Beverly Draper

University of Cape Town, Kaapstad, Western Cape, South Africa

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Publications (4)14.12 Total impact

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    ABSTRACT: Objective. It has previously been demonstrated that a peak in registered infant deaths, at 2-3 months of age at death, developed between 1997 and 2002 in South Africa, alongside the evolving HIV epidemic. The objective of this analysis was to explore the age distribution of post-neonatal infant deaths in South Africa by province, and relate the observed distributions to HIV and intervention characteristics. Design. Ecological study based on registered infant deaths and published HIV and intervention characteristics. Methods. Numbers of registered infant deaths beyond 1 month of age at death were plotted by year of death, province of South Africa and age at death in months, for the years 1997-2007. Results. The total number of registered deaths in infants aged 1-11 months increased from 15 404 in 1997 to 34 479 in 2006. Eight of the 9 provinces experienced an annual peak in registered infant deaths at 2-3 months of age between 1997 and 2007. This peak in mortality was not observed in the Western Cape. In 7 of 9 provinces registered post-neonatal infant deaths did not rise markedly in 2007 compared with 2005. Conclusions. We identified a single province out of 9 South African provinces in which a peak in early infant deaths at age 2-3 months did not occur during the period 1997-2007. This was the province with the earliest and highest coverage of antiretroviral interventions from 1999 onwards. It is possible that these interventions have averted the greater increase in early infant deaths seen in the rest of South Africa over this period.
    No preview · Article · Apr 2011 · Southern African Journal of HIV Medicine
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    ABSTRACT: South Africa has among the highest levels of HIV prevalence in the world. Our objectives are to describe the distribution of South African infant and child mortality by age at fine resolution, to identify any trends over recent time and to examine these trends for HIV-associated and non HIV-associated causes of mortality. A retrospective review of vital registration data was conducted. All registered postneonatal deaths under 1 year of age in South Africa for the period 1997-2002 were analysed by age in months using a generalized linear model with a log link and Poisson family. Postneonatal mortality increased each year over the period 1997-2002. A peak in HIV-related deaths was observed, centred at 2-3 months of age, rising monotonically over time. We interpret the peak in mortality at 2-3 months as an indicator for paediatric AIDS in a South African population with high HIV prevalence and where other causes of death are not sufficiently high to mask HIV effects. Intrauterine and intrapartum infection may contribute to this peak. It is potentially a useful surveillance tool, not requiring an exact cause of death. The findings also illustrate the need for early treatment of mother and child in settings with very high HIV prevalence.
    No preview · Article · Feb 2009 · AIDS (London, England)
  • Beverly Draper · Fareed Abdullah

    No preview · Article · Jul 2008 · South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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    ABSTRACT: There are two injectable progestogen-only contraceptives (IPCs) that have been available in many countries in the world since 1983. They are both still extensively used in many developing countries, forming a large proportion of the health system's expenditure on contraception. These are depot medroxyprogesterone acetate (DMPA) and norethisterone oenanthate (NET-EN). These are both highly effective contraceptives that receive wide acceptance amongst women in their fertile years. They differ in frequency of administration that has implications on patient uptake. They also differ in cost that may significantly affect budgeting in the health system. A systematic comparison will aid to ensure their rational use. To determine if there are differences between depot medroxyprogesterone acetate given at a dose of 150 mg IM every 3 months and norethisterone oenanthate given at a dose of 200mg IM every 2 months, in terms of contraceptive effectiveness, reversibility and discontinuation patterns, minor effects and major effects. We searched the computerized databases MEDLINE using PubMed, Popline, Cochrane Controlled Trials Register, Biblioline, LILACS, EMBASE and PASCAL for randomised controlled trials of DMPA versus NET-EN for long-acting progestogenic contraception. Studies were included regardless of language, and all databases were reviewed from the time that injectable progestogens have been in use. All randomised controlled comparisons of DMPA acetate given at a dose of 150 mg IM every 3 months versus NET-EN given at a dose of 200mg IM every 2 months, used for contraception, were included. Trials had to report on contraceptive efficiency and return to fertility, discontinuation risks and reasons for discontinuation, and clinical effects, both menstrual and non-menstrual. BD and CM evaluated the titles and abstracts obtained through applying the search strategy and applied the eligibility criteria. BD attempted to contact authors where clarification of the data was required, and contacted all main manufacturers of the contraceptives. After inclusion of the two studies, the data was abstracted and analysed with RevMan 4.2. Two trials were included in this review. There was no significant difference between the two treatment groups for the frequency of discontinuation for either contraceptive, although the women on NET-EN were 4% more likely to discontinue for personal reasons than those on DPMA. Discontinuation because of accidental pregnancy did not differ between the groups. Although the duration of bleeding and spotting events was the same in each group, women on DPMA were 21% more likely to develop amenorrhoea. Mean changes in body weight at 12 and 24 months, and in systolic and diastolic blood pressure at 12 months did not differ significantly between the studies. While the choice between DPMA and NET-EN as injectable progestogen contraceptives may vary between both health providers and patients, data from randomized controlled trials indicate little difference between the effects of these methods, except that women on DMPA are more likely to develop amenorrhoea. There is inadequate data to detect differences in some non-menstrual major and minor clinical effects.
    Full-text · Article · Feb 2006 · Cochrane database of systematic reviews (Online)