Browsing by Author "Bradshaw, Debbie"
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- ItemEpidemiology of lower respiratory infection and pneumonia in South Africa (1997 – 2015) : a systematic review protocol(BMJ Publishing Group, 2016) Roomaney, Rifqah A.; Pillay-van Wyk, Victoria; Awotiwon, Oluwatoyin F.; Dhansay, Ali; Groenewald, Pam; Joubert, Jane D.; Nglazi, Mweete D.; Nicol, Edward; Bradshaw, DebbieIntroduction: Lower respiratory infections (LRIs) and pneumonia are among the leading causes of death worldwide, especially in children aged under 5 years, and these patterns are reflected in the South African population. Local epidemiological data for LRIs and pneumonia are required to inform the Second National Burden of Disease Study underway in South Africa. The aim of this systematic review is to identify published studies reporting the prevalence, incidence, case fatality, duration or severity of LRI and pneumonia in adults and children in South Africa. Methods and analysis: Electronic database searches will be conducted to obtain studies reporting on the prevalence, incidence, case fatality, duration and severity of LRI and pneumonia in South Africa between January 1997 and December 2015. Studies that are assessed to have moderate or low risk of bias will be included in a meta-analysis, if appropriate. Where meta-analysis is not possible, the articles will be described narratively. Subgroup analysis (eg, age groups) will also be conducted where enough information is available. Ethics and dissemination: This systematic review will only include published data with no linked patientlevel information; thus, no ethics approval is required. The findings will be used to calculate the burden of disease attributed to LRI and pneumonia in South Africa and will highlight the type of epidemiological data available in the country. The article will be disseminated in a peer-reviewed publication.
- ItemEpidemiology of major depressive disorder in South Africa (1997 – 2015): a systematic review protocol(BMJ Publishing Group, 2016) Nglazi, Mweete D.; Joubert, Jane D.; Stein, Dan J.; Lund, Crick; Wiysonge, Charles S.; Vos, Theo; Pillay-van Wyk, Victoria; Roomaney, Rifqah A.; Muhwava, Lorrein S.; Bradshaw, DebbieENGLISH SUMMARY : Introduction: Major depressive disorder (MDD) is a leading cause of disease and disability globally and in South Africa. Epidemiological data for MDD are essential to estimate the overall disease burden in a country. The objective of the systematic review is to examine the evidence base for prevalence, incidence, remission, duration, severity, case fatality and excess mortality of MDD in South Africa from 1997 to 2015. Methods and analysis: We will perform electronic searches in PubMed, PsycINFO, Scopus and other bibliographical databases. Articles published between January 1997 and December 2015 will be eligible for inclusion in this review. The primary outcomes will be prevalence, incidence, remission, duration, severity, case fatality and excess mortality of MDD. The secondary outcomes will be risk factors and selected populations for MDD. If appropriate, a meta-analysis will be performed. If a meta-analysis is not possible, the review findings will be presented narratively and in tables. Subgroup analyses will be conducted with subgroups defined by population group, rural/urban settings and study designs, if sufficient data are available.
- ItemEstimating the burden of disease attributable to vitamin A deficiency in South Africa in 2000(Health and Medical Publishing Group (HMPG), 2007-08) Nojilana, Beatrice; Norman, Rosana; Bradshaw, Debbie; Van Stuijvenberg, Martha E.; Dhansay, Muhammad A.; Labadarios, Demetre; South African Comparative Risk Assessment Collaborating GroupObjectives. To estimate the burden of disease attributable to vitamin A deficiency in children aged 0 - 4 years and pregnant women aged 15 - 49 years in South Africa in 2000. Design. The framework adopted for the most recent World Health Organization comparative risk assessment (CRA) methodology was followed. Population-attributable fractions were calculated from South African Vitamin A Consultative Group (SAVACG) survey data on the prevalence of vitamin A deficiency in children and the relative risks of associated health problems, applied to revised burden of disease estimates for South Africa in the year 2000. Small community studies were used to derive the prevalence in pregnant women. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 years and pregnant women 15 - 49 years. Outcome measures. Direct sequelae of vitamin A deficiency, including disability-adjusted life years (DALYs), as well as mortality associated with measles, diarrhoeal diseases and other infections, and mortality and DALYs associated with malaria in children and all-cause maternal mortality. Results. One-third of children aged 0 - 4 years and 1 - 6% of pregnant women were vitamin A-deficient. Of deaths among young children aged 0 - 4 years in 2000, about 28% of those resulting from diarrhoeal diseases, 23% of those from measles, and 21% of those from malaria were attributed to vitamin A deficiency, accounting for some 3 000 deaths. Overall, about 110 467 (95% uncertainty interval 86 388 - 136 009) healthy years of life lost, or between 0.5% and 0.8% of all DALYs in South Africa in 2000 were attributable to vitamin A deficiency. Conclusions. The vitamin A supplementation programme for children and the recent food fortification programme introduced in South Africa in 2003 should prevent future morbidity and mortality related to vitamin A deficiency. Monitoring the effectiveness of these interventions is strongly recommended.
