Headship of older persons in the context of HIV/AIDS in rural South Africa

This paper examines older persons’ positions as heads of households in the Agincourt sub-district of Mpumalanga Province, South Africa. Older people’s access to non-contributory pensions in a context of AIDS-related chronic illness and premature death might increase their household responsibilities which, in turn, may be manifested in higher rates of household headship. We use descriptive analysis to outline the traits of household heads, compare household characteristics, in particular recent mortality experience, across headship types (male/female, pre/ post-pension eligibility). While some significant differences in household composition exist across headship types, older persons were no more likely to be heading households with a HIV/AIDS-related death over the 2000-2005 period—prior to extensive antiretroviral (ARV) rollout. This provides an important starting point for further investigations aimed at understanding the impact of HIV/AIDS on older persons’ lives, and as a baseline for measuring the effects of ARV rollout on older persons’ status in AIDS-endemic communities

The implications of long term community involvement for the production and circulation of population knowledge

Demographic surveillance systems (DSS) depend on community acceptance and involvement to produce high quality longitudinal data. Ensuring community support also exposes power relations usually concealed in the research process. We discuss the Agincourt Health and Demographic Surveillance System in South Africa to argue that: 1) long-term presence and community involvement contribute to high response rates and data quality, 2) to maintain community support the project must demonstrate its usefulness, 3) reporting to community members provides valuable checks on the local relevance and comprehension of questions, and 4) community opinion can modify both wording and content of research questions.community, demographic surveillance system, fertility, health, knowledge, longitudinal, migration, mortality, South Africa

"One hand does not bring up a child:" Child fostering among single mothers in Nairobi slums

Background: Childrearing in sub-Saharan Africa is often viewed as collaborative, where children benefit from support from kin. For single mothers living in informal settlements, kin networks may be highly dispersed and offer little day-to-day childrearing support, but may provide opportunities for child fostering. Objective: Our study uses a linked lives approach, where single mothers' connections with kin and romantic partners may influence whether - and what type of - kin are relied on to support child fostering. Methods: We leverage an innovative survey on the kin networks of 404 single mothers and 741 children, collected in 2016, and 41 in-depth interviews conducted in 2011 and 2013, to explore fostering among single mothers in Korogocho and Viwandani, two slums in Nairobi, Kenya. Results: Quantitative findings show 6.2Š of single mothers' children are fostered, with provision of emotional support associated with lower likelihood of fostering. Both quantitative and qualitative results reflect strong reliance on maternal kin. Maternal kin play a key role in fostering to protect children, to fulfill traditional lineage obligations, and due to their willingness to foster when others will not. Contribution: This study contributes to a growing body of research on the role of kin in contemporary fostering arrangements in sub-Saharan Africa. In particular, we highlight fostering among a potentially highly vulnerable group: the children of single mothers in slum settlements. Sending children to live with kin may be an important coping strategy for single mothers, both to reduce the burden of raising children alone and to provide children with opportunities to grow up outside the slums

Indian herbal formulation Kaba Sura Kudineer possesses the most powerful ligands to block ACE2-RBD interaction of SARS-CoV-2 infection

Medicinal herbs play an important role in the primary health care system of developing countries and always uphold the importance of ethnomedicinal studies in the drug discovery process. Indian Siddha practitioners urged people to consume a polyherbal formulation named ‘Kaba Sura kudineer (KSK)’ as a prophylactic measure against COVID-19. To validate the presence of anti-COVID 19 agents if any in KSK, virtual screening of 80 phytochemicals was done by blind docking, fixing the RBD-ACE2 complex as the target using PyRx software. The binding energy of the compounds was calculated using Autodock Vina. The SWISSADME server was used to identify the phytochemicals that obey the Lipinski rule and the blood-brain barrier permeability of the compounds. The outcome of the study revealed that phytochemicals such as diosgenin, diosgenone, coumaperine, bisdemethoxycurcumin, tinocordifolin, isovanillinand 1,8-Cineole displayed hydrogen bond interactions with the complex residues in the interacting site (−8.9 to −5.1 kcal/mol) and were found to obey the Lipinski rule as well as possess blood-brain barrier (BBB) permeability. Based on the highest docking score and the more number of interacting residues at the active site herein we suggest diosgenin and bisdemethoxycurcumin as potential inhibitors of SARS-Co-V-2

Overweight status of the primary caregivers of orphan and vulnerable children in 3 Southern African countries: a cross sectional study

