Public Health

High blood pressure is a global public health problem. High blood pressure shows no signs or symptoms and it can only be detected through BP measurements by a health professionals. It's a chronic condition which requires long term management. Poor control of high blood pressure can lead to complications and even death. The aim of the study was to determine the prevalence of high blood pressure among University of Venda academic staff. UNIVEN is situated in Thohoyandou, Vhembe District in Limpopo. A cross-sectional design was used. A modified WHO stepwise questionnaire for non-communicable diseases version 3.1 was used to collect data regarding demographic characteristics, BP status, and stress and lifestyle characteristics. Charts and graphs were used to present the results of the study. The Statistical Package of Social Sciences was used to analyse data. The Chi-square test was used to determine the association between blood pressure and risk factors. A total of 179 respondents were selected, their ages of were ranged from 22 to 68 years. Their blood pressure, weight and height of the participants were also measured. The prevalence of high blood pressure was 20%, while 46% were on prehypertension stage and about 34% had a normal BP. About 23% had been previously diagnosed with HBP, while about 90% were on treatment for high blood pressure. Only 13% had their BP under control. The prevalence of high blood pressure was associated with gender, family history, vegetable intake and diabetes. Department of Sports need to introduce sports among academic staff as a way of prevention and management of high blood pressure.

Background Obesity is an important public health challenge. The World Health Organization has emphasized the assessment of overweight and obesity in different populations, to help with prevention. Obesity is associated with cardiovascular diseases, arthritis and diabetes. Exercise and diet are used in prevention and management. This study sets out to determine the prevalence of obesity and its associated risk factors among University of Venda academic staff. Methods Academic staff (n = 179) mean age 43.9 ± 10.1, including 104 male and 75 female were recruited from all eight schools at the University of Venda, South Africa, using simple random sampling in a cross-sectional study. A pretested questionnaire was used to determine demographic and lifestyle characteristics of respondents. Weight and height was measured using a standard procedure and body mass index was calculated and classi ed using the World Health Organization classi cation. Data was analysed using the Statistical Package for Social Scientists Version 23.0. The Chi-square test was used to determine the association between body mass index and related risk characteristics, both demographic and lifestyle, for obesity. The level of signi cance was set at P ≤ 0.05. Results The prevalence of obesity was 37.29% (66/177), overweight was 36.16% (64/177) and only 26.55% (46/177) had a normal body mass index. The prevalence of obesity was signi cantly associated with age, gender and fast-food intake.

The Political Declaration of High-level Meeting of the General Assembly on the Prevention and Control of NCDs has noted possible linkages between HIV/AIDS and NCDs. The aim of this study was to develop a public health framework for those linkages between HIV/AIDS and the co mmon NCDs. The overall method used in this study was a thematic research synthesis. Descriptive, integrative and configurative syntheses of evidence on linkages between HIV/AIDS and NCDs were conducted. The searching process was iterative; appraisal was stepwise; and extraction was verbatim. All retrieved informat ion was described, analysed and then configured in to a concept map using majo r pathways of relationships between HIV/AIDS and NCDs. The concept map was developed in to the public health framework through progressive review and revisions. Two major forms and pathways of lin kages between HIV/AIDS and NCDs were identified. There are five nodes that mediate the indirect HIV-NCD linkage: co mmon underlying factors, life style factors, antiretroviral treat ment, common co mp licat ions, and other mediating disease conditions. These lin kages along with med iating factors are organized in to a public health framework. In conclusion, the main pathways and forms of relat ionship between HIV/AIDS and NCDs were described; and a public health framewo rk for the epidemiological interrelat ionships between HIV/AIDS and NCDs was developed.

HIV/AIDS and non-communicable diseases (NCDs) epidemics may have many important similarities in their aetiology, pathogenesis and management. Evidence about the similarities and differences between the national responses HIV/AIDS and NCDs is essential for an integrated response. The objective of this study was to examine the parallels and differences between national responses to HIV/AIDS and NCDs in selected developing countries. This study applied a strategic level comparative case study approach as its study design. The main construct was national response to HIV/AIDS and NCDs. The 4 overarching themes were policy response, institutional mechanism, programmatic response and strategic information. Four countries were purposively selected as cases. Data were collected and triangulated from a multiple sources. The focus of analysis included identifying items for comparison, characteristics to be compared, degrees of similarity, and strategic importance of similarities. Analysis of data was qualitative content analysis with within-case, between-case, and across-case comparisons.

