Graeme Hoddinott
Biographic Data
| ID | 237059 |
|---|---|
| NAME | Graeme Hoddinott |
| GIVEN NAMES | Graeme |
| FAMILY NAME | Hoddinott |
| SIGNATURE | HODDINOTT G |
| AFFILIATIONS | Desmond Tutu HIV Foundation |
| ORCID | 0000-0001-5915-8126 |
| VERIFIED | Yes |
| TOTAL WORKS | 61 |
| TOTAL CITATIONS | 8 |
| AUTHOR COUNT | 36 |
| EDITOR COUNT | 25 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Projected population level impact and cost-effectiveness of clinic and community-based tuberculosis screening approaches
The South African National Department of Health have set ambitious targets to scale up TB testing, focusing primarily on clinic attendees. In the context of declining funding for TB care and prevention, the most cost-effective approaches for targeting testing should be identified. We developed a mathematical model of TB in South Africa, explicitly incorporating clinic attendance by sex and HIV/ART status. We simulated six screening approaches ove…
The impact of social protection interventions on treatment and socioeconomic outcomes of tuberculosis-affected people and households in low income, high burden settings
Tuberculosis (TB) is the leading cause of death due to infectious disease worldwide. Social protection interventions can benefit TB-affected households. We conducted a systematic review and meta-analysis to quantify the effectiveness of social protection on TB treatment and socioeconomic outcomes. We identified articles published from January 2012 to December 2025 by searching PubMed (includes MEDLINE), Embase, and Web of Science. We included stu…
Predicted choice and acceptability of regimens for tuberculosis preventive treatment among people living with HIV in Uganda – A discrete choice experiment
Little is known about people living with HIV’s preferences for different tuberculosis preventive treatment (TPT) regimens, or the conditions under which they would accept treatment. Actionable evidence regarding preference for TPT is needed to inform policy and the development of novel TPT regimens. Adults engaged in care at an HIV clinic in Kampala, Uganda, completed a discrete choice experiment survey with nine random choice tasks. In each task…
Mapping the research, policy, and clinical management landscape of post-tuberculosis lung disease
Tuberculosis (TB) can result in debilitating long-term health consequences, most notably post-tuberculosis lung disease (PTLD). However, these conditions remain insufficiently integrated into global policy and routine care, contributing to fragmented care for millions of TB survivors. This scoping review maps the current landscape to identify critical gaps and support the harmonisation of research, policy, and practice. We conducted a scoping rev…
Identifying pediatric extrapulmonary tuberculosis through an active screening program
We assessed 188 children diagnosed with extrapulmonary tuberculosis in Bangladesh. Over half were aged 10–14 years old. Common symptoms included fever (91.5%), weight loss (88.3%), and decreased appetite (72.9%). Four children died prior to treatment; of 176 children on treatment, 4.0% had unsuccessful outcomes, potentially influenced by age and low weight. Findings highlight the need for improved diagnosis and management in children.
