COVID-19 hospital admissions and mortality among healthcare workers in South Africa, 2020–2021

AVAILABILITY OF DATA AND MATERIALS : The datasets generated and/or analyzed during this current study are available in the repository of the National Institute of Communicable Diseases. The data can be made available on request, which may be directed to [email protected]. Those requesting data will need to sign a data access agreement. The request will require approval by the National Department of Health.OBJECTIVES : This study describes the characteristics of admitted HCWs reported to the DATCOV surveillance system, and the factors associated with in-hospital mortality in South African HCWs. METHODS : Data from March 5, 2020 to April 30, 2021 were obtained from DATCOV, a national hospital surveillance system monitoring COVID-19 admissions in South Africa. Characteristics of HCWs were compared with those of non-HCWs. Furthermore, a logistic regression model was used to assess factors associated with in-hospital mortality among HCWs. RESULTS : In total, there were 169 678 confirmed COVID-19 admissions, of which 6364 (3.8%) were HCWs. More of these HCW admissions were accounted for in wave 1 (48.6%; n = 3095) than in wave 2 (32.0%; n = 2036). Admitted HCWs were less likely to be male (28.2%; n = 1791) (aOR 0.3; 95% CI 0.3–0.4), in the 50–59 age group (33.1%; n = 2103) (aOR 1.4; 95% CI 1.1–1.8), or accessing the private health sector (63.3%; n = 4030) (aOR 1.3; 95% CI 1.1–1.5). Age, comorbidities, race, wave, province, and sector were significant risk factors for COVID-19-related mortality. CONCLUSION : The trends in cases showed a decline in HCW admissions in wave 2 compared with wave 1. Acquired SARS-COV-2 immunity from prior infection may have been a reason for reduced admissions and mortality of HCWs despite the more transmissible and more severe beta variant in wave 2.DATCOV is funded by the National Institute for Communicable Diseases (NICD) and the South African National Government.http://www.elsevier.com/locate/ijregihj2023School of Health Systems and Public Health (SHSPH

The significance of non-occupational asbestos exposure in women with mesothelioma

CITATION: Tlotleng, N. et al. 2018. The significance of non-occupational asbestos exposure in women with mesothelioma. Respirology Case Reports, 7(1). doi:10.1002/rcr2.386The original publication is available at https://onlinelibrary.wiley.com/journal/20513380ENGLISH ABSTRACT: Malignant mesothelioma is a rare and aggressive pleural or peritoneal tumour almost always caused by exposure to asbestos fibres. Exposure to asbestos can cause malignant mesothelioma 30–40 years after exposure. A description of sources of exposure is important for prevention and possible financial compensation. Three women with cases of histologically confirmed malignant mesothelioma diagnosed from non‐occupational asbestos exposure are described. Patients were contacted for an interview to assess their exposure history to asbestos. All three cases had mixed exposure histories related to secondary, environmental contamination, and domestic exposure. This case series highlight how ubiquitous asbestos is in the environment and how diverse the exposures may be. It is anticipated that a significant number of cases of non‐occupational mesothelioma will be seen in many countries for several decades given the extent of asbestos containing materials.https://onlinelibrary.wiley.com/doi/full/10.1002/rcr2.386Publisher’s versio

Prevalence of respiratory health symptoms among landfill waste recyclers in the City of Johannesburg, South Africa

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Evaluation of atomic force microscopy techniques for imaging and studying surface characteristics of bacterial systems involved in bioleaching

M.TechAtomic force microscopy (AFM) has been an integral tool in bacterial studies for resolving surface structures. Novel applications of this instrument in research require the development of sample preparation techniques and improvement of existing ones. Careful selection of the scanning parameters is particularly crucial when exploring the full potential of the AFM. The objective of this study was to design sample preparation methods for AFM imaging bioleaching bacteria and optimise the scanning parameters (deflection setpoint, feedback loop and the scan rate) for contact mode (CM) imaging in air. The method should be simple, fast and cost effective. The strategy used in this study of (i) evaluation of support substrates for bacterial attachment, (ii) investigation of the effect of pH and centrifugation on cell samples during imaging. Centrifuged and noncentrifuged cell samples suspended in either deionised water (pH 7) or acidified water (pH 1.5) were tested for imaging. Mica and glass cover slips were used as potential substrates for attachment. Cells were attached to substrates for imaging by simple adsorption (‘air-drying’ method). To optimise the scanning parameters, the effect of different values of the scan rate, deflection setpoint and the feedback gains on the quality of AFM imaging was investigated. Optimisation of these parameters was found to be instrumental when imaging weakly adsorbed samples prepared by simple adsorption and ‘soft’ samples such as bacterial cells. The results obtained from these experiments were used during preparation of iron- oxidising leaching bacteria for AFM imaging. The surface morphology of iron-grown bacterial samples was investigated with contact mode AFM in air. Reproducible results obtained in each scan shown by the stability of morphological characteristics of bacterial samples indicate that (i) mica can be used successfully as a substrate for attaching cells, (ii) centrifuged bacterial samples can be easily imaged (iii) scanning with scan rate values of <0.5Hz, deflection setpoint of between 0.2-0.5V and feedback values of < 5.000V improve the image quality and can prevent deformation of the bacterial cells by the tip. Non-centrifuged samples could not be imaged, indicating that bacterial cells need to be separated from growth residues as a prerequisite for successful AFM imaging

