scholarly journals Longitudinal SARS-CoV-2 seroprevalence in a rural and urban community household cohort in South Africa, during the first and second waves July 2020-March 2021

2021 ◽  
Author(s):  
Jackie Kleynhans ◽  
Stefano Tempia ◽  
Nicole Wolter ◽  
Anne von Gottberg ◽  
Jinal N. Bhiman ◽  
...  
Keyword(s):  
South Africa ◽  
Rural Community ◽  
Urban Community ◽  
Age Distribution ◽  
Sub Saharan Africa ◽  
Contact Tracing ◽  
Rural Site ◽  
Urban Site ◽  
Rural And Urban ◽  
Second Wave

Background SARS-CoV-2 infections may be underestimated due to limited testing access, particularly in sub-Saharan Africa. South Africa experienced two SARS-CoV-2 waves, the second associated with emergence of variant 501Y.V2. In this study, we report longitudinal SARS-CoV-2 seroprevalence in cohorts in two communities in South Africa. Methods We measured SARS-CoV-2 seroprevalence two monthly in randomly selected household cohorts in a rural and an urban community (July 2020-March 2021). We compared seroprevalence to laboratory-confirmed infections, hospitalisations and deaths reported in the districts to calculate infection-case (ICR), infection-hospitalisation (IHR) and infection-fatality ratio (IFR) in the two waves of infection. Findings Seroprevalence after the second wave ranged from 18% (95%CrI 10-26%) and 28% (95%CrI 17-41%) in children <5 years to 37% (95%CrI 28-47%) in adults aged 19-34 years and 59% (95%CrI 49-68%) in adults aged 35-59 years in the rural and urban community respectively. Individuals infected in the second wave were more likely to be from the rural site (aOR 4.7, 95%CI 2.9-7.6), and 5-12 years (aOR 2.1, 95%CI 1.1-4.2) or ≥60 years (aOR 2.8, 95%CI 1.1-7.0), compared to 35-59 years. The in-hospital IFR in the urban site was significantly increased in the second wave 0.36% (95%CI 0.28-0.57%) compared to the first wave 0.17% (95%CI 0.15-0.20%). ICR ranged from 3.69% (95%CI 2.59-6.40%) in second wave at urban community, to 5.55% (95%CI 3.40-11.23%) in first wave in rural community. Interpretation The second wave was associated with a shift in age distribution of cases from individuals aged to 35-59 to individuals at the extremes of age, higher attack rates in the rural community and a higher IFR in the urban community. Approximately 95% of SARS-CoV-2 infections in these two communities were not reported to the national surveillance system, which has implications for contact tracing and infection containment. Funding US Centers for Disease Control and Prevention

scholarly journals A cross-sectional study measuring contact patterns using diaries in an urban and a rural community in South Africa, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jackie Kleynhans ◽  
Stefano Tempia ◽  
Meredith L. McMorrow ◽  
Anne von Gottberg ◽  
Neil A. Martinson ◽  
...  
Keyword(s):  
South Africa ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Rural Site ◽  
Urban Site ◽  
Contact Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Contact Rates ◽  
Contact Patterns

Abstract Background Describing contact patterns is crucial to understanding infectious disease transmission dynamics and guiding targeted transmission mitigation interventions. Data on contact patterns in Africa, especially South Africa, are limited. We measured and compared contact patterns in a rural and urban community, South Africa. We assessed participant and contact characteristics associated with differences in contact rates. Methods We conducted a cross-sectional study nested in a prospective household cohort study. We interviewed participants to collect information on persons in contact with for one day. We described self-reported contact rates as median number people contacted per day, assessed differences in contact rates based on participant characteristics using quantile regression, and used a Poisson model to assess differences in contact rates based on contact characteristics within age groups. We also calculated cumulative person hours in contact within age groups at different locations. Results We conducted 535 interviews (269 rural, 266 urban), with 17,252 contacts reported. The overall contact rate was 14 (interquartile range (IQR) 9–33) contacts per day. Those ≤18 years had higher contact rates at the rural site (coefficient 17, 95% confidence interval (95%CI) 10–23) compared to the urban site, for those aged 14–18 years (13, 95%CI 3–23) compared to < 7 years. No differences were observed for adults. There was a strong age-based mixing, with age groups interacting more with similar age groups, but also interaction of participants of all ages with adults. Children aged 14–18 years had the highest cumulative person hours in contact (116.3 rural and 76.4 urban). Conclusions Age played an important role in the number and duration of contact events, with children at the rural site having almost double the contact rate compared to the urban site. These contact rates can be utilized in mathematical models to assess transmission dynamics of infectious diseases in similar communities.

