↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Träfflista för sökning "WFRF:(Collinson Mark) "

Sökning: WFRF:(Collinson Mark)

Resultat 1-50 av 73

Sortera/gruppera träfflistan

Sortering: Träffar per sida:

Numrering	Referens	Omslagsbild	Hitta
1.	Collinson, Mark A, 1964-, et al. (författare) Child mortality, migration and parental presence in rural South Africa near the border with Mozambique Annan publikation (övrigt vetenskapligt/konstnärligt)
2.	Ginsburg, Carren, et al. (författare) Healthy or unhealthy migrants? : Identifying internal migration effects on mortality in Africa using health and demographic surveillance systems of the INDEPTH network 2016 Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 164, s. 59-73 Tidskriftsartikel (refereegranskat)abstract Migration has been hypothesised to be selective on health but this healthy migrant hypothesis has generally been tested at destinations, and for only one type of flow, from deprived to better-off areas. The circulatory nature of migration is rarely accounted for. This study examines the relationship between different types of internal migration and adult mortality in Health and Demographic Surveillance System (HDSS) populations in West, East, and Southern Africa, and asks how the processes of selection, adaptation and propagation explain the migration-mortality relationship experienced in these contexts. The paper uses longitudinal data representing approximately 900 000 adults living in nine sub-Saharan African HDSS sites of the INDEPTH Network. Event History Analysis techniques are employed to examine the relationship between all-cause mortality and migration status, over periods ranging from 3 to 14 years for a total of nearly 4.5 million person-years. The study confirms the importance of migration in explaining variation in mortality, and the diversity of the migration-mortality relationship over a range of rural and urban local areas in the three African regions. The results confirm that the pattern of migration-mortality relationship is not exclusively explained by selection but also by propagation and adaptation. Consequences for public health policy are drawn.
3.	Ginsburg, Carren, et al. (författare) Human capital on the move : Education as a determinant of internal migration in selected INDEPTH surveillance populations in Africa 2016 Ingår i: Demographic Research. - 1435-9871. ; 34:on Internal Migration and Urbanization in Developing Countries, JAN 22-24, 1996,, s. 845-884 Tidskriftsartikel (refereegranskat)abstract BACKGROUND Education, as a key indicator of human capital, is considered one of the major determinants of internal migration, with previous studies suggesting that human capital accumulates in urban areas at the expense of rural areas. However, there is fragmentary evidence concerning the educational correlates of internal migration in sub-Saharan Africa. OBJECTIVES The study questions whether more precise measures of migration in Health and Demographic Surveillance System (HDSS) populations support the hypothesis that migrants are self-selected on human capital and more educated people are more likely to leave rural areas or enter urban areas within a geographical region. METHODS Using unique longitudinal data representing approximately 900,000 people living in eight sub-Saharan African HDSS sites that are members of the INDEPTH Network, the paper uses Event History Analysis techniques to examine the relationship between formal educational attainment and in-and out-migration, over the period 2009 to 2011. RESULTS Between 7% and 27% of these local populations are moving in or out of the HDSS area over this period. Education is positively associated with both in-and out-migration in the Kenyan HDSS areas; however, the education effect has no clear pattern in the HDSS sites in Burkina Faso, Mozambique, and South Africa. CONCLUSIONS Empirical results presented in this paper confirm a strong age profile of migration consistent with human capital expectation, yet the results point to variability in the association of education and the propensity to migrate. In particular, the hypothesis of a shift of human capital from rural to urban areas is not universally valid.
4.	Arridge, Christopher S., et al. (författare) Uranus Pathfinder : exploring the origins and evolution of Ice Giant planets 2012 Ingår i: Experimental astronomy. - : Springer Science and Business Media LLC. - 0922-6435 .- 1572-9508. ; 33:2-3, s. 753-791 Tidskriftsartikel (refereegranskat)abstract The "Ice Giants" Uranus and Neptune are a different class of planet compared to Jupiter and Saturn. Studying these objects is important for furthering our understanding of the formation and evolution of the planets, and unravelling the fundamental physical and chemical processes in the Solar System. The importance of filling these gaps in our knowledge of the Solar System is particularly acute when trying to apply our understanding to the numerous planetary systems that have been discovered around other stars. The Uranus Pathfinder (UP) mission thus represents the quintessential aspects of the objectives of the European planetary community as expressed in ESA's Cosmic Vision 2015-2025. UP was proposed to the European Space Agency's M3 call for medium-class missions in 2010 and proposed to be the first orbiter of an Ice Giant planet. As the most accessible Ice Giant within the M-class mission envelope Uranus was identified as the mission target. Although not selected for this call the UP mission concept provides a baseline framework for the exploration of Uranus with existing low-cost platforms and underlines the need to develop power sources suitable for the outer Solar System. The UP science case is based around exploring the origins, evolution, and processes at work in Ice Giant planetary systems. Three broad themes were identified: (1) Uranus as an Ice Giant, (2) An Ice Giant planetary system, and (3) An asymmetric magnetosphere. Due to the long interplanetary transfer from Earth to Uranus a significant cruise-phase science theme was also developed. The UP mission concept calls for the use of a Mars Express/Rosetta-type platform to launch on a Soyuz-Fregat in 2021 and entering into an eccentric polar orbit around Uranus in the 2036-2037 timeframe. The science payload has a strong heritage in Europe and beyond and requires no significant technology developments.
5.	Bawah, Ayaga, et al. (författare) The Evolving Demographic and Health Transition in Four Low- and Middle-Income Countries : Evidence from Four Sites in the INDEPTH Network of Longitudinal Health and Demographic Surveillance Systems 2016 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:6 Tidskriftsartikel (refereegranskat)abstract This paper contributes evidence documenting the continued decline in all-cause mortality and changes in the cause of death distribution over time in four developing country populations in Africa and Asia. We present levels and trends in age-specific mortality (all-cause and cause-specific) from four demographic surveillance sites: Agincourt (South Africa), Navrongo (Ghana) in Africa; Filabavi (Vietnam), Matlab (Bangladesh) in Asia. We model mortality using discrete time event history analysis. This study illustrates how data from INDEPTH Network centers can provide a comparative, longitudinal examination of mortality patterns and the epidemiological transition. Health care systems need to be reconfigured to deal simultaneously with continuing challenges of communicable disease and increasing incidence of non-communicable diseases that require long-term care. In populations with endemic HIV, long-term care of HIV patients on ART will add to the chronic care needs of the community.
6.	Bocquier, Philippe, et al. (författare) A training manual for event history data management using health and demographic surveillance system data 2017 Ingår i: BMC Research Notes. - : BioMed Central (BMC). - 1756-0500. ; 10:1 Tidskriftsartikel (refereegranskat)abstract Objective: The objective of this research note is to introduce a training manual for event history data management. The manual provides a first comprehensive guide to longitudinal Health and Demographic Surveillance System (HDSS) data management that allows for a step-by-step description of the process of structuring and preparing a dataset for the calculation of demographic rates and event history analysis. The research note provides some background information on the INDEPTH Network, and the iShare data repository and describes the need for a manual to guide users as to how to correctly handle HDSS datasets.Results: The approach outlined in the manual is flexible and can be applied to other longitudinal data sources. It facilitates the development of standardised longitudinal data management and harmonization of datasets to produce a comparative set of results.
7.	Bocquier, Philipe, et al. (författare) Ubiquitous burden : The contribution of migration to AIDS and tuberculosis mortality in rural South Africa 2014 Ingår i: African Population Studies. - : Stellenbosch University. - 0850-5780 .- 2308-7854. ; 28:1, s. 691-701 Tidskriftsartikel (refereegranskat)abstract The paper aims to estimate the extent to which migrants are contributing to AIDS or tuberculosis (TB) mortality among rural sub-district populations. The Agincourt (South Africa) health and socio-demographic surveillance system provided comprehensive data on vital and migration events between 1994 and 2006. AIDS and TB cause-deleted life expectancy, and crude death rates by gender, migration status and period were computed. The annualised crude death rate almost tripled from 5∙39 [95% CI 5∙13-5∙65] to 15∙10 [95% CI 14∙62-15∙59] per 1000 over the years 1994-2006. The contribution of AIDS and TB in returned migrants to the increase in crude death rate was 78∙7% [95% CI 77∙4-80∙1] for males and 44∙4% [95% CI 43∙2-46∙1] for females. So, in a typical South African setting dependent on labour migration for rural livelihoods, the contribution of returned migrants, many infected with AIDS and TB, to the burden of disease is high.
8.	Byass, Peter, 1957-, et al. (författare) A Successful Failure : missing the MDG4 Target for Under-Five Mortality in South Africa 2015 Ingår i: PLoS Medicine. - : PloS. - 1549-1277 .- 1549-1676. ; 12:12 Tidskriftsartikel (refereegranskat)
9.	Byass, Peter, et al. (författare) Assessing a population's exposure to heat and humidity : an empirical approach 2010 Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 3, s. Article nr 5421- Tidskriftsartikel (refereegranskat)abstract Background: It is widely accepted that assessing the impact of heat on populations is an important aspect of climate change research. However, this raises questions about how best to measure people’s exposure to heat under everyday living conditions in more detail than is possible by relying on nearby sources of meteorological data. Objective: This study aimed to investigate practical and viable approaches to measuring air temperature and humidity within a population, making comparisons with contemporaneous external data sources. This was done in a rural South African population during the subtropical summer season. Results: Air temperature and humidity were measured indoors and outdoors at three locations over 10 days and the datalogger technology proved reliable and easy to use. There was little variation in measurements over distances of 10 km. Conclusions: Small battery-powered automatic dataloggers proved to be a feasible option for collecting weather data among a rural South African population. These data were consistent with external sources but offered more local detail. Detailed local contemporary data may also allow post hoc modelling of previously unmeasured local weather data in conjunction with global gridded climate models.
