BackgroundHealthcare-associated tuberculosis (TB) has become a major occupational hazard for healthcare workers (HCWs). HCWs are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Whenever there is a possibility of exposure, implementation of infection prevention and control (IPC) practices is critical.ObjectiveFollowing a high incidence of TB among HCWs at Maluti Adventist Hospital in Lesotho, a study was carried out to assess the knowledge, attitudes and practices of HCWs regarding healthcare-associated TB infection and infection controls.MethodsThis was a cross-sectional study performed in June 2011; it involved HCWs at Maluti Adventist Hospital who were involved with patients and/or sputum. Stratified sampling of 140 HCWs was performed, of whom, 129 (92.0%) took part. A self-administered, semi-structured questionnaire was used.ResultsMost respondents (89.2%) had appropriate knowledge of transmission, diagnosis and prevention of TB; however, only 22.0% of the respondents knew the appropriate method of sputum collection. All of the respondents (100.0%) were motivated and willing to implement IPC measures. A significant proportion of participants (36.4%) reported poor infection control practices, with the majority of inappropriate practices being the administrative infection controls (> 80.0%). Only 38.8% of the participants reported to be using the appropriate N-95 respirator.ConclusionPoor infection control practices regarding occupational TB exposure were demonstrated, the worst being the first-line administrative infection controls. Critical knowledge gaps were identified; however, there was encouraging willingness by HCWs to adapt to recommended infection control measures. Healthcare workers are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Implementation of infection prevention and control practices is critical whenever there is a possibility of exposure.
Household food security impacts heavily on quality of life. We determined factors associated with food insecurity in 886 households in rural and urban Free State Province, South Africa. Significantly more urban than rural households reported current food shortage (81% and 47%, respectively). Predictors of food security included vegetable production in rural areas and keeping food for future use in urban households. Microwave oven ownership was negatively associated with food insecurity in urban households and using a primus or paraffin stove positively associated with food insecurity in rural households. Interventions to improve food availability and access should be emphasized.
BackgroundChronic lifestyle diseases share similar modifiable risk factors, including hypertension, tobacco smoking, diabetes, obesity, hyperlipidaemia and physical inactivity. Metabolic syndrome refers to the cluster of risk factors that increases the risk for developing type 2 diabetes mellitus (DM) and cardiovascular disease.ObjectivesThe study aimed to assess health status and identify distinct risk-factor profiles for both chronic lifestyle diseases and metabolic syndrome in rural and urban communities in central South Africa.MethodsThe investigation formed part of the Assuring Health for All in the Free State (AHA-FS) study. During interviews by trained researchers, household socio-demographic and health information, diet, risk factors (i.e. history of hypertension and/or diabetes) and habits (e.g. smoking and inadequate physical activity levels) were determined. Adult participants underwent anthropometric evaluation, medical examination and blood sampling.ResultsThe risk-factor profile for chronic lifestyle diseases revealed that self-reported hypertension and physical inactivity were ranked the highest risk factor for the rural and urban groups respectively. The cumulative risk-factor profile showed that 40.1% of the rural and 34.4% of the urban study population had three or more risk factors for chronic lifestyle diseases. Furthermore, 52.2% of rural and 39.7% of urban participants had three or more risk factors for metabolic syndrome.ConclusionThis study confirmed that the worldwide increase in the prevalence of chronic lifestyle diseases can be attributed to a more sedentary lifestyle, especially illustrated in the urban study population, and increasing obesity. The rural study population had a higher prevalence of risk factors for metabolic syndrome.
This study compared the diet and anthropometric status of adults (25–64 years) in rural and urban South Africa. Anthropometric status of adults and preschool children (<7 years old) from the same households were also determined.A descriptive cross-sectional design was applied. All adults from three towns in the rural southern Free State (n = 553) and a stratified proportional cluster sample from urban Mangaung (n = 419) participated. Anthropometric assessments included body mass index and waist circumference. Trained students administered a qualitative food frequency questionnaire in a structured interview with each participant to assess frequency of consumption of foods. The 35 foods that were included were chosen as a measure of protection or predisposition to obesity and non-communicable diseases. The height-for-age, weight-for-age and weight-for-height of 60 rural and 116 urban children were also assessed.Sugar was the most frequently consumed food item, eaten at least twice per day by all groups. Cooked porridge was the most frequently consumed starchy food (range 47.3–53.2 times a month), followed by bread, consumed at a mean frequency of 20 or more times per month in all groups. Tea was the most frequently consumed fluid (used at least once a day by all). Salt and/or stock was used more than once a day, while margarine, oil and other fats were consumed at least once per day. Fruit and vegetables were consumed at a mean frequency of less than once a day, while milk was consumed less than once daily in urban participants and once per day in rural participants. Chicken or eggs were the most frequently consumed protein-rich food (approximately 10 times per month). Overweight/obesity was identified in 65.6% rural and 66.2% urban women. Fewer men (23.3% rural and 16.0% urban) were overweight/obese. More than 66% of stunted, underweight and wasted children lived with an overweight/obese caregiver.Daily consumption of sugar, salt and fats and inadequate frequency of consumption of vegetables, fruits and milk was confirmed in both rural and urban participants. In addition, a double burden of malnutrition was evident.
