Browsing by Author "Ncayiyana, Jabulani"

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    Open Access
    Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis
    (2019) Kosmas, Petrus Ndiiluka; Ncayiyana, Jabulani; Engel, Mark E.
    Background: There is a dearth of information regarding prevalence of extensively drugresistant tuberculosis (XDR-TB) in Africa. Although countries in Africa conduct national tuberculosis surveys on a regular basis, this information has not been systematically reviewed to ascertain the overall prevalence of XDR-TB in Africa. Methods: The study aimed to perform a systematic review and meta-analysis of the prevalence and factors associated with prevalence of pulmonary XDR-TB among adults in Africa. Eligible studies, published between 2006 and 2018, were sourced from various electronic databases including PubMed, Scopus, and Web of Science. Meta-analysis was performed using STATA (version 14.2) statistical software. The protocol of this review was registered with PROSPERO, reg No CRD42018117037. Result: A total of 6242 records were retrieved. Forty-eight studies were screened for eligibility and seven, which varied in terms of country setting and study design, were included. The prevalence of XDR-TB is 4% (95%CI 2-7) among participants tested for second-line anti-TB drug resistance, and 3% (95%1-6) among participants with drug resistant TB. The prevalence of XDR-TB was 7% (95%CI 1-18) among participants with MDR-TB. A few studies reported on the factors associated with the prevalence of XDR-TB. Discussion: The reported prevalence of XDR-TB among participants tested for second-line anti-TB drug resistance is low compared to WHO estimates. The systematic review underscores a dearth of studies depicting the reality regarding the prevalence of XDR-TB in Africa. Policymakers and stakeholders interested in drug-resistant TB should apply prudence when considering XDR-TB prevalence reported for Africa.
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    Spatial Patterns and Correlates of Lower Respiratory Tract Illnesses in Children from Drakenstein, Western Cape
    (2022) Bhenxa, Namhla; Brittain, Kirsty; Ncayiyana, Jabulani; Zar, Heather J
    Background: Lower respiratory tract infections (LRTIs) in children under 5 years of age are a major public health concern globally with high proportions of cases occurring in low- and middle-income countries. However, little is known about the spatial variation of LRTIs especially in developing countries such as South Africa. This study aimed to explore and map the spatial dependence and clustering of childhood pneumonia and wheeze and to identify factors associated with these diseases in two communities of the Western Cape province in South Africa. Methods: This analysis used case-control data from the Drakenstein Child Health Study. Cases were children who developed pneumonia or wheeze, and controls were incidence density matched on date of birth, age, and enrolment site. Smooth maps were created using Kernel density estimation and cluster analysis was performed using Ripley's K function and Kullddorf spatial scan statistics. Finally, generalized additive models were used to identify socio-demographic factors associated with pneumonia and wheeze. Results: A total of 947 children were included in analysis, with 406 cases of wheeze and 466 cases of pneumonia. Overall, cases and controls had a similar spatial concentration, although there was some variation in the density of wheezing cases in comparison to controls. In particular, there was evidence of a non-random difference in the distribution between cases and controls, and cases of wheeze were significantly more concentrated the TC Newman area than expected. Those who developed pneumonia and wheeze were more likely to be males as compared to females (both p<0.05). There were no statistically significant association between socioeconomic status, ethnicity, education, breastfeeding practices and maternal smoking (all p>0.05). Conclusions: This study revealed a significant clustering of wheeze in TC Newman, which may be attributable to socio-demographic differences between communities, while pneumonia was spatially dispersed across the study areas. These findings suggest that focused public health interventions are needed to reduce the incidence of LRTIs in the area of TC Newman specifically.
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    The burden of cancers associated with HIV in the South African public health sector, 2004–2014: a record linkage study
    (2019-05-03) Dhokotera, Tafadzwa; Bohlius, Julia; Spoerri, Adrian; Egger, Matthias; Ncayiyana, Jabulani; Olago, Victor; Singh, Elvira; Sengayi, Mazvita
    Abstract Introduction The impact of South Africa’s high human immunodeficiency virus (HIV) burden on cancer risk is not fully understood, particularly in the context of antiretroviral treatment (ART) availability. We examined national cancer trends and excess cancer risk in people living with HIV (PLHIV) compared to those who are HIV-negative. Methods We used probabilistic record linkage to match cancer records provided by the National Cancer Registry to HIV data provided by the National Health Laboratory Service (NHLS). We also used text search of specific HIV terms from the clinical section of pathology reports to determine HIV status of cancer patients. We used logistic and Joinpoint regression models to evaluate the risk and trends in cancers in PLHIV compared to HIV-negative patients from 2004 to 2014. In sensitivity analysis, we used inverse probability weighting (IPW) to correct for possible selection bias. Results A total of 329,208 cancer cases from public sector laboratories were reported to the NCR from 2004 to 2014 with the HIV status known for 95,279 (28.9%) cancer cases. About 50% of all the female cancer cases (n = 30,486) with a known status were HIV-positive. PLHIV were at higher risk of AIDS-defining cancers (Kaposi sarcoma [adjusted OR:134, 95% CI:111–162], non-Hodgkin lymphoma [adjusted OR:2.73, 95% CI:2.56–2.91] and, cervix [adjusted OR:1.70, 95% CI:1.63–1.77], conjunctival cancer [adjusted OR:21.5, 95% CI:16.3–28.4] and human papilloma virus (HPV) related cancers (including; penis [adjusted OR:2.35, 95% CI:1.85–2.99], and vulva [adjusted OR:1.94, 95% CI:1.67–2.25]) compared to HIV-negative patients. Analysis using the IPW population yielded comparable results. Conclusion There is need for improved awareness and screening of conjunctival cancer and HPV-associated cancers at HIV care centres. Further research and discussion is warranted on inclusive HPV vaccination in PLHIV.