Research forms the foundation for Anova’s programmatic work. Reliable data are an invaluable source of direction for project teams, helping them identify needs and shortfalls and ensuring that their responses are targeted and comprehensive.

Anova has become increasingly involved in the production of research and is making significant contributions to the existing body of knowledge around HIV. Specifically, this work is providing insight where there is little current knowledge. These traditionally under-researched areas include children, STIs in rural areas, ocular disease and HIV, as well as at-risk populations, including men who have sex with men (MSM).

By partnering with renowned local and international universities and research institutions Anova is producing research that partners, government and donors can trust.

Finding effective ways of diagnosing TB

The accurate diagnosis of TB in public health facilities remains problematic. Many sites are far removed from laboratories where routine TB sputum tests and microscopy are usually performed, making the process lengthy and resource-intensive.

With the introduction of new technology that tests for TB on a molecular level, diagnosis can now take place at the point-of-care. The GeneXpert ™ is a small portable machine that provides results on the same day. But the cost of acquiring the GeneXpert™ is steep, raising questions about the feasibility of point-of-care testing.

Anova has embarked on research that will evaluate different operational setups for TB testing to provide some direction on the future of mobile TB testing. This high-profile project compares the diagnostic and clinical impact of direct diagnosis with laboratory-based diagnosis of TB. The project is conducted in collaboration with the University of Pretoria, the Medical Research Council Pretoria and the National Institute for Communicable Diseases.

Understanding ART effects on children

Children are often unable to properly identify and communicate the effect that medication has on their bodies and psyche. Knowing how certain treatments affect children and finding ways to respond to these effects is crucial to ensuring they comply with treatment and continue to lead a happy and rewarding life.

Anova’s Limpopo-based team conducted research to improve understanding of the effects of HIV treatment on children. Their findings revealed that hyperlactataemia—the build up of lactic acid in the body—is a common side-effect among children taking antiretroviral treatment (ART) in the Mopani district of Limpopo.

Knowing that hyperlactataemia is prevalent among children in the district will facilitate future early diagnosis of the condition, which is likely to lead to improved management of side-effects for these young patients.

The same team also found that peripheral neuropathy is common among children on ART in the Mopani district. Whilst peripheral neuropathy, the damage of nerve endings that can cause pain and numbness in the legs and arms, is frequently associated with ART and HIV infection, data on neuropathy in children is thin. Anova used the neuropathy symptom score (NSS) and neuropathy disability score (NDS) to screen for peripheral neuropathy, proving that these tools are effective in resource-poor settings.

Little research exists around the prevalence of STIs in rural areas. In response, Anova conducted research among 604 women in the Mopani district, screening for chlamydia and gonorrhoea. The research included oral and anal infection, an area for which there is virtually no data in Africa.

The study also assessed condom use and sexual coercion. Preliminary results presented at the AIDS 2012 conference revealed a high prevalence of infections and also showed that these are often asymptomatic.

Anova’s Health4Men team is conducting a number of research projects which promise to shed more light on this under-researched area. This has included an investigation into the prevalence of symptomatic and asymptomatic STIs among men who have sex with men, a study conducted in collaboration with the National Institute of Communicable Diseases in Pretoria. The study is based on the knowledge that many cases of sexually transmitted infection do not have outwardly detectable symptoms and are thus termed “asymptomatic”.

Eye infections and HIV

The effect HIV has on the body’s immune system leaves it vulnerable to many diseases. This includes often devastating eye conditions. Anova is partnering with the Erasmus University Rotterdam on a study funded through the Virus Discovery initiative that aims to improve the management of eye diseases among people living with HIV, particularly in rural settings.

Anova’s Khutšo Kurhula project will has been raising the level of awareness of ocular conditions among healthcare workers in Mopani, Limpopo, and has started rolling out appropriate training withing the clinics.

Anova’s monitoring and evaluation teams have conducted research into the effective implementation of an electronic ART register, known as Tier.Net – which allows for more efficient and accurate capturing of patient information and progress.

National implementation of the system will for the first time allow for the collation and thorough analysis of the country’s ART data.

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