Emmanuel Dube - Academia.edu (original) (raw)
Papers by Emmanuel Dube
Open Forum Infectious Diseases, Nov 26, 2023
Journal of the American Society of Nephrology, Nov 1, 2023
Infectious diseases and therapy, May 10, 2024
Introduction: AZD7442 is a combination of two neutralizing antibodies (tixagevimab/ cilgavimab) w... more Introduction: AZD7442 is a combination of two neutralizing antibodies (tixagevimab/ cilgavimab) with demonstrated efficacy in reducing the risk of symptomatic coronavirus disease 2019 (COVID-19) among individuals at high risk of severe COVID-19 ≤ 6 months after administration. On February 15, 2022, the Israeli Ministry of Health (IMoH) authorized the administration of 300 mg AZD7442 as preexposure prophylaxis (PrEP) against severe acute respiratory syndrome coronavirus 2 infection
Open Forum Infectious Diseases, Nov 26, 2023
The Lancet Regional Health - Europe, Nov 30, 2023
European Journal of Public Health
Background AZD7442, a combination of 2 neutralizing antibodies, has been shown to reduce symptoma... more Background AZD7442, a combination of 2 neutralizing antibodies, has been shown to reduce symptomatic COVID-19 risk by 83% at 6 months among high-risk individuals in a Phase 3 trial (PROVENT). The French Health Authorities authorized AZD7442 use in immunocompromised patients through Early Access Program (EAP). Eligibility for EAP was serological anti-spike levels of < 260 BAU/ml and very high risk of severe COVID. This abstract aims to describe the AZD7442 eligible population in France and characterize AZD7442 uptake in the EAP. Methods This is a retrospective observational database analysis of the EAP data. Demographics, and clinical characteristics of participants are described. Results 27,782 patients were included in the EAP between 12/15/2021 and 11/30/2022. AZD7442 was mostly prescribed by onco-hematologists (24.2%), followed by nephrologists (19.9%), internal medicine specialists (15.6%), and rheumatologists (6.5%). 50% of participants were over 65 years, 54.7% were male. T...
Open Forum Infectious Diseases, Nov 26, 2023
Ovarian cancer, 2021
Introduction/Background* Niraparib is a poly(ADP-ribose) polymerase (PARP) inhibitor approved as ... more Introduction/Background* Niraparib is a poly(ADP-ribose) polymerase (PARP) inhibitor approved as maintenance treatment for patients (pts) with newly diagnosed advanced or recurrent ovarian cancer following a response to platinum-based chemotherapy (CT) doublet. The PRIMA/ENGOT-OV26/GOG-3012 (NCT02655016) study showed that niraparib following firstline treatment improved progression-free survival (PFS) in the overall intention-to-treat (ITT) population (hazard ratio [HR] 0.62; 95% CI 0.50-0.76). Methodology This double-blind, placebo (PBO)-controlled, phase 3 trial evaluated niraparib in pts with newly diagnosed, advanced, high-grade serous or endometrioid ovarian, primary peritoneal, or fallopian tube cancer with a complete or partial response to first-line CT. Pts were considered to be at a high risk for disease progression based on their clinical characteristics. This post-hoc analysis presents the efficacy of niraparib, measured by PFS, based on time of surgery and residual disease status, and was not powered to determine differences among the subgroups. Result(s)* Data cutoff was May 2019. In total, 733 pts were randomized in the PRIMA study. Efficacy outcomes by surgical timing, either primary debulking surgery (PDS) or interval debulking surgery (IDS), and postoperative residual disease status, either no visible residual disease (NVRD) or visible residual disease (VRD), are shown in table 1. Pts who underwent PDS or IDS had similar efficacy with niraparib maintenance treatment versus PBO in the ITT population (PFS HRs were 0.67 and 0.57, respectively). Niraparib treatment reduced risk of progression by 42% in pts who received PDS and had VRD, 35% in those with IDS and NVRD, and 59% in those with IDS and VRD. Efficacy was not evaluable for pts with PDS and NVRD due to low sample size. Conclusion* In this post-hoc analysis, the impact of residual disease after PDS or IDS on the efficacy of niraparib was comparable across subgroups. Pts with IDS and VRD had the highest reduction in the risk of progression.