Background: Africa is facing a nutritional transition where underweight and overweight coexist. Although the majority of programs for orphan and vulnerable children (OVC) focus on undernourishment, the association between OVC primary caregiving and the caregivers\u27 overweight status remains unclear. We investigated the association between OVC primary caregiving status with women\u27s overweight status in Namibia, Swaziland and Zambia. Methods: Demographic Health Survey (DHS) cross-sectional data collected during 2006-2007 were analyzed using weighted marginal means and logistic regressions. We analyzed data from 20-49 year old women in Namibia (N 6638), Swaziland (N 2875), and Zambia (N 4497.) Results: The overweight prevalence of the primary caregivers of OVC ranged from 27.0 % (Namibia) to 61.3 % (Swaziland). In Namibia, OVC primary caregivers were just as likely or even less likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were just as likely or more likely to be overweight than other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were more likely to be overweight than non-primary caregivers living with OVC (Swaziland AOR = 1.56, Zambia AOR = 2.62) and non-primary caregivers not living with OVC (Swaziland AOR = 1.92, Zambia AOR = 1.94). Namibian OVC caregivers were less likely to be overweight than non-caregivers not living with an OVC only in certain age groups (21-29 and 41-49 years old). Conclusions: African public health systems/OVC programs may face an overweight epidemic alongside existing HIV/AIDS, tuberculosis and malaria epidemics. Future studies/interventions to curb overweight should consider OVC caregiving status and address country-level differences

Evidence for localised HIV related micro-epidemics associated with the decentralised provision of antiretroviral treatment in rural South Africa: a spatio-temporal analysis of changing mortality patterns (2007-2010).

BACKGROUND: In this study we analysed the spatial and temporal changes in patterns of mortality over a period when antiretroviral therapy (ART) was rolled out in a rural region of north-eastern South Africa. Previous studies have identified localised concentrated HIV related sub-epidemics and recommended that micro-level analyses be carried out in order to direct focused interventions. METHODS: Data from an ongoing health and socio-demographic surveillance study was used in the analysis. The follow-up was divided into two periods, 2007-2008 and 2009-2010, representing the times immediately before and after the effects on mortality of the decentralised ART provision from a newly established local health centre would be expected to be evident. The study population at the start of the analysis was approximately 73 000 individuals. Data were aggregated by village and also using a 2 × 2 km grid. We identified villages, grid squares and regions in the site where mortality rates within each time period or rate ratios between the periods differed significantly from the overall trends. We used clustering techniques to identify cause-specific mortality hotspots. FINDINGS: Comparing the two periods, there was a 30% decrease in age and gender standardised adult HIV-related and TB (HIV/TB) mortality with no change in mortality due to other causes. There was considerable spatial heterogeneity in the mortality patterns. Areas separated by 2 to 4 km with very different epidemic trajectories were identified. There was evidence that the impact of ART in reducing HIV/TB mortality was greatest in communities with higher mortality rates in the earlier period. CONCLUSIONS: This study shows the value of conducting high resolution spatial analyses in order to understand how local micro-epidemics contribute to changes seen over a wider area. Such analyses can support targeted interventions

Immediate Adaptations to Post-Stroke Walking Performance Using a Wearable Robotic Exoskeleton

Objective To examine the immediate effects of a hip-assistive wearable robotic exoskeleton on clinical walking performance, walking energetics, gait kinematics, and corticomotor excitability in individuals with stroke. Design Randomized cross-over trial. Setting Research laboratory of a rehabilitation hospital. Participants Twelve individuals (4F/8M, mean age 57.8±7.2) with chronic hemiparetic stroke. Interventions Honda’s Stride Management Assist (SMA) exoskeleton, which provides torque-based flexion and extension assistance at the hip joints during walking. Main Outcome Measures The primary outcome measure was change in self-selected walking speed with the device off vs. with the device on. Secondary outcome measures included changes in clinical endurance, energy expenditure, kinematics, and corticomotor excitability of lower limb muscles. Results In a single session using the device, participants exhibited adaptations over most outcome measures. Self-selected walking speed and peak treadmill speed increased, while oxygen consumption rate decreased during overground and treadmill endurance tests. More symmetric walking patterns were observed during treadmill walking. Changes in corticomotor excitability were highly variable among participants, with a non-significant increase in excitability for the paretic rectus femoris. Conclusions The SMA hip exoskeleton causes immediate positive adaptations in walking performance in individuals with stroke when the device is in use