Risk factors for Coronavirus disease 2019 (Covid-19) death in a population cohort study from the Western Cape province, South Africa

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1)

Review of 30 years of longitudinal studies on the association between job insecurity and health and well-being: Is there causal evidence?

Objective In this review article, we present an overview of the results of longitudinal studies on the consequences of job insecurity for health and well-being. We discuss the evidence for normal causation (“Does job insecurity influence outcomes?”), reversed causation (“Do specific outcomes predict job insecurity?”), and reciprocal causation. We also review the various theories used to develop the hypotheses and whether theory has been used at all. Method Scientific and scholarly databases were searched to find all existing articles. We found 57 longitudinal studies published since 1987 in a variety of countries throughout the world. All articles were summarised in an encompassing table. Results The results show strong evidence for normal causation, in which job insecurity influences both psychological well-being and somatic health over time. The results were somewhat dependent on the type of outcome variable analysed, with clear evidence regarding exhaustion (burnout), general mental/psychological well-being, self-rated health, and a variety of somatic complaints. For aspects such as job satisfaction, work engagement, and psychosomatic complaints, the results suggested normal causation in one half to two thirds of the studies only. Reversed or reciprocal causation was rarely studied, and when studied, rarely found. Conclusions Job insecurity influences health and well-being over time, rather than the other way round. Limitations and suggestions for future research are discussed.status: publishe

Allometric equations for biomass and carbon pool estimation in short rotation Pinus radiata stands of the Western Cape, South Africa

19 Pág.The quantification of tree growth and carbon storage over time is an important task for sustainable forest management and carbon sequestration projects. For the South African short-rotation Pinus radiata (D. Don) forests, this knowledge is lacking. We developed allometric equations and compared the estimated weights to previously published biomass studies and we used Dirichlet Regression (DR) modelling to ensure additivity of the component proportions. The biomass components and their contribution to carbon storage depend strongly on forest structure and mean tree size but also on-site conditions and tree architecture. Our first two hypotheses were that the (1) best model for stemwood (SW), bark and total mass will include the combined variable DBH2H and (2) that the DR will yield statistically similar estimates for all components when compared to the best models. Our third hypothesis was that allometric equations developed for sites with high resource availability (e.g. wet, fertile sites) will yield biased estimates when extrapolated to sites with lower levels of resource availability (drier and/or infertile sites). The results indicated that DBH2H was the best variable to describe SW, bark and total mass and the DR yield similar estimates for all component proportions when compared to the best models. There were strong similarities in the SW and total mass of independent test sites in comparison to the SW and total mass of this study but greater variability in the bark, needle and branch mass. This can be associated to site and seasonal differences as well as variability in tree architecture brought about by different silvicultural operations on individual sites. Previously developed equations by other authors for sites with high resource availability overpredicted the SW and total mass of the models developed in this study. Our set of additive component equations performed well even when applied to sites of similar productivity over a climate gradient. The presented new equations bridge the gap in knowledge where allometric equations for short rotation Radiata pine stands are lacking.Open access funding provided by Stellenbosch University. This project was funded by the Marie Sklodowska Curie Skill-for.Action programme under Grant Agreement No. 956355.Peer reviewe

The Lenition and Deletion of Medial Voiced Obstruents in Afrikaans: Some Internal, External, and Extralinguistic Factors

In Afrikaans, medial /g/, /v/, and /d/ have often been lenited or deleted, sometimes giving rise to alternations or the restructuring of stem forms. After an analysis of the distribution of the processes, some of the morphological consequences are briefly sketched. In order to find out more about the determinants of the lenition or deletion processes, which do not seem to have applied exceptionlessly, a quantitative analysis of lexicographical data containing over 200 different items was carried out. A number of probabilistic phonological and grammatical conditions were uncovered that provided insight into the rule-typological status of the processes. The lenition or deletion of /d/ appears to be sensitive to usage frequency as well. Some of the exceptions are due to sporadic reborrowing from Dutch. Cape Dutch Pidgin, one of the two main roots of modern Afrikaans, developed as a result of contact between 17th-century Dutch settlers and Cape Khoekhoen, who spoke Nàmá. Properties of the Nàmá phonology suggest that at least in Cape Dutch Pidgin, the obstruents that were subject to the lenition and deletion processes in question constituted a natural class

Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa

Objectives: We aimed to compare the clinical severity of Omicron BA.4/BA.5 infection with BA.1 and earlier variant infections among laboratory-confirmed SARS-CoV-2 cases in the Western Cape, South Africa, using timing of infection to infer the lineage/variant causing infection. Methods: We included public sector patients aged ≥20 years with laboratory-confirmed COVID-19 between May 01-May 21, 2022 (BA.4/BA.5 wave) and equivalent previous wave periods. We compared the risk between waves of (i) death and (ii) severe hospitalization/death (all within 21 days of diagnosis) using Cox regression adjusted for demographics, comorbidities, admission pressure, vaccination, and previous infection. Results: Among 3793 patients from the BA.4/BA.5 wave and 190,836 patients from previous waves, the risk of severe hospitalization/death was similar in the BA.4/BA.5 and BA.1 waves (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.93; 1.34). Both Omicron waves had a lower risk of severe outcomes than previous waves. Previous infection (aHR 0.29, 95% CI 0.24; 0.36) and vaccination (aHR 0.17; 95% CI 0.07; 0.40 for at least three doses vs no vaccine) were protective. Conclusion: Disease severity was similar among diagnosed COVID-19 cases in the BA.4/BA.5 and BA.1 periods in the context of growing immunity against SARS-CoV-2 due to previous infection and vaccination, both of which were strongly protective

Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa.

OBJECTIVE: We aimed to compare clinical severity of Omicron BA.4/BA.5 infection with BA.1 and earlier variant infections among laboratory-confirmed SARS-CoV-2 cases in the Western Cape, South Africa, using timing of infection to infer the lineage/variant causing infection. METHODS: We included public sector patients aged ≥20 years with laboratory-confirmed COVID-19 between 1-21 May 2022 (BA.4/BA.5 wave) and equivalent prior wave periods. We compared the risk between waves of (i) death and (ii) severe hospitalization/death (all within 21 days of diagnosis) using Cox regression adjusted for demographics, comorbidities, admission pressure, vaccination and prior infection. RESULTS: Among 3,793 patients from the BA.4/BA.5 wave and 190,836 patients from previous waves the risk of severe hospitalization/death was similar in the BA.4/BA.5 and BA.1 waves (adjusted hazard ratio (aHR) 1.12; 95% confidence interval (CI) 0.93; 1.34). Both Omicron waves had lower risk of severe outcomes than previous waves. Prior infection (aHR 0.29, 95% CI 0.24; 0.36) and vaccination (aHR 0.17; 95% CI 0.07; 0.40 for at least 3 doses vs. no vaccine) were protective. CONCLUSION: Disease severity was similar amongst diagnosed COVID-19 cases in the BA.4/BA.5 and BA.1 periods in the context of growing immunity against SARS-CoV-2 due to prior infection and vaccination, both of which were strongly protective