An analysis of the extent of migration and its impacts on the sending household in a rural area in South Africa.

Master of Arts in Population Studies. University of KwaZulu-Natal, Howard College 2014.The aim of this study is to analyse the extent and nature of labour migration and its impacts on the sending households in a rural area in South Africa, namely Agincourt, Mpumalanga. This is achieved through a quantitative analysis of a cross-sectional dataset from the 2007 temporary migration module of the Agincourt Health and Demographic Surveillance System. Results indicate that most temporary migration in this area is related to the need to work elsewhere, i.e. labour migration, and that labour migrants are more likely to be men rather than women. Consistent with expectations, temporary labour migrants appear to maintain close ties with sending households, evidenced in three key features of migrants` behaviour, namely: method of communication with the household; pattern of return; and propensity to remit cash and goods to the household of origin. A number of the factors investigated here differ by the gender of the migrant, and whether children were left behind in the household by the migrant. The effect of labour migration on additional household composition changes, such as the co-migration of children, appears negligible in this sample, contrary to expectations. Interestingly, the study finds that a large percentage of migrants leave children behind in the sending households, and that more female migrants compared to male migrants leave behind at least one child in the household. These children tend to be cared for within the household by another female relative. These findings underscore the need for more inter-disciplinary and in-depth research on labour migration, yielding more refined results particularly on the impact of migration on the health and well-being of children left in the sending household

HIV focused sexual risk‑reduction interventions targeting adolescent boys and young men in Sub‑Saharan Africa : a scoping review

DATA AVAILABILITY: All data relevant to the study are included in the article or uploaded as supplementary information. Any further data required are available on request from the corresponding author.Adolescent girls and young women’s exceptionalism with HIV interventions has left adolescent boys and young men (ABYM) trailing behind, thus becoming a marginalized and underserved population. The scoping review aimed to provide an overview of interventions that have targeted sexual risk behaviors in ABYM in Sub-Saharan Africa (SSA) over the previous 21 years with critical insights on ‘what works’ in preventing the sexual transmission of HIV. A scoping review guided by Arksey and O’Malley’s (in Int J Soc Res Methodol 8(1):19–32, 16) framework and the 2015 Johanna Briggs Institute’s guidelines was conducted. A search of literature published between 2000 and 2020 was reviewed and twenty nine interventions from nine Sub Saharan African countries that met the eligibility criteria were reviewed. The review provides evidence on the successes and the limitations of sexual risk behavior interventions for ABYM in SSA. There is clear and consistent evidence that interventions reduce sexual risk behaviors in adolescent boys and young men. Their efciency seems to grow with the length and intensity of the intervention. Positive efects were generally observed in condom use and on measures of HIV knowledge, attitudes and sexual behaviors as well as uptake of HIV tests and voluntary male circumcision. This review shows that sexual-risk interventions engaging men and boys in SSA are promising and warrant further rigorous development in terms of conceptualization, design and evaluation.The National Research Foundation (NRF) of South Africa and Swedish International Development Agency. Open access funding provided by University of KwaZulu Natal.http://link.springer.com/journal/10461Nursing Scienc

Epidemiology of multimorbidity among people living with HIV in sub-Saharan Africa : a systematic review protocol

CITATION: Oladimeji, Kelechi Elizabeth et al. 2020. Epidemiology of multimorbidity among people living with HIV in sub-Saharan Africa : a systematic review protocol. BMJ Open, 10(12):e036988, doi:10.1136/bmjopen-2020-036988.The original publication is avaialble at: https://bmjopen.bmj.comIntroduction Sub-Saharan Africa remains the epicentre of the HIV pandemic, yet enormous knowledge gaps still exist to elicit a comprehensive portrait of multimorbidity and HIV linkage. This study aims to conduct a systematic meta-analysis of peer-reviewed literature to investigate the current status of multimorbidity epidemiology among people living with HIV (PLHIV) in sub-Saharan Africa. Methods and analysis Our review will assess observational studies (ie, cohort, case–control and cross-sectional) on multimorbidity associated with HIV/AIDS between 1 January 2005 and 31 October 2020 from sub-Saharan Africa. Databases to be searched include PubMed/MEDLINE, Scopus, Web of Science, Cochrane library, African Index Medicus and African Journals Online. We will also search the WHO clinical trial registry and databases for systematic reviews. The search strategy will involve the use of medical subject headings and key terms to obtain studies on the phenomena of HIV and multimorbidity at high precision. Quality assessment of eligible studies will be ascertained using a validated quality assessment tool for observational studies and risk of bias through sensitivity analysis to identify publication bias. Further, data on characteristics of the study population, multimorbid conditions, epidemiological rates and spatial distribution of multimorbid conditions in PLHIV will be extracted. Heterogeneity of individual studies will be evaluated using the I2 statistic from combined effect size estimates. The statistical analysis will be performed using STATA statistical software V.15 and results will be graphically represented on a forest plot.Publisher's versio

