Browsing by Author "Dawood, Halima."

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Adolescent HIV treatment issues in South Africa.
(South African Medical Association., 2015) Dawood, Halima.
Abstract available in pdf.
Apoptosis in peripheral blood mononuclear cells of human immunodeficiency virus (HIV) infected patients undergoing highly active antiretroviral therapy.
(2008) Karamchand, Leshern.; Chuturgoon, Anil Amichund.; Dawood, Halima.
Highly active antiretroviral therapy (HAART) is currently the only treatment that effectively reduces the morbidity and mortality of individuals infected with Human Immunodeficiency Virus-1 (HIV-1). Standard HAART regimens typically comprise 2 nucleoside reverse transcriptase inhibitors and either one non-nucleoside reverse transcriptase inhibitor or a protease inhibitor. These drugs bind to and inhibit the HIV-1 Reverse Transcriptase and Protease enzymes respectively, thereby suppressing viral replication. The nucleoside reverse transcriptase inhibitors promote mitochondrial (mt) dysfunction by strongly inhibiting mt polymerase gamma (Pol-y) and subsequently, mtDNA replication. In contrast, the non-nucleoside reverse transcriptase inhibitors, efavirenz (EFV) and nevirapine (NVP) do not inhibit Pol-y although EFV has been shown to induce mt depolarisation ( mlow) in vitro at supra-therapeutic concentrations. However, the capacity of non-nucleoside reverse transcriptase inhibitor drugs to induce mt toxicity in vivo previously remained undetermined. The objective of this study was to determine the influence of EFV and NVP on peripheral lymphocyte mt transmembrane potential (Avj/m) and apoptosis in HIV-1-infected patients treated with these non-nucleoside reverse transcriptase inhibitors. Thirty-two HIV-1-infected patients on HAART between 4 and 24 months (12 on EFV, 20 on NVP) and 16 HAART-naive HIV-1-infected patients were enrolled into this study. All participants were black South African patients. Spontaneous peripheral lymphocyte apoptosis and mlow were measured ex vivo by flow cytometry for all patients. CD4 T-helper apoptosis for the EFV and NVP cohorts was 19.38% ± 2.62% and 23.35% ± 1.51% (mean ± SEM), respectively, whereas total lymphocyte mlow was 27.25% ± 5.05% and 17.04% ± 2.98%, respectively. Both parameters for each cohort were significantly lower (P < 0.05) than that of the HAART-naive patients. The NVP cohort exhibited both a significant time dependent increase in peripheral lymphocyte ö¿mlow (P = 0.038) and correlation between Thelper apoptosis and low (P = 0.0005). These trends were not observed in the EFV cohort. This study provides evidence that both EFV and NVP induce peripheral lymphocyte ö¿ m low in HIV-1-infected patients on non-nucleoside reverse transcriptase inhibitor-based HAART, which in the case of NVP is sufficient to induce the apoptosis cascade.
Assessing the implementation effectiveness and safety of 1% tenofovir gel provision through family planning services in KwaZulu-Natal, South Africa: study protocol for an open-label randomized controlled trial.
(BioMed Central., 2014) Mansoor, Leila Essop.; Abdool Karim, Quarraisha.; Mngadi, Kathryn Therese.; Dlamini, Sarah Alexandra.; Montague, Carl.; Nkomonde, Nelisiwe.; Mvandaba, Nomzamo.; Baxter, Cheryl.; Gengiah, Tanuja Narayansamy.; Samsunder, Natasha.; Dawood, Halima.; Grobler, Anna Christina.; Fröhlich, Janet Ann.; Abdool Karim, Salim Safurdeen.
Background: The Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 trial demonstrated a 39% reduction in HIV infection, with a 54% HIV reduction in women who used tenofovir gel consistently. A confirmatory trial is expected to report results in early 2015. In the interim, we have a unique window of opportunity to prepare for and devise effective strategies for the future policy and programmatic scale-up of tenofovir gel provision. One approach is to integrate tenofovir gel provision into family planning (FP) services. The CAPRISA 008 implementation trial provides an opportunity to provide post-trial access to tenofovir gel while generating empiric evidence to assess whether integrating tenofovir gel provision into routine FP services can achieve similar levels of adherence as the CAPRISA 004 trial. Methods/design: This is a two-arm, open-label, randomized controlled non-inferiority trial. A maximum of 700 sexually active, HIV-uninfected women aged 18 years and older who previously participated in an antiretroviral prevention study will be enrolled from an urban and rural site in KwaZulu-Natal, South Africa. The anticipated study duration is 30 months, with active accrual requiring approximately 12 months (following which an open cohort will be maintained) and follow-up continuing for approximately 18 months. At each of the two sites, eligible participants will be randomly assigned to receive tenofovir gel through either FP services (intervention arm) or through the CAPRISA research clinics (control arm). As part of the study intervention, a quality improvement approach will be used to assist the FP services to expand their current services to include tenofovir gel provision. Discussion: This protocol aims to address an important implementation question on whether FP services are able to effectively incorporate tenofovir gel provision for this at-risk group of women in South Africa. Provision of tenofovir gel to the women from the CAPRISA 004 trial meets the ethical obligation for post-trial access, and helps identify a potential avenue for future scale-up of microbicides within the public health system of South Africa. Trial registration: This trial was registered with the South Africa Department of Health (reference: DOH-27-0812-4129) and ClinicalTrials.gov (reference: NCT01691768) on 05 July 2012.
