Multi-mycotoxin exposure of children (0-24 months) in rural maize-subsistence farming areas of the Eastern Cape Province, South Africa

2020 ◽  
Vol 13 (3) ◽  
pp. 401-410
Author(s):  
R.S. Tshalibe ◽  
J.P. Rheeder ◽  
J.F. Alberts ◽  
C. Taljaard-Krugell ◽  
W.C.A. Gelderblom ◽  
...  
Keyword(s):  
South Africa ◽  
Rural Areas ◽  
Daily Intake ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Subsistence Farming ◽  
Eastern Cape ◽  
Cross Sectional ◽  
The Mean ◽  
Daily Intakes

In South Africa, child malnutrition is highly prevalent among children from in rural areas mostly at risk. In the Eastern Cape (EC) Province, maize is commonly used as complementary and weaning food. Previous studies conducted in parts of EC have indicated high levels of fumonisin B (FB) mycotoxins in home-grown maize, as well as the co-occurrence of other Fusarium mycotoxins, such as deoxynivalenol (DON) and zearalenone (ZEN). A cross-sectional study of children below 24 months was conducted in rural maize-subsistence farming areas in Centane, EC to determine mycotoxin exposure. Home-grown maize samples (n=171) were collected from households in the study area and analysed by LC-MS/MS for FB, DON and ZEN. Food intakes of 129 children were quantified using a validated quantitative food frequency questionnaire (QFFQ). Individual raw maize consumption was calculated using recipes from the QFFQ. Probable daily intakes (PDIs) for each mycotoxin were determined using a deterministic approach and were compared to the respective mycotoxins’ provisional maximum tolerable daily intake (PMTDI). The numerical means for total FB (sum of fumonisin B1, B2 and B3), DON and ZEN levels in home-grown maize were 1,035, 24.5 and 31.0 μg/kg, respectively. Mean daily maize intakes of children ranged from 2-321 g/day and increased with age. The mean PDIs for total FB, DON and ZEN were 8.4, 0.2 and 0.3 μg/kg body weight (bw)/day, respectively. Exposures stratified by age indicated persistent high mean PDIs for total FB, above the PMTDI of 2 μg/kg bw/day, ranging between 5.0-11.6 μg/kg bw/day. Mean exposure to DON and ZEN were below their relevant PMTDIs (1 and 0.5 μg/kg bw/day, respectively). Individually, 81 and 13% of children had exposures above the PMTDI for total FB and for ZEN, respectively. Results confirm the magnitude of FB exposure among vulnerable groups from rural maize subsistence farming areas in EC.

scholarly journals Clinical outcomes of hospitalised COVID-19 patients at Mthatha Regional Hospital, Eastern Cape, South Africa: A retrospective study

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Ramprakash Kaswa ◽  
Parimalaranie Yogeswaran ◽  
Busisiwe Cawe
Keyword(s):  
South Africa ◽  
Clinical Outcomes ◽  
Cross Sectional Study ◽  
Regional Hospital ◽  
Sudden Expansion ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Health Crisis ◽  
Hospitalised Patients ◽  
The Mean

Background: Coronavirus disease 2019 (COVID-19) is a public health crisis that threatens the current health system. The sudden expansion in the need for inpatient and intensive care facilities raised concerns about optimal clinical management and resource allocation. Despite the pressing need for evidence to make context-specific decisions on COVID-19 management, evidence from South Africa remained limited. This study aimed to describe the clinical characteristics and outcomes of COVID-19 hospitalised patients.Methods: A retrospective cross-sectional study design was used to evaluate the clinical outcomes of hospitalised adult patients (≥ 18 years old) with laboratory-confirmed COVID-19 illness at Mthatha Regional Hospital (MRH), Eastern Cape.Results: Of the 1814 patients tested for COVID-19 between 20 March 2020 and 31 July 2020 at MRH, two-thirds (65.4%) were female. About two-thirds (242) of the 392 patients (21.6%) who tested positive for this disease were hospitalised and one-third (150) were quarantined at home. The mean age of the patients tested for COVID-19 was 42.6 years and there was no difference between males and females. The mean age of hospitalised patients was 55.5 years and the mean age of hospitalised patients who died (61.3 years) was much higher than recovered (49.5 years). Overall, 188 (77.6%) hospitalised patients had clinical comorbidity on admission. Diabetes (36.8%) and hypertension (33.1%) were the most common comorbidities amongst COVID-19 hospitalised patients.Conclusion: The majority of the patients who were hospitalised for COVID-19 were elderly and had high baseline comorbidities. Advance age and underlying comorbidities (diabetes, hypertension and HIV) were associated with high mortality in hospitalised COVID-19 patients.

