Browsing by Author "Chodziwadziwa Kabudula"
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Item Agreement between cause of death assignment by computercoded verbal autopsy methods and physician coding of verbal autopsy interviews in South Africa(CO-ACTION PUBLISHING) P Groenewald; J Thomas; S.J Clark; D Morof; Chodziwadziwa Kabudula; E et alItem Associations Between Key Psychosocial Stressors and Viral Suppression and Retention in Care Among Youth with HIV in Rural South AfricaL Filiatreau; Audrey Pettifor; Nkosinathi Masilela; Rhian Twine; Francesc Gomez-Olive Casas; N Haberland; Chodziwadziwa Kabudula; Sheri Lippman; Kathleen KahnItem Cohort Profile South African Population Research Infrastructure Network SAPRINMark Collinson; T Mudzana; T Mutevedzi; Kathleen Kahn; E Maimela; Francesc Gomez-Olive Casas; T Mngomezulu; Chodziwadziwa Kabudula; Stephen Tollman; E et alItem The effects of participation in an intensive HIV prevention trial on longterm sociodemographic outcomes on young women in rural South Africa(LIPPINCOTT WILLIAMS & WILKINS) M Stoner; E Browne; Chodziwadziwa Kabudula; Molly Rosenberg; Francesc Gomez-Olive Casas; T Neilands; M Kang Dufour; J Ahern; Kathleen Kahn; Sheri Lippman; Audrey PettiforItem Household structure, composition and child mortality in the unfolding antiretroviral therapy era in rural South Africa: comparative evidence from population surveillance, 2000–2015(2023-03-15) Brian Houle; Chodziwadziwa Kabudula; Dickman Gareta; Kobus Herbst; Samuel J ClarkObjectives The structure and composition of the household has important influences on child mortality. However, little is known about these factors in HIVendemic areas and how associations may change with the introduction and widespread availability of antiretroviral treatment (ART). We use comparative, longitudinal data from two demographic surveillance sites in rural South Africa (2000–2015) on mortality of children younger than 5 years (n=101 105). Design We use multilevel discrete time event history analysis to estimate children’s probability of dying by their matrilineal residential arrangements. We also test if associations have changed over time with ART availability. Setting Rural South Africa. Participants Children younger than 5 years (n=101 105). Results 3603 children died between 2000 and 2015. Mortality risks differed by co-residence patterns along with different types of kin present in the household. Children in nuclear households with both parents had the lowest risk of dying compared with all other household types. Associations with kin and child mortality were moderated by parental status. Having older siblings lowered the probability of dying only for children in a household with both parents (relative risk ratio (RRR)=0.736, 95%CI (0.633 to 0.855)). Only in the later ART period was there evidence that older adult kin lowered the probability of dying for children in single parent households (RRR=0.753, 95%CI (0.664 to 0.853)). Conclusions Our findings provide comparative evidence of how differential household profiles may place children at higher mortality risk. Formative research is needed to understand the role of other household kin in promoting child well-being, particularly in one-parent households that are increasingly prevalent.Item Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional populationbased study in four African countries(2023-02-15) Lisa K Micklesfield; Richard Munthali; Godfred Agongo; Gershim Asiki; Palwende Boua; Solomon SR Choma; Nigel J Crowther; June Fabian; Francesc Xavier Gómez-Olivé; Chodziwadziwa Kabudula; Eric Maimela; Shukri F Mohamed; Engelbert A Nonterah; Frederick J Raal; Hermann Sorgho; Furahini D Tluway; Alisha N Wade; Shane A Norris; Michele RamsayObjectives To determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA). Design Cross-sectional, multicentre, population-based study. Setting Six urban and rural communities in four subSaharan African countries. Participants Men (n=4808) and women (n=5892) between the ages of 40 and 60 years from the AWI-Gen study. Measures Sociodemographic and anthropometric data, and multimorbidity as defined by the presence of two or more of the following conditions: HIV infection, cardiovascular disease, chronic kidney disease, asthma, diabetes, dyslipidaemia, hypertension. Results Multimorbidity prevalence was higher in women compared with men (47.2% vs 35%), and higher in South African men and women compared with their East and West African counterparts. The most common disease combination at all sites was dyslipidaemia and hypertension, with this combination being more prevalent in South African women than any single disease (25% vs 21.6%). Age and body mass index were associated with a higher risk of multimorbidity in men and women; however, lifestyle correlates such as smoking and physical activity were different between the sexes. Conclusions The high prevalence of multimorbidity in middle-aged adults in SSA is of concern, with women currently at higher risk. This prevalence is expected to increase in men, as well as in the East and West African region with the ongoing epidemiological transition. Identifying common disease clusters and correlates of multimorbidity is critical to providing effective interventions.Item The impact of a randomized cash transfer intervention on mortality of adult household members in rural South Africa, 2011 - 2022Molly Rosenberg; E Beidelman; X Chen; D Canning; Lindsay Kobayashi; Kathleen Kahn; Audrey Pettifor; Chodziwadziwa KabudulaItem Indirect effects of COVID-19 on maternal and child health in South Africa(2022-11-25) Evelyn Thsehlaa; Adam Balusik; Micheal Kofi Boachie; Winfrida Tombe-Mdewa; Chodziwadziwa Kabudula; Jacques Du Toit; Kathleen Kahn; Francesc Xavier Gómez-Olivéc; Stephen Tollman; Susan Goldsteina; Karen HofmanaBackground: The unfinished burden of poor maternal and child health contributes to the quadruple burden of disease in South Africa with the direct and indirect effects of the COVID19 pandemic yet to be fully documented. Objective: To investigate the indirect effects of COVID-19 on maternal and child health in different geographical regions and relative wealth quintiles. Methods: We estimated the effects of COVID-19 