Tuberculosis Under Apartheid in Cape Town, South Africa, 1950–1989
This article explores the paradox that tuberculosis (TB) in the post-war period had become ‘a completely curable disease’ yet remained a leading cause of death amongst global majority populations. Cape Town, South Africa, in the apartheid era provides our case study of the structural violence that inhibited appropriate social and clinical interventions. We first review recent historical literature on TB in global health, then describe the develop…
Tuberculosis comorbidities, multimorbidity and mortality amongst adults in South Africa
Tuberculosis (TB) comorbidities and multimorbidity - the presence of two or more concurrent diseases or health conditions - are major contributors to TB incidence and mortality. We investigated the prevalence and associated mortality of TB comorbidities and multimorbidity in South Africa. We conducted a prospective cohort study of adults ≥15 years with bacteriologically-confirmed pulmonary TB, nested within a trial in two provinces of South Afric…
Implementation of differentiated service delivery strategies for patients with tuberculosis in Haiti during a severe humanitarian crisis, January–August 2021
Global efforts to control tuberculosis (TB) faced significant challenges during the COVID-19 pandemic, particularly in Haiti, where it coincided with a severe humanitarian crisis. To minimize facility visits for patients, a differentiated service delivery (DSD) model with multi-month dispensing of TB drugs was implemented at two high-volume health facilities in Port-au-Prince, Haiti. All patients aged 18 years and older who initiated drug-suscept…
Non-communicable disease care in peri-urban Nepal
Non-communicable diseases (NCDs) are a growing public health challenge in Nepal, driven by hypertension, diabetes, and smoking, and contributing substantially to morbidity and mortality. Access to equitable and affordable care remains limited, particularly in community settings. Task-sharing with Female Community Health Volunteers (FCHVs), a national cadre of volunteer community health workers primarily engaged in maternal and child health, offer…
Community-based, peer-led psychosocial support to address stigma and reduce depression among adults with tuberculosis in Indonesia
We co-developed and evaluated a community-based, peer-led psychosocial support intervention consisting of individual and peer-led group counselling, online group messaging, and community-based “TB-Talks” to address tuberculosis (TB)-Stigma and reduce depression among adults with TB in Indonesia. A non-randomized, single-arm prospective interventional cohort study was conducted in five primary healthcare centres and two public hospitals in Depok a…
Perceived stigma among hospitalized pulmonary tuberculosis patients in Hue Central Hospital
Perceived tuberculosis related stigma remains a critical structural barrier to timely healthcare-seeking and a major driver of the global tuberculosis burden. This study aimed to estimate the prevalence of perceived stigma and identify its associated factors among hospitalized pulmonary tuberculosis inpatients in Hue Central Hospital - a national tertiary hospital in Vietnam - in 2024. A mixed-methods design was employed, incorporating both quant…
Development of a survey tool to measure pediatric experience of care
Despite increased availability of child health services, poor quality of care remains a major barrier to improved health outcomes in low-resource settings. Few validated tools exist to measure pediatric experience of care (PEC). Building on prior work in respectful maternity care, this study developed a caregiver-reported PEC survey based on a new conceptual framework and assessed the clarity, relevance, and cultural appropriateness of survey ite…
An emerging Timer-2C framework for addressing barriers to research culture and productivity among local healthcare providers in the Middle East and sub-Saharan Africa
Contributions from healthcare professionals in the Middle East and North Africa (MENA) and sub-Saharan Africa (SSA) to global health research remain disproportionately low. We conceptualized the TIMER-2C framework to capture the multi-level barriers and facilitators shaping research productivity among local healthcare professionals in MENA and SSA. We conducted qualitative interviews using a modified Delphi approach comprising two rounds to: 1) i…
Health issues and needs among adolescents in Ethiopia
Adolescence, which is a critical foundation for lifelong health, comes with distinct health challenges and needs. Understanding these is crucial for timely and effective measures. This study therefore examines adolescent health issues and needs and identifies unmet health information and service needs, including differences by sex, grade level, and school type, to inform tailored and effective interventions. The study employed a cross-sectional d…
Settings, characteristics, and experiences of stigma among people with tuberculosis in Kenya
