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Martin CE, Cox LA, Nongena P, Butler V, Ncube S, Sawry S, Mullick S. Patterns of HIV Pre-exposure Prophylaxis use Among Adolescent Girls and Young Women Accessing Routine Sexual and Reproductive Health services in South Africa. J Adolesc Health 2023; 73:S81-S91. [PMID: 37953014 DOI: 10.1016/j.jadohealth.2023.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 08/04/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE This study describes the patterns of pre-exposure prophylaxis (PrEP) use among adolescent girls and young women (AGYW) initiated on daily oral PrEP for the prevention of HIV, within routine sexual and reproductive health services in South Africa. METHODS We analysed clinical and survey data from a nested cohort of 967 AGYW initiated on oral PrEP between January 2019 and December 2021 in four geographical clusters in South Africa. We describe the periods of PrEP use, and the proportion who discontinued and subsequently restarted PrEP. Logistic regression analyses were conducted to determine factors associated with early PrEP discontinuation, PrEP use for ≥4 months and PrEP restart. RESULTS PrEP use for ≤1 month was high (68.6%), although 27% returned and restarted PrEP; and 9% restarted more than once. Initiating PrEP at a mobile clinic (AOR 2.10, 95% CI 1.51 - 2.93) and having a partner known to be HIV negative or whose HIV status was unknown (AOR 7.11, 95% CI 1.45 - 34.23; AOR 6.90, 95% CI 1.44 - 33.09) were associated with PrEP use for ≤1 month. AGYW receiving injectable contraceptives were more likely to restart PrEP (AOR 1.61, 95% CI 1.10 - 2.35). Compared to those aged 15-17 years, participants 18 - 20 and 21 - 24 years were less likely to restart PrEP (AOR 0.51, 95% CI 0.35 - 0.74; AOR 0.60, 95%, CI 0.41 - 0.87), as were those initiating PrEP at a mobile clinic compared to a fixed facility (AOR 0.66, 95% CI 0.47 - 0.92). DISCUSSION Although early PrEP discontinuation was high, it appears that PrEP use is frequently cyclical in nature. Further research is needed to determine if these cycles of PrEP correlate to periods of perceived or actual vulnerability to HIV, which may also be cyclical. PrEP delivery presents a unique opportunity to address multiple unmet health needs of young people.
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Affiliation(s)
| | | | - Pelisa Nongena
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Vusile Butler
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Sydney Ncube
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Shobna Sawry
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Saiqa Mullick
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
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Butler V, Kutywayo A, Martin CE, Pleaner M, Mojapele MV, Ncube S, Fipaza Z, Mundeta B, Mullick S. Implementing Differentiated and Integrated HIV Prevention Services for Adolescent Girls and Young Women: Experiences From Oral PrEP Rollout in Primary Care Services in South Africa. J Adolesc Health 2023; 73:S58-S66. [PMID: 37953010 DOI: 10.1016/j.jadohealth.2023.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/31/2023] [Accepted: 09/12/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE In South Africa, adolescent girls and young women (AGYW, aged 15-24 years) are disproportionately affected by human immunodeficiency viruses (HIV). Oral pre-exposure prophylaxis (PrEP) has been available in South Africa since 2016; however, there is limited evidence on oral PrEP implementation and integration in real-world settings, particularly among AGYW. Project PrEP is an implementation science project that sought to inform the introduction and integration of oral PrEP as part of combination HIV prevention and sexual and reproductive health services (SRH) in South Africa. The project focused on AGYW, as a priority population in need of HIV prevention. This paper presents strategies Project PrEP employed to increase oral PrEP and SRH service access and utilization. METHODS We present strategies employed to increase oral PrEP and SRH services uptake. Using routine monitoring data, facility assessments, stakeholder engagement, training and progress reports, and observations, we share implementation lessons learned and describe how strategies can be adapted by HIV prevention programs in different contexts. RESULTS Approximately 22, 000 people initiated on oral PrEP (December 2018-December 2021) across eight facilities and four mobile clinics. Two-thirds (67%) of initiated clients were AGYW. DISCUSSION Lessons are to be learned from the introduction of oral PrEP as implementers prepare for the introduction of new PrEP methods. Stakeholders must be continuously engaged to ensure buy-in, and social mobilization and demand creation should be contextual, focused, and innovative. Continuous staff training is needed to reinforce knowledge, and AGYW service delivery models must be local context relevant.
