HIV Incidence Remains High in KwaZulu-Natal, South Africa: Evidence from Three Districts

Mapping Intimacies ◽

10.31234/osf.io/r5edn ◽

2020 ◽

Author(s):

Lungwani Muungo

Keyword(s):

South Africa ◽

Urban Areas ◽

Contraceptive Use ◽

Hormonal Contraceptive ◽

Incidence Rates ◽

Hiv Prevalence ◽

Hiv Positive ◽

Sexually Active ◽

Hiv Incidence ◽

Kwazulu Natal

Background: HIV prevalence and incidence among sexually active women in peri-urban areas of Ladysmith, Edendale, andPinetown, KwaZulu-Natal, South Africa, were assessed between October 2007 and February 2010 in preparation for vaginalmicrobicide trials.Methodology/Principal Findings: Sexually active women 18–35 years, not known to be HIV-positive or pregnant weretested cross-sectionally to determine HIV and pregnancy prevalence (798 in Ladysmith, 1,084 in Edendale, and 891 inPinetown). Out of these, approximately 300 confirmed non-pregnant, HIV-negative women were subsequently enrolled ateach clinical research center (CRC) in a 12-month cohort study with quarterly study visits. Women in the cohort studies wererequired to use a condom plus a hormonal contraceptive method. HIV prevalence rates in the baseline cross-sectionalsurveys were high: 42% in Ladysmith, 46% in Edendale and 41% in Pinetown. Around 90% of study participants at each CRCreported one sex partner in the last 3 months, but only 14–30% stated that they were sure that none of their sex partnerswere HIV-positive. HIV incidence rates based on seroconversions over 12 months were 14.8/100 person-years (PY) (95% CI9.7, 19.8) in Ladysmith, 6.3/100 PY (95% CI 3.2, 9.4) in Edendale, and 7.2/100 PY (95% CI 3.7, 10.7) in Pinetown. The 12-monthpregnancy incidence rates (in the context of high reported contraceptive use) were: 5.7/100 PY (95% CI 2.6, 8.7) inLadysmith, 3.1/100 PY (95% CI 0.9, 5.2) in Edendale and 6.3/100 PY (95% CI 3.0, 9.6) in Pinetown.Conclusions/Significance: HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal.

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Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa

International Journal of Epidemiology ◽

10.1093/ije/dyq176 ◽

2010 ◽

Vol 40 (4) ◽

pp. 922-930 ◽

Cited By ~ 85

Author(s):

Q. A. Karim ◽

A. B. Kharsany ◽

J. A. Frohlich ◽

L. Werner ◽

M. Mashego ◽

...

Keyword(s):

South Africa ◽

Urban Women ◽

Incidence Rates ◽

Hiv Prevalence ◽

Hiv Incidence ◽

Rural And Urban ◽

Kwazulu Natal

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Challenges in estimating HIV prevalence trends and geographical variation in HIV prevalence using antenatal data: Insights from mathematical modelling

PLoS ONE ◽

10.1371/journal.pone.0242595 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242595

Author(s):

Leigh F. Johnson ◽

Mmamapudi Kubjane ◽

Jeffrey W. Eaton

Keyword(s):

