Publications (7)17.14 Total impact
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Article: Translating global health research aims into action: the example of the ALPHA network.
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ABSTRACT: There is increasing consensus on the importance of strengthening global health research to meet health and development goals. Three key global health research aims are to ensure that research (i) addresses priority health needs, (ii) contributes to policy development, and (iii) adds value to investments in developing countries through South-South collaboration and capacity-strengthening in the South. The ALPHA network (Analysing Longitudinal Population-based HIV/AIDS data on Africa) is an illustrative example of how these global health research aims can be translated into action. The network facilitates additional collaborative HIV epidemiological research among six independent research projects in Africa studying population-based cohorts. Under the first of the earlier mentioned aims, the network addresses key epidemiology research issues in HIV/AIDS which are crucial to making progress and monitoring progress in the response against HIV/AIDS. Under the second aim, the network's scientific programme of research has contributed to strengthening the evidence base on HIV epidemiology in Africa and has informed policy development in areas such as targeted HIV prevention, social support, monitoring epidemic response and epidemic forecasting. Under the third aim, investment in the network has added value to the research investment in the individual projects through capacity development among African researchers as well as through the collaborative research outputs of the individual projects. Lessons from the network are relevant to collaborations facing similar challenges in other areas of global health research. These include the importance of establishing transparent and efficient governance for research collaborations, developing advance consensus on data sharing, ensuring effective communication for networking and demonstrating the added value of research investment in South-South collaborations.Tropical Medicine & International Health 03/2010; 15(3):321-8. · 2.80 Impact Factor -
Article: Translating global health research aims into action: the example of the ALPHA network*
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ABSTRACT: There is increasing consensus on the importance of strengthening global health research to meet health and development goals. Three key global health research aims are to ensure that research (i) addresses priority health needs, (ii) contributes to policy development, and (iii) adds value to investments in developing countries through South–South collaboration and capacity-strengthening in the South. The ALPHA network (Analysing Longitudinal Population-based HIV/AIDS data on Africa) is an illustrative example of how these global health research aims can be translated into action. The network facilitates additional collaborative HIV epidemiological research among six independent research projects in Africa studying population-based cohorts. Under the first of the earlier mentioned aims, the network addresses key epidemiology research issues in HIV/AIDS which are crucial to making progress and monitoring progress in the response against HIV/AIDS. Under the second aim, the network’s scientific programme of research has contributed to strengthening the evidence base on HIV epidemiology in Africa and has informed policy development in areas such as targeted HIV prevention, social support, monitoring epidemic response and epidemic forecasting. Under the third aim, investment in the network has added value to the research investment in the individual projects through capacity development among African researchers as well as through the collaborative research outputs of the individual projects. Lessons from the network are relevant to collaborations facing similar challenges in other areas of global health research. These include the importance of establishing transparent and efficient governance for research collaborations, developing advance consensus on data sharing, ensuring effective communication for networking and demonstrating the added value of research investment in South–South collaborations.Point de vue: Transposition en action des objectifs mondiaux de la recherche en santé: l’exemple du réseau ALPHAIl y a de plus en plus un consensus sur l’importance du renforcement de la recherche en santé mondiale afin d’atteindre les objectifs de santé et de développement. Trois principaux objectifs de recherche en santé mondiale sont de s’assurer que la recherche: (1) traite des besoins de santé prioritaires, (2) contribue à l’élaboration des politiques et (3) ajoute de la valeur aux investissements dans les pays en développement à travers la collaboration sud-sud et le renforcement des capacités dans le sud. Le réseau ALPHA (Analyse longitudinale des données VIH/SIDA basées sur la Population en l’Afrique) est un exemple illustratif de la manière dont ces objectifs de recherche en santé mondiale peuvent être traduits en action. Le réseau facilite la collaboration additionnelle en recherche épidémiologique sur le VIH entre six projets de recherche indépendants en Afrique étudiant des cohortes basées sur la population. Au titre du premier des objectifs ci-dessus, le réseau traite des grandes questions de recherche en épidémiologie sur le VIH/SIDA qui sont cruciaux pour faire avancer et surveiller