2021
Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa
Brault MA, Vermund SH, Aliyu MH, Omer SB, Clark D, Spiegelman D. Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa. International Journal Of Environmental Research And Public Health 2021, 18: 10751. PMID: 34682492, PMCID: PMC8535610, DOI: 10.3390/ijerph182010751.Peer-Reviewed Original ResearchConceptsNon-communicable diseasesNon-communicable disease careInfectious diseasesHIV care infrastructureTropical infectious diseasesHIV/AIDS epidemicIntegrated service delivery modelCOVID-19Future pandemic threatsLow-cost interventionMinistry of HealthDisease careChronic diseasesCardiovascular diseaseSuch careIntegrated careAIDS ReliefHealth systemSub-Saharan AfricaDiseaseService delivery modelsPandemic threatAIDS epidemicCare infrastructureHealthcare modelLongitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial
Boeke CE, Khan S, Walsh FJ, Lejeune C, Hettema A, Spiegelman D, Okello V, Bärnighausen T. Longitudinal analysis of client appointment adherence under Universal Test and Treat strategy: A stepped‐wedge trial. HIV Medicine 2021, 22: 854-859. PMID: 34293243, DOI: 10.1111/hiv.13144.Peer-Reviewed Original ResearchConceptsImpact of UTTStepped-wedge trialAntiretroviral therapyAppointment adherencePublic sector health systemJoint United Nations ProgrammeMultivariable-adjusted modelsHIV/AIDSUniversal testClient adherenceUTT strategyVisit adherenceHIV clientsUnited Nations ProgrammeStudy enrollmentClinical benefitTreat strategyHealth facilitiesART statusHealth systemAdherenceMarital statusNations ProgrammeMeasures analysisLongitudinal analysisHealth system gaps in cardiovascular disease prevention and management in Nepal
Shrestha A, Maharjan R, Karmacharya BM, Bajracharya S, Jha N, Shrestha S, Aryal A, Baral PP, Bhatt RD, Bhattarai S, Bista D, Citrin D, Dhimal M, Fitzpatrick AL, Jha AK, Karmacharya RM, Mali S, Neupane T, Oli N, Pandit R, Parajuli SB, Pradhan PMS, Prajapati D, Pyakurel M, Pyakurel P, Rai BK, Sapkota BP, Sapkota S, Shrestha A, Shrestha AP, Shrestha R, Sharma GN, Sharma S, Spiegelman D, Suwal PS, Thapa B, Vaidya A, Xu D, Yan LL, Koju R. Health system gaps in cardiovascular disease prevention and management in Nepal. BMC Health Services Research 2021, 21: 655. PMID: 34225714, PMCID: PMC8258928, DOI: 10.1186/s12913-021-06681-0.Peer-Reviewed Original ResearchConceptsHealth systemCardiovascular disease preventionCause of deathHealth system gapsQuality of careResource-limited settingsNational health policyHealth system performanceBackgroundCardiovascular diseaseCVD preventionCVD careCVD servicesHealth outcomesDisease preventionHealth policyHealth insuranceHealth spendingCarePreventionKey informant interviewsTask ForceSystem gapsInformant interviewsService deliverySafety
2020
Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial
Khan S, Spiegelman D, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Chao A, Bärnighausen T, Okello V. Early access to antiretroviral therapy versus standard of care among HIV‐positive participants in Eswatini in the public health sector: the MaxART stepped‐wedge randomized controlled trial. Journal Of The International AIDS Society 2020, 23: e25610. PMID: 32949103, PMCID: PMC7507004, DOI: 10.1002/jia2.25610.Peer-Reviewed Original ResearchConceptsViral suppressionStandard of careAntiretroviral treatmentCox proportional hazards modelHealth systemART-naïve participantsHIV-positive patientsHIV-positive adultsViral load monitoringHIV-positive participantsAppropriate care managementProportional hazards modelEarly accessPublic sector health facilitiesHealth system effectsPublic health systemHealth system's abilityClinic transitionAntiretroviral therapyCD4 countCare retentionVL monitoringPublic health sectorDisease stageEndpoint rateGetting to 90–90–90: Experiences from the MaxART Early Access to ART for All (EAAA) Trial in Eswatini
Walsh F, Khan S, Bärnighausen T, Hettema A, Lejeune C, Mazibuko S, Mlambo CK, Reis R, Fleming Y, Khumalo G, Zwane M, Okello V, Spiegelman D. Getting to 90–90–90: Experiences from the MaxART Early Access to ART for All (EAAA) Trial in Eswatini. Current HIV/AIDS Reports 2020, 17: 324-332. PMID: 32474844, DOI: 10.1007/s11904-020-00501-6.Peer-Reviewed Original ResearchConceptsTreatment guidelinesRoutine viral load monitoringNational HIV careViral load monitoringAdolescent malesSystem-level barriersEarly accessInnovative community-based approachesPublic health systemCommunity outreach strategiesImplementation science researchART initiationHIV careHIV testHIV testingMiddle-income countriesUNAIDS 90Adult menMultiple interventionsHealth systemAdolescent femalesEswatini MinistryTrialsFast trackBaseline dataMortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial
Chao A, Spiegelman D, Khan S, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Bärnighausen T, Okello V. Mortality under early access to antiretroviral therapy vs. Eswatini’s national standard of care: the MaxART clustered randomized stepped‐wedge trial. HIV Medicine 2020, 21: 429-440. PMID: 32458567, DOI: 10.1111/hiv.12876.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMortality rateDisease-related mortality rateCox proportional hazards modelCause mortality ratesStepped-wedge trialProportional hazards modelStepped-wedge designQuality of lifeEvidence of harmClinic transitionSecondary outcomesSOC participantsHealth clinicsLong-term consequencesImplementation trialHazards modelHIVStudy participantsMortalityHealth systemDecrease infectionEarly accessClinicTherapy