: 385-394. PMID: 27509239, PMCID: PMC4991585, DOI: 10.1089/apc.2016.0096.Peer-Reviewed Original ResearchConceptsCommunity health workersHIV careCommunity health worker rolesHIV care provisionAntiretroviral therapy initiationHIV treatment outcomesHealth worker rolesHealthcare systemBasic emergency careHIV/AIDS epidemicRural KwaZulu-NatalCommunity-based programsAdherence persistTherapy initiationAntiretroviral medicationsHIV prevalenceTreatment outcomesCHW rolesHealth workersHolistic careCentered careHIV resourcesEmergency careClinical practiceRural South Africa
2015
Community Health Worker Perspectives on Barriers to HIV+ Patients' Initiation of and Retention in Antiretroviral Therapy in Rural South Africa
Loeliger K, Niccolai L, Mntungwa N, Moll A, Friedland G, Shenoi S. Community Health Worker Perspectives on Barriers to HIV+ Patients' Initiation of and Retention in Antiretroviral Therapy in Rural South Africa. Open Forum Infectious Diseases 2015, 2: 405. DOI: 10.1093/ofid/ofv133.281.Peer-Reviewed Original Research