Socio-environmental factors associated with self-rated oral health : a mixed effects model

Background : Studies of self-rated oral health are always done at either the individual level or the aggregate level. Partitioning individual and neighbourhood sources of variation also enables explorations of the influences of people’s social context on their self-rated oral health. Objective : The main objective of the study was to examine the influence of the social context in which people live on their self-rating of their oral health, independent of individual indicators of good oral health. Method : This study used a secondary analysis of data on a nationally representative sample of 2 907 South African adults (aged ≥ 16 years) who had participated in the 2007 annual South African Social Attitude Survey (SASAS). The 2007 SASAS used a multi-stage probability sampling strategy, with census enumeration areas as the primary sampling unit. Using an interviewer-administered questionnaire, the information obtained included socio-demographic data, the respondents’ level of trust in people (a proxy measure for social capital), oral health behaviours and self-rated oral health. Using the 2005 General Household Survey (GHS) (persons’ n=107 987; households’ n=28 129), the living environment characteristics of participants of the SASAS were obtained, including sources of water and energy supply and household cell phone ownership as a proxy measure for social networking. A mixed-effects model was then constructed to determine factors associated with a self-rating of oral health as ‘very good/good’. Results : Of the respondents, 51.7% were female. Among the respondents, 76.3% self-rated their oral health as good. There was a significant gender modifying effect, thus analyses was stratified by gender. The odds of self-rating oral health as good was significantly higher only among females living in areas with higher household cell phone ownership density, even after controlling for potential confounders. At the individual level, trust was positively associated with good self-rated oral health only among males, and higher social ranking in the society was positively associated with good self-rated oral health only among females. Overall, 55% of the total variance in self-rated oral health was explained by factors operating at the individual level, whereas 18% of the total variance was explained by factors operating at the community level. Self-report of recent oral health problems such as toothache and oral malodour were significantly associated with lower odds of self-rating their oral health as good, as was with reporting less frequent brushing. Conclusion : Good self-rated oral health may be positively associated with indicators of higher levels of social capital both at the level of the individual and the community and with less physical impairments of oral functioning. Furthermore, the findings indicate that unlike men’s oral health ratings, women’s oral health ratings are more likely to be influenced by women’s social relationships with others in the society. CopyrightDissertation (MSc)--University of Pretoria, 2011.School of Health Systems and Public Health (SHSPH)Unrestricte

Does apparent temperature modify the effects of air pollution on respiratory disease hospital admissions in an industrial area of South Africa?

Please read abstract in the article.https://cleanairjournal.org.zaam2022School of Health Systems and Public Health (SHSPH

‘Roll-your-own’ cigarette smoking in South Africa between 2007 and 2010

BACKGROUND: The prevalence of smoking and consumption of cigarettes have decreased in South Africa over the last 20 years. This decrease is a result of comprehensive tobacco control legislation, particularly large cigarette tax increases. However, little attention has been given to the potential use of ‘roll-your-own’ cigarettes as cheaper alternatives, especially among the socio-economically disadvantaged population. This study therefore sought to determine socio-demographic correlates of ‘roll-your-own’ cigarette use among South African adults (2007–2010). METHODS: This secondary data analysis used a merged dataset from two nationally representative samples of 2 907 and 3 112 South African adults (aged ≥16 years) who participated in the 2007 and 2010 annual South African Social Attitude Surveys respectively. The surveys used a face-to-face interviewer-administered questionnaire. The overall response rates were 83.1% for 2007 and 88.9% for 2010. Data elicited included socio-demographic data, current smoking status, type of tobacco products used, past quit attempts and self-efficacy in quitting. Data analysis included chi-square statistics and multi-variable adjusted logistic regression analysis. RESULTS: Of the 1 296 current smokers in this study, 24.1% (n = 306) reported using roll-your-own cigarettes. Some of whom also smoked factory-made cigarettes. Roll-your-own cigarette smoking was most common among black Africans and was more common among male smokers than among female smokers (27% vs 15.8%; p < 0.01). Compared to smokers who exclusively used factory-made cigarettes, roll-your-own cigarette smokers were less confident that they could quit, more likely to be less educated, and more likely to reside in rural areas. The odds of use of roll-your-own cigarette were significantly higher in 2010 than in 2007 (OR = 1.24; 95% CI: 1.07-1.44). CONCLUSIONS: Despite an aggregate decline in smoking prevalence, roll-your-own cigarette smoking has increased and is particularly common among smokers in the lower socio-economic group. The findings also suggest the need for a more intensive treatment intervention to increase self-efficacy to quit among roll-your-own cigarette smokers.This work was carried out with the support of a grant from the American Cancer Society (Grant A0U146).http://www.biomedcentral.com/1471-2458/13/597am201

Socio-environmental factors associated with self-rated oral health in South Africa : a multilevel effects model

