Search

Abstract Background There is a high burden of depression globally, including in South Africa. Maternal depression is associated with poverty, unstable income, food insecurity, and lack of partner support, and may lead to poor outcomes for mothers and children. In South Africa one-third of working women are in informal work, which is associated with socioeconomic vulnerability. Methods A cross sectional survey explored work setting and conditions, food security and risk of depression among informal working women with young children (0–3 years). Depression risk was assessed using the Edinburgh Postnatal Depression Score (EPDS) and Whooley score. Food insecurity was evaluated using Household Food Insecurity Access Scale. Data was analysed using SPSS and Stata. Results Interviews were conducted with 265 informal women workers. Types of work included domestic work, home-based work, informal employees and own account workers, most of whom were informal traders. Most participants (149/265; 56.2%) earned between US$70–200 per month, but some participants (79/265; 29.8%) earned US$200 per month (37/265; 14.0%). Many participants experienced mild (38/267; 14.3%), moderate (72/265; 27.2%) or severe (43/265; 16%) food insecurity. Severe food insecurity was significantly higher among participants with the lowest income compared to those with the highest income (p = 0.027). Women who received financial support from the baby’s father were less likely to be food insecure (p = 0.03). Using EPDS scores, 22/265 (8.3%) women were designated as being at risk of depression. This was similar among postnatal women and women with older children. Household food insecurity was significantly associated with depression risk (p

Partnerships between Higher Education Institutions in the global South and North have potential for building capacity in public health research in low-resource countries. We present experiences of partners involved in a North–South–South partnership between universities in Norway, the Democratic Republic of Congo (DRC) and South Africa. The partnership aimed to establish a postgraduate programme in nutritional epidemiology at the University of Kinshasa, DRC, and develop a cadre of researchers and academic leaders to provide locally generated health research to inform policy. In-depth interviews were conducted with 31 purposively selected stakeholders, facilitators, and students from partner institutions. All participants expressed positive experiences, indicating that the partnership provided excellent opportunities to network, enriched participants' learning and enhanced academic growth, with benefits at individual, institutional, and country levels. Participants suggested that maintaining a common vision was important for success, facilitated by joint planning of project activities, focussing strongly on building research and academic capacity at Kinshasa School of Public Health and addressing local nutrition problems. Important challenges highlighted for future partnerships included failures of co-facilitation and co-supervision, poor research dissemination and policy impact, and concerns about sustainability. Notwithstanding, North–South–South partnerships can address skills shortages in public health research with significant benefits to all partner institutions. [ABSTRACT FROM AUTHOR]

