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H H Vorster - One of the best experts on this subject based on the ideXlab platform.
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the nutrition and Health Transition in the north west province of south africa a review of the thusa Transition and Health during urbanisation of south africans study
Public Health Nutrition, 2005Co-Authors: H H Vorster, Christina S Venter, Marie P Wissing, Barrie MargettsAbstract:Objective: To describe how urbanisation influences the nutrition and Health Transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study. Design: The THUSA study was a cross-sectional, comparative, population-based survey. Setting: The North West Province of South Africa. Subjects: In total, 1854 apparently Healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. Outcome measures and methods: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental Health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples. Results: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day-1); dietary fibre, 15.8 to 17.7 g day-1; calcium, 348 to 512 mg day-1; iron from 8.4 to 10.4 mg day-1; vitamin A from 573 to 1246 g retinol equivalents day-1; and ascorbic acid from 30 to 83 mg day-1. Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure >140 mmHg was observed in 10.4–34.8% of subjects in different groups and diabetes mellitus in 0.8–6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status. Conclusions: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional Health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths in preventing the adverse effects of urbanisation on Health needs to be examined in more detail.
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the emergence of cardiovascular disease during urbanisation of africans
Public Health Nutrition, 2002Co-Authors: H H VorsterAbstract:OBJECTIVE: To review the available data on risk factors for cardiovascular disease (CVD), the influence of urbanisation of Africans on these risk factors, and to examine why stroke emerges as a higher risk than ischaemic heart disease (IHD) in the Health Transition of black South Africans. DESIGN: A review of published data on mortality from and risk factors of CVD in South Africans. SETTING: South Africa. SUBJECTS: South African population groups and communities. METHODS: The available data on the contribution of stroke and IHD to CVD mortality in South Africa are briefly reviewed, followed by a comparison of published data on the prevalence and/or levels of CVD risk factors in the different South African population groups. The impact of urbanisation of black South Africans on these risk factors is assessed by comparing rural and urban Africans who participated in the Transition and Health during Urbanisation of South Africans (THUSA) study. RESULTS AND CONCLUSIONS: The mortality rates from CVD confirmed that stroke is a major public Health problem amongst black South Africans, possibly because of an increase in hypertension, obesity, smoking habit and hyperfibrinogenaemia during various stages of urbanisation. The available data further suggest that black South Africans may be protected against IHD because of favourable serum lipid profiles (low cholesterol and high ratios of high-density lipoprotein cholesterol) and low homocysteine values. However, increases in total fat and animal protein intake of affluent black South Africans, who can afford Western diets, are associated with increases in body mass indices of men and women and in total serum cholesterol. These exposures may increase IHD risk in the future.
Michel Garenne - One of the best experts on this subject based on the ideXlab platform.
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The Impact of HIV/AIDS on the Health Transition Among Under-Five Children in Africa
Social and Psychological Aspects of HIV AIDS and their Ramifications, 2011Co-Authors: Michel GarenneAbstract:Child survival improved dramatically throughout the world over the past century. Measured as the under-five death rate (the probability of dying before reaching the fifth birthday), child mortality declined from values as high as 300 to 600 per 1000 live births to values as low as 5 to 10 per 1000 in most advanced countries, sometimes even lower, and values around or below 100 per 1000 in most developing countries. [Stolnitz, 1955 & 1965; United Nations, 1982; Ahmad et al., 2000] In industrialized countries this mortality decline was associated firstly with the development of hygiene, clean water supply, sanitation, improved nutrition, and more recently with major advances in preventive and curative medicine. [Szreter, 2003] In developing countries of Africa and Asia, child mortality decline seems more associated with preventive and curative medicine, and less so with hygiene and nutrition, although these have also improved in most cases. [Preston, 1980; Feachem and Jamison, 1991; Ahmad et al., 2000; Jamison et al., 2006] Beyond regular improvements associated with economic development, social change and modern medicine, reversals in the Health Transition might occur as a result of external shocks, such as emerging diseases. When a new very lethal disease appears, it may cause an increase in child mortality, despite a decline in mortality