B32. ASTHMA OUTCOMES, 2020
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2008
The World Health Organization recommends a single-dose nevirapine (NVP) regimen for prevention of... more The World Health Organization recommends a single-dose nevirapine (NVP) regimen for prevention of mother-to-child transmission (PMTCT) of HIV in settings without the capacity to deliver more complex regimens, but the population-level impact of this intervention has rarely been assessed. A decision analysis model was developed, parameterized, and applied using local epidemiologic and demographic data to estimate vertical transmission of HIV and the impact of the PMTCT program in Zimbabwe up to 2005. Between 1980 and 2005, of approximately 10 million children born in Zimbabwe, a cumulative 504,000 (range: 362,000 to 665,000) were vertically infected with HIV; 59% of these infections occurred in nonurban areas. Mother-to-child transmission (MTCT) of HIV decreased from 8.2% (range: 6.0% to 10.7%) in 2000 to 6.2% (range: 4.9% to 8.9%) in 2005, predominantly attributable to declining maternal HIV prevalence rather than to the PMTCT program. Between 2002 and 2005, the single-dose NVP PMTCT program may have averted 4600 (range: 3900 to 7800) infections. In 2005, 32% (range: 26% to 44%) and 4.0% (range: 2.7% to 6.2%) of infections were attributable to breast-feeding and maternal seroconversion, respectively, and the PMTCT program reduced infant infections by 8.8% (range: 5.5% to 12.1%). Twice as many infections could have been averted had a more efficacious but logistically more complex NVP + zidovudine regimen been implemented with similar coverage (50%) and acceptance (42%). The decline in MTCT from 2000 to 2005 is attributable more to the concurrent decrease in HIV prevalence in pregnant women than to PMTCT at the current level of rollout. To improve the impact of PMTCT, program coverage and acceptance must be increased, especially in rural areas, and local infrastructure must then be strengthened so that single-dose NVP can be replaced with a more efficacious regimen.
EThOS - Electronic Theses Online ServiceGBUnited Kingdo
The Journal of Allergy and Clinical Immunology: In Practice, 2022
BACKGROUND Benralizumab is an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody... more BACKGROUND Benralizumab is an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody that depletes eosinophils, reducing exacerbations and oral corticosteroid (OCS) use, and improves asthma control for patients with severe eosinophilic asthma (SEA). Data on response in patients previously treated with other biologic therapies are limited. OBJECTIVE The goal of this study was to describe real-world clinical outcomes with benralizumab for patients with and without prior biologic use for uncontrolled SEA. METHODS This retrospective study compared clinical outcomes before and after benralizumab initiation in adults with uncontrolled SEA with ≥3 asthma exacerbations in the previous 12 months or on maintenance OCS (mOCS) treatment. Outcomes included exacerbations, OCS use, patient-reported outcomes (PROs), and health care resource utilization (HCRU), including emergency department visits and hospitalizations. RESULTS In all, 208 patients were enrolled, including 90 (43.3%) with previous experience with an alternate biologic for SEA. Benralizumab led to an 81% reduction in exacerbation rate, with 48% of patients with prior exacerbations experiencing none after 48 weeks. Overall, 67% of patients requiring baseline mOCS achieved ≥50% reduction in daily OCS dosage, and 53% eliminated mOCS. Clinically meaningful improvements in PROs were seen, with response at 4 weeks predicting longer-term benefits. HCRU also decreased. Improvements were observed irrespective of previous biologic experience, fractional exhaled nitric oxide (FeNO) concentrations, atopic status, or other baseline characteristics. CONCLUSION In a multicenter real-world setting, patients with uncontrolled SEA achieved substantial improvements in all clinical outcome measures with benralizumab irrespective of previous biologic use, atopic status, or baseline FeNO concentration.
