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  1. Article ; Online: Effectiveness of the BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years

    Sumayyah Ebrahim / Ntombifuthi Blose / Natasha Gloeck / Ameer Hohlfeld / Yusentha Balakrishna / Rudzani Muloiwa / Andy Gray / Andy Parrish / Karen Cohen / Ruth Lancaster / Tamara Kredo

    PLOS Global Public Health, Vol 3, Iss 12, p e

    A systematic review and meta-analysis.

    2023  Volume 0002676

    Abstract: A rapid systematic review, based on Cochrane rapid review methodology was conducted to assess the effectiveness of two 10μg doses of BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years. We ... ...

    Abstract A rapid systematic review, based on Cochrane rapid review methodology was conducted to assess the effectiveness of two 10μg doses of BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years. We searched the Cochrane Library COVID-19 study register, the COVID-NMA living review database and the McMaster University Living Evidence Synthesis for pre-appraised trials and observational studies up to 7 December 2022. Records were screened independently in duplicate. Where appraisal was not available, these were done in duplicate. Meta-analysis was conducted using RevMan 5.3 presenting risk ratios/odds ratios/inverse vaccine efficacy with 95% confidence intervals (CI). GRADE for assessing the overall certainty of the evidence was done in Gradepro. We screened 403 records and assessed 52 full-text articles for eligibility. One randomised controlled trial (RCT) and 24 observational studies were included. The RCT reported that BNT162b2 was likely safe and 91% efficacious, RR 0.09 (95% CI 0.03 to 0.32) against incident COVID-19 infection (moderate certainty evidence). In absolute terms, this is 19 fewer cases per 1,000 vaccines delivered (ranging from 15 to 21 fewer cases). Observational studies reported vaccine effectiveness (VE) against incident COVID-19 infection of 65% (OR 0.35, 95% CI 0.26 to 0.47) and 76% against hospitalisation (OR 0.24, 95% CI 0.13 to 0.42) (moderate certainty evidence). The absolute effect is 167 fewer cases per 1,000 vaccines given (ranging from 130 fewer to 196 fewer cases) and 4 fewer hospitalisations per 10,000 children (from 3 fewer to 5 fewer hospitalisations). Adverse events following vaccination with BNT162b2 were mild or moderate and transient. The evidence demonstrated a reduction in incident COVID-19 cases and small absolute reduction in hospitalisation if a two-dose BNT162b2 vaccine regimen is offered to children aged 5 to 11 years, compared to placebo. PROSPERO registration: CRD42021286710.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Effectiveness of the BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years

    Sumayyah Ebrahim / Ntombifuthi Blose / Natasha Gloeck / Ameer Hohlfeld / Yusentha Balakrishna / Rudzani Muloiwa / Andy Gray / Andy Parrish / Karen Cohen / Ruth Lancaster / Tamara Kredo

    PLOS Global Public Health, Vol 3, Iss

    A systematic review and meta-analysis

    2023  Volume 12

    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article ; Online: Conducting research in a resource-constrained environment

    Janine I. Munsamy / Andy Parrish / Gavin Steel

    Healthcare in Low-resource Settings, Vol 2, Iss

    avoiding the pitfalls

    2014  Volume 1

    Abstract: Practical challenges affected the conducting of a retrospective drug use evaluation (DUE) on the rational use of tenofovir in a resourceconstrained South African Antiretroviral Treatment Programme. The primary outcome measure was the percentage of ... ...

    Abstract Practical challenges affected the conducting of a retrospective drug use evaluation (DUE) on the rational use of tenofovir in a resourceconstrained South African Antiretroviral Treatment Programme. The primary outcome measure was the percentage of patient records compliant with DUE criteria using initiation prescriptions from March 2009 to February 2010. Health system challenges encountered included stringent institutional administrative procedures, lack of efficient communication channels, reliance on overburdened personnel and fear of audit. Forty percent (222 of 556) of patient records identified for inclusion in the study had to be excluded, mainly due to poor record keeping. Research budgetary constraints also limited data collection. This experience highlighted real, unforeseen challenges when conducting a retrospective study in a resource-constrained environment. A sound understanding of the environment and adequate preparation is recommended. The lessons learnt may prove valuable to both firsttime and experienced researchers in a resource-limited setting using a similar methodology.
    Keywords research ; challenges ; public health ; resource-constrained ; Public aspects of medicine ; RA1-1270
    Subject code 306
    Language English
    Publishing date 2014-03-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Implementing emergency department-based HIV testing in a low-resource setting

    Madeleine Whalen / Pamela Mda / Andy Parrish / Thomas C. Quinn / Richard Rothman / David Stead / Bhakti Hansoti

    Southern African Journal of HIV Medicine, Vol 19, Iss 1, Pp e1-e

    The value of a structured feasibility assessment tool

    2018  Volume 5

    Abstract: Introduction: HIV is a worldwide health problem with continuing high rates of new infections in many parts of the world. This lack of progress in decreasing overall incidence rates has sparked innovative HIV testing strategies, including expansion of ... ...