AIM : This study examined the influence of the social context in which people live on self-ratings of their oral health. METHOD : This study involved a representative sample of 2,907 South African adults (≥16 years) who participated in the 2007 South African Social Attitude Survey (SASAS). We used the 2005 General Household Survey (n = 107,987 persons from 28,129 households) to obtain living environment characteristics of SASAS participants, including sources of water and energy, and household cell-phone ownership (a proxy measure for the social network available to them). Information obtained from SASAS included socio-demographic data, respondents’ level of trust in people, oral health behaviors and self-rated oral health. RESULTS : Of the respondents, 76.3% self-rated their oral health as good. Social context influenced women’s self-rated oral health differently from that of men. Good self-rated oral health was significantly higher among non-smokers, employed respondents and women living in areas with higher household cell-phone ownership. Furthermore, trust and higher social position were associated with good self-rated oral health among men and women respectively. Overall, 55.1% and 18.3% of the variance in self-rated oral health were explained by factors operating at the individual and community levels respectively. CONCLUSION : The findings highlight the potential role of social capital in improving the population’s oral health.South African National Research Foundation (NRF)http://www.mdpi.com/journal/ijerphhb2016Community DentistrySchool of Health Systems and Public Health (SHSPH

Prenatal exposure to aluminum and status of selected essential trace elements in rural South African women at delivery

Abstract: This study sought to evaluate the in utero exposure to aluminum and status of selected trace elements in South African women at delivery since aluminum is known to be toxic in all developmental stages even at low concentrations. Serum aluminum was negatively correlated with aluminum in urine, both uncorrected and corrected for creatinine, which suggests the retention of aluminum in body stores. Serum copper and zinc levels were found to be high in this study population. Serum copper levels were negatively correlated with aluminum in serum (β = −0.095; p = 0.05). There was a marginal negative correlation between aluminum levels in serum and manganese levels in whole blood (β = −0.087; p = 0.08). Copper levels in maternal serum were negatively correlated with birth weight and the length of neonates. There were a number of positive correlations between maternal characteristics and birth outcomes. Mothers who consumed root vegetables frequently appeared to be protected from aluminum retention and increased body burden since their serum aluminum levels were found to be significantly lower. The findings of the current study can be used as a baseline for further research on aluminum exposure and its associated interactions and outcomes in vulnerable populations

Factors associated with parent-reported wheeze and cough in children living in an industrial area of Gauteng, South Africa

We examined the factors associated with mother-reported wheeze and dry cough in children living in Tembisa, a residential and industrial community in South Africa. A cross-sectional sample of parents reported wheezing and dry cough in children (aged 1 to 26 months) by completing the standardised International Study of Asthma and Allergies in Childhood questionnaire with additional questions concerning tobacco use, income, living conditions, and mothers’ educational level. Data were analysed using chi-square, univariate, and multivariable logistic regressions. Of the 493 children who participated, 81 (16.4%) had wheeze ever and 186 (37.7%) had dry cough ever. We observed that children had a higher probability of wheezing if mothers had lived in the area for longer periods (aOR 1.05; 95% CI 1.01–1.08). Children who had trucks passing on their streets frequently were more likely to have had dry cough ever compared to those with no trucks passing on their streets (aOR 3.88; 95% CI 2.29–6.57). In Tembisa, dry cough in a child was associated with the frequency of trucks passing in front of the child’s home. Children were also more likely have wheeze if their mothers had been living in the community for longer times.http://link.springer.com/journal/113562019-11-01hj2018School of Health Systems and Public Health (SHSPH

Cigarette smoking trends and social disparities among South African adults, 2003-2011

INTRODUCTION : Cigarette prices have almost doubled in South Africa within the past decade due to pricing/taxation policies. Little is known about the equity impact of these price increases in concert with other tobacco control policies. This study therefore examined trends in current cigarette smoking overall and by socioeconomic status (SES) in South Africa during 2003-2011. METHODS : Data were obtained from the 2003 (n = 2,855), 2007 (n = 2,907), and 2011 (n = 3,003) South African Social Attitudes Survey. Educational attainment (> grade 12, grade 12, grade 1-11, or no education) was used as a proxy for SES, and all analyses were restricted to respondents aged ≥25 years. Trends in current cigarette smoking-defined as daily or some days use of cigarettes-during 2003-2011 were assessed with estimates of annual percentage change (APC), while smoking disparities were assessed with relative concentration index (RCI). RESULTS : Although no significant change was observed in the overall prevalence of current smoking during 2003-2011, declines were observed among those with no education (APC = -8.2; p < .05 for linear trend). However, increased smoking was observed among the most educated women (from 4.0% in 2003 to 13.1% in 2011; p < .05 for linear trend). The RCI by educational status changed significantly during the study period, from 0.80 (2003) to 1.35 (2007) to 1.94 (2011). CONCLUSIONS : The policy environment in South Africa during 2003-2011 had a significant positive equity impact by SES, even though no aggregate change in smoking prevalence was observed. Intensified implementation of taxation measures as part of a comprehensive tobacco control may further reduce smoking disparities.The South African National Research Foundation (#93093) and the American Cancer Society (NHINTLTAA02).http://ntr.oxfordjournals.org2016-10-31hb2016Community Dentistr

