Browsing by Author "Abdullah, F."
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- ItemMasking through averages - intraprovincial heterogeneity in HIV prevalence within the Western Cape(Health & Medical Publishing Group, 2006) Shaikh, N.; Abdullah, F.; Lombard, C. J.; Smit, L.; Bradshaw, D.; Makubalo, L.Objective. To measure HIV prevalence at health-district level in the Western Cape (WC) and to compare these findings with those of the National HIV Antenatal Surveys (NHASs). This investigation aimed to estimate the degree of heterogeneity of HIV prevalence within the province in order to inform the design of appropriate and targeted HIV interventions. Method. Annual cross-sectional, unlinked district HIV antenatal surveys were implemented in all 25 health districts of the WC for the years 2001 - 2004, concurrently with the NHAS. A stratified proportional sample was drawn for each district, involving all 344 antenatal clinics in the province, and the anonymous screening method as described by the World Health Organization (WHO) was applied. Results. The NHAS revealed a significant increase in HIV prevalence in the WC from 8.6% (95% confidence interval (CI): 5.6 - 11.6) in 2001 to 15.4% (95% CI: 12.5 - 18.2) in 2004. The district-level HIV surveys showed wide variation in HIV prevalence across the health districts, which increased progressively during this period (a range of 0.6 - 22% for the year 2001 increased to 1 - 33% in 2004). Spatial analysis of HIV prevalence by health district for this period also revealed progressive spatial growth of the sub-epidemics, with the highest prevalence observed in districts located in the Cape metropole region. Conclusions. These concurrent surveys highlight the fact that examining a provincial estimate of HIV prevalence alone has the potential to mask epicentres within the province. This underscores the importance of expanding the surveillance systems to detect heterogeneity sub-provincially, in order to link with local-level planning and resource allocation.
- ItemProvincial differences in infant deaths in South Africa - An effect of antiretroviral interventions?(2011) Boulle, A.; Thompson, M. L.; Laubscher, R.; Johnson, L. F.; Sayed, R.; Brody, L. L.; Draper, B.; Cotton, M. F.; Abdullah, F.; Myers, J. E.; Bourne, D. E.Objective. It has previously been demonstrated that a peak in registered infant deaths, at 2-3 months of age at death, developed between 1997 and 2002 in South Africa, alongside the evolving HIV epidemic. The objective of this analysis was to explore the age distribution of post-neonatal infant deaths in South Africa by province, and relate the observed distributions to HIV and intervention characteristics. Design. Ecological study based on registered infant deaths and published HIV and intervention characteristics. Methods. Numbers of registered infant deaths beyond 1 month of age at death were plotted by year of death, province of South Africa and age at death in months, for the years 1997-2007. Results. The total number of registered deaths in infants aged 1-11 months increased from 15 404 in 1997 to 34 479 in 2006. Eight of the 9 provinces experienced an annual peak in registered infant deaths at 2-3 months of age between 1997 and 2007. This peak in mortality was not observed in the Western Cape. In 7 of 9 provinces registered post-neonatal infant deaths did not rise markedly in 2007 compared with 2005. Conclusions. We identified a single province out of 9 South African provinces in which a peak in early infant deaths at age 2-3 months did not occur during the period 1997-2007. This was the province with the earliest and highest coverage of antiretroviral interventions from 1999 onwards. It is possible that these interventions have averted the greater increase in early infant deaths seen in the rest of South Africa over this period.