10.	Byass, Peter, et al. (författare) Moving from data on deaths to public health policy in Agincourt, South Africa : approaches to analysing and understanding verbal autopsy findings 2010 Ingår i: PLoS Medicine. - : Public Library of Science. - 1549-1277 .- 1549-1676. ; 7:8, s. e1000325- Tidskriftsartikel (refereegranskat)abstract There were no differences between physician interpretation and probabilistic modelling that might have led to substantially different public health policy conclusions at the population level. Physician interpretation was more nuanced than the model, for example in identifying cancers at particular sites, but did not capture the uncertainty associated with individual cases. Probabilistic modelling was substantially cheaper and faster, and completely internally consistent. Both approaches characterised the rise of HIV-related mortality in this population during the period observed, and reached similar findings on other major causes of mortality. For many purposes probabilistic modelling appears to be the best available means of moving from data on deaths to public health actions. Please see later in the article for the Editors' Summary.
11.	Byass, Peter, et al. (författare) The long road to elimination : malaria mortality in a South African population cohort over 21 years 2017 Ingår i: Global Health, Epidemiology and Genomics. - : Cambridge University Press. - 2054-4200. ; 2 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.
12.	Byass, Peter, et al. (författare) Using verbal autopsy to track epidemic dynamics : the case of HIV-related mortality in South Africa. 2011 Ingår i: Population Health Metrics. - : BioMed Central (BMC). - 1478-7954. ; 9, s. 46- Tidskriftsartikel (refereegranskat)abstract Background Verbal autopsy (VA) has often been used for point estimates of cause-specific mortality, but seldom to characterize long-term changes in epidemic patterns. Monitoring emerging causes of death involves practitioners' developing perceptions of diseases and demands consistent methods and practices. Here we retrospectively analyze HIV-related mortality in South Africa, using physician and modeled interpretation.Methods Between 1992 and 2005, 94% of 6,153 deaths which occurred in the Agincourt subdistrict had VAs completed, and coded by two physicians and the InterVA model. The physician causes of death were consolidated into a single consensus underlying cause per case, with an additional physician arbitrating where different diagnoses persisted. HIV-related mortality rates and proportions of deaths coded as HIV-related by individual physicians, physician consensus, and the InterVA model were compared over time.Results Approximately 20% of deaths were HIV-related, ranging from early low levels to tenfold-higher later population rates (2.5 per 1,000 person-years). Rates were higher among children under 5 years and adults 20 to 64 years. Adult mortality shifted to older ages as the epidemic progressed, with a noticeable number of HIV-related deaths in the over-65 year age group latterly. Early InterVA results suggested slightly higher initial HIV-related mortality than physician consensus found. Overall, physician consensus and InterVA results characterized the epidemic very similarly. Individual physicians showed marked interobserver variation, with consensus findings generally reflecting slightly lower proportions of HIV-related deaths. Aggregated findings for first versus second physician did not differ appreciably.Conclusions VA effectively detected a very significant epidemic of HIV-related mortality. Using either physicians or InterVA gave closely comparable findings regarding the epidemic. The consistency between two physician coders per case (from a pool of 14) suggests that double coding may be unnecessary, although the consensus rate of HIV-related mortality was approximately 8% lower than by individual physicians. Consistency within and between individual physicians, individual perceptions of epidemic dynamics, and the inherent consistency of models are important considerations here. The ability of the InterVA model to track a more than tenfold increase in HIV-related mortality over time suggests that finely tuned "local" versions of models for VA interpretation are not necessary.
13.	Clark, Samuel J, et al. (författare) Returning home to die : circular labour migration and mortality in South Africa 2007 Ingår i: Scandinavian Journal of Public Health. - : Taylor and Francis. - 1403-4948 .- 1651-1905. ; 35:Suppl. 69, s. 35-44 Tidskriftsartikel (refereegranskat)abstract AIM: To examine the hypothesis that circular labour migrants who become seriously ill while living away from home return to their rural homes to convalesce and possibly to die. METHODS: Drawing on longitudinal data collected by the Agincourt health and demographic surveillance system in rural northeastern South Africa between 1995 and 2004, discrete time event history analysis is used to estimate the likelihood of dying for residents, short-term returning migrants, and long-term returning migrants controlling for sex, age, and historical period. RESULTS: The annual odds of dying for short-term returning migrants are generally 1.1 to 1.9 times (depending on period, sex, and age) higher than those of residents and long-term returning migrants, and these differences are generally highly statistically significant. Further supporting the hypothesis is the fact that the proportion of HIV/TB deaths among short-term returning migrants increases dramatically as time progresses, and short-term returning migrants account for an increasing proportion of all HIV/TB deaths. CONCLUSIONS: This evidence strongly suggests that increasing numbers of circular labour migrants of prime working age are becoming ill in the urban areas where they work and coming home to be cared for and eventually to die in the rural areas where their families live. This shifts the burden of caring for them in their terminal illness to their families and the rural healthcare system with significant consequences for the distribution and allocation of health care resources.
14.	Clark, Samuel J., et al. (författare) Young Children's Probability of Dying Before and After Their Mother's Death : A Rural South African Population-Based Surveillance Study 2013 Ingår i: PLoS Medicine. - San Francisco : Public library of science. - 1549-1277 .- 1549-1676. ; 10:3, s. e1001409- Tidskriftsartikel (refereegranskat)abstract Background: There is evidence that a young child's risk of dying increases following the mother's death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother's death, as well as for several months after her death. Therefore we investigated the relationship between young children's likelihood of dying and the timing of their mother's death and, in particular, the existence of a critical period of increased risk. Methods and Findings: Data from a health and socio-demographic surveillance system in rural South Africa were collected on children 0-5 y of age from 1 January 1994 to 31 December 2008. Discrete time survival analysis was used to estimate children's probability of dying before and after their mother's death, accounting for moderators. 1,244 children (3% of sample) died from 1994 to 2008. The probability of child death began to rise 6-11 mo prior to the mother's death and increased markedly during the 2 mo immediately before the month of her death (odds ratio [OR] 7.1 [95% CI 3.9-12.7]), in the month of her death (OR 12.6 [6.2-25.3]), and during the 2 mo following her death (OR 7.0 [3.2-15.6]). This increase in the probability of dying was more pronounced for children whose mothers died of AIDS or tuberculosis compared to other causes of death, but the pattern remained for causes unrelated to AIDS/tuberculosis. Infants aged 0-6 mo at the time of their mother's death were nine times more likely to die than children aged 2-5 y. The limitations of the study included the lack of knowledge about precisely when a very ill mother will die, a lack of information about child nutrition and care, and the diagnosis of AIDS deaths by verbal autopsy rather than serostatus. Conclusions: Young children in lower income settings are more likely to die not only after their mother's death but also in the months before, when she is seriously ill. Interventions are urgently needed to support families both when the mother becomes very ill and after her death.
15.	Collinson, Mark A. (författare) Age-sex profiles of migration : who is a migrant? 2009 Ingår i: The dynamics of migration, health and livelihoods. - : Ashgate. - 9780754697268 - 9780754678755 ; , s. 49-64 Bokkapitel (refereegranskat)
16.	Collinson, Mark A. (författare) Age-sex profiles of migration : who is a migrant? 2018 Ingår i: The dynamics of migration, health and livelihoods. - : Routledge. - 9781351147040 - 9780815397670 ; , s. 49-62 Bokkapitel (refereegranskat)abstract The chapter examines multi-site migration age-sex profiles in the INDEPTH network. Certain age groups, like primary school children, show very low levels of migration, while young adults in their prime are the most likely to be migrants. The regularity of age-patterns of migration has been long observed and model migration schedules have been developed since the 1980s. The age patterns presented in the data had excesses or deficits of migration in particular age groups in particular settings, but the pattern was uniform enough to be modelled. The age-sex profile is a compact summary of how migration is actually experienced, a measure of who is most likely to move at what point in their lives and whether and how this differs by gender. The age-sex profiles of migration reveal how the intensity of migration bears upon certain age groups more than others, notably young adults, but there is a diversity of levels presented across the different sites.
17.	Collinson, Mark A., et al. (författare) Migration and socio-economic change in rural South Africa, 2000-2007 2009 Ingår i: The dynamics of migration, health and livelihoods. - : Ashgate. - 9780754697268 - 9780754678755 ; , s. 81-108 Bokkapitel (refereegranskat)
