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Background: The relationship between overweight and under-nutrition, particularly in resource-poor settings, poses practical challenges for targeting nutrition interventions. Current anthropometric indicators including weight for length (WLZ) recommended by the WHO may be challenging in community settings. Objectives: The aim of this study was to assess whether MUAC can accurately identify children aged younger than two years with overweight and obesity. Method: A descriptive, cross-sectional study was used to collect data from a non-probability sample of 397 young South African children from October 2015 to February 2016. MUAC cut-off values were tested using a receiver operating characteristic and area under the curve (AUC). Results: The prevalence of overweight (WLZ > +2) and obesity (WLZ > +3) was 11% (n = 44) and 5% (21) respectively. A MUAC cut-off value for identifying male children 6 to 24 months old with overweight was determined at 16.5 cm (85% sensitivity, 71.4% specificity, AUC = 0.821) and female children at 16.5 cm (100% sensitivity, 76.6% specificity, AUC = 0.938). Conclusions: MUAC may be an appropriate tool for identifying children younger than two years old with overweight and obesity. The predicted MUAC cut-off values were able to identify infants and young children with overweight accurately. [ABSTRACT FROM AUTHOR]

Shared learning and supportive conversations between parents encourages disclosure and cultivates an environment of support. This paper presents the process evaluation through the qualitative outcomes of community parent support groups facilitated by local mentor mothers. Qualitative data collected via two (2) Focus Group Discussions (FGD) with group facilitators was followed by four (4) FGD with a total of forty of the parents from the support groups. During the two (2) FGDs with the facilitators, group values were established and adopted. The facilitators agreed amongst themselves to implement the group values to champion and promote the stability of each parent support group. Three key themes emerged from the four FGDs involving support group mothers included: (1) Awareness of mutual connection gained by attending parent groups; (2) Health and social support gained through collectively sharing knowledge and (3) Improved confidence in parenting ability through dialogue. Findings are a showcase the relevance of the group values and mutual benefits of attending parent support groups. The unique parent support initiative revealed that positive health seeking behaviour could be promoted amongst parents in the Early Childhood Development (ECD) phase using a participatory action research approach. Recommendations and implications for group work practice are provided which encourage the use of group values to enable conducive environments for participation and trust building in community based parent support groups. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to analyse the dispensing patterns of vitamins (Anatomical Therapeutic Chemical (ATC) group A11) over a one-year period in a group of community pharmacies in South Africa. Design and setting: A retrospective drug utilisation study was conducted on community pharmacy electronic dispensing records in South Africa recorded in 2013. Outcome measures: All products for ATC subgroup A11 were extracted and analysed. Results: A total of 164 233 vitamin products were dispensed to 84 805 patients (62.64% female patients). Males received on average 2.09 (SD = 2.63) vitamin products per year, compared to 1.84 (SD = 2.13) products for females. Ergocalciferol (A11CC01) was the most often dispensed (37.48% of all vitamin products), followed by plain Vitamin B-complex products (A11EA00) accounting for 32.77%. Ergocalciferol (vitamin D2) is only available on prescription (50 000 IU tablets or 50 000 IU/ml oily drops) in South Africa. Tablets were the preferred dosage form (62.84% of products). Most injections were for Vitamin B1 or Vitamin B combination products. Conclusion: Ergocalciferol and injectable vitamins have recently been rescheduled to prescription-only; it is probable that this has impacted on the usage of these products. It is important to monitor future vitamin supplementation behaviour in community pharmacies since pharmacies are selling many of these products and pharmacists can, by counselling patients, determine the reasons for the use of these products. Furthermore, should dietitians and nutritionists choose to work with this captive audience, supplementation patterns can be monitored to develop and implement appropriate awareness campaigns. Further studies to explore these baseline results are recommended. [ABSTRACT FROM AUTHOR]

