Publications by authors named "Pillay D"

Modifying the food environment holds promise for instilling healthier behaviours in children and may be an effective public health strategy for preventing childhood obesity and adverse health outcomes. The school food environment is a valuable setting to influence most children's dietary behaviours from an early age, yet evidence suggests that the New Zealand and Australian school food environment is not conducive to healthy food and drink consumption. The present study aimed to investigate the level of compliance in New Zealand and Australia with government guidelines for food and drink availability within schools and the subsequent effect on food consumption and purchasing behaviours of children.

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Anthropogenic pressures are increasing in coastal ecosystems globally, yet identifying robust indicators of change and managing coastal resources can be complicated by phenotypic plasticity and differential life-history responses of key organisms. We illustrate this using biogeochemical and sandprawn (Kraussillichirus kraussi) response metrics along a human recreation gradient (trampling, sandprawn harvesting) in a South African lagoonal ecosystem. Benthic compaction, oxygen depletion and high porewater ammonia concentrations were associated with greatest recreation intensity.

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Article Synopsis
  • - The study addresses the rising incidence of sexually transmitted infections (STIs) among young people and aims to improve knowledge and prevention strategies through a gamified training intervention for primary care professionals using an online video game called SEXIT.
  • - A multicentre cluster randomized controlled trial will compare groups of primary care professionals who use the game with control groups not using it, measuring knowledge and clinical management of STIs before and after the intervention over six months.
  • - The researchers anticipate that the intervention will lead to significant improvements in knowledge and clinical behaviors related to STIs, ultimately developing an engaging educational tool on sexuality and violence prevention.
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Intrauterine alcohol exposure delays bone maturation and intensifies osteoporosis and fracture risk. As most studies emphasize the neurological aspects of intrauterine alcohol exposure, there is a lack of research on the implications pertaining to osseous tissue. Previous studies investigated these effects in fetuses, with limited studies on postnatal life.

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Background: Tenofovir/lamivudine/dolutegravir (TLD) is the preferred first-line antiretroviral therapy (ART) regimen for people with HIV (PWH), including those who were previously virologically suppressed on nonnucleoside reverse transcriptase inhibitors (NNRTIs). We sought to estimate the real-world effectiveness of the TLD transition in Ugandan public-sector clinics.

Methods: We conducted a prospective cohort study of PWH aged ≥18 years who were transitioned from NNRTI-based ART to TLD.

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Article Synopsis
  • Expanded antiretroviral therapy (ART) in South Africa has not eliminated HIV-1 transmission, which is concerning despite new treatment options like integrase strand transfer inhibitors (INSTIs) and long-acting injectables.
  • A community-based study in rural KwaZulu-Natal enrolled 18,025 individuals to analyze HIV-1 drug resistance and identify transmission networks, revealing that one-third were HIV-positive and that 62.1% of those with detectable viral loads had never received ART.
  • While resistance to older drugs was found, INSTI resistance was low, though there was notable concern over resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) in ART-naïve individuals; findings highlight the need
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Background: People with HIV (PWH) on integrase inhibitor-based regimens may be at risk of excess weight gain, but it is unclear if this risk is consistent across settings. We assessed weight change over 48 weeks among PWH who were transitioned to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD).

Design: We conducted a prospective cohort study at public-sector HIV clinics in Uganda and South Africa.

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Health-related quality of life (HRQoL) assesses the perceived impact of health status across life domains. Although research has explored the relationship between specific conditions, including HIV, and HRQoL in low-resource settings, less attention has been paid to the association between multimorbidity and HRQoL. In a secondary analysis of cross-sectional data from the Vukuzazi ("Wake up and know ourselves" in isiZulu) study, which identified the prevalence and overlap of non-communicable and infectious diseases in the uMkhanyakunde district of KwaZulu-Natal, we (1) evaluated the impact of multimorbidity on HRQoL; (2) determined the relative associations among infectious diseases, non-communicable diseases (NCDs), and HRQoL; and (3) examined the effects of controlled versus non-controlled disease on HRQoL.

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Aims: This qualitative study aimed to develop the first cognitive behavioural (CBT) model outlining the development and maintenance of disordered eating in adult men living with Type 1 diabetes to improve on previous theoretical models of Type 1 diabetes and disordered eating and to draw comparisons to women with Type 1 diabetes and disordered eating.

Methods: Twenty-seven men (n = 16 with Type 1 diabetes and disordered eating, n = 11 with Type 1 diabetes without disordered eating) participated in semi-structured interviews. Data were analysed using thematic analysis and individual CBT formulations were developed for each participant to inform the model.

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This paper describes the protocol to test the feasibility of the Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY) intervention. STEADY is a novel complex intervention for people with type 1 diabetes and disordered eating (T1DE) of mild to moderate severity. The STEADY intervention integrates cognitive behavioural therapy (CBT) with diabetes education, and was developed using Experience-Based Co-Design.

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Introduction: intrauterine alcohol exposure has adverse health effects on the offspring, which may result in fetal Alcohol Spectrum Disorders (FASD). The neurological and craniofacial aspects have been well studied; however, long bones have received limited attention despite the short stature reported in FASD children.

Methods: time-mated (n=13) pregnant Sprague Dawley dams were assigned to either the ethanol (n=5), saline control (n=5) or untreated group (n=3) which received no treatment.

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Background: Automated haematology analysers such as the Sysmex XN-3000 (Sysmex Corporation, Kobe, Japan) utilise white blood cell (WBC) flags to identify quantitative and qualitative abnormalities. Owing to clinical and biological factors, the sensitivity and specificity of the flags vary when compared to microscopy, the gold-standard method for assessing peripheral blood smear (PBS) morphology.