Objective To report the rates of mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV), and the coverage of interventions designed to prevent such transmission, in KwaZulu-Natal. Methods Mothers with infants aged [Less than or equal to] 16 weeks and fathers or legal guardians with infants aged 4-8 weeks who, between May 2008 and April 2009, attended immunization clinics in six districts of KwaZulu-Natal were included. The mothers' uptake of interventions for the prevention of MTCT was explored. Blood samples from infants aged 4-8 weeks were tested for anti-HIV antibodies and, if antibody-positive, for HIV desoxyribonucleic acid (DNA). Findings Of the 19494 mothers investigated, 89.9% reported having had an HIV test in their recent pregnancy. Of the 19138 mothers who reported ever having had an HIV test, 34.4% reported that they had been found HIV-positive and, of these, 13.7% had started lifelong antiretroviral treatment and 67.2% had received zidovudine and nevirapine. Overall, 40.4% of the 7981 infants tested were found positive for anti-HIV antibodies, indicating HIV exposure. Just 7.1% of the infants checked for HIV DNA (equating to 2.8% of the infants tested for anti-HIV antibodies) were found positive. Conclusion The low levels of MTCT observed among the infants indicate the rapid, successful implementation of interventions for the prevention of such transmission. Sampling at immunization clinics appears to offer a robust method of estimating the impact of interventions designed to reduce such transmission. Large-scale elimination of paediatric HIM infections appears feasible, although this goal has not yet been fully achieved in KwaZulu-Natal. [TEXT NOT REPRODUCIBLE IN ASCII.] Elimination du VIH pediatrique dans le KwaZulu-Natal, Afrique du Sud: evaluation a grande echelle des mesures de prevention contre la transmission mere-enfant Objectif Presenter les taux de transmission mere-enfant (TME) du virus de l'immunodeficience humaine (VIH), ainsi que la portee des mesures concues pour prevenir cette transmission, dans le KwaZulu-Natal. Methodes Ont ete incluses des meres de nourrissons d'un age ≤ a 16 semaines et des peres ou des tuteurs legaux de nourrissons ages de 4 a 8 semaines qui, entre mai 2008 et avril 2009, avaient frequente des centres de vaccination dans six districts du KwaZulu-Natal. On a etudie l'adhesion a ces mesures de prevention de la TME par les meres. On a recherche les anticorps anti-VIH dans les echantillons de sang des nourrissons ages de 4 a 8 semaines puis, en cas de presence de ces anticorps, on a procede a la recherche de l'acide desoxyribonucleique (ADN) du VIH. Resultats Parmi les 19 494 meres ayant participe a l'etude, 89,9% ont signale avoir fait realiser un depistage VIH lors de leur recente grossesse. Parmi les 19 138 meres ayant signale avoir eu un depistage VIH, 34,4% ont signale que le resultat avait indique qu'elles etaient seropositives et parmi celles-ci, 13,7% avaient commence une therapie antiretrovirale a vie et 67,2% avaient recu de la zidovudine et de la nevirapine. Globalement, on a constate la presence d'anticorps anti-VIH chez 40,4% des 7 981 nourrissons ayant fait l'objet de cette recherche, indiquant leur exposition au VIH. Seuls 7,1% des nourrissons ayant fait l'objet du test d'ADN du VIH (equivalent a 2,8% des nourrissons chez lesquels la presence d'anticorps VIH avait ete detectee) presentaient des echantillons positifs. Conclusion Les faibles niveaux de TME observes chez ces nourrissons indiquent la mise en place rapide et reussie des mesures de prevention contre cette transmission. Le prelevement d'echantillons dans les centres de vaccination semble offrir u ne methode solide d'estimation de l'impact des mesures destinees a reduire cette transmission. L'elimination a grande echelle des infections a VIH chez l'enfant parait realisable, en depit du fait qu'elle n'ait pas ete entierement atteinte dans le KwaZulu-Natal. [TEXT NOT REPRODUCIBLE IN ASCII.] Eliminacion del VIH pediatrico en KwaZulu-Natal, Sudafrica: valoracion a gran escala de las intervenciones para prevenir la transmision maternofilial Objetivo Notificar los indices de transmision maternofilial (TMT) del virus de la inmunodeficiencia humana (VIH) y la cobertura de las intervenciones disenadas para prevenir dicha transmision en KwaZulu-Natal. Metodos Se incluyeron las madres con hijos con edad igual o inferior a 16 semanas y los padres o tutores legales con ninos de edades comprendidas entre 4 y 8 semanas que hubieran asistido a los centros de vacunacion de seis distritos de KwaZulu-Natal entre mayo de 2008 y abril de 2009. Se evaluo la aceptacion de las madres respecto a las intervenciones para la prevencion de la transmision del VIH de la madre al nino. Se analizaron las muestras de sangre de ninos de entre 4 y 8 semanas para comprobar la presencia de anticuerpos anti-VIH y, en el caso de obtener un resultado positivo para dichos anticuerpos, se comprobo la presencia del acido desoxirribonucleico (ADN) del VIH. Resultados El 89,9% de las 19 494 madres que participaron en el estudio afirmaron haberse realizado una prueba del VIH en su Ultimo embarazo. De las 19 138 madres que afirmaron haberse realizado alguna vez una prueba del VIH, un 34,4% aseguro que la prueba para el VIH resulto positiva en su caso y, de ese porcentaje, un 13,7% inicio un tratamiento cronico con antirretrovirales y un 67,2% recibio zidovudina y nevirapina. En total, el 40,4% de los 7981 ninos estudiados obtuvieron un resultado positivo de anticuerpos anti-VIH, lo que indica su exposicion al VIH. Solo el 7,1% de los ninos sometidos a las pruebas del ADN del VIH (equivalente al 2,8% de los ninos a quienes se les realizo pruebas de anticuerpos anti-VIH) obtuvieron un resultado positivo en dicha prueba. Conclusion Los bajos niveles deTMT del VIH observados en los ninos reflejan una puesta en practica rapida y fructifera de las intervenciones para la prevencion de dicha transmision. Las tomas de muestras en los centros de vacunacion parecen constituir un metodo solido para calcular el impacto de las intervenciones disenadas para reducir dicha transmision. La eliminacion de las infecciones pediatricas del VIH a gran escala parece viable, si bien este objetivo no esta completamente conseguido en KwaZulu-Natal., Introduction For the public health systems of countries with high prevalences of infection with the human immunodeficiency virus (HIV), the identification of HIV-infected pregnant women and their treatment with antiretroviral [...]

South Africa has a documented high prevalence of stunting and increasing obesity in children as well as obesity in adults. The double burden of malnutrition, which can be on an individual‐, household‐ or population level, has implications for both health and the economic development of a community and country. This paper describes a large‐scale survey (N = 774) of infant feeding, growth monitoring and anthropometry among mother and child pairs aged 6 months of age in KwaZulu‐Natal (KZN), South Africa, conducted between January and August 2017. Among children, a large increase in the prevalence of stunting and obesity was seen between birth and 6 months of age increasing from 9.3% to 21.7% and 4.0% to 21.0%, respectively. 32.1% of the mothers were overweight [body mass index (BMI): 25.0–29.9] and 28.4% had obesity grade 1 (BMI: 30–<40). Although most mothers (93%; 563/605) initiated breastfeeding, the introduction of other foods started early with 17.6% (56/319) of the mothers having started giving other fluids or food to their child within the first month. At 6 months 70.6% (427/605) children were still breastfed and 23.5% were exclusively breastfed. In addition, we found that length measurements were done less frequently than weight measurements between birth and 6 months, on average 2.2 (SD: 1.3) versus 5.8 (SD: 1.5) times. Moreover, there is a need for improvement of health worker training and understanding regarding anthropometric measurements when assessing malnutrition in children in the clinics. Early detection and improved infant feeding practices are key in preventing both stunting and obesity in children. Key messages: The double burden of malnutrition is severe in KwaZulu‐Natal with high rates of maternal obesity and increasing prevalence of stunting and obesity among infants in the first 6 months of life.Breastfeeding and complementary feeding practices are suboptimal and additional support for breastfeeding is required in the post‐natal period and in the workplace to address breastfeeding challenges.Growth monitoring is inadequate in health facilities leading to many lost opportunities for early identification of malnutrition. Hence, anthropometric practices and interpretation of findings need to be strengthened. [ABSTRACT FROM AUTHOR]