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Article ; Online: The ambiguities of the 'partnership' between civil society and the state in Uganda's AIDS response during the 1990s and 2000s as demonstrated in the development of TASO.

Grebe, Eduard

2016 Volume 11, Issue 4, Page(s) 496–512

Abstract: This article critically investigates state-civil society relations in the Ugandan AIDS response by tracing the history of Uganda's 'multisectoral' and 'partnership' approaches, particularly as it pertains to The AIDS Support Organisation (TASO). It finds ...

Abstract	This article critically investigates state-civil society relations in the Ugandan AIDS response by tracing the history of Uganda's 'multisectoral' and 'partnership' approaches, particularly as it pertains to The AIDS Support Organisation (TASO). It finds that the Ugandan government's reputation for good leadership on AIDS is more ambiguous than commonly supposed and that the much-vaunted 'partnership' approach has not enabled strong critical civil society voices to emerge or prevented the harmful impact of a socially conservative agenda. By the 1990s, TASO had become the most important provider of medical and psychosocial support services to HIV/AIDS patients, but was less effective in influencing policy or holding the state accountable (because the political context prevented a more activist stance). The effectiveness of civil society has been constrained by an authoritarian political culture and institutions that discourage vocal criticism. Despite these limitations, however, state-civil society partnership did contribute to the emergence of a relatively effective coalition for action against HIV/AIDS. Donors were essential in encouraging the emergence of this coalition.
MeSH term(s)	Acquired Immunodeficiency Syndrome/epidemiology ; Acquired Immunodeficiency Syndrome/prevention & control ; Health Policy ; Humans ; International Agencies/organization & administration ; International Cooperation ; Leadership ; Organizational Objectives ; Politics ; Uganda/epidemiology
Language	English
Publishing date	2016
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2234129-8
ISSN	1744-1706 ; 1744-1692
ISSN (online)	1744-1706
ISSN	1744-1692
DOI	10.1080/17441692.2015.1062121
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The impact of non-disclosure of HIV status and antiretroviral therapy on HIV recency testing and incidence algorithms.

van den Berg, Karin / Murphy, Edward L / Maartens, Gary / Louw, Vernon J / Grebe, Eduard

Vox sanguinis

2024

Abstract: Background and objectives: Accurate HIV incidence estimates among blood donors are necessary to assess the effectiveness of programs aimed at limiting transfusion-transmitted HIV. We assessed the impact of undisclosed HIV status and antiretroviral (ARV) ...

Abstract	Background and objectives: Accurate HIV incidence estimates among blood donors are necessary to assess the effectiveness of programs aimed at limiting transfusion-transmitted HIV. We assessed the impact of undisclosed HIV status and antiretroviral (ARV) use on HIV recency and incidence estimates using increasingly comprehensive recent infection testing algorithms. Materials and methods: Using 2017 donation data from first-time and lapsed donors, we populated four HIV recency algorithms: (1) serology and limiting-antigen avidity testing, (2) with individual donation nucleic amplification testing (ID-NAT) added to Algorithm 1, (3) with viral load added to Algorithm 2 and (4) with ARV testing added to Algorithm 3. Algorithm-specific mean durations of recent infection (MDRI) and false recency rates (FRR) were calculated and used to derive and compare incidence estimates. Results: Compared with Algorithm 4, progressive algorithms misclassified fewer donors as recent: Algorithm 1: 61 (12.1%); Algorithm 2: 14 (2.8%) and Algorithm 3: 3 (0.6%). Algorithm-specific MDRI and FRR values resulted in marginally lower incidence estimates: Algorithm 1: 0.19% per annum (p.a.) (95% confidence interval [CI]: 0.13%-0.26%); Algorithm 2: 0.18% p.a. (95% CI: 0.13%-0.22%); Algorithm 3: 0.17% p.a. (95% CI: 0.13%-0.22%) and Algorithm 4: 0.17% p.a. (95% CI: 0.13%-0.21%). Conclusion: We confirmed significant misclassification of recent HIV cases when not including viral load and ARV testing. Context-specific MDRI and FRR resulted in progressively lower incidence estimates but did not fully account for the context-specific variability in incidence modelling. The inclusion of ARV testing, in addition to viral load and ID-NAT testing, did not have a significant impact on incidence estimates.
Language	English
Publishing date	2024-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	80313-3
ISSN	1423-0410 ; 0042-9007
ISSN (online)	1423-0410
ISSN	0042-9007
DOI	10.1111/vox.13627
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Article ; Online: Quantitative interpretation of Sedia LAg Assay test results after HIV diagnosis.

