An Exploration into the Determinants of Noncommunicable Diseases Among Rural-to-Urban Migrants in Periurban South Africa

Introduction Noncommunicable diseases are increasing in developing countries, exacerbated by growing urbanization. We examined the experiences and perceptions about noncommunicable diseases of people who migrated from rural areas to urban Cape Town, South Africa. Methods We conducted a qualitative study in an impoverished periurban township that has a noncommunicable disease prevention program, including health clubs. We used in-depth interviews, participatory reflection and action groups, and focus group discussions. Results Participants described changes in eating patterns and levels of physical activity. These changes were a result of socioeconomic and environmental constraints. However, respondents were not concerned about these changes. Despite hardships, they were pleased with their urban lifestyle. Furthermore, they approved of their weight gain because it signified dignity and respect. Participants who attended health clubs found them informative and socially and emotionally supportive. Conclusion The study highlighted the complexity of the risk factors for noncommunicable diseases and the need to develop prevention strategies that extend beyond the traditional focus on diet and exercise.Medical Research Council of South Africa, Tygerberg, and partly by the National Research Foundation and the University of the Western Cap

Perceptions about body image and sizes among Black African girls living in Cape Town

OBJECTIVE: To assess beliefs about body size (fatness and thinness) and body image in Black girls aged 10–18 years living in Cape Town. DESIGN: Exploratory using qualitative methods. SETTING: Cape Town, South Africa. METHOD: Participants were Black African girls (n5240), aged 10–18 years, who attended 5 primary and 6 high schools in Black townships in Cape Town. The schools and the girls were randomly selected. This paper presents qualitative data from 6 focus groups among 60 girls regarding their beliefs about thinness and fatness, and the advantages and disadvantages of being overweight or thin. RESULTS: Beliefs regarding body image indicate that two thirds of the girls perceived fatness as a sign of happiness and wealth. Socially, fatness was accepted but one third of the girls had contradictory views about its advantages. Among obese girls who believed that being obese was preferable, the dominant reasons were that being fat allowed one to engage in sport activities that need strength and also makes one look respectable. On the other hand fatness was viewed as associated with diseases such as diabetes and hypertension and with increased difficulty in finding appropriate clothing sizes. Three quarters of the girls associated thinness with ill health particularly HIV and AIDS and tuberculosis. An advantage of thinness was being less prone to develop chronic non-communicable diseases. CONCLUSION: The study shows that opinions and beliefs about body image start in adolescence. It is therefore important to consider these perceptions when designing interventions for preventing obesity and other chronic non-communicable diseases during early childhoo

Chronic non-communicable diseases

This chapter will examine the current actions, including lifestyle measures, for the prevention and management of non-communicable diseases within a South African context. It will also focus on the biological, behavioural and social determinants of health. Interventions and initiatives directed at primary, secondary and tertiary prevention of chronic non-communicable diseases are also discussed. This chapter ends with recommended lifestyle changes, which can be taken to influence the adoption of healthy lifestyles, and therefore reduce the risks for chronic non-communicable diseases.Non

A Case Study of Community-Level Intervention for Non-Communicable Diseases in Khayelitsha, Cape Town

Non-communicable diseases (NCDs) have become a major cause of mortality globally, but especially in low and middle-income countries (LMIC), where nearly 80 per cent of all NCD related deaths occur. There has been a growing interest in tackling the burden of NCDs in South Africa. In September 2011, the South African government convened a summit on the ‘Prevention and Control of Non-Communicable Diseases’ which produced a declaration that endorsed action aimed at various levels of risk factors, i.e. behavioural, environmental and structural, and further acknowledged the need for intersectoral collaboration. This case study looks at the town of Khayelitsha in South Africa, focusing in particular on the health of women and girls in a rapidly urbanising setting. It outlines the intervention as it was implemented in stages between 2001–2005. Further sections report on the interviews that were conducted, discuss the interview data and reflect upon the implications for the current policy plans for addresses the burden of NCDs in South Africa. It then concludes with a view to future interventions to address the NCD burden, specifically for women and girls, in contexts like Khayelitsha.DFI

The roles of community health workers in management of non-communicable diseases in an urban township

BACKGROUND: Community health workers (CHWs) are increasingly being recognised as a crucial part of the health workforce in South Africa and other parts of the world. CHWs have taken on a variety of roles, including community empowerment, provision of services and linking communities with health facilities. Their roles are better understood in the areas of maternal and child health and infectious diseases (HIV infection, malaria and tuberculosis). AIM: This study seeks to explore the current roles of CHWs working with non-communicable diseases (NCDs). Setting: The study was conducted in an urban township in Cape Town, South Africa. Method: A qualitative naturalistic research design utilising observations and in-depth interviews with CHWs and their supervisors working in Khayelitsha was used. Results: CHWs have multiple roles in the care of NCDs. They act as health educators, advisors, rehabilitation workers and support group facilitators. They further screen for complications of illness and assist community members to navigate the health system. These roles are shaped both by expectations of the health system and in response to community needs. CONCLUSION: This study indicates the complexities of the roles of CHWs working with NCDs. Understanding the actual roles of CHWs provides insights into not only the competencies required to enable them to fulfil their daily functions, but also the type of training required to fill the present gaps. Introduction Community health workers (CHWs) are increasingly being recognised as a crucial part of the health workforce.1 In South Africa and worldwide, CHWs have provided health care to communities for many decades and have assumed a variety of roles, including communityWeb of Scienc

Development of an integrated model of care for use by community health workers working with chronic non-communicable diseases in Khayelitsha, South Africa