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Affiliation(s)
- Vusile Butler
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
| | - Alison Kutywayo
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Melanie Pleaner
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Sydney Ncube
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Zukiswa Fipaza
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Bongai Mundeta
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Saiqa Mullick
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
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Mullick S, Cox LA, Martin CE, Fipaza Z, Ncube S. Comparing the Integration of Syndromic versus Etiological Management of Sexually Transmitted Infections Into HIV Pre-Exposure Prophylaxis Services for Adolescent Girls and Young Women, in South Africa. J Adolesc Health 2023; 73:S67-S72. [PMID: 37953011 DOI: 10.1016/j.jadohealth.2023.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 11/14/2023]
Abstract
South Africa has a high incidence of human immunodeficiency virus and sexually transmitted infections (STIs), particularly among adolescent girls and young women. National and global guidelines recommend varied strategies for integrating STI and pre-exposure prophylaxis (PrEP) services. PURPOSE This paper describes the implementation of a syndromic compared to an etiological approach to STI integration within PrEP services in South Africa. METHODS We analysed program data from eight fixed and four mobile clinics to describe a cascade of STI care and integration of syndromic management among clients accessing PrEP services. Diagnostic testing was conducted in a subset of clients to determine the prevalence of STIs and estimate the burden of disease missed using a syndromic approach. RESULTS Between December 2018 and December 2021, 22,505 clients sought services and a high proportion (92.9%) was screened for STI symptoms. Of these, 9% of females and 3% of males had symptoms and 89.5% had recorded treatment. In a subset of PrEP clients (406 females, 70 males) screened through laboratory testing, chlamydia was identified in 25.7% of female and 20.0% of male samples, gonorrhea in 14.1% of female and 18.6% of male samples, and syphilis in 2.3% of female and 1.4% of male samples. Highest prevalence was found among females aged 18-20 years. DISCUSSION Syndromic STI screening and management can be integrated into routine PrEP service delivery and can identify symptomatic STIs, but misses asymptomatic infections. PrEP clients have a high prevalence of treatable STIs. Etiologic approaches can identify more infections than syndromic screening, but cheap point-of-care tests are needed.
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Affiliation(s)
- Saiqa Mullick
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
| | | | | | - Zukiswa Fipaza
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Sydney Ncube
- Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
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Pleaner M, Fipaza Z, Mabetha K, Greener L, Ncube S, Butler V, Beksinska M, Mullick S. Uptake of Contraception Among Adolescent Girls and Young Women PrEP Clients: Leveraging the Opportunity to Strengthen HIV and Sexual and Reproductive Health Integration. Front Reprod Health 2021; 3:684114. [PMID: 36304059 PMCID: PMC9580788 DOI: 10.3389/frph.2021.684114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/10/2021] [Indexed: 10/27/2023] Open
Abstract
The introduction of oral pre-exposure prophylaxis (PrEP) for HIV prevention was a major breakthrough in South Africa (SA). While the initial introduction focused on issues such as the development and implementation of new guidelines, supply, and the development of demand creation strategies, the need to integrate PrEP services with sexual and reproductive health (SRH) services has gained traction both globally and locally. Project PrEP was implemented in eight healthcare facilities and four mobile clinics in three provinces in SA. Using monitoring data from across the four project clusters, and 4,949 clients, over a 21-month period, we conducted an analysis of baseline routine monitoring data to examine contraceptive uptake in adolescent girls and young women (AGYW) initiating PrEP at project sites. Two-thirds of women (62.3%, n = 3,083) reported the current use of contraception at baseline, with the most commonly used methods being hormonal injectables (61.9%, n = 1,829) and male condoms (19.4%, n = 575). A third (32.3%, n = 603) of the non-contraceptive users accepted a method at PrEP initiation. From a total of 1,007 (32.7%) current contraceptive users at baseline, 865 (85.9%) chose the same or a different method at this visit. The method uptake at PrEP initiation increased the overall contraceptive prevalence by 12.2 to 74.5%. Data indicated that over a third (38.8%, n = 725) who were not using a method at baseline described themselves as consistent condom users. Although a major focus of the project was on PrEP service provision, all women were counseled and offered contraceptive services. The acceptance of a method by a third of non-users was promising; however, more understanding of those who did not take up a method is required. The need to leverage opportunities for the promotion of the integration of HIV and family planning at all levels of PrEP provision was highlighted.