scholarly journals Impact of rural versus urban setting on kidney markers: a cross-sectional study in South-Kivu, DRCongo

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mannix Imani Masimango ◽  
Michel P. Hermans ◽  
Espoir Bwenge Malembaka ◽  
Pierre Wallemacq ◽  
Ernest Kiswaya Sumaili ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Democratic Republic Of Congo ◽  
Urban Setting ◽  
Sub Saharan Africa ◽  
Rural Site ◽  
Urban Site ◽  
Cross Sectional ◽  
South Kivu

Abstract Background Most studies of chronic kidney disease (CKD) in Sub-Saharan Africa (SSA) have been conducted in urban settings. They relied on GFR estimated from serum creatinine alone and on the inexpensive, convenient urinary dipstick to assess proteinuria. The dipstick for proteinuria has not been directly compared with the gold standard albumin-to-creatinine ratio (ACR) in a large-sized study in SSA. We hereby assessed the influence of rural versus urban location on the level, interpretation, and diagnostic performance of proteinuria dipstick versus ACR. Methods In a cross-sectional population-based study of CKD in both urban (n = 587) and rural (n = 730) settings in South-Kivu, Democratic Republic of Congo (DRC), we assessed the prevalence, performance (sensitivity, specificity, positive predictive value and negative predictive value) and determinants of a positive dipstick proteinuria as compared with albuminuria (ACR). Albuminuria was subdivided into: A1 (< 30 mg/g creatinine), A2 (30 to 299 mg/g creatinine) and A3 (≥ 300 mg/g creatinine). Results The overall prevalence of positive dipstick proteinuria (≥ 1+) was 9.6 % (95 % CI, 7.9–11.3) and was higher in rural than in urban residents (13.1 % vs. 4.8 %, p < 0.001), whereas the prevalence of albuminuria (A2 or A3) was similar in both sites (6 % rural vs. 7.6 % urban, p = 0.31). In both sites, dipstick proteinuria ≥ 1 + had a poor sensitivity (< 50 %) and positive predictive value (< 11 %) for the detection of A2 or A3. The negative predictive value was 95 %. Diabetes [aOR 6.12 (1.52–24.53)] was a significant predictor of A3 whereas alkaline [aOR 7.45 (3.28–16.93)] and diluted urine [aOR 2.19 (1.35–3.57)] were the main predictors of positive dipstick proteinuria. Conclusions ACR and dipstick proteinuria have similar positivity rates in the urban site whereas, in the rural site, dipstick was 2-fold more often positive than ACR. The poor sensitivity and positive predictive value of the dipstick as compared with ACR makes it unattractive as a screening tool in community studies of CKD in SSA.

scholarly journals Wintertime aerosol chemical composition, volatility, and spatial variability in the greater London area

2016 ◽  
Vol 16 (2) ◽  
pp. 1139-1160 ◽  
Author(s):  
L. Xu ◽  
L. R. Williams ◽  
D. E. Young ◽  
J. D. Allan ◽  
H. Coe ◽  
...  
Keyword(s):  
Biomass Burning ◽  
Solid Fuel ◽  
Field Studies ◽  
Rural Site ◽  
Urban Site ◽  
High Temporal Resolution ◽  
Volatile Organics ◽  
Aerosol Mass ◽  
Rural And Urban ◽  
Wide Range

