scholarly journals Impact of the Covid-19 epidemic and related social distancing regulations on social contact and SARS-CoV-2 transmission potential in rural South Africa: analysis of repeated cross-sectional surveys

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicky McCreesh ◽  
Vuyiswa Dlamini ◽  
Anita Edwards ◽  
Stephen Olivier ◽  
Njabulo Dayi ◽  
...  
Keyword(s):  
South Africa ◽  
Social Contact ◽  
Cross Sectional ◽  
Rural South ◽  
Social Distancing ◽  
Transmission Potential ◽  
Close Interaction ◽  
June July ◽  
The Impact ◽  
Rural South Africa

Abstract Background South Africa implemented rapid and strict physical distancing regulations to minimize SARS-CoV-2 epidemic spread. Evidence on the impact of such measures on interpersonal contact in rural and lower-income settings is limited. Methods We compared population-representative social contact surveys conducted in the same rural KwaZulu-Natal location once in 2019 and twice in mid-2020. Respondents reported characteristics of physical and conversational (‘close interaction’) contacts over 24 hours. We built age-mixing matrices and estimated the proportional change in the SARS-CoV-2 reproduction number (R0). Respondents also reported counts of others present at locations visited and transport used, from which we evaluated change in potential exposure to airborne infection due to shared indoor space (‘shared air’). Results Respondents in March–December 2019 (n = 1704) reported a mean of 7.4 close interaction contacts and 196 shared air person-hours beyond their homes. Respondents in June-July 2020 (n = 216), as the epidemic peaked locally, reported 4.1 close interaction contacts and 21 shared air person-hours outside their home, with significant declines in others’ homes and public spaces. Adults aged over 50 had fewer close contacts with others over 50, but little change in contact with 15–29 year olds, reflecting ongoing contact within multigenerational households. We estimate potential R0 fell by 42% (95% plausible range 14–59%) between 2019 and June-July 2020. Conclusions Extra-household social contact fell substantially following imposition of Covid-19 distancing regulations in rural South Africa. Ongoing contact within intergenerational households highlighted a potential limitation of social distancing measures in protecting older adults.

scholarly journals Impact of social distancing regulations and epidemic risk perception on social contact and SARS-CoV-2 transmission potential in rural South Africa: analysis of repeated cross-sectional surveys

2020 ◽  
Author(s):  
Nicky McCreesh ◽  
Vuyiswa Dlamini ◽  
Anita Edwards ◽  
Stephen Olivier ◽  
Njabulo Dayi ◽  
...  
Keyword(s):  
South Africa ◽  
Social Contact ◽  
Cross Sectional ◽  
Rural South ◽  
Social Distancing ◽  
Transmission Potential ◽  
Close Interaction ◽  
June July ◽  
The Impact ◽  
Rural South Africa

ABSTRACTBackgroundSouth Africa implemented rapid and strict physical distancing regulations to minimize SARS-CoV-2 epidemic spread. Evidence on the impact of such measures on interpersonal contact in rural and lower-income settings is limited.MethodsWe compared population-representative social contact surveys conducted in the same rural KwaZulu-Natal location once in 2019 and twice in mid-2020. Respondents reported characteristics of physical and conversational (‘close interaction’) contacts over 24 hours. We built age-mixing matrices and estimated the proportional change in the SARS-CoV-2 reproduction number (R0). Respondents also reported counts of others present at locations visited and transport used, from which we evaluated change in potential exposure to airborne infection due to shared indoor space (‘shared air’).ResultsRespondents in March-December 2019 (n=1704) reported a mean of 7.4 close interaction contacts and 196 shared air person-hours beyond their homes. Respondents in June-July 2020 (n=216), as the epidemic peaked locally, reported 4.1 close interaction contacts and 21 shared air person-hours outside their home, with significant declines in others’ homes and public spaces. Adults aged over 50 had fewer close contacts with others over 50, but little change in contact with 15-29 year olds, reflecting ongoing contact within multigenerational households. We estimate potential R0 fell by 42% (95% plausible range 14-59%) between 2019 and June-July 2020.DiscussionExtra-household social contact fell substantially following imposition of Covid-19 distancing regulations in rural South Africa. Ongoing contact within intergenerational households highlighted the limitation of social distancing measures in protecting older adults.FundingWellcome Trust, UKRI, DFID, European Union