A description of the profile of the patients and outcomes of fiber-optic bronchoscopies, performed at a tertiary care hospital in KwaZulu-Natal, South Africa, from January to December 2011.
(2014) Ramkillawan, Yeishna.; Dawood, Halima.
Background Tuberculosis (TB), pneumonia and human immunodeficiency virus (HIV) were the three leading causes of natural deaths in South Africa in 2013 and 11.9% of all deaths in KwaZulu Natal were attributed to TB. In 2013, there was an estimated 5.26 million people infected with HIV in South Africa. HIV infected individuals have an increased risk of respiratory tract infections including smear negative TB. Lung cancer is the most common type of cancer in the world. However, due to infrequent updates of the cancer registry in South Africa, current prevalence is unknown. Bronchoscopy is a useful tool for the diagnosis of broncho-respiratory pathology. Aims and Objectives This study describes the patient profile and outcomes of bronchoscopy in a tertiary centre in KwaZulu Natal in 2011. Specific objectives were to describe bronchoscopy indications, microbiological, cellular and histological findings and prevalence of TB amongst smear negative patients by broncho-alveolar lavage (BAL). In addition, the common types of lung cancer diagnosed on biopsy during bronchoscopy were to be described. Background Tuberculosis (TB), pneumonia and human immunodeficiency virus (HIV) were the three leading causes of natural deaths in South Africa in 2013 and 11.9% of all deaths in KwaZulu Natal were attributed to TB. In 2013, there was an estimated 5.26 million people infected with HIV in South Africa. HIV infected individuals have an increased risk of respiratory tract infections including smear negative TB. Lung cancer is the most common type of cancer in the world. However, due to infrequent updates of the cancer registry in South Africa, current prevalence is unknown. Bronchoscopy is a useful tool for the diagnosis of broncho-respiratory pathology. Aims and Objectives This study describes the patient profile and outcomes of bronchoscopy in a tertiary centre in KwaZulu Natal in 2011. Specific objectives were to describe bronchoscopy indications, microbiological, cellular and histological findings and prevalence of TB amongst smear negative patients by broncho-alveolar lavage (BAL). In addition, the common types of lung cancer diagnosed on biopsy during bronchoscopy were to be described. Background Tuberculosis (TB), pneumonia and human immunodeficiency virus (HIV) were the three leading causes of natural deaths in South Africa in 2013 and 11.9% of all deaths in KwaZulu Natal were attributed to TB. In 2013, there was an estimated 5.26 million people infected with HIV in South Africa. HIV infected individuals have an increased risk of respiratory tract infections including smear negative TB. Lung cancer is the most common type of cancer in the world. However, due to infrequent updates of the cancer registry in South Africa, current prevalence is unknown. Bronchoscopy is a useful tool for the diagnosis of broncho-respiratory pathology. Aims and Objectives This study describes the patient profile and outcomes of bronchoscopy in a tertiary centre in KwaZulu Natal in 2011. Specific objectives were to describe bronchoscopy indications, microbiological, cellular and histological findings and prevalence of TB amongst smear negative patients by broncho-alveolar lavage (BAL). In addition, the common types of lung cancer diagnosed on biopsy during bronchoscopy were to be described. Methods A retrospective review of consecutive bronchoscopies performed by the pulmonologist at a tertiary hospital in western KwaZulu Natal, between 1 January and 31 December 2011 was performed. A total of 107 patients met the inclusion criteria. Data was collected from clinical records, laboratory and radiology computerised record systems and entered on an Excel workbook using Microsoft Office 2010® software. Data was analysed using Epi-Info Version 3.5.4® and Stata/IC 13.0®. The demographic, bronchoscopy and chest CT scan findings were summarised with descriptive summary measures and expressed as means ± standard deviation (SD) and/or medians with the range and interquartile