scholarly journals Protective behaviours and secondary harms from non-pharmaceutical interventions during the COVID-19 epidemic in South Africa: a multisite prospective longitudinal study

2020 ◽  
Author(s):  
Guy Harling ◽  
Francesc Xavier Gómez-Olivé ◽  
Joseph Tlouyamma ◽  
Tinofa Mutevedzi ◽  
Chodziwadziwa Whiteson Kabudula ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
South African ◽  
Rural Areas ◽  
Economic Losses ◽  
Depression Symptoms ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Pharmaceutical Interventions

ABSTRACTBackgroundIn March 2020 South Africa implemented strict non-pharmaceutical interventions (NPIs) to contain Covid-19. Over the subsequent five months NPIs were eased in stages according to national strategy. Covid-19 spread throughout the country heterogeneously, reaching rural areas by July and peaking in July-August. Data on the impact of NPI policies on social and economic wellbeing and access to healthcare is limited. We therefore analysed how rural residents of three South African provinces changed their behaviour during the first epidemic wave.MethodsThe South African Population Research Infrastructure Network (SAPRIN) nodes in Mpumalanga (Agincourt), KwaZulu-Natal (AHRI) and Limpopo (DIMAMO) provinces conducted longitudinal telephone surveys among randomly sampled households from rural and peri-urban surveillance populations every 2-3 weeks. Interviews included questions on: Covid-19 knowledge and behaviours; health and economic impact of NPIs; and mental health.Results2262 households completed 10,966 interviews between April and August 2020. By August, self-reported satisfaction with Covid-19 knowledge had risen from 48% to 85% and facemask use to over 95%. As selected NPIs were eased mobility increased, and economic losses and anxiety and depression symptoms fell. When Covid-19 cases spiked at one node in July, movement dropped rapidly, and missed daily medication rates doubled. Economic concerns and mental health symptoms were lower in households receiving a greater number of government-funded old-age pensions.ConclusionsSouth Africans reported complying with stringent Covid-19 NPIs despite the threat of substantial social, economic and health repercussions. Government-supported social welfare programmes appeared to buffer interruptions in income and healthcare access during local outbreaks. Epidemic control policies must be balanced against impacts on wellbeing in resource-limited settings and designed with parallel support systems where they threaten income and basic service access.

scholarly journals Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study (Preprint)

2020 ◽  
Author(s):  
Guy Harling ◽  
Francesc Xavier Gómez-Olivé ◽  
Joseph Tlouyamma ◽  
Tinofa Mutevedzi ◽  
Chodziwadziwa Whiteson Kabudula ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
South African ◽  
Well Being ◽  
Economic Losses ◽  
Depression Symptoms ◽  
Prospective Longitudinal Study ◽  
Nonpharmaceutical Interventions ◽  
Prospective Longitudinal ◽  
The Impact

BACKGROUND In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited. OBJECTIVE We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave. METHODS The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics: COVID-19–related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics. RESULTS In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents’ self-reported satisfaction with their COVID-19–related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often. CONCLUSIONS South Africans complied with stringent, COVID-19–related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples’ income and access to basic services.

scholarly journals Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10164
Author(s):  
Ilango Saraswathi ◽  
Jayakumar Saikarthik ◽  
K. Senthil Kumar ◽  
Kumar Madhan Srinivasan ◽  
M. Ardhanaari ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Sleep Quality ◽  
Undergraduate Medical Students ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Self Administered Questionnaire

Background The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27–39.9%], 21.2% [16–27.2%] and 20.7% [15.5–26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1–42.2%], 33.2% [27–39.9%] and 24.9% [19.3–31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family’s monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.

scholarly journals The Impact of Non-Pharmaceutical Interventions on the First COVID-19 Epidemic Wave in South Africa

2021 ◽  
Author(s):  
Thabo Mabuka ◽  
Nesisa Ncube ◽  
Michael Ross ◽  
Andrea Silaji ◽  
Willie Macharia ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
African Population ◽  
South African Population ◽  
Seir Model ◽  
The Government ◽  
The Impact ◽  
Epidemic Wave ◽  
Pharmaceutical Interventions ◽  
Excess Deaths