South Africa ◽

Pregnant Women ◽

Rural Areas ◽

Urban Areas ◽

Geographical Variation ◽

Sexual Experience ◽

Hiv Prevalence ◽

Hiv Incidence ◽

African Countries ◽

Prevalence Data

Background HIV prevalence data among pregnant women have been critical to estimating HIV trends and geographical patterns of HIV in many African countries. Although antenatal HIV prevalence data are known to be biased representations of HIV prevalence in the general population, mathematical models have made various adjustments to control for known sources of bias, including the effect of HIV on fertility, the age profile of pregnant women and sexual experience. Methods and findings We assessed whether assumptions about antenatal bias affect conclusions about trends and geographical variation in HIV prevalence, using simulated datasets generated by an agent-based model of HIV and fertility in South Africa. Results suggest that even when controlling for age and other previously-considered sources of bias, antenatal bias in South Africa has not been constant over time, and trends in bias differ substantially by age. Differences in the average duration of infection explain much of this variation. We propose an HIV duration-adjusted measure of antenatal bias that is more stable, which yields higher estimates of HIV incidence in recent years and at older ages. Simpler measures of antenatal bias, which are not age-adjusted, yield estimates of HIV prevalence and incidence that are too high in the early stages of the HIV epidemic, and that are less precise. Antenatal bias in South Africa is substantially greater in urban areas than in rural areas. Conclusions Age-standardized approaches to defining antenatal bias are likely to improve precision in model-based estimates, and further recency adjustments increase estimates of HIV incidence in recent years and at older ages. Incompletely adjusting for changing antenatal bias may explain why previous model estimates overstated the early HIV burden in South Africa. New assays to estimate the fraction of HIV-positive pregnant women who are recently infected could play an important role in better estimating antenatal bias.

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HIV Incidence Among Non-Pregnant Women Living in Selected Rural, Semi-Rural and Urban Areas in Kwazulu-Natal, South Africa

AIDS and Behavior ◽

10.1007/s10461-011-0043-7 ◽

2011 ◽

Vol 16 (7) ◽

pp. 2062-2071 ◽

Cited By ~ 28

Author(s):

Gita Ramjee ◽

Handan Wand ◽

Claire Whitaker ◽

Sheena McCormack ◽

Nancy Padian ◽

...

Keyword(s):

South Africa ◽

Pregnant Women ◽

Urban Areas ◽

Hiv Incidence ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Kwazulu Natal

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South Africa and national TB control: Are we making progress?

South African Family Practice ◽

10.4102/safp.v59i6.4786 ◽

2017 ◽

Vol 59 (2) ◽

pp. 4

Author(s):

Gboyega A Ogunbanjo

Keyword(s):

South Africa ◽

World Health Organisation ◽

Incidence Rates ◽

World Health ◽

Hiv Positive ◽

Western Cape ◽

Eastern Cape ◽

Tb Control ◽

Kwazulu Natal ◽

The World

South Africa accounts for the worst global tuberculosis epidemics fuelled by the spread of HIV infection. The tuberculosis (TB) incidence increased from 300 per 100,000 people in the early 1990s to more than 950 per 100,000 in 2012.1 In addition, the country remains one of the countries with the highest TB burden globally, with the World Health Organisation (WHO) statistics giving an estimated incidence of 454,000 cases of active TB in 2015.2 This means that about 0.8% of South Africa’s population of 54 million develop active TB disease annually. Of the 454 000 TB cases in South Africa in 2015, WHO estimated that about 57% (258,000) were HIV positive. It also estimated that of 157,505 whose status was known, and who were known to be HIV positive, some 85% (133,116) were on antiretroviral therapy.3 From the same 2015 report, Eastern Cape, KwaZulu-Natal and Western Cape provinces had the highest incidence rates of 692, 685 and 681 per 100,000 respectively. The most notable decline was in KwaZulu-Natal where the incidence decreased from 1,185 to 685 per 100,000 over the last five years.1

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Social and Demographic Factors Associated with Postnatal Depression Symptoms among HIV-Positive Women in Primary Healthcare Facilities, South Africa

Healthcare ◽

10.3390/healthcare9010065 ◽

2021 ◽

Vol 9 (1) ◽

pp. 65

Author(s):

Kebogile Elizabeth Mokwena ◽

Nontokozo Lilian Mbatha

Keyword(s):

