Eveline Geubbels

• PhD
• Head of Clinical Research at GOAL 3

Background The absence of high-quality comprehensive civil registration and vital statistics systems across many settings in Africa has led to little empirical data on causes of death in the region. We aimed to use verbal autopsy data to provide comparative, population-based estimates of cause-specific mortality among adolescents and adults in east...

Symptoms persisting >4 weeks after an acute SARS-CoV-2 infection (post-COVID condition, PCC) can have substantial consequences for the daily functioning and labor force participation of working age patients. We examined care consultations during PCC among patients on Bonaire, Caribbean Netherlands, identified activity limitations among patients who...

Background The severity of Severe Acute Respiratory Syndrome Coronavirus 2 infection varies with age and time. Here, we quantify how age‐specific risks of hospitalization, intensive care unit (ICU) admission, and death upon infection changed from February 2020 to June 2021 in the Netherlands. Methods A series of large representative serology surve...

The Dutch national open database on COVID-19 has been incrementally expanded since its start on 30 April 2020 and now includes datasets on symptoms, tests performed, individual-level positive cases and deaths, cases and deaths among vulnerable populations, settings of transmission, hospital and ICU admissions, SARS-CoV-2 variants, viral loads in se...

Aim: To assess the prevalence of post COVID-19 condition (PCC) on Bonaire and develop a practical risk scoring tool for PCC screening, using easily obtainable characteristics. Methods: A retrospective cohort study of symptomatic SARS-CoV-2 cases were randomly sampled from Bonaire their case-registry and telephone interviewed between 15-November-202...

Background: This study describes factors promoting child labour in small-scale gold mines in rural Tanzania, a pernicious problem despite the country's adoption of laws and regulations intended to curb it. Methods: Employing a phenomenological design, we collected qualitative data using focus group discussions and in-depth interviews to describe...

Background: Severity of SARS-CoV-2 infection may vary over time. Here, we estimate age-specific risks of hospitalization, ICU admission and death given infection in the Netherlands from February 2020 - June 2021. Methods: A nationwide longitudinal serology study was used to estimate numbers of infections in three epidemic periods (February 2020 - J...

Background: Children play a key role in the transmission of many infectious diseases. They have many of their close social encounters at home or at school. We hypothesized that most of the transmission of respiratory infections among children occur in these two settings and that transmission patterns can be predicted by a bipartite network of scho...

Given the emergence of the SARS-CoV-2 Omicron BA.1 and BA.2 variants and the roll-out of booster COVID-19 vaccination, evidence is needed on protection conferred by primary vaccination, booster vaccination and previous SARS-CoV-2 infection by variant.

Background Children play a key role in the transmission of many infectious diseases. They have many of their close social encounters at home or at school. We hypothesized that most of the transmission of respiratory infections among children occur in these two settings and that transmission patterns can be predicted by a bipartite network of school...

The impact of COVID-19 on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or ICU admission, results in prolonged and chronic illness, or leads to premature death. We aimed to quantify the total disease burden of acu...

The extent to which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) break through infection- or vaccine-induced immunity is not well understood. We analyzed 28,578 sequenced SARS-CoV-2 samples from individuals with known immune status obtained through national community testing in the Netherlands from March to...

Background

Although integration of HIV and maternal health services is recommended by the World Health Organization, evidence to guide implementation is limited. We describe facility-level implementation of policies for integrating HIV care within maternal health services and explore experiences of service users and providers in rural Tanzania (Ifakara), Sout...

Background Trained community workers (CWs) successfully deliver health and social services, especially due to greater community acceptance. Orphans and vulnerable children (OVC) and their caregivers (CG) often need support from several sectors. We identified CW, program and referral characteristics that were associated with success of referrals pro...

Little is known about how CD4 and viral load testing have evolved following implementation of universal test and treat (UTT) in African settings. We reviewed World Health Organization (WHO) guidance from 2013 to 2018, and compared it against national HIV policies in Malawi, Tanzania and South Africa. Three surveys rounds were conducted in 2013, 201...

Effective implementation of policies for expanding antiretroviral therapy (ART) requires a well-trained and adequately staffed workforce. Changes in national HIV workforce policies, health facility practices, and provider experiences were examined in rural Malawi and Tanzania between 2013 and 2017. In both countries, task-shifting and task-sharing...

National HIV testing policies aim to increase the proportion of people living with HIV who know their status. National HIV testing policies were reviewed for each country from 2013 to 2018, and compared with WHO guidance. Three rounds of health facility surveys were conducted to assess facility level policy implementation in Karonga (Malawi), uMkha...

Objective: To assess adoption of World Health Organization (WHO) guidance into national policies for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) and to monitor implementation of guidelines at facility level in rural Malawi, South Africa and the United Republic of Tanzania. Methods: We summarized natio...