18.	Collinson, Mark A., et al. (författare) Migration and the epidemiological transition : insights from the Agincourt sub-district of northeast South Africa 2014 Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 7, s. 122-136 Tidskriftsartikel (refereegranskat)abstract Background:Migration and urbanization are central to sustainable development and health, but data on temporal trends in defined populations are scarce. Healthy men and women migrate because opportunities for employment and betterment are not equally distributed geographically. The disruption can result in unhealthy exposures and environments and income returns for the origin household.Objectives: The objectives of the paper are to describe the patterns, levels, and trends of temporary migration in rural northeast South Africa; the mortality trends by cause category over the period 2000-2011; and the associations between temporary migration and mortality by broad cause of death categories.Method:Longitudinal, Agincourt Health and Demographic Surveillance System data are used in a continuous, survival time, competing-risk model. Findings: In rural, northeast South Africa, temporary migration, which involves migrants relocating mainly for work purposes and remaining linked to the rural household, is more important than age and sex in explaining variations in mortality, whatever the cause. In this setting, the changing relationship between temporary migration and communicable disease mortality is primarily affected by reduced exposure of the migrant to unhealthy conditions. The study suggests that the changing relationship between temporary migration and non-communicable disease mortality is mainly affected by increased livelihood benefits of longer duration migration.Conclusion: Since temporary migration is not associated with communicable diseases only, public health policies should account for population mobility whatever the targeted health risk. There is a need to strengthen the rural health care system, because migrants tend to return to the rural households when they need health care.
19.	Collinson, Mark A, 1964-, et al. (författare) Migration, settlement change and health in post-apartheid South Africa : triangulating health and demographic surveillance with national census data. 2007 Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; Suppl. 69, s. 77-84 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: World population growth will be increasingly concentrated in the urban areas of the developing world; however, some scholars caution against the oversimplification of African urbanization noting that there may be "counter-urbanization" and a prevailing pattern of circular rural-urban migration. The aim of the paper is to examine the ongoing urban transition in South Africa in the post-apartheid period, and to consider the health and social policy implications of prevailing migration patterns. METHODS: Two data sets were analysed, namely the South African national census of 2001 and the Agincourt health and demographic surveillance system. A settlement-type transition matrix was constructed on the national data to show how patterns of settlement have changed in a five-year period. Using the sub-district data, permanent and temporary migration was characterized, providing migration rates by age and sex, and showing the distribution of origins and destinations. FINDINGS: The comparison of national and sub-district data highlight the following features: urban population growth, particularly in metropolitan areas, resulting from permanent and temporary migration; prevailing patterns of temporary, circular migration, and a changing gender balance in this form of migration; stepwise urbanization; and return migration from urban to rural areas. CONCLUSIONS: Policy concerns include: rural poverty exacerbated by labour migration; explosive conditions for the transmission of HIV; labour migrants returning to die in rural areas; and the challenges for health information created by chronically ill migrants returning to rural areas to convalesce. Lastly, suggestions are made on how to address the dearth of relevant population information for policy-making in the fields of migration, settlement change and health.
20.	Collinson, Mark A (författare) Striving against adversity : the dynamics of migration, health and poverty in rural South Africa 2010 Ingår i: Global health action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 3 Tidskriftsartikel (refereegranskat)abstract This article is a review of the PhD thesis of Mark Collinson, titled, 'Striving against adversity: the dynamics of migration, health and poverty in rural South Africa'. The findings show that in rural South Africa, temporary migration has a major impact on household well-being and health. Remittances from migrants make a significant difference to socioeconomic status (SES) in households left behind by the migrant. For the poorest households the key factors improving SES are government grants and female temporary migration, while for the less poor it is male temporary migration and local employment. Migration is associated with HIV but not in straightforward ways. Migrants that return more frequently may be less exposed to outside partners and therefore less implicated in the HIV epidemic. There are links between migration and mortality patterns, including a higher risk of dying for returnee migrants compared with permanent residents. A mother's migration impacts significantly on child survival for South African and former refugee parents, but there is an additional mortality risk for children of Mozambican former refugees. It is recommended that national censuses and surveys account for temporary migration when collecting information on household membership, because different migration types have different outcomes. Without discriminating between different migration types, the implications for sending and receiving communities will remain lost to policy-makers.
21.	Collinson, Mark A, 1964- (författare) Striving against adversity. : the dynamics of migration, health and poverty in rural South Africa 2009 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Background: The study is based in post-apartheid South Africa and looks at the health and well being of households in the rural northeast. Temporary migration remains important in South Africa because it functions as a mainstay for income and even survival of rural communities. The economic base of rural South Africans is surprisingly low because there is high inequity at a national level, within and between racial groups. There has now been a democratic system in place for 15 years and there is no longer restriction of mobility, but there remain high levels of poverty in rural areas and rising mortality rates. Migration patterns did not change after apartheid in the manner expected. We need to examine consequences of migration and learn how to offset negative impacts with targeted policies. Aims: To determine a relevant typology of migration in a typical rural sending community, namely the Agincourt sub-district of Mpumalanga, South Africa, and relate it to the urban transition at a national level – Paper (I) . To evaluate the dynamics of socio-economic status in this rural community and examine the relationship with migration – Paper (II). To explore, using longitudinal methods, the impact of migration on key dimensions of health, including adult and child mortality, and sexual partnerships, over a period of an emerging HIV/AIDS epidemic – Papers (III), (IV) and (V). Methods: The health and socio-demographic surveillance system (HDSS) is a large open cohort where the migration dynamics are monitored as they unfold. They are recorded as temporary or permanent migration. Settled refugees are captured using nationality on entry into the HDSS. Longitudinal methods, namely a household panel and two discrete time event history analyses, are used to examine consequences of migration. Results: Migration features prominently and different types have different age and sex profiles. Temporary migration impacts the most on socio-economic status (SES) and health, but permanent migration and the settlement of former refugees are also important. Remittances from migrants make a significant difference to SES. For the poorest households the key factors improving SES are government grants and female temporary migration, while for less poor it is male temporary migration and local employment. Migration has been associated with HIV. Migrants that return more frequently may be less exposed to outside partners and therefore less implicated in the HIV epidemic. There are links between migration and mortality including a higher risk of dying for returnee migrants compared to permanent residents. A mother’s migration can impact on child survival after accounting for other factors. There remains a higher mortality risk for children of Mozambican former refugee parents. Interpretation: Migration changes the risks and resources for health with positive and negative implications. Measures such as improved transportation and roads should be seen as a positive, not a negative intervention, even though it will create more migration. Health services need to adapt to a reality of high levels of circular migration ranging from budget allocation to referral systems. Data should be enhanced at a national level by accounting for temporary migration in national censuses and surveys. At individual level we can offset negative consequences by treating migrants as persons striving against adversity, instead of unwelcome visitors in our better-off communities.
22.	Collinson, Mark A, 1964-, et al. (författare) The dynamics of poverty and migration in a rural South African community, 2001-2005 Annan publikation (övrigt vetenskapligt/konstnärligt)
23.	Collinson, Mark A, 1964-, et al. (författare) Trends in internal labour migration from rural Limpopo Province, male risk behaviour and implications for the spread of HIV/AIDS in rural South Africa 2006 Ingår i: Journal of ethnic and migration studies. - : Routledge. - 1369-183X .- 1469-9451. ; 32:4, s. 633-648 Tidskriftsartikel (refereegranskat)abstract Given improvements in the transport infrastructure and the end of travel restrictions characteristic of the apartheid period, there could be a reasonable expectation that male risk behaviour in sexual relations would be reduced as rural-/urban connections were enhanced. Using the example of Limpopo Province, South Africa, this research draws on an existing demographic surveillance system and a specialised survey to test the hypothesis. We find that male risk behaviour and lack of awareness of risks have not altered significantly and that there are potentially explosive possibilities for the spread of HIV/AIDS to and from Limpopo Province. There have to be enhanced measures to bring the labour market closer to rural settings to arrest this phenomenon.
24.	Garenne, Michel, et al. (författare) Completeness of birth and death registration in a rural area of South Africa : the Agincourt health and demographic surveillance, 1992-2014 2016 Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 9 Tidskriftsartikel (refereegranskat)abstract Background: Completeness of vital registration remains very low in sub-Saharan Africa, especially in rural areas. Objectives: To investigate trends and factors in completeness of birth and death registration in Agincourt, a rural area of South Africa covering a population of about 110,000 persons, under demographic surveillance since 1992. The population belongs to the Shangaan ethnic group and hosts a sizeable community of Mozambican refugees.Design: Statistical analysis of birth and death registration over time in a 22-year perspective (1992-2014). Over this period, major efforts were made by the government of South Africa to improve vital registration. Factors associated with completeness of registration were investigated using univariate and multivariate analysis.Results: Birth registration was very incomplete at onset (7.8% in 1992) and reached high values at end point (90.5% in 2014). Likewise, death registration was low at onset (51.4% in 1992), also reaching high values at end point (97.1% in 2014). For births, the main factors were mother's age (much lower completeness among births to adolescent mothers), refugee status, and household wealth. For deaths, the major factors were age at death (lower completeness among under-five children), refugee status, and household wealth. Completeness increased for all demographic and socioeconomic categories studied and is likely to approach 100% in the future if trends continue at this speed.Conclusion: Reaching high values in the completeness of birth and death registration was achieved by excellent organization of the civil registration and vital statistics, a variety of financial incentives, strong involvement of health personnel, and wide-scale information and advocacy campaigns by the South African government.
