Pregnancy incidence and correlates in a clinical trial preparedness study, North West Province South Africa.

Introduction: Women in HIV prevention trials often must typically agree to avoid pregnancy. Regardless, some become pregnant. Screening tools predicting pregnancy risk could maximize trial safety and efficiency.

Individualised motivational counselling to enhance adherence to antiretroviral therapy is not superior to didactic counselling in South African patients: findings of the CAPRISA 058 randomised controlled trial.

Concerns that standard didactic adherence counselling may be inadequate to maximise antiretroviral therapy (ART) adherence led us to evaluate more intensive individualised motivational adherence counselling. We randomised 297 HIV-positive ART-naïve patients in Durban, South Africa, to receive either didactic counselling, prior to ART initiation (n = 150), or an intensive motivational adherence intervention after initiating ART (n = 147). Study arms were similar for age (mean 35.

Effect of home-based interventions on virologic outcomes in adults receiving antiretroviral therapy in Africa: a meta-analysis.

Background: The success of adherence to combination antiretroviral therapy (ART) in sub-Saharan Africa is hampered by factors that are unique to this setting. Home based interventions have been identified as possible strategies for decentralizing ART care and improving access and adherence to ART. There is need for evidence at individual- or community-level of the benefits of home-based interventions in improving HIV suppression in African patients receiving ART.

Social trust, risk perceptions and public acceptance of recycled water: testing a social-psychological model.

Faced with a severe drought, the residents of the regional city of Toowoomba, in South East Queensland, Australia were asked to consider a potable wastewater reuse scheme to supplement drinking water supplies. As public risk perceptions and trust have been shown to be key factors in acceptance of potable reuse projects, this research developed and tested a social-psychological model of trust, risk perceptions and acceptance. Participants (N = 380) were surveyed a few weeks before a referendum was held in which residents voted against the controversial scheme.

High tuberculosis prevalence in a South African prison: the need for routine tuberculosis screening.

Background: Tuberculosis is a major health concern in prisons, particularly where HIV prevalence is high. Our objective was to determine the undiagnosed pulmonary tuberculosis ("undiagnosed tuberculosis") prevalence in a representative sample of prisoners in a South African prison. In addition we investigated risk factors for undiagnosed tuberculosis, to explore if screening strategies could be targeted to high risk groups, and, the performance of screening tools for tuberculosis.

A trial of mass isoniazid preventive therapy for tuberculosis control.

Background: Tuberculosis is epidemic among workers in South African gold mines. We evaluated an intervention to interrupt tuberculosis transmission by means of mass screening that was linked to treatment for active disease or latent infection.

Methods: In a cluster-randomized study, we designated 15 clusters with 78,744 miners as either intervention clusters (40,981 miners in 8 clusters) or control clusters (37,763 miners in 7 clusters).

Eligibility for isoniazid preventive therapy in South African gold mines.

Setting: The "Thibela TB" cluster randomised trial of community-wide isoniazid preventive therapy (IPT) to reduce tuberculosis incidence in the South African gold mines.

Objectives: To determine the proportion of participants eligible for IPT and the reasons and risk factors for ineligibility, to inform the scale-up of IPT.

Design: Cross-sectional survey of participants in intervention clusters (mine shafts) consenting to tuberculosis screening and assessment for eligibility to start IPT.

Body composition and bone mineral density of national football league players.

The purpose of the present study was to examine the body composition of National Football League (NFL) players before the start of the regular season. Four hundred eleven NFL players were measured for height, weight and lean, fat, and bone mass using dual-energy x-ray absorptiometry (DXA). Subjects were categorized by their offensive or defensive position for comparison.

Exploring the factors associated with youth homelessness and arrests.

Problem: The high rate of arrests among homeless youths has stimulated a growing interest in uncovering the factors associated with police involvement in this population. This study explored external factors related to their arrests.

Method: This secondary analysis involved 186 homeless youths.

Preventive therapy for child contacts of multidrug-resistant tuberculosis: a prospective cohort study.

Background: Evidence is limited to guide the management of children exposed to multidrug-resistant (MDR) tuberculosis. We aimed to study the tolerability and toxicity of a standard preventive therapy regimen given to children exposed to infectious MDR tuberculosis, and explore risk factors for poor outcome.

Methods: In this prospective cohort study in the Western Cape, South Africa, children <5 years of age, or human immunodeficiency virus (HIV)-positive children aged <15 years, were recruited from May 2010 through April 2011 if exposed to an ofloxacin-susceptible, MDR tuberculosis source case.

Risk factors for infection and disease in child contacts of multidrug-resistant tuberculosis: a cross-sectional study.

Background: Young children exposed to Mycobacterium tuberculosis have a high risk of disease progression following infection. This study aimed to determine risk factors for M. tuberculosis infection and disease in children following exposure to adults with multidrug-resistant (MDR) tuberculosis (TB).

Viral suppression following switch to second-line antiretroviral therapy: associations with nucleoside reverse transcriptase inhibitor resistance and subtherapeutic drug concentrations prior to switch.

Background: High rates of second-line antiretroviral treatment (ART) failure are reported. The association with resistance and nonadherence on switching to second-line ART requires clarification.

