Search Results (12)

Multimorbidity, defined as the co-occurrence of two or more chronic conditions in an individual, has emerged as a worldwide public health concern contributing to mortality and morbidity. This complex health phenomenon is becoming increasingly prevalent worldwide, particularly as populations continue to age. Despite the growing burden of multimorbidity, the development and implementation of interventions published by scholars are still in their early stages with significant variability in strategies and outcomes. The variability in strategy and outcome may result from factors such as lack of infrastructure, socioeconomic status and lifestyle factors. The review aims to synthesize interventions designed to manage and mitigate multimorbidity and explore a range of approaches, including pharmacological treatments, lifestyle modifications, care coordination models, and technological innovations. The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. It included 1,553,877 individuals with multimorbidity with no age restriction; in the studies that included gender difference, 463,339 male participants and 1,091,538 female participants were involved. Multimorbidity interventions were defined as strategies or programs designed to manage and improve the health and quality of life of individuals with multiple chronic conditions. Of the downloaded articles, those that met the inclusion criteria were published between 2012 and 2024. The final analysis included 100 articles from 3119 published articles, which resulted in 9 themes and 15 subthemes. Themes on the need for lifestyle and behavioural interventions, patient empowerment and engagement, multimorbidity management, health integration, pharmacotherapy optimization, community and policy interventions, healthcare system improvements, technology and digital health, as well as research and evidence-based practice interventions, emerged. The reviewed literature emphasizes the necessity of multidisciplinary approaches to effectively combat the growing public health challenge of multimorbidity. Full article

Healthcare workers have been the backbone of information regarding behavioral risk factors and non-communicable diseases that have caused morbidity and mortality globally over the past decades. The study explores the knowledge of healthcare workers about behavioral risk factors contributing to non-communicable diseases. The study utilized a qualitative, explorative, and descriptive design. Data were collected through a semi-structured interview guide, involving eight healthcare workers from Bushbuckridge. Purposive sampling was used to select the participants. Healthcare workers were interviewed at their convenience, such as at lunch or as per their appointment time. Using thematic analysis, the researchers were able to systematically organize and interpret the data presented in the themes. Two themes and seven subthemes emerged regarding the knowledge of healthcare workers about behavioral risk factors contributing to non-communicable diseases. These themes, identified through deductive analysis, include behavioral risk factors and health system factors. The study found that a lack of seminars or training in the management of chronic disorders has left healthcare providers in Bushbuckridge with less information about behavioral risk factors related to non-communicable diseases. However, these findings reflect the perspectives of a small sample and require further investigation through broader qualitative and quantitative research to determine their generalizability and potential systemic implications. Full article

In the past, it has been reported that the black South African population may have a cardio-protective lipid profile; however, this may no longer be the case with urbanization, industrialization, and the nutritional transition that occurred in South Africa. Although these transitions may be low in rural areas, one would expect this influence to be lower in the rural populations; however, they are not immune to these changes. Hence, the present study aimed to determine the association of serum lipid profiles and lipid ratios with kidney dysfunction. This cross-sectional retrospective study used the AWI-Gen 1 dataset. This study consisted of 1399 participants who took part in the AWI-Gen phase 1. Participants aged below 40 years, pregnant women, mentally disturbed and participants with incomplete information to answer the aims and objectives of this study were excluded in the analysis of this study. The data were analyzed using SPSS. In the present study, the prevalence of kidney dysfunction was 11.7%, with women having a significantly higher prevalence as compared to men. Women with kidney dysfunction had significantly higher TC, TG, TG/HDL-C, and TC/HDL-C compared to those without kidney dysfunction. However, in men, there was no association between the two groups. TC, and LDL/HDL-C were associated with kidney dysfunction in women only. TG/HDL-C was associated with kidney dysfunction in both women and men. Elevated TC, LDL/HDL-C, TC/HDL-C, and TG/HDL-C were the risk factors for kidney dysfunction, particularly in women. This suggests that TC, TC/HDL-C, and TG/HDL-C levels may be useful for risk stratification and a potential target to reduce the risk of developing kidney dysfunction, particularly in women. Upcoming longitudinal studies examining the causal connection between serum lipids, and lipid ratios with the risk of kidney dysfunction are necessary to fully understand the potential relationship between TG/HDL-C, TC, and TC/HDL-C levels and kidney dysfunction. Full article

