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Introduction
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June 2005 - January 2015
June 2007 - February 2015
Publications
Publications (170)
Background. Bronchiectasis, a chronic suppurative lung condition, is a largely neglected disease, especially in low- to middle-income countries (LMICs), from which there is a paucity of data. Post-infectious causes are more common in LMICs, while in high-income countries, inborn errors of immunity (IEIs), recurrent aspiration, primary ciliary dyski...
Background
Exposure to air pollution can cause adverse health effects in people living with chronic lung disease. In people with asthma, it is not clear whether strategies to reduce outdoor air pollution can affect clinical symptoms and lung function.
Objectives
To determine strategies to reduce air pollution exposure for people with asthma, and t...
Primary ciliary dyskinesia (PCD) is an inherited ciliopathy that results in impaired mucous clearance and affects primarily the respiratory tract, causing upper airway disease, bronchial inflammation and bronchiectasis. The prevalence of PCD in low- and middle-income settings, including South Africa (SA), is unknown, largely owing to challenges wit...
Objectives This study identifies barriers and provides
recommendations to improve asthma care in children
across sub-Saharan Africa, where qualitative data is
lacking despite high rates.
Design One of the aims of our National Institute for Health
Research global health research group ‘Achieving Control
of Asthma in Children in Africa’ was to u...
Background: The use of donated expressed breast milk (DBM) is encouraged in South Africa, with donor milk banks and
legislated policies and programmes available in hospitals serving populations with a high HIV prevalence. Concerns over
poor attitudes amongst mothers towards DBM seem to persist.
Methods: A cross-sectional mixed-methods approach was...
Background
Eczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology.
Methods
The Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Allerg...
Background
Asthma is one of the most common non-communicable diseases globally. This study aimed to assess asthma medicine use, management plan availability, and disease control in childhood, adolescence, and adulthood across different country settings.
Methods
We used data from the Global Asthma Network Phase I cross-sectional epidemiological stud...
The British Thoracic Society (BTS) launched a Global Health Group in 2019 in partnership with the Pan African Thoracic Society. This paper reports the third of a series of BTS Winter Meeting global lung health symposia addressing lung health in African children in the context of poverty. In this report, we summarize the two presentations included i...
Background:
Multisystem inflammatory syndrome in children (MIS-C) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been infrequently described in Africa.
Objective:
To describe the clinical characteristics, outcomes and associations of severe disease in children hospitalized with MIS-C in KwaZulu-Natal.
Metho...
Spirometry is required as part of the comprehensive evaluation of both adult and paediatric individuals with suspected or confirmed respiratory diseases and occupational assessments. It is used in the categorisation of impairment, grading of severity, assessment of potential progression and response to interventions. Guidelines for spirometry in So...
Rationale:
The use of self-reported race/ethnicity to interpret lung function measurements has historically assumed that the observed differences in lung function between racial and ethnic group were due to thoracic cavity size differences relative to standing height. Very few studies have considered the influence of environmental and social deter...
Background and Objectives
Asthma is one of the most common chronic respiratory diseases across the life course and remains highly prevalent, with more severe symptoms in low- to middle-income countries (LMICs). Identifying risk factors for severe asthma symptoms can assist in improving asthma care. We aimed to determine the prevalence, severity and...
BACKGROUND
Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs), causing avoidable morbidity and mortality. The International Union Against Tuberculosis and Lung Disease convened a stakeholder meeting on this topic in February 2022.
METHODS
Focused group disc...
Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relative to asthma prevalence. This is particularly true...
Background. Lack of paediatric intensive care infrastructure, human resources and expertise in low- and middle-income countries (LMICs) often results in critically ill children being managed in non-intensive-care unit (ICU) settings.
Objectives. To compare the mortality between critically ill patients who required ventilation for more than 24 hours...
Background:
Paediatric intensive care units (PICUs) are high-risk settings for healthcare-associated infections. Invasive fungal infection (IFI) is one of the common causes of healthcare-associated infections.
Objectives:
To describe the prevalence and short-term outcomes of children with IFI, and to offer a basis for the efficient prevention an...
Bronchiectasis (BE) is a chronic condition affecting the bronchial tree.
It is characterized by the dilatation of large and medium-sized airways, secondary to damage of the underlying bronchial wall structural elements and accompanied by the clinical picture of recurrent or persistent cough. Despite an increased awareness of childhood BE, there is...
Background. Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. Methods. We conducted a 6-countr...
BACKGROUND: Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. METHODS: We conducted a 6-countr...
Background:
Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice.
Methods:
We conducted a 6-cou...
The World Conferences on Research Integrity have produced significant collaborative conference statements including the Singapore Statement on Research Integrity and more recently the Hong Principles on Researcher Assessment. The 7th World Conference on Research Integrity (7WCRI) takes place in Cape Town from the 29th May 2022 to 1st June 2022. The...
Available evidence indicates that children and adolescents can transmit SARS-CoV-2 infection and are also vulnerable to severe disease and death.
There has been recent acceleration in approvals, initiation and scale-up of COVID-19 vaccination among children under 18 years in high-, low- and middle-income countries around the world.
Current data i...
Objectives
Despite bearing a substantial burden of respiratory diseases, low- and middle-income countries in Africa contribute little to the research literature. Since 2007, the Pan African Thoracic Society’s Methods in Epidemiologic, Clinical, and Operations Research (PATS-MECOR) program has been working to strengthen capacity in lung health resea...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PA...
Importance: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. / Objective: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. / Design, Setting,...
Background:
The prevalence of asthma, the most common respiratory disease in children, has increased in many low- and middle-income countries (LMICs), particularly in Africa. Despite poor infrastructure and limited resources, researchers in southern Africa have sought to determine the prevalence of childhood asthma, with variable results reflectin...
