The HIATUS study, a research programme being launched by the Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa) at the University of Cape Town (UCT), will investigate the interaction between the COVID-19 pandemic and common endemic infectious diseases in the South African context.
CIDRI-Africa will launch a programme of projects focused on understanding and providing information on the clinical presentation and pathogenesis of COVID-19 in the South African population. COVID-19 is the disease caused by the newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
The “health facility-based observational studies to investigate interaction and overlap between SARS-CoV-2, M. tuberculosis and HIV-1 infections” programme will take place at Groote Schuur Hospital and the Site B Community Health Centre in Khayelitsha, Cape Town, and Livingstone Hospital in Port Elizabeth.
Principal investigator Professor Robert J Wilkinson, a member of the Institute of Infectious Disease and Molecular Medicine and director of CIDRI-Africa, said, “It is important to understand not only the COVID-19 infection itself but also its potential interaction with common endemic infectious diseases in South Africa, which are HIV-1 and tuberculosis [TB].”
As part of the HIATUS study, researchers in the programme of four related projects will invite hospitalised COVID-19 patients to donate small extra samples of blood and cerebrospinal fluid during normal care procedures. From these samples, the researchers hope to glean a wealth of information about the pathology of and immune response to SARS-CoV-2 in people with and without HIV or TB co-infection.
The study will start once feedback from the Institutional Biosafety Committee is received.
TB and HIV in South Africa
According to the World Health Organization’s (WHO) Global Tuberculosis Report 2019, South Africa carries about 3% of the global incidence of TB. A 2019 profile of South Africa developed by the Joint United Nations Programme on HIV/AIDS stated that 20% of the HIV prevalence in the world occurs in South Africa.
TB in 2018
Global | South Africa | |
Cases | 10 000 000 | 301 000 |
HIV positive TB deaths | 251 000 | 42 000 |
HIV/TB cases | 862 000 | 177 000 |
HIV in 2018
Global | South Africa | |
Prevalence | 37 900 000 | 7 700 000 |
New infections | 1 700 000 | 240 000 |
AIDS deaths | 770 000 | 71 000 |
As reported on the WHO COVID-19 Dashboard, 6 040 609 cases of COVID-19 have occurred across the globe to date. Of these, 32 683 (0.5%) have occurred in South Africa, according to the National Institute for Communicable Diseases.
There are grave concerns about the impact that COVID-19 might have in South Africa owing to considerable existing epidemics like HIV and TB, which may increase vulnerability to and severity of COVID-19 infection. However, the consequences of SARS-CoV-2 co-infection alongside HIV and TB are at present unknown.
There is an urgent need for us to better understand the clinical manifestations and pathogenesis of SARS-CoV-2 in order to develop tools, strategies and interventions to stop the spread of disease and improve treatment within our unique population. CIDRI-Africa will contribute to meeting this need through the various projects of the HIATUS study.
“We anticipate these studies will provide important information on COVID-19 infection that will be directly relevant to African populations.”
HIATUS projects
In the first HIATUS project, the team will investigate the SARS-CoV-2-specific response of immune cells called T-cells and determine whether these responses correlate with disease outcomes. Results from this study could also provide the basis for a simplified test to assess viral immunity.
In the second project, CIDRI-Africa researchers will examine the role of specific pathological phenomena, such as clotting and cytokine storms in COVID-19. Cytokine storms are severe and potentially life-threatening hyperinflammatory immune reactions in which the body releases a flood of cellular signalling molecules.
Although COVID-19 is primarily a respiratory disease, it is increasingly evident that there are also neurological effects, such as anosmia (loss of smell), which suggests that the virus may infect the nerves and brain. CIDRI-Africa’s team will therefore describe and characterise the prevalence, clinical presentation, biochemistry and severity of neurological COVID-19 in their third project.
In their last project, researchers will extend an existing TB close-contact study by including COVID-19 screening and testing in future clinic visits.
“We anticipate these studies will provide important information on COVID-19 infection that will be directly relevant to African populations,” said Wilkinson.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Please view the republishing articles page for more information.
COVID-19 is a global pandemic that caused President Cyril Ramaphosa to declare a national disaster in South Africa on 15 March 2020 and to implement a national lockdown from 26 March 2020. UCT is taking the threat of infection in our university community extremely seriously, and this page will be updated with the latest COVID-19 information. Please note that the information on this page is subject to change depending on current lockdown regulations.
Minister of Health, Dr Joe Phaahla, has in June 2022 repealed some of South Africa’s remaining COVID-19 regulations: namely, sections 16A, 16B and 16C of the Regulations Relating to the Surveillance and the Control of Notifiable Medical Conditions under the National Health Act. We are now no longer required to wear masks or limit gatherings. Venue restrictions and checks for travellers coming into South Africa have now also been removed.
On Wednesday, 20 July, staff from the University of Cape Town’s (UCT) Faculty of Health Sciences came together with representatives from the Western Cape Government at the UCT Community of Hope Vaccination Centre at Forest Hill Residence to acknowledge the centre’s significance in the fight against COVID-19 and to thank its staff for their contributions. The centre opened on 1 September 2021 with the aim of providing quality vaccination services to UCT staff, students and the nearby communities, as well as to create an opportunity for medical students from the Faculty of Health Sciences to gain practical public health skills. The vaccination centre ceased operations on Friday, 29 July 2022.
With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.
“After almost a year of operation, the University of Cape Town’s (UCT) Community of Hope Vaccination Centre, located at the Forest Hill residence complex in Mowbray, will close on Friday, 29 July 2022. I am extremely grateful and proud of all staff, students and everyone involved in this important project.”
– Vice-Chancellor Prof Mamokgethi PhakengWith the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.
UCT’s Institute of Infectious Disease and Molecular Medicine (IDM) collaborated with Global Citizen, speaking to trusted experts to dispel vaccine misinformation.
If you have further questions about the COVID-19 vaccine check out the FAQ produced by the Desmond Tutu Health Foundation (DTHF). The DTHF has developed a dedicated chat function where you can ask your vaccine-related questions on the bottom right hand corner of the website.
IDM YouTube channel | IDM website
“As a contact university, we look forward to readjusting our undergraduate and postgraduate programmes in 2023 as the COVID-19 regulations have been repealed.”
– Prof Harsha Kathard, Acting Deputy Vice-Chancellor: Teaching and Learning
We are continuing to monitor the situation and we will be updating the UCT community regularly – as and when there are further updates. If you are concerned or need more information, students can contact the Student Wellness Service on 021 650 5620 or 021 650 1271 (after hours), while staff can contact 021 650 5685.