Prevalence and characteristics of hearing and vision loss in preschool children from low income South African communities: results of a screening program of 10,390 children

Background The majority of children with sensory impairments live in low- and middle-income countries. More studies of hearing and vision impairment prevalence are needed, in order to generate more accurate estimates of trends in sensory impairments. This study aimed to estimate the prevalence and describe the characteristics of hearing and vision loss among preschool children (4–7 years) in an underserved South African community following community-based mobile health (mHealth) supported hearing and vision services. Methods A screening program of sensory impairments was undertaken of children attending preschools in the communities of Khayelitsha and Mitchell’s Plain, Cape Town, from September 2017 until June 2019. Hearing and vision screening were done by trained community health workers using mHealth technology. Children who failed hearing and vision screening were seen for follow-up assessments at their preschools. Follow-up assessments were conducted using smartphones that host point-of-care validated and calibrated hearing and vision testing applications (hearTest app, hearX Group, South Africa and PeekAcuity app, Peek Vision, United Kingdom). Descriptive statistical analysis and logistic regression analysis were conducted after extracting data from a secure cloud-based server (mHealth Studio, hearX Group) to Microsoft Excel (2016). Results A total of 10,390 children were screened at 298 preschools over 22 months. Of the children screened, 5.6 and 4.4% of children failed hearing and vision screening respectively. Community-based follow-up hearing tests were done at the preschools on 88.5% (514) of children of whom 240 children (54.2% female) presented with hearing loss. A preschool-based follow-up vision test was done on 400 children (88.1%). A total of 232 children (46.1% female) had a vision impairment, and a further 32 children passed the test but had obvious signs of ocular morbidity. Logistic regression analysis found that age was a significant predictor of vision loss (p < 0.05), but not for hearing loss (p = 0.06). Gender was not a significant predictor of hearing (p = 0.22) or vision loss (p = 0.20). Conclusions Hearing loss is prevalent in at least 22 per 1000 and vision loss in at least 23 per 1000 preschool children in an underserved South African community. Timely identification of sensory losses can be facilitated through community-based hearing and vision services supported by mHealth technology.

Perception Regarding Knowledge of COVID-19 Prevention in a Sample of a Middle Eastern and North African (MENA) Community in Houston, Texas, USA

(1) Background: Knowledge of COVID-19 prevention among communities is the first step towards protective behaviors. The objective of this study was to assess COVID-19 prevention knowledge among a Middle Eastern and North African community in Houston, Texas. (2) Methods: A cross-sectional study was conducted using a validated quantitative survey; survey questions consisted of three parts: COVID-19 specific questions, general health questions, and sociodemographic questions. A multivariable logistic regression model was used to determine predictors of perception of knowledge on preventing COVID-19 spread. The outcome of interest comprised of “good/excellent” versus “average and below” knowledge. (3) Results: A total of 366 participants (66.39% males) completed the survey. A univariate analysis demonstrated significant differences in self-reported COVID-19 prevention knowledge among those with and without health insurance, different ages, level of knowledge, and perceived severity of COVID-19 infection. In the multivariate logistic regression, two predictors were identified: those in the 18–25-year-old group were more likely to have “excellent/good” knowledge on COVID-19 spread compared to the ≥40-year-old group (OR: 6.36; 95% CI: 1.38, 29.34). Those who somewhat agree with knowing how to protect themselves from COVID-19 were more likely to have “excellent/good” knowledge of preventing COVID-19 spread compared to those that neither agree nor disagree or disagree (OR: 7.74; 95% CI: 2.58, 23.26). (4) Conclusions: Younger adults reported higher knowledge of COVID-19 prevention.

Sustainable Development Goals and Their Implication on Economic Growth

The MDGs have been criticised for being too narrow and leaving out many people and their needs, like mental health. Likewise, not all MDGs were implemented successfully in all countries. Some countries implemented one or two MDGs of their choice and left others untouched, others partially implemented all MDGs. It was on this basis that the UN member states met in Rio to frame the Sustainable Development Goals (SDGs). However, in order for the SDGs to address systemic challenges across economic, social, and ecological dimensions of sustainable development they require appropriate institutional support to effectively integrate them into institutions and practices, to coordinate activities, and to mobilize resources for implementation. Rising income inequality negatively impacts economic growth and is threatening sustainable development of East African Community (EAC) member states. Since, the SDGs are many, it is recommended that, East African Member states should adopt a targeted approach in implementing the SDGs and focus on the smallholder farming sector.

