Asabo Samuel | University of Cape Town (original) (raw)

Papers by Asabo Samuel

BackgroundHealthcare workers are at an increased risk of acquiring vaccine-preventable diseases a... more BackgroundHealthcare workers are at an increased risk of acquiring vaccine-preventable diseases and are known to be reliable source of information for the patients and their relatives. Knowledge and attitudes of Healthcare workers about vaccines are thus important determinants of their own vaccination uptake and their intention to recommend vaccinations to their patients. However, culturally adapted tools and studies to address vaccine uptake and hesitancy as well as related behaviours among Healthcare workers in the Global South are limited.MethodsWe propose a mixed methods project to understand the extent and determinants of vaccination hesitancy among Healthcare workers and construct a validated scale to measure this complex and context-specific phenomenon in Cape Town. We will summarise responses as counts and percentages for categorical variables and means with standard deviations (or median with inter quartile ranges) for continuous variables. We will run the Shapiro-Wilks tes...

leads me besides quiet waters, He restores my soul, and He guides me in the paths of righteousnes... more leads me besides quiet waters, He restores my soul, and He guides me in the paths of righteousness for His name's sake. Even though I walk through the valley of the shadow of death, I will fear no evil for you are with me. Your rod and your staff comfort me in the presence of my enemies. You anoint my head with oil, my cup overflows. Surely, the goodness of the Lord will follow me all the days of my life, and I will dwell in the house of the Lord forever (Psalm 23). To my loving wife, Olive Mejane Alobwede, you encouraged and stood by me during the difficult moments of this journey. Even though I was battling with work, studies and travelling, you still encouraged me to spur on. You took the responsibility of the head of the family, and you did it to perfection. Through your patience and support, I was able to walk towards this achievement. To my supervisor, Prof Deliwe Rene Phetlhu, your academic guidance was of excellent quality and high standard. Your experience as an educator has always encouraged me. You played the role of a supervisor, mother and advisor and invested much effort in making me a good researcher. You went the extra mile to make sure I complete this programme in record time, and for that, I am indeed grateful. To my co-supervisor, Mrs V. Ticha, you displayed a character of patience and a good sense of humour. Your guidance and support did not go unnoticed; I am indeed grateful for all the support you gave me. http://etd.uwc.ac.za/ To my sisters and brothers-in-law, Brenda Ntube Foryam, Violet Melioge Ngane, Berine Epolle Alobwede, Gideon Foryam, Felix kumelle Enongene, you were of significant help in the course of this journey mostly for my son, junior Samuel Asabo thank you all for supporting me and my family. To the participants of this research study, thank you very much for your time and willingness to share your perceptions. Your input is highly valued, and it will go a long way to the betterment of good quality health care. To my colleagues and friends and everybody who contributed to the success of this research, thank you; Patsy de Lora, Nico Strauss, Sr Lynette Best and all my staff members, your support did not go unnoticed.

Vaccines

Vaccination attitudes among healthcare workers (HCWs) predict their level of vaccination uptake a... more Vaccination attitudes among healthcare workers (HCWs) predict their level of vaccination uptake and intention to recommend vaccinations to their patients. To our knowledge, no study has been conducted in South Africa to assess hesitancy toward influenza vaccines among HCWs. We adapted a questionnaire developed and validated by Betsch and colleagues and used it to conduct online and face-to-face interviews among HCWs at the start of the COVID-19 vaccine rollout. Multivariate logistic regression was used to assess predictors of influenza vaccine hesitancy. Of 401 participants, 64.5% were women, 49.2% were nurses, and 12.5% were physicians. A total of 54.9% were willing to accept, 20.4% were undecided, and 24.7% intended to refuse influenza vaccination. Participants who were above 25 years of age and physicians were more likely to accept the vaccine. Key predictors of vaccine acceptance were confidence in the effectiveness, consideration of benefits and risks, and willingness to be vac...

Cochrane Database of Systematic Reviews, 2013

Background UNAIDS estimates that 34 million people are currently living with the human immunodefi... more Background
UNAIDS estimates that 34 million people are currently living with the human immunodeficiency virus (HIV) worldwide. Currently recommended regimens for initiating HIV treatment consist of either a non‐nucleoside reverse transcriptase inhibitor (NNRTI) or ritonavir‐boosted protease inhibitor (PI) combined with two nucleoside reverse transcriptase inhibitors (NRTIs). However, there may be some patients for whom NNRTIs and PIs may not be appropriate. This is an update of the review published in the Cochrane Library Issue 3, 2009.

