Helmet use and associated factors among motorcyclists in the Association of Southeast Asian Nations: Prevalence and effect of interventions

The Association of Southeast Asian Nations (ASEAN) is a collaborative group of 10 countries (Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, Vietnam) located in South-East Asia. In most ASEAN countries, the majority of road users are motorcyclists. Globally, among the 20 countries with the greatest rate of motorcycle deaths per 100,000 population, six ASEAN countries are included. A review found that across ASEAN countries, a significant proportion of motorcycle drivers did not wear a helmet; this ranged from 11–20% in Indonesia, 35–66% in Cambodia, 25–97% in Laos, 24.2–67.2% in Malaysia, 44.2%–56.3% in Thailand, and 10–70.1% in Vietnam, while rates of non-use of helmets were higher in motorcycle passengers, ranging from 25% in Vietnam, 38.1% in Malaysia, 48–80% in Indonesia, 72–81% in Thailand, and 91% in Cambodia. The effect of the introduction of helmetuse legislation for drivers and passengers was evaluated in Thailand and Vietnam, and in both evaluations, significant increases in helmet use were found compared to prior the legislation in both countries. Multisectoral or community intervention programmes in localised areas and schools in Laos and Thailand also lead to significant increases in motorcycle helmet use. The effectiveness of the enforcement of helmet laws in ASEAN countries was rated an average of 7.2 (on a scale of 0 to 10, where 0 is not effective at all and 10 is highly effective), with the lowest (5) in Malaysia and the highest (10) in Brunei Duressalam. Stricter enforcement of mandatory helmet laws for two-wheeler riders (both drivers and pillion-riders) are needed. Keywords: helmet use, motorcycle, prevalence, interventions, Southeast Asia

The severity of violence against women by intimate partners and associations with perpetrator alcohol and drug use in the Vhembe district, South Africa

Substance use is cited as a major contributing factor to intimate partner violence in South Africa. The aim of the study was to assess the association between the frequency and severity of several types of intimate partner violence against women, who have been granted a protection order, and the use of alcohol and illicit drug use by perpetrators. Using systematic sampling, 268 women (18 years and older), who had consecutively received a protection order in the Vhembe district in South Africa, were assessed by a research assistant. The results indicate that these women reported perpetrators 34% of whom did not have a drinking problem and no drug use in the past three months, 31.3% with problem drinking only, 4.1% drug use only, and 30.6% with problem drinking and drug use in the past three months. Multivariate logistic regression found that having a partner with problem drinking only (OR = 4.14, CI = 2.02–8.51) and having a partner with problem drinking and drug use (OR = 2.77, CI = 1.36–5.65) were associated with greater physical intimate partner violence. Having a partner with problem drinking and drug use (OR = 2.80, CI = 1.35–5.79) was associated with an increased psychological intimate partner abuse. Problem drinking and drug use among male partners is a strong determinant of physical intimate partner violence among battered women in South Africa. Intimate partner violence prevention measures should address reduction of problem drinking and drug use among men.Keywords: physical violence, psychological abuse, stalking, intimate partner, problem drinking, drug use, South Afric

Knowledge, attitudes and management of alcohol problems in general practice in rural South Africa

Background: There has been increasing emphasis on the role of primary health care in the prevention and management of alcohol-related harm. The aim of this study was to determine attitudes to and management of alcohol problems in general practice in rural South Africa. Methods: A total of 61 general practitioners (GPs) were interviewed with the aid of a structured questionnaire (response rate 50%) in two rural districts. Results: The results indicate that 51% of the GPs felt that alcohol is an important issue in general practice. GPs were able to discriminate accurately between cases of problem drinking and alcohol dependence. GPs who reported high levels of alcohol-related education and training were more prepared to counsel problem drinkers, expressed more therapeutic commitment in their role and reported more appropriate management of these patients than did GPs with lower levels of Continuing Medical Education (CME) experience. Alcohol problems are recognised as an important problem in general practice, and improved training could increase the identification and management of alcohol problems in primary care. GPs rated the most critical barriers to alcohol interventions as competency training, role endorsement, not being adequately reimbursed, health policy not supporting prevention and their own alcohol problem. Conclusion: Alcohol problems are recognised as an important problem in general practice, and improved training, adequate reimbursement and health policy support could increase the identification and management of alcohol problems in primary care. South African Family Practice Vol. 50 (1) 2008: pp. 66-66