Biased child mortality statistics owing to mothers ' HIV-related deaths Measuring and correc... more Biased child mortality statistics owing to mothers ' HIV-related deaths Measuring and correcting biased child mortality statistics in countries with generalized epidemics of HIV infection
Bulletin of The World Health Organization, 2010
Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se fa... more Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. املقالة. لهذه الكامل النص نهاية يف الخالصة لهذه العربية الرتجمة Objective Under Millennium Development Goal 4, countries are required to reduce child mortality by two-thirds between 1990 and 2015. In countries with generalized epidemics of human immunodeficiency virus (HIV) infection, standard statistics based on fertility history may misrepresent progress towards this target owing to the correlation between deaths among mothers and early childhood deaths from acquired immunodeficiency syndrome. Methods To empirically estimate this bias, child mortality data and fertility history, including births to deceased women, were collected through prospective household surveys in eastern Zimbabwe during 1998-2005. A mathematical model was then used to investigate the determinants and temporal dynamics of the bias, first in Zimbabwe and then in other countries with different background mortality rates and HIV-related epidemic profiles. Findings According to the empirical data, standard cross-sectional survey statistics underestimated true infant and under-5 mortality by 6.7% and 9.8%, respectively. These estimates were in agreement with the output from the model, in which the bias varied according to the magnitude and stage of the epidemic of HIV infection and background mortality rates. The bias was greater the longer the period elapsed before the survey and in later stages of the epidemic. Bias could substantially distort the measured effect of interventions to reduce non-HIV-related mortality and of programmes to prevent mother-to-child transmission, especially when trends are based on data from a single survey. Conclusion The correlation between the HIV-related deaths of mothers and their children can bias survey estimates of early child mortality. A mathematical model with a user-friendly interface is available to correct for this bias when measuring progress towards Millennium Development Goal 4 in countries with generalized epidemics of HIV infection.
Clinical Colorectal Cancer, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Colorectal Cancer, 2020
Aim: Correct identification of RAS gene variants is key for targeted treatment decisions in patie... more Aim: Correct identification of RAS gene variants is key for targeted treatment decisions in patients with metastatic colorectal cancer. Published RAS mutation rates differ and could be influenced by several factors including testing methods. This study aimed to describe the performance of laboratories to correctly identify RAS variants over time and to understand how RAS testing has evolved in Europe. Materials & methods: Misclassification and test failure rates were calculated and related to the used test methodology for 239 unique laboratories participating in external quality assessment for metastatic colorectal cancer between 2013 and 2018. In addition, 33 laboratories completed a survey aiming to obtain more details on their routine testing strategies, number of samples analyzed and RAS mutation rates between 2013 and 2017. Results: The mutation status was correctly analyzed in 96.1% (N = 5471) RAS and BRAF tests. A total of 4.6% (N = 2860) RAS tests included false-negative res...
HIV, Resurgent Infections and Population Change in Africa, 2007
... AD McNAGHTEN CDC Zimbabwe and Centers for Disease Control & Prevention, Atlanta, USA ... more ... AD McNAGHTEN CDC Zimbabwe and Centers for Disease Control & Prevention, Atlanta, USA SABADA DUBE AND NICHOLAS C. GRASSLY Department of Infectious Disease Epidemiology, Imperial College London, London, UK Abstract. ...
Sexually Transmitted Infections, 2006
Background: This paper brings together data from a variety of reports to provide a basis for asse... more Background: This paper brings together data from a variety of reports to provide a basis for assessing future steps for responding to and monitoring the HIV epidemic in Zimbabwe. Method: Data reported from four antenatal clinic (ANC) surveys conducted between 2000 and 2004, two small local studies in Zimbabwe conducted from 1997 through 2003, four general population surveys from 1999 through 2003, and service statistics covering 1990 through 2004 were used to describe recent trends in HIV prevalence and incidence, behaviour change, and programme provision. Results: HIV prevalence among pregnant women attending ANCs declined substantially from 32.1% in 2000 to 23.9% in 2004. The local studies confirmed the decline in prevalence. However, prevalence continued to be high. Sexual behaviour data from surveys suggests a reduction in sexual experience before age 15 years among both males and females age 15-19 years, and in the proportions of males and females aged 15-29 years reporting non-regular sexual partners in the past 12 months. Reported condom use with non-regular partners has been high since 1999. Condom distribution and HIV counseling and testing increased from 2000 to 2004. Discussion: On the basis of examination of data from a variety of sources, the recent decrease in HIV prevalence may be related to recent reductions in early-age sexual activity and non-regular sexual partnerships and increases in condom use. Comparison of data from sentinel surveillance systems, population based serosurveys, local studies, and service statistics provide increased confidence that a decline in HIV prevalence in Zimbabwe is actually happening in the population.
