The relationship between parental or caregiver monitoring and risky behaviours that are associated with the prevalence of schistosomiasis amongst adolescent girls living in endemic KwaZulu-Natal.

M. Soc. Sc. University of KwaZulu-Natal, Peitermaritzburg 2014.The high prevalence of schistosomiasis found in adolescents living in KwaZulu-Natal, where the co-infection of multiple diseases is rife, is concerning. Adolescence is a pivotal stage of development that is characterised by transformation and transition. During this period, children are faced with many changes that impact on their health and wellbeing and this thrusts these adolescents into new roles and experiences that can lead to them engaging in behaviours that increase their risk of negative health outcomes. However, the social context within which they exist is considered to be important in this process, especially the parentadolescent relationship. In particular, parental/caregiver monitoring is considered to serve as a buffer against risky adolescent behaviour. This study aimed to understand whether risky behaviours are prevalent amongst adolescents in KwaZulu-Natal and whether these risky behaviours are associated with schistosomiasis. This study also sought to establish whether a relationship exists between parental or caregiver monitoring, the prevalence of schistosomiasis infection amongst adolescents, and risky behaviours that increase the chances of infection. The sample consisted of 970 adolescent girls living in the Ugu district, KwaZulu-Natal. Interviews were administered and urine samples were collected. Crosstabulation analysis and binary logistic regression were utilised to analyse the data. The results indicate that there are significant associations between the prevalence of schistosomiasis and risky adolescent behaviour. Parental/caregiver monitoring was not associated with schistosomiasis infection and did not reduce the odds of schistosomiasis infection when engaging in risky water contact behaviour

Adolescent antiretroviral management: Understanding the complexity of non-adherence

This case-based discussion highlights challenges in adolescent antiretroviral management, focusing on non-disclosure of status and thesubsequent impact of suboptimal treatment adherence. Despite the scale-up of antiretroviral therapy (ART) and recommendations made bythe World Health Organization (WHO) for ART for all human immunodeficiency virus (HIV)-infected paediatric patients, ART coveragein adolescents lags behind that in adults. Challenges of sustaining lifelong ART in children and adolescents require consideration of specificbehavioural, physiological and psychosocial complexities associated with this special group. To preserve future drug options and sustainlifelong access to therapy, addressing non-adherence to treatment is critical to minimising acquisition of ART drug resistance and treatmentfailure. We review the psychosocial and developmental components that influence the course of the disease in adolescents and consider thecomplexities arising from perinatal exposure to ART and the growing risk of transmitted ART drug resistance in high-burden resourcelimitedsettings

Adolescent antiretroviral management: Understanding the complexity of non-adherence.

CAPRISA, 2015.Abstract available in pdf

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile

The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003-2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children’s primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere