Unwanted pregnancies in Gauteng and Mpumalanga provinces, South Africa: Examining mortality data on dumped aborted fetuses and babies

Controversy continues to surround the age-old practice of virginity testing, which in South Africa made a visible comeback around the time of the country’s first democratic elections when most South Africans began to feel free to practise their cultural beliefs without fear. It coincided with the period when the HIV pandemic began to take hold. It is practised mainly in some countries of Asia and Africa, and in South Africa it is practised mainly amongst amaZulu. It is believed that this practice prevents unwanted pregnancies and sexually transmitted diseases (STDs), especially HIV/AIDS, as well as engendering a sense of pride in teenage and young females, in particular. However, some individuals, organisations and sectors of the community frown upon the practice because it violates constitutional laws that protect the right to equality, privacy, bodily integrity and sexual autonomy. The purpose of this article is to present current discourse on the cultural practice of virginity testing and the controversies surrounding this discourse. This article draws its arguments from the existing literature on virginity testing.

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Tuberculosis Mortality by Occupation in South Africa, 2011–2015

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122756 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2756 ◽

Cited By ~ 4

Author(s):

Tahira Kootbodien ◽

Kerry Wilson ◽

Nonhlanhla Tlotleng ◽

Vusi Ntlebi ◽

Felix Made ◽

...

Keyword(s):

South Africa ◽

Smoking Status ◽

Direct Method ◽

Multivariate Logistic Regression Analysis ◽

World Health ◽

Health Concern ◽

Mortality Data ◽

Middle Income ◽

Risk Of Death ◽

Increased Risk

Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MORadj = 3.44, 95% CI 2.91–4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65–4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.

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Trends in Melanoma Mortality in the Population Groups of South Africa

Dermatology ◽

10.1159/000500663 ◽

2019 ◽

Vol 235 (5) ◽

pp. 396-399 ◽

Cited By ~ 3

Author(s):

Caradee Yael Wright ◽

Thandi Kapwata ◽

Elvira Singh ◽

Adele C. Green ◽

Peter Baade ◽

...

Keyword(s):

South Africa ◽

Regression Models ◽

Population Group ◽

Mortality Rates ◽

Mortality Data ◽

African Countries ◽

South Africans ◽

Awareness Campaigns ◽

Increasing Trend ◽

Join Point

The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM (n = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 (p < 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 (p < 0.05) and of 3% from 1999 to 2014 (p < 0.01). These results may be used to inform CM awareness campaigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.

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A Contact-Explicit Covid-19 Epidemic and Response Assessment Model

10.1101/2020.07.16.20155812 ◽

2020 ◽

Author(s):

Wayne M Getz ◽

Ludovica Luisa-Vissat ◽

Richard Salter

Keyword(s):

South Africa ◽

Latent Class ◽

Assessment Model ◽

Mortality Data ◽

Actual Number ◽

Social Distancing ◽

Pathogen Invasion ◽

Incidence And Mortality ◽

Negative Constant ◽

Web App

We formulate a refined SEIR epidemic model that explicitly includes a contact class C that either thwarts pathogen invasion and returns to the susceptible class S or progresses successively through a latent class L, a presymptomatic/asymptomatic class A, and a symptomatic class I. Individuals in both A and I may go directly to an immune class V, and in I to a dead class D. Upon this SCLAIV formulation we impose a set of drivers that can be used to develop policy to manage current Covid-19 and similar type disease outbreaks. These drivers include surveillance, social distancing (rate and efficacy), social relaxation, quarantining (linked to contact tracing), patient treatment/isolation and vaccination processes that can either be a non-negative constant or an s-shaped switching curve. The latter are defined in terms of onset and switching times, initial and final values, and abruptness of switching. We built a Covid-19 NMB-DASA web app to generate both deterministic and stochastic solutions to our SCLAIV and drivers model and use incidence and mortality data to provide both maximum-likelihood frequentist and Bayesian fitting of parameters. In the context of South African and English Covid-19 incidence data we demonstrate how to both identify and evaluate the role of drivers in ongoing outbreaks. In particular, we show that early social distancing in South Africa likely averted around 80,000 observed cases (actual number is double if only half the case are observed) during the months of June and July. We also demonstrated that incidence rates in South Africa will increase to between a conservative estimate of 15 and 30 thousand observed cases per day (again, actual number considerably higher) by the end of August if stronger social distancing measures are not effected during July and August, 2020. On different a note, we show that comparably good local optimal fits of the English data using surveillance, social distancing and social relaxation drivers can represent very different kinds of outbreaks---one with close to 90% and another with under 8% immune individuals. This latter result provides a cautionary tale of why fitting SEIR-like models to incidence or prevalence data can be extremely problematic when not anchored by other critical measures, such as levels of immunity in the population. Our presentation illustrates how our Covid-19 web app can be used by individuals without any programming skills to carry out forensic and scenario analyses in spatially contained populations such as small countries or metropolitan areas.

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Association between ambient air pollution and cause-specific mortality in Cape Town, Durban, and Johannesburg, South Africa: any susceptible groups?