South Africa ◽

Primary Healthcare ◽

Postnatal Depression ◽

Hiv Positive ◽

P Value ◽

Depression Symptoms ◽

Healthcare Facilities ◽

Factors Associated ◽

Hiv Positive Women ◽

Kwazulu Natal

Background: Mothers living with HIV are at risk for mental health problems, which may have a negative impact on the management of their HIV condition and care of their children. Although South Africa has a high prevalence of HIV, there is a dearth of studies on sociodemographic predictors of postnatal depression (PND) among HIV-positive women in South Africa, even in KwaZulu Natal, a province with the highest prevalence of HIV in the country. Objective: The objective of the study was to determine sociodemographic factors associated with the prevalence of postnatal depression symptoms among a sample of HIV-positive women attending health services from primary healthcare facilities in Umhlathuze District, KwaZulu Natal. Methods: A quantitative cross-sectional survey was used to collect data from 386 HIV-positive women who had infants aged between 1 and 12 weeks. The Edinburgh Postnatal Depression Scale (EPNDS), to which sociodemographic questions were added, was used to collect data. Results: The prevalence of PND symptoms among this sample of 386 HIV-positive women was 42.5%. The age of the mothers ranged from 16 to 42 years, with a mean of 29 years. The majority of the mothers were single or never married (85.5%; n = 330), living in a rural setting (81.9%; n = 316%), with a household income of less than R 2000 (estimated 125 USD) per month (64.9%; n = 120). The government child support grant was the main source of income for most of the mothers (53%; n = 183). PND symptoms were significantly associated with the participant’s partner having other sexual partners (p-value < 0.001), adverse life events (p-value = 0.001), low monthly income (p-value = 0.015), and being financially dependent on others (p-value = 0.023). Conclusion: The prevalence of PND symptoms among the sample is high, with a number of social and demographic factors found to be significantly associated with PND. This requires the consideration of sociodemographic information in the overall management of both HIV and postnatal depression. Addressing the impact of these factors can positively influence the health outcomes of both the mother and the baby.

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Population-level HIV incidence estimates using a combination of synthetic cohort and recency biomarker approaches in KwaZulu-Natal, South Africa

PLoS ONE ◽

10.1371/journal.pone.0203638 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0203638 ◽

Cited By ~ 4

Author(s):

Eduard Grebe ◽

Alex Welte ◽

Leigh F. Johnson ◽

Gilles van Cutsem ◽

Adrian Puren ◽

...

Keyword(s):

South Africa ◽

Population Level ◽

Hiv Incidence ◽

Synthetic Cohort ◽

Kwazulu Natal

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Core competencies acquired in indigenous training of traditional health practitioners in Kwazulu-Natal

African Health Sciences ◽

10.4314/ahs.v19i4.32 ◽

1970 ◽

Vol 19 (4) ◽

pp. 3100-3106

Author(s):

Mbatha Nompumelelo ◽

Exnevia Gomo ◽

Nceba Gqaleni ◽

Mlungisi Ngcobo

Keyword(s):

South Africa ◽

Health Care ◽

Spiritual Development ◽

Urban Areas ◽

Core Competencies ◽

Sequential Data ◽

Traditional Health ◽

Traditional Health Practitioners ◽

Kwazulu Natal ◽

Health Practitioners

Introduction: Despite the recognition of Traditional Medicine systems as a critical component of health care by the WHO and the African Union, its integration into the health care mainstream remains very subdued in South Africa. This is partly due to the lack of empirical data pertinent to traditional healer training that could inform the accreditation process. Objective: To determine core competencies acquired by Traditional Health Practitioners (THP) of KwaZulu-Natal Province, South Africa during their apprenticeship. Materials and methods: Purposeful, convenient and snowballing sampling and the sequential data collection methods of questionnaires, journaling and focus groups was used to collect data from the THP tutors and their trainees in rural, peri-urban and urban areas of eThekwini and uThungulu Districts of Kwa Zulu Natal (KZN). Results: Eleven core competencies were identified: consultation, diagnoses, holistic patient care and treatment, integrative and holistic healing, application of healing procedures and cultural rituals, spiritual development, ethical competencies, problem solving, herbalism, ancestral knowledge and end of life care. Conclusion: The apprenticeship of THPs in KZN is based on eleven core competencies. These competencies are fundamental pillars for critical health care provided by THPs and are crucial for setting standards for the accreditation of traditional training in South Africa if the THP Act 22 of 2007 is to achieve its purpose of providing for the management of and control over the registration, training and conduct of the practitioners. Hence, the appointed interim THP Council should include the identified competencies when articulating bases for accreditation of the training and assessments.Keywords: Indigenous training, traditional health practitioners, Kwazulu-Natal.

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