Division of Epidemiology and Biostatistics
European & Developing Countries Clinical Trials Partnership (EDCTP) Project
Dr Moleen Dzikiti (Zunza) from the Division of Epidemiology and Biostatistics was recently awarded a grant of more than R2.6m to study infant feeding practices among women living with HIV.
The grant is from the European & Developing Countries Clinical Trials Partnership (EDCTP), which is a public-public partnership between countries in Europe and sub-Saharan Africa, supported by the European Union.
"The awarding of the funding was based on a call from EDCTP for proposals to support early- to mid-career researchers by providing them with opportunities to train and develop their clinical research skills in poverty-related diseases and child and adolescent health," explained Dzikiti.
The mission of the EDCTP is to accelerate the clinical development of new or improved medicinal products for the identification, treatment and prevention of poverty-related infectious diseases, including (re-)emerging diseases.
The member countries consist of 14 European countries and 16 African countries, which include South Africa and Mozambique.
Zunza, who grew up in a village in Zimbabwe, originally trained and worked as a nurse, before getting married and moving with her family to South Africa, where her husband received a post-doctoral position at Stellenbosch University. In 2011, she graduated with a masters in Clinical Epidemiology, followed by a PhD in Paediatrics and a BCom Honours in Applied Statistics.
The grant will enable Dzikiti in her role as principal investigator to lead a large group sequential randomised controlled trial.
"The aim of the trial is to evaluate the effects of text messaging combined with motivational interviewing versus the standard-of-care on sustaining continued breastfeeding, as well as the contribution of the combined intervention on child health and survival outcomes, among women living with HIV and their infants," she explained.
In 2010, changes were made to global HIV and infant feeding guidelines, and the South African vertical transmission prevention programme stopped provision of formula milk, and adopted breastfeeding as the recommended infant feeding modality.
"However, in reality, there are short-falls in attaining optimal infant feeding practices, which are contributing to failure to achieving the Sustainable Development under-five child health targets in South Africa," added Dzikiti.
In South Africa exclusive breastfeeding rates are low: only 8% among infants under six months of age. It is therefore essential for the wellbeing of infants born to women living with HIV to have models established for supporting infant feeding to achieve the desired child health outcomes.
The large trial (to be conducted during the EDCTP fellowship), will support a full investigation of the effects of mobile phone text messaging combined with motivational interviewing versus standard of care on sustaining continued breastfeeding and improving child health and survival outcomes among women living with HIV and their infants.
The large randomised trial will build on the success of the pilot trial conducted between 2019 and 2020 that showed a promising beneficial effect of text messaging combined with motivational interviewing versus standard of care on sustaining continued exclusive breastfeeding rates (73% versus 46%) at six months of age among South African women living with HIV.
"The proposed study gives me the opportunity to lead the research project as principal investigator, and gain research skills and experience in advanced adaptive trial designs and analytic methods relevant to clinical trials," said Dzikiti.
"It will also equip me with the combination of management, leadership and research skills and experience required to become a successful independent researcher. This will be achieved through drawing on the strengths of three institutions with strong collaborative ties: Stellenbosch University, McMaster University and Columbia University."