- ItemMedical certification of death in South Africa – moving forward(Health & Medical Publishing Group, 2015) Burger, Elsie Helena; Groenewald, Pam; Rossouw, Anastasia; Bradshaw, DebbieDespite improvements to the Death Notification Form (DNF) used in South Africa (SA), the quality of cause-of-death information remains suboptimal. To address these inadequacies, the government ran a train-the-trainer programme on completion of the DNF, targeting doctors in public sector hospitals. Training materials were developed and workshops were held in all provinces. This article reflects on the lessons learnt from the training and highlights issues that need to be addressed to improve medical certification and cause-of-death data in SA. The DNF should be completed truthfully and accurately, and confidentiality of the information on the form should be maintained. The underlying cause of death should be entered on the lowest completed line in the cause-of-death section, and if appropriate, HIV should be entered here. Exclusion clauses for HIV in life insurance policies with Association of Savings and Investments South Africa companies were scrapped in 2005. Interactive workshops provide a good learning environment, but are logistically challenging. More use should be made of online training resources, particularly with continuing professional development accreditation and helpline support. In addition, training in the completion of the DNF should become part of the curriculum in all medical schools, and part of the orientation of interns and community service doctors in all facilities.
- ItemPerceptions about data-informed decisions : an assessment of information-use in high HIV-prevalence settings in South Africa(BioMed Central, 2017-12-04) Nicol, Edward; Bradshaw, Debbie; Uwimana-Nicol, Jeannine; Dudley, LilianBackground: Information-use is an integral component of a routine health information system and essential to influence policy-making, program actions and research. Despite an increased amount of routine data collected, planning and resource-allocation decisions made by health managers for managing HIV programs are often not based on data. This study investigated the use of information, and barriers to using routine data for monitoring the prevention of mother-to-child transmission of HIV (PMTCT) programs in two high HIV-prevalence districts in South Africa. Methods: We undertook an observational study using a multi-method approach, including an inventory of facility records and reports. The performance of routine information systems management (PRISM) diagnostic ‘Use of Information’ tool was used to assess the PMTCT information system for evidence of data use in 57 health facilities in two districts. Twenty-two in-depth interviews were conducted with key informants to investigate barriers to information use in decision-making. Participants were purposively selected based on their positions and experience with either producing PMTCT data and/or using data for management purposes. We computed descriptive statistics and used a general inductive approach to analyze the qualitative data. Results: Despite the availability of mechanisms and processes to facilitate information-use in about two-thirds of the facilities, evidence of information-use (i.e., indication of some form of information-use in available RHIS reports) was demonstrated in 53% of the facilities. Information was inadequately used at district and facility levels to inform decisions and planning, but was selectively used for reporting and monitoring program outputs at the provincial level. The inadequate use of information stemmed from organizational issues such as the lack of a culture of information-use, lack of trust in the data, and the inability of program and facility managers to analyze, interpret and use information. Conclusions: Managers’ inability to use information implied that decisions for program implementation and improving service delivery were not always based on data. This lack of data use could influence the delivery of health care services negatively. Facility and program managers should be provided with opportunities for capacity development as well as practice-based, in-service training, and be supported to use information for planning, management and decision-making.