scholarly journals Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Ter Goon ◽  
Anthony Idowu Ajayi ◽  
Oladele Vincent Adeniyi
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Exclusive Breastfeeding ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practice

Abstract Background Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first 6 months among mothers on antiretroviral therapy in the Eastern Cape, South Africa. Methods This was a cross-sectional study conducted between January to May 2018, on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice. Results The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. E Exclusive breastfeeding’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women (adjusted odds ratio [AOR] 1.66, 95% Confidence Interval [CI] 1.08–2.56) and those with grade 12 or less level of education (AOR 2.76, 95% CI 1.02–7.49) had a higher likelihood of practising EBF for 6 months since birth while mothers who consumed alcohol (AOR 0.54, 95% CI 0.34–0.85) were less likely to practice EBF for 6 months. Conclusions The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

scholarly journals An analysis of heavy metals contamination and estimating the daily intakes of vegetables from Uganda

2021 ◽  
Vol 5 ◽  
pp. 239784732098525
Author(s):  
Keneth Iceland Kasozi ◽  
Eric Oloya Otim ◽  
Herbert Izo Ninsiima ◽  
Gerald Zirintunda ◽  
Andrew Tamale ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Daily Intake ◽  
Principal Component ◽  
Absorption Spectrometry ◽  
Cross Sectional Study ◽  
Essential Elements ◽  
World Health ◽  
Cross Sectional ◽  
Health Organization ◽  
Daily Intakes

Background: Environmental contamination with elevated levels of copper (Cu), cobalt (Co), iron (Fe), zinc (Zn), lead (Pb), chromium (Cr6+), cadmium (Cd), and nickel (Ni)—all states of which are found in Uganda—raises health risk to the public. Pb, Cr6+, Cd, and Ni for instance are generally considered nonessential to cellular functions, notwithstanding the importance of the oxidative state of the metals in bioavailability. As such, we aimed in this study (i) to evaluate heavy metal concentrations in four vegetables from a typical open-air market in Uganda, (ii) to assess the safety of consuming these vegetables against the World Health Organization (WHO) recommended limits of heavy metals consumption, and (iii) to formulate a model of estimated daily intake (EDI) among consumers in the country. Methods: This was a cross-sectional study conducted in five georeferenced markets of Bushenyi district in January 2020. Amaranthus, cabbages, scarlet eggplants, and tomatoes were collected from open markets, processed, and analyzed by atomic absorption spectrometry. Modeled EDI, principal component (PCA) and cluster analysis (CA) were conducted to identify relationships in the samples. Results: The levels of essential elements in the four vegetables were found to fall from Co > Cu > Fe > Zn. Those of non-essential metals were significantly higher and followed the pattern Cd > Cr > Pb > Ni. The highest EDI values were those of Cu in scarlet eggplants, Zn in amaranthus, Fe in amaranthus, Co in amaranthus, Pb in cabbages, total Cr in scarlet eggplant, Cd in cabbages and tomatoes, and Ni in cabbages. In comparison to international limits, EDIs for Zn, Cu, Co and Fe were low while Ni in cabbages were high. PCA showed high variations in scarlet eggplant and amaranthus. The study vegetables were found to be related with each other, not according to the location of the markets from where they were obtained, but according to their species by CA. Conclusion: The presence of non-essential elements above WHO limits raises policy challenges for the consumption and marketing of vegetables in the study area. Furthermore, low EDIs of essential elements in the vegetables create demand for nutritious foods to promote healthy communities.

scholarly journals The Oral Health Situation of 12-Year-Old School Children in the Rural Region of Ilembula in Southwestern Tanzania: A Cross-Sectional Study

2021 ◽  
Vol 18 (22) ◽  
pp. 12237
Author(s):  
Lisa Zumpe ◽  
Tobias Bensel ◽  
Andreas Wienke ◽  
Matilda Mtaya-Mlangwa ◽  
Jeremias Hey
Keyword(s):  
Dental Caries ◽  
Rural Areas ◽  
Primary Schools ◽  
Cross Sectional Study ◽  
Risk Indicators ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Prophylactic Measures ◽  
The Mean

