Sociodemographic and behavioral characteristics associated with self-reported diagnosed diabetes mellitus in adults aged 50+ years in Ghana and South Africa: results from the WHO-SAGE wave 1

ObjectiveThe objective is to identify and describe the sociodemographic and behavioral characteristics of adults, aged 50 years and over, who self-reported having been diagnosed and treated for diabetes mellitus (DM) in Ghana and South Africa.Research design and methodsThis is a cross-sectional study based on the WHO Study on global AGEing and adult health (SAGE) wave 1. Information on sociodemographic factors, health states, risk factors and chronic conditions is captured from questionnaires administered in face-to-face interviews. Self-reported diagnosed and treated DM is confirmed through a ‘yes’ response to questions regarding 1 having previously been diagnosed with DM, and 2 having taken insulin or other blood sugar lowering medicines. Crude and adjusted logistic regressions test associations between candidate variables and DM status. Analyses include survey sampling weights. The variance inflation factor statistic tested for multicollinearity.ResultsIn this nationally representative sample of adults aged 50 years and over in Ghana, after adjusting for the effects of sex, residence, work status, body mass index, waist-hip and waist-height ratios, smoking, alcohol, fruit and vegetable intake and household wealth, WHO-SAGE survey respondents who were older, married, had higher education, very high-risk waist circumference measurements and did not undertake high physical activity, were significantly more likely to report diagnosed and treated DM. In South Africa, respondents who were older, lived in urban areas and had high-risk waist circumference measurements were significantly more likely to report diagnosed and treated DM.ConclusionsCountries in sub-Saharan Africa are challenged by unprecedented ageing populations and transition from communicable to non-communicable diseases such as DM. Information on those who are already diagnosed and treated needs to be combined with estimates of those who are prediabetic or, as yet, undiagnosed. Multisectoral approaches that include socioculturally appropriate strategies are needed to address diverse populations in SSA countries.

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Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys

Public Health Nutrition ◽

10.1017/s1368980014000275 ◽

2014 ◽

Vol 17 (11) ◽

pp. 2407-2418 ◽

Cited By ~ 16

Author(s):

Helga Bjørnøy Urke ◽

Maurice B Mittelmark ◽

Martín Valdivia

Keyword(s):

Urban Areas ◽

Health Surveys ◽

Maternal Education ◽

Wealth Quintile ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Sampling Weights ◽

Cross Sectional ◽

Growth Standards ◽

Low Educated

AbstractObjectiveTo examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria.DesignTrend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991–2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban–rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights).SettingPeru.SubjectsChildren aged 0–59 months surveyed in 1991–92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007–08 (n 8232) and 2011 (n 8186).ResultsChild stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991–2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020).ConclusionsThe 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.

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Antimicrobial Resistance of Neisseria gonorrhoeae Isolates from High-Risk Men in Johannesburg, South Africa

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00906-20 ◽

2020 ◽

Vol 64 (11) ◽

Cited By ~ 1

Author(s):

Liteboho D. Maduna ◽

Marleen M. Kock ◽

Brian M. J. W. van der Veer ◽

Oscar Radebe ◽

James McIntyre ◽

...

Keyword(s):

South Africa ◽

High Risk ◽

Antimicrobial Resistance ◽

Neisseria Gonorrhoeae ◽

Genetic Relatedness ◽

Scale Up ◽

Sub Saharan Africa ◽

Molecular Testing ◽

Content Type ◽

Urethral Discharge

ABSTRACT Neisseria gonorrhoeae antimicrobial drug resistance has emerged worldwide; however, the situation in sub-Saharan Africa is not well documented. We investigated the molecular epidemiology and occurrence of antimicrobial resistance in Neisseria gonorrhoeae infections in two core transmission groups of men in Johannesburg, South Africa. We recruited men who have sex with men (MSM) presenting with urethral discharge and men with recurrent episodes of urethral discharge. Molecular testing and culture for N. gonorrhoeae were performed, followed by antimicrobial susceptibility testing. Whole-genome sequencing (WGS) was used to identify resistance-conferring mutations and to determine the genetic relatedness of the isolates. In all, 51 men were recruited; 42 (82%) had N. gonorrhoeae infections. Most gonococcal isolates were resistant to ciprofloxacin (78%) and tetracycline (74%); 33% were penicillin resistant. All gonococcal isolates were susceptible to cephalosporins and spectinomycin. Azithromycin resistance was observed in 4 (15%) isolates (epidemiological cutoff), all with mutations in the mtrR promoter region. Most of the isolates (19/27) harbored the gonococcal genetic island, which is associated with antimicrobial resistance. WGS revealed a diverse epidemic with mostly novel NG-STAR (70%) and NG-MAST (70%) sequence types. Thus, we demonstrate a high prevalence of antimicrobial resistance in Neisseria gonorrhoeae strains obtained from high-risk men in South Africa. The introduction of diagnostics and scale-up of surveillance are warranted to prevent the emergence of multidrug-resistant infections.

