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  • 1
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    Online Resource
    Food insecurity and coping strategies and their association with anxiety and depression: a nationally representative South African survey
    Cambridge University Press (CUP) ; 2023
    In:  Public Health Nutrition Vol. 26, No. 4 ( 2023-04), p. 705-715
    Details
    In: Public Health Nutrition, Cambridge University Press (CUP), Vol. 26, No. 4 ( 2023-04), p. 705-715
    Abstract: To investigate food insecurity and related coping strategies among South African households and their associations with anxiety and depression. Design: Cross-sectional study. Food insecurity and coping strategies were assessed using a modified Community Childhood Hunger Identification Project and the Coping Strategies Index questionnaires. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were used to assess anxiety and depression risk. Ordered logistic regressions were used to test associations of food insecurity and related coping strategies with anxiety and depression. Setting: South Africa during COVID-19, October 2021. Participants: Nationally representative sample of 3402 adults, weighted to 39,640,674 South African households. Results: About 20·4 % of South African households were food insecure, with the most affected being from the lowest socio-economic groups. Shifting from ‘food secure’ to ‘at risk’ or from ‘at risk’ to ‘food insecure’ group was associated with 1·7 times greater odds of being in a higher category of anxiety or depression ( P 〈 0·001). All coping strategies were used to some extent in South African households, with 46·0 % relying on less preferred and less expensive foods and 20·9 % sending a household member to beg for food. These coping strategies were mostly used by food-insecure households. Although the odds of moving to a higher category of anxiety and depression were observed among all coping strategies (all P 〈 0·001), begging for food was associated with the highest odds (OR = 2·3). Conclusions: Food insecurity remains a major health threat in South Africa. Public measures to address mental health should consider reductions in food insecurity as part of their strategy.
    Type of Medium: Online Resource
    ISSN: 1368-9800 , 1475-2727
    URL: Article
    DOI: 10.1017/S1368980023000186
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2016337-X
    SSG: 21
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  • 2
    Online Resource
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    The Effects of COVID-19 Pandemic Lockdowns on Alcohol Consumption and Tobacco Smoking Behaviour in South Africa: A National Survey
    S. Karger AG ; 2023
    In:  European Addiction Research Vol. 29, No. 2 ( 2023), p. 127-140
    Details
    In: European Addiction Research, S. Karger AG, Vol. 29, No. 2 ( 2023), p. 127-140
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 During the first phase of the coronavirus (COVID-19) pandemic lockdowns in South Africa (SA), both alcohol and tobacco were considered non-essential goods and their sales were initially prohibited and further restricted to certain days and timeframes. This study investigates self-reported changes in alcohol consumption and tobacco smoking behaviour in the general population during the COVID-19 pandemic lockdowns in SA. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A cross-sectional national survey was conducted in October 2021 (before the Omicron wave 4 and while SA was in low-level lockdown) among 3,402 nationally representative respondents (weighted to 39,640,674) aged 18 years and older. Alcohol consumption and tobacco use were assessed from the beginning of the lockdown towards the end of March 2020 until October 2021 using the WHO-AUDIT and the US Centre for Disease Control (CDC) Global Adult Tobacco Survey questionnaires, respectively. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among those that drank alcohol (33.2%), 31.4% were classified as having a drinking problem that could be hazardous or harmful and 18.9% had severe alcohol use disorder during the COVID-19 lockdowns. Twenty-two per cent (22.0%) of those that reported alcohol consumption reported that the COVID-19 pandemic lockdowns changed their alcohol consumption habits, with 38.1% reporting a decreased intake or quitting altogether. Among the one in five respondents (19.2%) who had ever smoked, most reported smoking at the time of the survey (82.6%) with many classified as light smokers (87.8%; ≤10 cigarettes/day). Almost a third (27.2%) of those smoking reported that the COVID-19 pandemic lockdowns had changed their use of tobacco products or vaping, with 60.0% reporting a reduction/quitting tobacco use. Given that sales were restricted this indicates that people could still get hold of tobacco products. Heavy smoking was associated with older age ( 〈 i 〉 p 〈 /i 〉 = 0.02), those classified as wealthy ( 〈 i 〉 p 〈 /i 〉 & lt; 0.001), those who started or increased tobacco smoking during the pandemic lockdowns ( 〈 i 〉 p 〈 /i 〉 = 0.01) and residential provinces ( 〈 i 〉 p 〈 /i 〉 = 0.04). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Given restrictions on the sale of alcohol and tobacco in SA between 27 March and August 17, 2020, during the pandemic, respondents reported an overall decline in alcohol consumption and tobacco use which might suggest that the regulatory restrictive strategies on sales had some effect but may be inadequate, especially during times where individuals are likely to experience high-stress levels. These changes in alcohol consumption and tobacco use were different from what was reported in several European countries, possibly due to differences in the restrictions imposed in SA when compared to these European countries.
