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- Kowal, Paul, et al.
(författare)
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Data resource profile : the World Health Organization Study on global AGEing and adult health (SAGE)
- 2012
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 41:6, s. 1639-1649
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Tidskriftsartikel (refereegranskat)abstract
- Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).
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| 2. |
- Streatfield, P Kim, et al.
(författare)
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HIV/AIDS-related mortality in Africa and Asia : evidence from INDEPTH health and demographic surveillance system sites
- 2014
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Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data.OBJECTIVE: To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia.DESIGN: Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population.RESULTS: The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates.CONCLUSIONS: Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.
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| 5. |
- Byass, Peter, et al.
(författare)
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Malaria mortality in a hypoendemic area of North-Eastern South Africa : population-based surveillance from 1992 to 2013 reveals an increasing malaria burden
- 2015
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Ingår i: Tropical medicine & international health. - : Wiley-Blackwell. - 1360-2276 .- 1365-3156. ; 20:Suppl. 1, s. 128-128
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Most of South Africa is malaria-free, but hypoendemic levels of transmission persist in lowveld areas in the north-east of the country, adjacent to Mozambique. Many families have links to relatives in Mozambique, where malaria transmission remains much higher, and cross-border travel is commonplace, although the Kruger National Park provides something of a depopulated buffer zone along the border. Malaria diagnosis and treatment is relatively easily available at public and private facilities in the endemic area.Methods: The Agincourt Health and Socio-Demographic Surveillance Site has monitored population health in a defined area within Mpumulanga Province, around 24.7°S, 31.2°E, since 1992. A circumscribed semi-rural area with a population ranging from approximately 60 000 in 1992 to 90 000 in 2013 was covered. All households were visited regularly to consistently record demographic and health data, including the documentation of deaths and their causes using verbal autopsy.Results: From 1992 to 2013 a total of 13 251 deaths were documented over 1.58 million person-years observed. Of that total mortality burden, 1.2% of deaths were ascribed to malaria. Half of the malaria deaths were among children aged under 15 years, with most of the remainder among working-age adults. Malaria deaths were strongly correlated with temperature and rainfall. The malaria mortality rate was over 50% higher during the last 5 years of the surveillance period, compared with earlier years. A huge HIV/AIDS epidemic that developed and receded in this population during the period of observation had no apparent effect on malaria mortality.Conclusions: This detailed longitudinal examination of malaria mortality showed that although malaria is a relatively minor cause of death in this population, it has become more common in recent years, and shows no sign of retreating despite rapid socioeconomic development. In addition to local relevance, these findings are important for understanding potential population burdens of hypoendemic malaria in other areas of sub-Saharan Africa as progress towards malaria control and elimination targets is realised.
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| 6. |
- Byass, Peter, et al.
(författare)
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The long road to elimination : malaria mortality in a South African population cohort over 21 years
- 2017
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Ingår i: Global Health, Epidemiology and Genomics. - : Cambridge University Press. - 2054-4200. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Malaria elimination is on global agendas following successful transmission reductions. Nevertheless moving from low to zero transmission is challenging. South Africa has an elimination target of 2018, which may or may not be realised in its hypoendemic areas.Methods: The Agincourt Health and Demographic Surveillance System has monitored population health in north-eastern South Africa since 1992. Malaria deaths were analysed against individual factors, socioeconomic status, labour migration and weather over a 21-year period, eliciting trends over time and associations with covariates.Results: Of 13 251 registered deaths over 1.58 million person-years, 1.2% were attributed to malaria. Malaria mortality rates increased from 1992 to 2013, while mean daily maximum temperature rose by 1.5 °C. Travel to endemic Mozambique became easier, and malaria mortality increased in higher socioeconomic groups. Overall, malaria mortality was significantly associated with age, socioeconomic status, labour migration and employment, yearly rainfall and higher rainfall/temperature shortly before death.Conclusions: Malaria persists as a small but important cause of death in this semi-rural South African population. Detailed longitudinal population data were crucial for these analyses. The findings highlight practical political, socioeconomic and environmental difficulties that may also be encountered elsewhere in moving from low-transmission scenarios to malaria elimination.
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| 9. |
- Manyema, M., et al.