Open Forum Infectious Diseases, Nov 26, 2023
Journal of the American Society of Nephrology, Nov 1, 2023
Infectious diseases and therapy, May 10, 2024
Introduction: AZD7442 is a combination of two neutralizing antibodies (tixagevimab/ cilgavimab) w... more Introduction: AZD7442 is a combination of two neutralizing antibodies (tixagevimab/ cilgavimab) with demonstrated efficacy in reducing the risk of symptomatic coronavirus disease 2019 (COVID-19) among individuals at high risk of severe COVID-19 ≤ 6 months after administration. On February 15, 2022, the Israeli Ministry of Health (IMoH) authorized the administration of 300 mg AZD7442 as preexposure prophylaxis (PrEP) against severe acute respiratory syndrome coronavirus 2 infection
Open Forum Infectious Diseases, Nov 26, 2023
The Lancet Regional Health - Europe, Nov 30, 2023
European Journal of Public Health
Background AZD7442, a combination of 2 neutralizing antibodies, has been shown to reduce symptoma... more Background AZD7442, a combination of 2 neutralizing antibodies, has been shown to reduce symptomatic COVID-19 risk by 83% at 6 months among high-risk individuals in a Phase 3 trial (PROVENT). The French Health Authorities authorized AZD7442 use in immunocompromised patients through Early Access Program (EAP). Eligibility for EAP was serological anti-spike levels of < 260 BAU/ml and very high risk of severe COVID. This abstract aims to describe the AZD7442 eligible population in France and characterize AZD7442 uptake in the EAP. Methods This is a retrospective observational database analysis of the EAP data. Demographics, and clinical characteristics of participants are described. Results 27,782 patients were included in the EAP between 12/15/2021 and 11/30/2022. AZD7442 was mostly prescribed by onco-hematologists (24.2%), followed by nephrologists (19.9%), internal medicine specialists (15.6%), and rheumatologists (6.5%). 50% of participants were over 65 years, 54.7% were male. T...
Open Forum Infectious Diseases, Nov 26, 2023
Ovarian cancer, 2021
Introduction/Background* Niraparib is a poly(ADP-ribose) polymerase (PARP) inhibitor approved as ... more Introduction/Background* Niraparib is a poly(ADP-ribose) polymerase (PARP) inhibitor approved as maintenance treatment for patients (pts) with newly diagnosed advanced or recurrent ovarian cancer following a response to platinum-based chemotherapy (CT) doublet. The PRIMA/ENGOT-OV26/GOG-3012 (NCT02655016) study showed that niraparib following firstline treatment improved progression-free survival (PFS) in the overall intention-to-treat (ITT) population (hazard ratio [HR] 0.62; 95% CI 0.50-0.76). Methodology This double-blind, placebo (PBO)-controlled, phase 3 trial evaluated niraparib in pts with newly diagnosed, advanced, high-grade serous or endometrioid ovarian, primary peritoneal, or fallopian tube cancer with a complete or partial response to first-line CT. Pts were considered to be at a high risk for disease progression based on their clinical characteristics. This post-hoc analysis presents the efficacy of niraparib, measured by PFS, based on time of surgery and residual disease status, and was not powered to determine differences among the subgroups. Result(s)* Data cutoff was May 2019. In total, 733 pts were randomized in the PRIMA study. Efficacy outcomes by surgical timing, either primary debulking surgery (PDS) or interval debulking surgery (IDS), and postoperative residual disease status, either no visible residual disease (NVRD) or visible residual disease (VRD), are shown in table 1. Pts who underwent PDS or IDS had similar efficacy with niraparib maintenance treatment versus PBO in the ITT population (PFS HRs were 0.67 and 0.57, respectively). Niraparib treatment reduced risk of progression by 42% in pts who received PDS and had VRD, 35% in those with IDS and NVRD, and 59% in those with IDS and VRD. Efficacy was not evaluable for pts with PDS and NVRD due to low sample size. Conclusion* In this post-hoc analysis, the impact of residual disease after PDS or IDS on the efficacy of niraparib was comparable across subgroups. Pts with IDS and VRD had the highest reduction in the risk of progression.