Rift Valley fever (RVF) is one of the major viral zoonoses in Africa, affecting humans and several domestic animal species. The epidemics in eastern Africa occur in a 5-15 year cycle coinciding with abnormally high rainfall generally associated to the warm phase of the El Niño event. However, recently, evidence has been gathered of inter-epidemic t...

Background Extramarital sex is a potential driver of human immunodeficiency virus (HIV) transmission for long-term couples in sub-Saharan Africa. It is increasingly recognized that preventing sexual risk behaviours requires an understanding and adjustment of sexual relationship factors beyond the individual level. We investigated the association be...

Physical activity is essential for healthy aging. Evidence suggests that vigorous-intensity physical activity (VPA) may be more beneficial than moderate-intensity physical activity (MPA). We examined physical activity levels (MPA, VPA and total physical activity), and their socio-demographic determinants in 2311 participants (15–93 years; 68% women...

Background: Global evidence shows that sexually transmitted infections (STIs) prevalence and sexual risk behaviours are high among youth, and knowledge about STIs is low. In Tanzania, there is limited recent evidence regarding these issues. The aim of this study was to describe the health seeking behaviour of youth reporting STI symptoms in semi-r...

A daily intake of 5 portions of fruit and vegetables (FV) is recommended for protection against non-communicable diseases (NCDs). Inadequate FV intake is a global problem but resource-poor countries like Tanzania are most deprived and constitute settings where little is known for informing public health interventions. This study aimed to describe t...

HIV status disclosure is a key support strategy to start and maintain HIV care and treatment and to reduce HIV transmission. We explored the patterns and correlates of disclosure and described the effectiveness of nurse-facilitated disclosure among HIV-infected mothers of infants in coastal Tanzania. We enrolled 400 HIV positive women in an observa...

Background Understanding the implementation of 2013 World Health Organization (WHO) consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection at the facility level provides important lessons for the roll-out of future HIV policies. Methods A national policy review was conducted in six sub-Saharan African...

Most HIV research in Sub-Saharan Africa (SSA) ignores persons aged 50 years and above, though a few studies have reported a high HIV prevalence among older people. This study aimed to estimate socio-demographic inequalities in HIV testing behaviour and HIV prevalence among adults aged 50+ years, living in Ifakara town, Tanzania. This cross-sectiona...

Background Tanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman’s eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural setti...

(DOC)

Current HIV policies in Tanzania have adopted the three long-term impact results of zero new infections, zero HIV deaths and zero stigma and discrimination. Strategies to reach these results include scaling-up HIV Testing and Counselling (HTC); Preventing Mother-To-Child Transmission (PMTCT); and strengthening Care and Treatment Clinic (CTC) servic...

Diabetes prevalence in Tanzania was estimated at 9.1% in 2012 among adults aged 24-65 years - higher than the HIV prevalence in the general population at that time. Health systems in lower- and middle-income countries are not designed for chronic health care, yet the rising burden of non-communicable diseases such as diabetes demands chronic care s...

Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although so...

Background: The high prevalence of chronic diseases in Tanzania is putting a strain on the already stretched health care services, patients and their families. This study sought to find out how health care for diabetes and HIV is perceived, practiced and experienced by patients and family caregivers, to inform strategies to improve continuity of c...

The Network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA Network) was established in 2005 and aims to: (i) broaden the evidence base on HIV epidemiology for informing policy; (ii) strengthen analytical capacity for HIV research; and (iii) foster collaboration between study sites. 1 All of the study sites participating...

Cumulative evidence indicates increasing HIV infection among married individuals. Voluntary Counselling and Testing for HIV (HCT) is known to be an effective intervention to induce safer sex behaviour and access to early treatment, care and support among married individuals, which are important for HIV prevention. In this context, knowledge of fact...

Diabetes mellitus is an emerging public health problem in Tanzania. For the community and the health system to respond adequately to this problem, it is important that we understand the meanings given to its symptoms, and the care-seeking practices of individuals. To explore collective views on the meanings given to diabetes symptoms, we conducted...

Background: Appropriate infant feeding is a persistent challenge for human immunodeficiency virus (HIV)-infected mothers in sub-Saharan Africa. Objective: This study aimed to describe correlates of infant feeding among HIV-infected mothers in coastal Tanzania. Methods: HIV-infected women (n = 400) with infants younger than 18 months were enrol...

Background: In sub-Saharan Africa, the prevalence of HIV among married and cohabiting couples is substantial. Information about the underlying social drivers of HIV transmission in couples is critical for the development of structural approaches to HIV prevention, but not readily available. We explored the association between social drivers, pract...

Background: Tanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman's eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural sett...

To compare national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. We reviewed HIV policies as part of a multi-country study on adult mortality in sub-Saharan Africa. A policy extraction tool was developed and used to review national HIV policy documents and...