Background: Diabetes mellitus [DM) is a fast-increasing non-communicable disease in South Africa, with a prevalence of 11.3%. The present study aimed to longitudinally investigate the association of carotid intima-media thickness [CIMT) progression and cardiovascular risk factors in the T2DM and non-DM rural black population of South Africa. Methods: This population-based retrospective cohort study was conducted in the Dikgale Mamabolo Mothiba Surveillance area between 2014 and 2023 by the Africa Wits INDEPTH Partnership for Genomic Research (AWI-Gen). The IBM Statistical Package for the Social Sciences version 27 was used to analyze data. The paired T-test was used to determine the mean differences between baseline and follow-up. Longitudinal estimates of the association of CIMT with CVD risk factors in the T2DM and non-DM groups were analyzed using linear mixed models. Results: The baseline mean age was 51.64 years. There was a significant increase in CIMT (left and mean CIMT), low-density lipoprotein-cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate in the T2DM and non-DM groups. In the T2DM group, there was a strong significant association between age (2.20 mm), LDL-C (4.30 mm), SBP (4.57 mm), and waist/hip ratio (0.24 mm) with CIMT progression. The non-DM group revealed a significant association between LDL-C (0.001 mm), SBP (1.41 mm), and CIMT progression. Conclusion: CIMT was associated with other main CVD-related risk factors (age, LDL-C, LDL-C/HDL-C ratio, TC/HDL-C ratio, waist/hip ratio, and SBP). CIMT progression was more pronounced in the T2DM group than non-DM, suggesting a higher risk of atherosclerosis and cardiovascular complications in T2DM individuals. Full article

A crucial aspect of delivering healthcare is infection prevention and control (IPC), especially in public hospitals where the high volume of patients and limited resources can heighten the risk of healthcare-associated infections. This qualitative study explores IPC nurses’ knowledge, attitudes, and practices in public hospitals within the Limpopo province of South Africa. The study adopted a qualitative descriptive design. This qualitative study utilized self-developed validated semi-structured interviews with IPC nurses from 12 public hospitals (4 tertiary, 4 regional, and 4 district). The interviews were transcribed verbatim and analysed using thematic analysis to identify key themes related to knowledge, attitudes, and practices in IPC. Each interview lasted approximately 15 to 20 min. Themes and subthemes that emerged provided a structured overview of the key aspects discussed. Each theme captures a different facet of the experiences, perceptions, and challenges faced by IPC nurses in their role. The subthemes further break down these views into specific areas of focus, offering deeper insights into the nurses’ experiences of their professional responsibilities. This study shows that, although IPC nurses have a good understanding of infection control and a positive attitude toward it, systemic problems and resource constraints make it difficult to consistently implement optimal practices. Affective mood, opportunity cost, coherence of the intervention, burden, perceived efficacy, self-efficacy, and ethics are among the major themes that were found. To improve IPC efforts, there is a clear need for more focused training, resources, and managerial support. Full article

Controlling hyperglycemia and inflammation in type 2 diabetes (T2D) remains an important approach to control diabetes. The use of phytochemicals found in natural herbs has been investigated widely, and there are inconsistent findings in clinical trials, likely associated with a small sample size. A meta-analysis of clinical trials was performed by conducting a comprehensive literature search on PubMed, Scopus, EBSCOHost, and Web of Sciences. The search terms included Curcumin longa, turmeric, curcumin, curcuma xanthorrhiza, diferuloylmethane, and type 2 diabetes. Data were analyzed using an online meta-analysis tool, Jamovi version 2.4.8 and IBM SPSS statistics version 29. The data were reported as either mean difference (MD) or standard mean difference (SMD) and 95% confidence intervals. The evidence from 18 trials with 1382 T2D with a mean age of 55.9 years was analyzed. Supplementation with curcumin led to a significant decrease in fasting blood glucose, MD = −11.48 mg/dL, 95%CI (−14.26, −8.70), p < 0.01 and glycated hemoglobin, MD = −0.54%, 95%CI (−0.73, −0.35), p < 0.01. Additionally, there was a significant decrease in C-Reactive Protein in curcumin compared to a placebo, SMD = −0.59, 95%CI (−1.11, −0.07), p = 0.03. The findings observed in this study suggest that curcumin can ameliorate hyperglycemia and inflammation in T2D compared to a placebo. While the potential benefits were observed, it is recommended that future trials focus on finding a suitable dose and duration of intervention and incorporate formulation in curcumin to enhance its absorption. Full article

