Nutrition knowledge and food choice among black students in South Africa

A CAJM journal article.Objectives: To investigate the relationship between nutrition knowledge and dietary behaviour, and to assess the perceived influences on food selection among Black students in South Africa. Design: Cross sectional study. Setting: University of the North and two semi-urban Secondary Schools. Subjects: 213 second year social science university students, 104 (48.2%) male and 112 (51.9%) female, and 199 Grade 11 secondary school students, 67 male (32.7%) and 132 female (66.3%). Main Outcome Measures: A General Nutrition Knowledge Questionnaire and a Food Choice Questionnaire. Results: Generally, students seemed to have below average nutrition knowledge levels. University students had significantly more nutrition knowledge than secondary school students. Dietary recommendations were associated with source of nutrients and diet-disease relationships, and sources of nutrients were associated with diet-disease relationships. Choosing everyday foods was not associated with dietary recommendations, source of nutrients, and diet-disease relationships. Among both university and secondary school students the three highest food choice factors included health, sensory appeal and mood

Avoiding drunk driving: the behaviour of South African general drivers

The aim of this article is to examine the degree to which drivers participate in activities aimed at avoiding drunk-driving victimisation, and to assess protective behaviour in relation to drunk driving. The sample included 100 black and 100 white drivers drawn from the general public of an urban area in the then Northern Province of South Africa. 59% reported having practised three out of four self-protective behaviours and 68% having practised all four other-protective behaviours in the preceding twelve months. Some evidence was found to support the fear-andvictimisation model, since one or more individual factors were related to each of the four self-protective behaviours and three of the four other-protective behaviours. Important gender and racial differences were also found

Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa

The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56–4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03–2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09–3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37–0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34–0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25–0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68–6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73–5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36–0.99), being on ART (OR = 0.48, 95% CI = 0.25–0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18–0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15–0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19–3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82–10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16–0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24–0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41–0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.Keywords: sexual risk behaviour, TB patients, health status, mental health, longitudinal study, South Afric

Conjoint alcohol and tobacco use among tuberculosis patients in public primary healthcare in South Africa

Objective. To determine the prevalence of, and factors associated with conjoint alcohol and tobacco use among tuberculosis (TB) patients in South Africa (SA). Methods. In a cross-sectional survey, 4 900 (54.5% men, 45.5% women) consecutively selected TB patients (including new TB and new TB retreatment patients) from 42 public primary care clinics in three districts in SA were assessed using various measures (including those for alcohol and tobacco use), within one month of anti-TB treatment. Results. Overall, 10.1% (15.5% among men; 3.4% among women) were conjointly hazardous, harmful or dependent alcohol users and daily or almost-daily tobacco users. The proportion of daily or almost-daily tobacco users among hazardous, harmful or dependent alcohol users was 48.9%, (53.3% among men; 26.4% among women). Those with hazardous, harmful or dependent alcohol use had significantly higher odds of having anxiety and/or depression (odds ratio (OR) 1.37; confidence interval (CI) 1.13 - 1.65) and exhibiting daily or almost-daily tobacco use (OR 5.94; CI 4.33 - 5.87). The mean ± standard deviation alcohol use disorders identification test (AUDIT) score among conjoint hazardous, harmful or dependent alcohol users and daily or almost-daily tobacco users was significantly higher (17.1±6.1) than among hazardous, harmful or dependent alcohol users who were not current tobacco users (15.4±5.6) (p<0.001). In multivariate analysis, male gender, coloured ethnicity, lower education and greater poverty, TB retreatment patient status and non-adherence to anti-TB medication were associated with a greater risk for conjoint alcohol and tobacco use. Conclusions. A high prevalence and several risk factors for conjoint alcohol and tobacco use were found among TB patients. The findings of this study call for dual-intervention approaches to alcohol and tobacco use

Seatbelt use among university students from 26 low-, middle- and high-income countries

