Clinical Trial Data Management in Environmental Health Tailored for an African Setting

Clinical trial data management tools are widely available—some free to access and others relatively expensive, particularly for low- and middle-income countries. Such tools also do not always permit adaptation for local conditions nor include options to capture environmental and meteorological data. In the context of climate change and pressing environmental health threats, more studies that aim to assess the impacts of environmental change on public health are being carried out. Here, using freely available software, we tailor-made a clinical trial data management tool that managed all aspects of an intervention-based clinical trial to assess the impact of personal solar ultraviolet radiation exposure on vaccine e ectiveness. Data captured and associated procedures included patient data, scheduling, reporting, analysis and data management. Moreover, patient enrolment, recruitment, follow-up and decision-making in response to patient data were managed. Given the multidisciplinary study approach, the tool also managed all environmental and meteorological data for the rural African study site. Application of the tool ensured e cient communication between rural sites, a relatively high overall participant response rate (87%) and minimal loss to follow-up. This study suggests that it is possible to tailor-make a clinical trial data management tool for environmental and public health studies.The National Research Foundation (NRF) of South Africa and the South African Medical Research Council (SAMRC).www.mdpi.com/journal/ijerpham2020Geography, Geoinformatics and Meteorolog

Spatial and temporal variation of PM10 from industrial point sources in a rural area in Limpopo, South Africa

Air pollution from industrial point sources accounts for a large proportion of air pollution issues a ecting many communities around the world. However, emissions from these sources are technically controllable by putting in place abatement technologies with feasible and stringent regulatory conditions in the operation licenses. Pollution from other sources such as soil erosion, forest fires, road dust, and biomass burning, are subject to several unpredictable natural or economic factors. In this study, findings from dispersion modelling and spatial analysis of pollution were presented to evaluate the potential impacts of PM10 concentrations from point sources in the Greater Tubatse Municipality of Limpopo, South Africa. The Air Pollution Model (TAPM) was used to model nested horizontal grids down to 10 km for meteorology and 4 km resolution for air pollution was used for simulation of PM10. An analysis of annual and seasonal variations of PM10 concentrations from point sources was undertaken to demonstrate their impact on the environment and the surrounding communities based on 2016 emissions data. A simple Kriging method was used to generate interpolation surfaces for PM10 concentrations from industrial sources with the purpose of identifying their areas of impact. The results suggest that valley wind channeling is responsible for the distribution of pollutants in a complex terrain. The results revealed that PM10 concentrations were higher closer to the sources during the day and distributed over a wide area during the night.The South African Weather Servicehttp://www.mdpi.com/journal/ijerpham2020Geography, Geoinformatics and Meteorolog

Real-time measurement of outdoor worker’s exposure to solar ultraviolet radiation in Pretoria, South Africa

The city of Pretoria in South Africa receives considerable solar ultraviolet radiation (UVR) because of its low latitude (22–35°S) and relatively clear skies. Certain meteorological factors affect the amount of solar UVR that reaches the ground; the most dominant factors being stratospheric ozone, cloud cover and solar zenith angle. It is known that overexposure to solar UVR may lead to the development of adverse health conditions, the most significant being skin cancer. Outdoor workers spend a significant amount of time outside and are thus susceptible to this risk. In this case study, we estimated, for the first time, the realtime solar UVR exposure of an outdoor worker in Pretoria. Measurements were made on 27 and 28 May 2013 using a handheld ultraviolet index (UVI) meter calibrated against a science-grade biometer at the South African Weather Service in Pretoria. Personal exposure estimation was used to discern the pattern in diurnal and annual sunburn risk for the outdoor worker. Ambient UVR levels ranged from 0 UVI to 4.66 UVI and the outdoor worker’s potential exposure estimates regularly exceeded 80% of these levels depending on the time of day. The risk of sunburn was evident; however, actual incidents would depend on individual skin photosensitivity and melanin content, as well as sun protection used. Further research is needed to determine the personal exposure estimations of outdoor workers in other provinces in which solar UVR levels may be equally high, or higher than those in Pretoria.http://www.sajs.co.za/am201

Where have all the flowers gone? – Changing climate, seasons and weather and the challenges and opportunities for public health research

Since the United Nations Framework Convention on Climate Change (UNFCCC) negotiations produced the Paris Agreement1 of December 2015, despite its subsequent notorious political challenges, the zeitgeist of global warming and subsequent climate change (GWCC) concerns has moved on from debating its very existence, toward understanding the way in which GWCC is and will manifest now and in the future. Any dispute regarding the attribution of global warming, and the consequences of climate change, to industrial-era emissions of greenhouse gasses emanating from anthropogenic origins, is now in the realm of ‘Flat-Earthers’. The more relevant questions are now about how we rehabilitate the worldwide fossil fuel addiction (mitigation) and how we respond to the impacts of GWCC (adaptation).http://www.tandfonline.com/loi/ojid20am2019Geography, Geoinformatics and Meteorolog

Make science cool at school and change our country's future!