Introduction: Recent evidence suggests that HIV/AIDS and Noncommunicable diseases (NCDs) share essential commonalities in their risk factors, progression and management. However, the interrelatedness between the global responses to HIV/AIDS and NCDs hasn't been systematically analyzed. Objective: To examine the similarities and differences between global responses to HIV/AIDS and NCDs. Methods: Using preliminary review of literature, we identified four major themes of the global response: Strategies, Systems, Intervention and Monitoring and Evaluation. Detailed review of purposively selected documents was then conducted under these four themes. Similarities and differences between the global response to HIV/AIDS and NCDs were then examined for each major theme using qualitative content analysis and interpretive synthesis. The findings were presented using narrative summaries, tables and boxes. Findings: HIV/AIDS and NCD strategies are similar in their general approach. However,

Although the clinical relationship between HIV/AIDS and Diabetes is well established, there is a little summarized evidence about the magnitude ofDiabetescomorbidity among people liv ing with HIV.The aim of this study was to summa rizeevidence on the incidence and prevalence of Diabetes comorbid ityamong people living with HIV.A systematic review of the incidence and prevalence of Diabetes comorbid ity among people living with HIV was conducted. Studies reporting incidence and/orprevalence of diabetes among people living with HIV were retrieved fro m Embase and Medline databases. Selection of the studieswas based on both relevance and quality.Study and outcome characteristics, were ext racted using a standardized checklist. Resulted were presented using narrative and graphic summaries. PRISMA checklist was used as a guide for reporting of the review results. A total of 12 studies met the inclusion and quality. In total of 43,296 people liv ing with HIV, 1,144 incident cases of diabetes were identified over 174,574 person-years. The incidence rates of diabetes comorbid ity as reported by these studies ranged from 5.72 to 23.8 per 1000 person-years. Similarly, a total of 1,724 prevalent cases of diabetes were identified among 41,068 people living with HIV. The reported prevalence rates ranged from 2.85% to 14.9%. High level of variab ility in the reported incidence and prevalence rates of diabetes comorb idity was observed. Generally, the findings are not in favour of a significantly increased magnitude of diabetes comorbidity in HIV.

The South African government released a policy document for the introduction of a National Health Insurance (NHI) system planned to start in 2012. The consultation process for involving the public in the implementation of the NHI was also announced in August. When the consultation process on the NHI was announced, everyone assumed that the Government's aim was to devolve power to communities and create a more patientfocused and community-oriented NHI. In this paper we look not only at how community engagement process on the NHI works, but we also review the democratic process to determine if it is a good means of holding decision makers to account to communities before and during the implementation of the NHI in South Africa. We review reasons for involving or engaging communities in health and related matters, the policy context of community engagement and review potential roles of nongovernmental organizations in assisting people to participate in debates for implementation of this new health policy initiative.

Background: HIV counselling and testing (HCT) and knowledge about HIV have been key strategies utilised in the prevention and control of HIV/AIDS worldwide. HIV knowledge and uptake of HCT services in sub-Saharan Africa are still low. This study was conducted to determine factors associated with HCT and HIV/AIDS knowledge levels among a commuter population in Johannesburg, South Africa. Objective: To identify the factors associated with HCT uptake among the commuter population. Design: A simple random sampling method was used to select participants in a venue-based intercept survey at a taxi rank in the Johannesburg Central Business District. Data were collected using an electronic questionnaire. Logistic regression analysis assessed factors associated with HIV testing stratified by gender. Results: 1,146 respondents were interviewed, the maority (n 0579, 50.5%) were females and (n 0780, 68.1%) were over 25 years of age. Overall HCT knowledge was high (n 0951, 83%) with more females utilising HCT facilities. There was a significant difference in HIV testing for respondents living closer to and further away from health facilities. Slightly more than half of the respondents indicated stigma as one of the barriers for testing (n 0594, 52%, p-value00.001). For males, living with a partner (aOR: 1.68, 95% CI: 1.02Á2.78, p-value: 0.041) and possessing a post-primary education were positively associated with testing (aOR: 2.00, 95% CI: 1.15Á3.47, p-value: 0.014), whereas stigma and discrimination reduced the likelihood of testing (aOR: 0.40, 95% CI: 0.31Á0.62, p-value: B0.001). For females, having one sexual partner (aOR: 2.65, 95% CI: 1.19Á5.90, p-value: 0.017) and a low perceived benefit for HIV testing (aOR: 0.54, 95% CI: 0.30Á0.96, p-value: 0.035) were associated with HIV testing. The overall HIV/AIDS knowledge was generally high. Gender-specific health education and HIV intervention programmes are needed for improved access to HCT services. One favourable intervention would be the use of home-based HCT programmes.

An integrated model of health system responses to public health problems is considered to be the most preferable approach. Accordingly, there are several models that stipulate what an integrated architecture should look like. However, tools that can guide the overall process of integration are lacking. This tool is designed to guide the entire process of integration of health system responses to major public health problems. It is developed by taking into account the contexts of health systems of developing countries and the emergence of double-burden of chronic diseases in these settings. Chronic diseases -HIV/AIDS and NCDs -represented the evidence base for the development of the model. System level horizontal integration of health system responses were considered in the development of this tool.