from other causes of death. Since 1980, the most important of these emerging diseases is HIV/AIDS, and the continent the most hardly hit by HIV is sub-Saharan Africa. [Newell et al., 2004; UNAIDS, 2010; Jamison et al., 2006] In addition to emerging infectious diseases, other heath threats could also contribute to increasing mortality, for instance various pollutions or exposure to Health hazards which may cause cancer, and behavioural changes such as smoking, substance abuse and obesity, although these are more likely to affect adults than under-five children. Sub-Saharan Africa is very heterogeneous in terms of level of income, level of education, hygiene and sanitation, as well as culturally. Some countries are already quite advanced and modern (e.g. countries in the Southern cone), whereas others lag behind, with low income, low education, low hygiene and poor public Health (e.g. Sahelian countries). The effects of an external shock such as an emerging disease are therefore likely to differ among these countries, partly because the spread of the disease might differ, partly because the response to it might differ, and partly because baseline values also differ. Trends in under-five mortality are also determined by other dynamics, and are often related with political
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implications of mortality Transition for primary Health care in rural south africa a population based surveillance study
The Lancet, 2008Co-Authors: Michel Garenne, Stephen Tollman, Kathleen Kahn, Benn Sartorius, Mark A Collinson, Samuel J ClarkAbstract:Summary Background In southern Africa, a substantial Health Transition is underway, with the heavy burden of chronic infectious illness (HIV/AIDS and tuberculosis) paralleled by the growing threat of non-communicable diseases. We investigated the extent and nature of this Health Transition and considered the implications for primary Health care. Methods Health and sociodemographic surveillance started in the Agincourt subdistrict, rural South Africa, in 1992. In a population of 70 000, deaths (n=6153) were rigorously monitored with a validated verbal autopsy instrument to establish probable cause. We used age-standardised analyses to investigate the dynamics of the mortality Transition by comparing the period 2002–05 with 1992–94. Findings Mortality from chronic non-communicable disease ranked highest in adults aged 50 years and older in 1992–94 (41% of deaths [123/298]), whereas acute diarrhoea and malnutrition accounted for 37% of deaths (59/158) in children younger than 5 years. Since then, all-cause mortality increased substantially (risk ratio 1·87 [95% CI 1·73–2·03]; p vs 1·31 [1·12–1·55]; p=0·0003). Interpretation Mortality from non-communicable disease remains prominent despite the sustained increase in deaths from chronic infectious disease. The implications for primary Health-care systems are substantial, with integrated chronic care based on scaled-up delivery of antiretroviral therapy needed to address this expanding burden. Funding The Wellcome Trust, UK; University of the Witwatersrand, Medical Research Council, and Anglo American and De Beers Chairman's Fund, South Africa; the European Union; Andrew W Mellon Foundation, Henry J Kaiser Family Foundation, and National Institute on Aging, National Institutes of Health, USA.
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Health Transitions in sub-Saharan Africa: overview of mortality trends in children under 5 years old (1950-2000).
Bulletin of The World Health Organization, 2006Co-Authors: Michel Garenne, Enéas GakusiAbstract:OBJECTIVE: To reconstruct and analyse mortality trends in children younger than 5 years in sub-Saharan Africa between 1950 and 2000. METHODS: We selected 66 Demographic and Health Surveys and World Fertility Surveys from 32 African countries for analysis. Death rates were calculated by yearly periods for each survey. When several surveys were available for the same country, overlapping years were combined. Country-specific time series were analysed to identify periods of monotonic trends, whether declining, steady or increasing. We tested changes in trends using a linear logistic model. FINDINGS: A quarter of the countries studied had monotonic declining mortality trends: i.e. a smooth Health Transition. Another quarter had long-term declines with some minor rises over short periods of time. Eight countries had periods of major increases in mortality due to political or economic crises, and in seven countries mortality stopped declining for several years. In eight other countries mortality has risen in recent years as a result of paediatric AIDS. Reconstructed levels and trends were compared with other estimates made by international organizations, usually based on indirect methods. CONCLUSION: Overall, major progress in child survival was achieved in sub-Saharan Africa during the second half of the twentieth century. However, Transition has occurred more slowly than expected, with an average decline of 1.8% per year. Additionally, Transition was chaotic in many countries. The main causes of mortality increase were political instability, serious economic downturns, and emerging diseases.
Barrie Margetts - One of the best experts on this subject based on the ideXlab platform.
