Psychological well-being of institutionalised and non-institutionalised isiXhosa and English ethnic speaking elderly south African residing within the Buffalo City area

Background: International research has clearly indicated that the world’s population is ageing: almost all countries in the world are experiencing a significant growth in the proportion of older persons in their population. This is also true for developing countries such as South Africa that are beginning to show signs and symptoms of an ageing population. Among Southern African Development Communities (SADC), South Africa has the highest number of ‘senior citizens’. Population reports indicate that the population of old people rose from paltry 2.8 million in 1996 to more than 4 million in 2011 and this is expected to skyrocket to seven million by 2030. In spite of the increasing number of senior citizens in socio-structural landscapes in South Africa, there is still lack of adequate, workable and effective policy frameworks for the wellbeing of the elderly. There is also paucity of psychological data of the elderly, especially along racial divides to determine whether the after-effects of apartheid still hold sway or not in post-apartheid South Africa. This study was conceived to investigate the psychological well-being of the elderly in Buffalo City, Eastern Cape, South Africa between two racial-ethnic elderly groups. The specific objectives of the study were to explore the relationship between the socio-demographic characteristics and psychological well-being of the black (Xhosa) and white (English) elderly in Buffalo City, South Africa and second, to validate the relationship between psychological well-being and physical activity, loneliness, spirituality/religiosity as well as ageism among the sampled population. The set-point theory, selective optimisation compensation theory (SOCT) as well as the continuity theory were employed to guide the conduct of the study. Method: Psychological measuring instruments were deployed to collect data for the study from a total of 301 elderly respondents in retirement and private individual homes (191 isiXhosa and 110 English speaking elderly). Both simple random sampling (SRS) and purposive sampling procedures were used to select the respondents. The measuring instruments included the Ryff Scales of Psychological Well-being (RSPWB), Physical Activity Scale for the Elderly (PASE), Assessment of Spiritual and Religious Sentiments Scale (ASPIRES), University of California at Los Angeles (UCLA) Loneliness Scale, the Palmore Ageism Survey scale and a biographical questionnaire. Data was analysed using MANOVA, One-way variance analysis and regression coefficient. The racial differences logically influenced the selection of the respondents for the study. Results: The study revealed a significant statistical relationship between physical activity (PA) and psychological well-being of the elderly, regardless of the sociodemographic variables. PA showed a significant relationship with psychological wellbeing of the elderly. The study also discovered that loneliness correlates significantly with all four of the psychological well-being scales. It shows that the higher the levels of loneliness experienced by the elderly, socio-demographic variables controlled, the lower the levels of psychological well-being in terms of autonomy, environmental mastery, purpose in life, and self-acceptance. However, with the exception of the relationship between loneliness and purpose in life, ethnic affiliation moderates autonomy, environmental mastery and self-acceptance. English elderly constantly experienced higher levels of autonomy than the isiXhosa elderly do with an increase in loneliness. The study also found a positive relationship between ageism and psychological well- being. However, with low levels of ageism, the English elderly, in comparison with the isiXhosa elderly, is likely to show higher levels of autonomy. In addition, a significant statistical relationship between ageism and environmental mastery and purpose in life was found among the isiXhosa elderly. Although, with an increase in ageism, there is a slight increase in autonomy in both groups, the English elderly throughout showed higher levels of autonomy than the isiXhosa elderly showed. The study found a positive relationship between religiosity/spirituality and psychological well-being of the elderly. However, race could moderate the relationship between prayer fulfillment and psychological well-being at all four levels (autonomy, environmental mastery, purpose in life, and self-acceptance). With an increase in prayer fulfillment, the autonomy of the English elderly increases fairly quickly, while the autonomy of the isiXhosa elderly decreases slightly. Comparatively, the study found that isiXhosa elderly reported lower levels of psychological well-being than the English elderly. Conclusion/Recommendation: The study concludes that there is the need to develop a solid national data bases on needs and use of services, and process of ageing in order to access research data to assist planning, dissemination, delivery and evaluation of effective service delivery for the elderly population in South Africa, especially along racial divides

Conducting water and sanitation survey using Personal Digital Assistants and Geographic Information System technologies in rural Zimbabwe

Access to clean water and improved sanitation are basic human right. This quantitative, descriptive study sought to establish current water and sanitation coverage in Chirumanzu and Shurugwi districts in Zimbabwe and develop methods of assessing coverage using Geographic Information Systems. Google Earth was used to identify homesteads. Personal digital assistant-based forms were used to collect geo-referenced data on all water points and selected households. Geospatial analysis methods were used to calculate borehole water coverage. Using Google Earth, 29375 homesteads were identified. The water survey mapped 4134 water points; 821 were boreholes; and only 548 were functional. Functional borehole water coverage was: 57.3%, 46.2%, and 33.5% for distance from household to water point of within 1500 m, 1000 m, and 500 m respectively. Sanitation coverage was 44.3%, but 96% of the latrines did not meet Blair Ventilated Pit latrine standards.Health StudiesM.A. (Public Health) (Medical Informatics