    Type of Medium: Online Resource
    ISSN: 1022-6877 , 1421-9891
    URL: Article
    DOI: 10.1159/000528484
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482231-3
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  • 3
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    Multimorbidity and overall survival among women with breast cancer: results from the South African Breast Cancer and HIV Outcomes Study
    Springer Science and Business Media LLC ; 2023
    In:  Breast Cancer Research Vol. 25, No. 1 ( 2023-01-23)
    Details
    In: Breast Cancer Research, Springer Science and Business Media LLC, Vol. 25, No. 1 ( 2023-01-23)
    Abstract: Breast cancer survival in South Africa is low, but when diagnosed with breast cancer, many women in South Africa also have other chronic conditions. We investigated the impact of multimorbidity (≥ 2 other chronic conditions) on overall survival among women with breast cancer in South Africa. Methods Between 1 July 2015 and 31 December 2019, we enrolled women newly diagnosed with breast cancer at six public hospitals participating in the South African Breast Cancer and HIV Outcomes (SABCHO) Study. We examined seven chronic conditions (obesity, hypertension, diabetes, HIV, cerebrovascular diseases (CVD), asthma/chronic obstructive pulmonary disease, and tuberculosis), and we compared socio-demographic, clinical, and treatment factors between patients with and without each condition, and with and without multimorbidity. We investigated the association of multimorbidity with overall survival using multivariable Cox proportional hazard models. Results Of 3,261 women included in the analysis, 45% had multimorbidity; obesity (53%), hypertension (41%), HIV (22%), and diabetes (13%) were the most common individual conditions. Women with multimorbidity had poorer overall survival at 3 years than women without multimorbidity in both the full cohort (60.8% vs. 64.3%, p  = 0.036) and stage groups: stages I–II, 80.7% vs. 86.3% ( p  = 0.005), and stage III, 53.0% vs. 59.4% ( p  = 0.024). In an adjusted model, women with diabetes (hazard ratio (HR) = 1.20, 95% confidence interval (CI) = 1.03–1.41), CVD (HR = 1.43, 95% CI = 1.17–1.76), HIV (HR = 1.21, 95% CI = 1.06–1.38), obesity + HIV (HR = 1.24 95% CI = 1.04–1.48), and multimorbidity (HR = 1.26, 95% CI = 1.13–1.40) had poorer overall survival than women without these conditions. Conclusions Irrespective of the stage, multimorbidity at breast cancer diagnosis was an important prognostic factor for survival in our SABCHO cohort. The high prevalence of multimorbidity in our cohort calls for more comprehensive care to improve outcomes for South African women with breast cancer.
    Type of Medium: Online Resource
    ISSN: 1465-542X
    URL: Article
    DOI: 10.1186/s13058-023-01603-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041618-0
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  • 4
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    Online Resource
    Treatment of pre- and confirmed cervical cancer in HIV-seropositive women from developing countries: a systematic review
    Springer Science and Business Media LLC ; 2020
    In:  Systematic Reviews Vol. 9, No. 1 ( 2020-12)
    Details
    In: Systematic Reviews, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2020-12)
    Abstract: Cervical cancer has become a major public health challenge in developing countries with a reported age-standardised incidence rate of about 17.9/100,000/year and lifetime risks approaching 1 in 20 in some settings. Evidence indicates that HIV-seropositive women are 2 to 12 times more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. There is a lack of rigorous evidence on which treatment methods are being utilised for HIV-positive women, and this review aims to synthesise available evidence on treatment modalities for both cervical neoplasia and cervical cancer in HIV-seropositive women in developing countries. Methods A systematic review guided by a published protocol was conducted. Online databases including MEDLINE/PubMed, Embase, CINAHL and Emerald (via EBSCOhost), PsycINFO, Cochrane Library, and health databases, which cover developing countries (3ie Systematic Reviews, WHO library and databases, World Bank website), were searched for published articles. Additional articles were found through citation, reference list tracking, and grey literature. Study design, treatment category, geographic country/region, and key outcomes for each included article were documented and summarised. Results Thirteen research articles from sub-Saharan Africa, Asia, and South America were included. Eight (61.5%) articles focused on the treatment of cervical cancer with the remaining five (38.5%) assessed cervical neoplasia treatment. The available cervical cancer treatments, radiotherapy, chemotherapy, chemoradiation, and surgery are effective for HIV-seropositive patients, and these are the same treatments for HIV-negative patients. Both cryotherapy and LEEP are effective in reducing CIN2+ among HIV-seropositive women, and a choice between the treatments