Sempa, Joseph B / Grebe, Eduard / Welte, Alex

PloS one

2022 Volume 17, Issue 7, Page(s) e0271763

Abstract: Background: Testing for 'recent HIV infection' is common in surveillance, where only population-level estimates (of incidence) are reported. Typically, 'recent infection' is a category, obtained by applying a threshold on an underlying continuous ... ...

Abstract	Background: Testing for 'recent HIV infection' is common in surveillance, where only population-level estimates (of incidence) are reported. Typically, 'recent infection' is a category, obtained by applying a threshold on an underlying continuous biomarker from some laboratory assay(s). Interpreting the biomarker values obtained for individual subjects, as estimates of the date of infection, has obvious potential applications in the context of studies of early infection, and has also for some years attracted significant interest as an extra component of post-test counselling and treatment initiation. The applicable analyses have typically run aground on the complexity of the full biomarker growth model, which is in principle a non-linear mixed-effects model of unknown structure, the fitting of which seems infeasible from realistically obtainable data. Methods: It is known that to estimate Mean Duration of Recent Infection (MDRI) at a given value of the recent/non-recent -infection discrimination threshold, one may compress the full biomarker growth model into a relation capturing the probability of a recent test result as a function of time t since infection, given a value of assay threshold h which defines the recent/non-recent discrimination. We demonstrate that the derivative (gradient), with respect to h. of the probability of recent infection, seen as a function of both t and h, is identical to the formal likelihood relevant to Bayesian inference of the time since seroconversion, for a subject yielding an assay result h, at or close to the date of their first positive HIV test. This observation bypasses the need for fitting a complex detailed biomarker growth model. Using publicly available data from the CEPHIA collaboration, we calibrated this likelihood function for the Sedia Lag assay, and performed Bayesian inference on hypothetical infection data. Results: We demonstrate the generation of posteriors for infection date, for patients with various delays between their last negative and first positive HIV test, and a range of LAg assay results (ODn) hypothetically obtained on the date of the first positive result. Conclusion: Depending on the last-negative / first-positive interval, there is a range of ODn values that yields posteriors significantly different from the uniform prior one would be left with based merely on interval censoring. Hence, a LAg ODn obtained on the date of, or soon after, diagnosis contains potentially significant information about infection dating. It seems worth analysing other assays with meaningful dynamic range, especially tests already routinely used in primary HIV diagnosis (for example chemiluminescent assays and reader/cartridge lateral flow tests which admit objective variable line intensity readings) which have a sufficient dynamic range that corresponds to a clinically meaningful range of times-since-infection that are worth distinguishing from each other.
MeSH term(s)	Bayes Theorem ; Biomarkers ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Testing ; Humans ; Incidence
Chemical Substances	Biomarkers
Language	English
Publishing date	2022-07-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0271763
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Article ; Online: Clinical Protection During the First Omicron Wave in Unvaccinated, Convalescent US Adults.

Stone, Mars / Grebe, Eduard / Busch, Michael P

JAMA

2022 Volume 328, Issue 2, Page(s) 212

Language	English
Publishing date	2022-07-12
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.10332
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Article ; Online: Factors driving availability of COVID-19 convalescent plasma: Insights from a demand, production, and supply model.

Russell, W Alton / Grebe, Eduard / Custer, Brian

Transfusion

2021 Volume 61, Issue 5, Page(s) 1370–1376

Abstract: Background: COVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs.: Methods: We developed a detailed simulation model of CCP donor recruitment, ... ...