Methods: Using prospectively collected data from patients in South Africa, we constructed a cohort of patients switched to second-line ART (1 January 2003 through 31 December 2008).

Modulation of NKG2D expression in human CD8(+) T cells corresponding with tuberculosis drug cure.

Background: Biomarkers predicting tuberculosis treatment response and cure would facilitate drug development. This study investigated expression patterns of the co-stimulation molecule NKG2D in human tuberculosis and treatment to determine its potential usefulness as a host biomarker of tuberculosis drug efficacy.

Methods: Tuberculosis patients (n = 26) were recruited in Lahore, Pakistan, at diagnosis and followed up during treatment.

Effect of household and community interventions on the burden of tuberculosis in southern Africa: the ZAMSTAR community-randomised trial.

Background: Southern Africa has had an unprecedented increase in the burden of tuberculosis, driven by the HIV epidemic. The Zambia, South Africa Tuberculosis and AIDS Reduction (ZAMSTAR) trial examined two public health interventions that aimed to reduce the burden of tuberculosis by facilitating either rapid sputum diagnosis or integrating tuberculosis and HIV services within the community.

Methods: ZAMSTAR was a community-randomised trial done in Zambia and the Western Cape province of South Africa.

Resistance to tenofovir-based regimens during treatment failure of subtype C HIV-1 in South Africa.

Background: Tenofovir disoproxil fumarate (TDF) is increasingly available for patients infected with subtype C HIV-1. This subtype is reported to develop the principal TDF resistance mutation in the HIV reverse transcriptase, K65R, with greater propensity than other subtypes. We sought to describe K65R development during TDF use in a cohort of patients infected with subtype C HIV.

An evaluation of culture results during treatment for tuberculosis as surrogate endpoints for treatment failure and relapse.

It is widely acknowledged that new regimens are urgently needed for the treatment of tuberculosis. The primary endpoint in the Phase III trials is a composite outcome of failure at the end of treatment or relapse after stopping treatment. Such trials are usually both long and expensive.

Mortality associated with delays between clinic entry and ART initiation in resource-limited settings: results of a transition-state model.

Objective: To estimate the mortality impact of delay in antiretroviral therapy (ART) initiation from the time of entry into care.

Design: A state-transition Markov process model. This technique allows for assessing mortality before and after ART initiation associated with delays in ART initiation among a general population of ART-eligible patients without conducting a randomized trial.

The measurement of household socio-economic position in tuberculosis prevalence surveys: a sensitivity analysis.

Objective: To assess the robustness of socio-economic inequalities in tuberculosis (TB) prevalence surveys.

Design: Data were drawn from the TB prevalence survey conducted in Lusaka Province, Zambia, in 2005-2006. We compared TB socio-economic inequalities measured through an asset-based index (Index 0) using principal component analysis (PCA) with those observed using three alternative indices: Index 1 and Index 2 accounted respectively for the biases resulting from the inclusion of urban assets and food-related variables in Index 0.

Spectrum of non-tuberculous mycobacteria identified using standard biochemical testing vs. 16S sequencing.

Non-tuberculous mycobacterial isolates from gold miners were speciated using standard biochemical testing (SBT) and 16S rDNA sequencing. Of 237 isolates tested, SBT identified 126, compared with all 237 identified using sequencing. Of 111 isolates unspeciated by SBT but identified by sequencing, 38 (34.

"Proof-of-concept" evaluation of an automated sputum smear microscopy system for tuberculosis diagnosis.

Background: "TBDx" is an innovative smear microscopy system that automatically loads slides onto a microscope, focuses and digitally captures images and then classifies smears as positive or negative using computerised algorithms.

Objectives: To determine the diagnostic accuracy of TBDx, using culture as the gold standard, and compare this to a microscopist's diagnostic performance.

Methods: This study is nested within a cross-sectional study of tuberculosis suspects from South African gold mines.

An experimental test of voluntary strategies to promote urban water demand management.

In light of the current and future threats to global water security the current research focuses on trialing interventions to promote urban water conservation. We report an experimental study designed to test the long-term impact of three different interventions on household water consumption in South East Queensland. Participants from 221 households were recruited and completed an initial survey, and their houses were fitted with smart water meters which measured total water usage at 5 s intervals.

Energizing and de-motivating effects of norm-conflict.

Norms have a pervasive influence on behavior, yet previous research has not addressed that people often face conflicting norms from multiple ingroups. The current research addresses this gap in the context of proenvironmental behavior and demonstrates two effects predicted by the novel theoretical position we offer: People can be de-motivated by norm-conflict, or conversely, norm-conflict can encourage people to take action. Studies 1 and 2 demonstrated that norm-conflict is associated with increased perceived effectiveness for those with positive attitudes to the issue and reduced perceived effectiveness for those with moderate attitudes, and effectiveness perceptions mediated an indirect effect on behavioral intentions.

Decentralised care for the management of child contacts of multidrug-resistant tuberculosis.

Setting: Cape Town, South Africa.

Objective: To determine the number of multidrug-resistant tuberculosis (MDR-TB) child contacts routinely identified by health services, and whether a model of decentralised care improves access.

Methods: All MDR-TB source cases registered in Cape Town from April 2010 to March 2011 were included.