Socio-contextual factors as determinants of psychological wellbeing of selected aged in South Africa: a moderating approach

The psychological wellbeing of the elderly has become an important global health issue. This study investigated the socio-contextual factors moderating some dimensions of psychological well-being (self-acceptance, purpose in life, environmental mastery and autonomy) among 301 selected aged in South Africa. Simple random and purposive sampling techniques were deployed to select the respondents (93 males and 208 females) in Buffalo city, South Africa. A questionnaire pack which included the Ryff Psychological Well-Being Scale (RPWBS) and the Physical Activity Scale for the Elderly (PASE) were utilised. The study found a significant relationship between physical activity and psychological wellbeing of the elderly. However, ethnicity could moderate the relationship between physical activity and the dimensions of psychological wellbeing. Recreational activities, particularly in Black communities, must be improved to encourage participation in physical exercise.http://www.pertanika.upm.edu.my/pjsshhj2022Psycholog

Perceptions of homosexual Xhosa men of ulwaluko (traditional circumcision)

vital:61292The study investigated perceptions of homosexual Xhosa traditionally circumcised men with regards to ulwaluko (Xhosa initiation into manhood). The study employed snowball sampling as a method of data collection. As a result of the assumption that ulwaluko is a terrain of masculinity, initiates were expected to exemplify traditional notions of masculinity. The study found that reasons for going to initiation school differed. Respondents wanted to validate their manhood while some felt forced to undergo the ritual. Dominant family values also played a role in respondent’s decision to undergo initiation. Respondents reported that community members and family members had hoped that ulwaluko would reform or convert those who were homosexual.Thesis (MA) -- Faculty of Social Sciences and Humanities, 201

Perceptions of homosexual Xhosa men of ulwaluko (traditional circumcision)

The study investigated perceptions of homosexual Xhosa traditionally circumcised men with regards to ulwaluko (Xhosa initiation into manhood). The study employed snowball sampling as a method of data collection. As a result of the assumption that ulwaluko is a terrain of masculinity, initiates were expected to exemplify traditional notions of masculinity. The study found that reasons for going to initiation school differed. Respondents wanted to validate their manhood while some felt forced to undergo the ritual. Dominant family values also played a role in respondent’s decision to undergo initiation. Respondents reported that community members and family members had hoped that ulwaluko would reform or convert those who were homosexual.Thesis (MA) -- Faculty of Social Sciences and Humanities, 201

Inflammation, cytomegalovirus and the growth hormone axis in HIV-exposed uninfected Zimbabwean infants.

OBJECTIVES: Despite avoiding HIV infection, HIV-exposed uninfected (HEU) infants have poorer clinical outcomes than HIV-unexposed infants, including impaired growth. The growth hormone (GH) axis is an important regulator of infant growth through hepatic synthesis of insulin-like growth-factor-1 (IGF-1), and may be disrupted by chronic inflammation and acute infections, including cytomegalovirus (CMV). We tested the hypothesis that these factors lead to disruption of the GH axis in HEU infants, which might contribute to their impaired growth. DESIGN: Substudy of 343 infants from the ZVITAMBO trial in Harare, Zimbabwe. METHODS: IGF-1, growth parameters, C-reactive protein (CRP) and CMV viraemia were evaluated in 243 HEU infants and 100 HIV-unexposed infants. Univariable linear and logistic regression models were used to determine associations between IGF-1 and growth parameters, CRP and CMV. RESULTS: Mean 6-week IGF-1 was significantly lower in HEU compared with HIV-unexposed infants (29.6 vs. 32.6 ng/ml; P = 0.014), and associated with subsequent linear and ponderal growth through 6 months of age. CRP was inversely correlated with IGF-1 in all infants regardless of HIV exposure status (β = -0.84; P = 0.03). CMV viral loads were inversely correlated with IGF-1 in HEU (β = -1.16; P = 0.008) but not HIV-unexposed (β = 0.21; P = 0.83) infants. CONCLUSION: Overall, we found evidence for greater disruption of the GH axis in HEU compared with HIV-unexposed infants as early as 6 weeks of age, suggesting a role for reduced IGF-1 in mediating growth impairment in HEU infants. Inflammation and coinfections may be drivers of growth impairment in HEU infants by disrupting the GH axis

Characterising school-age health and function in rural Zimbabwe using the SAHARAN toolbox

