Mabaso M.L.H.,Human science Research Council |
Ndlovu N.C.,Malaria Research Programme
Public Health | Year: 2012
Objectives: To obtain a better understanding of existing research evidence towards the development of climate-driven malaria early warning systems (MEWS) through critical review of published literature in order to identify challenges and opportunities for future research. Study Design: Literature review. Methods: A comprehensive search of English literature published between 1990 and 2009 was conducted using the electronic bibliographic database, PubMed. Only studies that explored the associations between environmental and meteorological covariates, El Nino Southern Oscillation (ENSO) and malaria as the basis for developing, testing or implementing MEWS were considered. Results: In total, 35 relevant studies revealed that the development of functional climate-based MEWS remains a challenge, partly due to the complex web of causality and partly due to the use of imprecise malaria data, spatially and temporally varying covariate data, and different analytical approaches with divergent underlying assumptions. Nevertheless, high resolution spatial and temporal data, innovative analytical tools, and new and automated approaches for early warning and the development of operational MEWS. Conclusions: Future research should exploit these opportunities and incorporate the various aspects of MEWS for functional epidemic forecasting systems to be realized. © 2012 The Royal Society for Public Health.
Richter L.M.,Human science Research Council
Journal of the International AIDS Society | Year: 2012
Virtual prevention of HIV transmission from parents to children is possible. This is cause for hope and renewed energy for prevention in general. The Global Plan is the most concerted and ambitious plan to date to protect children and to promote their care. But the inspiring and much appreciated global targets cannot be achieved, nor will they be realized in spirit in addition to form, without joint action between health services, affected women, their partners, families and communities and the wider society. In turn, this engagement is only possible under enabling political, legal, material and social conditions. Much has already been achieved, and community engagement can everywhere be seen in efforts to increase demand, to supply services and to create and improve enabling environments. Some of these initiatives are highly organized and expansive, with demonstrated success. Others are local but essential adjuncts to health services. The nature of this engagement varies because the challenges are different across countries and parts of countries. To be sustained and effective, community action must simultaneously be inclusive and supportive for those people who are affected, it must be appreciated and assigned a place within the broad systemic response, and it must promote and defend social justice. © 2012 Richter LM; licensee International AIDS Society. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Temple N.J.,Athabasca University |
Steyn N.P.,Human science Research Council
Nutrition | Year: 2011
Energy-dense foods are relatively cheap sources of energy but typically have a low nutrient density. People with a low income may therefore select a relatively less healthy diet. The high energy density of such diets helps explain the association between obesity and low socioeconomic status. Most studies have been carried out in highly developed countries. We have extended this research to South Africa. Some foods, such as oats, beans, carrots, and apples, are moderately priced sources of energy and are healthy (i.e., they have a low energy density and are nutrient dense). However, such foods are likely to be less desired than many other foods, such as candy, cookies, jam, and chocolate, that have a similar cost (in terms of food energy) but are less healthy. We compared the cost of a typical South African diet with a healthier one. On average, the healthier diet costs 69% more, but this estimate is greatly affected by food choices. For a family whose household income is exceeded by one-third of the population, this increased expenditure represents about 30% of total household income. This could be decreased to about 10% to 15% if a healthy diet is carefully designed. Overall, a healthy diet is unaffordable for most South Africans. This shows the importance of not only educating people in developing countries to the importance of a healthy diet but also explaining how to make such a diet affordable. A more effective strategy is government intervention that manipulates food prices. © 2011 Elsevier Inc.
Peltzer K.,Human science Research Council |
Peltzer K.,University of the Free State
Acta Paediatrica, International Journal of Paediatrics | Year: 2010
Makoae M.G.,Human Science Research Council
Psychology, Health and Medicine | Year: 2011
The article describes the caregiving responsibility to provide food for chronically ill family members and the meanings attached to food and eating when ill created stress for family caregivers. The results come from a qualitative phenomenological study using in-depth interviews with 21 family caregivers of chronically ill HIV and AIDS patients in one district in Lesotho. Analysis of the interview data showed that the caregivers attached profound meanings to food and feeding care recipients. Their perceptions about food as part of family life and caring, the role of food and eating in curbing disease progression, the link between food and medical efficacy and the link between food and life led to ritualised behaviour around food, and moments of optimism and anguish in caregiving. Patients' behaviour in relation to food was in most instances inconsistent with the caregivers' goals, thus leading this aspect of caregiving to induce stress. Services intended to support home-based caregivers and patients could contribute to the reduction of stress associated with food through suitably tailored food assistance and professional support to caregivers to enhance their competences and understanding of the dynamics of food intake as AIDS progressed. © 2011 Taylor & Francis.