Abstract. The composition of PM1 (particulate matter with diameter less than 1 µm) in the greater London area was characterized during the Clean Air for London (ClearfLo) project in winter 2012. Two high-resolution time-of-flight aerosol mass spectrometers (HR-ToF-AMS) were deployed at a rural site (Detling, Kent) and an urban site (North Kensington, London). The simultaneous and high-temporal resolution measurements at the two sites provide a unique opportunity to investigate the spatial distribution of PM1. We find that the organic aerosol (OA) concentration is comparable between the rural and urban sites, but the contribution from different sources is distinctly different between the two sites. The concentration of solid fuel OA at the urban site is about twice as high as at the rural site, due to elevated domestic heating in the urban area. While the concentrations of oxygenated OA (OOA) are well-correlated between the two sites, the OOA concentration at the rural site is almost twice that of the urban site. At the rural site, more than 70 % of the carbon in OOA is estimated to be non-fossil, which suggests that OOA is likely related to aged biomass burning considering the small amount of biogenic SOA in winter. Thus, it is possible that the biomass burning OA contributes a larger fraction of ambient OA in wintertime than what previous field studies have suggested. A suite of instruments was deployed downstream of a thermal denuder (TD) to investigate the volatility of PM1 species at the rural Detling site. After heating at 250 °C in the TD, 40 % of the residual mass is OA, indicating the presence of non-volatile organics in the aerosol. Although the OA associated with refractory black carbon (rBC; measured by a soot-particle aerosol mass spectrometer) only accounts for < 10 % of the total OA (measured by a HR-ToF-AMS) at 250 °C, the two measurements are well-correlated, suggesting that the non-volatile organics have similar sources or have undergone similar chemical processing as rBC in the atmosphere. Although the atomic O : C ratio of OOA is substantially larger than that of solid fuel OA and hydrocarbon-like OA, these three factors have similar volatility, which is inferred from the change in mass concentration after heating at 120 °C. Finally, we discuss the relationship between the mass fraction remaining (MFR) of OA after heating in the TD and atomic O : C of OA and find that particles with a wide range of O : C could have similar MFR after heating. This analysis emphasizes the importance of understanding the distribution of volatility and O : C in bulk OA.

scholarly journals Training primary care nurses to conduct alcohol screening and brief interventions in South Africa

Curationis ◽  
2006 ◽  
Vol 29 (2) ◽  
Author(s):  
K Peltzer ◽  
P Seoka ◽  
T Babor ◽  
I Obot
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Health Care Providers ◽  
World Health Organisation ◽  
Alcohol Screening ◽  
World Health ◽  
Rural Site ◽  
Urban Site ◽  
Care Providers ◽  
Screening And Brief Intervention

Although progress has been made in developing a scientific basis for alcohol screening and brief intervention (SBI), training packages are necessary for its widespread dissemination in primary care settings in developing societies. Using a training package developed by the World Health Organisation 121 nurses from one rural site (29 clinics in Vhembe District) and one urban site (3 clinics and 6 mobile clinics in Polokwane/ Seshego) in South Africa were compared before and after SBI training regarding knowledge and attitudes, and the subsequent practice of SBI in routine clinical practice. Although the training effects were at times moderate, all changes were in a direction more conducive to implementing SBI. Health care providers significantly increased in knowledge, confidence in SBI and higher self-efficacy in implementing SBI at followup after 9 months after receiving the training. When delivered in the context of a comprehensive SBI implementation programme, this training is effective in changing providers’ knowledge, attitudes, and practice of SBI for at-risk drinking.

scholarly journals Persistent primary organic tar particles during the regional wintertime hazes in North China: insights into their aging and optical changes

2020 ◽  
Author(s):  
Lei Liu ◽  
Jian Zhang ◽  
Yinxiao Zhang ◽  
Yuanyuan Wang ◽  
Liang Xu ◽  
...  
Keyword(s):  
Radiative Forcing ◽  
Aging Process ◽  
North China ◽  
Clean Energy ◽  
Rural Site ◽  
Urban Site ◽  
Average Particle ◽  
Rural And Urban ◽  
Lensing Effect ◽  
Urban Sites