Sociodemographic and environmental factors associated with diarrhoeal illness in children under 5 years in Uganda, 2016 : a cross-sectional study

BACKGROUND : Uganda is among the 10 countries in the sub-Saharan Africa region that have the highest prevalence of diarrhoeal disease. Evidence suggests that the severity of childhood diarrhoeal disease is escalated through various sociodemographic and environmental factors. OBJECTIVES : To assess prevalence of diarrheal illness in children below the age of 5 years in Uganda in 2016 and associated factors. METHODS : A cross-sectional study was employed that analyzed secondary data from the 2016 Uganda Demography and Health Surveys. Children with and without diarrhea were compared. A logistic regression was used to determine sociodemographic and environmental factors associated with diarrheal illness in children with statistical significance at p < 0.05. RESULTS : The prevalence of childhood diarrhoeal illness for children below the age of 5 years in Uganda was 20.9% (n = 2838/13,753). There was a statistically significant difference when comparing children diarrhoeal with the following sociodemographic factors: caregiver’s age, child’s age and gender and duration of breastfeeding (p < 0.0001). Children with a caregiver aged between 15 and 24 years (aOR;1.42; 95% CI:1.24–1.62) and 25–34 years (aOR;1.19; 95% CI:1.04–1.37) were more likely to report diarrhoeal disease, compared to those with a caregiver aged 35–49 years. For environmental factors, households using springs water, access to health facility and children who received a dose of vitamin A had a decreased risk of reporting children diarrhoeal. CONCLUSION : Significant factors in the study like caregiver’s age, gender and duration of breastfeeding will create the opportunity for all interventions to shift their focus to these factors thus a better evidence-based approach to reducing of diarrhoeal disease will be achieved in the country.https://bmcinfectdis.biomedcentral.comSchool of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Work Related Musculoskeletal Pain in Golf Caddies—Johannesburg, South Africa

Golf is an important and growing industry in South Africa that currently fosters the creation of an informal job sector of which little is known about the health and safety risks. The purpose of the study is to investigate the prevalence and significance of musculoskeletal pain in male caddies compared to other golf course employees while holding contributing factors such as socioeconomic status, age, and education constant. Cross-sectional data were collected and analyzed from a convenience sample of 249 caddies and 74 non-caddies from six golf courses in Johannesburg, South Africa. Structural interviews were conducted to collect data on general demographics and musculoskeletal pain for two to three days at each golf course. On average, caddies were eight years older, had an income of 2880 rand less a month, and worked 4 h less a shift compared to non-caddies employed at the golf courses. Caddies were approximately 10% more likely to experience lower back and shoulder pain than non-caddies. Logistic regression models show a significantly increased adjusted odds ratio for musculoskeletal pain in caddies for neck (3.29, p = 0.015), back (2.39, p = 0.045), arm (2.95, p = 0.027), and leg (2.83, p = 0.019) compared to other golf course workers. The study findings indicate that caddying, as a growing informal occupation is at higher risk for musculoskeletal pain in caddies. Future policy should consider the safety of such a vulnerable population without limiting their ability to generate an income.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacult

Disease Severity and Comorbidities among Healthcare Worker COVID-19 Admissions in South Africa: A Retrospective Analysis

