Frank Tanser
Biographic Data
| ID | 355947 |
|---|---|
| NAME | Frank Tanser |
| GIVEN NAMES | Frank |
| FAMILY NAME | Tanser |
| SIGNATURE | TANSER F |
| AFFILIATIONS | Africa Health Research Institute |
| ORCID | 0000-0001-9797-0000 |
| VERIFIED | Yes |
| TOTAL WORKS | 52 |
| TOTAL CITATIONS | 32 |
| AUTHOR COUNT | 52 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2006 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Do men face greater barriers to accessing HIV testing services than women? Might HIV self-testing be the answer? Evidence from a longitudinal survey in east Zimbabwe (2018–2023)
HIV testing is crucial for prevention and treatment, yet barriers may disproportionately affect men in some sub-Saharan African settings. HIV self-testing (HIVST) may offer a promising solution, but its uptake remains under-explored. This study examines sex-specific barriers, HIV testing trends, and HIVST uptake in Manicaland, Zimbabwe, across three survey rounds pre-, during-, and post-COVID-19. We conducted longitudinal surveys 2018–2019 (pre- …
Worldwide trends in underweight and obesity from 1990 to 2022
BACKGROUND: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS: ). For school-aged children and adolescents, we report thinness (BMI 2 SD above the median). FINDINGS: From 1990 to 20…
Convergence of HIV and non-communicable disease epidemics
INTRODUCTION: As people living with HIV (PLHIV) are experiencing longer survival, the co-occurrence of HIV and non-communicable diseases has become a public health priority. In response to this emerging challenge, we aimed to characterise the spatial structure of convergence of chronic health conditions in an HIV hyperendemic community in KwaZulu-Natal, South Africa. METHODS: In this cross-sectional study, we used data from a comprehensive popula…
Exploring mental health emergencies attended by ambulances in rural England during the Covid-19 pandemic
Ambulance data offer novel insight into the mental health impacts of the pandemic in rural areas, which are typically underrepresented in health service use data. This research involved a retrospective observational study of all records of patients experiencing mental health emergencies attended by ambulances in the East Midlands of the United Kingdom between March 11 and December 31, 2020, and patients in regions classified as “rural towns” and …
Geospatial and temporal mapping of detectable HIV-1 viral loads amid dolutegravir rollout in KwaZulu-Natal, South Africa
South Africa rolled out dolutegravir (DTG) as first-line antiretroviral therapy (ART) in December 2019 to overcome high rates of pretreatment non-nucleoside reverse transcriptase inhibitor drug resistance. In the context of transition to DTG-based ART, this study spatiotemporally analysed detectable HIV viral loads (VLs) prior to- and following DTG rollout in public-sector healthcare facilities in KwaZulu-Natal (KZN) province, the epicentre of th…
Increasing HIV testing and linkage to care among men in rural South Africa using conditional financial incentives and a decision support app
Men in sub-Saharan Africa are less likely to accept HIV testing and link to HIV care than women. We conducted a trial to investigate the impact of conditional financial incentives and a decision support application, called EPIC-HIV, on HIV testing and linkage to care. We report the findings of the trial process evaluation to explore whether the interventions were delivered as intended, identify mechanisms of impact and any contextual factors that…
Tuberculin skin test surveys and the Annual Risk of Tuberculous Infection in school children in Northern KwaZulu-Natal
Tuberculin skin test surveys in primary school children can be used to quantify Mycobacterium tuberculosis transmission at community level. KwaZulu-Natal province, South Africa, is home to 11.5 million people and suffers a burden of tuberculosis disease that is among the highest in the world. The last tuberculin survey in the province was undertaken in 1979. We performed a tuberculin skin test survey nested within a demographic and health househo…
Effect of a Male-Targeted Digital Decision Support Application Aimed at Increasing Linkage to HIV Care Among Men
Improving early infant diagnosis for HIV-exposed infants using unmanned aerial vehicles for blood sample transportation in Conakry, Guinea
BACKGROUND: Early infant diagnosis (EID) for HIV-exposed infants is essential due to high mortality during the first months of their lives. In Conakry (Guinea), timely EID is difficult as traffic congestion prevents the rapid transport of blood samples to the central laboratory. We investigated the cost-effectiveness of transporting EID blood samples by unmanned aerial vehicles (UAV), also known as drones. METHODS AND FINDINGS: Using Monte Carlo …
Identifying sex-specific anthropometric measures and thresholds for dysglycemia screening in an HIV-endemic rural South African population
Valid screening and diagnostic algorithms are needed to achieve 2030 targets proposed by the WHO’s Global Diabetes Compact . We explored anthropometric thresholds to optimally screen and refer individuals for diabetes testing in rural South Africa. We evaluated screening thresholds for waist circumference (WC), body mass index (BMI), and waist-hip ratio (WHR) to detect dysglycemia based on a glycated hemoglobin (HbA1C) ≥6.5% among adults in a pop…
Ethical considerations in using a smartphone‐based GPS app to understand linkages between mobility patterns and health outcomes