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Towards an automated monitoring of human settlements in South Africa using high resolution SPOT satellite imagery

ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences ◽

10.5194/isprsarchives-xl-7-w3-1389-2015 ◽

2015 ◽

Vol XL-7/W3 ◽

pp. 1389-1394 ◽

Cited By ~ 6

Author(s):

T. Kemper ◽

N. Mudau ◽

P. Mangara ◽

M. Pesaresi

Keyword(s):

South Africa ◽

Satellite Imagery ◽

Urban Areas ◽

Informal Settlement ◽

Informal Settlements ◽

Image Features ◽

Sub Saharan Africa ◽

Image Feature ◽

Data Set ◽

Spot 5

Urban areas in sub-Saharan Africa are growing at an unprecedented pace. Much of this growth is taking place in informal settlements. In South Africa more than 10% of the population live in urban informal settlements. South Africa has established a National Informal Settlement Development Programme (NUSP) to respond to these challenges. This programme is designed to support the National Department of Human Settlement (NDHS) in its implementation of the Upgrading Informal Settlements Programme (UISP) with the objective of eventually upgrading all informal settlements in the country. Currently, the NDHS does not have access to an updated national dataset captured at the same scale using source data that can be used to understand the status of informal settlements in the country. <br><br> This pilot study is developing a fully automated workflow for the wall-to-wall processing of SPOT-5 satellite imagery of South Africa. The workflow includes an automatic image information extraction based on multiscale textural and morphological image features extraction. The advanced image feature compression and optimization together with innovative learning and classification techniques allow a processing of the SPOT-5 images using the Landsat-based National Land Cover (NLC) of South Africa from the year 2000 as low-resolution thematic reference layers as. The workflow was tested on 42 SPOT scenes based on a stratified sampling. The derived building information was validated against a visually interpreted building point data set and produced an accuracy of 97 per cent. Given this positive result, is planned to process the most recent wall-to-wall coverage as well as the archived imagery available since 2007 in the near future.

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Relationship between socioeconomic status and HIV infection: findings from a survey in the Free State and Western Cape Provinces of South Africa

BMJ Open ◽

10.1136/bmjopen-2017-016232 ◽

2017 ◽

Vol 7 (11) ◽

pp. e016232 ◽

Cited By ~ 12

Author(s):

Erick Wekesa Bunyasi ◽

David John Coetzee

Keyword(s):

South Africa ◽

Socioeconomic Status ◽

Hiv Infection ◽

Formal Education ◽

Household Wealth ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Free State ◽

Western Cape ◽

Women Of Reproductive Age

BackgroundStudies have shown a mixed association between socioeconomic status (SES) and prevalent HIV infection across and within settings in sub-Saharan Africa. In general, the relationship between years of formal education and HIV infection changed from a positive to a negative association with maturity of the HIV epidemic. Our objective was to determine the association between SES and HIV in women of reproductive age in the Free State (FSP) and Western Cape Provinces (WCP) of South Africa (SA).Study designCross-sectional.SettingSA.MethodsWe conducted secondary analysis on 1906 women of reproductive age from a 2007 to 2008 survey that evaluated effectiveness of Prevention of Mother-to-Child HIV Transmission Programmes. SES was measured by household wealth quintiles, years of formal education and employment status. Our analysis principally used logistic regression for survey data.ResultsThere was a significant negative trend between prevalent HIV infection and wealth quintile in WCP (P<0.001) and FSP (P=0.025). In adjusted analysis, every additional year of formal education was associated with a 10% (adjusted OR (aOR) 0.90 (95% CI 0.85 to 0.96)) significant reduction in risk of prevalent HIV infection in WCP but no significant association was observed in FSP (aOR 0.99; 95% CI 0.89 to 1.11). There was no significant association between employment and prevalent HIV in each province: (aOR 1.54; 95% CI 0.84 to 2.84) in WCP and (aOR 0.96; 95% CI 0.71 to 1.30) in FSP.ConclusionThe association between HIV infection and SES differed by province and by measure of SES and underscores the disproportionately higher burden of prevalent HIV infection among poorer and lowly educated women. Our findings suggest the need for re-evaluation of whether current HIV prevention efforts meet needs of the least educated (in WCP) and the poorest women (both WCP and FSP), and point to the need to investigate additional or tailored strategies for these women.