The aim of this study was to estimate the prevalence of self-reported seatbelt use and sociodemographic, health risk behaviour and social-legal correlates among university students in 26 low-, middle- and high-income countries. Using anonymous questionnaires, data were collected from 16 770 undergraduate university students (mean age 20.9, SD=2.9) from 23 universities in 26 countries across Asia, Africa and the Americas. Results indicate that the percentage of university students reporting to be inconsistently using a seatbelt were 54.7% for all countries, 56.0% for men and 53.7% for women. In multivariate logistic regression, younger age, poorer family background, living in a low-income or lower-middle-income country, having no national seatbelt law or a law that does not apply to all occupants, poor attitudes towards seatbelt use, not always following the speed limit, having depressive symptoms, drug use, and low physical activity were associated with self-reported inconsistent seatbelt use. High selfreported inconsistent seatbelt use was found and several risk factors were identified which can be utilised in seatbelt use promotion programmes.Keywords: seatbelt use, traffic-related behaviour, health risk behaviour, depression, legislation, university students, multi-countr

Extent of alcohol use and mental health (depressive and post- traumatic stress disorder symptoms) in undergraduate univer- sity students from 26 low-, middle- and high-income countries

Objective. To estimate if there is a non-linear association between varying levels of alcohol use and poor mental health (depressive and post-traumatic stress disorder (PTSD) symptoms) in university students from low-, middle- and high-income countries.  Methods. Using anonymous questionnaires, data were collected from 19 238 undergraduate university students (mean age 20.8; standard deviation (SD) 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Alcohol use was assessed in terms of number of drinks in the past 2 weeks and number of drinks per episode, and measures of depression and PTSD symptoms were administered.  Results. The proportion of students with elevated depression scores was 12.3%, 16.9%, and 11.5% for non-drinkers, moderate drinkers, and heavy drinkers, respectively, while the proportion of students with high PTSD symptoms was 20.6%, 20.4% and 23.1% for non-drinkers, moderate drinkers, and heavy drinkers, respectively. Logistic regression found that non-drinkers and heavy drinkers had a lower odds than moderate drinkers to have severe depression, after adjusting for sociodemographic variables, social support and subjective health status. Further, heavy, more frequent drinkers and more frequent binge drinkers had a higher odds to have elevated PTSD symptoms than moderate and non-drinkers, after adjusting for sociodemographic variables, social support and subjective health status.  Conclusion. The results suggest a reverse U-shaped association between recent alcohol use volume and frequency and depressive symptoms (unlike that previously identified), and a J-shaped association between binge drinking frequency and depressive symptoms and alcohol use and PTSD symptoms

The prevalence and social determinants of fruit and vegetable consumption among adults in Kenya: a cross-sectional national population-based survey, 2015

Introduction:&nbsp;low fruit and vegetable consumption contributes significantly to the burden of disease. The study aimed to assess the prevalence and correlates of fruit and vegetable (FAV) consumption among adults in a national survey in Kenya. Methods:&nbsp;a national cross-sectional study based on a stratified cluster random sampling was conducted in 2015. The total sample included 4479 individuals 18-69 years, (females = 60.0%; median age 38.0 years, Inter Quartile Range 23) from Kenya. Sociodemographics, health risk behaviour and anthropometric data were collected using the WHO-STEPS questionnaire. Results:&nbsp;on average, participants had 0.78 servings of fruits a day, 1.31 servings of vegetables a day, and 2.09 servings of FAV. Only 12.4% of respondents had two or more servings of fruit a day, 7.4% had three or more servings of vegetables a day and 94.0% had less than five servings of FAV a day. In adjusted logistic regression analysis, higher education (Odds Ratio=OR: 1.68, Confidence Interval = CI: 1.18, 2.39), greater wealth (OR: 1.61, CI: 1.04, 2.48), and being a Kikuyu (OR: 2.17, CI: 1.46, 3.23) or Luo (OR: 1.58, CI: 1.05, 2.37) were associated with two or more servings of fruits daily. Urban residence (OR: 0.44, CI: 0.23, 0.82) and being male (OR: 0.72, CI: 0.53, 0.98) decreased the odds, and older age (OR: 1.68, CI: 1.05, 2.69) and being Luo (OR: 2.84, CI: 1.53, 5.27) increased the odds of having three or more servings of vegetables daily. Being male (OR: 0.71, CI: 0.52, 0.99) and being Luo (OR: 0.40, CI: 0.23, 0.70) decreased the odds and urban residence (OR: 2.50, CI: 1.27, 4.96) increased the odds of inadequate (&lt; five servings) FAV consumption. Conclusion:&nbsp;a high prevalence of inadequate FAV consumption was found, and risk factors identified, such as being female, lower education, urban residence, and not being Luo, that may help in guiding strategies to increase FAV consumption