Sociodemographic factors affect how metabolic syndrome (MetS) manifests and progresses. This study aimed to investigate the prevalence between MetS and sociodemographic factors among adult participants in the Dikgale HDSS. This was a comprehensive retrospective study where the records of 575 participants were meticulously evaluated. MetS was defined using a joint interim statement (JIS). The data were analyzed using the Statistical Package for SPSS, version 25. A chi-square test was used to compare proportions between groups, with Cramer’s V used to assess the strength of association. Logistic regression was used to determine the association between MetS and sociodemographic profiles. A p-value of less than 0.05 was considered statistically significant. The prevalence of MetS was 28.2% (females 33.3% vs. males 15.6%, p ≤ 0.001). In addition, logistic regression showed males to have lower odds of MetS as compared to females (OR = 0.36, 95% CI: 0.2–0.6, and AOR = 0.4, 95% CI: 0.2–0.6). The 55–60 age group had the highest proportion of affected individuals, and MetS was also more common among individuals with low educational attainment. In addition, on regression, the same association was observed. This study found sociodemographic disparities in MetS among rural adults, especially females, who had an increased risk of MetS, and participants with low educational attainment. Full article

Obesity is a growing epidemic that threatens to deplete healthcare resources by increasing the prevalence of diabetes, heart disease, high blood pressure, cancer, and chronic kidney disease. The prevalence of general and central obesity among the rural Black population in Limpopo Province is high; however, few studies have evaluated the association between obesity and its comorbidities among the rural Black population, and, hence, this study aims to determine the relationship between obesity and associated comorbidities. This study was cross-sectional and retrospective in design, using secondary data from the Africa Wits-INDEPTH Partnership for Genomic (AWI-Gen) research phase 1 study. A sample size of 791 participants was collected conveniently. Data were analysed using the Statistical Package for Social Sciences version 27 (SPSS). A chi-square, unpaired Student’s t-test, bivariate and partial correlation, and multivariate regression analysis were used for analysis. General obesity correlated positively and significantly with LDL-C/HDL-C ratio and hypertension, while central obesity correlated positively and significantly with diabetes, hypertension, chronic kidney disease, LDL-C/HDL-C ratio, and TC/HDL-C ratio. In the present study, obese participants were more likely to be hypertensive, and have an increased LDL-C/HDL-C ratio. Centrally obese participants were more likely to be diabetic, hypertensive, have dyslipidaemia, and exhibit reduced kidney function. Full article

Background. The effect of statins on CIMT progression and C-reactive protein (CRP) in T2DM patients is widely reported. However, some studies demonstrated no effect of statins on CIMT and CRP in T2DM patients, while others reported otherwise. Thus, the current study comprehensively and quantitatively analyzes data from previous studies to evaluate the overall effect of statins on CIMT and CRP in T2DM to rule out any inconsistencies observed in previous clinical evidence. Therefore, the aim of this meta-oanalysis was to evaluate the effect of statins on CIMT progression and CRP in T2DM. Methods. A comprehensive search for studies was performed using PubMed, Scopus, Web of Sciences, and the Cochrane Library, for publications from their inception to 16 July 2024. The meta-analysis was conducted using Jamovi (version 4.2.8) and Review Manager (version 5.4), with the overall effect sizes reported as standardized mean differences (SMD) and 95% confidence intervals (CI). Results. Evidence from eleven studies (fifteen statin dosages) that met the inclusion criteria with a sample size of 983 T2DM patients on statin treatment was analyzed. The overall effect size from the random effect model meta-analysis showed a reduction in the CIMT status amongst T2DM patients post-statin treatment compared to at baseline [SMD = −0.47, 95%CI (−0.76, −0.18), p = 0.001]. Furthermore, there was a reduction in the level of CRP in T2DM patients post-treatment [SMD = −1.80, 95% CI (−2.76, −0.84), p < 0.001]. Conclusions. Evidence gathered in this study suggests that statin therapy effectively reduces CIMT and CRP levels among patients living with T2DM. Interestingly, this evidence suggests that 20 mg of atorvastatin is more effective in reducing CIMT and CRP. Therefore, we recommend conducting further trials with larger sample sizes and proper methodology for T2DM. Full article