Tuberculosis (TB) related stigma remains a significant barrier to TB care and treatment adherence in Kenya. Despite progress in TB control, stigma continues to affect individuals diagnosed with TB and their families, leading to delayed healthcare-seeking behaviors, social exclusion, and economic consequences. This study examines the prevalence and dimensions of TB-related stigma among people infected and affected by TB in Kenya. A cross-sectional…
Piloting the feasibility of a population-based joint TB-HIV survey in KwaZulu-Natal Province, South Africa, 2019
South Africa bears a high burden of infectious diseases, including intersecting epidemics of human immunodeficiency virus (HIV) and tuberculosis (TB). Among people living with HIV, TB is the predominant cause of death. Since 2002, South Africa has conducted six national population-based HIV surveys, and its first national TB prevalence survey between 2017 and 2019. Given the epidemiologic overlap of these conditions and dwindling resources, a joi…
Improving private tuberculosis patient notifications in Akot Tuberculosis Unit of Vidarbha region of India
India bears the world’s largest tuberculosis (TB) burden, and under-reporting from private-sector providers continues to hinder elimination goals. In the Akot Tuberculosis Unit (TU) of Maharashtra, private notifications remained disproportionately low despite extensive private healthcare presence. This study implemented a structured quality-improvement (QI) model using Plan–Do–Study–Act (PDSA) cycles to enhance TB case notifications from private …
Community health intervention through musical engagement (CHIME) in South Africa
In South Africa, perinatal depression, stress or anxiety affect an estimated 16% to 50% of women posing serious concerns for both mothers and infants. The vast majority of women receive no perinatal mental healthcare through the public health system, partly due to high levels of stigma and a lack of culturally sensitive mental health care. South African musical traditions such as group singing are culturally significant for supporting social conn…
The correlates and experiences of HIV-related intersectional stigma among caregivers of adolescents living with HIV during Covid-19 in KwaZulu-Natal, South Africa
Caregivers play a critical role in promoting HIV adherence and positive mental health among adolescents living with HIV (ALHIV). However, the health and wellbeing of caregivers are often compromised by HIV-related stigma. Furthermore, in sub-Saharan Africa, the effects of HIV-related stigma are amplified by intersecting forms of stigma, such as poverty and gender. If we can identify the key drivers of HIV-related intersectional stigma, then we ca…
Civil society perspectives on tuberculosis care for people living with HIV in Brazil
In Brazil, tuberculosis–human immunodeficiency virus (TB–HIV) coinfection remains a major public health challenge despite advances in antiretroviral therapy and tuberculosis preventive treatment (TPT) Civil society has historically contributed to HIV responses, but little is known about how it perceives TB care for people living with HIV (PLHIV). This study examined how organized civil society perceives and represents TB care for PLHIV. We conduc…
Reaching the 100 by 2027 target for universal access to rapid molecular diagnostic tests for tuberculosis in Africa
Although WHO recommended rapid molecular diagnostic tools for TB over a decade ago, only about one-third of diagnostic sites in high burden countries have access to them. We conducted a mixed-methods study to understand the barriers and facilitators to reaching universal access to WHO-recommended rapid molecular diagnostics (WRDs) in a selection of African countries. Data for 24 African countries were sourced from the WHO Global TB database to ev…
Identifying missed opportunities in tuberculosis preventive treatment care cascade
Tuberculosis infection is a condition when a person harbours the bacilli without having signs of active disease. In India, over 50% of household contacts of people with pulmonary tuberculosis have the infection. The national tuberculosis elimination programme recommends preventive treatment to such household contacts after ruling out active disease. Maharashtra is one of the bigger states in India with high tuberculosis burden. We analysed the pr…
Service providers’ perspectives on strategies to reduce caregiver burden among informal carers of people living with mental health conditions in rural South Africa
Caregiver burden is a public health problem affecting the emotional, physical, and mental health of informal caregivers of persons with severe mental health conditions worldwide. When caregivers feel overwhelmed, their ability to provide quality care is compromised. Although global evidence highlights the need for interventions to alleviate caregiver burden, such evidence is limited in low-resource settings, particularly in sub-Saharan Africa. Th…
Factors associated with delayed diagnosis of pulmonary tuberculosis in Chitwan district of Nepal