Newspaper coverage of South African tobacco issues, 1997-2001

The purpose of this study was to investigate the way in which the tobacco issue has been framed in the mass media in South Africa. 363 South African newspaper articles published from January 1997 to December 2001 were analysed. Of the 224 articles finally selected for analysis, 100 were in line with the tobacco interest group and 124 supported the tobacco control group. The dominant frames used by the tobacco industry included “good product for the economy”, “concern about teenagers and youth”, “government’s role in reducing marketing visibility and destruction of jobs” and “discrimination and segregation”. The dominant frames used by the tobaccocontrol advocates included “death/diseases”, “innocent children”, “smokers in great danger”, “glamourisation of smoking; intentional lie”, “passive smokers’ rights” and “smoking areas”. A major finding is that the frames used by both the tobacco control movement and the tobacco industry have changed over time. The tobacco industry has been steadfast in consistently targeting core human values as its dominant framing tactic. The finding may have implications for developing more effective arguments for tobacco policies

Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand

ObjectivesThe purpose of this study was to assess the bidirectional association between multimorbidity (MM) and functional disability among middle-aged and older adults in a longitudinal study in Thailand.MethodsWe analyzed longitudinal data of participants aged 45 years and older from two consecutive waves (in 2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART). Functional disability was assessed with a 4-item activity of daily living (ADL) scale. Logistic regression analysis was conducted to assess the association between baseline functional disability and incident MM (≥2), and baseline morbidity and incident functional disability.ResultsThe results indicate that a total of 1,716 individuals without morbidity at baseline and 3,529 without functional disability at baseline were included. At follow-up, 16.7 and 20.0% of functional disability cases and 7.1 and 3.6% of nonfunctional disability cases developed 2 morbidities and 3 or more morbidities, respectively, and 6.6% of MM cases and 4.0% of non-MM cases developed a functional disability. In the final logistic regression model adjusted for education, income, age, marital status, sex, smoking tobacco, body mass index (BMI), alcohol use, physical activity, and social engagement, functional disability at baseline was positively associated with incident MM (≥2) (adjusted odds ratio [aOR]: 2.58, 95% CI: 1.42–4.72), and MM (≥3) at baseline was positively associated with incident functional disability (aOR: 1.97, 95% CI: 1.13–3.43).ConclusionMultimorbidity and functional disability were bidirectionally associated

HIV symptoms and health-related quality of life prior to initiation of HAART in a sample of HIV-positive South Africans.

This study investigates the relationship between current symptom status (no symptoms vs. symptoms present) and dimensions of health-related quality of life and overall quality of life (QoL) (poor vs. good) of 612 people living with HIV, just prior to initiating highly active antiretroviral therapy at three public hospitals in KwaZulu-Natal, South Africa. The mean number of symptoms reported on the day of interview was 8.4. Experiencing symptoms was most reported by patients in receipt of a disability grant, patients who did not have enough money to meet basic needs, who experienced negative feelings less, who had prayed in the last 6 months and who reported better QoL. Higher QoL was in turn associated with experiencing negative feelings less, praying, receiving a disability grant and having enough money to meet basic needs. Physical health and independence were important predictors of higher QoL for patients both with and without symptoms. Psychological health and spirituality may however mediate the effects of HIV symptoms and socioeconomic stressors