On the 5th of March 2020, South Africa reported its first cases of COVID-19. This signalled the onset of the first COVID-19 epidemic wave in South Africa. The response by the Government of South Africa to the COVID-19 epidemic in South Africa was the use of non-pharmaceutical interventions (NPIs). In this study, a semi-reactive COVID-19 model, the ARI COVID-19 SEIR model, was used to investigate the impact of NPIs in South Africa to understand their effectiveness in the reduction of COVID-19 transmission in the South African population. This study also investigated the COVID-19 testing, reporting, hospitalised cases and excess deaths in the first COVID-19 epidemic wave in South Africa.

scholarly journals Doctor retention and distribution in post-apartheid South Africa: tracking medical graduates (2007–2011) from one university

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ann George ◽  
Duane Blaauw ◽  
Jarred Thompson ◽  
Lionel Green-Thompson
Keyword(s):  
South Africa ◽  
Public Sector ◽  
South African ◽  
Rural Areas ◽  
Specialist Training ◽  
Financial Loss ◽  
Cross Sectional ◽  
Middle Income ◽  
The Public ◽  
The Impact

Abstract Background Doctor emigration from low- and middle-income countries represents a financial loss and threatens the equitable delivery of healthcare. In response to government imperatives to produce more health professionals to meet the country’s needs, South African medical schools increased their student intake and changed their selection criteria, but little is known about the impact of these changes. This paper reports on the retention and distribution of doctors who graduated from the University of the Witwatersrand, South Africa (SA), between 2007 and 2011. Methods Data on 988 graduates were accessed from university databases. A cross-sectional descriptive email survey was used to gather information about graduates’ demographics, work histories, and current work settings. Frequency and proportion counts and multiple logistic regressions of predictors of working in a rural area were conducted. Open-ended data were analysed using content analysis. Results The survey response rate was 51.8%. Foreign nationals were excluded from the analysis because of restrictions on them working in SA. Of 497 South African respondents, 60% had completed their vocational training in underserved areas. At the time of the study, 89% (444) worked as doctors in SA, 6.8% (34) practised medicine outside the country, and 3.8% (19) no longer practised medicine. Eighty percent of the 444 doctors still in SA worked in the public sector. Only 33 respondents (6.6%) worked in rural areas, of which 20 (60.6%) were Black. Almost half (47.7%) of the 497 doctors still in SA were in specialist training appointments. Conclusions Most of the graduates were still in the country, with an overwhelmingly urban and public sector bias to their distribution. Most doctors in the public sector were still in specialist training at the time of the study and may move to the private sector or leave the country. Black graduates, who were preferentially selected in this graduate cohort, constituted the majority of the doctors practising in rural areas. The study confirms the importance of selecting students with rural backgrounds to provide doctors for underserved areas. The study provides a baseline for future tracking studies to inform the training of doctors for underserved areas.

Some Reflections on Reparation in Post-Apartheid South Africa, using a Couple Therapy Intervention as a Microcosm of South African Society

2011 ◽  
Vol 1 (2) ◽  
Author(s):  
Andrea Hill ◽  
Sylvia Poss
Keyword(s):  
South Africa ◽  
South African ◽  
Couple Therapy ◽  
South African Society ◽  
Depressive Position ◽  
Central Hypothesis ◽  
Transference And Countertransference ◽  
Constructive Engagement ◽  
The Impact ◽  
Therapy Intervention

The paper addresses the question of reparation in post-apartheid South Africa. The central hypothesis of the paper is that in South Africa current traumas or losses, such as the 2008 xenophobic attacks, may activate a ‘shared unconscious phantasy’ of irreparable damage inflicted by apartheid on the collective psyche of the South African nation which could block constructive engagement and healing. A brief couple therapy intervention by a white therapist with a black couple is used as a ‘microcosm’ to explore this question. The impact of an extreme current loss, when earlier losses have been sustained, is explored. Additionally, the impact of racial difference on the transference and countertransference between the therapist and the couple is explored to illustrate factors complicating the productive grieving and working through of the depressive position towards reparation.