Objective: This study assessed the performance of the Sysmex XN-3000 haematology analyser in comparison to PBS microscopy for the detection of WBC abnormalities.

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Article Synopsis
  • Despite increased access to HIV treatment in South Africa, new HIV-1 infections are still widespread, prompting a need for more effective therapies like long-acting injectables.
  • A community-based study conducted in KwaZulu-Natal found that out of over 18,000 participants, nearly one-third tested positive for HIV, with significant pre-existing drug resistance observed among treated individuals.
  • The study highlighted the urgency of understanding drug resistance and transmission networks to improve interventions, particularly as certain mutations could limit the effectiveness of new treatment options.
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Background: Seagrass meadows provide valuable ecosystem services but are threatened by global change pressures, and there is growing concern that the functions seagrasses perform within an ecosystem will be reduced or lost without intervention. Restoration has become an integral part of coastal management in response to major seagrass declines, but is often context dependent, requiring an assessment of methods to maximise restoration success. Here we investigate the use of different restoration strategies for the endangered in South Africa.

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Identifying processes that confer resilience against global change is a scientific challenge but is central to managing ecosystem functionality in future. Detecting resilience-enhancing mechanisms is especially relevant in coastal ecosystems, where multi-stressor interactions can drive degradation over time. Here, we quantify the resilience-conferring potential of endobenthic sandprawns against eutrophication, including under high temperatures.

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Article Synopsis
  • A study investigated preferences for STI diagnosis and treatment among HIV PrEP users in South Africa, finding that most participants preferred self-sampling and same-day treatment over traditional methods.
  • The research involved a survey conducted with 496 individuals aged 18-49, primarily female and under 30, analyzing their preferences using discrete choice experiments.
  • Results showed two distinct groups: one with a strong preference for self-sampling and expedited partner treatment, and another group with a lower preference for self-sampling but favoring healthcare professional-initiated partner notification.
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 • Human immunodeficiency virus (HIV) drug resistance has implications for antiretroviral treatment strategies and for containing the HIV pandemic because the development of HIV drug resistance leads to the requirement for antiretroviral drugs that may be less effective, less well-tolerated, and more expensive than those used in first-line regimens.  • HIV drug resistance studies are designed to determine which HIV mutations are selected by antiretroviral drugs and, in turn, how these mutations affect antiretroviral drug susceptibility and response to future antiretroviral treatment regimens.  • Such studies collectively form a vital knowledge base essential for monitoring global HIV drug resistance trends, interpreting HIV genotypic tests, and updating HIV treatment guidelines.

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Introduction: In acquired hemophilia A (AHA), the body produces auto-antibodies against Factor VIII. Although AHA is rare, with an incidence of 1.5 patients/1 million population/year, there is a strong association with human immunodeficiency virus (HIV) infection.

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Issue Addressed: Unhealthy food and drinks are widely available in New Zealand school canteens. The aim of this study was to assess primary school canteen food menus against the newly implemented Ministry of Health 'Food and Drink Guidance for Schools'.

Methods: A convenience sample of 133 primary school canteen menus was collected in 2020 as part of the baseline evaluation of the Healthy Active Learning initiative across New Zealand.

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Background: The convergence of infectious diseases and non-communicable diseases in South Africa is challenging to health systems. In this analysis, we assessed the multimorbidity health needs of individuals and communities in rural KwaZulu-Natal and established a framework to quantify met and unmet health needs for individuals living with infectious and non-communicable diseases.

Methods: We analysed data collected between May 25, 2018, and March 13, 2020, from participants of a large, community-based, cross-sectional multimorbidity survey (Vukuzazi) that offered community-based HIV, hypertension, and diabetes screening to all residents aged 15 years or older in a surveillance area in the uMkhanyakude district in KwaZulu-Natal, South Africa.

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Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with HIV (PLHIV).

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Objective: To investigate the effect of exposure to MTV Shuga:Down South' (MTVShuga-DS) during the scale-up of combination HIV-prevention interventions on awareness and uptake of sexual reproductive health (SRH) and HIV-prevention services by adolescent girls and young women (AGYW).

Design: One longitudinal and three cross-sectional surveys of representative samples of AGYW.

Setting: AGYW in four South African districts with high HIV prevalence (>10%) (May 2017 and September 2019).

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Non-communicable diseases (NCDs) account for half of all deaths in South Africa, partly reflecting unmet NCDs healthcare needs. Leveraging existing HIV infrastructure is touted as a strategy to alleviate this chronic care gap. We evaluated whether HIV care platforms are associated with improved NCDs care.

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Background: Timely linkage to care and ART initiation is critical to decrease the risks of HIV-related morbidity, mortality and HIV transmission, but is often challenging. We report on the implementation and effectiveness of a linkage-to-care intervention in rural KwaZulu-Natal, South Africa.

Methods: In the ANRS 12249 TasP trial on Universal Testing and Treatment (UTT) implemented between 2012-2016, resident individuals ≥16 years were offered home-based HIV testing every six months.

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Background: The recommendation for coagulation blood samples is to centrifuge at 4000 revolutions per minute (rpm) for 15 min to produce platelet-poor plasma before analysis. Rapid centrifugation, defined as centrifuging samples at higher speeds for shorter durations, could potentially reduce turn-around times (TAT), provided sample integrity is maintained.

Objective: This study assessed the impact of rapid centrifugation on routine coagulation assay results.

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