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Affiliation(s)
- Melanie Pleaner
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Zukiswa Fipaza
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Khuthala Mabetha
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Letitia Greener
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Sydney Ncube
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Vusile Butler
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Mags Beksinska
- MatCH Research Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Saiqa Mullick
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
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Gobvu V, Ncube S, Caron A, Mugabe PH. Community-based performance indicators for monitoring and evaluating livestock interventions. Trop Anim Health Prod 2021; 53:387. [PMID: 34218348 DOI: 10.1007/s11250-021-02818-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
The research aimed at identifying livestock performance indicators used by farmers in Malipati community, Zimbabwe, and use them in developing a monitoring and evaluation framework for livestock interventions. Mixed methods research was used in the study. A questionnaire was administered to identify performance indicators of preference by farmers. Focus group discussions were done to rank performance indicators. Data analysis was done using SPSS version 25, and data were analysed using the ranking matrix. Scientific validity of performance indicators was determined through literature review. The study concluded that performance indicators of importance in poultry, cattle, goats/sheep, and donkeys were egg production, milk yield, kidding/lambing interval, and animal power, respectively. All performance indicators identified by farmers in Malipati are scientifically valid and were used in the development of the monitoring and evaluation framework.
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Affiliation(s)
- V Gobvu
- Department of Livestock Sciences, University of Zimbabwe, P O Box MP 167, Mount Pleasant, Harare, Zimbabwe.
| | - S Ncube
- Department of Livestock Sciences, University of Zimbabwe, P O Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - A Caron
- ASTRE, CIRAD, INRAD, Universite' de Montpellier, Montpellier, France
- Faculty of Veterinary Medicine, Eduardo Mondlane University, Praca 25 de Junho Caixa Postal 257, Maputo, Mozambique
| | - P H Mugabe
- Department of Livestock Sciences, University of Zimbabwe, P O Box MP 167, Mount Pleasant, Harare, Zimbabwe
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Washaya S, Tavirimirwa B, Dube S, Sisito G, Tambo G, Ncube S, Zhakata X. Reproductive efficiency in naturally serviced and artificially inseminated beef cows. Trop Anim Health Prod 2019; 51:1963-1968. [PMID: 31065932 DOI: 10.1007/s11250-019-01889-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 04/11/2019] [Indexed: 11/29/2022]
Abstract
A study was conducted to compare conception rates in 71 Tuli and 86 Afrikander beef cattle bred using either artificial insemination (AI) or the bull. Animals were bred using either artificial insemination or natural service at Matopos Research Station. Animals were grouped into three groups of heifers (parity 0; P0), second calvers (parity 1; P1) and mature cows (parity 2; P2) before being randomly assigned to one of the two breeding methods. A binary logistic regression was used for statistical analysis where breeding method (AI vs natural service) was the treatment factor and conception rate was the measured response while breed, parity and last calving date were non-treatment factors. No significant differences were observed in conception rates between breeds (P > 0.05). However, the method of breeding animals, parity and calving interval affected (P < 0.05) conception rates. The breeding method, parity and calving interval had a positive Kendall's tau-b correlation coefficients to conception. More animals were pregnant when AI (77.6%) was used compared with natural mating (56.79%). Conception rates were significantly lower (P < 0.05) in C1 compared with C2 cattle. The odds ratio for breeding method and parity are positive and significant (P < 0.05). In conclusion, the study confirms that artificial inseminated animals had similar conception rates to naturally serviced animals for both Tuli and Afrikander breeds. As such, artificial insemination technology can be used to complement or substitute natural service in indigenous cattle's of Zimbabwe.