25.	Garenne, Michel, et al. (författare) Improving completeness of birth and death registration in rural Africa 2016 Ingår i: The Lancet Global Health. - 2214-109X. ; 4:9, s. E604-E605 Tidskriftsartikel (refereegranskat)
26.	Garenne, Michel L, et al. (författare) Fertility trends and net reproduction in Agincourt, rural South Africa : 1992-2004 2007 Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:Suppl. 69, s. 68-76 Tidskriftsartikel (refereegranskat)abstract Aims: To analyse trends in fertility rates and net reproduction rates in Agincourt, a rural area of South Africa located in the former homeland of Gazankulu near the Mozambican border. Trends are analysed in the context of widely available modern contraceptive methods and increasing HIV/AIDS. Methods: A health and demographic surveillance system has been in place since 1992, covering a population of approximately 70,000 persons, with an annual census update and comprehensive recording of births and deaths. It was complemented by a retrospective study of fertility at baseline. Retrospective and prospective data were used to calculate trends in fertility, survival, and net reproduction. When possible, they were compared with data from other censuses and surveys in the same ethnic group. Results: The fertility transition has almost ended over a course of 25 years in Agincourt. The total fertility rate (TFR) averaged 6.0 in 1979 and 2.3 in 2004. Fertility declined in proportionate fashion in all age groups including adolescents in the recent period. The net reproduction rate (NRR) declined from 1.8 to 1.0 during the prospective period (1992—2004). At current rates of change in fertility and mortality, the NRR can be expected to reach 0.63 by the year 2010. Conclusions: The situation of a below-replacement fertility level is new for rural Africa, and is likely to have many demographic, economic and social implications. The population could decline in the country as a whole, and is nearly static in Agincourt because of negative migration flows balancing the small excess from natural increase.
27.	Garenne, Michel, et al. (författare) Maternal mortality in rural South Africa : the impact of case definition on levels and trends. 2013 Ingår i: International Journal of Women's Health. - : Dovepress. - 1179-1411. ; 5, s. 457-463 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Uncertainty in the levels of global maternal mortality reflects data deficiencies, as well as differences in methods and definitions. This study presents levels and trends in maternal mortality in Agincourt, a rural subdistrict of South Africa, under long-term health and sociodemographic surveillance.METHODS: All deaths of women aged 15 years-49 years occurring in the study area between 1992 and 2010 were investigated, and causes of death were assessed by verbal autopsy. Two case definitions were used: "obstetrical" (direct) causes, defined as deaths caused by conditions listed under O00-O95 in International Classification of Diseases-10; and "pregnancy-related deaths", defined as any death occurring during the maternal risk period (pregnancy, delivery, 6 weeks postpartum), irrespective of cause.RESULTS: The case definition had a major impact on levels and trends in maternal mortality. The obstetric mortality ratio averaged 185 per 100,000 live births over the period (60 deaths), whereas the pregnancy-related mortality ratio averaged 423 per 100,000 live births (137 deaths). Results from both calculations increased over the period, with a peak around 2006, followed by a decline coincident with the national roll-out of Prevention of Mother-to-Child Transmission of HIV and antiretroviral treatment programs. Mortality increase from direct causes was mainly due to hypertension or sepsis. Mortality increase from other causes was primarily due to the rise in deaths from HIV/AIDS and pulmonary tuberculosis.CONCLUSION: These trends underline the major fluctuations induced by emerging infectious diseases in South Africa, a country undergoing rapid and complex health transitions. Findings also pose questions about the most appropriate case definition for maternal mortality and emphasize the need for a consistent definition in order to better monitor and compare trends over time and across settings.
28.	Garenne, Michel, et al. (författare) Protective Effect of Pregnancy in Rural South Africa : Questioning the Concept of "Indirect Cause'' of Maternal Death 2013 Ingår i: PLOS ONE. - : PLOS, Public Library of Science. - 1932-6203. ; 8:5, s. e64414- Tidskriftsartikel (refereegranskat)abstract Background: Measurement of the level and composition of maternal mortality depends on the definition used, with inconsistencies leading to inflated rates and invalid comparisons across settings. This study investigates the differences in risk of death for women in their reproductive years during and outside the maternal risk period (pregnancy, delivery, puerperium), focusing on specific causes of infectious, non-communicable and external causes of death after separating out direct obstetrical causes. Methods: Data on all deaths of women aged 15-49 years that occurred in the Agincourt sub-district between 1992 and 2010 were obtained from the Agincourt health and socio-demographic surveillance system (HDSS) located in rural South Africa. Causes of death were assessed using a validated verbal autopsy instrument. Analysis included 2170 deaths, of which 137 occurred during the maternal risk period. Findings: Overall, women had significantly lower mortality during the maternal risk period than outside it (age-standardized RR = 0.75; 95% CI = 0.63-0.89). This was true in most age groups with the exception of adolescents aged 15-19 years where the risk of death was higher. Mortality from most causes, other than obstetric causes, was lower during the maternal risk period except for malaria, cardiovascular diseases and violence where there were no differences. Lower mortality was significant for HIV/AIDS (RR = 0.29, P<0.0001), cancers (RR = 0.10, P<0.023), and accidents (RR = 0, P<0.0001). Interpretation: In this rural setting typical of much of Southern Africa, pregnancy was largely protective against the risk of death, most likely because of a strong selection effect amongst those women who conceived successfully. The concept of indirect cause of maternal death needs to be re-examined.
29.	Gerritsen, Annette, et al. (författare) Health and demographic surveillance systems : contributing to an understanding of the dynamics in migration and health 2013 Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 6, s. 1-6 Tidskriftsartikel (refereegranskat)abstract Background: Migration is difficult to measure because it is highly repeatable. Health and Demographic Surveillance Systems (HDSSs) provide a unique opportunity to study migration as multiple episodes of migration are captured over time. A conceptual framework is needed to show the public health implications of migration.Objective/design: Research conducted in seven HDSS centres [International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH) Network], published in a peer-reviewed volume in 2009, is summarised focussing on the age-sex profile of migrants, the relation between migration and livelihoods, and the impact of migration on health. This illustrates the conceptual structure of the implications of migration. The next phase is described, the Multi-centre Analysis of the Dynamics In Migration And Health (MADIMAH) project, consisting of workshops focussed on preparing data and conducting the analyses for comparative studies amongst HDSS centres in Africa and Asia. The focus here is on the (standardisation of) determinants of migration and the impact of migration on adult mortality.Results: The findings in the volume showed a relatively regular age structure for migration among all HDSS centres. Furthermore, migration generally contributes to improved living conditions at the place of origin. However, there are potential negative consequences of migration on health. It was concluded that there is a need to compare results from multiple centres using uniform covariate definitions as well as longitudinal analysis techniques. This was the starting point for the on-going MADIMAH initiative, which has increased capacity at the participating HDSS centres to produce the required datasets and conduct the analyses.Conclusions: HDSS centres brought together within INDEPTH Network have already provided strong evidence of the potential negative consequences of migration on health, which contrast with the beneficial impacts of migration on livelihoods. Future comparative evidence using standardised tools will help design policies for mitigating the negative effects, and enhancing the positive effects, of migration on health.
30.	Ginsburg, Carren, et al. (författare) Association between internal migration and epidemic dynamics : an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data 2018 Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 18 Tidskriftsartikel (refereegranskat)abstract Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a divergence to higher AIDS/TB mortality risk amongst female migrants to the Nairobi HDSS from 2010. Conclusion: Results suggest that structural socioeconomic issues, rather than epidemic dynamics are likely to be associated with differences in mortality risk by migrant status. Interventions aimed at improving recent migrant's access to treatment may mitigate risk.
31.	Gómez-Olivé, F. Xavier, et al. (författare) Cohort Profile : Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) 2018 Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 47:3, s. 689-690j Tidskriftsartikel (refereegranskat)