Abstract. Primary organic aerosol (POA) is a major component of PM2.5 in the winter polluted air in the North China Plain (NCP), but our understanding on the atmospheric aging process of POA particles and the resulting influences on their optical properties is limited. As part of the Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-Beijing) programme, we collected airborne particles at an urban site (Beijing) and an upwind rural site (Gucheng, Hebei province) in the NCP during 13–27 November 2016 for microscopic analyses. We confirmed that a distinct group of spherical or irregular POA particles with high viscosity, defined as primary organic tar (POT) particles, was emitted from the domestic coal and biomass burning at the rural site and was further transported to the urban site during the regional wintertime hazes. During the heavily polluted period (PM2.5 > 200 μg m−3), more than 60 % of the POT particles were thickly coated with secondary inorganic aerosols (named as core–shell POT-SIA particle) through the aging process, suggesting that POT particles can provide surfaces for the heterogeneous reactions of SO2 and NOx. As a result, their average particle-to-core ratios at the rural and urban sites in the heavily polluted period increased to 1.60 and 1.67, respectively. Interestingly, we found that the aging process did not change the morphology and sizes of the POT cores, indicating that POT particles are quite inert in the atmosphere and can be transported long distances. We using the Mie theory estimated that the light absorption of individual POT particles was enhanced by ~ 1.39 times in the heavily polluted period at the rural and urban sites due to the lensing effect of secondary inorganic coatings. We highlight that the lensing effect on POT particles should be considered in radiative forcing models and the governments should continue to promote clean energy in rural areas to effectively reduce primary emissions.

scholarly journals SARS-CoV-2 incidence, transmission and reinfection in a rural and an urban setting: results of the PHIRST-C cohort study, South Africa, 2020-2021

2021 ◽  
Author(s):  
Cheryl Cohen ◽  
Jackie Kleynhans ◽  
Anne von Gottberg ◽  
Meredith McMorrow ◽  
Nicole Wolter ◽  
...  
Keyword(s):  
South Africa ◽  
Cohort Study ◽  
Index Case ◽  
Urban Community ◽  
Multivariable Analysis ◽  
Threshold Value ◽  
Control Measures ◽  
Urban Setting ◽  
Household Members ◽  
Second Wave

Background By March 2021, South Africa experienced two waves of SARS-CoV-2 infections; the second associated with emergence of Beta variant. We estimated the burden and transmission of SARS-CoV-2 over the two waves. Methods We conducted a prospective cohort study during July 2020-March 2021 in one rural and one urban community. Mid-turbinate nasal swabs were collected twice-weekly from consenting household members irrespective of symptoms and tested for SARS-CoV-2 using real-time reverse transcription polymerase chain reaction (rRT-PCR). Serum was collected every two months and tested for anti-SARS-CoV-2 antibodies. Household cumulative infection risk (HCIR) was defined as the proportion of household members with infection following SARS-CoV-2 introduction. Findings Among 71,759 nasal specimens from 1,189 members (follow-up rate 93%), 834 (1%) were SARS-CoV-2-positive. By PCR detection and serology combined, 34% (406/1189) of individuals experienced ≥1 SARS-CoV-2 infection episode, and 3% (12/406) experienced reinfection. Infection by PCR and/or serology before the second wave was 84% (95% confidence interval (CI) 65%-93%) protective against re-infection. Of 254 PCR-confirmed episodes with available data, 17% (n=43) were associated with ≥1 symptom, of which 21% (9/43) were medically attended. Among 222 included households, 161 (73%) had ≥1 SARS-CoV-2-positive individual. HCIR was 16% (66/411). On multivariable analysis, index case lower cycle threshold value (OR 5.8, 95% CI 1.8-19.1), urban community (OR 3.1, 95% CI 1.5-6.2) and infection with Beta variant (OR 3.7, 95% CI 1.6-8.4) were associated with increased HCIR. HCIR was similar for symptomatic (8/67,12%) and asymptomatic (61/373, 16%) index cases (p-0.302). Interpretation In this study, 83% of SARS-CoV-2 infections were asymptomatic and index case symptom status did not affect HCIR, suggesting a limited role for control measures targeting symptomatic individuals. Previous infection was protective against SARS-CoV-2 infection in the second wave although household transmission increased following the emergence of Beta variant. Funding US Centers for Disease Control and Prevention

scholarly journals Persistent residential burning-related primary organic particles during wintertime hazes in North China: insights into their aging and optical changes