Smartphones with Global Positioning System (GPS) apps offer simple and accurate tools to collect data on human mobility. However, their associated ethical challenges remain to be assessed. We used the Emanuel framework to assess the ethical concerns of using smartphone GPS to record mobility patterns of young adults in rural South Africa for a larger study on mobility and HIV risk (Sesikhona). We conducted four focus groups (FGDs) with individual…
Spatial variations in STIs among women enrolled in HIV prevention clinical trials in Durban, KwaZulu-Natal, South Africa
South Africa is faced with a high HIV and STI prevalence and incidence, respectively, with pockets of high burden areas driving these diseases. Localised monitoring of the HIV epidemic and STI endemic would enable more effective targeted prevention strategies. We assessed spatial variations in curable STI incidence among a cohort of women enrolled in HIV prevention clinical trials between 2002 and 2012. STI incidence rates from 7557 South African…
An early warning precision public health approach for assessing Covid-19 vulnerability in the UK
The MHVI identifies regions with known high rates of poor health outcomes prior to the pandemic that case rates or mortality rates alone fail to identify. Pre-hospital early warning measures could be utilised to prevent mortality during a novel pandemic
Feasibility and acceptability of using biometric fingerprinting to track migrations and support retention in HIV prevention research in fishing population in East Africa
Use of fingerprinting in fishing populations is feasible and acceptable. It is possible to track this mobile population for clinical trials or health services using this technology since most movements could be traced within and between villages
Exploring the Impact of the Covid-19 Pandemic on Male Mental Health Emergencies Attended by Ambulances During the First National “Lockdown” in the East Midlands of the United Kingdom
The novel coronavirus disease 2019 (COVID-19) pandemic and associated mitigation strategies such as “lockdown” are having widespread adverse psychological effects, including increased levels of anxiety and depression. Most research using self-reported data highlights the pandemic’s impact on the psychological well-being of females, whereas data for mental health emergency presentations may reflect the impact on male mental health more accurately.…
Characterizing Unusual Spatial Clusters of Male Mental Health Emergencies Occurring During the First National Covid-19 “Lockdown” in the East Midlands Region, UK
The widespread psychological effects of contagion mitigation measures associated with the novel coronavirus disease 2019 (COVID-19) are well known. Phases of “lockdown” have increased levels of anxiety and depression globally. Most research uses methods such as self-reporting that highlight the greater impact of the pandemic on the mental health of females. Emergency medical data from ambulance services may be a better reflection of male mental h…
Rethinking the health implications of society-environment relationships in built areas
An exploration of factors characterising unusual spatial clusters of Covid-19 cases in the East Midlands region, UK
The role of high-risk geographies in the perpetuation of the HIV epidemic in rural South Africa
In this study, we hypothesize that HIV geographical clusters (geospatial areas with significantly higher numbers of HIV positive individuals) can behave as the highly connected nodes in the transmission network. Using data come from one of the most comprehensive demographic surveillance systems in Africa, we found that more than 70% of the HIV transmission links identified were directly connected to an HIV geographical cluster located in a peri-u…
The geography and inter-community configuration of new sexual partnership formation in a rural South African population over fourteen years (2003–2016)
Understanding spatial configuration of sexual network structure is critical for effective use of HIV preventative interventions in a community. However, this has never been described at the population level for any setting in sub-Saharan Africa. We constructed the comprehensive geospatial sexual network among new heterosexual partnerships in rural KwaZulu-Natal, South Africa. In the Africa Health Research Institute (AHRI)’s population-based surve…
Isisekelo Sempilo study protocol for the effectiveness of HIV prevention embedded in sexual health with or without peer navigator support (Thetha Nami) to reduce prevalence of transmissible HIV amongs…
gov Identifier NCT04532307 . Registered: March 2020
Predictors of migration in an HIV hyper-endemic rural South African community
Globally, South Africa hosts the highest number of people living with HIV (PLHIV) and the unique legacy of internal labour migration continues to be a major driver of the regional epidemic, interrupting treatment-as-prevention efforts. The study examined levels, trends, and predictors of migration in rural KwaZulu-Natal Province, South Africa, using population-based surveillance data from 2005 through 2017. We followed 69 604 adult participants a…
PrEP uptake and delivery setting preferences among clients visiting six healthcare facilities in Eswatini
Due to the high HIV incidence among the general population of Eswatini, pre-exposure prophylaxis (PrEP) for HIV-exposed individuals is recommended. However, little is known about PrEP uptake and preferences in PrEP delivery healthcare setting among the general population. We conducted a secondary analysis of a randomized trial that aimed to increase PrEP uptake. All clients eligible for PrEP in one of six public-sector healthcare facilities in Es…
Health trends, inequalities and opportunities in South Africa’s provinces, 1990–2019