There has been no research on the prevalence of and factors associated with dental caries in rural southwestern Tanzania among schoolchildren. Determining the prevalence of and factors associated with dental caries will help to assess the need for dental intervention and prophylactic measures among children in the region. In February 2020, a cross-sectional study was conducted in the Wanging’ombe District of the Ilembula Ward. The data were collected through clinical examinations and personal interviews at two primary schools. Univariable and multivariable logistic regression analyses were performed to identify potential risk indicators for caries. The study included 319 students aged 11–12 years (average 11.92 ± 0.27 years). The mean Decayed, Missing and Filled Teeth index was 0.24 ± 0.68, and the mean Specific affected Caries Index was 1.66 ± 0.9. The greatest influences on the caries risk were poor oral hygiene (OR 8.05, 95% CI 0.49–133.23), low tooth brushing frequency (OR 3.03, 95% CI 1.26–7.26) and low level of education in parents (OR 2.63, 95% CI 0.99–6.98). Dental caries was low among students in rural areas in the Wanging’ombe District.

scholarly journals Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2021 ◽  
Author(s):  
Daniel Ter Goon ◽  
Anthony Idowu Ajayi ◽  
Oladele Vincent Adeniyi
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Exclusive Breastfeeding ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practice

Abstract Background: Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa. Methods: This was a cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice.Results: The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. EBF’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women [adjusted odds ratio (AOR) = 1.66, 95% Confidence Interval CI), 1.08-2.56] and those with grade 12 or less level of education (AOR =2.76, 95% CI, 1.02-7.49) had a higher likelihood of practising EBF for six months since birth while mothers who consumed alcohol (AOR = 0.54, 95% CI, 0.34-0.85) were less likely to practice EBF for six months. Conclusions: The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

Exposure Assessment of Artificial Sweeteners among Type 2 Diabetic, Overweight and Obese Individuals

2016 ◽  
Vol 53 (3) ◽  
pp. 268
Author(s):  
A. Bhagyasri ◽  
R. Naveen Kumar ◽  
N. Balakrishna ◽  
V. Sudershan Rao
Keyword(s):  
Exposure Assessment ◽  
Daily Intake ◽  
Cross Sectional Study ◽  
Consumption Pattern ◽  
Cross Sectional ◽  
Significant Difference ◽  
Overweight Group ◽  
The Mean ◽  
Type 2 Diabetic

In recent years consumption of artificially sweetened foods and beverages became popular in India, with the regulatory formulations to use them in selected foods; their inclusion especially in sweets, biscuits and beverages has increased. There are many concerns rising regarding their safety and is becoming an area of controversy. So an exposure assessment has been carried out to evaluate intake levels among type II diabetic, overweight and obese individuals. A cross-sectional study design was applied and a food frequency questionnaire was used to obtain the information on consumption pattern. Range, standard deviation and mean daily intake levels were calculated and the values were compared with an appropriate Acceptable Daily Intake (ADI). Results indicated that, the mean daily intake levels of aspartame (0.85±0.75) were found to be high among type 2 diabetic individuals whereas sucralose (0.41±0.41) and acesulfame-k (0.07±0.02) were high among overweight group. There was a significant difference (p<0.0001) observed in intake levels among both groups and all the sweeteners were found to be well within the ADI levels.

scholarly journals Environmental health community service: Confronting the human resource challenges

2019 ◽  
Vol 17 ◽  
Author(s):  
Patience Mbola ◽  
Izanne S. Human ◽  
Paula E. Melariri
Keyword(s):  
South Africa ◽  
Environmental Health ◽  
Community Service ◽  
Cross Sectional Study ◽  
Eastern Cape ◽  
Chi Square ◽  
Cross Sectional ◽  
Health Practitioners ◽  
Effective Selection ◽  
Chi Square Test

Orientation: The environmental health graduates are required to complete community service before they could be registered as independent practitioners by the Health Professions Council of South Africa. Community service programme serves as the mechanism to recruit healthcare professionals who will improve the provision of equitable and quality healthcare.Research purpose: The study aimed to explore, identify and describe the factors that had an influence on the effective selection, placement and utilisation of environmental health graduates as well as an evaluation of the effectiveness of community service.Research approach/design and method: A quantitative, cross-sectional study was conducted using self-administered questionnaires. The study included 24 environmental health practitioners who completed their community service and 10 environmental health practitioners responsible for coordinating community service in the municipal, provincial and national spheres of government in the Eastern Cape province of South Africa during 2013–2016. Purposive sample was drawn from each population. T-test and chi-square test were used to determine the statistical significant differences. The open-ended question responses from the structured questionnaire were qualitatively analysed by an independent coder.Main findings: The findings revealed major problems regarding the effective implementation of community service that included decreasing number of community service posts, inadequate material resources, lack of induction, inconsistent supervision, and a lack of evaluation of the community service.Contribution: The study findings suggest important inequalities that should deserve urgent attention. Study concludes by presenting recommendations for the improvement of the community service in the environmental health.

