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Anova\’s Dr Moyahabo Mabitsi shares her insight on the implementation of NIMART training that has led to an increase in access to HIV treatment in Johannesburg since more PHC facilities are providing HIV treatment services. \”In our experiences, the biggest success in implementation was based on training followed by facility-based clinical mentorship, continuous medical education and co-ordination with the District team.\”   Read full article in HIV Matters Journal, page 20, below…  HIV Matters March 2015 small-934.pdf

Remco Peters, a clinical programme specialist at Anova Health Institute, presented findings from a cohort study on tuberculosis (TB) testing at the TB conference held in Durban last week. The study was conducted at 5 primary healthcare (PHC) facilities in Mopani District, comparing clinic versus remote laboratory basedXpert® MTB/RIF for diagnosis of tuberculosis (TB) in rural South Africa. This TB test provides accurate data within two hours so that patients can be offered proper treatment on the same day. See the full presentation together with its findings below: Downloads:  A cohort study of clinic versus laboratory based Xpert A presentation by Remco Peters from Anova

Anova\’s Remco Peters, a clinical programme specialist, together with Erik Schaftenaar, a PhD student doing research with Anova, recently conducted a study on seroprevalence of Human Herpesviruses (HHVs) in Rural South Africa. The study in Mopani District (a rural area in Limpopo) found high seroprevalence of HHVs in HIV-infected people attending primary healthcare facilities in rural South Africa. Anova would also like to acknowledge the Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands, in their collaboration with Anova on this interesting and informative report. Seroprevalence data of human herpesviruses (HHVs) are limited for sub-Saharan Africa. These are important to provide an indication of potential burden of HHV-related disease, in particular in human immunodeficiency virus (HIV)-infected individuals who are known to be at increased risk of these conditions in the Western world. In this cross-sectional study among 405 HIV-infected and antiretroviral therapy naive individuals in rural South Africa the seroprevalence of HHVs was: herpes simplex virus type 1 (HSV-1) (98%), herpes simplex virus type 2 (HSV-2) (87%), varicella zoster virus (VZV) (89%), and 100% for both Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Independent factors associated with VZV seropositivity were low educational status and having children. Lack of in-house access to drinking water was independently associated with positive HSV-1 serostatus, whereas Shangaan ethnicity was associated with HSV-2 seropositivity. Increasing age was associated with higher IgG titres to both EBV and CMV, whereas CD4 cell count was negatively associated with EBV and CMV IgG titres. Moreover, IgG titres of HSV-1 and 2, VZV and CMV, and CMV and EBV were positively correlated. The high HHV seroprevalence emphasises the importance of awareness of these viral infections in HIV-infected individuals in South Africa. In a recently published ANC survey on HSV-2 prevalence in four provinces (not Limpopo though), prevalence was in a similar range for HIV-infected individuals, but much higher than among those without HIV infection. The study, High Seroprevalence of Human Herpesviruses in HIV-Infected Individuals Attending Primary Healthcare Facilities in Rural South Africa, which was published in a science journal Plos One, is available for you to read below: Downloads:  High Seroprevalence of HHVs in HIV-Infected Individuals Attending PHC Facilities in Rural SA A study conducted by Remco Peters and Eric Schaftenaar

Last year Anova has seen a reshaping of priorities and a renewed focus on sustainable support of the SA government\’s leadership on HIV and AIDS. We have seen huge strides in health systems strengthening activities, including increased effort in clinical mentorship and effective data collection. It has been a productive and innovative year. Read more on what 2013 has meant for Anova and the health sector.   Downloads:  Annual Report 2013 PDF version

Two accepted publications about the work done on side-effects in HIV-infected children on antiretroviral treatment (ART) in Mopani were recently published. You can access the study done on lactate levels here, and the neuropathy manuscript. To read the full study you need to subscribe to the relevant journals. In one recent case study conducted by Anova, led by clinical programme specialist, Remco Peters, on the side-effects of ART in children, interesting findings were made around prepubertal gynecomastia. It was the first reported case of prepubertal gynecomastia in a young girl attributed to efavirenz use. Prepubertal gynecomastia is a rare condition and most frequently classified as idiopathic. The study looked at a seven-year-old African girl presented with true gynecomastia four months after initiation on ART (abacavir, lamivudine, efavirenz). History, physical examination and laboratory tests excluded known causes of gynecomastia and efavirenz was considered as the most likely cause. Six weeks after withdrawal of efavirenz the breast enlargement had completely resolved. In HIV-infected adults gynecomastia is a recognised but infrequent side-effect of ART and mostly attributed to efavirenz use. In the medical literature only five cases of prepubertal gynecomastia in children taking ART are described and underlying pathogenesis was unknown. The occurrence of adverse effects of ART may interfere with therapy adherence and long-term prognosis and for that reason requires attention. Read the full research report below:  Case study