A study protocol to determine heat-related health impacts among primary chsoolchildren in South Africa

Abstract:Climate models predict that the global average temperature of Earth will rise in the future. Studies show that high classroom temperatures can affect the ability of the student to learn and function. It is important to understand the impact that heat will have on the health, wellbeing, and academic performance of learners, as they spend a significant amount of time in classrooms compared to any other environment. A follow-up panel study among 20 public primary schools in the Gauteng province (South Africa) will be carried out, in which Grade 4 learners will be selected to complete an hourly heat-health symptom questionnaire. A Cambridge Neuropsychological Test Automated Battery (CANTAB) test will be used to determine their memory and attention span. A nursing practitioner will measure body weight, height, and temperature. Lascar data loggers will beusedtomeasureindoorclassroomtemperature. Schoolprincipalswillcompleteaquestionnaireon existing school coping mechanisms and policies in place that help deal with hot weather conditions. This is the first study to quantitatively assess the effects of heat on learners’ health, well-being and school performance in South Africa. The outcomes of this study will enable policymakers and public officials to develop appropriate school heat adaptation and mitigation measures and will assist in channeling their resources where it is most needed

Indoor and outdoor NO2 and SO2 levels in 13 randomly selected preschools from 7 districts in Mpumalanga Province, South Africa

DATA AVAILABILITY STATEMENT : We did not receive ethics approval to share raw field data publicly. The data belong to the University of Pretoria (UP). The raw data analysed in the current study are available from UP on reasonable request.Please read abstract in the article.South African Medical Research Council's Division of Research Capacity Development, specifically through the Bongani Mayosi National Health Scholars Programme; the Public Health Enhancement Fund, South African National Department of Health.https://wileyonlinelibrary.com/journal/puh2hj2024Human NutritionSchool of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-beingSDG-11:Sustainable cities and communitie

Allergic rhinitis, rhinoconjunctivitis and hayfever symptoms among children are associated with frequency of truck traffic near residences : a cross sectional study

BACKGROUND : Allergic rhinitis (AR) is an increasing and common condition affecting many people globally, especially children. The aim of the study was to investigate the association between the frequency of truck traffic and allergic rhinitis symptoms, rhinoconjunctivitis and hayfever among 13 to 14 year old school children in Ekurhuleni Metropolitan Municipality, Gauteng Province, South Africa. METHODS : In a cross-sectional study design, 3764 children from 16 randomly selected high schools were eligible to participate, 3468 completed the International Study of Asthma and Allergies in Childhood (ISAAC) Phase I questionnaire of which 3424 were suitable for analysis; the overall response rate was 92 %. Data were analysed using multilevel logistic regression analysis. RESULTS : The prevalence of self-reported rhinitis ever, current rhinitis rhinoconjunctivitis and hayfever was 52, 40, 21 and 37 % respectively. Rhinitis ever, current rhinitis and current rhinoconjunctivitis were significantly associated with the frequency of trucks passing near residences almost all day on weekdays, (OR 1.46 95 % CI: 1.16 − 1.84), (OR 1.60 95 % CI: 1.24–2.02) and (OR 1.42 95 % CI: 1.09–1.84) respectively. No association was observed between truck traffic and hay fever in the multiple analyses. CONCLUSION : The study shows a high prevalence of allergic rhinitis symptoms amongst children. The results support the hypothesis that traffic related pollution plays a role in the prevalence of allergic rhinitis symptoms in children residing in the area.The University of Pretoria, Tshwane University of Technology, Medical Research Council and the National Research Foundation.http://www.ehjournal.netam201

Association between wheeze and selected air pollution sources in an air pollution priority area in South Africa : a cross-sectional study