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Affiliation(s)
- S Washaya
- Department of Agriculture, College of Health, Agriculture and Natural Sciences, Africa University, P Bag 1320, Mutare, Zimbabwe. .,Faculty of Science and Agriculture. Department of Livestock and Pasture Science, University of Fort Hare, King Williams Town Road, P. Bag X1314, Alice, 5700, South Africa.
| | - B Tavirimirwa
- Department of Research and Specialist Services, Matopos Research Institute, P Bag k5137, Bulawayo, Zimbabwe
| | - S Dube
- Faculty of Agriculture and Natural Resources Management, Midlands State University, Gweru, Zimbabwe
| | - G Sisito
- Department of Research and Specialist Services, Matopos Research Institute, P Bag k5137, Bulawayo, Zimbabwe
| | - G Tambo
- Department of Research and Specialist Services, Matopos Research Institute, P Bag k5137, Bulawayo, Zimbabwe
| | - S Ncube
- Department of Research and Specialist Services, Matopos Research Institute, P Bag k5137, Bulawayo, Zimbabwe
| | - X Zhakata
- Department of Research and Specialist Services, Matopos Research Institute, P Bag k5137, Bulawayo, Zimbabwe
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Ncube S, Coleman C, Strydom A, Flahaut E, de Sousa A, Bhattacharyya S. Kondo effect and enhanced magnetic properties in gadolinium functionalized carbon nanotube supramolecular complex. Sci Rep 2018; 8:8057. [PMID: 29795177 PMCID: PMC5966395 DOI: 10.1038/s41598-018-26428-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/08/2018] [Indexed: 11/09/2022] Open
Abstract
We report on the enhancement of magnetic properties of multiwalled carbon nanotubes (MWNTs) functionalized with a gadolinium based supramolecular complex. By employing a newly developed synthesis technique we find that the functionalization method of the nanocomposite enhances the strength of magnetic interaction leading to a large effective moment of 15.79 µB and non-superparamagnetic behaviour unlike what has been previously reported. Saturating resistance at low temperatures is fitted with the numerical renormalization group formula verifying the Kondo effect for magnetic impurities on a metallic electron system. Magnetoresistance shows devices fabricated from aligned gadolinium functionalized MWNTs (Gd-Fctn-MWNTs) exhibit spin-valve switching behaviour of up to 8%. This study highlights the possibility of enhancing magnetic interactions in carbon systems through chemical modification, moreover we demonstrate the rich physics that might be useful for developing spin based quantum computing elements based on one-dimensional (1D) channels.
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Affiliation(s)
- S Ncube
- Nano-Scale Transport Physics Laboratory, School of Physics, and DST/NRF Centre of Excellence in Strong materials, University of the Witwatersrand, Johannesburg, South Africa
| | - C Coleman
- Nano-Scale Transport Physics Laboratory, School of Physics, and DST/NRF Centre of Excellence in Strong materials, University of the Witwatersrand, Johannesburg, South Africa
| | - A Strydom
- Highly Correlated Matter Research Group, Department of Physics, University of Johannesburg, Auckland Park, 2006, South Africa.,Max Planck Institute for Chemical Physics of Solids, Nöthnitzerstr. 40, D-01187, Dresden, Germany
| | - E Flahaut
- CIRIMAT, Université de Toulouse, CNRS, INPT, UPS, UMR CNRS-UPS-INP No. 5085, Université Toulouse Paul Sabatier, Bât. CIRIMAT, 118, route de Narbonne, 31062, Toulouse, cedex 9, France
| | - A de Sousa
- School of Chemistry, University of the Witwatersrand, Johannesburg, South Africa
| | - S Bhattacharyya
- Nano-Scale Transport Physics Laboratory, School of Physics, and DST/NRF Centre of Excellence in Strong materials, University of the Witwatersrand, Johannesburg, South Africa.