scholarly journals Linkage to primary care after home-based blood pressure screening in rural KwaZulu-Natal, South Africa: a population-based cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023369 ◽  
Author(s):  
Mark J Siedner ◽  
Kathy Baisley ◽  
Joanna Orne-Gliemann ◽  
Deenan Pillay ◽  
Olivier Koole ◽  
...  
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
Linkage To Care ◽  
Sampling Weights ◽  
Rural South ◽  
Home Based ◽  
Kwazulu Natal ◽  
Blood Pressure Screening ◽  
The Impact ◽  
Rural South Africa

ObjectivesThe expanding burden of non-communicable diseases (NCDs) globally will require novel public health strategies. Community-based screening has been promoted to augment efficiency of diagnostic services, but few data are available on the downstream impact of such programmes. We sought to assess the impact of a home-based blood pressure screening programme on linkage to hypertension care in rural South Africa.SettingWe conducted home-based blood pressure screening withinin a population cohort in rural KwaZulu-Natal, using the WHO Stepwise Approach to Surveillance (STEPS) protocol.ParticipantsIndividuals meeting criteria for raised blood pressure (≥140 systolic or ≥90 diastolic averaged over two readings) were referred to local health clinics and included in this analysis. We defined linkage to care based on self-report of presentation to clinic for hypertension during the next 2 years of cohort observation. We estimated the population proportion of successful linkage to care with inverse probability sampling weights, and fit multivariable logistic regression models to identify predictors of linkage following a positive hypertension screen.ResultsOf 11 694 individuals screened, 14.6% (n=1706) were newly diagnosed with elevated pressure. 26.9% (95% CI 24.5% to 29.4%) of those sought hypertension care in the following 2 years, and 38.1% (95% CI 35.6% to 40.7%) did so within 5 years. Women (adjusted OR (aOR) 2.41, 95% CI 1.68 to 3.45), those of older age (aOR 11.49, 95% CI 5.87 to 22.46, for 45–59 years vs <30) and those unemployed (aOR 1.71, 95% CI 1.10 to 2.65) were more likely to have linked to care.ConclusionsLinkage to care after home-based identification of elevated blood pressure was rare in rural South Africa, particularly among younger individuals, men and the employed. Improved understanding of barriers and facilitators to NCD care is needed to enhance the effectiveness of blood pressure screening in the region.

scholarly journals The impact of adult mortality on the living arrangements of older people in rural South Africa

2005 ◽  
Vol 25 (6) ◽  
pp. 431-444 ◽  
Author(s):  
VICTORIA HOSEGOOD ◽  
IAN M. TIMÆUS
Keyword(s):  
South Africa ◽  
Older People ◽  
Living Arrangements ◽  
Adult Mortality ◽  
Living Alone ◽  
Rural South ◽  
Kwazulu Natal ◽  
The Impact ◽  
Quality Infrastructure ◽  
Rural South Africa

This paper examines changes in households with older people in a northern rural area of KwaZulu Natal province, South Africa, between January 2000 and January 2002. The focus is the impact of adult deaths, especially those from AIDS, on the living arrangements of older people. The longitudinal data are from the Africa Centre Demographic Information System. In 2000, 3,657 older people (women aged 60 years or older, men 65 years or older) were resident in the area, and 3,124 households had at least one older member. The majority (87%) of older people lived in three-generation households. Households with older people were significantly poorer, more likely to be headed by a woman, and in homesteads with poorer quality infrastructure than households without older members. By January 2002, 316 (8%) of the older people in the sample had died. Of all the households with an older person, 12 per cent experienced at least one adult death from AIDS. The paper shows that older people, particularly those living alone or with children in the absence of other adults, were living in the poorest households. They were also coping with an increasing burden of young adult deaths, the majority of which were attributable to AIDS.