    Abstract Introduction: HIV is a worldwide health problem with continuing high rates of new infections in many parts of the world. This lack of progress in decreasing overall incidence rates has sparked innovative HIV testing strategies, including expansion of testing into the emergency department (ED) setting. Emergency departments have been shown to be high-yield testing venues in the United States and other developed world settings. The feasibility of expanding public health HIV services in the ED in limited-resource countries is unclear. Methods: We performed a cross-sectional feasibility assessment of a convenience sample of four hospitals in the Eastern Cape, South Africa. We administered three adapted interview tools from a previously field-tested survey instrument at each facility (total of 10 interviews) to gather an overview of the health facility, their HIV counselling and testing services, and their laboratory services. Results: All of the health facilities had access to basic commodities such as water and electricity. Many had severe human resource limitations and provided care to wide population catchment areas. In addition, there was little integration of HIV testing into current daily ED operations. Hospital staff identified numerous barriers to future ED testing efforts. Conclusions: Although control of the HIV epidemic requires innovative testing strategies and treatment, specific assessments are warranted on how to incorporate routine HIV testing into an acute care facility like the ED, which typically has many competing priorities. The use of a prospective structured tool incorporating both barriers and benefits can provide valuable field-tested guidance for increased programme planning for HIV testing.
    Keywords HIV ; emergency department ; Public aspects of medicine ; RA1-1270 ; Infectious and parasitic diseases ; RC109-216
    Subject code 360
    Language English
    Publishing date 2018-07-01T00:00:00Z
    Publisher AOSIS
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  5. Article ; Online: HIV testing in a South African Emergency Department

    Bhakti Hansoti / David Stead / Andy Parrish / Steven J Reynolds / Andrew D Redd / Madeleine M Whalen / Nomzamo Mvandaba / Thomas C Quinn

    PLoS ONE, Vol 13, Iss 3, p e

    A missed opportunity.

    2018  Volume 0193858

    Abstract: South Africa has the largest HIV epidemic in the world, with 19% of the global number of people living with HIV, 15% of new infections and 11% of AIDS-related deaths. Even though HIV testing is mandated in all hospital-based facilities in South Africa ( ... ...

    Abstract South Africa has the largest HIV epidemic in the world, with 19% of the global number of people living with HIV, 15% of new infections and 11% of AIDS-related deaths. Even though HIV testing is mandated in all hospital-based facilities in South Africa (SA), it is rarely implemented in the Emergency Department (ED). The ED provides episodic care to large volumes of undifferentiated who present with unplanned injury or illness. Thus, the ED may provide an opportunity to capture patients with undiagnosed HIV infection missed by clinic-based screening programs.In this prospective exploratory study, we implemented the National South African HIV testing guidelines (counselor initiated non-targeted universal screening with rapid point of care testing) for 24-hours a day at Frere Hospital in the Eastern Cape from September 1st to November 30th, 2016. The purpose of our study was to quantify the burden of undiagnosed HIV infection in a South African ED setting. Furthermore, we sought to evaluate the effectiveness of the nationally recommended HIV testing strategy in the ED. All patients who presented for care in the ED during the study period, and who were clinically stable and fully conscious, were eligible to be approached by HIV counseling and testing (HCT) staff to receive a rapid point-of-care HIV test. A total of 2355 of the 9583 (24.6%) patients who presented to the ED for care during the study period were approached by the HCT staff, of whom 1714 (72.8%) accepted HIV testing. There was a high uptake of HIV testing (78.6%) among a predominantly male (58%) patient group who mostly presented with traumatic injuries (70.8%). Four hundred (21.6%) patients were HIV positive, including 115 (6.2%) with newly diagnosed HIV infection. The overall prevalence of HIV infection was twice as high in females (29.8%) compared to males (15.4%). Both sexes had a similar prevalence of newly diagnosed HIV infection (6.0% for all females and 6.4% for all males) in the ED.Overall there was high HIV testing acceptance by ED patients. A ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 310
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  6. Article ; Online: Patient and provider attitudes to emergency department-based HIV counselling and testing in South Africa

    Bhakti Hansoti / Sarah E. Hill / Madeleine Whalen / David Stead / Andy Parrish / Richard Rothman / Yu-Hsiang Hsieh / Thomas C. Quinn

    Southern African Journal of HIV Medicine, Vol 18, Iss 1, Pp e1-e

    2017  Volume 7

    Abstract: Background: The national South African HIV Counselling and Testing (HCT) guidelines mandate that voluntary counselling and testing (VCT) should be offered in all healthcare facilities. Emergency departments (EDs) are at the forefront of many healthcare ... ...

    Abstract Background: The national South African HIV Counselling and Testing (HCT) guidelines mandate that voluntary counselling and testing (VCT) should be offered in all healthcare facilities. Emergency departments (EDs) are at the forefront of many healthcare facilities, yet VCT is not routinely implemented in this setting. Methods: We conducted a cross-sectional study that surveyed patients and healthcare providers at a tertiary care ED in the spring and summer of 2016 to ascertain their attitudes to VCT in the ED. We also used two previously validated survey instruments to gather data on patients’ HIV knowledge and providers’ stigma against patients living with HIV, as we anticipated that these may have an impact on providers’ and patients’ attitudes to the provision of HIV testing within the ED, and may offer insights for future intervention development. Results: A total of 104 patients and 26 providers were enrolled in the study. Overall, patients responded more favourably to ED-based HIV testing (92.3%) compared to providers (only 40% responded favourably). When asked about potential barriers to receiving or providing HIV testing, 16.4% of patients and 24% of providers felt that the subject of HIV was too sensitive and 58.7% of patients and 80% of providers indicated that privacy and confidentiality issues would pose major barriers to implementing ED-based HIV testing. Conclusion: This study shows that while ED-based HIV testing is overall highly acceptable to patients, providers seem less willing to provide this service. The survey data also suggest that future development of ED-based testing strategies should take into consideration privacy and confidentiality concerns that may arise within a busy emergency care setting. Furthermore, every effort should be made to tackle HIV stigma among providers to improve overall attitudes towards HIV-positive individuals that present for care in the ED.
    Keywords HIV/AIDS ; HIV Testing ; Emergency Department ; Public aspects of medicine ; RA1-1270 ; Infectious and parasitic diseases ; RC109-216
    Subject code 360
    Language English
    Publishing date 2017-05-01T00:00:00Z
    Publisher AOSIS
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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