The intervention effects of a community-based hypertension control programme in two rural South African towns: the CORIS study

The objective of the hypertension programme of the Coronary Risk Factor Study (CORlS) was to evaluate the effectiveness of the first 4 years of community-based intervention. The hypertension intervention model comprised a blood pressure station where the whole population was screened for hypertension, non-drug management was provided and hypertensives were monitored after referral to general practitioners for drug therapy. Two levels of intervention were maintained: in the high-intensity intervention town (N =2 278) hypertensives were actively followed up, and in the low-intensity intervention town (N =2 620) no active follow-up procedure existed. A third town acted as control (N= 2 290).In the cohort which was hypertensive at baseline, the net decreases in systolic blood pressure (mean ± SE) after correction for changes in the control town were 0,5 ± 2,2 mmHg (men) and 4,5 ± 2,2 mmHg (women) in the low-intensity intervention town, and 5,6 ± 2,3 mmHg (men) and 7,5 ± 2,2 mmHg (women) in the high-intensity intervention town. The net decrease in diastolic blood pressure was 3,4 ± 1,2 mmHg (men) and 4,4 ± 1,1 mmHg (women) in the low-intensity intervention town, and 6,1 ± 1,2 mmHg (men) and 5,9 ± 1,1 mmHg (women) in the high-intensity intervention town. These reductions were statistically significant with one exception. The changes in the total population in the 3 communities after 4 years of intervention were similar to those found in the hypertensive cohort.Decreases in mean blood pressure were accompanied by marked increases in the proportion of hypertensives on drug treatment and the proportion under control (< 160/95 mmHg).Distribution curves of blood pressure indicated a large effect in the subgroup above the cut-off point for hypertension; however, the entire curve also shifted to the left, indicating, in addition, benefit to the whole population. An increase in the appropriate knowledge and action for hypertension control was observed in the intervention towns compared with the control town.The CORlS community-based hypertension control programme successfully reduced the risk for cardiovascular diseases in the intervention towns compared with the control town

Apolipoprotein B levels and related factors in a rural white South African community - the CORIS study

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Editorial

Community anti-smoking intervention in South Afric

Iodine deficiency and endemic goitre in the Langkloof area of South Africa

No Abstract

Iodine-deficiency disorders

billion individuals worldwide have insufficient iodine intake, with those in south Asia and sub-Saharan Africa particularly affected. Iodine deficiency has many adverse effects on growth and development. These effects are due to inadequate production of thyroid hormone and are termed iodine-deficiency disorders. Iodine deficiency is the most common cause of preventable mental impairment worldwide. Assessment methods include urinary iodine concentration, goitre, newborn thyroid-stimulating hormone, and blood thyroglobulin. In nearly all countries, the best strategy to control iodine deficiency is iodisation of salt, which is one of the most cost-effective ways to contribute to economic and social development. When iodisation of salt is not possible, iodine supplements can be given to susceptible groups. Introduction of iodised salt to regions of chronic iodine-deficiency disorders might transiently increase the proportion of thyroid disorders, but overall the small risks of iodine excess are far outweighed by the substantial risks of iodine deficiency. International efforts to control iodine-deficiency disorders are slowing, and reaching the third of the worldwide population that remains deficient poses major challenges

An evaluation of two guidance programmes to promote breast-feeding

During the past ten years a comprehensive research project has been undertaken to develop a guidance programme in three adjacent communities in the South- Western Cape with the aim o f lowering the high incidence o f coronary heart disease. The purpose o f this substudy was to determine whether the guidance provided in the different communities had any influence on the knowledge o f and attitudes towards the nutrition o f pregnant women, babies and infants as well as breast-feeding practices o f the women who gave birth during the period 1980 to 1986. In the first community guidance was provided by means o f small mass media and interpersonal communication whereas only the small mass media were employed in the second. The third served as the control community. The findings suggest that the combined interpersonal and mass media programme was more successful than the mass media programme alone

Changes in smoking during a community-based cardiovascular disease intervention programme - The Coronary Risk Factor Study

A prospective anti-smoking clinical trial was conducted as part of a coronary risk factor Intervention study in three rural South African communities in the south western Cape over a period of 4 years. The aim of the part of the study was to reduce smoklng rates in two of the communities through application of high- and low-intensity intervention. The effect was evaluated by examining the net change in smoking habits, which was defined as the residual change in the intervention areas after allowing for change in the reference area. This paper presents the analyses of the estimated effect of the programme on the cohort aged 15 - 64 years at baseline who participated in the two surveys (4087 subjects). The intervention programme among men in the high-intensity intervention area resulted in a reduction of 8,4% in smoking rates and 13.0% in the amount smoked per day. Among women in this area there was a reduction of 30,6% in smoking rates and 20,5% in amount smoked. Smoking and the amount smoked per day also  decreased in the low-intensity intervention area, but less so than in the high-lntensity intervention area. Smoking quit rates were strongly " associated with initial smoking level, with light smokers being significanty more successful quitters than heavy smokers. The study has proved that a community based intervention programme can effectively reduce smoking

Endemic goitre in a rural community of KwaZuluNatal

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The lipid and lipoprotein profile of the urban black South African population of the Cape Peninsula - the BRISK study

No Abstract