Abstract	Background: COVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs. Methods: We developed a detailed simulation model of CCP donor recruitment, collection, production, and distribution processes. We ran our model using varying epidemic trajectories from 11 U.S. states and with key input parameters drawn from wide ranges of plausible values to identify key drivers of ability to scale collections capacity and meet demand for CCP. Results: Utilization of available CCP collections capacity followed increases in COVID-19 hospital discharges with a lag. Utilization never exceeded 75% of available capacity in most simulations. Demand was met for most of the simulation period in most simulations, but a substantial portion of demand went unmet during early, sharp increases in hospitalizations. For epidemic trajectories that included multiple epidemic peaks, second wave demand could generally be met due to stockpiles established during the decline from an earlier peak. Apheresis machine capacity (number of machines) and probability that COVID-19 recovered individuals are willing to donate were the most important supply-side drivers of ability to meet demand. Recruitment capacity was important in states with early peaks. Conclusions: Epidemic trajectory was the most important determinant of ability to meet demand for CCP, although our simulations revealed several contributing operational drivers of CCP program success.
MeSH term(s)	Antibodies, Viral/blood ; Antibodies, Viral/therapeutic use ; Blood Donors ; COVID-19/blood ; COVID-19/therapy ; Convalescence ; Humans ; Immunization, Passive ; Models, Biological ; SARS-CoV-2/metabolism
Chemical Substances	Antibodies, Viral
Language	English
Publishing date	2021-02-16
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/trf.16317
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Article ; Online: Evidence of HIV incidence reduction in young women, but not in adolescent girls, in KwaZulu-Natal, South Africa.

Mhlanga, Laurette / Welte, Alex / Grebe, Eduard / Ohler, Liesbet / Van Cutsem, Gilles / Huerga, Helena / Conan, Nolwenn

IJID regions

2023 Volume 8, Page(s) 111–117

Abstract: Objectives: We estimated changes in the HIV incidence from 2013-2018 in Eshowe/Mbongolwane, KwaZulu-Natal, South Africa where Médecins Sans Frontières is engaged in providing HIV testing and care since 2011.: Methods: Using data from two cross- ... ...

Abstract	Objectives: We estimated changes in the HIV incidence from 2013-2018 in Eshowe/Mbongolwane, KwaZulu-Natal, South Africa where Médecins Sans Frontières is engaged in providing HIV testing and care since 2011. Methods: Using data from two cross-sectional household-based surveys conducted in 2013 and 2018, with consenting participants aged 15-59 years, we applied the incidence estimation frameworks of Mahiane et al and Kassanjee et al. Results: In total, 5599 (62.4% women) and 3276 (65.9% women) individuals were included in 2013 and 2018, respectively. We found a mean incidence in women aged 20-29 years of 2.71 cases per 100 person-years (95% confidence interval [CI]: 1.23;4.19) in 2013 and 0.4 cases per 100 person-years (95% CI: 0.0;1.5) in 2018. The incidence in men aged 20-29 years was 1.91 cases per 100 person-years (95% CI: 0.87; 2.93) in 2013 and 0.53 cases per 100 person-years (95% CI: 0.0; 1.4) in 2018. The incidence decline among women aged 15-19 was -0.34 cases per 100 person-years (95% CI: -1.31;0.64). Conclusions: The lack of evidence of incidence decline among adolescent girls is noteworthy and disconcerting. Our findings suggest that large-scale surveys should seriously consider focusing their resources on the core group of women aged 15-19 years.
Language	English
Publishing date	2023-07-13
Publishing country	England
Document type	Journal Article
ISSN	2772-7076
ISSN (online)	2772-7076
DOI	10.1016/j.ijregi.2023.07.004
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Article ; Online: Associations of Temporal Cardiometabolic Patterns and Incident SARS-CoV-2 Infection Among U.S. Blood Donors With Serologic Evidence of Vaccination.

Yu, Elaine A / Stone, Mars / Bravo, Marjorie D / Grebe, Eduard / Bruhn, Roberta L / Lanteri, Marion C / Townsend, Mary / Kamel, Hany / Jones, Jefferson M / Busch, Michael P / Custer, Brian

AJPM focus

2024 Volume 3, Issue 2, Page(s) 100186

Abstract: Introduction: Cardiometabolic diseases are associated with greater COVID-19 severity; however, the influences of cardiometabolic health on SARS-CoV-2 infections after vaccination remain unclear. Our objective was to investigate the associations between ... ...

