Browsing by Subject "Rural Population"

Now showing 1 - 7 of 7
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    Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia
    (2017) Bitew, Tesera; Hanlon, Charlotte; Kebede, Eskinder; Honikman, Simone; Fekadu, Abebaw
    Antenatal depressive symptoms affect around 12.3% of women in in low and middle income countries (LMICs) and data are accumulating about associations with adverse outcomes for mother and child. Studies from rural, low-income country community samples are limited. This paper aims to investigate whether antenatal depressive symptoms predict perinatal complications in a rural Ethiopia setting.
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    Association between perceived built environmental attributes and physical activity among adults in South Africa
    (2017) Malambo, Pasmore; Pheiffer, Carmen; Lambert, Estelle V; De Villers, Anniza; Puoane, Thandi
    Abstract Background To investigate the association between perceived environmental attributes and leisure-time and transport-related physical activity. Methods This was a cross-sectional survey involving 671 South Africans aged ≥35 years from urban and rural settings. International Physical Activity Questionnaire and Neighbourhood Walkability Scale were used to collect data. Multivariable logistic regressions were used to investigate the associations. Results Significant urban vs. rural differences were apparent in the distribution of most attributes of neighborhood environment. After adjusting for gender, age, setting and relevant interaction terms, proximity to local stores was significantly associated with leisure-time physical activity (OR: 4.26; 95% CI, 1.00–18.08); while proximity to transit stops (2.44; 1.48–4.02), pleasant scenery (1.93; 1.07–3.46), sidewalks (2.36; 1.25–4.44), shade from trees (2.14; 1.19–3.85), traffic (2.17; 91.21–3.91) and well-lit streets (2.01; 1.04–3.89) were significantly associated with walking for leisure. Four-way intersections (4.54; 1.54–13.43), pleasant scenery (3.84; 1.35–10.99), traffic (0.28; 0.09–0.89), sidewalks (3.75; 1.06-13.27) and crosswalks were associated with transport related physical activity. Proximity to transit stops (2.12; 1.17–3.84) and well maintained sidewalks (2.69; 2.20–10.02) were significantly associated with total physical activity. Significant interactions by setting were apparent in some of the associations. Conclusion Some, but not all attributes of a neighborhood environment were significantly associated in expected directions with the three physical activity domains in this mixed urban and rural population. This study highlights the need for policy strategies aimed at improving or maintaining these perceived environmental attributes to promote physical activity.
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    Developing intervention strategies to optimise body composition in early childhood in South Africa
    (2017) Draper, Catherine E; Tomaz, Simone A; Stone, Matthew; Hinkley, Trina; Jones, Rachel A; Louw, Johann; Twine, Rhian; Kahn, Kathleen; Norris, Shane A
    Purpose. The purpose of this research was to collect data to inform intervention strategies to optimise body composition in South African preschool children. Methods. Data were collected in urban and rural settings. Weight status, physical activity, and gross motor skill assessments were conducted with 341 3–6-year-old children, and 55 teachers and parents/caregivers participated in focus groups. Results. Overweight and obesity were a concern in low-income urban settings (14%), but levels of physical activity and gross motor skills were adequate across all settings. Focus group findings from urban and rural settings indicated that teachers would welcome input on leading activities to promote physical activity and gross motor skill development. Teachers and parents/caregivers were also positive about young children being physically active. Recommendations for potential intervention strategies include a teacher-training component, parent/child activity mornings, and a home-based component for parents/caregivers. Conclusion. The findings suggest that an intervention focussed on increasing physical activity and improving gross motor skills per se is largely not required but that contextually relevant physical activity and gross motor skills may still be useful for promoting healthy weight and a vehicle for engaging with teachers and parents/caregivers for promoting other child outcomes, such as cognitive development.
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    Factors associated with contraceptive use in a rural area in Western Cape Province
    (2013) Peer, N; Morojele, N; London, L
    BACKGROUND: Safe and effective contraceptive use can substantially improve women's reproductive health. Although the contraceptive prevalence rate (CPR) in South Africa is comparable to rates globally, inequalities in CPR affect poor and rural women. This study aimed to determine the CPR and factors associated with contraceptive use in a rural district of Western Cape Province. METHOD: Cross-sectional survey data based on 412 face-to-face interviews with female participants between 18 and 44 years of age were collected in 2006 for a primary fetal alcohol syndrome prevention study in a rural district in Western Cape Province. The study used effective contraception (ECC) as the outcome variable. ECC included use of oral contraceptives, condoms, injectables or sterilisation. Independent variables included socio-demographic factors, substance use, psychosocial factors, community factors, childbearing characteristics and partner characteristics. RESULTS: Women were more likely to use ECC if they reported high self-esteem (compared with low or moderate self-esteem (prevalence risk ratio (PRR)=1.23; 95% confidence interval (CI) 0.99 - 1.53); if they strongly or moderately agreed that their culture entitled men to make decisions regarding child-bearing compared with those who disagreed (PRR=1.28; 95% CI 0.96 - 1.71); and if they had one child or more compared with no children (PRR=1.62; 95% CI 1.24 - 2.11). CONCLUSION: The CPR for sexually active women in this study was low at 39.3%. To promote contraceptive use in similar rural populations, family planning programmes should focus on increasing men's approval of contraception, improving partner communication around family planning and bolstering women's confidence in their reproductive decision-making, and particularly their self-esteem. There should be greater focus on nulliparous women.