2021 ◽  
Vol 21 (3) ◽  
pp. 2251-2265
Author(s):  
Lei Liu ◽  
Jian Zhang ◽  
Yinxiao Zhang ◽  
Yuanyuan Wang ◽  
Liang Xu ◽  
...  
Keyword(s):  
Radiative Forcing ◽  
Aging Process ◽  
North China ◽  
Clean Energy ◽  
Rural Site ◽  
Urban Site ◽  
Average Particle ◽  
Rural And Urban ◽  
Lensing Effect ◽  
Urban Sites

Abstract. Primary organic aerosols (POAs) are a major component of PM2.5 in winter polluted air in the North China Plain (NCP), but our understanding of the atmospheric aging processes of POA particles and the resulting influences on their optical properties is limited. As part of the Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-Beijing) program, we collected airborne particles at an urban site (Beijing) and an upwind rural site (Gucheng, Hebei province) in the NCP during 13–27 November 2016 for microscopic analyses. We confirmed that large numbers of light-absorbing spherical POA (i.e., tarball) and irregular POA particles with high viscosity were emitted from domestic coal and biomass burning at the rural site and were further transported to the urban site during regional wintertime hazes. During the heavily polluted period (PM2.5 > 200 µg m−3), more than 60 % of these burning-related POA particles were thickly coated with secondary inorganic aerosols (named as core–shell POA–SIA particles) through the aging process, suggesting that POA particles can provide surfaces for the heterogeneous reactions of SO2 and NOx. As a result, during the heavily polluted period, their average particle-to-core diameter ratios at the rural and urban sites increased to 1.60 and 1.67, respectively. Interestingly, we found that the aging process did not change the morphology and sizes of POA cores, indicating that the burning-related POA particles are quite inert in the atmosphere and can be transported over long distances. Using Mie theory we estimated that the absorption capacity of these POA particles was enhanced by ∼ 1.39 times in the heavily polluted period at the rural and urban sites due to the “lensing effect” of secondary inorganic coatings. We highlight that the lensing effect on burning-related POA particles should be considered in radiative forcing models and authorities should continue to promote clean energy in rural areas to effectively reduce primary emissions.

scholarly journals Prevalence of substance abuse among adolescents of urban and rural community in Surendranagar district, Gujarat

2019 ◽  
Vol 6 (5) ◽  
pp. 1970
Author(s):  
Pratik K. Jasani ◽  
Yadeepsinh M. Jadeja ◽  
Nitesh M. Patel ◽  
Dhara Y. Jadeja ◽  
Jayraj B. Shrimali ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Rural Community ◽  
Urban Community ◽  
Simple Random Sampling ◽  
Tobacco Consumption ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Rural And Urban ◽  
Health Organization

Background: According to the World Health Organization (WHO), substance abuse is “persistent or sporadic drug use inconsistent with or unrelated to acceptable medical practice.” Recently, substance abuse has been increasing among children and adolescents. Alcohol is one of the leading causes of death and disability globally and in India. Tobacco consumption is a major preventable cause of death, accounting for 13,000 deaths per day globally. This study was conducted to identify the prevalence of substance abuse and its pattern among adolescents in rural and urban community of Surendranagar district.Methods: It was a cross-sectional study carried out among 300 rural (150 from school and 150 from community) and 300 urban (150 from school and 150 from community) adolescents selected by simple random sampling. Data was collected and analysed by Statistical Package for Social Sciences and Microsoft excel have been used to generate graphs, tables, etc.Results: Prevalence of substance abuse in our study was 30.17%. Adolescents from rural community had higher prevalence (37.67%). Prevalence was significantly higher in males (55.33%) than compared to females (5%). Tobacco was most common substance abused by the adolescents.Conclusions: Prevalence of substance abuse was higher in rural compared to urban community and in males compared to females. Chewing form being the most common form of abusing the tobacco followed by smoking and drinking form in our study. 