Assessment of job satisfaction among dentists working in different settings in the Tshwane metro

INTRODUCTION: Job satisfaction of dentists is important, as dentists are critical in the delivery of comprehensive health care. Whilst job satisfaction among dentists has been widely investigated elsewhere, it is poorly researched in South Africa. AIMS AND OBJECTIVES: To assess job satisfaction among dentists working in Tshwane district. DESIGN: A cross-sectional study. METHODS: Data were collected using a self-administered, validated, modified questionnaire adapted from the Dentists' Satisfaction Survey. Demographic data and the responses associated with job satisfaction in various settings were collected. Two of the questions were qualitative and open-ended. Data were analysed using statistical software package (STATA) version 10. Ethical clearance was obtained and all data were anonymous. RESULTS: The response rate was 77% and 53 %( 41) of respondents were female. Perception of income, relationships with patients and personal time were significantly positively associated with job satisfaction. Patient happiness with treatment, the autonomy and flexibility of private practice and imparting knowledge also contributed to job satisfaction. Unrealistic expectations of patients, long working hours, restricted funding and lack of equipment contributed to job dissatisfaction. CONCLUSION: Overall the dentists were satisfied, however, satisfaction and dissatisfaction were conditional and influenced by factors such as perception of income and unrealistic patient expectations.https://www.sada.co.za/the-sadjam2020Community DentistrySchool of Health Systems and Public Health (SHSPH

Evaluation of in utero exposure to arsenic in South Africa

Early life exposure to inorganic arsenic (iAs) has been shown to interfere with foetal and early childhood development, and is associated with morbidity and mortality in adulthood. The purpose of this study was to evaluate exposure to As in utero, to determine the association between maternal and cord blood of As and birth outcomes in South African populations. Total arsenic was measured in maternal blood of a total cohort (n=650) and in paired cord blood and urine of a subset cohort (n=317). Overall, the geometric mean (GM) of As in maternal blood was 0.62μg/L (n=650; 95% CI, 0.58-0.66). In the subset cohort, the GM of maternal blood As was 0.96μg/L (n=350; 95% CI, 0.91-1.02); in paired cord blood, the GM was 0.78μg/L (n=317; 95% CI, 0.74-0.83); and in urine (creatinine-corrected), the GM was 14.26μg/g creatinine (n=317; 95% CI, 12.64-16.09). A linear correlation was found between log maternal blood As and log cord blood As (rho=0.80, p<0.001). Birth outcomes showed geographical differences. in gestational age (p<0.001), birth length (p=0.019), head circumference (p<0.001), Apgar score at 5min (p<0.001) and parity (p<0.002). In a multivariate analysis, no association between maternal blood (AsB) levels and birth outcomes were found. However, the lower the gestational age, the higher the levels of maternal AsB (β=-0.054; 95% CI-0.087 to -0.020) and mothers who had had at least one child were less likely to have higher AsB if compared to those who had never had any child (β=-0.177; 95CI-0.322 to 0.031). In both univariate and multivariate analyses, being single, and drinking water from communal outdoor taps, boreholes and rivers was associated with higher As levels. The findings suggest that more research is needed to evaluate the impact of low level As exposure on postnatal development.The Research Council of Norway and the National Research Foundation (NRF), South Africa (Grant 64528); the Arctic Monitoring and Assessment Programme (AMAP); and the Norwegian Royal Ministry for Foreign Affairs.http://www.elsevier.com/locate/scitotenv2018-01-31hb2017School of Health Systems and Public Health (SHSPH

In utero exposure to aluminium and other neurotoxic elements in urban coastal South African women at delivery : an emerging concern

Aluminium (Al) is a non-essential neurotoxicant and there is limited information regarding exposure to Al in utero. This study sought to evaluate the in utero exposure to Al in urban South African women, its e ects on birth outcomes and possible synergistic e ects between Al, essential and neurotoxic elements such as lead (Pb), mercury (Hg) and arsenic (As), as well as a a potential sex-dependent response to these elements in neonates. This study has found elevated levels of Al in urban women at delivery. The Spearman’s rank correlation coe cients (p-value) of the association between maternal serum Al and birth outcomes (gestational age and parity), and between maternal serum Al and Cu, Zn and Se, were statistically significant. However, in the general and the stratified models, no association was found between any of the birth outcomes and maternal serum Al. The association between maternal serum Al and neurotoxic elements at delivery showed a significant positive correlation for Pb only (rho = 0.361; p < 0.001) which was found to be sex-dependent in neonates (males, rho = 0.285; p < 0.004 and females, rho = 0.444, p < 0.001). Our preliminary findings indicate that in utero exposure to Al is an emerging concern requiring further research and directives from public health authorities.The National Research Foundation (NRF), South Africa, the Research Council of Norway, the Arctic Monitoring and Assessment Programme (AMAP) and the Norwegian Royal Ministry for Foreign Affairs.http://www.mdpi.com/journal/ijerpham2020School of Health Systems and Public Health (SHSPH