scholarly journals Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e023033 ◽  
Author(s):  
Yafei Si ◽  
Zhongliang Zhou ◽  
Min Su ◽  
Xiao Wang ◽  
Xin Lan ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Expenditure ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Urban China ◽  
Shaanxi Province ◽  
Vulnerable Groups ◽  
Cross Sectional

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.

scholarly journals Assessment of quality of life among elderly population of rural areas of Etawah district: a cross sectional study

2019 ◽  
Vol 6 (5) ◽  
pp. 1965
Author(s):  
Priyanka Bansal ◽  
Anand M. Dixit ◽  
Pankaj K. Jain ◽  
Sandip K. Gupta ◽  
Prashant K. Bajpai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rural Areas ◽  
Elderly Population ◽  
Death And Dying ◽  
Cross Sectional Study ◽  
Elderly Subjects ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean

Background: All the aspects of health status, lifestyle, life satisfaction, mental health and well-being together reflects the multidimensional nature of quality of life (QOL) in an individual. The objective of the study was to assess the quality of life among rural elderly population of Etawah district and their association with various socio demographic factors.Methods: A community based cross-sectional study was conducted among 316 elderly subjects in rural areas of Etawah district. QOL was assessed by using WHOQOL-OLD tool. Socio-demographic factors were assessed by using a self-structured questionnaire. Data was analysed by using Microsoft Excel 2010 and statistical software SPSS-22. Transformed facet sore were calculated using WHOQOL- OLD manual and Independent sample t- test were applied.Results: Majority (86%) were in the (≤75) years of age.  Among the study participants, 52.8% were females, 67.5% were illiterate, 72.5% belong to nuclear family. The mean scores of QOL domains was maximum in death and dying (83.20), followed by sensory ability (62.99).The lowest mean score was seen Intimacy domain (22.80). Gender, type of family, financial status and staying with partner were found to be the determinants of better QOL (p>0.05).Conclusions: The mean quality of life score was below average in intimacy domain. It was maximum in death and dying domain.

scholarly journals Fermentable Oligo-, Di-, and Mono-Saccharides and Polyols (FODMAPs) Consumption and Irritable Bowel Syndrome in the French NutriNet-Santé Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4513
Author(s):  
Elodie Schneider ◽  
Jean-Marc Sabaté ◽  
Michel Bouchoucha ◽  
Serge Hercberg ◽  
Mathilde Touvier ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Daily Intake ◽  
Population Based ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
The Mean ◽  
Irritable Bowel ◽  
Composition Table

(1) Background: Specific foods, and more particularly, fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) are often considered as triggers of digestive symptoms in Irritable Bowel Syndrome (IBS). Our aim was to study FODMAP consumption in controls and IBS participants in a large French population-based cohort; (2) Methods: Participants from the NutriNet-Santé cohort study completed the Rome IV and IBS-SSS questionnaire in a cross sectional study. Among them, 27,949 eligible participants had previously completed three 24-h recalls as well as anthropometrics, socio-demographical and lifestyle data. Total FODMAP intake (in g/day) was computed using a specific composition table. The association between FODMAPs and IBS was estimated through multivariable logistic regression models; (3) Results: Included participants were mainly women (75.4%) and the mean age was 43.4 ± 14.1 years. FODMAPs accounted for a mean daily intake of 19.4 ± 9.5 g/day. Overall 1295 participants (4.6%) were identified with an IBS. After adjusting for confounding factors, IBS participants had lower intakes in FODMAPs than non-IBS ones (aOR: 0.88, 95% CI: 0.82–0.95, p-value: 0.001). IBS severity was associated with more frequent low FODMAP intakes (<9 g/day); (4) Conclusions: Participants tended to consume 19 g of FODMAPs per day, but slightly less for IBS participants than for controls. In IBS participants, higher severity was associated with lower intakes.

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