Introduction: Individuals residing in Limpopo, KwaZulu-Natal and the Eastern Cape provinces who had access to public health services were surveyed to determine public knowledge and awareness of the new National Health Insurance (NHI). Methods: A descriptive cross-sectional study was conducted and a total of 748 adult respondents were sampled using a two-stage systematic sampling design. Data were collected using mobile phone assisted personal interviews. Results: The study found that 80.3% of the respondents were aware of the NHI and slightly less than half (49.8%) of the respondents did not have knowledge of how the NHI works and 71.8% lacked awareness about the origin of the development of the NHI concept in South Africa. The knowledge of what the NHI would pay for was poor and 48.1% knew that the NHI Fund would pay for medical expenses if a person got sick and 45.7% knew that with health insurance, basic health requirement is ensured and that if one becomes ill, medical treatment would be paid for by the NHI Fund, 50.9% of respondents did not understand how the NHI Fund will pay for health care received, only 44.8% understood how the NHI will pay for health care services received. Conclusion: The public education campaigns to increase knowledge and understanding of the NHI scheme might have been inadequate hence might not have penetrated many communities. It is recommended that a comprehensive community consultation plan be established to increase awareness and knowledge of the NHI among community members targeting clinics, schools, pension pay points and other community sites.

The Political Declaration of High-level Meeting of the General Assembly on the Prevention and Control of NCDs has noted possible linkages between HIV/AIDS and NCDs. The aim of this study was to develop a public health framework for those linkages between HIV/AIDS and the co mmon NCDs. The overall method used in this study was a thematic research synthesis. Descriptive, integrative and configurative syntheses of evidence on linkages between HIV/AIDS and NCDs were conducted. The searching process was iterative; appraisal was stepwise; and extraction was verbatim. All retrieved informat ion was described, analysed and then configured in to a concept map using majo r pathways of relationships between HIV/AIDS and NCDs. The concept map was developed in to the public health framework through progressive review and revisions. Two major forms and pathways of lin kages between HIV/AIDS and NCDs were identified. There are five nodes that mediate the indirect HIV-NCD linkage: co mmon underlying factors, life style factors, antiretroviral treat ment, common co mp licat ions, and other mediating disease conditions. These lin kages along with med iating factors are organized in to a public health framework. In conclusion, the main pathways and forms of relat ionship between HIV/AIDS and NCDs were described; and a public health framewo rk for the epidemiological interrelat ionships between HIV/AIDS and NCDs was developed.

Although the clinical relationship between HIV/AIDS and Diabetes is well established, there is a little summarized evidence about the magnitude ofDiabetescomorbidity among people liv ing with HIV.The aim of this study was to summa rizeevidence on the incidence and prevalence of Diabetes comorbid ityamong people living with HIV.A systematic review of the incidence and prevalence of Diabetes comorbid ity among people living with HIV was conducted. Studies reporting incidence and/orprevalence of diabetes among people living with HIV were retrieved fro m Embase and Medline databases. Selection of the studieswas based on both relevance and quality.Study and outcome characteristics, were ext racted using a standardized checklist. Resulted were presented using narrative and graphic summaries. PRISMA checklist was used as a guide for reporting of the review results. A total of 12 studies met the inclusion and quality. In total of 43,296 people liv ing with HIV, 1,144 incident cases of diabetes were identified over 174,574 person-years. The incidence rates of diabetes comorbid ity as reported by these studies ranged from 5.72 to 23.8 per 1000 person-years. Similarly, a total of 1,724 prevalent cases of diabetes were identified among 41,068 people living with HIV. The reported prevalence rates ranged from 2.85% to 14.9%. High level of variab ility in the reported incidence and prevalence rates of diabetes comorb idity was observed. Generally, the findings are not in favour of a significantly increased magnitude of diabetes comorbidity in HIV.

HIV/AIDS and non-communicable diseases (NCDs) epidemics may have many important similarities in their aetiology, pathogenesis and management. Evidence about the similarities and differences between the national responses HIV/AIDS and NCDs is essential for an integrated response. The objective of this study was to examine the parallels and differences between national responses to HIV/AIDS and NCDs in selected developing countries. This study applied a strategic level comparative case study approach as its study design. The main construct was national response to HIV/AIDS and NCDs. The 4 overarching themes were policy response, institutional mechanism, programmatic response and strategic information. Four countries were purposively selected as cases. Data were collected and triangulated from a multiple sources. The focus of analysis included identifying items for comparison, characteristics to be compared, degrees of similarity, and strategic importance of similarities. Analysis of data was qualitative content analysis with within-case, between-case, and across-case comparisons.