BACKGROUND: An association between wheeze (a symptom of asthma) and environmental tobacco smoke (ETS), types of fuel used for residential heating or cooking and the frequency of trucks passing near homes, has been reported mainly in developed countries. Little is known about the strength of such associations in developing countries. This study was conducted in residential areas situated in Ekurhuleni Metropolitan Municipality, namely Tembisa and Kempton Park, which form part of the Highveld region, a priority area in terms of air pollution in South Africa. METHODS: From 3764 eligible school children, aged between 13 and 14 years, from 16 selected high schools in the study area, 3468 completed a modified questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC). Data were analysed using multiple logistic regression models. RESULTS: The results are based on data from 3424 children. In the adjusted models, exposure to ETS at school was associated with wheeze ever (OR 1.22 95% CI: 1.03 − 1.45) and current wheeze (OR 1.33 95% CI: 1.08 − 1.64). When gas was most frequently used for residential heating the likelihood of wheeze ever increased by 47% (OR 1.47 95% CI: 1.15 − 1.88). Trucks passing near homes for almost the whole day during weekdays, increased the likelihood of wheeze ever (OR 1.32 95% CI: 1.01 − 1.73), current wheeze (OR 1.61 95% CI: 1.15 − 2.24) and current severe wheeze (OR 2.22 95% CI: 1.28 − 3.77). When data were stratified according to residential area, for children living in Tembisa, ETS exposure at home was associated with current wheeze (OR 1.36 95% CI: 1.06 − 1.77); gas most frequently used for residential heating was associated with wheeze ever (OR 1.68 95% CI: 1.23 − 2.28) and current wheeze (OR 1.61 95% CI: 1.08 − 2.39); paraffin most frequently used for residential heating was associated with current severe wheeze (OR 1.85 95% CI: 1.04 − 3.28). CONCLUSION: It was concluded that children living in one of the air pollution priority areas of South Africa, have an increased risk of wheezing due to exposure to both indoor and outdoor air pollution sources.The University of Pretoria, Tshwane University of Technology, Medical Research Council and the National Research Foundation.http://www.ehjournal.net/content/13/1/32am201

Environmental tobacco smoke and the risk of eczema symptoms among school children in South Africa : a cross-sectional study

OBJECTIVE : The aim of this study was to investigate the association between eczema ever (EE) and current eczema symptoms (ES) in relation to exposure to environmental tobacco smoke (ETS). DESIGN : A cross-sectional study using the International Study of Asthma and Allergies in Childhood questionnaire. SETTING : 16 schools were randomly selected from two neighbourhoods situated in Ekurhuleni Metropolitan Municipality, Gauteng Province, South Africa. PARTICIPANTS : From a total population of 3764 school children aged 12–14 years, 3468 completed the questionnaire (92% response rate). A total of 3424 questionnaires were included in the final data analysis. PRIMARY OUTCOME : The prevalence of EE and current ES was the primary outcome in this study. RESULTS : Data were analysed using Multilevel Logistic Regression Analysis (MLRA). The likelihood of EE was increased by exposure to ETS at home (OR 1.30 95% CI 1.01 to 1.67) and at school (OR 1.26 95% CI 1.00 to 1.60). The likelihood of EE was lower for males (OR 0.66 95% CI 0.51 to 0.84). The likelihood of ES was increased by ETS at home (OR 1.93 95% CI 1.43 to 2.59) and school (1.44 95% CI 1.09 to 1.90). The likelihood of ES was again lower for males (OR 0.56 95% CI 0.42 to 0.76). Smoking by mother/female guardian increased the likelihood of EE and ES, however, this was not significant in the multivariate analysis. CONCLUSIONS : Symptoms of eczema were positively associated with exposure to ETS at home and school. The results support the hypothesis that ETS is an important factor in understanding the occurrence of eczema.Tshwane University of Technology, South Africa, Medical Research Council, South Africa and the National Research Foundation, South Africa (grant number TTK20110725000021950).http://bmjopen.bmj.comam201

Prevalence of asthma and wheeze among preschool and school-aged children in Africa : a meta-analysis

DATA AVAILABILITY STATEMENT : We did not receive ethics approval to share raw field data publicly. The data belong to the University of Pretoria (UP). The raw data analyzed in the current study are available from UP on reasonable request.Please read abstract in the article.Bongani Mayosi National Health Scholars Programme; Public Health Enhancement Fund; South African National Department of Health; South African Medical Research Council.https://wileyonlinelibrary.com/journal/puh2hj2024Human NutritionSchool of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Knowledge, attitude and practices on notifiable diseases among environmental health practitioners in the City of Johannesburg

BACKGROUND : Notifiable diseases, a public health challenge in low- and middle-income countries, require mandatory reporting and play a significant role in disease prevention and control. Environmental health practitioners are responsible for reporting and investigating notifiable diseases. AIM : The study aimed to assess the knowledge, attitude and practices on notifiable diseases among environmental health practitioners within a metropolitan municipality. SETTING : The study was conducted in the seven regions of the City of Johannesburg in Gauteng province, South Africa. METHODS : A cross-sectional and descriptive study was used. One hundred and thirty-five participants were randomly sampled. The data were collected using a semi-structured questionnaire and analysed using version 27 of the Statistical Package for the Social Sciences (SPSS) software. All ethical considerations such as permissions, ethical clearance and informed consent were observed throughout the study. RESULTS : The majority of participants (n = 64; 47.4%) were aged between 30 and 39 years and had a BTech/Honours degree (n = 106; 78.5%). A total of 106 (78.5%) participants had received formal training, while 83.7% (n = 113) of the participants understood notifiable diseases. Years of experience had a significant negative correlation with the ‘need to report notifiable diseases’ (r = -0.193; p = 0.025). CONCLUSION : The results could facilitate a knowledge improvement programme that includes a structured training programme and standard operating procedures. The study results cannot be generalised to the whole country; hence, the recommendation of a national survey on similar phenomena should be considered. CONTRIBUTION : The study findings could assist in improving the role of environmental health services in reporting and investigating notifiable diseases.https://www.hsag.co.zaam2023School of Health Systems and Public Health (SHSPH

Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa

DATA AVAILABITY STATEMENT: Data supporting the findings of this study are available from the corresponding author, T.C., on request.BACKGROUND: Zimbabwean undocumented migrants rely on the South African public health care system for treatment of non-communicable and communicable diseases, surgery and medical emergency services. A gap remains to understand undocumented migrant experiences at a time when accessing public healthcare has been topical in South Africa. AIM: This article aimed to describe and understand the experiences, challenges and health seeking alternatives of undocumented Zimbabwean migrants in accessing healthcare services in Nellmapius in Pretoria. SETTING: The study was conducted at Nellmapius in Pretoria. METHODS: A qualitative descriptive research design was used. Structured interviews with 13 undocumented migrants were conducted by applying purposive and snowballing sampling techniques. The data were thematically analysed. RESULTS: Migrants reported that the attitudes by healthcare officials suggest unwillingness to provide services to undocumented migrants, aggravating their vulnerability and perennial illness. Migrants faced challenges of discrimination, a lack of professional service delivery, a lack of financial capacity to pay for services and a lack of documentation evoking health seeking alternatives. CONCLUSION: Migrants continue to face challenges while accessing subsidised health care. This study confirms that medical xenophobia is generally present in the public health care centres, at least for the sampled undocumented Zimbabwean migrants. The majority of undocumented migrants cannot afford to pay for private healthcare. CONTRIBUTION: The findings of this study inform national, provincial and local healthcare facilities to be ethical and provide dignified quality healthcare to undocumented migrants in line with international practices.https://phcfm.org/index.php/phcfmSchool of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-beingSDG-10:Reduces inequalitiesSDG-16:Peace,justice and strong institution

Perceptions and attitudes of black men in a rural district of South Africa towards depression and its treatment

BACKGROUND : Depression is a major contributor to the overall global burden of disease, impacting social life, family life and occupational functioning if left untreated. Despite its high prevalence and morbidity, the evidence suggests that men are hesitant to seek help, with a large percentage remaining undiagnosed. This study aimed to determine the attitudes and perceptions related to depression and its treatment amongst black men in a rural district of South Africa. METHODS : The design used was an exploratory descriptive qualitative design. Participants were selected by purposive sampling. Individual semistructured interviews were conducted, which were audio-recorded and transcribed verbatim. The data were subsequently analysed thematically to develop themes and subthemes. RESULTS : Participants described depression as a psychological problem associated with lack of sleep, loneliness, feeling unwanted, increased stress, deep sadness, weight loss, forgetfulness, crying over small things and lack of concentration. Collectively, the interviews with participants showed a good understanding of the psychosocial determinants of depression but exposed a lack of awareness of its biological determinants. A large proportion (n = 13; 68.4%) of participants reported not having knowledge of available services in their area for people seeking treatment for depression. Barriers to help-seeking behaviours were fear of social stigma, fear of expressing their feelings, gender norms and stereotypes and lack of trust in others. CONCLUSION : Interventions such as support groups and mental health awareness programmes to counteract personal perceptions may help to improve and expand the effectiveness of depression treatment. The results highlight the future need to raise awareness of depressive symptoms and expand health outreach programmes.https://www.safpj.co.zaam2023School of Health Systems and Public Health (SHSPH

Inhalation health risk assessment of ambient PM2.5 and associated trace elements in Cape Town, South Africa

This manuscript was part of the Ph.D. project of Anna Alfeus. Prof Janine Wichmann and Dr. Joyce Shirinde supervised the Ph.D. thesis.DATA AVAILABILITY : The authors are working on other manuscripts with the data, hence the data is not available to the public.Please read abstract in article.The University of Pretoria doctoral bursary, University of Namibia Staff Development office, the AGNES grant office and analysis funding with an NRF grant.https://www.tandfonline.com/loi/bher20hj2023School of Health Systems and Public Health (SHSPH