Objective: To describe catch-up growth in children with moderate acute malnutrition (MAM) on targeted supplementation using Ready-to-Use Supplementary Food (RUSF). Methods: An impact study was done to determine anthropometric changes in children aged 12-60 months who received RUSF (175 kcal/kg/day) for six weeks, managed as outpatients and followed up for 12 weeks until a final assessment. Results: Default rates were high, with 30% of children returning to the primary healthcare facility for follow-up only once or twice. Despite significant improvement in height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), weight-for-height Z-score (WHZ) and mid-upper arm circumference (MUAC), 70.5% of the sample remained in the same malnutrition classification and only 26% recovered. The growth velocity of children with a lower initial WHZ was significantly higher (r = -0.15, p < 0.05) than those with less wasting, but only 20% grew at a rate to achieve catch-up growth. The mean growth velocity decreased as the intervention period continued. Conclusion: All median anthropometric indicators improved with RUSF supplementation. However, catch-up growth or recovery occurred in only 20-25% of children included in the study. These findings create questions about the value of supplementation in the absence of blanket food distribution or other interventions to address food security. [ABSTRACT FROM AUTHOR]

The prevalence of HIV&AIDS is embedded in social and economic inequity and the relationship between social determinants and HIV incidence is well established. The aim of this study was to determine which socio-economic and demographic factors are related to HIV status in the age group 18 to 49 years in informal settlements in the Eastern Cape, South Africa. This cross-sectional study was conducted in 3 informal settlements (n= 752) during March 2013 within the Nelson Mandela Bay and Buffalo City districts. A proportional cluster sample was selected and stratified by area and formal plot/squatter households in open areas. Respondents who volunteered to participate had to provide informed written consent before trained, bilingual peer educators interviewed them and completed the structured questionnaire. HIV status was determined and information on demographic and socio-economic variables was included in the bivariate analysis. The prevalence of HIV was higher, at 17.3%, than the 2011 estimated national prevalence among the general population in South Africa. The level of education (χ2= 5.50, df = 1,p< 0.05), geographical site (χ2= 7.41, df = 2,p< 0.05), gender (χ2= 33.10, df = 1,p< 0.0005), household food insecurity (χ2= 4.77, df = 1,p< 0.05), cooking with cast iron pots (χ2= 15.0, df = 3,p< 0.05) and availability of perceived ‘wealth’ indicators like mobile telephones and refrigerators (χ2= 9.67, df = 2,p< 0.05) were significantly associated with HIV-status. No significant associations could be demonstrated between household income, the number of people living in the household and the availability of electricity/water and HIV status. As the observed levels of HIV prevalence underlined gender bias and failure to graduate from high school, future interventions should focus on HIV prevention in female schoolchildren. However, HIV infection is also prevalent among wealthier individuals in informal settlements, which indicates that renewed efforts should be made to improve sexual risk behaviour within this group. [ABSTRACT FROM PUBLISHER]

HIV and AIDS has serious repercussions on psychological, social and physical well-being, and the assessment of Quality of Life (QoL) of people living with HIV and AIDS is essential to gauge how these challenges are met. The WHOQoL-HIV Bref forms part of a suite of instruments developed by the World Health Organisation. The purpose of this paper is to describe the quality of life of a sample of HIV-infected students at a South African university, as well as explain the internal consistency between questions within each of the QoL domains. A descriptive, cross-sectional study design using a quantitative approach was applied. A non-probability, purposive sampling approach was utilized and students enrolled in the antiretroviral therapy or wellness programme were invited to voluntarily participate in this study. The WHOQOL-HIV Bref was self-administered after explanation of the questions by a registered, trained health care professional. A total of 63 students returned completed questionnaires that were included in the analysis. Acceptable to good reliability scores were established for the following domains: Level of Independence; Social Relations; Environment and Spiritual or Personal Beliefs. Assessing QoL in the sample, the lowest score was for “Spirituality” and the highest “Social Relations”. The “Physical” and “Psychological” domain scores for females were significantly lower than the score for males. There was no significant difference between any of the domain scores among participants with CD4 cell counts above or below 350 cells/mm3. In general the performance of this sample is encouraging and it is recommended that the measure be utilized for QoL screening, and further research. The WHOQOL-HIV Bref for students does not contain an academic wellness component which should be added considering the significant effects of HIV on neuropsychological functioning. Also further investigation into the reasons for poor scores obtained in physical and psychological well-being in females should be encouraged. [ABSTRACT FROM PUBLISHER]