Objectives
To evaluate the effects of any fixed‐dose combination of three NRTIs (co‐formulated abacavir‐lamivudine‐zidovudine) for initial treatment of HIV infection.

Search methods
Between December 2010 and July 2011, we used standard Cochrane methods to search electronic databases and conference proceedings with relevant search terms without limits to language or publication status.

Selection criteria
We selected randomised controlled trials (RCTs) with a minimum follow‐up time of six months which compared co‐formulated abacavir‐lamivudine‐zidovudine with either PI‐based or NNRTI‐based therapy among antiretroviral‐naive HIV‐infected patients aged at least 13 years.

Data collection and analysis
Three authors independently selected eligible studies, assessed risk of bias, and extracted data; resolving discrepancies by consensus. We calculated the risk ratio (RR) or mean difference (MD), as appropriate, with its 95% confidence interval (CI) and conducted meta‐analysis using the random‐effects method because of significant statistical heterogeneity (P<0.1).

Main results
We identified 15 potentially eligible RCTs, four of which met our inclusion criteria. The four included RCTs were conducted in the United States of America (USA); USA, Puerto Rico, Guatemala, Dominican Republic, and Panama; USA and Mexico; and Botswana, respectively. The RCTs compared co‐formulated abacavir‐lamivudine‐zidovudine to treatment based on efavirenz (NNRTI), nelfinavir (PI), atazanavir (PI), and co‐formulated lopinavir‐ritonavir (PI), respectively. Overall, there was no significant difference in virological suppression between co‐formulated abacavir‐lamivudine‐zidovudine and NNRTI‐ or PI‐based therapy (4 trials; 2247 participants: RR 0.73, 95% CI 0.39 to 1.36). However, the results showed significant heterogeneity (I2=79%); with co‐formulated abacavir‐lamivudine‐zidovudine inferior to NNRTI (1 trial, 1147 participants: RR 0.35, 95%CI 0.26 to 0.49) but with a trend towards co‐formulated abacavir‐lamivudine‐zidovudine being superior to PI (3 trials, 1110 participants: RR 1.07, 95%CI 1.00 to 1.16; I2=0%). We found no significant differences between co‐formulated abacavir‐lamivudine‐zidovudine and either PI or NNRTI on CD4+ cell counts (3 trials, 1687 participants: MD ‐0.01, 95%CI ‐0.11 to 0.09; I2=0%), severe adverse events (4 trials: RR 1.22, 95%CI 0.78 to 1.92; I2=62%) and hypersensitivity reactions (4 trials: RR 4.04, 95% CI 0.41 to 40.02; I2=72%). Only two studies involving PIs reported data on the lipid profile. One study found that the mean increase in total cholesterol from baseline to 96 weeks was significantly lower with co‐formulated abacavir‐lamivudine‐zidovudine than with nelfinavir, but there were no differences with triglyceride levels. The second study found the fasting lipid profile to be comparable in both co‐formulated abacavir‐lamivudine‐zidovudine and atazanavir arms at 48 weeks.

The significant heterogeneity of effects for most outcomes evaluated was largely due to differences in the control therapy used in the included trials (i.e. NNRTIs or PIs). Using the GRADE approach, we rated the overall quality of the evidence on the relative effects of co‐formulated abacavir‐lamivudine‐zidovudine for initial treatment of HIV infection as moderate. The main reason for downgrading the quality of the evidence was imprecision of the findings. The estimate of the treatment effect for each outcome has wide confidence intervals, which extend from the fixed‐dose NRTI combination regimen being appreciably better to the regimen being appreciably worse than PI‐ or NNRTI‐based regimens.

Authors' conclusions
This review provides evidence that co‐formulated abacavir‐lamivudine‐zidovudine remains a viable option for initiating antiretroviral therapy, especially in HIV‐infected patients with pre‐existing hyperlipidaemia. The varied geographical locations of the included trials augment the external validity of these findings. We are moderately confident in our estimate of the treatment effects of the triple NRTI regimen as initial therapy for HIV infection. In the context of the GRADE approach, such moderate quality of evidence implies that the true effects of the regimen are likely to be close to the estimate of effects found in this review; but there is a possibility that they could be substantially different. Further research should be geared towards defining the subgroup of HIV patients for whom this regimen will be most beneficial.

Vaccines, 2022

Keywords: influenza vaccines; vaccine hesitancy; healthcare workers; South Africa

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Drafts by Asabo Samuel

F1000, 2022

Background: Healthcare workers are at an increased risk of acquiring vaccine-preventable diseases... more Background: Healthcare workers are at an increased risk of acquiring vaccine-preventable diseases and are known to be reliable source of information for the patients and their relatives. Knowledge and attitudes of Healthcare workers about vaccines are thus important determinants of their own vaccination uptake and their intention to recommend vaccinations to their patients. However, culturally adapted tools and studies to address vaccine uptake and hesitancy as well as related behaviours among Healthcare workers in the Global South are limited.
Methods: We propose a mixed methods project to understand the extent and determinants of vaccination hesitancy among Healthcare workers and construct a validated scale to measure this complex and context-specific phenomenon in Cape Town. We will summarise responses as counts and percentages for categorical variables and means with standard deviations (or median with inter quartile ranges) for continuous variables. We will run the Shapiro-Wilks test to assess the normality. Analysis of the variance, chi-square tests, and equivalents will be conducted as appropriate for group comparisons. Logistic regression models will also be performed to assess association between variables.
We will focus on the seasonal influenza and COVID-19 vaccine. We will use an existing tool developed and validated in Germany and the United States of America to measure five psychological determinants of vaccination (referred to as the 5C scale), as the basis to develop and validate a scale to measure the scope and determinants of vaccine hesitancy and acceptance among Healthcare workers in Cape Town.
Discussion and conclusion: Through this study, we hope to expand the scientific evidence based on vaccination acceptance and demand among Healthcare workers in South Africa and build resources to enable better understanding of, detection, and response to vaccination hesitancy in Cape Town.

Keywords: COVID-19 vaccines, Influenza vaccines, vaccine attitudes, vaccine confidence, vaccine hesitancy, healthcare workers, Cape Town.

Conference Presentations by Asabo Samuel

Proceedings of 45th Biennial Convention Sigma Theta Tau International Honor Society of Nursing, 2019

HIV stigma is still affecting People Living with HIV (PLHIV) despite biomedical and structural in... more HIV stigma is still affecting People Living with HIV (PLHIV) despite biomedical and structural interventions to reduce this phenomenon. Stigma, particularly health facility related stigma, experienced by PLHIV is reported to fuel poor access to services. As a result, considerable interventions to reduce the stigma among PLHIV have been proposed. However, poor HIV indicators are still reported. Little is reported about PLHIV’s lived experiences of stigma, especially at health facilities, which might be the contributor to poor health outcomes. Hence, this study sought to explore and describe the stigma experienced by PLHIV at a health facility in Khayelitsha Sub-District, Cape Town, South Africa. A qualitative approach, using an exploratory design was followed. Participants were purposively selected, and unstructured interviews were conducted. In total, 15 participants were anticipated to be interviewed. However, saturation occurred after 12 participants were interviewed, but the researcher went further to interview 14 participants. Audiotaped interviews were transcribed verbatim by the researcher (those in English) and assistant researchers (isiXhosa and Afrikaans). Data were then organised and entered into ATLAS.Ti version 8, a Computer Assisted Qualitative Data Analysis Software (CAQDAS) used for analysis of large sets of data. An independent coder was given raw data, and the two outcomes were discussed to reach a consensus on generated themes. The supervisor reviewed the analysed data. Rigour was ensured through the criteria of credibility, dependability, transferability and conformability. The ethical clearance for this study was obtained from the Biomedical Research Ethics Committee (BMREC) at the University of the Western Cape and the City of Cape Town. Six themes emerged from the data because of participants’ experience of stigma at the facility. These include: existence of stigma triggers, participants’ experience of stigma at the clinic, direct stigmatising behaviour, and PLHIV’s characterisation of stigma types, PLHIV’s directed health outcomes, and activism as a secondary health outcome. The results of the study revealed that stigma was perpetuated in the health facility in numerous forms. These were: physical demarcation of the facility, negative behaviour of nurses towards People living with HIV and incompetence of the nurses. This gave rise to recommendations in nursing practice, to policymakers and a need for further research on the topic.