32.	Houle, Brian, et al. (författare) Household context and child mortality in rural South Africa : the effects of birth spacing, shared mortality, household composition and socio-economic status 2013 Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 42:5, s. 1444-1454 Tidskriftsartikel (refereegranskat)abstract Background Household characteristics are important influences on the risk of child death. However, little is known about this influence in HIV-endemic areas. We describe the effects of household characteristics on children's risk of dying in rural South Africa.Methods We use data describing the mortality of children younger than 5 years living in the Agincourt health and socio-demographic surveillance system study population in rural northeast South Africa during the period 1994-2008. Using discrete time event history analysis we estimate children's probability of dying by child characteristics and household composition (other children and adults other than parents) (N = 924 818 child-months), and household socio-economic status (N = 501 732 child-months).Results Children under 24 months of age whose subsequent sibling was born within 11 months experience increased odds of dying (OR 2.5; 95% CI 1.1-5.7). Children also experience increased odds of dying in the period 6 months (OR 2.1; 95% CI 1.2-3.6), 3-5 months (OR 3.0; 95% CI 1.5-5.9), and 2 months (OR 11.8; 95% CI 7.6-18.3) before another household child dies. The odds of dying remain high at the time of another child's death (OR 11.7; 95% CI 6.3-21.7) and for the 2 months following (OR 4.0; 95% CI 1.9-8.6). Having a related but non-parent adult aged 20-59 years in the household reduces the odds (OR 0.6; 95% CI 0.5-0.8). There is an inverse relationship between a child's odds of dying and household socio-economic status.Conclusions This detailed household profile from a poor rural setting where HIV infection is endemic indicates that children are at high risk of dying when another child is very ill or has recently died. Short birth intervals and additional children in the household are further risk factors. Presence of a related adult is protective, as is higher socio-economic status. Such evidence can inform primary health care practice and facilitate targeting of community health worker efforts, especially when covering defined catchment areas.
33.	Hunter, Lori M., et al. (författare) Rural Outmigration, Natural Capital, and Livelihoods in South Africa 2014 Ingår i: Population, Space and Place. - : Wiley. - 1544-8444 .- 1544-8452. ; 20:5, s. 402-420 Tidskriftsartikel (refereegranskat)abstract Rural households across the globe engage in both migration and natural resource use as components of livelihood strategies designed to meet household needs. Yet, migration scholars have only recently begun to regularly integrate environmental factors into empirical modelling efforts. To examine the migration-environment association in rural South Africa, we use vegetation measures derived from satellite imagery combined with detailed demographic data from over 9000 households at the Agincourt Health and Demographic Surveillance Site. Results reveal that household-level temporary migration is associated with higher levels of local natural capital, although no such association exists for permanent migration. Further, more advantaged households exhibit a stronger association between migration-environment, in-line with the 'environmental capital' hypothesis, suggesting that natural resource availability can facilitate household income diversification. We argue that a focus on migration's environmental aspects is especially timely in the contemporary era of climate change and that natural capital availability and variability represent critical pieces of the empirical migration puzzle, especially regarding cyclical livelihood migration.
34.	Hussain-Alkhateeb, Laith, 1977, et al. (författare) Effects of recall time on cause-of-death findings using verbal autopsy: empirical evidence from rural South Africa. 2016 Ingår i: Emerging Themes in Epidemiology. - : Springer Science and Business Media LLC. - 1742-7622. ; 13 Tidskriftsartikel (refereegranskat)abstract Verbal autopsy (VA) is a widely used technique for assigning causes to non-medically certified deaths using information gathered from a close caregiver. Both operational and cultural factors may cause delays in follow-up of deaths. The resulting time lag-from death to VA interview-can influence ways in which terminal events are remembered, and thus affect cause-of-death assignment. This study investigates the impact of recall period on causes of death determined by VA.A total of 10,882 deaths from the Agincourt Health and Demographic Surveillance System (HDSS) with complete VAs, including recall period, were incorporated in this study. To measure seasonal effect, cause specific mortality fractions (CSMFs) were calculated and compared by every cause for VAs undertaken within six months of death and those undertaken from six to 12months of death. All causes were classified into eight broad categories and entered in a multiple logistic regression to explore outcome by recall period in relation to covariates.The majority of deaths (83%) had VAs completed within 12months. There was a tendency towards longer recall periods for deaths of those under one year or over 65years of age. Only the acute respiratory, diarrhoeal and other unspecified non-communicable disease groups showed a CSMF ratio significantly different from unity at the 99% confidence level between the two recall periods. Only neonatal deaths showed significantly different OR for recall exceeding 12months (OR 1.69; p value=0.004) and this increased when adjusting for background factors (OR 2.58; p value=0.000).A recall period of up to one year between death and VA interview did not have any consequential effects on the cause-of-death patterns derived, with the exception of neonatal causes. This is an important operational consideration given the planned widespread use of the VA approach in civil registration, HDSS sites and occasional surveys.
35.	Ibisomi, Latifat, et al. (författare) The stall in fertility decline in rural, Northeast, South Africa : The contribution of a self-settled, Mozambican, refugee sub-population 2014 Ingår i: African Population Studies. - : Stellenbosch University. - 0850-5780 .- 2308-7854. ; 28:1, s. 590-600 Tidskriftsartikel (refereegranskat)abstract Using longitudinal data from the Agincourt Health and socio-Demographic Surveillance System (HDSS) in rural South Africa, this paper examines the role of the fertility of self-settled, former Mozambican refugee sub-population on the stall in fertility decline in the Agincourt HDSS from 1993 to 2009. The Agincourt HDSS fertility trend is decomposed to quantify the relative contribution of the Mozambicans to fertility changes. Results show that fertility level declined by about 1.5 children per woman over the period and the level remain around 2.5 children per woman in the last eight years of the period examined suggesting a stall in fertility decline in the sub-district population covered by the HDSS. However, while the fertility of the Mozambicans fell consistently over the period, there was a reversal in the fertility decline of South African women residing in the area suggesting that the overall stalls are attributable to stalls in fertility decline among South African women.
36.	Kabudula, Chodziwadziwa W., et al. (författare) Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001-2013 : A Distributional Analysis Using Household Asset Indicators 2017 Ingår i: Social Indicators Research. - : Springer. - 0303-8300 .- 1573-0921. ; 133:3, s. 1047-1073 Tidskriftsartikel (refereegranskat)abstract Understanding the distribution of socioeconomic status (SES) and its temporal dynamics within a population is critical to ensure that policies and interventions adequately and equitably contribute to the well-being and life chances of all individuals. This study assesses the dynamics of SES in a typical rural South African setting over the period 2001-2013 using data on household assets from the Agincourt Health and Demographic Surveillance System. Three SES indices, an absolute index, principal component analysis index and multiple correspondence analysis index, are constructed from the household asset indicators. Relative distribution methods are then applied to the indices to assess changes over time in the distribution of SES with special focus on location and shape shifts. Results show that the proportion of households that own assets associated with greater modern wealth has substantially increased over time. In addition, relative distributions in all three indices show that the median SES index value has shifted up and the distribution has become less polarized and is converging towards the middle. However, the convergence is larger from the upper tail than from the lower tail, which suggests that the improvement in SES has been slower for poorer households. The results also show persistent ethnic differences in SES with households of former Mozambican refugees being at a disadvantage. From a methodological perspective, the study findings demonstrate the comparability of the easy-to-compute absolute index to other SES indices constructed using more advanced statistical techniques in assessing household SES.
37.	Kabudula, Chodziwadziwa W., et al. (författare) Progression of the epidemiological transition in a rural South African setting : findings from population surveillance in Agincourt, 1993-2013 2017 Ingår i: BMC Public Health. - : BIOMED CENTRAL LTD. - 1471-2458. ; 17 Tidskriftsartikel (refereegranskat)abstract Background: Virtually all low-and middle-income countries are undergoing an epidemiological transition whose progression is more varied than experienced in high-income countries. Observed changes in mortality and disease patterns reveal that the transition in most low-and middle-income countries is characterized by reversals, partial changes and the simultaneous occurrence of different types of diseases of varying magnitude. Localized characterization of this shifting burden, frequently lacking, is essential to guide decentralised health and social systems on the effective targeting of limited resources. Based on a rigorous compilation of mortality data over two decades, this paper provides a comprehensive assessment of the epidemiological transition in a rural South African population. Methods: We estimate overall and cause-specific hazards of death as functions of sex, age and time period from mortality data from the Agincourt Health and socio-Demographic Surveillance System and conduct statistical tests of changes and differentials to assess the progression of the epidemiological transition over the period 1993-2013. Results: From the early 1990s until 2007 the population experienced a reversal in its epidemiological transition, driven mostly by increased HIV/AIDS and TB related mortality. In recent years, the transition is following a positive trajectory as a result of declining HIV/AIDS and TB related mortality. However, in most age groups the cause of death distribution is yet to reach the levels it occupied in the early 1990s. The transition is also characterized by persistent gender differences with more rapid positive progression in females than males. Conclusions: This typical rural South African population is experiencing a protracted epidemiological transition. The intersection and interaction of HIV/AIDS and antiretroviral treatment, non-communicable disease risk factors and complex social and behavioral changes will impact on continued progress in reducing preventable mortality and improving health across the life course. Integrated healthcare planning and program delivery is required to improve access and adherence for HIV and non-communicable disease treatment. These findings from a local, rural setting over an extended period contribute to the evidence needed to inform further refinement and advancement of epidemiological transition theory.