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Expat anxieties: Risk and safety in Cape Town, South Africa and Santiago de Chile

European Journal of Cultural Studies ◽

10.1177/13675494211013813 ◽

2021 ◽

pp. 136754942110138

Author(s):

Nicky Falkof

Keyword(s):

South Africa ◽

Latin America ◽

High Risk ◽

Cape Town ◽

Sub Saharan Africa ◽

The North ◽

Santiago De Chile ◽

Two Cities ◽

Sub Saharan ◽

Discursive Constructions

This article considers ‘expatriate’ discourses about security in Cape Town, South Africa and Santiago de Chile. The cities themselves have reputations as desirable, beautiful, civilised, modern and welcoming, in contrast to lurid ideas about poverty, crime, filth and corruption that often characterise northern imaginings of the developing world. Yet, their locations within sub-Saharan Africa and Latin America, respectively, nonetheless mark them out as potential spaces of high risk for migrants from the north. In this article, I am interested in the way in which lifestyle migrants to these cities negotiate fears about risk and safety within their new homes. In order to consider this question, I discuss posts on the online messageboards dedicated to these two cities within the popular InterNations ‘expat forum,’ as well as a series of interviews with people who use the forum. I use these respondents’ discursive constructions of safety, threat, otherness, belonging and the unknowability of the global south city to consider some of the affective underpinnings of this form of privileged migration.

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Household socio-economic status and likelihood of HIV infection among under five-year children in Muheza district, north-eastern Tanzania

10.1101/661801 ◽

2019 ◽

Author(s):

Veneranda M. Bwana ◽

Edgar Simulundu ◽

Leonard E.G. Mboera ◽

Sayoki G. Mfinanga ◽

Charles Michelo

Keyword(s):

Hiv Infection ◽

Rural Areas ◽

Urban Areas ◽

Household Wealth ◽

Education Level ◽

Hiv Prevalence ◽

Sub Saharan Africa ◽

Economic Factors ◽

Under Five ◽

Socio Economic Factors

AbstractBackgroundThere are evidences of the association between socio-economic factors and HIV prevalence in Sub-Saharan Africa. However, there is dearth of information on such relationship in Tanzania. Here, we present data on the relationship between household’s socio-economic factors and HIV prevalence among under five-year children in Muheza district, Tanzania.MethodsWe conducted a facility-based study from June 2015 to June 2016 in which we enrolled under five-year children born to HIV positive mothers. Information on HIV status of the child and socio-demographic characteristic of the head of the household was collected using a structured questionnaire. Data analysis was done using STATA version 13.0.ResultsA total of 576 mothers/guardians were interviewed each with respective HIV exposed under five-year child. Children who belonged to a head of household with at least a high education level (AOR= 0.4, 95% CI 0.2-0.8) and living in a relatively wealthy household (AOR = 0.5, 95% CI 0.2-0.9) was associated with reduced odds of HIV infection among children. Univariate analysis revealed that the odds of HIV infection was three-fold (COR = 2.9, 95% CI 1.2-7.0) higher among children living in rural than in urban areas. The heads of household living in rural areas (AOR=0.3 95% CI 0.1-0.9) had low education level compared to those living in urban areas.ConclusionChildren who belong to the head of households with high educational level, high household wealth were associated with reduced likelihood of HIV infection in Tanzania. Children living in rural areas had increased likelihood of acquiring HIV infection. These findings stress the need to focus on improving education status of the population and economically disadvantaged populations as a strategy for HIV prevention and control measures.