les progrès dans la lutte contre le VIH/SIDA. Dans le cadre du second objectif, le programme scientifique du réseau de recherche contribue au renforcement de la base de données probantes sur l’épidémiologie du VIH en Afrique et en a informé l’élaboration des politiques dans des domaines tels que la prévention ciblée du VIH, le soutien social, le suivi de la réponse épidémique et la prévision des épidémies. Dans le cadre du troisième objectif, l’investissement dans le réseau a une valeur ajoutée dans l’investissement dans la recherche dans les différents projets à travers le développement des capacités des chercheurs africains ainsi que dans les résultats de la recherche collaborative des projets individuels. Les leçons tirées du réseau sont pertinentes pour les collaborations faisant face à des défis similaires dans d’autres domaines de la recherche en santé mondiale. Ceux-ci comprennent l’importance d’établir une gouvernance transparente et efficace pour des collaborations de recherche, le développement d’un consensus préalable sur le partage des données assurant une communication efficace pour le réseau et de démontrer la valeur ajoutée de l’investissement dans la recherche dans les collaborations sud-sud.Punto de vista: Traduciendo en acción los objetivos de investigación en salud: los ejemplos de la red ALPHAExiste un consenso sobre la importancia de fortalecer la investigación en salud global para alcanzar los objetivos de salud y desarrollo. Tres objetivos claves en la investigación de la salud global son el asegurar que la investigación (1) aborde necesidades prioritarias de salud, (2) contribuya al desarrollo de políticas, y (3) tenga un valor añadido para inversiones en países en vías de desarrollo a través de colaboraciones Sur-Sur y fortalecimiento de capacidades del Sur. La red ALPHA (por sus siglas en inglés Analyzing Longitudinal Population-based HIV/AIDS data on Africa) es un ejemplo ilustrativo de como estos objetivos de investigación en salud global pueden traducirse en acción. La red facilita la investigación adicional colaborativa en epidemiología del VIH, entre seis proyectos independientes en África, estudiando cohortes basadas en la población. Dentro del primer objetivo planteado, la red aborda cuestiones claves en la investigación epidemiológica del VIH/SIDA que son cruciales para progresar y monitorizar el progreso como respuesta frente al VIH/SIDA. Bajo el segundo objetivo, el programa científico de investigación de la red ha contribuido a fortalecer la base de evidencia sobre la epidemiología de VIH en África, y ha informado acerca del desarrollo de políticas en áreas tales como la prevención dirigida del VIH, el apoyo social, la monitorización de la respuesta epidémica, y la predicción de epidemias. Bajo el tercer objetivo, la inversión en la red a dado un valor añadido a la inversión en la investigación en los proyectos individuales a través del desarrollo de capacidades entre los investigadores africanos al igual que mediante los resultados de investigación colaborativa de los proyectos individuales. Las lecciones de la red son relevantes para colaboraciones que se estén enfrentando a retos similares en otras áreas de investigación en salud global. Esto incluye la importancia de establecer procesos de gobernabilidad transparentes y eficientes en las colaboraciones en investigación, desarrollando de antemano un consenso sobre el manejo de datos, asegurando una comunicación efectiva para el trabajo en red, y demostrando el valor añadido de la inversión en investigación en colaboraciones Sur-Sur.Tropical Medicine & International Health 02/2010; 15(3):321 - 328. · 2.80 Impact Factor -
Article: Measuring trends in age at first sex and age at marriage in Manicaland, Zimbabwe.
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ABSTRACT: To identify reporting biases and to determine the influence of inconsistent reporting on observed trends in the timing of age at first sex and age at marriage. Longitudinal data from three rounds of a population-based cohort in eastern Zimbabwe were analysed. Reports of age at first sex and age at marriage from 6837 individuals attending multiple rounds were classified according to consistency. Survival analysis was used to identify trends in the timing of first sex and marriage. In this population, women initiate sex and enter marriage at younger ages than men but spend much less time between first sex and marriage. Among those surveyed between 1998 and 2005, median ages at first sex and first marriage were 18.5 years and 21.4 years for men and 18.2 years and 18.5 years, respectively, for women aged 15-54 years. High levels of reports of both age at first sex and age at marriage among those attending multiple surveys were found to be unreliable. Excluding reports identified as unreliable from these analyses did not alter the observed trends in either age at first sex or age at marriage. Tracing birth cohorts as they aged revealed reporting biases, particularly among the youngest cohorts. Comparisons by birth cohorts, which span a period of >40 years, indicate that median age at first sex has remained constant over time for women but has declined gradually for men. Although many reports of age at first sex and age at marriage were found to be unreliable, inclusion of such reports did not result in artificial generation or suppression of trends.Sexually transmitted infections 05/2009; 85 Suppl 1:i34-40. · 2.18 Impact Factor -
Article: Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998-2003.