might be based on available resources and expertise. Radiation, chemotherapy, concurrent treatment using radiotherapy and chemotherapy, and surgery have shown the possibility of effectiveness among HIV-seropositive women. Cervical cancer stage, immunosuppressive level including those on HAART, and multisystem toxicities due to treatment are associated with treatment completion, prognostic, and survival outcomes. Conclusions Treatment of cervical cancer is based on the stage of cancer, and poor outcomes in most developing countries might be due to a lack of optimal treatment regimen. Those infected with HIV were younger and had advanced cervical cancer as compared to those who were HIV-negative. Facilitation and putting HIV-infected people on life-long ART is of importance and has been found to have a positive impact on cervical cancer treatment response. Research on precancerous lesions and cervical cancer management of HIV-seropositive patients focusing on the quality of life of those treated; the effectiveness of the treatment method considering CD4+ count and ART is required. Systematic review registration PROSPERO CRD42018095707
    Type of Medium: Online Resource
    ISSN: 2046-4053
    URL: Article
    DOI: 10.1186/s13643-020-01345-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2662257-9
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  • 5
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    Impact of excluded studies on medical male circumcision and HIV risk compensation
    Elsevier BV ; 2021
    In:  The Lancet Global Health Vol. 9, No. 11 ( 2021-11), p. e1505-
    Details
    In: The Lancet Global Health, Elsevier BV, Vol. 9, No. 11 ( 2021-11), p. e1505-
    Type of Medium: Online Resource
    ISSN: 2214-109X
    URL: Article
    DOI: 10.1016/S2214-109X(21)00435-6
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2723488-5
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  • 6
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    Socioeconomic position, perceived weight, lifestyle risk, and multimorbidity in young adults aged 18 to 35 years: a Multi-country Study
    Springer Science and Business Media LLC ; 2023
    In:  BMC Public Health Vol. 23, No. 1 ( 2023-07-15)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-07-15)
    Abstract: Multimorbidity-risk is established early in life, therefore reducing modifiable risk factors such as overweight or obesity may, in part, tackle the burden of multimorbidity in later life. Methods We made use of a cross-sectional online survey that included young adults (18-35yrs old) from three countries – Kenya, South Africa, and the United Kingdom ( n  = 3000). Information pertaining to socio-demographic, health, lifestyle, and perceived weight was collected. Additionally, the sum of affirmed morbidities was used to determine a morbidity score. Likewise, a lifestyle risk score was calculated based on information obtained from questions surrounding four unhealthy lifestyle behaviours, namely current smoking, alcohol consumption, physical inactivity, and overweight/obese weight status as a confirmed clinic condition. We further explored differences in socioeconomic position, and the prevalence of perceived weight, multimorbidity, and lifestyle risk factors between the three countries. We also determined the odds ratio of multimorbidity with perceived weight as a main predictor variable. We furthermore performed a generalised structural equation model to determine whether the association between socioeconomic position and multimorbidity was mediated via perceived weight and/or lifestyle risk. Results Socioeconomic position, weight perceptions, lifestyle risk, and multimorbidity varied significantly across the different economic countries. Higher morbidity (by  〉  11.9%) and lifestyle risk (by  〉  20.7%) scores were observed in those who reported an overweight weight perception when compared to those with an underweight or normal weight perception. In pooled analyses, the odds ratio in developing 2 or more morbidities increased multiple times in those who perceived themselves as overweight (all models: OR ≥ 2.241 [95% CI ≥ 1.693; ≥ 2.966] p   〈  0.001), showing a larger odds ratio with high significance in those who reported 3 or more morbidities (all models: OR ≥ 3.656 [95% CI ≥ 2.528; ≥ 5.286] p   〈  0.001). Furthermore, this study showed that an overweight weight perception partially mediated ( p  ≤ 0.001) the association between socioeconomic position and multimorbidity. Conclusions This study confirmed poorer health outcomes in those who perceived themselves as overweight. The findings from this study further emphasise the importance of targeted intervention strategies directed at raising weight-related awareness and potentiating risk factors, specifically in those who reside in lower economic developed countries.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-023-16234-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041338-5
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  • 7