Peltzer K.,Human science Research Council
Global health action | Year: 2012
Numerous studies support the protective effect of high fruit and vegetable (FV) consumption on chronic disease risk, mainly against cancer and cardiovascular diseases. Compared with younger adults, older people experience additional health, social, and environmental conditions that affect dietary intake. To identify those additional dimensions and examine them in association with FV intake, data on 3,840 participants in the Study of Global Ageing and Adults Health (SAGE) in South Africa were analyzed. We conducted a national population-based cross-sectional study in 2008 with a sample of 3,840 participants, aged 50 years or older, in South Africa. The questionnaire included questions on socio-demographic characteristics, health variables, anthropometry, and blood pressure measurements. Multivariable regression analysis was performed to assess the associations between socio-demographic factors, health variables, and inadequate FV consumption. Overall prevalence rates of insufficient FV intake were 68.5%, 64.8% among men and 71.4% among women, with a mean intake of 4.0 servings of FV among older adults (50 years and older). In multivariable analysis, coming from the Black African or Colored population group, lower educational level and daily tobacco use were associated with inadequate FV intake. The amount of fruit and vegetables (FVs) consumed by older South African participants was considerably lower than current recommendations (daily intake of at least five servings; 400 g). Public education and campaigns on adequate consumption of FVs should be promoted targeting lower educated and Black African and Colored population groups.
Peltzer K.,Human science Research Council
Cardiovascular journal of Africa | Year: 2013
Older adults are disproportionately affected by hypertension, which is an established risk factor for cardiovascular disease. Little attention has been focused on hypertension and associated factors among older adults in Africa. Therefore, this study aimed to investigate the prevalence and associated factors of hypertension in a national sample of older South Africans who participated in the Study of Global Ageing and Adults' Health (SAGE) in 2008. In 2008 we conducted a national, population-based, cross-sectional study of a sample of 3 840 subjects aged 50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements. The prevalence of hypertension in the sample population was 77.3% (male 74.4%, female 79.6%). The rates of awareness, treatment and control among the hypertensive participants were 38.1, 32.7 and 17.1%, respectively. The results of multivariate logistic regression analysis revealed that the prevalence of hypertension was associated with being in the Coloured population group, having had a stroke, being overweight or obese and having had five or more out-patients care visits in the past 12 months. Hypertension was inversely associated with current alcohol use. This study revealed high rates of hypertension among older adults (50 years and more) in South Africa, which puts them at risk for cardiovascular disease. The percentages of hypertensive subjects who were aware, treated and controlled were very low. These data underscore the urgent need to strengthen the public health education and blood pressure-monitoring systems to better manage hypertension among older adults in South Africa.
Turok I.,Human science Research Council
Environment and Planning A | Year: 2014
South Africa emerged from a cataclysm two decades ago to experience a stable democratic transition during which the local government system was transformed. The creation of large metropolitan municipalities was intended to accelerate socioeconomic development and urban restructuring in order to overcome the legacy of segregation and exclusion. This paper assesses their achievements, ten years on, using the concept of resilience as the analytical frame. Resilience helps to examine cities as interconnected systems open to external influences but with some capacity for self-organisation and learning. It is useful for exploring the coexistence of urban continuity and change. Evidence shows that the responses of South Africa city authorities to globalisation, urbanisation, and democracy have been circumscribed. Continuity and incremental change have been more evident than transformation and development. Hesitant progress exposes cities to the risk of greater social instability. Insights from resilience theory support the idea that enhanced municipal capabilities could facilitate a more enduring outcome. © 2014 Pion and its Licensors.