B32. ASTHMA OUTCOMES, 2020
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2008
The World Health Organization recommends a single-dose nevirapine (NVP) regimen for prevention of... more The World Health Organization recommends a single-dose nevirapine (NVP) regimen for prevention of mother-to-child transmission (PMTCT) of HIV in settings without the capacity to deliver more complex regimens, but the population-level impact of this intervention has rarely been assessed. A decision analysis model was developed, parameterized, and applied using local epidemiologic and demographic data to estimate vertical transmission of HIV and the impact of the PMTCT program in Zimbabwe up to 2005. Between 1980 and 2005, of approximately 10 million children born in Zimbabwe, a cumulative 504,000 (range: 362,000 to 665,000) were vertically infected with HIV; 59% of these infections occurred in nonurban areas. Mother-to-child transmission (MTCT) of HIV decreased from 8.2% (range: 6.0% to 10.7%) in 2000 to 6.2% (range: 4.9% to 8.9%) in 2005, predominantly attributable to declining maternal HIV prevalence rather than to the PMTCT program. Between 2002 and 2005, the single-dose NVP PMTCT program may have averted 4600 (range: 3900 to 7800) infections. In 2005, 32% (range: 26% to 44%) and 4.0% (range: 2.7% to 6.2%) of infections were attributable to breast-feeding and maternal seroconversion, respectively, and the PMTCT program reduced infant infections by 8.8% (range: 5.5% to 12.1%). Twice as many infections could have been averted had a more efficacious but logistically more complex NVP + zidovudine regimen been implemented with similar coverage (50%) and acceptance (42%). The decline in MTCT from 2000 to 2005 is attributable more to the concurrent decrease in HIV prevalence in pregnant women than to PMTCT at the current level of rollout. To improve the impact of PMTCT, program coverage and acceptance must be increased, especially in rural areas, and local infrastructure must then be strengthened so that single-dose NVP can be replaced with a more efficacious regimen.
EThOS - Electronic Theses Online ServiceGBUnited Kingdo
The Journal of Allergy and Clinical Immunology: In Practice, 2022
BACKGROUND Benralizumab is an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody... more BACKGROUND Benralizumab is an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody that depletes eosinophils, reducing exacerbations and oral corticosteroid (OCS) use, and improves asthma control for patients with severe eosinophilic asthma (SEA). Data on response in patients previously treated with other biologic therapies are limited. OBJECTIVE The goal of this study was to describe real-world clinical outcomes with benralizumab for patients with and without prior biologic use for uncontrolled SEA. METHODS This retrospective study compared clinical outcomes before and after benralizumab initiation in adults with uncontrolled SEA with ≥3 asthma exacerbations in the previous 12 months or on maintenance OCS (mOCS) treatment. Outcomes included exacerbations, OCS use, patient-reported outcomes (PROs), and health care resource utilization (HCRU), including emergency department visits and hospitalizations. RESULTS In all, 208 patients were enrolled, including 90 (43.3%) with previous experience with an alternate biologic for SEA. Benralizumab led to an 81% reduction in exacerbation rate, with 48% of patients with prior exacerbations experiencing none after 48 weeks. Overall, 67% of patients requiring baseline mOCS achieved ≥50% reduction in daily OCS dosage, and 53% eliminated mOCS. Clinically meaningful improvements in PROs were seen, with response at 4 weeks predicting longer-term benefits. HCRU also decreased. Improvements were observed irrespective of previous biologic experience, fractional exhaled nitric oxide (FeNO) concentrations, atopic status, or other baseline characteristics. CONCLUSION In a multicenter real-world setting, patients with uncontrolled SEA achieved substantial improvements in all clinical outcome measures with benralizumab irrespective of previous biologic use, atopic status, or baseline FeNO concentration.