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Establishing and Evaluating Cancer Surveillance System in KwaZulu-Natal, South Africa

Cancer Informatics ◽

10.1177/11769351211029967 ◽

2021 ◽

Vol 20 ◽

pp. 117693512110299

Author(s):

Noluthando P Mbeje ◽

Themba G Ginindza ◽

Nkosana Jafta

Keyword(s):

Public Health ◽

South Africa ◽

Urban Areas ◽

Surveillance System ◽

Cancer Registries ◽

Health Systems Strengthening ◽

Cancer Surveillance ◽

Sub Saharan Africa ◽

Cancer Burden ◽

Kwazulu Natal

Background: The increasing cancer burden remains a public health challenge. Quality and accurate population data is important to improve cancer control, screening, and treatment programmes for the sub-Saharan Africa region. Aim: The aim of this study was to establish hospital-based cancer surveillance system, thereby reporting the burden that cancer diagnosis and treatment place on 3 hospitals – an approach of health systems strengthening. Methods: A hospital-based cancer surveillance was established in 3 public health facilities that provide oncology services in KwaZulu-Natal. An active method was used for finding cancer cases. The cancer surveillance database was evaluated according to the criteria recommended for cancer registries. Analyses of data included descriptive and crude incidence rates. Results: A total of 2307 newly diagnosed cancer cases were reported in 2018, with a majority from Inkosi Albert Luthuli Central hospital (65.3%), followed by Greys hospital (30.8%) and then Addington hospital (3.94%). Most of the cancer cases were from the 2 major urban areas of the province (eThekwini and uMgungundlovu district). The most commonly diagnosed cancers from all combined 3 facilities for both sexes were breast, cervix, colorectal, Kaposi Sarcoma, and lung. Approximately half of the cancer cases had no staging, and 12.8% of the cases were diagnosed at stage 4. The mostly prescribed treatments for the patients were radiotherapy and chemotherapy. Conclusions: Based on our hospital-based surveillance, cancer burden is high in the 3 facilities. Strengthening cancer screening and diagnostic policies and procedures that will allow expansion of accurate cancer surveillance system is essential in KwaZulu-Natal and South Africa as a whole.

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Translation, Cross-Cultural Adaptation and Validation of the Gestational Diabetes Mellitus Knowledge Questionnaire in the Western Cape, South Africa

10.21203/rs.3.rs-1076498/v1 ◽

2021 ◽

Author(s):

Lorisha Manas ◽

Tawanda Chivese ◽

Ankia Coetzee ◽

Madga Conradie ◽

Linzette Deidre Morris

Keyword(s):

Diabetes Mellitus ◽

South Africa ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

South African ◽

Antenatal Clinic ◽

Validity And Reliability ◽

Knowledge Questionnaire ◽

Culturally Adapted

Abstract Background. Gestational diabetes mellitus (GDM) is a major public health concern. The International Diabetes Federation estimated that the global prevalence of hyperglycemia in pregnancy is 16.2%. In South Africa, the most recent prevalence of GDM ranges between 9.1-25.8%. Serious adverse events associated with GDM can be mitigated by lifestyle modifications and education. Good comprehension of GDM, and improved understanding has been shown to translate into better glycemic control and reduces peri-natal complications. Assessing the knowledge base of mothers with GDM, whether in a country like South Africa, or any other similar country, is therefore imperative in bridging the gap and improving their understanding and control of their condition. Objective. To ascertain the validity and reliability of translated, cross-culturally adapted South African English, Afrikaans and isiXhosa versions of the Malaysian GDM Knowledge Questionnaire (M-GDMKQ). Methods. This mixed-method study was conducted prospectively within a high-risk antenatal clinic setting. The study consisted of three phases. Women ≥18-years, with GDM who were able to read basic level English, Afrikaans or isiXhosa; and attended the high-risk antenatal clinic throughout the index pregnancy were consecutively sampled and stratified into three language groups across phases. Results. The cross-culturally adapted English, Afrikaans and isiXhosa South African GDMKQ demonstrated reasonable face and content validity. Kappa values ranged between Kappa (SE), -0.03 (0.18) to 0.89 (0.13) for the English version, Kappa (SE), -0.07 (0.18) to 0.53 (0.13) for the Afrikaans version and Kappa (SE), 0.28 (0.18) to 0.87 (0.17) for the isiXhosa version respectively. Cronbach alpha for the individual questions ranged from 0.31 to 0.90, while correlation between overall scores was rho=0.79 (p<0.001). Conclusion. While the translated and cross-culturally adaptation South African English, Afrikaans and isiXhosa versions of the GDMKQ were found to be feasible, acceptable and easy to comprehend, more research is required to confirm validity and reliability.