Environmental Science and Pollution Research ◽

10.1007/s11356-021-13778-w ◽

2021 ◽

Author(s):

Nomsa Duduzile Lina Thabethe ◽

Kuku Voyi ◽

Janine Wichmann

Keyword(s):

South Africa ◽

Air Pollution ◽

Environmental Conditions ◽

Air Pollutants ◽

Cape Town ◽

Ambient Air ◽

Ambient Air Pollution ◽

Mortality Data ◽

Interaction Terms ◽

Specific Mortality

AbstractStudies have confirmed that adverse human health effects that are associated with exposure to air pollution may differ depending on other factors such as age, gender, environmental conditions, and socio-economic factors. This study was conducted to assess the association between ambient air pollution and cause-specific mortality in the three big cities in South Africa and to determine the susceptible groups thereof. Cause-specific mortality data for all ages and PM10, NO2, and SO2 in Cape Town, Durban, and Johannesburg for the period from 1 January 2006 to 31 December 2010 were obtained. Statistical analyses were done to estimate the associations between air pollutants and cause-specific mortality. Susceptibility was therefore investigated in stratified analyses by sex and age (≥60 years) and environmental conditions (heat and cold) followed by models with interaction terms. Our estimates showed independent associations between these air pollutants, environmental conditions, and susceptible groups.

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The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two south African hospitals with a high HIV burden

BMC Palliative Care ◽

10.1186/s12904-019-0487-5 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Peter J. Raubenheimer ◽

Cascia Day ◽

Faried Abdullah ◽

Katherine Manning ◽

Clint Cupido ◽

...

Keyword(s):

South Africa ◽

Observational Study ◽

Predictive Value ◽

Prospective Observational Study ◽

Screening Tool ◽

Young Patients ◽

Public Hospitals ◽

Mortality Data ◽

Hospitalised Patients ◽

Identification Tool

Abstract Background Timely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process. We aimed to evaluate the performance of a identification tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South Africa. Methods Patients admitted to the acute medical services in two public hospitals in Cape Town, South Africa were enrolled in a prospective observational study. Demographic data were collected from patients and patient notes. Patients were assessed within two days of admission by two trained clinicians who were not the primary care givers, using the identification tool. Outcome mortality data were obtained from patient folders, the hospital electronic patient management system and the Western Cape Provincial death registry which links a unique patient identification number with national death certificate records and system wide electronic records. Results 822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified using the screening tool as being in the last year of their lives. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68–81%), specificity of 85% (83–88%), a positive predictive value of 56% (49–63%) and a negative predictive value of 93% (91–95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87–16.9, p < 0.001). Conclusions The identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst young patients, the majority under age 60.

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Peritoneal Infections in Children Undergoing Acute Peritoneal Dialysis at a Tertiary/Quaternary Central Hospital in Kwazulu-Natal, South Africa

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00284 ◽

2018 ◽

Vol 38 (6) ◽

pp. 413-418 ◽

Cited By ~ 1

Author(s):

Mulalo Nepfumbada ◽

Elaene Naicker ◽

Rajendra Bhimma

Keyword(s):

South Africa ◽

Peritoneal Dialysis ◽

Retrospective Study ◽

Referral Hospital ◽

Mortality Data ◽

Central Hospital ◽

Poststreptococcal Glomerulonephritis ◽

Gram Negative ◽

Kwazulu Natal ◽

Gram Negative Organisms

Background In a resource-limited setting, acute peritoneal dialysis (APD) is the modality of choice as a form of renal replacement therapy in children with acute kidney injury (AKI). However, there is a high risk of peritonitis that causes significant morbidity and mortality. Data on PD and peritonitis in developing countries are scarce. The purpose of this retrospective study was to determine the prevalence of APD-related peritonitis at a central referral hospital in KwaZulu-Natal, South Africa. Methods A retrospective study from January 2010 until December 2014 was done at Inkosi Albert Luthuli Central Hospital (IALCH). All children under the age of 13 years with AKI requiring APD were included in the study. Results Forty children were included in the study. Age ranged from 0.2 years to 12.25 years; 25 (62.5%) were male and 15 (37.5%) female. Twenty-seven (67.5%) were admitted to the intensive care unit (ICU) and 13 (32.5%) to the pediatric high care ward. Septicemia with multi-organ dysfunction was the was the main cause of AKI requiring APD in 18 (45%) children followed by poststreptococcal glomerulonephritis in 8 (20%). Acute PD was complicated by culture-proven peritonitis in 19 (47.5%) children of whom 16 (84.2%) had a single organism cultured while in 3, (15.7%) there was a mixed culture. The total number of organisms cultured was 24: 8 (33.3%) were gram-positive organisms, 12 (50%) gram-negative organisms, and 4 (16.67%) fungal. The Paediatric Index of Mortality (PIM) 2 Score risk of mortality was 99.4% for patients admitted to ICU. Mortality rate was 65%, and 14 (53%) of the children who demised had peritonitis. Conclusion This study showed an inordinately high complication rate of peritonitis, mostly secondary to gram-negative organisms, of children undergoing APD in a central referral hospital. The use of surgically placed, tunneled catheters, meticulous attention to aseptic techniques and judicious use of antimicrobials is highly recommended in reducing the incidence of peritonitis in children undergoing APD.

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