Epidemiology of multimorbidity among people living with HIV in sub-Saharan Africa: a systematic review protocol

Introduction Sub-Saharan Africa remains the epicentre of the HIV pandemic, yet enormous knowledge gaps still exist to elicit a comprehensive portrait of multimorbidity and HIV linkage. This study aims to conduct a systematic meta-analysis of peer-reviewed literature to investigate the current status of multimorbidity epidemiology among people living with HIV (PLHIV) in sub-Saharan Africa.Methods and analysis Our review will assess observational studies (ie, cohort, case–control and cross-sectional) on multimorbidity associated with HIV/AIDS between 1 January 2005 and 31 October 2020 from sub-Saharan Africa. Databases to be searched include PubMed/MEDLINE, Scopus, Web of Science, Cochrane library, African Index Medicus and African Journals Online. We will also search the WHO clinical trial registry and databases for systematic reviews. The search strategy will involve the use of medical subject headings and key terms to obtain studies on the phenomena of HIV and multimorbidity at high precision. Quality assessment of eligible studies will be ascertained using a validated quality assessment tool for observational studies and risk of bias through sensitivity analysis to identify publication bias. Further, data on characteristics of the study population, multimorbid conditions, epidemiological rates and spatial distribution of multimorbid conditions in PLHIV will be extracted. Heterogeneity of individual studies will be evaluated using the I2 statistic from combined effect size estimates. The statistical analysis will be performed using STATA statistical software V.15 and results will be graphically represented on a forest plot.Ethics and dissemination Ethical approval is not applicable in this study as it is a systematic review of published literature. The review findings may also be presented at conferences or before other relevant stakeholders.PROSPERO registration number CRD42020148668

Additional file 4: of Mobility and increased risk of HIV acquisition in South Africa: a mixed-method systematic review protocol

PRISMA-P (preferred reporting items for systematic review and meta-analysis protocols) 2015 checklist: recommended items to address in a systematic review protocol. (DOC 73 kb

Additional file 1: of Mobility and increased risk of HIV acquisition in South Africa: a mixed-method systematic review protocol

Sample search strategy in Web of Science. (DOCX 77 kb

Patterns of multimorbidity and their association with hospitalisation: a population-based study of older adults in urban Tanzania

Background while the HIV epidemic remains a considerable challenge in sub-Saharan Africa, a dramatic reduction in the associated mortality has led to a fundamental shift in the public health priorities aimed at tackling multimorbidity. Against the unprecedented level of urbanisation taking place in Tanzania, the burden of multimorbidity and its consequences among ageing adults, in the form of costly inpatient hospitalisation, remain unquantified. Methods we used data from one of Africa’s largest urban population cohort, the Dar es Salaam Health and the Demographic Surveillance System, to quantity the extent of multimorbidity (occurrence of 2 ≥ health conditions) and discordant multimorbidity (occurrence of conditions in 2 ≥ domains in mental health, non-communicable and communicable health) among 2,299 adults aged ≥40 years in Dar es Salaam, Tanzania. We fitted logistic regression models to investigate the association between multimorbidity and inpatient hospitalisation. Results the prevalence of multimorbidity and discordant multimorbidity were 25.3 and 2.5%, respectively. Although the severe forms of multimorbidity (2.0% with ≥4 health conditions) and discordancy were low, hospitalisation was significantly higher based on the regression analyses. Household food insecurity was the only socio-economic variable that was significantly and consistently associated with a greater hospitalisation. Conclusion we found an alarmingly high degree of multimorbidity among this ageing urban population where hospitalisation was driven by multimorbidity. As public health resources remain scarce, reducing costly inpatient hospitalisation requires multilevel interventions that address clinical- and structural-level challenges (e.g. food insecurity) to mitigate multimorbidity and promote long-term healthy independent living among older adults in Tanzania