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Educational Assortative Mating in Sub-Saharan Africa: Compositional Changes and Implications for Household Wealth Inequality

Demography ◽

10.1215/00703370-9000609 ◽

2021 ◽

Author(s):

Luca Maria Pesando

Keyword(s):

Assortative Mating ◽

Social Stratification ◽

Rural Areas ◽

Urban Areas ◽

Wealth Inequality ◽

Household Wealth ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Educational Assortative Mating ◽

Sub Saharan

Abstract Sub-Saharan Africa (SSA) is undergoing rapid transformations in the realm of union formation in tandem with significant educational expansion and rising labor force participation rates. Concurrently, the region remains the least developed and most unequal along multiple dimensions of human and social development. In spite of this unique scenario, never has the social stratification literature examined patterns and implications of educational assortative mating for inequality in SSA. Using 126 Demographic and Health Surveys from 39 SSA countries between 1986 and 2016, this study is the first to document changing patterns of educational assortative mating by marriage cohort, subregion, and household location of residence and relate them to prevailing sociological theories on mating and development. Results show that net of shifts in educational distributions, mating has increased over marriage cohorts in all subregions except for Southern Africa, with increases driven mostly by rural areas. Trends in rural areas align with the status attainment hypothesis, whereas trends in urban areas are consistent with the inverted U-curve framework and the increasing applicability of the general openness hypothesis. The inequality analysis conducted through a combination of variance decomposition and counterfactual approaches reveals that mating accounts for a nonnegligible share (3% to 12%) of the cohort-specific inequality in household wealth, yet changes in mating over time hardly move time trends in wealth inequality, which is in line with findings from high-income societies.

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Past Sodium Intake, Contemporary Sodium Intake, and Cardiometabolic Health in Southwest Coastal Bangladesh

Journal of the American Heart Association ◽

10.1161/jaha.119.014978 ◽

2020 ◽

Vol 9 (18) ◽

Author(s):

Abu Mohd Naser ◽

Mahbubur Rahman ◽

Leanne Unicomb ◽

Solaiman Doza ◽

Shahjada Selim ◽

...

Keyword(s):

Diabetes Mellitus ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Disease Risk ◽

Sodium Intake ◽

Controlled Trial ◽

Fasting Blood Glucose ◽

Household Wealth ◽

Cardiometabolic Health ◽

Coastal Bangladesh

Background We compared the relationship of past and contemporary sodium (Na) intake with cardiometabolic biomarkers. Methods and Results A total of 1191 participants' data from a randomized controlled trial in coastal Bangladesh were analyzed. Participants provided 24‐hour urine Na (24UNa) data for 5 monthly visits. Their fasting blood glucose, total cholesterol, triglycerides, high‐density lipoprotein, blood pressure, and 24‐hour urine protein were measured at the fifth visit. Participants' mean 24UNa over the first 4 visits was the past Na, and 24UNa of the fifth visit was the contemporary Na intake. We estimated the prevalence ratios of elevated cardiometabolic biomarkers and metabolic syndrome across 24UNa tertiles by multilevel logistic regression using participant‐, household‐, and community‐level random intercepts. Models were adjusted for age, sex, body mass index, smoking, physical activity, alcohol consumption, sleep hours, religion, and household wealth. Compared with participants in tertile 1 of past urine Na, those in tertile 3 had 1.46 (95% CI, 1.08–1.99) times higher prevalence of prediabetes or diabetes mellitus, 5.49 (95% CI, 2.73–11.01) times higher prevalence of large waist circumference, and 1.60 (95% CI, 1.04–2.46) times higher prevalence of metabolic syndrome. Compared with participants in tertile 1 of contemporary urine Na, those in tertile 3 had 1.93 (95% CI, 1.24–3.00) times higher prevalence of prediabetes or diabetes mellitus, 3.14 (95% CI, 1.45–6.83) times higher prevalence of proteinuria, and 2.23 (95% CI, 1.34–3.71) times higher prevalence of large waist circumference. Conclusions Both past and contemporary Na intakes were associated with higher cardiometabolic disease risk.

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