To determine the impact of nutrition education on feeding practices of caregivers with children aged 3 to 5 years at baseline and post intervention. Methodology: A pre-test-post-test control group design was chosen using eight villages (four villages in the experimental group (E) and four villages in the control group (C)). The nutrition education intervention programme (NEIP) comprised ten topics emphasising healthy eating, hygiene and sanitation. Results: Majority of children in both the experimental and control groups were given three meals or more per day, including starchy and protein rich foods at baseline and post intervention. The median carbohydrates and protein intake in both groups was adequate when compared to the Estimated Average Requirements/Recommended Dietary Allowance (EAR/RDA), though median energy intake was inadequate. Even before intervention, the majority of children ate indigenous foods. Despite this, the intake of some indigenous foods did improve significantly in the experimental group, but not in the control group (termites; mopani worms; indigenous vegetables including black jack, spider flower and wild jute; and, indigenous fruits including baobab fruit and pawpaw). On the other hand, the intake of mixed traditional dishes as well as the intake of the indigenous foods, stinging nettle, meldar, wild peach, pineapple, dovhi, tshigume and thophi, increased significantly in both the experimental and control groups. Conclusion: Due to the fact that most children in both groups consumed most food items, including indigenous foods, before the intervention, improvements were only seen in a few feeding practices in the experimental group after the NEIP.
Objectives: Obesity prevalence is increasing worldwide. In South Africa, older and urbanised African women have significantly higher rates of obesity. Limited information is available on the relationship between anthropometric parameters, adipokines and metabolic health status of African women. This study investigated the relationship between obesity, adipokines and the components of metabolic syndrome in urban African women. Methods: This study included 135 urban African women that were 26-63 years of age, identified with metabolic syndrome in the urban leg of the Assuring Health for All in the Free State (AHA-FS) study. To establish anthropometric status, the following measures were taken: body weight, height and waist circumference. Blood was drawn to determine leptin, adiponectin levels and metabolic status. Results: Adiponectin levels in obese women were significantly decreased compared to normal weight women. Leptin levels and leptin:adiponectin ratios (L:A) were increased in the obese group compared to the overweight and normal weight groups. Leptin and L:A showed strong positive correlations with body mass index and waist circumference. Adiponectin levels decreased as the number of components of metabolic syndrome increased. The L:A ratio was significantly lower in women with elevated triglycerides and significantly higher in women with elevated blood glucose levels. Adiponectin levels were significantly lower in women with elevated blood glucose. Conclusion: This study confirms the inverse relationship between adiponectin and leptin with increased body adiposity. Results indicate that waist circumference, fasting blood glucose and triglyceride levels are the metabolic syndrome components most closely associated with altered adiponectin and leptin levels and L:A in urban African women with metabolic syndrome.Normal weight kg/m 2 ) (n = 17)* Age 50.0 [47.0-52.0] Adiponectin (μg/mL) 14.4 [9.3-19.1] Leptin (ng/mL) 9.1 [5.7-14.1] L:A ratio # 0.7 [0.5-1.3] Overweight (BMI 25-29.9 kg/m 2 ) (n = 35) Age 45.0 [37.0-54.0] Adiponectin (μg/mL) 9.2 [5.0-13.2] Leptin (ng/mL) 22.0 [12.3-31.7] L:A ratio 2.2 [1.4-5.4] Obese (BMI ≥ 30 kg/m 2 ) (n = 83) Age 48.0 [41.0-56.0] Adiponectin (μg/mL) 6.4 [4.1-10.2] Leptin (ng/mL) 44.1 [31.8-75.7] L:A ratio 7.9 [3.6-11.9]
Apart from the home environment, care and education programmes are critical towards children's development and success 1. However, numerous children up to the age of five years old living in developing countries, including South African rural areas, face exposure to multiple risks affecting their early childhood development. These risks include poverty, malnutrition, poor health conditions, and deficient stimulation in their home environment 2,3. These disadvantaged children often do poorly at school causing them to enter low-income jobs which eventually limit their opportunities to live long, healthy, creative and dignified lives 4. Ultimately, this may cause a snowball effect transferring poverty from one generation to the next 2. Although the Education White Paper 5 5 , South African Schools Act 6 and the National Integrated Early Childhood Development (ECD) Policy 7 acknowledge the importance of quality early childhood development, children in the South African rural areas have limited access and opportunities to reach such goals 5,7. In fact, according to the Human Sciences Research Council 8 , in the National ECD Programme, there is currently no centre-based ECD programme provided by the state as that for health and education. However, since the National ECD Policy was approved by Cabinet in December 2015, ECD has been made a top priority and significant efforts are being made to implement a comprehensive package of essential ECD services to all South African children 3,7. In the meantime, these programmes are provided by the private and non-profit sector in South Africa 8 and such collaboration is crucial while the necessary systems are being put into place 3,7. Early Childhood Development and the Crosstrainer Programme in Rural Mahikeng Danette de Villiers, B OT (UFS).
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