Pulmonary Tuberculosis (PTB) remains a major public health issue in Nepal and is among the top ten causes of death from a single infectious agent globally. Diagnostic delay refers to the time lag between the onset of symptoms and the confirmation of a correct diagnosis. Delayed diagnosis increases disease severity, prolongs infectivity, and hinders timely treatment. This study aimed to identify factors contributing to diagnostic delays of PTB in …
The catastrophic financial burden of extrapulmonary tuberculosis and asset index-based inequality analysis
This prospective cohort study assessed the financial burden of extrapulmonary tuberculosis (EPTB) in India, revealing substantial costs across disease manifestations. Among 200 confirmed EPTB patients, those with pleuritis, meningitis, and other severe forms, incurred significantly higher out-of-pocket (OOP) and indirect costs than lymphadenitis patients. Over 90% of meningitis and 80% of pleuritis patients experienced catastrophic health expendi…
HIV-related stigma and universal testing and treatment for HIV prevention and care
Background : Stigma and discrimination related to HIV and key populations at high risk of HIV have the potential to impede the implementation of effective HIV prevention and treatment programmes at scale. Studies measuring the impact of stigma on these programmes are rare. We are conducting an implementation science study of HIV-related stigma in communities and health settings within a large, pragmatic cluster-randomized trial of a universal tes…
Value and Limitations of Broad Brush Surveys Used in Community-Randomized Trials in Southern Africa
We describe and reflect on a rapid qualitative survey approach called "Broad Brush Survey" (BBS) used in six community-randomized trials (CRTs)/studies in Zambia and South Africa (2004-2018) to document, compare, classify, and communicate community features systematically for public health and multidisciplinary research ends. BBS is based on a set sequence of participatory qualitative methods and fieldwork carried out prior to a CRT intervention …
Being seen” at the clinic
Health workers in 21 government health facilities in Zambia and South Africa linked spatial organisation of HIV services and material items signifying HIV-status (for example, coloured client cards) to the risk of People Living with HIV (PLHIV) 'being seen' or identified by others. Demarcated HIV services, distinctive client flow and associated-items were considered especially distinguishing. Strategies to circumvent any resulting stigma mostly i…
HIV prevention for South African youth
Why MSM in Rural South African Communities Should be an HIV Prevention Research Priority
Research into HIV and men who have sex with men's (MSM) health in South Africa has been largely confined to the metropolitan centres. Only two studies were located making reference to MSM in rural contexts or same-sex behaviors among men in the same. There is growing recognition in South Africa that MSM are not only disproportionately affected by HIV and have been underserved by the country's national response, but that they contribute significan…
A narrative analysis positioning HIV relative to personal (sexual) relationship challenges in an agony aunt column in the Western Cape, South Africa – Aunty Mona’s “love advice”
HIV prevalence and incidence in South Africa remain high, making HIV a part of everyday life. Community narratives on HIV treatment and prevention are important and influence official and unofficial health messaging and community perceptions and understandings of HIV. We explore how contributors and the columnist of an agony aunt column position HIV relative to choices made about love, partnership, and sex over three years. We analysed all column…
“The difference that makes a difference”
This paper explores contextual heterogeneity within a community randomised trial HPTN 071 (Population Effects of Antiretroviral Treatment to Reduce HIV Transmission) carried out in 21 study communities (12 Zambian, 9 South African). The trial evaluates the impact of a combination HIV prevention package (including household-based HIV counselling and testing and anti-retroviral treatment (ART) eligibility regardless of CD4-count) on HIV incidence. …
HIV-related stigma and universal testing and treatment for HIV prevention and care
Background : Stigma and discrimination related to HIV and key populations at high risk of HIV have the potential to impede the implementation of effective HIV prevention and treatment programmes at scale. Studies measuring the impact of stigma on these programmes are rare. We are conducting an implementation science study of HIV-related stigma in communities and health settings within a large, pragmatic cluster-randomized trial of a universal tes…
Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa
To achieve UNAIDS 90:90:90 targets at population-level, knowledge of HIV status must be followed by timely linkage to care, initiation and maintenance of antiretroviral therapy (ART) for all people living with HIV (PLHIV). Interpreting quantitative patterns using qualitative data, we investigate time taken to link to care and initiate ART amongst individuals aware of their HIV-status in high HIV-prevalence urban communities in the HPTN 071 (PopAR…