Is Transition from Secondary to Tertiary Education Less Likely among Black South Africans than their Non-Black Counterparts in the Democratic Dispensation?

Education provides the building blocks for skills development for acountry’s labour market. Investment in education is hence an importantdeterminant of economic growth and has been associated with various economicbenefits. However, non-transition to tertiary education is a common phenomenon.This study examined the probability of a specified age cohort transiting to tertiaryeducation in South Africa and compared Black South Africans with otherpopulation groups considering environmental and individual factors. Usingcross-sectional data from the 2016 South African Community Survey, the studyrevealed that the difference in the probability of transition to tertiary educationbetween Whites and Blacks was not statistically significant. The findings will beuseful to policymakers in formulating strategies to improve the quality of thelabour market, and thus South Africa’s economic competitiveness.Key words: Transition to tertiary education, South African education system,apartheid education, post-apartheid education, economic development

Impact of East African Community Integration on Trade: Gravity Model Approach

East African community (EAC) is a regional economic bloc established to foster economic corporation between Kenya, Rwanda, Burundi, Uganda and Tanzania. Using gravity model the study explores the short run and long run effect of East African community (EAC) on trade using parametric, random effect and fixed effect estimation techniques. Secondly, the study investigates whether formation of EAC led to trade creation or trade diversion in the long run among the member countries of EAC. Lastly, the study establishes the effect of entry of Burundi and Rwanda to the economic bloc of EAC on trade. The study used panel data obtained from the five countries of EAC for the period 1985 to 2019. Breausch Pagan LM test for restrictions in the parametric model and Hausman test for endogeinity in the gravity model found out that fixed effect estimation technique produced accurate and plausible results than parametric and random effect estimation techniques. The empirical results of fixed effect model established that trade across EAC member countries rose by 1.6% in the short run while random effect and parametric models recorded 3.6% increase in trade in the short run. This effect was insignificant meaning that trade between EAC member countries did not expand considerably in the short run. In the long run, fixed effect indicate that EAC increased trade by 24.2% while random effect and parametric model each show that EAC increased trade by 16%. The coefficients are statistically significant at 5% ceteris paribus. Secondly, economic corporation of EAC led to trade creation in Burundi, Kenya, Rwanda and Uganda by 41.6%, 12.2%, 33.9% and 30.1% respectively and trade diversion by 4.2% in Tanzania. Thirdly, entry of Burundi and Rwanda to EAC increased trade of EAC countries by 19.6%. The coefficient is statistically significant at 5% level. The results of random effect and parametric model each indicate a growth in trade by 19.1%. The results of parametric, random effect and fixed effect estimation techniques are all consistent. Lastly, the study established that countries in EAC ought to foster greater growth in GDP, to encourage and strengthen use of common language and to reduce cross border restrictions in order to realize more growth in trade.

Joint Medicines Regulatory Procedure in the East African Community: Registration Timelines and Way Forward

A review of the East African Community (EAC) joint regulatory review process was conducted, registration timelines analyzed and key milestones, challenges and opportunities documented for the period of July 2015 to January 2020. A total of 113 applications were submitted for joint scientific review. Among these, 109 applications were assessed, 57 were recommended for marketing authorisation, 52 applications had queries to applicants and four applications were under review. A total median approval time for all products ranged from 53 to 102 days. The maximum time taken by a regulator to review the dossier was 391 days and the minimum time was 44 days. For applicants, the maximum time to respond to queries was 927 days and the minimum time was nine days. The total median time for granting marketing authorisation by the National Medicines Regulatory Authorities (NMRA) decreased from 174 to 39 working days in 2015 and 2019 respectively. However, not all EAC NMRA has granted marketing authorisation to all 57 products due to non-payment of applicable fees by applicants. Long regulatory approval timelines were contributed by limited capacity for timely scientific review of dossier by some NMRA, lack of online portal to share dossiersand assessment reports, delay in responding to queries by applicants and deficiencies in dossier. The metric tool and register of medical products submitted for joint scientific review had incomplete data. Challenges were identified and actions recommended to ensure regional regulatory system optimization, efficiency, transparency, sustainability and accountability.