Philosophiae Doctor - PhDNon-communicable diseases (NCD) continue to be a public health concern globally and contribute to the burden of disease. The formal health system in developing countries lacks the capacity to deal with these NCD as it is overburdened by communicable diseases. Thus, community health workers (CHWs) have been suggested as a solution for alleviating the burden for primary health facilities, by extending NCD care to the community. This thesis aims to develop an integrated model of care for CHWs working with patients with non-communicable diseases by describing and exploring current CHW roles, knowledge and practices in relation to community-based NCD care. The specific objectives for this study included 1) the exploration of the NCD roles of generalist CHWs in the context of a limited resource urban setting; 2) determining the NCD-related knowledge of CHWs, and factors influencing this in a limited resource urban setting and 3) a comparison of actual and envisaged roles in the management and prevention of NCD using the integrated chronic diseases management model (ICDM) as a benchmark, and propose key competencies and systems support for NCD functions of CHWs in South Africa Mixed methods were used to achieve the objectives of this study. First, a qualitative enquiry was conducted using observations to respond to the first objective. A quantitative cross-sectional design was then used to achieve the second objective, and a questionnaire was used to interview CHWs. A comparison of findings from both the quantitative and qualitative studies with policy guidelines was undertaken to address the third objective

Mn-Doped ZnSe Quantum Dots as Fluorimetric Mercury Sensor

Quantum dots (QDs), because of their exciting optical properties, have been explored as alternative fluorescent sensors to conventional organic fluorophores which are routinely employed for the detection of various analytes via fluorometry. QD probes can detect toxic metal ions, anions, organic molecules with good selectivity and sensitivity. This chapter investigates the synthesis of Mn-doped ZnSe QDs using nucleation-doping strategy. The as-synthesized QDs were characterized by various analytical tools such as ultraviolet-visible (UV-vis) absorption, photoluminescence (PL) spectroscopy, X-ray diffractometry (XRD) and transmission electron microscopy (TEM). It was found that Mn doping of QDs significantly increases the PL intensity. The PL of the resulting QDs was examined in the presence of different metal ions to check its selective response. Among the various metal ions, Hg2+ exhibits a drastic quenching of the QD’s emission intensity. A Stern-Volmer plot of [Hg2+] sensing using the as-synthesized QDs showed linearity in the range of 0–30 × 10−6 ML−1 with the regression coefficient R2 = 0.99. The detection limit was found to be 6.63 × 10−7 ML−1. Thus, the present Mn-doped ZnSe QDs represent a simple, non-toxic fluorescent probe for the qualitative and quantitative detection of mercury ions in aqueous samples

Application of Quantum Dots in Lateral Flow Immunoassays: Non-Communicable and Communicable Diseases

Quantum Dots (QDs) are ideal fluorescent labels for lateral flow assays (LFA) due to their unique optical properties and resistance to chemical and photo-degradation. Lateral flow assay, known as immunochromatography test, is a diagnostic strip test that uses paper or membrane-based devices to detect the presence/absence of an analyte with the pregnancy test, the most known LFA. Diagnostic tools for non-communicable (NCDs) and communicable diseases (CDs) are available. However, other NCDs and CDs do not have LFAs as first-line diagnosis/point-of-care. QDs are promising fluorescent labels as they improve the LFA’s colourimetric sensitivity and fluorescence stability. This chapter discusses the tailoring and application of QDs in LFA. Particular focus on the applications of QDs in LFA for detecting or screening NCDs (i.e. cancers etc.) and CDs (i.e. SARS-CoV-2, HIV/AIDs etc.).The book chapter concludes by discussing different challenges and perspectives of QDs in LFA

The treatment ambassador program: a highly acceptable and feasible community-based peer intervention for South Africans living with HIV who delay or discontinue antiretroviral therapy

We conducted a novel pilot randomized controlled trial of the Treatment Ambassador Program (TAP), an 8-session, peerbased, behavioral intervention for people with HIV (PWH) in South Africa not on antiretroviral therapy (ART). PWH (43 intervention, 41 controls) completed baseline, 3- and 6-month assessments. TAP was highly feasible (90% completion), with peer counselors demonstrating good intervention fdelity. Post-intervention interviews showed high acceptability of TAP and counselors, who supported autonomy, assisted with clinical navigation, and provided psychosocial support. Intentionto-treat analyses indicated increased ART initiation by 3 months in the intervention vs. control arm (12.2% [5/41] vs. 2.3% [1/43], Fisher exact p-value=0.105; Cohen’s h=0.41). Among those previously on ART (of for>6 months), 33.3% initiated ART by 3 months in the intervention vs. 14.3% in the control arm (Cohen’s h=0.45). Results suggest that TAP was highly acceptable and feasible among PWH not on ART

Association between selected food purchase practices, physical activity and sociodemographic factors among people living in a low socioeconomic periurban and rural area of South Africa

This study examined the association between sociodemographic factors, Physical Activity (PA) engagement, and the selected Food Purchasing Practices (FPP) among people living in a low socioeconomic peri-urban and rural area of two provinces of South Africa. Four hundred participants were randomly selected from two communities, a township in Cape Town and a rural community in the Eastern Cape where the Prospective Urban and Rural Epidemiological (PURE) study was implemented. Data collected included socio-demographic characteristics, FPP and PA. Logistic regressions were performed to identify the associations between sociodemographic factors, PA involvement and selected FPP, and Odds Ratios (OR) were calculated with 95% Confidence Intervals (CIs). All statistical tests were two-tailed at p<0.0