Many of the amazing products that we use every day – from sticky tape to mobile phones – came about because of good ideas from ordinary people with big dreams, perseverance and confidence! Through trial and error, and maybe a little mathematics on a calculator or messy drawings on a whiteboard, new technologies can come alive and find their place in society.http://www.questinteractive.co.zaam201

The influence of HIV infection on the age dependence of squamous cell carcinoma of the skin in South Africa

BACKGROUND. Cancer incidence typically increases with age, but it is not known whether ethnic characteristics influence the age dependence of squamous cell carcinoma of the skin (SCC). OBJECTIVES. (i) To determine the age dependence of SCC in the black African, coloured and white population groups of South Africa (SA); and (ii) to show whether any differences in the rate of change of age dependence could be influenced by diversity in behaviour and lifestyle, especially with regard to the prevalence of HIV infection, rather than by a fundamental variation in cancer biology between the populations. METHODS. Linear regression analysis was applied to the logarithm of the age-specific incidence rates for SCC v. the logarithm of age between 35 and 74 years. The slopes of the regression (age exponent) were compared for each subset of gender, population group and year of diagnosis (between 2000 and 2010). RESULTS. The most notable feature was the low value of the age exponent in both male and female black African compared with the white and coloured populations. This finding could be explained in part by the difference in the prevalence of HIV infection in the black African population group compared with the white and coloured population groups. CONCLUSIONS. The prevalence of HIV infection in black Africans in SA tends to decrease the apparent age component in SCC compared with the white and coloured population groups. Other factors relating to lifestyle and behaviour that differ between the population groups are also likely to influence the age component in SCC.The National Research Foundation of South Africa and the South African Medical Research Council.http://www.samj.org.zaam2017Geography, Geoinformatics and Meteorolog

Climate change, public health and COP21 – a South African perspective

Current and future climate impacts on public health are a pressing global challenge. Southern Africa is predicted to experience significant changes in climate and by the end of the 21st century, annual average temperatures in the region may warm by up to 4 degrees Celsius. South Africa (SA) is considered to be among one of the most vulnerable countries in the world given the current high incidence of several life-threatening diseases, poverty and inequality. With the 21st session of the Conference of the Parties (COP21) to the United Nations Framework Convention on Climate Change taking place this year, we consider the challenges of and opportunities for SA to accelerate progress towards tackling the adverse impacts of climate change on human health.

Household air pollution exposure and respiratory health outcomes : a narrative review update of the South African epidemiological evidence

One of the greatest threats to public health is personal exposure to air pollution from indoor sources. The impact of air pollution on mortality and morbidity globally and in South Africa is large and places a burden on healthcare systems for treatment and care of air pollution-related diseases. Household air pollution (HAP) exposure attributed to the burning of solid fuels for cooking and heating is associated with several adverse health impacts including impacts on the respiratory system. The researchers sought to update the South African evidence on HAP exposure and respiratory health outcomes from 2005. Our quasi-systematic review produced 27 eligible studies, however, only four of these studies considered measures of both HAP exposure and respiratory health outcomes. While all of the studies that were reviewed show evidence of the serious problem of HAP and possible association with negative health outcomes in South Africa, no studies provided critically important information for South Africa, namely, local estimates of relative risks that may be applied in burden of disease studies and concentration response functions for criteria pollutants. Almost all of the studies that were reviewed were cross-sectional, observational studies. To strengthen the evidence of HAP exposure-health outcome impacts on respiratory health, researchers need to pursue studies such as cohort, time-series and randomised intervention trials, among other study designs. South African and other researchers working in this field need to work together and take a leap towards a new era of epidemiological research that uses more sophisticated methods and analyses to provide the best possible evidence. This evidence may then be used with greater confidence to motivate for policy-making, contribute to international processes such as for guideline development, and ultimately strengthen the evidence for design of interventions that will reduce HAP and the burden of disease associated with exposure to HAP in South Africa.The South African Medical Research Council and the National Research Foundation.http://www.cleanairjournal.org.zaam2019Geography, Geoinformatics and Meteorolog

'50 for 50’ : a celebration of 50 years of cancer research at the International Agency for Research on Cancer global conference in Lyon, France

The International Agency for Research on Cancer (IARC) was founded on 20 May 1965. For the past 50 years, the IARC has served as the specialised cancer research unit of the World Health Organization. The IARC strives to promote international collaboration in cancer research. Celebrating the 50th year of its existence, the IARC held a conference in Lyon on 7 - 10 June 2016, where almost 1 000 scientists from across the globe came together to discuss today’s cancer-related challenges and tomorrow’s agenda for cancer prevention. The programme was characterised by distinguished speakers, including Freddie Bray and Graham Colditz. There were themed parallel sessions on ‘epidemiology’, ‘mechanisms’ and ‘prevention and mortality reduction’ and panel debates and more than 300 posters were presented.CW receives research funding support from the South African Medical Research Council and the National Research Foundation. CT receives funding support from North-West University.http://www.samj.org.zaam2016Geography, Geoinformatics and Meteorolog

A study protocol to determine heat-related health impacts among primary chsoolchildren in South Africa

Abstract:Climate models predict that the global average temperature of Earth will rise in the future. Studies show that high classroom temperatures can affect the ability of the student to learn and function. It is important to understand the impact that heat will have on the health, wellbeing, and academic performance of learners, as they spend a significant amount of time in classrooms compared to any other environment. A follow-up panel study among 20 public primary schools in the Gauteng province (South Africa) will be carried out, in which Grade 4 learners will be selected to complete an hourly heat-health symptom questionnaire. A Cambridge Neuropsychological Test Automated Battery (CANTAB) test will be used to determine their memory and attention span. A nursing practitioner will measure body weight, height, and temperature. Lascar data loggers will beusedtomeasureindoorclassroomtemperature. Schoolprincipalswillcompleteaquestionnaireon existing school coping mechanisms and policies in place that help deal with hot weather conditions. This is the first study to quantitatively assess the effects of heat on learners’ health, well-being and school performance in South Africa. The outcomes of this study will enable policymakers and public officials to develop appropriate school heat adaptation and mitigation measures and will assist in channeling their resources where it is most needed