Objective To explore ideas of truck drivers and villagers from rural Tanzania about heterosexual anal sex (HAS) and the associated health risks. Methods Qualitative study using 8 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) with truck drivers and 16 IDIs and 4 FGDs with villagers from the Morogoro region. Study participants inclu...

To explore ideas of truck drivers and villagers from rural Tanzania about heterosexual anal sex (HAS) and the associated health risks. Qualitative study using 8 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) with truck drivers and 16 IDIs and 4 FGDs with villagers from the Morogoro region. Study participants included 24 women and 4...

The Ifakara Rural HDSS (125 000 people) was set up in 1996 for a trial of the effectiveness of social marketing of bed nets on morbidity and mortality of children aged under 5 years, whereas the Ifakara Urban HDSS (45 000 people) since 2007 has provided demographic indicators for a typical small urban centre setting. Jointly they form the Ifakara H...

Background: The Chronic Diseases Clinic Ifakara (CDCI) has been providing HIV care and treatment in Kilombero and Ulanga districts in Tanzania since 2005. Over time, several drug-refilling stations were created through the Tanzanian National AIDS Control Programme (NACP) to provide antiretroviral therapy (ART). Without any specific performance and...

The risk of contracting HIV through heterosexual anal sex (HAS) is significantly higher than from vaginal intercourse. Little has been done to understand the discourses around HAS and terms people use to describe the practice in Tanzania. A better understanding of discourses on HAS would offer useful insights for measurement of the practice as well...

Background: The Chronic Diseases Clinic Ifakara (CDCI) has been providing HIV care and treatment in Kilombero and Ulanga districts in Tanzania since 2005. Over time, several drug-refilling stations were created through the Tanzanian National AIDS Control Programme (NACP) to provide antiretroviral therapy (ART). Without any specific performance and...

Background Diabetes is a chronic condition which requires many patients to use medications for the remainder of their lives. While this regimen is demanding, little research has been done on the experiences individuals have with diabetes medication use and the continuity of use, especially patients from rural areas of Tanzania. This study explores...

In East Africa, epidemics of Rift Valley fever (RVF) occur in cycles of 5-15 years following unusually high rainfall. RVF transmission during inter-epidemic periods (IEP) generally passes undetected in absence of surveillance in mammalian hosts and vectors. We studied IEP transmission of RVF and evaluated the demographic, behavioural, occupational...

Background Around 3.3 million children worldwide are infected with HIV and 90% of them live in sub-Saharan Africa. Our study aimed to estimate adherence levels and find the determinants, facilitators and barriers of ART adherence among children and teenagers in rural Tanzania.Methods We applied a sequential explanatory mixed method design targeting...

The Sentinel Panel of Districts (SPD) consists of 23 districts selected to provide nationally representative data on demographic and health indicators in Tanzania. The SPD has two arms: SAVVY and FBIS. SAVVY (SAmple Vital registration with Verbal autopsY) is a demographic surveillance system that provides nationally representative estimates of mort...

SETTINGArusha, Mwanza, Mufindi and Kilosa in Tanzania. OBJECTIVE To assess the test characteristics of three indirect adherence measures against a gold standard of direct measurements of drug intake for use in a resource-constrained setting. METHODS We assessed sensitivity, specificity, positive predictive value (PPV) and negative predictive value...

Background: Most low-and middle-income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing the NCDs situation in Tanzania and ident...

Background Most low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing the NCDs situation in Tanzania and iden...

Rift Valley fever (RVF) occurs in outbreaks in cycles of 5-15 years in the Eastern Africa region and the Horn of Africa, following unusual high rainfall that leads to sustained flooding. In recent years, evidence of RVF transmission during inter-epidemic periods (IEP) in Africa has been reported. The IEP transmissions generally pass undetected in t...

Background: In recent years, evidence of Rift Valley fever (RVF) transmission during inter-epidemic periods in parts of Africa has increasingly been reported. The inter-epidemic transmissions generally pass undetected where there is no surveillance in the livestock or human populations. We studied the presence of and the determinants for inter-epid...

BACKGROUND: In recent years, evidence of Rift Valley fever (RVF) transmission during inter-epidemic periods in parts of Africa has increasingly been reported. The inter-epidemic transmissions generally pass undetected where there is no surveillance in the livestock or human populations. We studied the presence of and the determinants for inter-epid...

Comparison of RVF prevalence across species, sex and presence during the 2006/07 RVF epidemic. (DOC)

Background Patient Centred Tuberculosis Treatment (PCT) is a promising treatment delivery strategy for Mycobacterium tuberculosis (TB). It aims to improve adherence to treatment by giving patients the choice of having drug intake supervised at the health facility by a medical professional or at home by a supporter of their choice. Methods A cross-s...

Patient Centred Tuberculosis Treatment (PCT) is a promising treatment delivery strategy for Mycobacterium tuberculosis (TB). It aims to improve adherence to treatment by giving patients the choice of having drug intake supervised at the health facility by a medical professional or at home by a supporter of their choice. A cross-sectional survey was...

Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice between home-based treatment supervised by a treatment supporter o...

To estimate HIV prevalence and risk factors in population-based samples of female sex workers (FSW) and female voluntary counseling and testing (VCT) clients in Rwanda. We conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included interviewing and testing for HIV-1/2, HSV-2 and pregnancy, and BED-CEIA and A...

In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about in...

Data on combination antiretroviral therapy (cART) in remote rural African regions is increasing. We assessed prospectively initial cART in HIV-infected adults treated from 2005 to 2008 at St. Francis Designated District Hospital, Ifakara, Tanzania. Adherence was assisted by personal adherence supporters. We estimated risk factors of death or loss t...

To assess the local and systemic safety of dapivirine vaginal gel vs. placebo gel as well as the systemic absorption of dapivirine in healthy, HIV-negative women. Two prospective, randomized, double-blind, placebo-controlled phase I/II studies were conducted at five research centers, four in Africa and one in Belgium. A total of 119 women used dapi...

In Malawi the number of maternal deaths has been estimated using hospital-based surveys and populationbased surveys. The results of these studies sorted by setting and year of the study are presented in table 1. In addition large community-based surveillance systems are currently being implemented by the Karonga Prevention Study of the London Schoo...

Most of the studies on STI prevalence in Malawi have been conducted among selected groups such as commercial sex workers antenatal clinic attendees prisoners HIV infected subjects and STI clinic attendees. One study from Mangochi reported age-specific community based prevalence data on gonorrhoea and Chlamydia. Other community based STI prevalence...

To develop prognostic models for improved risk adjustment in surgical site infection surveillance for 5 surgical procedures and to compare these models with the National Nosocomial Infection Surveillance system (NNIS) risk index. In a multicenter cohort study, prospective assessment of surgical site infection and risk factors was performed from 199...

The acceptability and feasibility of microbicide studies and future microbicide use are influenced by existing norms and values regarding sexual and contraceptive behaviour. In preparation for microbicide research in Rwanda, focus group discussions were conducted to assess sexual and contraceptive behaviour, preferences for vaginal lubrication, and...

To estimate the effect of multicentre surveillance for nosocomial infections on patients' risk of surgical site infection (SSI). Prospective multi-centre cohort study, from January 1996 to December 2000. Acute care hospitals in The Netherlands. All 50 hospitals performing surveillance for one of seven selected procedures in the Dutch surveillance n...

To determine hospital-related risk factors for surgical-site infection (SSI) following hip arthroplasty. Prospective, multicenter cohort study based on surveillance data and data collected through a structured telephone interview. With the use of multilevel logistic regression, the independent effect of hospital-related characteristics on SSI was a...

Public reports of successful quality improvement efforts are useful, but seldom available. We present 5 successful efforts to prevent surgical site infections (SSIs) with the use of prospectively collected surveillance data. Before-and-after intervention studies were conducted in 5 acute care public hospitals in the national surveillance network fo...

The purpose of the study was to assess the relative importance of risk factors for surgical site infections (SSI) following total hip and total knee prostheses in The Netherlands. In the period 1996-99 63 hospitals in The Netherlands registered SSI after 36,629 orthopedic operations. Total hip and total knee prostheses were analyzed in detail. The...

To gain insight into the incidence of nosocomial infections and associated risk factors in Intensive Care Units (ICUs). Prospective. From July 1997 to December 1999, standardised surveillance of nosocomial infections was implemented in ICUs in 16 hospitals in the Netherlands. Surveillance was performed in patients with an ICU stay of > or = 48 hrs;...

Wanneer patiënten in het ziekenhuis een infectie oplo-pen, kan de kwaliteit van zorg in het geding zijn. In het 'European prevalence of infections in intensive care'-(EPIIC)-onderzoek, waaraan 78 intensive-careafdelin-gen (IC's) in Nederland deelnamen, had 16% van de 472 Nederlandse patiënten een infectie die op de IC was ont-staan. 1 2 De conclusi...

The PREZIES national surveillance network supports Dutch hospitals in introducing surveillance of surgical site infection (SSI), generates reference data on the incidence of SSI and associated risk factors, and provides an infrastructure for interventional research. Its ultimate goal is to reduce the occurrence of SSI. The aim was to discuss the me...

Background The aim was to study the feasibility of surveillance of sepsis related to central vascular catheters (CVCs) in the PREZIES network of hospitals in the Netherlands. Methods A national expert team developed a surveillance protocol. Ten hospitals conducted the surveillance during 3 months in 1999. The plot was evaluated in an interview wit...