INTRODUCTION: We developed the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) toolbox to address the shortage of school-age assessment tools that combine growth, physical and cognitive function. Here we present i) development, acceptability and feasibility of the SAHARAN toolbox; ii) characteristics of a pilot cohort; and iii) associations between the domains measured in the cohort. METHODS: Growth was measured with anthropometry, knee-heel length and skinfold thicknesses. Bioimpedance analysis measured lean mass index and phase angle. Cognition was assessed using the mental processing index, derived from the Kaufman Assessment Battery for Children version 2, a fine motor finger-tapping task, and School Achievement Test (SAT). Physical function combined grip strength, broad jump and the 20m shuttle-run test to produce a total physical score. A caregiver questionnaire was performed in parallel. RESULTS: The SAHARAN toolbox was feasible to implement in rural Zimbabwe, and highly acceptable to children and caregivers following some minor modifications. Eighty children with mean (SD) age 7.6 (0.2) years had mean height-for-age (HAZ) and weight-for-age Z-scores (WAZ) of -0.63 (0.81) and -0.55 (0.85), respectively. Lean mass index and total skinfold thicknesses were related to WAZ and BMI Z-score, but not to HAZ. Total physical score was associated with unit rises in HAZ (1.29, 95% CI 0.75, 1.82, p<0.001), and lean mass index (0.50, 95% CI 0.16, 0.83, p = 0.004), but not skinfold thicknesses. The SAT was associated with unit increases in the mental processing index and child socioemotional score. The caregiver questionnaire identified high levels of adversity and food insecurity. CONCLUSIONS: The SAHARAN toolbox provided a feasible and acceptable holistic assessment of child growth and function in mid-childhood. We found clear associations between growth, height-adjusted lean mass and physical function, but not cognitive function. The SAHARAN toolbox could be deployed to characterise school-age growth, development and function elsewhere in sub-Saharan Africa

Effects of improved complementary feeding and improved water, sanitation and hygiene on early child development among HIV-exposed children: substudy of a cluster randomised trial in rural Zimbabwe.

Introduction: HIV-exposed uninfected children may be at risk of poor neurodevelopment. We aimed to test the impact of improved infant and young child feeding (IYCF) and improved water, sanitation and hygiene (WASH) on early child development (ECD) outcomes. Methods: Sanitation Hygiene Infant Nutrition Efficacy was a cluster randomised 2×2 factorial trial in rural Zimbabwe ClinicalTrials.gov NCT01824940). Pregnant women were eligible if they lived in study clusters allocated to standard-of-care (SOC; 52 clusters); IYCF (20 g small-quantity lipid-based nutrient supplement/day from 6 to 18 months, complementary feeding counselling; 53 clusters); WASH (pit latrine, 2 hand-washing stations, liquid soap, chlorine, play space, hygiene counselling; 53 clusters) or IYCF +WASH (53 clusters). Participants and fieldworkers were not blinded. ECD was assessed at 24 months using the Malawi Developmental Assessment Tool (MDAT; assessing motor, cognitive, language and social skills); MacArthur Bates Communication Development Inventory (assessing vocabulary and grammar); A-not-B test (assessing object permanence) and a self-control task. Intention-to-treat analyses were stratified by maternal HIV status. Results: Compared with SOC, children randomised to combined IYCF +WASH had higher total MDAT scores (mean difference +4.6; 95% CI 1.9 to 7.2) and MacArthur Bates vocabulary scores (+8.5 words; 95% CI 3.7 to 13.3), but there was no evidence of effects from IYCF or WASH alone. There was no evidence that that any intervention impacted object permanence or self-control. Conclusions: Combining IYCF and WASH interventions significantly improved motor, language and cognitive development in HIV-exposed children. Trial registration number: NCT01824940

Design of an Intervention to Minimize Ingestion of Fecal Microbes by Young Children in Rural Zimbabwe.

We sought to develop a water, sanitation, and hygiene (WASH) intervention to minimize fecal-oral transmission among children aged 0-18 months in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. We undertook 4 phases of formative research, comprising in-depth interviews, focus group discussions, behavior trials, and a combination of observations and microbiological sampling methods. The resulting WASH intervention comprises material inputs and behavior change communication to promote stool disposal, handwashing with soap, water treatment, protected exploratory play, and hygienic infant feeding. Nurture and disgust were found to be key motivators, and are used as emotional triggers. The concept of a safe play space for young children was particularly novel, and families were eager to implement this after learning about the risks of unprotected exploratory play. An iterative process of formative research was essential to create a sequenced and integrated longitudinal intervention for a SHINE household as it expects (during pregnancy) and then cares for a new child