range for quantitative variables. Percentages, frequencies and proportions were used to describe categorical variables. Results The median age of patients was 55 ± 14.4 (Interquartile range (IQR) 43 - 63) years and 68 (63.6%) patients were male. Twenty-eight (26.2%) patients were HIV infected with a median cluster of differentiation 4 count of 254 ±164 (IQR 126 – 366.5) cells per cubic millimetre. Nine patients were on antiretroviral therapy. The commonest indications for bronchoscopy were investigation of a lung mass (35.8%), non-resolving lower respiratory tract infection (15%) and suspected TB (15%). Microbiological findings on BAL samples included gram positive and negative bacteria (14%) and fungi (20%). TB microscopy, polymerase chain reaction and culture revealed mycobacterium tuberculosis on 22.2% of all BAL samples. Two patients with mycobacterium tuberculosis on BAL samples were HIV infected. The prevalence of TB on smear negative patients was 11.1%. Cytological analysis of BAL samples detected pathology on eight (13.1%) patients and two (3.3%) of these patients had lung cancer. Malignant (52.9%) (squamous cell carcinoma and adenocarcinoma) and benign (11.1%) (pneumonia and interstitial fibrosis) pathology was found on histology. Squamous cell carcinoma (37%) was the commonest lung cancer detected. Bronchoscopy was helpful in determining broncho-respiratory pathology in 38 (35.5%) patients. The commonest diagnosis was lower respiratory tract infection in 7 of 15 (46.7%) patients referred with diffuse pulmonary infiltrates. Bronchoscopy also assisted with the diagnosis of lung cancer in 20 of 43 (46.5%) patients referred with suspected lung mass. Overall the procedure complication rate was 3.7%. Conclusion Bronchoscopy may be a useful tool in diagnosing and decreasing the morbidity associated with respiratory illness in South Africa as the diagnostic yield was greatest for lower respiratory tract infections. Samples collected during BAL had a relatively low diagnostic yield for TB. Prompt referral of smear negative TB suspects is recommended to assist with the microbiological diagnosis of TB and direct therapy thereof. Cytological examination of BAL samples was associated with a low yield of lung cancer and biopsy samples were more useful for this purpose. SCC was the commonest histological subtype of lung cancer in this cohort. Bronchoscopy was a relatively safe procedure in determining the aetiology of broncho-respiratory pathology.
Epidemiology and molecular identification and characterization of mycoplasma pneumoniae, South Africa, 2012-2015.
(Centers for Disease Control and Prevention., 2018) Carrim, Maimuna.; Wolter, Nicole.; Benitez, Alvaro J.; Tempia, Stefano.; du Plessis, Mignon.; Walaza, Sibongile.; Moosa, Fahima.; Diaz, Maureen H.; Wolf, Bernard J.; Treurnicht, Florette K.; Hellferscee, Orienka.; Dawood, Halima.; Variava, Ebrahim.; Cohen, Cheryl.; Winchell, Jonas M.; von Gottberg, Anne.
Abstract available in pdf.
High mortality rates in men initiated on anti-retroviral treatment in KwaZulu-Natal, South Africa.
(Public Library of Science., 2017) Naidoo, Kogieleum.; Hassan-Moosa, Razia.; Yende-Zuma, Fortunate Nonhlanhla.; Govender, Dhineshree.; Padayatchi, Nesri.; Dawood, Halima.; Adams, Rochelle Nicola.; Govender, Aveshen.; Chinappa, Tilagavathy.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.
Abstract available in pdf.
Mortality and treatment response amongst HIV-infected patients 50 years and older accessing antiretroviral services in South Africa.
(BioMed Central., 2018) Dawood, Halima.; Hassan-Moosa, Razia.; Yende-Zuma, Fortunate Nonhlanhla.; Naidoo, Kogieleum.
Abstract available in pdf.
Prevalence and trends of staphylococcus aureus bacteraemia in hospitalized patients in South Africa, 2010 to 2012: laboratory-based surveillance mapping of antimicrobial resistance and molecular epidemiology.
(Public Library of Science., 2015) Perovic, Olga.; Iyaloo, Samantha.; Kularatne, Ranmini.; Lowman, Warren.; Bosman, Noma.; Wadula, Jeannette.; Seetharam, Sharona.; Duse, Adriano.; Mbelle, Nontombi.; Bamford, Colleen.; Dawood, Halima.; Mahabeer, Yesholata.; Bhola, Prathna.; Abrahams, Shareef.; Singh-Moodley, Ashika.
Abstract available in pdf.
