Browsing by Author "Corbett EL"

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    Comparison of indoor contact time data in Zambia and Western Cape, South Africa suggests targeting of interventions to reduce Mycobacterium tuberculosis transmission should be informed by local data.
    (2016-Feb-09) McCreesh N; Looker C; Dodd PJ; Plumb ID; Shanaube K; Muyoyeta M; Godfrey-Faussett P; Corbett EL; Ayles H; White RG; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. clare_looker@hotmail.com.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. faussettp@unaids.org.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia. Monde.Muyoyeta@cidrz.org.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. idplumb@gmail.com.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia. helen@zambart.org.zm.; Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK. p.j.dodd@sheffield.ac.uk.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. p.j.dodd@sheffield.ac.uk.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. lizcorbett04@gmail.com.; HIV and TB Theme, Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi. lizcorbett04@gmail.com.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. richard.white@lshtm.ac.uk.; TB Modelling Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. nicky.mccreesh@lshtm.ac.uk.; TB Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. Monde.Muyoyeta@cidrz.org.; ZAMBART Project, School of Medicine, University of Zambia, Lusaka, Zambia. kshanaube@zambart.org.zm.; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. helen@zambart.org.zm.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: In high incidence settings, the majority of Mycobacterium tuberculosis (M.tb) transmission occurs outside the household. Little is known about where people's indoor contacts occur outside the household, and how this differs between different settings. We estimate the number of contact hours that occur between adults and adult/youths and children in different building types in urban areas in Western Cape, South Africa, and Zambia. METHODS: Data were collected from 3206 adults using a cross-sectional survey, on buildings visited in a 24-h period, including building function, visit duration, and number of adults/youths and children (5-12 years) present. The mean numbers of contact hours per day by building function were calculated. RESULTS: Adults in Western Cape were more likely to visit workplaces, and less likely to visit shops and churches than adults in Zambia. Adults in Western Cape spent longer per visit in other homes and workplaces than adults in Zambia. More adults/youths were present at visits to shops and churches in Western Cape than in Zambia, and fewer at homes and hairdressers. More children were present at visits to shops in Western Cape than in Zambia, and fewer at schools and hairdressers. Overall numbers of adult/youth indoor contact hours were the same at both sites (35.4 and 37.6 h in Western Cape and Zambia respectively, p = 0.4). Child contact hours were higher in Zambia (16.0 vs 13.7 h, p = 0.03). Adult/youth and child contact hours were highest in workplaces in Western Cape and churches in Zambia. Compared to Zambia, adult contact hours in Western Cape were higher in workplaces (15.2 vs 8.0 h, p = 0.004), and lower in churches (3.7 vs 8.6 h, p = 0.002). Child contact hours were higher in other peoples' homes (2.8 vs 1.6 h, p = 0.03) and workplaces (4.9 vs 2.1 h, p = 0.003), and lower in churches (2.5 vs 6.2, p = 0.004) and schools (0.4 vs 1.5, p = 0.01). CONCLUSIONS: Patterns of indoor contact between adults and adults/youths and children differ between different sites in high M.tb incidence areas. Targeting public buildings with interventions to reduce M.tb transmission (e.g. increasing ventilation or UV irradiation) should be informed by local data.
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    User perspectives and preferences on a novel TB LAM diagnostic (Fujifilm SILVAMP TB LAM)-a qualitative study in Malawi and Zambia.
    (2022) Herrmann Y; Lainati F; Castro MDM; Mwamba CP; Kumwenda M; Muyoyeta M; Broger T; Heinrich N; Olbrich L; Corbett EL; McMahon SA; Engel N; Denkinger CM; Malawi-Liverpool-Wellcome Clinical Research Programme (MLW), Public Health Group, Blantyre, Malawi.; London School of Hygiene and Tropical Medicine, Infectious and Tropical Diseases, London, United Kingdom.; Division for Infectious Diseases, LMU Hospital, Munich, Germany.; Maastricht University, Department of Health, Ethics & Society, Research School for Public Health and Primary Care, Maastricht, The Netherlands.; Centre for Infectious Disease Research in Zambia, Social & Behavioural Science Group, Lusaka, Zambia.; International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.; Centre for Infectious Disease Research in Zambia, Tuberculosis Department, Lusaka, Zambia.; Division of Clinical Infectious Disease and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.; German Centre for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany.; Heidelberg University Hospital, Heidelberg Institute of Global Health, Heidelberg, Germany.; German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    Widely available tuberculosis (TB) diagnostics use sputum samples. However, many patients, particularly children and patients living with HIV (PLHIV), struggle to provide sputum. Urine diagnostics are a promising approach to circumvent this challenge while delivering reliable and timely diagnosis. This qualitative study in two high TB/HIV burden countries assesses values and preferences of end-users, along with potential barriers for the implementation of the novel Fujifilm SILVAMP TB-LAM (FujiLAM, Fujifilm, Japan) urine test. Between September 2020 and March 2021, we conducted 42 semi-structured interviews with patients, health care providers (HCPs) and decision makers (DMs) (e.g., in national TB programs) in Malawi and Zambia. Interviews were transcribed verbatim and analyzed using a framework approach supported by NVIVO. Findings aligned with the pre-existing Health Equity Implementation Framework, which guided the presentation of results. The ease and convenience of urine-based testing was described as empowering among patients and HCPs who lamented the difficulty of sputum collection, however HCPs expressed concerns that a shift in agency to the patient may affect clinic workflows (e.g., due to less control over collection). Implementation facilitators, such as shorter turnaround times, were welcomed by operators and patients alike. The decentralization of diagnostics was considered possible with FujiLAM by HCPs and DMs due to low infrastructure requirements. Finally, our findings support efforts for eliminating the CD4 count as an eligibility criterion for LAM testing, to facilitate implementation and benefit a wider range of patients. Our study identified barriers and facilitators relevant to scale-up of urine LAM tests in Malawi and Zambia. FujiLAM could positively impact health equity, as it would particularly benefit patient groups currently underserved by existing TB diagnostics. Participants view the approach as a viable, acceptable, and likely sustainable option in low- and middle-income countries, though adaptations may be required to current health care processes for deployment. Trial registration: German Clinical Trials Register, DRKS00021003. URL: https://www.drks.de/drks_web/setLocale_EN.do.