Background: Socioeconomically deprived children are at increased risk of ill-health associated with sedentary behavior, malnutrition, and helminth infection. The resulting reduced physical fitness, growth retardation, and impaired cognitive abilities may impede children’s capacity to pay attention. The present study examines how socioeconomic status (SES), parasitic worm infections, stunting, food insecurity, and physical fitness are associated with selective attention and academic achievement in school-aged children. Methodology: The study cohort included 835 children, aged 8–12 years, from eight primary schools in socioeconomically disadvantaged neighborhoods of Port Elizabeth, South Africa. The d2-test was utilized to assess selective attention. This is a paper and pencil letter-cancellation test consisting of randomly mixed letters d and p with one to four single and/or double quotation marks either over and/or under each letter. Children were invited to mark only the letters d that have double quotation marks. Cardiorespiratory fitness was assessed via the 20 m shuttle run test and muscle strength using the grip strength test. The Kato-Katz thick smear technique was employed to detect helminth eggs in stool samples. SES and food insecurity were determined with a pre-tested questionnaire, while end of year school results were used as an indicator of academic achievement. Principal findings: Children infected with soil-transmitted helminths had lower selective attention, lower school grades (academic achievement scores), and lower grip strength (all p<0.05). In a multiple regression model, low selective attention was associated with soil-transmitted helminth infection (p<0.05) and low shuttle run performance (p<0.001), whereas higher academic achievement was observed in children without soil-transmitted helminth infection (p<0.001) and with higher shuttle run performance (p<0.05). Conclusions/Significance: Soil-transmitted helminth infections and low physical fitness appear to hamper children’s capacity to pay attention and thereby impede their academic performance. Poor academic achievement will make it difficult for children to realize their full potential, perpetuating a vicious cycle of poverty and poor health. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Background: An in-depth epidemiological investigation on intestinal parasite infections in an impoverished area of Port Elizabeth, South Africa provides a unique opportunity for research on its impact on children's physical fitness, cognitive performance and psychosocial health. Additionally, we will screen risk factors for the development of diabetes and hypertension in adulthood.Methods/design: A 2-year longitudinal cohort study will be conducted, consisting of three cross-sectional surveys (baseline and two follow-ups), in eight historically black and coloured (mixed race) primary schools located in different townships in Port Elizabeth, South Africa. Approximately 1000 Grade 4 primary schoolchildren, aged 8 to 12 years, will be enrolled and followed. At each survey, disease status, anthropometry and levels of physical fitness, cognitive performance and psychosocial health will be assessed. After each survey, individuals diagnosed with parasitic worm infections will be treated with anthelminthic drugs, while children with other infections will be referred to local clinics. Based on baseline results, interventions will be tailored to the local settings, embedded within the study and implemented in half of the schools, while the remaining schools will serve as controls. Implementation of the interventions will take place over two 8-week periods. The effect of interventions will be determined with predefined health parameters.Discussion: This study will shed new light on the health burden incurred by children in deprived urban settings of South Africa and provide guidance for specific health interventions. Challenges foreseen in the conduct of this study include: (i) difficulty in obtaining written informed consent from parents/guardians; (ii) administration of questionnaires in schools where three languages are spoken (Afrikaans, Xhosa and English); (iii) challenges in grasping concepts of psychosocial health among schoolchildren using a questionnaire; and (iv) loss to follow-up due to the study setting where illiteracy, mobility and violence are common. Finally, designing the health interventions together with local principals and teachers will allow all concerned with the research to bolster a sense of community ownership and sustained use of the interventions after the study has ceased.Trial Registration: Controlled-trials.com; identifier: ISRCTN68411960 (date assigned: 14 February 2014). [ABSTRACT FROM AUTHOR]