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    A Commentary on a Systematic Review Protocol and Commentary on Cervical Cancer Prevention in HIV-Seropositive Women from Developing Countries
    OMICS Publishing Group ; 2017
    In:  Journal of Community & Public Health Nursing Vol. 03, No. 03 ( 2017)
    Details
    In: Journal of Community & Public Health Nursing, OMICS Publishing Group, Vol. 03, No. 03 ( 2017)
    Type of Medium: Online Resource
    ISSN: 2471-9846
    URL: Journal
    URL: Article
    DOI: 10.4172/2471-9846
    DOI: 10.4172/2471-9846.1000180
    Language: Unknown
    Publisher: OMICS Publishing Group
    Publication Date: 2017
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  • 8
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    Associations between nutrition knowledge and obesity-related attitudes and physical activity among young adults from Kenya, South Africa, and the United Kingdom
    Informa UK Limited ; 2023
    In:  South African Journal of Clinical Nutrition
    Details
    In: South African Journal of Clinical Nutrition, Informa UK Limited
    Type of Medium: Online Resource
    ISSN: 1607-0658 , 2221-1268
    URL: Article
    DOI: 10.1080/16070658.2023.2198844
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
    detail.hit.zdb_id: 2259246-5
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  • 9
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    Ensuring Prevention Science Research is Synthesis-Ready for Immediate and Lasting Scientific Impact
    Springer Science and Business Media LLC ; 2022
    In:  Prevention Science Vol. 23, No. 5 ( 2022-07), p. 809-820
    Details
    In: Prevention Science, Springer Science and Business Media LLC, Vol. 23, No. 5 ( 2022-07), p. 809-820
    Type of Medium: Online Resource
    ISSN: 1389-4986 , 1573-6695
    URL: Article
    DOI: 10.1007/s11121-021-01279-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2018644-7
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  • 10
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    Drivers of disparities in stage at diagnosis among women with breast cancer: South African breast cancers and HIV outcomes cohort
    Public Library of Science (PLoS) ; 2023
    In:  PLOS ONE Vol. 18, No. 2 ( 2023-2-16), p. e0281916-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 2 ( 2023-2-16), p. e0281916-
    Abstract: In low- and middle-income countries (LMICs), advanced-stage diagnosis of breast cancer (BC) is common, and this contributes to poor survival. Understanding the determinants of the stage at diagnosis will aid in designing interventions to downstage disease and improve survival from BC in LMICs. Methods Within the South African Breast Cancers and HIV Outcomes (SABCHO) cohort, we examined factors affecting the stage at diagnosis of histologically confirmed invasive breast cancer at five tertiary hospitals in South Africa (SA). The stage was assessed clinically. To examine the associations of the modifiable health system, socio-economic/household and non-modifiable individual factors, hierarchical multivariable logistic regression with odds of late-stage at diagnosis (stage III-IV), was used. Results The majority (59%) of the included 3497 women were diagnosed with late-stage BC disease. The effect of health system-level factors on late-stage BC diagnosis was consistent and significant even when adjusted for both socio-economic- and individual-level factors. Women diagnosed in a tertiary hospital that predominantly serves a rural population were 3 times (OR = 2.89 (95% CI: 1.40–5.97) as likely to be associated with late-stage BC diagnosis when compared to those diagnosed at a hospital that predominantly serves an urban population. Taking more than 3 months from identifying the BC problem to the first health system entry (OR = 1.66 (95% CI: 1.38–2.00)), and having luminal B (OR = 1.49 (95% CI: 1.19–1.87)) or HER2-enriched (OR = 1.64 (95% CI: 1.16–2.32)) molecular subtype as compared to luminal A, were associated with a late-stage diagnosis. Whilst having a higher socio-economic level (a wealth index of 5) reduced the probability of late-stage BC at diagnosis, (OR = 0.64 (95% CI: 0.47–0.85)). Conclusion Advanced-stage diagnosis of BC among women in SA who access health services through the public health system was associated with both modifiable health system-level factors and non-modifiable individual-level factors. These may be considered as elements in interventions to reduce the time to diagnosis of breast cancer in women.
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
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    DOI: 10.1371/journal.pone.0281916
    DOI: 10.1371/journal.pone.0281916.g001
    DOI: 10.1371/journal.pone.0281916.t001
    DOI: 10.1371/journal.pone.0281916.t002
    DOI: 10.1371/journal.pone.0281916.t003
    DOI: 10.1371/journal.pone.0281916.t004
    DOI: 10.1371/journal.pone.0281916.t005
    DOI: 10.1371/journal.pone.0281916.s001
    DOI: 10.1371/journal.pone.0281916.s002
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2023
    detail.hit.zdb_id: 2267670-3
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