Healthcare workers (HCWs) are among the most vulnerable in regard to contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Comorbidities are reported to increase the risk for more severe COVID-19 outcomes, often requiring hospitalization. However, the evidence on disease severity and comorbidities among South African HCWs is lacking. This retrospective study analyzed the prevalence of comorbidities among HCW hospitalized with COVID-19 and its association with the severity of outcomes. Data from public and private hospitals in nine provinces of South Africa were extracted from the national hospital surveillance database for COVID-19 admissions. A total of 10,149 COVID-19 HCWs admissions were reported from 5 March 2020 to 31 December 2021. The risk of disease severity among HCWs increased with age, with those older (&ge;60 years) having seven times the odds of disease severity (aOR 7.0; 95% CI 4.2&ndash;11.8) compared to HCWs in the younger age (20&ndash;29 years) group. The most commonly reported comorbidity was hypertension (36.3%), followed by diabetes (23.3%) and obesity (16.7%). Hypertension (aOR 1.3; 95% CI 1.0&ndash;1.6), diabetes (aOR 1.6; 95% CI 1.3&ndash;2.0), and HIV (aOR 1.6; 95% CI 1.2&ndash;2.1) were significantly associated with disease severity. In conclusion, age, gender, and existing comorbidities were strong predictors of the prognosis of severe COVID-19 among HCWs in South Africa. The information is important in the development of occupational health policies and vulnerability risk assessments for HCWs in light of future COVID-19 waves or similar outbreaks

Tuberculosis Mortality by Occupation in South Africa, 2011–2015

Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96&#8315;4.32), cleaners (MORadj = 3.44, 95% CI 2.91&#8315;4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88&#8315;4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83&#8315;4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65&#8315;4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations

Association between Bone Lead Concentration and Aggression in Youth from a Sub-Cohort of the Birth to Twenty Cohort

Background: An association between blood-lead levels and aggression has been demonstrated in children and adolescent youth in South Africa. However, there are limited studies that have assessed aggression as an outcome for cumulative lead exposure using bone lead concentration. This study aims to assess the association between bone lead concentration and aggressive behaviour among a sample of youth in South Africa. Methods: Bone lead in 100 participants (53 males and 47 females) recruited and followed in the Birth to Twenty (BT20) Cohort were measured using 109 Cd-based, K-shell X-ray fluorescence (KXRF). The Buss&ndash;Perry Aggression questionnaire was used to measure aggressive behaviour. Linear regression models were fitted to determine the association between aggression score for physical, verbal, anger and hostility and bone lead, adjusting for known confounders. Results: A one-microgram-per-gram increase in bone lead was found to increase the score for all four scales of aggression, but significantly only for anger (&beta; = 0.2 [95% CI 0.04&ndash;0.370]). Psychosocial factors such as a history of family violence and exposure to neighbourhood crime were significant predictors for aggression. Conclusions: The study provides a preliminary overview of the relationship between cumulative lead exposure and behavioural problems such as aggression. A larger sample, across exposed communities, may prove more definitive in further investigating the association between these two important public health factors and to maximize generalizability

Illness, Self-Rated Health and Access to Medical Care among Waste Pickers in Landfill Sites in Johannesburg, South Africa

Waste pickers are exposed to various environmental health hazards, and self-rated health (SRH) could influence their medical care access. This study investigated the association between illness, clinic visits and SRH, and assessed if SRH can increase clinic visits. A cross-sectional study was conducted. SRH was defined as &ldquo;very good&rdquo;, &ldquo;good&rdquo;, &ldquo;fair&rdquo;, and &ldquo;poor&rdquo;. The illnesses were mental health, infectious, and chronic diseases. Medical care access included clinic visits in the previous 12 months. An ordinal logistic regression model was fitted to assess the association. There were 361 participants, 265 (73.41%) were males. Median age was 31 years, (interquartile range (IQR): 27&ndash;39). SRH: poor (29.89%), fair (15.92%), good (43.30%) very good (10.89%). Ever smoked (adjusted odds ratio (AOR): 1.72; 95% confidence interval (CI): 1.11&ndash;2.66), mental health (AOR: 1.87; 95% CI: 1.22&ndash;2.84), chronic (AOR: 2.34; 95% CI:1.47&ndash;3.68) and infectious (AOR: 2.07; 95% CI: 1.77&ndash;3.63) diseases were significantly associated with increased odds of reporting poor health. Clinic visit was not associated with SRH. From 99 (31%) individuals who rated their health as poor and ill, 40% visited a clinic (p = 0.0606). Acute and chronic illnesses were associated with poor SRH but this did not increase clinic visits. Provision of mobile clinic services at the landfill sites could increase access to medical care