Agency: GTR | Branch: MRC | Program: | Phase: Research Grant | Award Amount: 151.53K | Year: 2016
Mortality among pregnant teenagers in South Africa (SA) is very high: institutional Maternal Mortality Ratio (iMMR) of 67.1 deaths per 100,000 live births in teenagers; with 71.7% of deaths resulting from four causes: hypertension (22.8%); non-pregnancy related infections (21.1%) (HIV/AIDS-related, such as TB or pneumonia); obstetric haemorrhage (14.2%); and medical and surgical disorders (13.6%). Risk factors for these include poor antenatal clinic (ANC) attendance, lack of adherence to antiretroviral therapy, poor compliance to treatment for tuberculosis, inadequate management of preeclampsia, and slow referral of high risk pregnancies to secondary and tertiary centres. Changing the health-related behaviour of pregnant teenagers, using an m-health intervention combined with motivational interviewing (MI), could reduce the prevalence of these risk factors and, thus reduce mortality. This pilot study will test the feasibility, user acceptability and preliminary efficacy of an enhanced version of MomConnect - an m-Health program developed by our partners, the Praekelt Foundation and the SA National Department of Health (NDOH).The enhancements include adding tailored content to the SMS messaging platform; and an MI counselling intervention (4 sessions) delivered face to face by trained healthcare workers. The SMS messages will be tailored by age (13 - 19 years), motivational variables, appointment adherence, language and culture. Messages will be designed, pretested, and refined through formative evaluation procedures, under direction of our health communications expert. The revised program, Teen-MomConnect, will integrate both the enhanced SMS messages and the MI counselling for each pregnant teenager. For example, the MI counsellors will have access to the survey question responses, as well as ANC appointment-keeping status obtained via the cell phone. The MI clinical behavioural counselling training and implementation will be designed by, and pilot tested with health workers, who will deliver the counselling. Starting from week 12 of their pregnancy, the teenagers will receive 4 MI sessions delivered face to face (or via cell phone) at the ANC by a healthcare worker. The study has two phases. Phase 1 aims to develop, test, refine, and then pilot the major program enhancements (SMS and MI) to MomConnect. Phase II is the pilot field test and its aims are:1) to demonstrate whether pregnant teenagers can be recruited and retained in the study; 2) whether the causes of 71.7% of mortality in pregnant teenagers can be measured, 3) to establish uptake rates (both SMS use and completion of MI visit) for the enhanced Teen-MomConnect intervention; 4) evaluate if the integrated motivational behavioural face to face counselling, and the tailored health SMS intervention, impact pregnant teenagers ANC attendance (primary outcome), and the other risk factors for teenage maternal mortality. For the Phase II field pilot study, 200 pregnant teenagers will be recruited through clinics, schools and community organisations - 100 will be randomised to the behavioural intervention of Teen-MomConnect plus MI; and 100 will be given usual care with MomConnect alone. The study will take 18 months to complete at a cost of £150,000.The results of the pilot will be used to design a randomised controlled trial (RCT) to test the effectiveness of the Teen-MomConnect in a fully powered cohort of pregnant teenagers. The RCT will also include a cost effectiveness analysis. The products from this grant will include the Teen-MomConnect App and SMS messages; an MI training program for health workers; research instruments that have been designed and validated for the larger RCT; recruitment and retention protocols and a partnership between an international collaboration of scientists, Praekelt Foundation and the NDOH. This grant application has received the support of the NDOH who have issued a letter of support.
Zuma K.,Human science Research Council
African journal of reproductive health | Year: 2010
Age at sexual debut is an important determinant of HIV infection. The paper investigates the effects of age at sexual debut on sexual behaviour among South African youth. Among 2 875 respondents who ever had sexual intercourse, 39% had early sexual debut (sexual debut at age 16 years and below). Males (44.6%) were significantly more likely than females (35.1%) to report early sexual debut (odds ratio (OR) = 1.45, p-value < 0.001). Multiple sexual partners are significantly more common among those that had early sexual debut (10.4% vs. 4.8%) than those who had late sexual debut, (OR = 2.29, p-value < 0.001). Those aged 15 to 19 years were 1.4 times more likely to report multiple partners compared to those aged 20 to 24 years. Delaying sexual debut is a strategy many national programmes are promoting. The results of this study provide additional arguments to support such initiatives and show the need to strengthen intervention targeting youth.