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    Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared
    (2013) Labhardt, Niklaus Daniel; Keiser, Olivia; Sello, Motlalepula; Lejone, Thabo Ishmael; Pfeiffer, Karolin; Davies, Mary-Ann; Egger, Matthias; Ehmer, Jochen; Wandeler, Gilles
    IntroductionLesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs) to scale up the provision of antiretroviral therapy (ART). We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho.MethodsThe two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU) was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP) as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender.ResultsOf 3747 patients, 2042 (54.5%) started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81) and 68.8% at HCs versus 54.7% at hospitals among men (p<0.001). These findings persisted in adjusted analyses, with similar retention at HCs and hospitals among women (odds ratio (OR): 0.89, 95% confidence interval (CI): 0.73–1.09) and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20–1.96). The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51–0.93).ConclusionsIn rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities compared to hospitals.
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    Relationship between environmental exposure to pesticides and anthropometric outcomes of boys in the rural Western Cape, South Africa
    (2013) Ochieng, A A; Dalvie, M A; Little, F; Kromhout, H
    BACKGROUND: Rural residents in the Western Cape (WC), South Africa (SA) are highly exposed to agricultural pesticides that could impact their reproductive development. However, epidemiological evidence of the effect of pesticides on pubertal growth is contradictory. OBJECTIVE: To investigate the effect of pesticide exposure measured using indices of environmental exposure to pesticides on the pubertal growth of boys in rural WC, SA. METHODS: A cross-sectional study of 269 boys (177 of whom gave a history of residing on farms) was conducted. A questionnaire was administered, height and weight were measured and body mass index was calculated. A proximity index (PI) and spraying index (SI) was developed, measuring the lifetime average home distance from pesticide spraying and average frequency of spraying pesticides on a farm, respectively. RESULTS: Median age of boys was 12.4 years (interquartile range 9.5 - 13.3). More than 60% boys had height and weight <50th percentile for age. After adjusting for confounders, PI was significantly associated with shorter stature and lower weight (-1.7 cm/10-fold decrease, p=0.02 and -1.24 kg/10-fold decrease, p=0.04; respectively) and SI was non-significantly associated (-1.4 cm/10-fold increase, p=0.05 and -1.1 cm/10-fold increase, p=0.06; respectively). Associations were stronger for boys aged <11 years and were weaker when excluding non- farm boys. There were no other associations between outcome and exposure. CONCLUSIONS: The use of quantitative exposure indices showed that lower heights and weights might be associated with pesticide exposure in farm boys v. non-farm boys, but not among farm boys. Lower anthropometric measurements among farm boys v. non-farm boys appear stronger at a younger age. The indices of environmental exposure to pesticides require further development.
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    Sexual behaviour of women in rural South Africa: a descriptive study
    (2016) Dubbink, Jan Henk; van der Eem, Lisette; McIntyre, James A; Mbambazela, Nontembeko; Jobson, Geoffrey A; Ouburg, Sander; Morré, Servaas A; Struthers, Helen E; Peters, Remco P H
    Abstract Background Sexual behaviour is a core determinant of the HIV and sexually transmitted infection (STI) epidemics in women living in rural South Africa. Knowledge of sexual behaviour in these areas is limited, but constitutes essential information for a combination prevention approach of behavioural change and biomedical interventions. Methods This descriptive study was conducted in rural Mopani District, South Africa, as part of a larger study on STI. Women of reproductive age (18–49 years) who reported sexual activity were included regardless of the reason for visiting the facility. Questionnaires were administered to 570 women. We report sexual behaviour by age group, ethnic group and self-reported HIV status. Results Young women (34 years); there was no difference for condom use during last sex act (36 % overall). Sotho women were more likely to report concurrent sexual partners whereas Shangaan women reported more frequent intravaginal cleansing and vaginal scarring practice in our analysis. HIV-infected women were older, had a higher number of lifetime sexual partners, reported more frequent condom use during the last sex act and were more likely to have a known HIV-infected partner than women without HIV infection; hormonal contraceptive use, fellatio, and a circumcised partner were less often reported. Conclusions This study provides insight into women’s sexual behaviour in a rural South African region. There are important differences in sexual behaviour by age group and ethnicity and HIV status; these should be taken into account when designing tailor-made prevention packages.