Epidemiology & Public Health

Anova researches various aspects of the epidemiology of HIV, TB and STIs, as well as the evaluation of public health interventions for disease control.

Anova conducts research in various aspects of epidemiology of HIV, TB and STIs as well as evaluation of public health interventions for disease control. We focus on the following areas:

Routine data sources to provide programme information

Datasets that are collected routinely at healthcare facilities, such as TIER.Net, DHIS and ETR.net, constitute an important source of information. Despite some limitations, these datasets may have valuable insight in the state of epidemiological control and public health programmes. We are using these datasets to successfully gain insight in the paediatric ART programme; analyse groups at risk of HIV virological failure; determine the trends and gaps in diagnostic management of pulmonary TB and epidemiology of extra pulmonary TB; and the distribution of STIs in the population. To facilitate use of these routine datasets, we are investigating measures that improve accessibility and quality of routine data through implementation of innovative systems. Anova has been at the forefront of implementation of the ART, TB and pre-ART modules in TIER.Net and the lessons learnt in this process have been shown very valuable.

Research to determine programme impact

Anova constantly evaluates its operations to promote efficiency and show impact. Important evaluations that have been conducted include a qualitative study on the value of mentoring as part of technical assistance for HIV, TB and STI care, a systematic assessment of impact of direct service delivery and technical support provided by roving teams in Mopani District, evaluations of men-targeted HIV-testing services in Johannesburg, the value of various approaches of linking HIV-positive individuals to care, methods of alternative distribution of ART, a 3×90 hotspot model, etc. A specific evaluation is the ‘Health4Men reach’ project that aims to determine the number of MSM reached through the network of MSM-friendly healthcare facilities established by Anova. The results of all these initiatives are presented at various national and international meetings.

Implementation science

Anova is currently involved in two large implementation science projects. First, we are the implementing partner for the POP-ART study in the Cape Winelands. This project, aimed at determining the value of community-based testing and direct linkage to ART, provides a great opportunity to study lessons of programme implementation. Anova’s experience on real-world lessons on operationalising implementation strategies was presented at SA AIDS 2017 conference. The second large implementation science project focuses on the ward-based outreach teams (WBOTs) in Mopani District, Limpopo Province, and the contribution that these can make to the HIV and TB programmes in this district. The lessons learnt in implementation of the WBOTs assist in motivating for further scale-up of the programme as well as promote efficiency and impact in the context of HIV, TB and antenatal care.

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