BACKGROUND: Over the last 30 years, South Africa has experienced four 'colliding epidemics' of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), we evaluated national and provincial health trends and progress towards imp…
Can a conditional financial incentive (CFI) reduce socio-demographic inequalities in home-based HIV testing uptake? A secondary analysis of the Hits clinical trial intervention in rural South Africa
In sub-Saharan Africa, home-based HIV testing interventions are designed to reach sub-populations with low access to HIV testing such as men, younger or less educated people. Combining these interventions with conditional financial incentives (CFI) has been shown to be effective to increase testing uptake. CFI are effective for one-off health behaviour change but whether they operate differentially on different socio-demographic groups is less cl…
Modelling and understanding primary health care accessibility and utilization in rural South Africa
Methodology for optimising location of new primary health care facilities in rural communities
Study objective: To develop a quantitative methodology to optimally site new primary health care facilities so as to achieve the maximum population level increase in accessibility to care. The study aims to test the methodology in a rural community characterised by considerable heterogeneity in population distribution and health care access. Design: A geographical information system was used to estimate travel time to the nearest primary health c…
CD4 count at antiretroviral therapy initiation and the risk of loss to follow-up
BACKGROUND: Antiretroviral therapy (ART) initiation is now recommended irrespective of CD4 count. However data on the relationship between CD4 count at ART initiation and loss to follow-up (LTFU) are limited and conflicting. METHODS: We conducted a cohort analysis including all adults initiating ART (2008-2012) at three public sector sites in South Africa. LTFU was defined as no visit in the 6 months before database closure. The Kaplan-Meier esti…
Methodology for optimising location of new primary health care facilities in rural communities
Study objective: To develop a quantitative methodology to optimally site new primary health care facilities so as to achieve the maximum population level increase in accessibility to care. The study aims to test the methodology in a rural community characterised by considerable heterogeneity in population distribution and health care access. Design: A geographical information system was used to estimate travel time to the nearest primary health c…
Modelling and understanding primary health care accessibility and utilization in rural South Africa
Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa
It is likely that where ANC coverage and contraceptive use is widespread and fertility is low, population-based surveillance under-estimates HIV prevalence due to unrepresentative testing by age, residence and also probably by HIV status, and that ANC sentinel surveillance over-estimates prevalence due to selection bias in terms of age of sexual debut and contraceptive use. The results presented highlight the importance of accounting for unrepres…
Cohort Profile
The health and demography of the South African population has been undergoing substantial changes as a result of the rapidly progressing HIV epidemic. Researchers at the University of KwaZulu-Natal and the South African Medical Research Council established The Africa Centre for Health and Population Studies in 1997 funded by a large core grant from The Wellcome Trust, UK. Given the urgent need for high quality longitudinal data with which to moni…
Population uptake of antiretroviral treatment through primary care in rural South Africa
Despite concerns about the equitable nature of antiretroviral treatment rollout, we find very few differences in ART uptake across a range of socio-demographic variables in a rural South African population. However, even when socio-demographic factors were taken into account, individuals living further away from primary healthcare clinics were still significantly less likely to be accessing ART
Determinants and spatial patterns of adult overweight and hypertension in a high HIV prevalence rural South African population
We conducted a large population-based survey among adults measuring weight, height, and blood pressure nested within an HIV survey in rural KwaZulu-Natal, South Africa, to identify and characterize clusters of overweight and hypertension in a typical rural African population and to explore whether geographic clusters can be accounted for by established individual-level risk factors. 58.4% of the participants were overweight and 22.6% were hyperte…
High Coverage of ART Associated with Decline in Risk of HIV Acquisition in Rural KwaZulu-Natal, South Africa
Cost-Benefit of ART In the battle to control HIV, mass antiretroviral treatment (ART) costs $500 to $900 per person per year. Bor et al. (p. 961 ) calculated the impact of intensifying ART on the life expectancy of people living in rural KwaZulu Natal. The dates of death were collected from a population of about 100,000 people during 2000–2011: Four years before and 8 years after the scaling up of ART. Life expectancy of adults increased by more …
Partner Age-Disparity and HIV Incidence Risk for Older Women in Rural South Africa
CD4 count at antiretroviral therapy initiation and the risk of loss to follow-up
BACKGROUND: Antiretroviral therapy (ART) initiation is now recommended irrespective of CD4 count. However data on the relationship between CD4 count at ART initiation and loss to follow-up (LTFU) are limited and conflicting. METHODS: We conducted a cohort analysis including all adults initiating ART (2008-2012) at three public sector sites in South Africa. LTFU was defined as no visit in the 6 months before database closure. The Kaplan-Meier esti…