Background
Clinical presentations of coronavirus disease 2019 (COVID‐19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID‐19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest.
Methods
The Global Asthma Netwo...
Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children and adolescents; and these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in impr...
Despite the acknowledged injustice and widespread existence of parachute research studies conducted in low-or middle-income countries by researchers from institutions in high-income countries, there is currently no pragmatic guidance for how academic journals should evaluate manuscript submissions and challenge this practice. We assembled a multidi...
Nyaope/whoonga is an indigenous street drug in South Africa (SA). It is made from a combination of neuro-stimulatory illicit drugs such as antiretroviral drugs, heroin, cannabis, opioids, cocaine as well as common household powders such as flat-screen television glass powder. It is a very addictive substance and is used even during pregnancy. Its e...
Objective
To identify reasons for poor asthma control in African children and adolescents.
Design
Systematic review
Data sources
PubMed, Scopus, CINHAL, PsycINFO, MEDLINE and Web of Science databases were systematically searched up to 31 May 2020. Hand searching was done on Sabinet, African Journal online and Google Scholar.
Eligibility criteria...
Background
Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
Methods
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthm...
The British Thoracic Society (BTS) launched a Global Health Group in the winter of 2019 in partnership with the Pan African Thoracic Society. This key meeting generated a lot of interest and areas of mutual benefit. Due to the overwhelming interest at the 2019 meeting, a virtual offering of the BTS Winter meeting February 2021, included a symposium...
Neurodevelopmental impairment is common in premature infants. We aimed to describe neurodevelopmental outcomes in very low birth weight (VLBW) infants at 12 months postmenstrual age (PMA) and correlated with maternal HIV status. A single-centre, prospective cohort study was conducted from 1 June 2017 to 31 January 2019 with follow-up to 12 months....
Pulmonary arteriovenous malformations (PAVMs) are caused by abnormal connections between arteries and veins, which lead to right-to-left shunting of deoxygenated blood. Here, we report an 11-year-old male who presented with signs suggestive of intracranial pathology. The patient displayed signs of a chronic illness, possibly congenital malformation...
There is much ongoing debate and concern regarding access to COVID-19 vaccines and roll-out gaps in low-income and middle-income countries compared with high-income countries.
African countries, many of which are low-income, also face issues with reciprocation after vaccine trials are done among their populations and the need to devolve vaccine m...
Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of SARS-CoV-2 infection among children and adolescents; however, these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifes...
Low-income and middle-income countries (LMICs) bear a disproportionately high burden of the global morbidity and mortality caused by chronic respiratory diseases (CRDs), including asthma, chronic obstructive pulmonary disease, bronchiectasis, and post-tuberculosis lung disease. CRDs are strongly associated with poverty, infectious diseases, and oth...
Background
Extra-uterine growth restriction (EUGR) is common in preterms and may be associated with elevated pro-inflammatory cytokines.
Objective
Describe postnatal growth in a cohort of very low-birth-weight (VLBW) infants and determine the association of interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) in umbilical cord blood with...
Lung health across the life course is influenced by factors affecting airway and alveolar development and growth during antenatal and perinatal periods, throughout childhood and adolescence, and into adulthood. Lung function trajectories are set in early life and childhood deficits may predispose to non-communicable respiratory diseases, such as as...
Background:
Pulmonary hydatid cyst disease is still a major problem in countries like South Africa (SA), where livestock farming is common. Hydatidosis has a variable clinical course depending on the size, location and complications of the cyst. For pulmonary cysts of any size, surgery remains the gold standard for treatment, with lung conservatio...
Background:
Pneumonia remains a major cause of morbidity and mortality amongst South African children. More comprehensive immunisation regimens, strengthening of HIV programmes, improvement in socioeconomic conditions and new preventive strategies have impacted on the epidemiology of pneumonia. Furthermore, sensitive diagnostic tests and better sa...
BACKGROUND. Asthma is the most common chronic disease of childhood and presents a diagnostic and management dilemma to many healthcare practitioners. The use of guidelines in managing paediatric acute asthma is essential to improve quality of life and reduce morbidity and mortality.OBJECTIVE. To review the adherence of medical practitioners to the...
Air pollution is increasingly recognized as a global health emergency with its impacts being wide ranging, more so for low- and middle-income countries where both indoor and outdoor pollution levels are high. In Africa, more than 80% of children live in households which use unclean sources of energy. The effects of both indoor and outdoor pollution...
BACKGROUND. More comprehensive immunisation regimens, strengthening of HIV prevention and management programmes and improved socioeconomic conditions have impacted on the epidemiology of paediatric community-acquired pneumonia (CAP) in South Africa (SA). OBJECTIVES. To summarise effective preventive strategies to reduce the burden of childhood CAP....
BACKGROUND. Pneumococcal conjugate vaccine (PCV) administration and other advances have been associated with a shift in the aetiological spectrum of community-acquired pneumonia, necessitating reconsideration of empiric antibiotic treatment guidelines. Management strategies have also evolved in the last decade. OBJECTIVES. To produce revised guidel...
BACKGROUND. Spina bifida (SB) is a neural tube defect (NTD) that has an increased risk of fatal and disabling effects if not repaired early, i.e. within the first 24 to 48 hours of life. Its diagnosis holds an increased burden for the patient and the caregiver owing to secondary complications. The effects of the disease are detrimental even with ea...
Objectives
South Africa has a double burden of high neonatal mortality and maternal HIV prevalence. Common to both is a proinflammatory in utero and perinatal milieu. The aim of this study was to determine cytokine profiles in HIV exposed (HE) and HIV unexposed (HU) very low birthweight (VLBW) infants and to determine whether these were associated...