The impact of climate temperature on counts, recovery, and death rates due to SARS-CoV-2 in South Africa. (Preprint)

2020 ◽  
Author(s):  
Neven Chetty ◽  
Bamise Adeleye ◽  
Abiola Olawale Ilori
Keyword(s):  
South Africa ◽  
South African ◽  
Death Rate ◽  
Western Cape ◽  
Warm Climate ◽  
The South ◽  
Recovery Rates ◽  
Death Rates ◽  
Online Resource ◽  
The Impact

BACKGROUND The impact of climate temperature on the counts (number of positive COVID-19 cases reported), recovery, and death rates of COVID-19 cases in South Africa's nine provinces was investigated. The data for confirmed cases of COVID-19 were collected for March 25 and June 30, 2020 (14 weeks) from South Africa's Government COVID-19 online resource, while the daily provincial climate temperatures were collected from the website of the South African Weather Service. Our result indicates that a higher or lower climate temperature does not prevent or delay the spread and death rates but shows significant positive impacts on the recovery rates of COVID-19 patients. Thus, it indicates that the climate temperature is unlikely to impose a strict limit on the spread of COVID-19. There is no correlation between the cases and death rates, an indicator that no particular temperature range is closely associated with a faster or slower death rate of COVID-19 patients. As evidence from our study, a warm climate temperature can only increase the recovery rate of COVID-19 patients, ultimately impacting the death and active case rates and freeing up resources quicker to enable health facilities to deal with those patients' climbing rates who need treatment. OBJECTIVE This study aims to investigate the impact of climate temperature variation on the counts, recovery, and death rates of COVID-19 cases in all South Africa's provinces. The findings were compared with those of countries with comparable climate temperature values. METHODS The data for confirmed cases of COVID-19 were collected for March 25 and June 30 (14 weeks) for South African provinces, including daily counts, death, and recovery rates. The dates were grouped into two, wherein weeks 1-5 represent the periods of total lockdown to contain the spread of COVID-19 in South Africa. Weeks 6-14 are periods where the lockdown was eased to various levels 4 and 3. The daily information of COVID-19 count, death, and recovery was obtained from South Africa's Government COVID-19 online resource (https://sacoronavirus.co.za). Daily provincial climate temperatures were collected from the website of the South African Weather Service (https://www.weathersa.co.za). The provinces of South Africa are Eastern Cape, Western Cape, Northern Cape, Limpopo, Northwest, Mpumalanga, Free State, KwaZulu-Natal, Western Cape, and Gauteng. Weekly consideration was given to the daily climate temperature (average minimum and maximum). The recorded values were considered, respectively, to be in the ratio of death-to-count (D/C) and recovery-to-count (R/C). Descriptive statistics were performed for all the data collected for this study. The analyses were performed using the Person’s bivariate correlation to analyze the association between climate temperature, death-to-count, and recovery-to-count ratios of COVID-19. RESULTS The results showed that higher climate temperatures aren't essential to avoid the COVID-19 from being spread. The present results conform to the reports that suggested that COVID-19 is unlike the seasonal flu, which does dissipate as the climate temperature rises [17]. Accordingly, the ratio of counts and death-to-count cannot be concluded to be influenced by variations in the climate temperatures within the study areas. CONCLUSIONS The study investigates the impact of climate temperature on the counts, recovery, and death rates of COVID-19 cases in all South Africa's provinces. The findings were compared with those of countries with comparable climate temperatures as South Africa. Our result indicates that a higher or lower climate temperature does not prevent or delay the spread and death rates but shows significant positive impacts on the recovery rates of COVID-19 patients. Warm climate temperatures seem not to restrict the spread of the COVID-19 as the count rate was substantial at every climate temperatures. Thus, it indicates that the climate temperature is unlikely to impose a strict limit on the spread of COVID-19. There is no correlation between the cases and death rates, an indicator that there is no particular temperature range of the climatic conditions closely associated with a faster or slower death rate of COVID-19 patients. However, other shortcomings in this study's process should not be ignored. Some other factors may have contributed to recovery rates, such as the South African government's timely intervention to announce a national lockout at the early stage of the outbreak, the availability of intensive medical care, and social distancing effects. Nevertheless, this study shows that a warm climate temperature can only help COVID-19 patients recover more quickly, thereby having huge impacts on the death and active case rates.