38.	Kabudula, Chodziwadziwa W., et al. (författare) Socioeconomic differences in mortality in the antiretroviral therapy era in Agincourt, rural South Africa, 2001-13 : a population surveillance analysis 2017 Ingår i: The Lancet Global Health. - : ELSEVIER SCI LTD. - 2214-109X. ; 5:9, s. E924-E935 Tidskriftsartikel (refereegranskat)abstract Background Understanding the effects of socioeconomic disparities in health outcomes is important to implement specific preventive actions. We assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001-13.Methods We used data from 21 villages of the Agincourt Health and socio-Demographic Surveillance System (HDSS). We calculated the probabilities of death from birth to age 5 years and from age 15 to 60 years, life expectancy at birth, and cause-specific and age-specific mortality by sex (not in children <5 years), time period, and socioeconomic status (household wealth) quintile for HIV/AIDS and tuberculosis, other communicable diseases (excluding HIV/AIDS and tuberculosis) and maternal, perinatal, and nutritional causes, non-communicable diseases, and injury. We also quantified differences with relative risk ratios and relative and slope indices of inequality.Findings Between 2001 and 2013, 10 414 deaths were registered over 1 058 538 person-years of follow-up, meaning the overall crude mortality was 9.8 deaths per 1000 person-years. We found significant socioecomonic status gradients for mortality and life expectancy at birth, with outcomes improving with increasing socioeconomic status. An inverse relation was seen for HIV/AIDS and tuberculosis mortality and socioeconomic status that persisted from 2001 to 2013. Deaths from non-communicable diseases increased over time in both sexes, and injury was an important cause of death in men and boys. Neither of these causes of death, however, showed consistent significant associations with household socioeconomic status.Interpretation The poorest people in the population continue to bear a high burden of HIV/AIDS and tuberculosis mortality, despite free antiretroviral therapy being made available from public health facilities. Associations between socioeconomic status and increasing burden of mortality from non-communicable diseases is likely to become prominent. Integrated strategies are needed to improve access to and uptake of HIV testing, care, and treatment, and management of non-communicable diseases in the poorest populations.
39.	Kabudula, Chodziwadziwa W, et al. (författare) Two decades of mortality change in rural northeast South Africa 2014 Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 7, s. 25596- Tidskriftsartikel (refereegranskat)abstract BACKGROUND: The MRC/Wits University Agincourt research centre, part of the INDEPTH Network, has documented mortality in a defined population in the rural northeast of South Africa for 20 years (1992-2011) using long-term health and socio-demographic surveillance. Detail on the unfolding, at times unpredicted, mortality pattern has been published. This experience is reviewed here and updated using more recent data.OBJECTIVE: To present a review and summary of mortality patterns across all age-sex groups in the Agincourt sub-district population for the period 1992-2011 as a comprehensive basis for public health action.DESIGN: Vital events in the Agincourt population have been updated in annual surveys undertaken since 1992. All deaths have been rigorously recorded and followed by verbal autopsy interviews. Responses to questions from these interviews have been processed retrospectively using the WHO 2012 verbal autopsy standard and the InterVA-4 model for assigning causes of death in a standardised manner.RESULTS: Between 1992 and 2011, a total of 12,209 deaths were registered over 1,436,195 person-years of follow-up, giving a crude mortality rate of 8.5 per 1,000 person-years. During the 20-year period, the population experienced a major HIV epidemic, which resulted in more than doubling of overall mortality for an extended period. Recent years show signs of declining mortality, but levels remain above the 1992 baseline recorded using the surveillance system.CONCLUSIONS: The Agincourt population has experienced a major mortality shock over the past two decades from which it will take time to recover. The basic epidemic patterns are consistent with generalised mortality patterns observed in South Africa as a whole, but the detailed individual surveillance behind these analyses allows finer-grained analyses of specific causes, age-related risks, and trends over time. These demonstrate the complex, somewhat unpredicted course of mortality transition over the years since the dawn of South Africa's democratic era in 1994.
40.	Kahn, Kathleen, et al. (författare) Mortality trends in a new South Africa : hard to make a fresh start 2007 Ingår i: Scandinavian journal of public health. Supplement. - : SAGE Publications. - 1403-4956 .- 1403-4948 .- 1651-1905. ; 35:69 Suppl., s. 26-34 Tidskriftsartikel (refereegranskat)abstract Aims: This paper examines trends in age-specific mortality in a rural South African population from 1992 to 2003, a decade spanning major sociopolitical change and emergence of the HIV/AIDS pandemic. Changing mortality patterns are discussed within a health-transition framework. Methods: Data on population size, structure, and deaths, obtained from the Agincourt health and demographic surveillance system, were used to calculate person-years at risk and death rates. Life tables were computed by age, sex and calendar year. Mortality rates for the early period 1992—93 and a decade later, 2002— 03, were compared. Results: Findings demonstrate significant increases in mortality for both sexes since the mid-1990s, with a rapid decline in life expectancy of 12 years in females and 14 years in males. The increases are most prominent in children (0—4) and young adult (20—49) age groups, in which increases of two- and fivefold respectively have been observed in the past decade. Sex differences in mortality patterns are evident with increases more marked in females in most adult age groups. Conclusions: Empirical data demonstrate a marked ``counter transition'' with mortality increasing in children and young adults, ``epidemiologic polarization'' with vulnerable subgroups experiencing a higher mortality burden, and a ``protracted transition'' with simultaneous emergence of HIV/AIDS together with increasing non-communicable disease in older adults. The health transition in rural South Africa is unlikely to predict patterns elsewhere; hence the need to examine trends in as many contexts as have the data to support such analyses.
41.	Kahn, Kathleen, et al. (författare) Profile : Agincourt Health and Socio-demographic Surveillance System 2012 Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 41:4, s. 988-1001 Tidskriftsartikel (refereegranskat)abstract The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full 'reconciliation' of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities.
42.	Kahn, Kathleen, et al. (författare) Research into health, population, and social transitions in rural South Africa : data and methods of the Agincourt health and demographic surveillance system 2007 Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 35:Suppl. 69, s. 8-20 Tidskriftsartikel (refereegranskat)abstract Rationale for study: Vital registration is generally lacking in infrastructurally weak areas where health and development problems are most pressing. Health and demographic surveillance is a response to the lack of a valid information base that can provide high-quality longitudinal data on population dynamics, health, and social change to inform policy and practice. Design and measurement procedures: Continuous demographic monitoring of an entire geographically defined population involves a multi-round, prospective community study, with annual recording of all vital events (births, deaths, migrations). Status observations and special modules add value to particular research areas. A verbal autopsy is conducted on every death to determine its probable cause. A geographic surveillance system supports spatial analyses, and strengthens field management.Population and sample size considerations: Health and demographic surveillance covers the Agincourt sub-district population, sited in rural north-eastern South Africa, of some 70,000 people (nearly a third are Mozambican immigrants) in 21 villages and 11,700 households. Data enumerated are consistent or more detailed when compared with national sources; strategies to improve incomplete data, such as counts of perinatal deaths, have been introduced with positive effect.Basic characteristics: A major health and demographic transition was documented over a 12-year period with marked changes in population structure, escalating mortality, declining fertility, and high levels of temporary migration increasing particularly amongst women. A dual burden of infectious and non-communicable disease exists against a background of dramatically progressing HIV/AIDS.Potential and research questions: Health and demographic surveillance sites - fundamental to the INDEPTH Network - generate research questions and hypotheses from empirical data, highlight health, social and population priorities, provide cost-effective support for diverse study designs, and track population change and the impact of interventions over time.
43.	Katus, Hugo, et al. (författare) Early diagnosis of acute coronary syndrome 2017 Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 38:41, s. 3049-3055 Forskningsöversikt (refereegranskat)abstract The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources. A non-trivial proportion of patients fall in an indeterminate category according to rule-out algorithms, and minimal evidence-based guidance exists for the optimal evaluation, monitoring, and treatment of these patients. The Cardiovascular Round Table of the ESC proposes approaches for the optimal application of early strategies in clinical practice to improve patient care following the review of recent advances in the early diagnosis of acute coronary syndrome. The following specific 'indeterminate' patient categories were considered: (i) patients with symptoms and high-sensitivity cardiac troponin <99th percentile; (ii) patients with symptoms and high-sensitivity troponin <99th percentile but above the limit of detection; (iii) patients with symptoms and high-sensitivity troponin >99th percentile but without dynamic change; and (iv) patients with symptoms and high-sensitivity troponin >99th percentile and dynamic change but without coronary plaque rupture/erosion/dissection. Definitive evidence is currently lacking to manage these patients whose early diagnosis is 'indeterminate' and these areas of uncertainty should be assigned a high priority for research.