(författare)
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The associations between interpersonal violence and psychological distress among rural and urban young women in South Africa
- 2018
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Ingår i: Health and Place. - : Elsevier. - 1353-8292 .- 1873-2054. ; 51, s. 97-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately 25% of the world's population consists of young people. The experience of violence peaks during adolescence and the early adult years. A link between personal experience of violence and mental health among young people has been demonstrated but rural-urban differences in these associations are less well known in low to middle income countries. The aim of this study was to investigate the associations between interpersonal violence and psychological distress among rural and urban young women.Methods: Data on experiences of violence and psychological distress were collected from a total of 926 nonpregnant young women aged between 18 and 22 years of age in rural and urban sites in South Africa. The General Health Questionnaire-28 was used to assess psychological distress as an indicator of mental health. Generalised structural equation models were employed to assess potential pathways of association between interpersonal violence and psychological distress.Results: Thirty-four percent of the urban young women (n = 161) reported psychological distress compared to 18% of rural young women (n = 81). In unadjusted analysis, exposure to interpersonal violence doubled the odds of psychological distress in the urban adolescents and increased the odds 1.6 times in the rural adolescents. In adjusted models, the relationship remained significant in the urban area only (OR 1.84, 95% CI 1.13-3.00). Rural residence seemed protective against psychological distress (OR 0.41, 95% CI 0.24-0.69). Structural equation modelling did not reveal any direct association between exposure to interpersonal violence and psychological distress among rural young women. Stressful household events were indirectly associated with psychological distress, mediated by violence among young women in the urban area.Conclusion: The relationship between violence and psychological distress differs between urban and rural-residing young women in South Africa, and is influenced by individual, household and community (contextual) factors.
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| 10. |
- Nonterah, Engelbert A., et al.
(författare)
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Racial and Ethnic Differences in the Association Between Classical Cardiovascular Risk Factors and Common Carotid Intima-Media Thickness : An Individual Participant Data Meta-Analysis
- 2022
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Ingår i: Journal of the American Heart Association. - 2047-9980. ; 11:15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The major risk factors for atherosclerotic cardiovascular disease differ by race or ethnicity but have largely been defined using populations of European ancestry. Despite the rising prevalence of cardiovascular disease in Africa there are few related data from African populations. Therefore, we compared the association of established cardiovascular risk factors with carotid-intima media thickness (CIMT), a subclinical marker of atherosclerosis, between African, African American, Asian, European, and Hispanic populations. METHODS AND RESULTS: Cross-sectional analyses of 34 025 men and women drawn from 15 cohorts in Africa, Asia, Europe, and North America were undertaken. Classical cardiovascular risk factors were assessed and CIMT measured using B-mode ultrasound. Ethnic differences in the association of established cardiovascular risk factors with CIMT were determined using a 2-stage individual participant data meta-analysis with beta coefficients expressed as a percentage using the White population as the reference group. CIMT adjusted for risk factors was the greatest among African American populations followed by Asian, European, and Hispanic populations with African populations having the lowest mean CIMT. In all racial or ethnic groups, men had higher CIMT levels compared with women. Age, sex, body mass index, and systolic blood pressure had a significant positive association with CIMT in all races and ethnicities at varying magnitudes. When compared with European populations, the association of age, sex, and systolic blood pressure with CIMT was weaker in all races and ethnicities. Smoking (beta coeffi-cient, 0.39; 95% CI, 0.09– 0.70), body mass index (beta coefficient, 0.05; 95% CI, 0.01– 0.08) and glucose (beta coefficient, 0.13; 95% CI, 0.06– 0.19) had the strongest positive association with CIMT in the Asian population when compared with all other racial and ethnic groups. High-density lipoprotein-cholesterol had significant protective effects in African American (beta coefficient, −0.31; 95% CI, −0.42 to −0.21) and African (beta coefficient, −0.26; 95% CI, −0.31 to −0.19) populations only. CONCLUSIONS: The strength of association between established cardiovascular risk factors and CIMT differed across the racial or ethnic groups and may be due to lifestyle risk factors and genetics. These differences have implications for race-ethnicity-specific primary prevention strategies and also give insights into the differential contribution of risk factors to the pathogenesis of cardiovascular disease. The greatest burden of subclinical atherosclerosis in African American individuals warrants further investigations.
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