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the nutrition and Health Transition in the north west province of south africa a review of the thusa Transition and Health during urbanisation of south africans study
Public Health Nutrition, 2005Co-Authors: H H Vorster, Christina S Venter, Marie P Wissing, Barrie MargettsAbstract:Objective: To describe how urbanisation influences the nutrition and Health Transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study. Design: The THUSA study was a cross-sectional, comparative, population-based survey. Setting: The North West Province of South Africa. Subjects: In total, 1854 apparently Healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. Outcome measures and methods: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental Health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples. Results: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day-1); dietary fibre, 15.8 to 17.7 g day-1; calcium, 348 to 512 mg day-1; iron from 8.4 to 10.4 mg day-1; vitamin A from 573 to 1246 g retinol equivalents day-1; and ascorbic acid from 30 to 83 mg day-1. Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure >140 mmHg was observed in 10.4–34.8% of subjects in different groups and diabetes mellitus in 0.8–6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status. Conclusions: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional Health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths in preventing the adverse effects of urbanisation on Health needs to be examined in more detail.
Stephen Tollman - One of the best experts on this subject based on the ideXlab platform.
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implications of mortality Transition for primary Health care in rural south africa a population based surveillance study
The Lancet, 2008Co-Authors: Michel Garenne, Stephen Tollman, Kathleen Kahn, Benn Sartorius, Mark A Collinson, Samuel J ClarkAbstract:Summary Background In southern Africa, a substantial Health Transition is underway, with the heavy burden of chronic infectious illness (HIV/AIDS and tuberculosis) paralleled by the growing threat of non-communicable diseases. We investigated the extent and nature of this Health Transition and considered the implications for primary Health care. Methods Health and sociodemographic surveillance started in the Agincourt subdistrict, rural South Africa, in 1992. In a population of 70 000, deaths (n=6153) were rigorously monitored with a validated verbal autopsy instrument to establish probable cause. We used age-standardised analyses to investigate the dynamics of the mortality Transition by comparing the period 2002–05 with 1992–94. Findings Mortality from chronic non-communicable disease ranked highest in adults aged 50 years and older in 1992–94 (41% of deaths [123/298]), whereas acute diarrhoea and malnutrition accounted for 37% of deaths (59/158) in children younger than 5 years. Since then, all-cause mortality increased substantially (risk ratio 1·87 [95% CI 1·73–2·03]; p vs 1·31 [1·12–1·55]; p=0·0003). Interpretation Mortality from non-communicable disease remains prominent despite the sustained increase in deaths from chronic infectious disease. The implications for primary Health-care systems are substantial, with integrated chronic care based on scaled-up delivery of antiretroviral therapy needed to address this expanding burden. Funding The Wellcome Trust, UK; University of the Witwatersrand, Medical Research Council, and Anglo American and De Beers Chairman's Fund, South Africa; the European Union; Andrew W Mellon Foundation, Henry J Kaiser Family Foundation, and National Institute on Aging, National Institutes of Health, USA.
Massih-réza Amini - One of the best experts on this subject based on the ideXlab platform.
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Health Monitoring on Social Media over Time
IEEE Transactions on Knowledge and Data Engineering, 2018Co-Authors: Sumit Sidana, Sihem Amer-yahia, Marianne Clausel, Majdeddine Rebai, Massih-réza AminiAbstract:Social media has become a major source for analyzing all aspects of daily life. Thanks to dedicated latent topic analysis methods such as the Ailment Topic Aspect Model (ATAM), public Health can now be observed on Twitter. In this work, we are interested in using social media to monitor people's Health overtime. The use of tweets has several benefits including instantaneous data availability at virtually no cost. Early monitoring of Health data is complementary to post-factum studies and enables a range of applications such as measuring behavioral risk factors and triggering Health campaigns. We formulate two problems: Health Transition detection and Health Transition prediction. We first propose the Temporal Ailment Topic Aspect Model (TM-ATAM), a new latent model dedicated to solving the first problem by capturing Transitions that involve Health-related topics. TM-ATAM is a non-obvious extension to ATAM that was designed to extract Health-related topics. It learns Health-related topic Transitions by minimizing the prediction error on topic distributions between consecutive posts at different time and geographic granularities. To solve the second problem, we develop T-ATAM, a Temporal Ailment Topic Aspect Model where time is treated as a random variable natively inside ATAM. Our experiments on an 8-month corpus of tweets show that TM-ATAM outperforms TM-LDA in estimating Health-related Transitions from tweets for different geographic populations. We examine the ability of TM-ATAM to detect Transitions due to climate conditions in different geographic regions. We then show how T-ATAM can be used to predict the most important Transition and additionally compare T-ATAM with CDC (Center for Disease Control) data and Google Flu Trends.