scholarly journals Sources of social support and sexual behaviour advice for young adults in rural South Africa

2018 ◽  
Vol 3 (6) ◽  
pp. e000955 ◽  
Author(s):  
Guy Harling ◽  
Dumile Gumede ◽  
Maryam Shahmanesh ◽  
Deenan Pillay ◽  
Till W Bärnighausen ◽  
...  
Keyword(s):  
Social Support ◽  
South Africa ◽  
Young Adults ◽  
Hiv Prevention ◽  
Sexual Behaviour ◽  
Sub Saharan Africa ◽  
Social Connections ◽  
Cross Sectional ◽  
Rural South ◽  
Rural South Africa

IntroductionWhile young people in sub-Saharan Africa (SSA) are at greatest risk of HIV acquisition, uptake of HIV prevention interventions among them has been limited. Interventions delivered through social connections have changed behaviour in many settings, but not to date in SSA. There is little systematic evidence on whom young SSA adults turn to for advice. We therefore conducted an exploratory cross-sectional study from whom young rural South Africans received support and sexual behaviour-specific advice.MethodsWe asked 119 18–34  year olds in rural KwaZulu-Natal about the important people in their lives who provided emotional, informational, financial, physical, social or other support. We also asked whether they had discussed sex or HIV prevention with each contact named. We used descriptive statistics and logistic regression to analyse support and advice provision patterns.ResultsRespondents named 394 important contacts, each providing a mean of 1.7 types of support. Most contacts were relatives, same-gender friends or romantic partners. Relatives provided most informational, financial and physical support; friends and partners more social support and sexual advice. Respondents reported discussing sexual matters with 60% of contacts. Sources of support changed with age, from friends and parents, towards siblings and partners.DiscussionSexual health interventions for young adults in rural South Africa may be able to harness friend and same-generation kin social ties through which sex is already discussed, and parental ties through which other forms of support are transmitted. The gender-segregated nature of social connections may require separate interventions for men and women.

scholarly journals Tourism and poverty in rural South Africa: A revisit

2020 ◽  
Vol 116 (1/2) ◽  
Author(s):  
Daan Toerien
Keyword(s):  
South Africa ◽  
South African ◽  
Poverty Reduction ◽  
Rural South ◽  
Population Sizes ◽  
Hospitality Sector ◽  
Tourism And Hospitality ◽  
The Impact ◽  
New Geography ◽  
Rural South Africa

Debates about the value of pro-poor tourism indicated a need to revisit the links between the dynamics of tourism and hospitality enterprises and community poverty in rural South African towns. The numbers of tourism and hospitality enterprises in these towns are related to population numbers by a power law with a sub-linear exponent. The residents of smaller South African towns are more dependent on the tourism and hospitality sector than are the residents of larger towns. Measurement of the enterprise dependency indices (EDIs) of these towns provides a valid measurement of their wealth/poverty states. Their EDIs are directly and negatively associated with the strength of their tourism and hospitality sectors. Communities in towns with more tourist and hospitality enterprises are overall wealthier, and vice versa. This finding contrasts with a previous view about tourism and poverty reduction in South Africa. Debates about the benefits of pro-poor tourism should include information about the impact of tourism on community wealth/poverty. The EDI is a simple, yet powerful, measure to provide poverty information. Expressing the number of tourism and hospitality enterprises per 1000 residents of towns enables comparisons of towns of different population sizes. Based on ideas of the ‘new geography of jobs’, it is clear that tourism is part of what is called the traded sector and results in inflows of external money into local economies. Tourism is a driver of prosperity and a reducer of poverty in South African towns.

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