Being seen” at the clinic
Health workers in 21 government health facilities in Zambia and South Africa linked spatial organisation of HIV services and material items signifying HIV-status (for example, coloured client cards) to the risk of People Living with HIV (PLHIV) 'being seen' or identified by others. Demarcated HIV services, distinctive client flow and associated-items were considered especially distinguishing. Strategies to circumvent any resulting stigma mostly i…
Value and Limitations of Broad Brush Surveys Used in Community-Randomized Trials in Southern Africa
We describe and reflect on a rapid qualitative survey approach called "Broad Brush Survey" (BBS) used in six community-randomized trials (CRTs)/studies in Zambia and South Africa (2004-2018) to document, compare, classify, and communicate community features systematically for public health and multidisciplinary research ends. BBS is based on a set sequence of participatory qualitative methods and fieldwork carried out prior to a CRT intervention …
Stigma and HIV service access among transfeminine and gender diverse women in South Africa – a narrative analysis of longitudinal qualitative data from the HPTN 071 (PopART) trial
DOH-27-0513-4253
OUP accepted manuscript
Universal' access to antiretroviral treatment (ART) has become the global standard for treating people living with HIV and achieving epidemic control; yet, findings from numerous 'test and treat' trials and implementation studies in sub-Saharan Africa suggest that bringing 'universal' access to ART to scale is more complex than anticipated. Using South Africa as a case example, we describe the research priorities and foci in the literature on exp…
TB is a disease which hides in the body’
The WHO estimates 58 million people experienced one or more TB disease episodes between 2000 and 2018. These 'former TB patients' are at greater risk of future TB infection and death than TB naïve people. Additionally, former TB patients experience social, psychological, and physiological difficulties after microbiological cure. Drawing on semi-structured interviews collected with 28 people from communities in Zambia ( n = 8) and South Africa ( n…
Motivating people living with HIV to initiate antiretroviral treatment outside national guidelines in three clinics in the HPTN 071 (PopART) trial, South Africa
Background : The HPTN 071 (PopART) trial implemented universal test and treat (UTT) in three clinics in the Western Cape, South Africa at a time when antiretroviral treatment (ART) was only offered by CD4 threshold and World Health Organization clinical staging. This required a concomitant shift in the way health workers communicated ART initiation messages. We provide insight into front-line ART initiation communication pre-national policy shift…
Community-based health workers implementing universal access to HIV testing and treatment
The global expansion of HIV testing, prevention and treatment services is necessary to achieve HIV epidemic control and promote individual and population health benefits for people living with HIV (PLHIV) in sub-Saharan Africa. Community-based health workers (CHWs) could play a key role in supporting implementation at scale. In the HPTN 071 (PopART) trial in Zambia and South Africa, a cadre of 737 study-specific CHWs, working closely with governm…
Caregiver–child separation during tuberculosis hospitalisation
There are an estimated 32,000 incident cases of multidrug-resistant tuberculosis in children globally each year. Extended hospitalisation is often required to ensure optimal adherence to the complex multidrug-resistant tuberculosis treatment regimen. Hospitalisation usually results in caregiver–child separation which is known to cause psychological difficulties in children. We explored caregivers’ and health workers’ perceptions of the effects of…
Universal HIV testing and treatment and HIV stigma reduction
Despite continued development of effective HIV treatment, expanded access to care and advances in prevention modalities, HIV-related stigma persists. We examine how, in the context of a universal HIV-testing and treatment trial in South Africa and Zambia, increased availability of HIV services influenced conceptualisations of HIV. Using qualitative data, we explore people's stigma-related experiences of living in 'intervention' and 'control' stud…
Underlying reasons why some people haven't tested for HIV - a discourse analysis of qualitative data from Cape Town, South Africa
Reported barriers to HIV testing over the last 15 years have remained consistent, despite improved service offerings. We aimed to probe deeper by exploring how people who have never tested construct HIV testing in their talk. We used this to suggest underlying psychosocial barriers to testing even when there is high availability. We enrolled 14 participants who reported that they had never tested for HIV and conducted individual, open-ended inter…
