Browsing by Author "Jagarnath, Meryl"

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    Impacts of outdoor and indoor air pollution on COVID-19 health outcomes and interventions in the Southern African development community region: a scoping review
    (2025) Banwari, Aleya; Rother, Hanna-Andrea; Jagarnath, Meryl
    Purpose of Review: The Southern African Development Community (SADC) faces high poverty and pollution levels, with nearly half of urban residents living in informal settlements. Research on air pollution's impact on COVID-19 in SADC is limited. This review explored how pollutants like fine particulate matter (PM₂.₅), nitrogen dioxide (NO₂), and household air pollutants (HAP) affect COVID-19 severity. We examined outdoor and indoor exposures, noting that solid fuels and poor ventilation increase respiratory risks in low-income communities. We identified key pollutants, proposed mitigation strategies, highlighted knowledge gaps, and made recommendations for air quality management during and after pandemics. Recent Findings: Of 331 studies, 19 met eligibility criteria, with 11 from SADC countries like South Africa, Zimbabwe, and Zambia. Findings indicate that prolonged exposure to PM₂.₅ and NO₂ harms lung function, worsens asthma and chronic obstructive pulmonary disease (COPD), and increases COVID-19 hospitalisations and mortality. In many SADC informal settlements, poorly built structures limit ventilation, and burning biomass and paraffin indoors increases pollutant levels. Lockdowns may have reduced outdoor pollution, but indoor pollution increased, particularly harming vulnerable groups. Limited data from rural and low-income areas hinders thorough assessments of pollution-related health risks and the creation of effective, tailored policies. Summary: The interplay of air pollution, socio-economic inequalities, and constrained healthcare capacity intensifies COVID-19 outcomes in the SADC region. To address these intertwined challenges, urgent cleaner energy transitions, enhanced air quality monitoring, and strategies to reduce household pollution are needed. Stronger local research will support evidence-based policymaking, strengthening public health and pandemic resilience.
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    Investigating strategies for addressing child and adolescent mental health following exposure to extreme weather events in low- and middle-income countries: A scoping review
    (2022) Kadota, Molly Kaelin; Rother, Hanna-Andrea; Jagarnath, Meryl
    The inevitability of an increase in extreme weather events (EWE) due to climate change will likely influence every determinant of human health and wellbeing. Children and adolescents, defined as anyone under the age of 19, are among the most susceptible because of their unique vulnerabilities (i.e. physiologically, developmentally, biologically, and behaviourally) and lifespans. The effects on physical health are generally well documented, and many climate change adaptation strategies have begun to include them in their considerations. However, the implications of EWE exposure on mental health are less understood, particularly within low- and middle-income countries (LMICs). Populations residing in LMICs are especially vulnerable because of pre-existing conditions like already extreme weather, lack of resources, poor economic conditions, weak health systems, high burden of disease, and poor governance. Therefore, children and adolescents in LMICs maintain a heightened vulnerability to experiencing adverse effects. In Part A, a preliminary literature review determined the breadth of information documenting child and adolescent mental health outcomes following exposure to EWE. Research, mainly from high-income countries (HICs) or international organisations, demonstrating an association between mental health impacts and climate change, focused primarily on adult populations, has increased substantially over the last few years. Experiencing an EWE in childhood or adolescence likely leads to direct (e.g. anxiety, post-traumatic stress disorder, depression, behavioural disorders, and suicidal ideations), indirect (e.g. displacement, loss of sense of place, violence, malnutrition, developmental delays, and disruption of education), and overarching (e.g. general climate anxiety about impending threats) mental health impacts, presenting in both the short- and long-term. The goals of adaptation and mitigation strategies were also presented in the protocol to determine the potential for specific mental health strategies. In Part B, then, a scoping review was conducted to provide a narrative of where adaptation, resilience, and mitigation strategies in LMICs address, and where they do not, child and adolescent mental health impacts following exposures to EWE. A search conducted in June-August 2021 of 12 online databases from the Pubmed, EBSCOhost, and Scopus platforms and grey literature sites like Google Scholar, Microsoft Academic, and NGO pages identified 5,073 relevant records. Search results were limited to documents written in English and filtered by a 2000-2021 date range. In the current LMICs climate change strategies, the review highlighted a general lack of consideration for child and adolescent mental health and resilience. Therefore, eight main themes recurring in the literature were identified as integral components for including child and adolescent mental health in future national strategies and policymaking discussions. The themes provide general guidance, but their addition necessitates country-specific conceptualisation to determine technical considerations (e.g. funding and responsibility) and relevance. This review, therefore, emphasised the necessity for LMICs to begin including child and adolescent mental health in climate change strategies, highlighted key recommendations that were applicable in the LMICs context, and illuminated still existing gaps in the literature and potential areas for future research.
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    Prevalence and trends of diarrhoea in children under five in Masiphumelele, Cape Town, South Africa (2019-2023)
    (2025) Mokoena, Prince; Jagarnath, Meryl
    Background: Diarrhoea in children under five years is a major cause of morbidity and mortality in SubSaharan Africa. Informal settlements are disproportionately affected due to overcrowding, inadequate sanitation, and unsafe water practices. This study provides a comprehensive analysis of diarrhoea prevalence, demographic distribution, seasonal patterns, and the effect of the COVID-19 pandemic on paediatric diarrhoea cases in Masiphumelele Township, Cape Town, South Africa (2019-2023). Method: A retrospective observational analysis of clinical records from January 2019 to December 2023 at Masiphumelele Clinic was conducted. The prevalence of diarrhoea was calculated using various denominators, including the total clinic patients, the total children under five years of age, and the total number of clinic patients with diarrhoea. Statistical analyses evaluated trends using proportion comparisons (Z-tests) and temporal patterns (Chi-squared tests for trends) evaluate significant changes in prevalence over time and during the COVID19 period. Results: Diarrhoea in children under five years of age accounted for 2.04% of the total 391355 clinic visits, with the trend rising from 79 cases in 2019 to 233 in 2023. Children under five years of age accounted for 11.2% of all clinic patients and 74.7% of cases of diarrhoea. The highest burden was observed among boys (56%) and children between 2 and 3 years (28.2%). Seasonal peaks in diarrhoea prevalence were observed in the warmer months, with the highest case counts recorded in February (11.7%) and November (10.2%), which is consistent with the known diarrhoeal disease seasonality in South Africa. The prevalence of diarrhoea increased significantly from 1.37 cases per 1000 before the COVID-19 pandemic to 2.51 cases per 1000 after the pandemic (p < 0.001). This increase may reflect healthcare disruptions, limited access to prevention services, and changes in hygiene practices during the pandemic. Conclusions: This study highlights the continued burden of diarrhoeal diseases on informal settlements and the worsening role of the COVID-19 pandemic. Targeted interventions that focus on improving water and sanitation infrastructure, seasonal preparation, and educational campaigns that focus on age-specific vulnerabilities are essential. Strengthening public health policies and health systems that address seasonal disease patterns and vulnerabilities is critical to mitigate the effects of diarrhoea and ensure resilience to future public health crises.