High prevalence of HIV and non‐communicable disease (NCD) risk factors in rural KwaZulu‐Natal, South Africa

Abstract

IntroductionSouth Africa faces epidemics of HIV and non‐communicable diseases (NCDs). The aim of this study was to characterize the prevalence of non‐communicable disease risk factors and depression, stratified by HIV status, in a community with a high burden of HIV.MethodsWe conducted a home‐based HIV counselling and testing study in KwaZulu‐Natal, South Africa between November 2011 and June 2012. Contiguous households were approached and all adults ≥18 years old were offered an HIV test. During follow‐up visits in January 2015, screening for HIV, depression, obesity, blood glucose, cholesterol and blood pressure were conducted using point‐of‐care tests.ResultsOf the 570 participants located and screened; 69% were female and 33% were HIV‐positive. NCD risk factor prevalence was high in this sample; 71% were overweight (body mass index (BMI) 25 to 29.9 kg/m2) or obese (BMI≥30 kg/m2), 4% had hyperglycaemia (plasma glucose >11.0 mmol/l/200 mg/dl), 33% had hypertension (HTN, >140/90 mmHg), 20% had hyperlipidaemia (low density cholesterol >5.2 mmol/l/193.6 mg/dl) and 12% had major depressive symptoms (nine item Patient Health Questionnaire ≥10). Of the 570 participants, 87% had one or more of HIV, hyperglycaemia, HTN, hyperlipidaemia and/or depression. Over half (56%) had two or more. Older age and female gender were significantly associated with the prevalence of both HIV infection and NCD risk factors. Around 80% of both HIV‐positive and negative persons had one of the measured risk factors (i.e. obesity, hyperglycaemia, hyperlipidaemia, HTN), or depression.ConclusionsIn a community‐based sample of adults in KwaZulu‐Natal, South Africa, the prevalence of both HIV infection and NCD risk factors were high. This study is among the first to quantify the substantial burden of NCD risk factors and depression in this non‐clinic based population.

Using mHealth to Deliver a Home-Based Testing and Counseling Program to Improve Linkage to Care and ART Adherence in Rural South Africa

“…Rates of self-reported hypertension and diabetes among PLH in our study were lower than expected based on hypertension and diabetes screening results from PLH in a prior study conducted in KZN (van Heerden et al 2016), highlighting the need for screening of both communicable and noncommunicable diseases. Integrated screening programs are needed to make the best use of limited healthcare resources in South Africa and other resource-poor settings (Govindasamy et al 2013).…”

Cardiovascular risk factors among ART‐experienced people with HIV in South Africa

“…Our findings are consistent with previous reports of CVD risk factor prevalence among ART‐experienced PWH in South Africa: hypertension (12% to 39%) ; Stage 2 hypertension (14% to 66%) ; impaired glucose tolerance (16% to 21%) ; diabetes (2% to 8%) ; and self‐reported tobacco smoking (1% to 31%) . This substantial prevalence of CVD risk factors among a patient population who attends clinic on a routine basis underscores an important opportunity to screen for these intervenable risk factors.…”

Pensions, consumption and health: evidence from rural South Africa

“…However, across all households considerably larger shares of household food and drink consumption were allocated to tobacco and alcohol than to fruit and vegetables. This is in keeping with data on high rates of tobacco and alcohol consumption in countries like South Africa, although studies specifically related to their share of household spending are not available [30]. It is unclear what share of household spending on tobacco and alcohol was due to consumption by older people or by younger family members.…”