Browsing by Author "Dhansay, M. A."
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- ItemEstimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000(Health and Medical Publishing Group (HMPG), 2007-08) Nojilana, B.; Norman, R.; Dhansay, M. A.; Labadarios, D.; Van Stuijvenberg, M.E.; Bradshaw D.; South African Comparative Risk Assessment Collaborating GroupObjectives. To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. Design. The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/dl and ferritin level < 12 μg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 years and pregnant women 15-49 years. Outcome measures. Direct sequelae of IDA, maternal and perinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1% of children and 9-12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174 976 (95% uncertainty interval 150 344-203 961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA. Conclusions. This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.
- ItemFactors affecting body composition in preterm infants : assessment techniques and nutritional interventions(Elsevier, 2019) Strydom, K.; Van Niekerk, Evette; Dhansay, M. A.Limited research has been conducted that elucidates the growth and body composition of preterm infants. It is known that these infants do not necessarily achieve extra-utero growth rates and body composition similar to those of their term counterparts. Preterm infants, who have difficulty in achieving these growth rates, could suffer from growth failure. These infants display an increased intra-abdominal adiposity and abnormal body composition when they achieve catch-up growth. These factors affect the quality of weight gain, as these infants are not only shorter and lighter than term infants, they also have more fat mass (FM) and less fat-free mass (FFM), resulting in a higher total fat percentage. This could cause metabolic syndrome and cardiovascular problems to develop later in a preterm infant's life. The methods used to determine body composition in preterm infants should be simple, quick, non-invasive and inexpensive. Available literature was reviewed and the Dauncey anthropometric model, which includes skinfold thickness at two primary sites and nine body dimensions, is considered in this review the best method to accurately determine body composition in preterm infants, especially in resource-poor countries. It is imperative to accurately assess the quality of growth and body composition of this fragile population in order to determine whether currently prescribed nutritional interventions are beneficial to the overall nutritional status and quality of life—in the short- and long-term—of the preterm infant, and to enable timely implementation of appropriate interventions, if required.
- ItemSynchronized and regular deworming of children and women in South Africa : Policy and practice(Academy of Science of South Africa, 2005) Fincham, J. E.; Markus, M. B.; Ngobeni, J. T.; Mayosi, B. N.; Adams, V. J.; Kwitshana, Z. L.; Obihara, C. C.; Dhansay, M. A.; Jackson, T. F. H. G.SOUTH AFRICA IS A SIGNATORY TO WORLD Health Assembly (WHA) resolution 54.19 (May 2001), which calls for regular, synchronized treatment of helminthiasis in developing countries, particularly where the prevalence of worm infestation exceeds 50%. Helminthic infection is usually a hallmark of poverty and reasons why it should be controlled in disadvantaged communities are compelling. However, existing South African legislation regulating the procurement and use of anthelmintic medicines effectively renders group-based deworming as agreed to by WHA member states, and endorsed by the South African minister of health, non-implementable in practice. In order to make deworming sustainable, low-cost, unregistered anthelmintics must be imported from international procurement agencies. At present, this is not permitted. Another problem is that both medical and non-medical personnel are confused by out-of-date information in package-inserts regarding safety for young children and pregnant women. Albendazole and praziquantel should be de-scheduled and ivermectin, levamisole and possibly nitazoxanide should be registered in a way that permits treatment by non-medical personnel. Rational alternation of medication is important because reliance on mebendazole will lead to resistance. All batches of anthelmintics ought to comply with pharmacological quality specifications and testing should be routine. Facilities for doing this are available in South Africa.