Abstract	Introduction: Cardiometabolic diseases are associated with greater COVID-19 severity; however, the influences of cardiometabolic health on SARS-CoV-2 infections after vaccination remain unclear. Our objective was to investigate the associations between temporal blood pressure and total cholesterol patterns and incident SARS-CoV-2 infections among those with serologic evidence of vaccination. Methods: In this prospective cohort of blood donors, blood samples were collected in 2020-2021 and assayed for binding antibodies of SARS-CoV-2 nucleocapsid protein antibody seropositivity. We categorized participants into intraindividual pattern subgroups of blood pressure and total cholesterol (persistently, intermittently, or not elevated [systolic blood pressure <130 mmHg, diastolic blood pressure <80 mmHg, total cholesterol <200 mg/dL]) across the study time points. Results: Among 13,930 donors with 39,736 donations representing 1,127,071 person-days, there were 221 incident SARS-CoV-2 infections among those with serologic evidence of vaccination (1.6%). Intermittent hypertension was associated with greater SARS-CoV-2 infections among those with serologic evidence of vaccination risk (adjusted incidence rate ratio=2.07; 95% CI=1.44, 2.96; Conclusions: Our findings underscore that the benefits of cardiometabolic health, particularly blood pressure, include a lower risk of SARS-CoV-2 infection after vaccination.
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Journal Article
ISSN	2773-0654
ISSN (online)	2773-0654
DOI	10.1016/j.focus.2024.100186
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Article ; Online: Factors driving availability of COVID-19 convalescent plasma: Insights from a demand, production and supply model

Russell, W. Alton / Grebe, Eduard / Custer, Brian

medRxiv

Abstract: Background: COVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs. Methods: We developed a detailed simulation model of CCP donor recruitment, collection, ... ...

Abstract	Background: COVID-19 Convalescent Plasma (CCP) is a promising treatment for COVID-19. Blood collectors have rapidly scaled up collection and distribution programs. Methods: We developed a detailed simulation model of CCP donor recruitment, collection, production and distribution processes. Simulations based on epidemics in 11 U.S. states, in which key parameters were varied over wide ranges, allowed identification of the drivers of ability to calibrate collections capacity and ability to meet demand for CCP. Results: Changes in collection capacity utilization lagged increases and decreases in COVID-19 hospital discharges, and never exceeded 75% in most simulations. Demand could be met for most of the simulation period in most simulations, but in states with early sharp increases in hospitalizations a substantial portion of demand went unmet during these early peaks. Modeled second wave demand could generally be met with stockpiles established during first epidemic peaks. Apheresis machine capacity (number of machines) and probability that COVID-19 recovered individuals are willing to donate were the most important supply-side drivers of ability to meet demand. Recruitment capacity was important in states with early peaks. Conclusions: Epidemic trajectory was the most important determinant of ability to meet demand for CCP, although our simulations revealed several contributing operational drivers of CCP program success.
Keywords	covid19
Language	English
Publishing date	2020-10-27
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.10.25.20219170
Database	COVID19

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Article: Projecting COVID-19 Convalescent Plasma Production, Supply, and Demand During an Epidemic

Russell, W. Alton / Grebe, Eduard / Custer, Brian

Transfusion

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #838390
Database	COVID19

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Book ; Online: COVID-19 Convalescent Plasma Model

Grebe, Eduard / Russell, W. Alton / Custer, Brian

2020

Abstract: This tool was developed by researchers at Vitalant Research Institute to model COVID-19 Convalescent Plasama collection and distribution to inform policy and operations. The model has two main components, an agent-based microsimulation used to simulate ... ...

Abstract	This tool was developed by researchers at Vitalant Research Institute to model COVID-19 Convalescent Plasama collection and distribution to inform policy and operations. The model has two main components, an agent-based microsimulation used to simulate the donor recruitment and collection process, and a linked production and demand model to project CCP release, distribution and inventory. The model utilizes estimates and projections of COVID-19 patients discharged from hospital supplied by an external epidemic model to create agents that can be recruited as CCP donors. New hospital admissions from the same epidemic model are used to inform the CCP demand model.
Keywords	covid19
Publishing date	2020-10-13
Publishing country	eu
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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