Exclusive Breastfeeding Moderates the Association Between Prenatal and Postpartum Depression

2021 ◽  
pp. 089033442199105
Author(s):  
Bárbara Figueiredo ◽  
Tiago Miguel Pinto ◽  
Raquel Costa
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Postpartum Depression ◽  
Exclusive Breastfeeding ◽  
Maternal Mental Health ◽  
Prenatal Depression ◽  
Depression Symptoms ◽  
Public Health Services ◽  
Wide Range ◽  
Prospective Longitudinal

Background Exclusive breastfeeding has a wide range of benefits for maternal health. However, the benefit of exclusive breastfeeding for maternal mental health needs to be further explored. Research Aim To determine the moderating role of exclusive breastfeeding at 3 months on the association between prenatal and postpartum depression. Methods This study had a prospective, longitudinal, and comparative design with two groups and three assessment waves. The sample comprised 334 participants (70 depressed and 264 non-depressed) recruited at public health services in northern Portugal. Participants completed a measure of depression symptoms between the second and the third trimester of pregnancy and between 3 and 6 months, and a measure of breastfeeding status at 3 months. Results Exclusive breastfeeding at 3 months moderated the association between prenatal and postpartum depression. Participants with prenatal depression who were exclusively breastfeeding at 3 months showed fewer symptoms of depression and lower rates of depression between 3 and 6 months postpartum, compared to participants with prenatal depression who were not exclusively breastfeeding. Participants without prenatal depression who were exclusively breastfeeding at 3 months showed similar depression symptoms and similar rates of depression between 3 and 6 months postpartum, compared to participants without prenatal depression who were not exclusively breastfeeding. Conclusion Exclusive breastfeeding has a potential protective influence on postpartum depression among women with prenatal depression. Public health policies targeting women with prenatal depression should be implemented and include practices to promote and support exclusive breastfeeding in order to enhance women’s exclusive breastfeeding and mental health.

516 Impacts of Chronic Nausea and Vomiting on Daytime Sleepiness and Fatigue

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A203-A203
Author(s):  
Maurice Ohayon ◽  
Y J Chen ◽  
Marie-Lise Cote
Keyword(s):  
Longitudinal Study ◽  
Daytime Sleepiness ◽  
Nausea And Vomiting ◽  
Prospective Longitudinal Study ◽  
Logistic Regression Models ◽  
Related Quality ◽  
Health Related ◽  
Chronic Nausea ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Introduction Chronic nausea and vomiting (CNV), common symptoms in patients with GI disorders like gastroparesis, can be a debilitating health problem with considerable impact on patients’ health-related quality of life during daytime. Yet, little is known about how CNV may impact on sleepiness and fatigue during the daytime. Our aim was to examine the impact of CNV on daytime sleepiness and fatigue based on the data from a longitudinal study. Methods Prospective longitudinal study with two waves: 12,218 subjects interviewed by phone during wave 1 (W1); 10,931 during wave 2 (W2) three years later. The sample was representative of the US general population. Analyses included subjects participating to both waves (N=10,931). CNV was defined as episodes of nausea and vomiting occurring at least twice a month for at least 1 month (outside pregnancy). Logistic regression models were employed to determine whether CNV is a predictive variable for excessive sleepiness or fatigue. Results Out of all W1 participants, 9.8% (95% CI: 9.2%-10.4%) reported nausea only while 3% (95% CI: 2.7%-3.3%) reported CNV. In W2, 7.7% (95% CI: 7.2%-8.2%) reported nausea only and 2.5% (95% CI: 2.2%-2.8%) reported having CNV. Of the subjects who participated in both W1 and W2, 25.7% of them reported CNV in W1. CNV subjects reported more frequently excessive daytime sleepiness (53.5% vs. 25.9%) and being moderately or severely fatigued (38.6% vs, 5.4%) compared with the participants without nausea or vomiting. After controlling for age, sex, BMI, health status, alcohol intake, sleep disorders and psychiatric disorders that might impact on daytime sleepiness or fatigue, it was found that subjects with CNV at both W1 and W2 had a significantly higher relative risk of reporting daytime sleepiness (RR: 2.7 (95% CI:1.9–3.9) p&lt;0.0001) and fatigue (RR: 4.9 (95% CI:3.2–7.5) p&lt;0.0001) at W2, compared with the participants without nausea or vomiting. Conclusion Many factors are likely to influence daytime sleepiness. CNV appears to be an important contributor even after controlling for several factors that can explain the sleepiness. This underlines the extent to which alertness could be disturbed and impacted by chronicity of nausea/vomiting symptoms. Support (if any) This analysis study was funded by Takeda Pharmaceutical Company

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