on maternal and child health from April 2020 to June 2021. We estimated this by calculating mean changes across facilities, relative wealth index (RWI) quintiles, geographical areas and provinces. To account for confounding by underlying seasonal or linear trends, we subsequently fitted a segmented fixed effect panel model. Results: A total of 4956 public sector facilities were included in the analysis. Between April and September 2020, full immunisation and first dose of measles declined by 6.99% and 2.44%, respectively. In the follow-up months, measles first dose increased by 4.88% while full immunisation remained negative (−0.65%) especially in poorer quintiles. At facility level, the mean change in incidence and mortality due to pneumonia, diarrhoea and severe acute malnutrition was negative. Change in first antenatal visits, delivery by 15–19-year olds, delivery by C-section and maternal mortality was positive but not significant. Conclusion: COVID-19 disrupted utilisation of child health services. While reduction in child health services at the start of the pandemic was followed by an increase in subsequent months, the recovery was not uniform across different quintiles and geographical areas. This study highlights the disproportionate impact of the pandemic and the need for targeted interventions to improve utilisation of health services.Item Pension exposure and health: Evidence from a longitudinal study in South Africa(2023-10) Carlos Riumallo Herl; Chodziwadziwa Kabudula; Kathleen Kahn; Stephen Tollman; David CanningSocial protection schemes have been expanding around the world with the objective of protecting older persons during retirement. While theoretically they have been seen as tools to improve individual wellbeing, there are few studies that evaluate whether social pensions can improve health. In this study, we exploit the change in eligibility criteria for the South African Old Age grant to estimate the association between pension exposure eligibility and health of older persons. For this, we use data from the Health and Aging in Africa: A longitudinal Study of an INDEPTH Community in South Africa (HAALSI) and model pension exposure in terms of its cumulative effect. Our results show that pension exposure is associated with better health as measured by a set of health indices. Disentangling these effects, we find that pension exposure is most likely to improve health through the delayed onset of physical disabilities in the elderly population. Our study highlights the relevance of social protection schemes as a mechanism to protect older persons physical health.Item Physical Activity and Its Association With Body Mass Index: A Cross-Sectional Analysis in Middle-Aged Adults From 4 Sub-Saharan African Countries(2023-08-17) Monica Mut; Lisa J. Ware; Lisa K. Micklesfield; Michele Ramsay; Godfred Agongo; Palwende R. Boua; Isaac Kisiangani; Ian Cook; Francesc Xavier Go´mez-Olivé; Nigel J. Crowther; Chodziwadziwa Kabudula; Shane A. Norris; Tinashe ChikoworeBackground: This study aimed to explore association of self-reported physical activity domains of work, leisure, and transport-related physical activity and body mass index (BMI) in 9388 adult men and women from the Africa-Wits-INDEPTH partnership for Genomic (AWI-Gen) study in Africa. Africa-Wits-INDEPTH partnership for Genomic is a large, population-based cross-sectional cohort with participants from 6 sites from rural and urban areas in 4 sub-Saharan African countries. Methods: A sex-stratified meta-analysis of cross-sectional data from men and women aged 29–82 years was used to assess the association of physical activity with BMI. Results: Overall, meeting physical activity guidelines of at least 150 minutes per week was associated with 0.82 kg/m2 lower BMI in men (β = −0.80 kg/m2 ; 95% confidence interval [CI], −1.14 to −0.47) and 0.68 kg/m2 lower BMI in women (β = −0.68 kg/m2 ; 95% CI, −1.03 to −0.33). Sex and site-specific differences were observed in the associations between physical activity domains and BMI. Among those who met physical activity guidelines, there was an inverse association between transport-related physical activity and BMI in men from Nanoro (Burkina Faso) (β = −0.79 kg/m2 ; 95% CI, −1.25 to −0.33) as well as work-related physical activity and BMI in Navrongo men (Ghana) (β = −0.76 kg/m2 ; 95% CI, −1.25 to −0.27) and Nanoro women (β = −0.90 kg/m2 ; 95% CI, −1.44 to −0.36). Conclusions: Physical activity may be an effective strategy to curb rising obesity in Africa. More studies are needed to assess the impact of sex and geographic location-specific physical activity interventions on obesity.Item Telomere length, health, and mortality in a cohort of older black South African adultsS Gao; J Rohr; I de Vivo; Michele Ramsay; N Kriegler; Chodziwadziwa Kabudula; E et al; Lisa BerkmanItem TRENDS IN HOUSEHOLD MATERIAL RESOURCES AND COGNITIVE HEALTH IN A LONGITUDINAL COHORT STUDY OF AGING IN SOUTH AFRICA(2022) Lindsay Kobayashi; Chodziwadziwa Kabudula; Mohammed Kabeto; Xuexin Yu; Stephen Tollman; Kathleen Kahn; Lisa Berkman; Molly RosenbergMaterial resources that affect daily living conditions may be salient for cognitive aging in low-income settings, but evidence is limited on this topic. We investigated relationships between long-term trends in household material resources and subsequent cognitive function among 4,580 adults aged ≥40 in a population-representative cohort in Agincourt sub-district, South Africa, from 2001-2015. Household material resources (dwelling materials, water, sanitation, sources of power, modern amenities, and livestock) were assessed biennially from 2001- 2013. We evaluated mean resources, volatility in resources, and change in resources over this period in relation to cognitive function in 2014/2015. Higher mean household resources and larger improvements over time in resources were positively associated with subsequent cognitive function, independent of confounders. Findings were largely driven by modern amenities for food preparation, transportation, and communication outside of the household. Access to these amenities may support cognitive aging through boosting nutrition and cognitive reserve and should be investigated further.