A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis.
(2011) Islam, Jahangirul.; Wilson, Douglas Paul Kinghurst.; Dawood, Halima.; Thomson, Sandie Rutherford.; Clarke, Damian Luiz.
HIV epidemic is one of the major challenges to the South Africa’s socio-economic development. The incidence of tuberculosis is rising in sub-Saharan Africa, and in 2009 South Africa had the second highest incidence of tuberculosis in the world. Approximately 80% of incident tuberculosis cases in South Africa are HIV positive. In HIV positive individual, abdominal tuberculosis has been reported as the most common form of extra-pulmonary tuberculosis. HIV/AIDS has resulted in a resurgence of abdominal tuberculosis in South Africa. Making the diagnosis of abdominal tuberculosis is still difficult, though the condition is common. The role of laparoscopy in making the diagnosis is undefined. Method: All patients with clinically and radiologically suspected but histologically or microbiologically unconfirmed abdominal tuberculosis were referred to the investigating team and laparoscopy was performed to diagnose abdominal tuberculosis. Histology was performed on tissue biopsy specimens and TB culture on ascitic fluid and peripheral blood specimens. Results: From January 2008 to June 2010 a total of 190 patients were referred to us. No surgical intervention was taken in 60 patients; all of them were HIV positive. Twenty six of them died (43%) in the hospital during the evaluation period before the diagnostic laparoscopy, and the rest (57%) were unfit for anaesthesia. Forty nine patients required emergency laparotomy either for bowel obstruction or peritonitis and 39% of them died. Eighty one patients underwent diagnostic laparoscopy and 77% of them were HIV positive, in 16% the HIV status was unknown. Two percent had clinical ascites. Laparoscopic findings included intra-abdominal lymphadenopathy in 56, minimal ascitic fluid in 46, intra-abdominal mass in 17, and deposits on bowel wall, peritoneum or omentum in 20 patients. Fifty five patients (68%) had positive histology for tuberculosis. In 15 patients (19%) histology revealed non-specific inflammation, no pathology was found in one patient and no specimen was taken from one patient. Eighty percent of peritoneal deposits and 77% of lymph nodes were positive for tuberculosis, whereas 35% ascitic fluid culture was positive. In nine patients (11%) an alternative diagnosis was found (appendicitis, adenocarcinoma, lymphoma). Conclusion: Laparoscopy was feasible and showed a high yield to establish the diagnosis of abdominal tuberculosis and to provide an alternate diagnosis. Laparoscopy was useful to establish the gross features of abdominal tuberculosis and to provide the adequate specimens for examinations. Very poor follow negated the evaluation of the clinical response to anti tuberculosis therapy.
A review of progress on HIV, AIDS and Tuberculosis.
(2010) Padayatchi, Nesri.; Naidoo, Kogieleum.; Dawood, Halima.; Kharsany, Ayesha Bibi Mahomed.; Abdool Karim, Quarraisha.
As a United Nations member state, South Africa is signatory to the Millennium Declaration and is committed to achieve the Millennium Development Goals (MDGs) and targets for 2015. This chapter provides an overview of the status of South Africa’s response to MDG 6 with a specific focus on the progress made to date with respect to HIV and tuberculosis (TB) – two intertwined epidemics contributing disproportionately to morbidity and premature mortality in South Africa. These epidemics are also closely linked to MDG 4 and 5 outcomes. Any progress made by South Africa to reverse current trends will have substantial implications for the global MDG targets as well as country level outcomes. This chapter will use available evidence to document the status of HIV and TB in South Africa relative to the South African Ministry of Health’s strategy to address these diseases.
Safety, tolerability, and pharmacokinetics of long-acting injectable cabotegravir in low-risk HIV-uninfected individuals: HPTN 077, a phase 2a randomized controlled trial.
(Public Library of Science., 2018) Landovitz, Raphael J.; Li, Sue.; Grinsztejn, Beatriz.; Dawood, Halima.; Liu, Albert Y.; Magnus, Manya.; Hosseinipour, Mina C.; Panchia, Ravindre.; Cottle, Leslie.; Chau, Gordon.; Richardson, Paul.; Marzinke, Mark Albert.; Hendrix, Craig W.; Eshleman, Susan H.; Zhang, Yinfeng.; Tolley, Elizabeth E.; Sugarman, Jeremy.; Kofron, Ryan.; Adeyeye, Adeola.; Burns, David.; Rinehart, Alex R.; Margolis, David.; Spreen, William R.; Cohen, Myron S.; McCauley, Marybeth.; Eron, Joseph J.
Abstract available in pdf.