Biased child mortality statistics owing to mothers ' HIV-related deaths Measuring and correc... more Biased child mortality statistics owing to mothers ' HIV-related deaths Measuring and correcting biased child mortality statistics in countries with generalized epidemics of HIV infection
Bulletin of The World Health Organization, 2010
Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se fa... more Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. املقالة. لهذه الكامل النص نهاية يف الخالصة لهذه العربية الرتجمة Objective Under Millennium Development Goal 4, countries are required to reduce child mortality by two-thirds between 1990 and 2015. In countries with generalized epidemics of human immunodeficiency virus (HIV) infection, standard statistics based on fertility history may misrepresent progress towards this target owing to the correlation between deaths among mothers and early childhood deaths from acquired immunodeficiency syndrome. Methods To empirically estimate this bias, child mortality data and fertility history, including births to deceased women, were collected through prospective household surveys in eastern Zimbabwe during 1998-2005. A mathematical model was then used to investigate the determinants and temporal dynamics of the bias, first in Zimbabwe and then in other countries with different background mortality rates and HIV-related epidemic profiles. Findings According to the empirical data, standard cross-sectional survey statistics underestimated true infant and under-5 mortality by 6.7% and 9.8%, respectively. These estimates were in agreement with the output from the model, in which the bias varied according to the magnitude and stage of the epidemic of HIV infection and background mortality rates. The bias was greater the longer the period elapsed before the survey and in later stages of the epidemic. Bias could substantially distort the measured effect of interventions to reduce non-HIV-related mortality and of programmes to prevent mother-to-child transmission, especially when trends are based on data from a single survey. Conclusion The correlation between the HIV-related deaths of mothers and their children can bias survey estimates of early child mortality. A mathematical model with a user-friendly interface is available to correct for this bias when measuring progress towards Millennium Development Goal 4 in countries with generalized epidemics of HIV infection.
Clinical Colorectal Cancer, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Colorectal Cancer, 2020
Aim: Correct identification of RAS gene variants is key for targeted treatment decisions in patie... more Aim: Correct identification of RAS gene variants is key for targeted treatment decisions in patients with metastatic colorectal cancer. Published RAS mutation rates differ and could be influenced by several factors including testing methods. This study aimed to describe the performance of laboratories to correctly identify RAS variants over time and to understand how RAS testing has evolved in Europe. Materials & methods: Misclassification and test failure rates were calculated and related to the used test methodology for 239 unique laboratories participating in external quality assessment for metastatic colorectal cancer between 2013 and 2018. In addition, 33 laboratories completed a survey aiming to obtain more details on their routine testing strategies, number of samples analyzed and RAS mutation rates between 2013 and 2017. Results: The mutation status was correctly analyzed in 96.1% (N = 5471) RAS and BRAF tests. A total of 4.6% (N = 2860) RAS tests included false-negative res...
HIV, Resurgent Infections and Population Change in Africa, 2007
... AD McNAGHTEN CDC Zimbabwe and Centers for Disease Control & Prevention, Atlanta, USA ... more ... AD McNAGHTEN CDC Zimbabwe and Centers for Disease Control & Prevention, Atlanta, USA SABADA DUBE AND NICHOLAS C. GRASSLY Department of Infectious Disease Epidemiology, Imperial College London, London, UK Abstract. ...
Sexually Transmitted Infections, 2006
Background: This paper brings together data from a variety of reports to provide a basis for asse... more Background: This paper brings together data from a variety of reports to provide a basis for assessing future steps for responding to and monitoring the HIV epidemic in Zimbabwe. Method: Data reported from four antenatal clinic (ANC) surveys conducted between 2000 and 2004, two small local studies in Zimbabwe conducted from 1997 through 2003, four general population surveys from 1999 through 2003, and service statistics covering 1990 through 2004 were used to describe recent trends in HIV prevalence and incidence, behaviour change, and programme provision. Results: HIV prevalence among pregnant women attending ANCs declined substantially from 32.1% in 2000 to 23.9% in 2004. The local studies confirmed the decline in prevalence. However, prevalence continued to be high. Sexual behaviour data from surveys suggests a reduction in sexual experience before age 15 years among both males and females age 15-19 years, and in the proportions of males and females aged 15-29 years reporting non-regular sexual partners in the past 12 months. Reported condom use with non-regular partners has been high since 1999. Condom distribution and HIV counseling and testing increased from 2000 to 2004. Discussion: On the basis of examination of data from a variety of sources, the recent decrease in HIV prevalence may be related to recent reductions in early-age sexual activity and non-regular sexual partnerships and increases in condom use. Comparison of data from sentinel surveillance systems, population based serosurveys, local studies, and service statistics provide increased confidence that a decline in HIV prevalence in Zimbabwe is actually happening in the population.