The WHO and UNICEF recommend that only breastmilk, vitamin drops, oral rehydration solution, and prescribed medicine can go through the infant’s mouth. Non-prescribed medications (NPM) include over-the-counter medications and traditional medicine and are contraindicated during infancy. Furthermore, the updated exclusive breastfeeding (EBF) indicator details that herbal fluids and similar traditional medicines are counted as fluids, and infants who consume these are not exclusively breastfed. However, the use of these items is common among caregivers for various reasons, including religious reasons, cultural beliefs, prevention of diseases, and the treatment of diseases. The practice of administering NPM before six months of age undermines exclusive breastfeeding and can result in undesirable health outcomes. Methods: The purpose of this study was to determine the prevalence of NPM, describe the types of medications used, and explain why caregivers use NMP in infants younger than six months of age. A quantitative approach and a facility-based cross-sectional survey were used to conduct this study. Convenience sampling was used to select clinics, and proportionality and simple random sampling were used to select 146 participants. Data were analyzed using SPSS (29). A p-value of p < 0.05 was considered significant. Results: In this study, the prevalence of NPM was 75.3%. Of the 146 participants, most were 25–35 years old (54%) and first-time mothers (36.3%). More caregivers had high school and matric (67.1%), and 84.2% of caregivers delivered in public health facilities. Almost three-quarters are unemployed (66.7%) and on a child support grant (56.4%). About 43.6% of infants received NPM within the first month of life. The main source of advice to give NPM was family members (86.4%). The main reasons for administering NPM were the treatment of the umbilical cord (57.3%) and the prevention of colic (32.7%). The results show a statistically significant association between the administration of medication and the age of the infant, p < 0.005. Conclusions: Non-prescribed medications are highly prevalent in the rural areas of Polokwane and are practiced by caregivers between the ages of 25–35 years advised by the families. Access to self-medication should be controlled, especially in the first month of life. Interventions to reduce the use of NPM should be targeted at young mothers and their families. Full article

Background: Childhood obesity has become the most important and growing public health problem in the world. They add to public health challenges by increasing the burden of chronic non-communicable diseases. However, in spite of its importance, there is limited literature that evaluates the prevalence of obesity among rural adolescents in sub-Saharan Africa. We report the first study to present an insight into rural black overweight South African children and the physical characteristics and socio-economic status of the household head. A quantitative cross-sectional population study was conducted involving 51 selected primary villages within the DIMAMO surveillance area in the Capricorn District of Limpopo Province, South Africa. The study involved 294 adolescents, 154 girls and 140 boys, who were under the age of 18. Of these participants, 127 (43%) were within the normal weight range, and 167 (57%) were overweight. Gender made a significant difference, with more girls being overweight than boys. Adolescents who did not receive child grants and whose heads of household were 45–54 years old, poor, and overweight had a higher prevalence of obesity (p-value < 0.05). This study suggests that public health interventionists need to target both the heads of household and their children in hopes of reducing the prevalence of overweight and obese South African children. We further propose a better understanding of the causes of childhood overweight and obesity to guide policy development and implementation in rural settings. Full article

Background: The primary purpose of introducing the COVID-19 vaccine was to fight the pandemic. However, the vaccine was not well received worldwide. This challenge has threatened the effective implementation and roll-out of COVID-19 immunization campaigns. The challenge of vaccine hesitancy was reported to be more prevalent in rural areas due to various factors such as cultural beliefs, misinformation, poverty, lack of education, and distrust of vaccines. Yet there seems to be a scarcity of studies determining the prevalence of vaccine hesitancy in deep rural areas of Limpopo. Purpose: The study aimed to explore the prevalence of COVID-19 hesitancy among the rural black population in South Africa. Study Methods: A longitudinal quantitative study was conducted with data from the DIMAMO Health and Demographic Surveillance Site (HDSS) database for 2020 to 2022. A non-probability total sampling technique was used to select the respondents. Trained fieldworkers collected data using an electronic data capture questionnaire. A comparison of categorical variables was performed using Chi-Square in SPSS version 26 and the statistical significance was set at p < 0.05, with a 95% confidence interval to analyze the data. Results: The limited availability of vaccination sites in Limpopo Province, South Africa, was associated with a reduced certainty that the vaccine would be accepted, as reported in the current study. The prevalence of visiting traditional healers was significantly higher in non-vaccinated than vaccinated participants among the rural black population, indicating a different cultural belief among the rural black population that existed before and during the COVID-19 pandemic. Conclusion: The present study findings show diverse factors of concern associated with vaccination hesitancy for COVID-19 among rural black people. Lack of education, gender, not being diagnosed with COVID-19, not being a Christian, visiting traditional healers, vaccine mistrust, unknown side effects, and a lack of confidence in the vaccine itself. Conspiracy theories were factors that impacted vaccine acceptance among black people living in rural areas. The prevalence of visiting traditional healers was significantly higher in non-vaccinated than vaccinated participants. Therefore, the present study findings emphasize the need to collectively integrate and utilize the traditional healers in the South African healthcare system. Full article