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ABSTRACT: AIDS is the main driver of young widowhood in southern Africa. The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal population-based cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission. 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period. This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.Sexually transmitted infections 05/2009; 85 Suppl 1:i41-8. · 2.18 Impact Factor -
Article: Reported number of sexual partners: comparison of data from four African longitudinal studies.
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ABSTRACT: To compare reported numbers of sexual partners in Eastern and Southern Africa. Sexual partnership data from four longitudinal population-based surveys (1998-2007) in Zimbabwe, Uganda and South Africa were aggregated and overall proportions reporting more than one lifetime sexual partner calculated. A lexis-style table was used to illustrate the average lifetime sexual partners by site, sex, age group and birth cohort. The male-to-female ratio of mean number of partnerships in the last 12 months was calculated by site and survey. For each single year of age, the proportion sexually active in the past year, the mean number of partners in the past year and the proportion with more than one partner in the past year were calculated. Over 90% of men and women between 25 and 45 years of age reported being sexually active during the past 12 months, with most reporting at least one sexual partner. Overall, men reported higher numbers of lifetime sexual partners and partners in the last year than women. The male-to-female ratio of mean partnerships in the last year ranged from 1.41 to 1.86. In southern African cohorts, individuals in later birth cohorts reported fewer sexual partners and a lower proportion reported multiple partnerships compared with earlier birth cohorts, whereas these behavioural changes were not observed in the Ugandan cohorts. Across the four sites, reports of sexual partnerships followed a similar pattern for each sex. The longitudinal results show that reductions in the number of partnerships were more evident in southern Africa than in Uganda.Sexually transmitted infections 05/2009; 85 Suppl 1:i72-80. · 2.18 Impact Factor -
Article: Discrepancies between UN models and DHS survey estimates of maternal orphan prevalence: insights from analyses of survey data from Zimbabwe.
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ABSTRACT: Model-based estimates of maternal (but not paternal) orphanhood are higher than those based on data from demographic and health surveys (DHS). We investigate the consistency of reporting of parental survival status in data from Manicaland, Zimbabwe. We compared estimates of paternal and maternal orphan prevalence in three rounds of a prospective household census in Manicaland (1998-2005) with estimates from DHS surveys and UNAIDS model projections. We investigated the consistency of reporting of parental survival status across the three rounds and compared estimates of adult mortality from the orphan data with direct estimates from concurrent follow-up of a general population cohort. Qualitative data were collected on possible reasons for misreporting. Paternal and maternal orphan prevalence is increasing in Zimbabwe. Mothers reported as deceased in round 1 of the Manicaland survey were more likely than fathers to be reported as alive in rounds 2 or 3 (33.3% vs 13.4%). This pattern was most apparent among younger children. The qualitative findings suggest that foster parents sometimes claim adopted children as their natural children. These results are consistent with misreporting of foster parents as natural parents. This appears to be particularly common among foster mothers and could partly explain the discrepancy between mathematical model and DHS estimates of maternal orphanhood.Sexually transmitted infections 08/2008; 84 Suppl 1:i57-i62. · 2.18 Impact Factor -
Article: Informal confidential voting interview methods and temporal changes in reported sexual risk behaviour for HIV transmission in sub-Saharan Africa.
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ABSTRACT: Reliable data on sexual behaviour trends are needed to evaluate HIV interventions in sub-Saharan Africa but are difficult to obtain due inter alia to social desirability bias. The objective of this paper is to assess whether the use of informal confidential voting interviews (ICVI) was associated with greater reporting of socially proscribed behavioural risk factors for HIV infection than were conventional interviewing methods. Comparison of changes in reports of risk behaviours for HIV infection in ICVI versus face to face interviews (FTFIs) between the first two rounds of a large scale, longitudinal, population based survey in Manicaland, Zimbabwe. Examination of factors that could contribute to observed changes in the effect of ICVI, including temporal changes in response error and social desirability, and factors affecting statistical power to detect differences between methods-that is, reductions in the prevalence of risk behaviours and sample size. Enhanced reporting of HIV associated risk behaviours in ICVI interviews was not so apparent in the second round as in the first round of the survey, particularly for less frequently reported behaviours. Levels of reported HIV associated risk behaviour and sample sizes both declined between the two survey rounds. The level of response error was higher in ICVI interviews than in FTFI interviews but did not alter over time. ICVI interviews can reduce social desirability bias in data on HIV associated risk behaviours. The extent and direction of change in net reduction in bias over time remains uncertain and will depend on local circumstances.Sexually Transmitted Infections 01/2005; 80 Suppl 2:ii36-42. · 2.85 Impact Factor