44.	Leyk, Stefan, et al. (författare) Spatially and Temporally Varying Associations between Temporary Outmigration and Natural Resource Availability in Resource-Dependent Rural Communities in South Africa : A Modeling Framework. 2012 Ingår i: Applied Geography. - : Elsevier. - 0143-6228 .- 1873-7730. ; 34, s. 559-568 Tidskriftsartikel (refereegranskat)abstract Migration-environment models tend to be aspatial within chosen study regions, although associations between temporary outmigration and environmental explanatory variables likely vary across the study space. This research extends current approaches by developing migration models considering spatial non-stationarity and temporal variation - through examination of the migration-environment association at nested geographic scales (i.e. whole-population, village, and subvillage) within a specific study site. Demographic survey data from rural South Africa, combined with indicators of natural resource availability from satellite imagery, are employed in a nested modeling approach that brings out distinct patterns of spatial variation in model associations derived at finer geographic scales. Given recent heightened public and policy concern with the human migratory implications of climate change, we argue that consideration of spatial variability adds important nuance to scientific understanding of the migration-environment association.
45.	Madhavan, Sangeetha, et al. (författare) Child mobility, maternal status, and household composition in rural South Africa 2012 Ingår i: Demography. - : Duke University Press. - 0070-3370 .- 1533-7790. ; 49:2, s. 699-718 Tidskriftsartikel (refereegranskat)abstract This article examines the influence of maternal status, socioeconomic status of the household, and household composition on the mobility of children aged 0-14 in Mpumalanga Province, South Africa, from 1999 to 2008. Using data from the Agincourt Health and Demographic Surveillance System, we found that children whose mothers were temporary migrants, living elsewhere, or dead had higher odds of moving than children whose mothers were coresident. Older children and children living in richer households faced lower odds of mobility. For children whose mothers were coresident, there was no effect of maternal substitutes on child mobility. However, among children whose mothers were temporary migrants or living elsewhere, the presence of prime-aged and elderly females lowered the odds of mobility. For maternal orphans, the presence of elderly women in the household lowered their odds of mobility. The results underscore the importance of examining the conditions under which children move in order to strengthen service delivery targeted at safeguarding children's well-being.
46.	Madhavan, Sangeetha, et al. (författare) Kinship in Practice : Spatial Distribution of Children's Kin Networks 2014 Ingår i: Journal of Southern African Studies. - : Informa UK Limited. - 0305-7070 .- 1465-3893. ; 40:2, s. 401-418 Tidskriftsartikel (refereegranskat)abstract The examination of co-residential household arrangements has been a mainstay in demographic analysis, based on the assumption that those with whom one lives are the most important influences in one's life. In contrast, we know far less about the spaces not shared but none the less crucially important in the lives of children. In this analysis, we bring together detailed ethnographic data on kin connectivity with geographical information system (GIS) data in a rural area of South Africa, in order to: 1) describe the spatial distribution of kin from a child's perspective, with special attention paid to the role of circular migrants who constitute a critical point of spatial dispersion; 2) examine how type of kinship (maternal vs paternal) and 3) socio-economic status intersect with spatial distribution. Our analysis uses a three-category typology of kin spatial arrangement that reflects employment constraints, patterns of union formation and norms of kin obligation. Specifically, we find that 1) the high-density rural node with extensive dispersion is associated with economic and union stability and access to maternal and paternal kin; whereas 2) the rural node with limited dispersion faces greater economic vulnerability and often operates in the absence of formal unions; and 3) the rural node with minimal dispersion offers the least amount of economic security and is almost always dominated by single mothers reliant on maternal kin.
47.	Mbiba, Monicah, et al. (författare) Social capital is subordinate to natural capital in buffering rural livelihoods from negative shocks : Insights from rural South Africa 2019 Ingår i: Journal of Rural Studies. - : Elsevier. - 0743-0167 .- 1873-1392. ; 65, s. 12-21 Tidskriftsartikel (refereegranskat)abstract Rural livelihoods in developing countries are disproportionately vulnerable to multiple shocks and stresses that exacerbate vulnerability, which can result in increased dependence on natural resources. Several studies have been conducted on the safety net role of natural resources, which lower the impact of negative shocks on rural livelihoods. However, the role of social capital as a safety net that can potentially lower natural resource use when households experience negative shocks has been less studied. We examined the role of natural resources and social capital as buffers against negative shocks to reduce vulnerability in rural livelihoods. Using five years of panel data from a rural population in South Africa, multilevel models were constructed to quantify the influence of shocks, social capital and household socio-demographic characterization on three dimensions of natural resource use, namely the number of types of natural resources used, the frequency of natural resource use, and the quantities of natural resources used. Results show that household experience of negative shocks was consistently associated with a significant increase in all dimensions of natural resource use. However, and unexpectedly, social capital did not significantly reduce natural resource use when households experienced shocks. This in no way discounts the role social capital plays in cushioning households post experience of shocks, but rather indicates that reliance on social and natural capital could be complementary rather than substitutable coping strategies post experience of shocks. Efforts to secure rural livelihoods and achieve sustainability should thus focus on building household physical capital to reduce dependency on natural resources in rural households.
48.	Mee, Paul, et al. (författare) Changing use of traditional healthcare amongst those dying of HIV related disease and TB in rural South Africa from 2003 - 2011 : a retrospective cohort study 2014 Ingår i: BMC Complementary and Alternative Medicine. - : BioMed Central (BMC). - 1472-6882. ; 14:1 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: In 2011 there were 5.5 million HIV infected people in South Africa and 71% of those requiring antiretroviral therapy (ART) received it. The effective integration of traditional medical practitioners and biomedical providers in HIV prevention and care has been demonstrated. However concerns remain that the use of traditional treatments for HIV-related disease may lead to pharmacokinetic interactions between herbal remedies and ART drugs and delay ART initiation. Here we analyse the changing prevalence and determinants of traditional healthcare use amongst those dying of HIV-related disease, pulmonary tuberculosis and other causes in a rural South African community between 2003 and 2011. ART was made available in this area in the latter part of this period.METHODS: Data was collected during household visits and verbal autopsy interviews. InterVA-4 was used to assign causes of death. Spatial analyses of the distribution of traditional healthcare use were performed. Logistic regression models were developed to test associations of determinants with traditional healthcare use.RESULTS: There were 5929 deaths in the study population of which 47.7% were caused by HIV-related disease or pulmonary tuberculosis (HIV/AIDS and TB). Traditional healthcare use declined for all deaths, with higher levels throughout for those dying of HIV/AIDS and TB than for those dying of other causes. In 2003-2005, sole use of biomedical treatment was reported for 18.2% of HIV/AIDS and TB deaths and 27.2% of other deaths, by 2008-2011 the figures were 49.9% and 45.3% respectively. In bivariate analyses, higher traditional healthcare use was associated with Mozambican origin, lower education levels, death in 2003-2005 compared to the later time periods, longer illness duration and moderate increases in prior household mortality. In the multivariate model only country of origin, time period and illness duration remained associated.CONCLUSIONS: There were large decreases in reported traditional healthcare use and increases in the sole use of biomedical treatment amongst those dying of HIV/AIDS and TB. No associations between socio-economic position, age or gender and the likelihood of traditional healthcare use were seen. Further qualitative and quantitative studies are needed to assess whether these figures reflect trends in healthcare use amongst the entire population and the reasons for the temporal changes identified.
49.	Mee, Paul, et al. (författare) Determinants of the risk of dying of HIV/AIDS in a rural South African community over the period of the decentralised roll-out of antiretroviral therapy : a longitudinal study 2014 Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 7 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Antiretroviral treatment (ART) has significantly reduced HIV mortality in South Africa. The benefits have not been experienced by all groups. Here we investigate the factors associated with these inequities.DESIGN: This study was located in a rural South African setting and used data collected from 2007 to 2010, the period when decentralised ART became available. Approximately one-third of the population were of Mozambican origin. There was a pattern of repeated circular migration between urban areas and this community. Survival analysis models were developed to identify demographic, socioeconomic, and spatial risk factors for HIV mortality.RESULTS: Among the study population of 105,149 individuals, there were 2,890 deaths. The HIV/TB mortality rate decreased by 27% between 2007-2008 and 2009-2010. For other causes of death, the reduction was 10%. Bivariate analysis found that the HIV/TB mortality risk was lower for: those living within 5 km of the Bhubezi Community Health Centre; women; young adults; in-migrants with a longer period of residence; permanent residents; and members of households owning motorised transport, holding higher socioeconomic positions, and with higher levels of education. Multivariate modelling showed, in addition, that those with South Africa as their country of origin had an increased risk of HIV/TB mortality compared to those with Mozambican origins. For males, those of South African origin, and recent in-migrants, the risk of death associated with HIV/TB was significantly greater than that due to other causes.CONCLUSIONS: In this community, a combination of factors was associated with an increased risk of dying of HIV/TB over the period of the roll-out of ART. There is evidence for the presence of barriers to successful treatment for particular sub-groups in the population, which must be addressed if the recent improvements in population-level mortality are to be maintained.
50.	Mee, Paul, et al. (författare) 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) 2014 Ingår i: Journal of Global Health. - : Edinburgh University Global Health Society. - 2047-2978 .- 2047-2986. ; 4:1 Tidskriftsartikel (refereegranskat)abstract 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.

