Browsing by Author "Shey, Muki Shehu."

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Advances in childhood immunisation in South Africa: where to now? Programme managers’ views and evidence from systematic reviews.
(BioMed Central., 2012) Wiysonge, Charles Shey.; Ngcobo, Nthombenhle J.; Jeena, Prakash M.; Madhi, Shabir A.; Schoub, Barry D.; Hawkridge, Anthony.; Shey, Muki Shehu.; Hussey, Gregory D.
Background: The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective public health programmes to improve child survival. We assessed challenges and enablers for the programme in South Africa, as we approach the 2015 deadline for the Millennium Development Goals. Methods: Between September 2009 and September 2010 we requested national and provincial EPI managers in South Africa to identify key challenges facing EPI, and to propose appropriate solutions. We collated their responses and searched for systematic reviews on the effectiveness of the proposed solutions; in the Health Systems Evidence, Cochrane Library, and PubMed electronic databases. We screened the search outputs, selected systematic reviews, extracted data, and assessed the quality of included reviews (using AMSTAR) and the quality of the evidence (using GRADE) in duplicate; resolving disagreements by discussion and consensus. Results: Challenges identified by EPI managers were linked to healthcare workers (insufficient knowledge of vaccines and immunisation), the public (anti-immunisation rumours and reluctance from parents), and health system (insufficient financial and human resources). Strategies proposed by managers to overcome the challenges include training, supervision, and audit and feedback; strengthening advocacy and social mobilisation; and sustainable EPI funding schemes, respectively. The findings from reliable systematic reviews indicate that interactive educational meetings, audit and feedback, and supportive supervision improve healthcare worker performance. Structured and interactive communication tools probably increase parents’ understanding of immunisation; and reminders and recall, use of community health workers, conditional cash transfers, and mass media interventions probably increase immunisation coverage. Finally, a national social health insurance scheme is a potential EPI financing mechanism; however, given the absence of high-quality evidence of effects, its implementation should be pilot-tested and the impacts and costs rigorously monitored. Conclusion: In line with the Millennium Development Goals, we have to ensure that our children’s right to health, development and survival is respected, protected and promoted. EPI is central to this vision. We found numerous promising strategies for improving EPI performance in South Africa. However, their implementation would need to be tailored to local circumstances and accompanied by high-quality monitoring and evaluation. The strength of our approach comes from having a strong framework for interventions before looking for systematic reviews. Without a framework, we would have been driven by what reviews have been done and what is easily researchable; rather than the values and preferences of key immunisation stakeholders.
Co-formulated abacavir-lamivudine-zidovudine for initial treatment of HIV infection and AIDS.
(The Cochrane Collaboration., 2013) Shey, Muki Shehu.; Kongnyuy, Eugene J.; Alobwede, Samuel M.; Wiysonge, Charles Shey.
The primary objective of this review was to evaluate the antiviral efficacy of co-formulated abacavir-lamivudine-zidovudine for initial treatment of HIV infection. The secondary objectives were to evaluate the safety and tolerability of the triple drug combination. We identified 15 potentially eligible studies, four of which met our inclusion criteria. Our findings indicate that co-formulated abacavirlamivudine-zidovudine remains a viable option for initiating antiretroviral therapy, especially in HIV-infected patients with pre-existing hyperlipidaemia and those who do not tolerate ritonavir.
Lower concentrations of chemotactic cytokines and soluble innate factors in the lower female genital tract associated with the use of injectable hormonal contraceptive.
(Elsevier., 2015) Ngcapu, Sinaye.; Masson, Lindi.; Sibeko, Sengeziwe.; Werner, Lise.; McKinnon, Lyle R.; Mlisana, Koleka Patience.; Shey, Muki Shehu.; Samsunder, Natasha.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.; Passmore, Jo-Ann Shelley.
Abstract available in pdf.
Modulation of female genital tract-derived dendritic cell migration and activation in response to inflammatory cytokines and toll-like receptor agonists.
(Shey, M.S., Maharaj, N., Archary, D., Ngcapu, S., Garrett, N., Abdool Karim, S.S. and Passmore, J.A.S. 2016. Modulation of female genital tract-derived dendritic cell migration and activation in response to inflammatory cytokines and toll-like receptor agonists. PloS One 11(5), e0155668., 2016) Shey, Muki Shehu.; Maharaj, Niren Ray.; Archary, Derseree.; Ngcapu, Sinaye.; Garrett, Nigel Joel.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.
Abstract available in pdf.
The role of dendritic cells in driving genital tract inflammation and HIV transmission risk: are there opportunities to intervene?
(Sage Publications., 2015) Shey, Muki Shehu.; Garrett, Nigel Joel.; McKinnon, Lyle R.; Passmore, Jo-Ann Shelley.
Abstract available in pdf.