Limakatso Lebina
University of the Witwatersrand
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Publication
Featured researches published by Limakatso Lebina.
International Journal of Tuberculosis and Lung Disease | 2015
Tanvier Omar; Ebrahim Variava; Moroe E; Billioux A; Richard E. Chaisson; Limakatso Lebina; Neil Martinson
BACKGROUND A high proportion of deaths in Africa occur at home, where cause of death (CoD) is often unknown. We ascertained undiagnosed pulmonary tuberculosis (TB) by performing limited autopsies in adults dying at home in whom there was no apparent CoD. METHODS Mortuaries in Matlosana, South Africa, identified potentially eligible adults with no ante-mortem diagnosis and/or no recent hospital admission. A questionnaire was administered to family members. Bilateral lung core biopsies and modified bronchoalveolar lavage (BAL) were performed. The biopsies were examined histologically and submitted with BAL aspirates for mycobacterial culture (MGIT(TM)) and Xpert(®) MTB/RIF testing. Human immunodeficiency virus (HIV) testing was not performed. RESULTS Of 162 families approached, 28 refused and 29 of the deceased were on or had recently stopped anti-tuberculosis treatment; 85 were included. All were Black and 53% were men. The median age was 57 years (interquartile range [IQR] 44-66) and median symptom duration (mainly cough) was 63 days (IQR 14-112). Laboratory evidence of TB was found in 27 (31.8%); 21 were Xpert-positive, 23 were MGIT-positive and 14 had histological evidence consistent with active TB. CONCLUSION In this high HIV prevalence setting, a quarter of the home deaths had evidence of undiagnosed, likely infectious TB, suggesting that TB-related mortality is under-ascertained and under-reported, with serious implications for TB control in high TB burden settings.
PLOS ONE | 2015
Limakatso Lebina; Noah Taruberekera; Minja Milovanovic; Karin Hatzold; Miriam Mhazo; Cynthia Nhlapo; Nkeko Tshabangu; Mmatsie Manentsa; Victoria Kazangarare; Millicent Makola; Scott Billy; Neil Martinson
Background The World Health Organisation and the Joint United Nations Programme on HIV/AIDS have recommended the scale-up of Medical Male Circumcision (MMC) in countries with high HIV and low MMC prevalence. PrePex device circumcision is proposed as an alternate method for scaling up MMC. Objective Evaluate safety and feasibility of PrePex in South Africa. Design A multisite prospective cohort PrePex study in adults and adolescents at three MMC clinics. Participants were followed-up 8 times, up to 56 days after PrePex placement. Results In total, 398 PrePex circumcisions were performed (315 adults and 83 adolescents) their median ages were 26 (IQR: 22–30) and 16 years (IQR: 15–17), respectively. The median time for device placement across both groups was 6 minutes (IQR: 5–9) with the leading PrePex sizes being B (30%) and C (35%) for adults (18–45 years), and A (31%) and B (38%) for adolescents (14–17 years). Additional sizes (size 12–20) were rarely used, even in the younger age group. Pain of device application was minimal but that of removal was severe. However, described pain abated rapidly and almost no pain was reported 1 hour after removal. The Adverse Events rate were experienced by 2.7% (11/398) of all participants, three of which were serious (2 displacements and 1 self-removal requiring prompt surgery). None of the Adverse Events required hospitalization. The majority of participants returned to work within a day of device placement. Conclusion Our study shows that PrePex is a safe MMC method, for males 14 years and above. PrePex circumcision had a similar adverse event rate to that reported for surgical MMC, but device removal caused high levels of pain, which subsided rapidly.
Global Health Action | 2015
Hae Young Kim; Limakatso Lebina; Minja Milovanovic; Noah Taruberekera; David W. Dowdy; Neil Martinson
Background Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC) in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US
BMJ Open | 2014
Anna E Wherry; Cheyenne McCray; Temidayo I Adedeji-Fajobi; Xolani Sibiya; Peter Ucko; Limakatso Lebina; Jonathan E. Golub; Joanna E. Cohen; Neil Martinson
59.62 and
Tuberculosis Research and Treatment | 2016
Limakatso Lebina; Nigel Fuller; Tolu Osoba; Lesley Scott; Katlego Motlhaoleng; Modiehi Rakgokong; Pattamukkil Abraham; Ebrahim Variava; Neil Martinson
59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US
Tuberculosis | 2015
Limakatso Lebina; Pattamukkil Abraham; Katlego Motlhaoleng; Modiehi Rakgokong; Ebrahim Variava; Neil Martinson
51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US
International Journal of Tuberculosis and Lung Disease | 2014
Neil Martinson; Katherine E. McLeod; Minja Milovanovic; Reginah Msandiwa; Limakatso Lebina
10 and
PLOS ONE | 2016
Hillary Mukudu; Kennedy Otwombe; Fatima Laher; Erica Lazarus; Mmatsie Manentsa; Limakatso Lebina; Victor Mapulanga; Kasonde Bowa; Neil Martinson
2, the cost of VMMC was further reduced. Conclusions Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC.Background Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC) in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US
Journal of Acquired Immune Deficiency Syndromes | 2016
Minja Milovanovic; Noah Taruberekera; Neil Martinson; Limakatso Lebina
59.62 and
PLOS ONE | 2014
Cari van Schalkwyk; Ebrahim Variava; Adrienne E. Shapiro; Modiehi Rakgokong; Katlego Masonoke; Limakatso Lebina; Alex Welte; Neil Martinson
59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US