Worldwide trends in blood pressure from 1975 to 2015
BACKGROUND: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. METHODS: For this analysis, we pooled national, subnational, or comm…
Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016
BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS: We pooled 2416 population-based studies with measurements of height…
Space-time patterns in maternal and mother mortality in a rural South African population with high HIV prevalence (2000–2014)
There has been an overall decrease in maternal and mother death between 2000 and 2014. The identification of a clear cluster of mother deaths shows the possibility of targeting intervention programs in vulnerable communities, as population-wide interventions may be ineffective and too costly to implement
A Cluster Randomised Trial to Determine the Efficacy of the “Feeding Buddies” Programme in Improving Exclusive Breastfeeding Rates Among HIV-Infected Women in Rural KwaZulu-Natal, South Africa
Effect of timing of mother’s death on child survival in a rural HIV hyper-endemic South African population
Children (less than 10 years) in rural households are at their highest risk of dying within 6 weeks of mother's death and this risk decreases substantially after the highly vulnerable window. This indicates that the period of mother's death does play a critical role on the survival of her children.Thus, understanding this risk and its timing in relation to a mother's death is critical to guide interventions and stress the relevance of assessing t…
Association between internal migration and epidemic dynamics
Results suggest that structural socioeconomic issues, rather than epidemic dynamics are likely to be associated with differences in mortality risk by migrant status. Interventions aimed at improving recent migrant's access to treatment may mitigate risk
Effect of the Number of Pregnancies on Mortality Risk in HIV-Infected Women
We investigated whether mortality risk increases with the number of full-term pregnancies in HIV-infected women. Our study is based on data from the ACDIS cohort, collected in rural KwaZulu-Natal, South Africa. Mortality risk for different number of pregnancies in HIV-infected women was analyzed using Cox proportional hazards model. The risk of TB or AIDS mortality in HIV-uninfected women did not change with the number of full-term pregnancies, w…
High percentage of undiagnosed HIV cases within a hyperendemic South African community
BACKGROUND: Undiagnosed HIV infections could undermine efforts to reverse the global AIDS epidemic by 2030. In this study, we estimated the percentage of HIV-positive persons who remain undiagnosed within a hyperendemic South African community. METHODS: The data come from a population-based surveillance system located in the Umkhanyakude district of the northern KwaZulu-Natal province, South Africa. We annually tested 38 661 adults for HIV betwee…
Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017
HIV/AIDS is a leading cause of disease burden in sub-Saharan Africa. Existing evidence has demonstrated that there is substantial local variation in the prevalence of HIV; however, subnational variation has not been investigated at a high spatial resolution across the continent. Here we explore within-country variation at a 5 × 5-km resolution in sub-Saharan Africa by estimating the prevalence of HIV among adults (aged 15–49 years) and the corres…
Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3–6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean B…
Effect of ART scale-up and female migration intensity on risk of HIV acquisition
Women who migrated frequently after ART scale-up had a significantly reduced HIV acquisition risk compared to those before its implementation. While this reduction is encouraging, women who migrate frequently remain at high risk of HIV acquisition. In the era of ART, there remains a critical need for public health interventions to reduce the risk of HIV acquisition in this highly vulnerable population
Home-based intervention to test and start (Hits) protocol
This trial was registered on 28 November 2018 on, identifier https://clinicaltrials.gov
Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories
BACKGROUND: Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. METHODS: For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease …
HIV incidence declines in a rural South African population
We have followed participants in one of the world's largest and longest running HIV cohorts to estimate long-term trends in the population-wide incidence of infection. Using a G-imputation approach, we present further evidence for HIV incidence rate declines in this hyper-endemic South African setting
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019
BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blo…
Beyond HIV prevalence
INTRODUCTION: Despite progress towards the Joint United Nations Programme on HIV/AIDS 95-95-95 targets, South Africa is still suffering from one of the largest HIV epidemics globally. In this study, we generated high-resolution HIV prevalence maps and identified people living with HIV (PLHIV) in underserved areas to provide essential information for the optimal allocation of HIV-related services. METHODS: The data come from the South Africa Demog…
Medicine (51 works) · Environmental health (41 works) · Demography (38 works) · Population (33 works) · HIV/AIDS Research and Interventions (30 works) · Adolescent Sexual and Reproductive Health (21 works) · Public health (21 works) · Geography (20 works) · Demography (17 works) · Internal Medicine (16 works)