Toward a conceptual framework of the acceptability of tuberculosis treatment in children using a theory generative approach
To describe an early-stage holistic framework towards evaluating factors that impact the overall acceptability of TB treatment along the TB care cascade in children. We developed a conceptual framework utilising a theory generative approach. Domains were developed through review of existing definitions and analysis of existing qualitative data undertaken in acceptability studies of TB treatment in children. Clarity of domain definitions was achie…
Analysing interventions designed to reduce tuberculosis-related stigma
Stigma is a critical barrier for TB care delivery; yet data on stigma reduction interventions is limited. This review maps the available literature on TB stigma reduction interventions, using the Health Stigma and Discrimination framework and an implementation analysis to identify research gaps and inform intervention design. Using search terms for TB and stigma, we systematically searched PubMed, EMBASE and Web of Science. Two independent review…
Intimate Partner Violence (IPV) and Associated Factors in HPTN 071 (PopART) Study Communities in Zambia and South Africa—A Comparison by HIV Status
The HPTN 071(PopART) study was a community-randomised trial in Zambia and South Africa, examining the impact of combination-prevention including universal testing and treatment (UTT), on HIV-incidence. This sub-study evaluated factors associated with IPV (physical and/or sexual) to identify differences by HIV status. During 2015-16, a random subset of adults who participated in the first year of the PopART intervention were recruited and standard…
Testing when I know my status
Landmark studies demonstrating a reduction in onward HIV transmission and improved survival have informed a shift in global antiretroviral therapy policy to a ‘treat all’ approach. Global HIV stakeholders have called on countries to urgently scale up their HIV programs, involving responsibilities for various health system actors for accelerating HIV epidemic control. In this article we explore how community members in South Africa who were part o…
A scoping review of patient-centred tuberculosis care interventions
Tuberculosis (TB) is a leading cause of death globally. In 2015, the World Health Organization hailed patient-centred care as the first of three pillars in the End TB strategy. Few examples of how to deliver patient-centred care in TB programmes exist in practice; TB control efforts have historically prioritised health systems structures and processes, with little consideration for the experiences of people affected by TB. We aimed to describe ho…
Perspectives of people living with HIV and health workers about a point-of-care adherence assay
Current antiretroviral therapy (ART) adherence monitoring is premised on patients’ self-reported adherence behaviour (prone to recall error) and verified by blood viral load measurement (which can delay results). A newly developed Urine Tenofovir Rapid Assay (UTRA) assesses tenofovir in urine at point-of-care and is a novel tool to test and immediately respond to adherence levels of people living with HIV (PLHIV). We explored PLHIV and health wor…
The effect of universal testing and treatment for HIV on health-related quality of life – An analysis of data from the HPTN 071 (PopART) cluster randomised trial
The intervention did not change overall HRQoL, suggesting that raising HRQoL among PLHIV might require more than improved testing and treatment. However, PLHIV had fewer problems with pain/discomfort under the full intervention; this benefit of UTT should be maximised during roll-out
Redefining ‘family’
Transfeminine women (assigned male sex at birth and identifying with a feminine gender identity) are at risk for intersectional stigma related to their gender, sexual orientation, and other parts of their social identities (including age, class, and race). These layered stigmas can result in increased physical and mental health concerns related to physical and emotional violence, substance use, high risk sexual behaviour and HIV exposure. Social …
The socioeconomic impact of the Covid-19 lockdown on families affected by childhood respiratory illnesses in Cape Town, South Africa
The COVID-19 pandemic impacted families globally, directly and indirectly. Children presenting with respiratory illnesses are affected by emerging health systems and socioeconomic changes in the COVID-19 era. We explored the socioeconomic impacts of the COVID-19 lockdown on families with a respiratory illness diagnosed in their child in Cape Town, South Africa. This study was nested in a prospective observational cohort of children presenting wit…
Medicine (30 works) · Tuberculosis Research and Epidemiology (25 works) · HIV/AIDS Research and Interventions (22 works) · Tuberculosis (22 works) · Qualitative research (19 works) · Psychology (16 works) · Adolescent Sexual and Reproductive Health (14 works) · Health care (14 works) · Public health (14 works) · Sociology (14 works)