- ItemThe prevalence of type 2 diabetes in South Africa : a systematic review protocol(BMJ Publishing Group, 2018-06) Pheiffer, Carmen; Pillay-Van Wyk, Victoria; Joubert, Jane D.; Levitt, Naomi; Nglazi, Mweete D.; Bradshaw, DebbieIntroduction Type 2 diabetes mellitus is a major source of morbidity and mortality in South Africa, spurred by increased urbanisation and unhealthy lifestyle factors. Local epidemiological data are required to inform health planning and policy. The purpose of this systematic review is to identify, collate and synthesise all studies reporting the prevalence of diabetes in South Africa. A secondary aim is to report the prevalence of impaired glucose tolerance and impaired fasting glucose, conditions which are associated with an increased risk of progression to overt diabetes, and the prevalence of undiagnosed diabetes. Methods and analysis Multiple databases will be searched for diabetes prevalence studies conducted in South Africa between 1997 and 2018. Two authors will independently select studies that meet the inclusion criteria, extract data and appraise studies using a risk of bias tool for prevalence studies. Studies with low or moderate risk of bias will be included. Sources of heterogeneity will be explored using subgroup analysis. Ethics and dissemination The systematic review does not require ethics clearance since published studies with non-identifiable data will be used. This review will provide best estimates to inform the Second National Burden of Disease study which can guide health and policy planning.
- ItemRanking lifestyle risk factors for cervical cancer among Black women : a case-control study from Johannesburg, South Africa(Public Library of Science, 2021-12-08) Singini, Mwiza Gideon; Sitas, Freddy; Bradshaw, Debbie; Chen, Wenlong Carl; Motlhale, Melitah; Kamiza, Abram Bunya; Babb de Villiers, Chantal; Lewis, Cathryn M.; Mathew, Christopher G.; Waterboer, Tim; Newton, Robert; Muchengeti, Mazvita; Singh, ElviraBackground: Aside from human papillomavirus (HPV), the role of other risk factors in cervical cancer such as age, education, parity, sexual partners, smoking and human immunodeficiency virus (HIV) have been described but never ranked in order of priority. We evaluated the contribution of several known lifestyle co-risk factors for cervical cancer among black South African women. Methods : We used participant data from the Johannesburg Cancer Study, a case-control study of women recruited mainly at Charlotte Maxeke Johannesburg Academic Hospital between 1995 and 2016. A total of 3,450 women in the study had invasive cervical cancers, 95% of which were squamous cell carcinoma. Controls were 5,709 women with cancers unrelated to exposures of interest. Unconditional logistic regression models were used to calculate adjusted odds ratios (ORadj) and 95% confidence intervals (CI). We ranked these risk factors by their population attributable fractions (PAF), which take the local prevalence of exposure among the cases and risk into account. Results : Cervical cancer in decreasing order of priority was associated with (1) being HIV positive (ORadj = 2.83, 95% CI = 2.53–3.14, PAF = 17.6%), (2) lower educational attainment (ORadj = 1.60, 95% CI = 1.44–1.77, PAF = 16.2%), (3) higher parity (3+ children vs 2–1 children (ORadj = 1.25, 95% CI = 1.07–1.46, PAF = 12.6%), (4) hormonal contraceptive use (ORadj = 1.48, 95% CI = 1.24–1.77, PAF = 8.9%), (5) heavy alcohol consumption (ORadj = 1.44, 95% CI = 1.15–1.81, PAF = 5.6%), (6) current smoking (ORadj = 1.64, 95% CI = 1.41–1.91, PAF = 5.1%), and (7) rural residence (ORadj = 1.60, 95% CI = 1.44–1.77, PAF = 4.4%). Conclusion : This rank order of risks could be used to target educational messaging and appropriate interventions for cervical cancer prevention in South African women.
- ItemSetting priorities in child health research investments for South Africa(Public Library of Science, 2007) Tomlinson, Mark; Chopra, Mickey; Sanders, Mickey; Bradshaw, Debbie; Hendricks, Michael; Greenfield, David; Black, Robert E.; Arifeen, Shams El; Rudan, IgorThis paper aims to define health research priorities in South Africa, where it is estimated that nearly 100,000 children under 5 years of age still die each year.The authors applied the methodology for setting priorities in health research investments recently developed by Child Health and Nutrition Research Initiative (CHNRI).The predominant research priorities identified within the existing South African context were health policy and systems research activities to generate new knowledge on improving delivery of the simplest and most cost-effective existing interventions.Vitamin A supplementation was ranked first, followed by hand washing, antibiotics for pneumonia, prevention of mother-to-child HIV transmission (PMTCT), and exclusive breast-feeding.The CHNRI methodology has the power to discriminate among many competing research options using a simple conceptual framework.