Skapa referenser, mejla, bekava och länka

Länka till träfflistan

Resultat 1-50 av 73

Avgränsa träffmängd

Typ av publikation: tidskriftsartikel (65); bokkapitel (3); annan publikation (2); doktorsavhandling (2); forskningsöversikt (1)

Typ av innehåll: refereegranskat (69); övrigt vetenskapligt/konstnärligt (4)

Författare/redaktör: Collinson, Mark A. (44); Kahn, Kathleen (42); Tollman, Stephen M. (26); Tollman, Stephen (17); Collinson, Mark (17); Clark, Samuel J. (16); visa fler...; Byass, Peter (13); Gómez-Olivé, F. Xavi ... (11); Kabudula, Chodziwadz ... (11); Madhavan, Sangeetha (9); Mee, Paul (8); Collinson, Mark A., ... (7); Sartorius, Benn (6); Houle, Brian (6); Bocquier, Philippe (6); Kahn, Kathleen, 1960 ... (6); Garenne, Michel (6); Beguy, Donatien (6); Gomez-Olive, Frances ... (5); Wagner, Ryan G. (5); Alam, Nurul (5); Herbst, Kobus (5); Tollman, Stephen M., ... (5); Twine, Rhian (4); Oduro, Abraham (4); Ginsburg, Carren (4); Twine, Wayne (4); White, Michael J (4); Garenne, Michel L (4); Vounatsou, Penelope (4); Schatz, Enid (4); Gyapong, Margaret (3); Byass, Peter, 1957- (3); Silaule, Bernard (3); Odhiambo, Frank (3); Kabudula, Chodziwadz ... (3); Sankoh, Osman A (3); Wamukoya, Marylene (3); Afolabi, Sulaimon A. (3); Odhiambo, Frank O (3); Oti, Samuel (3); Williams, Thomas N (3); Afolabi, Sulaimon (3); Lankoande, Bruno (3); Clark, Benjamin D (3); Bauni, Evasius (3); Ezeh, Alex (3); Mossong, Joël (3); Ndila, Carolyne (3); Mochamah, George (3); visa färre...

Lärosäte: Umeå universitet (69); Uppsala universitet (3); Göteborgs universitet (1); Luleå tekniska universitet (1); Karolinska Institutet (1)

Språk: Engelska (73)

Forskningsämne (UKÄ/SCB): Medicin och hälsovetenskap (64); Samhällsvetenskap (5); Naturvetenskap (1); Teknik (1)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se

Stäng

Kopiera och spara länken för att återkomma till aktuell vy