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Ncube S, Halimani T, Chikosi E, Saidi P. Effect of Acacia angustissima leaf meal on performance, yield of carcass components and meat quality of broilers. S AFR J ANIM SCI 2018. [DOI: 10.4314/sajas.v48i2.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lalla-Edward ST, Ncube S, Matthew P, Hankins CA, Venter WDF, Gomez GB. Uptake of health services among truck drivers in South Africa: analysis of routine data from nine roadside wellness centres. BMC Health Serv Res 2017; 17:649. [PMID: 28903727 PMCID: PMC5598062 DOI: 10.1186/s12913-017-2595-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 09/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-distance truck drivers are occupationally susceptible to poor health outcomes. Their patterns of healthcare utilisation and the suitability of healthcare services available to them are not well documented. We report on truck driver healthcare utilisation across South Africa and characterise the client population of the clinics serving them for future service development. METHODS We analysed anonymised data routinely collected over a two-year period at nine Roadside Wellness Centres. Associations between services accessed and socio-demographic characteristics were assessed using univariable and multivariable logistic regression models. RESULTS We recorded 16,688 visits by 13,252 individual truck drivers (average of 1.26 visits/person) who accessed 17,885 services for an average of 1.07 services/visit and 1.35 services/person. The mean age of truck drivers was 39 years. Sixty-seven percent reported being in stable relationships. The most accessed services were primary healthcare (PHC)(62%) followed by HIV (32%). Low proportions (≤6%) accessed STI,TB and malaria services. Most visits were characterised by only one service being accessed (93%, n = 15,523/16,688). Of the remaining 7% of visits, up to five services were accessed per visit and the combination of TB /HIV services in one visit remained extremely low (<1%, n = 14/16,688). Besides PHC services at the beginning of the reporting period, all service categories displayed similar seasonal utilisation trends(i.e. service utilisation peaked in the immediate few months post clinics opening and substantially decreased before holidays). Across all service categories, younger truck drivers, those with a stable partner currently, and those of South African origin were the main clinic attendees. Older truck drivers (≥40 years) were more likely to access TB and PHC services, yet less likely to access HIV and STI services. Those with stable partners were less likely to access STI and TB services but more likely to access malaria and PHC services. South African attendees were more likely to access PHC, while attendees from other nationalities were more likely to access HIV and malaria services. CONCLUSIONS This utilisation analysis shows that tailored services assist in alleviating healthcare access challenges faced by truck drivers, but it underscores the importance of ensuring that service packages and clinics speak to truck drivers' needs in terms of services offered and clinic location.
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Affiliation(s)
- Samanta Tresha Lalla-Edward
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Hillbrow Health Precinct, 22 Esselen Street, Hillbrow, 2001, Johannesburg, South Africa.
| | - Sydney Ncube
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Hillbrow Health Precinct, 22 Esselen Street, Hillbrow, 2001, Johannesburg, South Africa
| | | | - Catherine A Hankins
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| | - W D Francois Venter
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Hillbrow Health Precinct, 22 Esselen Street, Hillbrow, 2001, Johannesburg, South Africa
| | - Gabriela B Gomez
- Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Gusha J, Halimani T, Ngongoni N, Ncube S. Effect of feeding cactus-legume silages on nitrogen retention, digestibility and microbial protein synthesis in goats. Anim Feed Sci Technol 2015. [DOI: 10.1016/j.anifeedsci.2015.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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