HIV counselling and testing utilisation and attitudes of male inmates in a South African prison

The Department of Correctional Services Policy on the management of HIV and AIDS for offenders include voluntary counselling and testing (VCT) for HIV as one of the priorities in the rehabilitation of inmates. The aim of this study was to determine factors associated with the utilisation of VCT services in the correctional centres in terms of level of satisfaction, their experiences and expectations, and motivating factors and barriers for VCT utilisation at Losperfontein Correctional Centre, South Africa. This was a case control study (cases being those who underwent testing and controls those who did not) examining predictors of HIV VCT utilisation among 200male adult sentenced inmates serving medium and maximum sentences. Results indicate that a poor health system (OR=0.34, 95%CI:0.23 - 0.50) was inversely associated with HIV testing acceptance in prison, while age, educational level, population group, marital status, length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of the participants (50%) agreed that VCT services are accessible and are promoted at their correctional centre. Most were satisfied with different components of VCT services, ranging from 79% (fair to very good) for ‘the way he/she received you’ to 62% ‘clarified all your concerns’. This study demonstrated some challenges and benefits to the field of health promotion and HIV prevention in the correctionalcentres especially with regard to VCT services

The association of nutrition behaviors and physical activity with general and central obesity in Caribbean undergraduate students

Objective. To quantify the prevalence of obesity and obesity-related factors in a cross-sectional, observational study of Caribbean students using the results of three recent surveys of health behavior among undergraduates in Barbados, Grenada, and Jamaica. Methods. A total of 1578 Caribbean undergraduate students from Barbados, Grenada, and Jamaica (ages 18.30 years) completed questionnaires and had physical measurements recorded. Multivariable logistic regression was used to estimate odds ratios (ORs) for the association of nutrition behaviors with prevalence of obesity (body mass index ≥ 30 kg/m2); elevated waist-to-height ratio (W/ht) (> 0.50); and high waist circumference (WC) (> 88 cm in females, > 102 cm in males). Models were adjusted for age, year in university, socioeconomic status, and sex. Results. There was a higher prevalence of obesity (13% versus 10%), high WC (21% versus 7%), and high W/ht (35% versus 25%) in females relative to males. Compared to females, males had reduced odds of obesity (OR 0.46), high WC (OR 0.22), and high W/ht (OR 0.61) (P < 0.05 for all). Both females (46%) and males (24%) reported high levels of physical inactivity. Fruit and vegetable consumption was low (approximately two servings per day). Many students reported avoiding fatty foods (40%); this behavior was associated with high W/ht (OR 1.68), obesity (OR 1.90), and high WC (OR 1.82) (P < 0.05 for all). Irregular breakfast consumption, age, and year of study were also positively associated with obesity. Physical activity was not significantly associated with any obesity measure. Conclusions. There was a low prevalence of healthy behaviors and a high prevalence of obesity in this sample of Caribbean young adults

Efficacy of a church-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members: a randomized controlled trial in Pretoria, South Africa

BACKGROUND: In persons 15 years and above in South Africa the prevalence of pre-diabetes and diabetes has been estimated at 9.1% and 9.6%, respectively, and the prevalence of systolic prehypertension and hypertension, 38.2% and 24.6%, respectively. Elevated blood glucose and elevated blood pressure are prototype of preventable chronic cardiovascular disease risk factors. Lifestyle interventions have been shown to control high normal blood pressure and/or high normal blood glucose. METHODS/DESIGN: This study proposes to evaluate the efficacy of a community (church)-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members in a randomized controlled trial in Gauteng, South Africa. The objectives are to: (1) measure non-communicable diseases profile, including hypertension and diabetes, health behaviours, weight management and psychological distress of church members; (2) measure the reduction of blood glucose and blood pressure levels after the intervention; (3) prevent the development of impaired glucose tolerance; (4) compare health behaviours, weight management and psychological distress, blood glucose and blood pressure levels between intervention and control groups, and within group during 6, 12, 24 and 36 months during and post intervention. The study will use a group-randomized design, recruiting 300 church members from 12 churches. Churches will be randomly assigned to experimental and control conditions. DISCUSSION: Lifestyle interventions may prevent from the development of high blood pressure and/or diabetes. The findings will impact public health and will enable the health ministry to formulate policy related to lifestyle interventions to control blood pressure and glucose. TRIAL REGISTRATION NUMBER: PACTR20110500029715