Prevalence and risk factor for injury in sub-Saharan Africa: a multicountry study

2017 ◽  
Vol 24 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Megan B Diamond ◽  
Shona Dalal ◽  
Clement Adebamowo ◽  
David Guwatudde ◽  
Carien Laurence ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Rural Site ◽  
Urban Site ◽  
Injury Data ◽  
Sub Saharan ◽  
Serious Injury

IntroductionInjury-related morbidity is a neglected health concern in many low-income and middle-income countries. Most injury data in Africa have been collected from hospital-based studies, and few studies have occurred across multiple countries. Using data from a novel cohort, we examined the prevalence and incidence of serious injuries and associated risk factors across five sites in sub-Saharan Africa (SSA).MethodsA common baseline and follow-up survey was administered to participants. The study population included 1316 persons at baseline and 904 persons at follow-up. Frequencies were calculated, and logistic regression models were used to assess risk factors for injury.ResultsA total of 233 (17.7%) persons reported a serious injury at baseline and 60 (6.6%) reported a serious injury 6 months later at follow-up. Sixty-nine per cent of participants responded to the follow-up questionnaire. At baseline and follow-up, the most common cause of serious injury at urban sites was transport related, followed by poison/overdose. In rural Uganda, sharp instruments injuries were most common, followed by transport-related injuries. Living at an urban site was associated with an increased odds for serious injury compared with those at the rural site (OR: 1.83, 95% CI 1.15 to 2.90). Participants who consumed above a moderate amount of alcohol were at a higher risk of serious injury compared with those who did not consume alcohol (OR: 1.86, 95% CI 1.02 to 3.41). High level of education was an important risk factor for injury.ConclusionAt baseline and follow-up, common causes of serious injury were transport related, sharp instrument and poison/overdose. Alcohol consumption, urban location and education are important risk factors for injury. It is feasible to collect longitudinal injury data using a standardised questionnaire across multiples sites in SSA. Longitudinal data collection should be leveraged to obtain robust data on risk factors for injury in SSA.

scholarly journals Intensified household contact tracing, prevention and treatment support versus enhanced standard of care for contacts of tuberculosis cases in South Africa: study protocol for a household cluster-randomised trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Peter MacPherson ◽  
Emily L. Webb ◽  
Ebrahim Variava ◽  
Sanjay G. Lala ◽  
Minja Milovanovic ◽  
...  
Keyword(s):  
South Africa ◽  
Standard Of Care ◽  
Household Contact ◽  
Sub Saharan Africa ◽  
Contact Tracing ◽  
Free Survival ◽  
Hiv Intervention ◽  
Household Contacts ◽  
Cluster Randomised ◽  
Household Cluster

Abstract Background Household contact tracing of index TB cases has been advocated as a key part of TB control for many years, but has not been widely implemented in many low-resource setting because of the current dearth of high quality evidence for effectiveness. Innovative strategies for earlier, more effective treatment are particularly important in contexts with hyper-endemic levels of HIV, where levels of TB infection remain extremely high. Methods We present the design of a household cluster-randomised controlled trial of interventions aimed at improving TB-free survival and reducing childhood prevalence of Mycobacterium tuberculosis infection among household contacts of index TB cases diagnosed in two provinces of South Africa. Households of index TB cases will be randomly allocated in a 1:1 ratio to receive either an intensified home screening and linkage for TB and HIV intervention, or enhanced standard of care. The primary outcome will compare between groups the TB-free survival of household contacts over 15 months. All participants, or their next-of-kin, will provide written informed consent to participate. Discussion Evidence from randomised trials is required to identify cost-effective approaches to TB case-finding that can be applied at scale in sub-Saharan Africa. Trial registration ISRCTN16006202 (01/02/2017: retrospectively registered) and NHREC4399 (11/04/2016: prospectively registered). Protocol version: 4.0 (date: 18th January 2018).

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