Browsing by Author "Sadson Harawa"

Now showing 1 - 6 of 6
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    Cohort Profile Migrant Health FollowUp Study MHFUS of internal migration in South Africa
    (OXFORD UNIV PRESS) Carren Ginsburg; Mark Collinson; C Pheiffer; Francesc Gomez-Olive Casas; Sadson Harawa; S McGarvey; Daniel Ohene-Kwofie; AD Foster; T Myroniuk; Stephen Tollman; Michael White; E et al
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    Dietary patterns and their sociodemographic correlates in the context of migration and urbanisation demonstrate nutrition transitions in South Africa
    (ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD) C Pheiffer; S McGarvey; Carren Ginsburg; Sadson Harawa; Michael White
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    Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis
    (2023-04-21) Armstrong Dzomba; Carren Ginsburg; Chodziwadziwa W. Kabudula; Rachel R. Yorlets; Pedzisai Ndagurwa; Sadson Harawa; Mark N. Lurie; Stephen T. McGarvey; Stephen Tollman; Mark A. Collinson; Michael J. White; Francesc X. Gomez-Olive
    Introduction: In sub-Saharan African settings, the increasing non-communicable disease mortality is linked to migration, which disproportionately exposes subpopulations to risk factors for co-occurring HIV and NCDs. Methods: We examined the prevalence, patterns, and factors associated with two or more concurrent diagnoses of chronic diseases (i.e., multimorbidity) among temporary within-country migrants. Employing a cross-sectional design, our study sample comprised 2144 residents and non-residents 18–40 years interviewed and with measured biomarkers in 2018 in Wave 1 of the Migrant Health Follow-up Study (MHFUS), drawn from the Agincourt Health and Demographic Surveillance System (AHDSS) in rural north-eastern South Africa. We used modified Poisson regression models to estimate the association between migration status and prevalent chronic multimorbidity conditional on age, sex, education, and healthcare utilisation. Results: Overall, 301 participants (14%; 95% CI 12.6–15.6), median age 31 years had chronic multimorbidity. Multimorbidity was more prevalent among non-migrants (14.6%; 95% CI 12.8–16.4) compared to migrants (12.8%; 95% CI 10.3–15.7). Nonmigrants also had the greatest burden of dual-overlapping chronic morbidities, such as HIV-obesity 5.7%. Multimorbidity was 2.6 times as prevalent (PR 2.65. 95% CI 2.07– 3.39) among women compared to men. Among migrants, men, and individuals with secondary or tertiary education manifested lower prevalence of two or more conditions. Discussion: In a rural community with colliding epidemics, we found low but significant multimorbidity driven by a trio of conditions: HIV, hypertension, and obesity. Understanding the multimorbidity burden associated with early adulthood exposures, including potential protective factors (i.e., migration coupled with education), is a critical first step towards improving secondary and tertiary prevention for chronic disease among highly mobile marginalised sub-populations.
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    The impact of COVID-19 on a cohort of origin residents and internal migrants from South Africa's rural northeast
    (2022-03) Carren Ginsburg; Mark A Collinson; F Xavier Gómez-Olivé; Sadson Harawa; Chantel F Pheiffer; Michael J White
    South Africa has a large temporary migrant population with people commonly moving to metropolitan areas to access employment, while maintaining links with their rural origin households. The COVID-19 pandemic has impacted patterns of movement, livelihoods and health seeking, and the effects on internal, temporary migrants are unclear. Using longitudinal data spanning 2018 to 2020, this paper employs descriptive statistics and regression analyses to assess the impacts of COVID-19 on a cohort of 2971 persons aged 18-40 at baseline, both residents and migrants, from a rural district in South Africa's northeast. In contrast with 2018-2019, in 2020 the share of rural residents initiating a migration decreased by 11 percentage points (p<0.001), while the share of temporary migrants returning to origin households increased by 5 percentage points (p<0.001). Study participants who were continuing migrants reported fewer job losses in comparison with rural-stayers, while 76% of return migrants who were employed in 2019 were no longer employed in 2020. Further, among those who did not experience food shortages in 2019, rural-stayers had 1.42 times the odds of continuing migrants of suffering shortages in 2020. In 2020 health service use in the cohort decreased overall, with return migrants having still lower odds of utilising health services. The results highlight the differential geographic and socioeconomic manifestations of the pandemic, with worsening socioeconomic circumstances observed for rural-staying (disproportionately female) and returning populations, while continuing migrants fared relatively better. It is vital that a COVID-19 response considers the potentially heterogeneous impact of the pandemic on mobile and stable populations. Policy responses may include targeting migrants at their destinations in health promotion of COVID-19 messaging, and strengthening health care and social support in origin communities in recognition that these areas receive return migrants into their catchment population.
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    Validity of self-report for ascertaining HIV status among circular migrants and permanent residents in South Africa: a cross-sectional, population-based analysis
    (2023-03) Rachel R Yorlets; Mark N Lurie; Carren Ginsburg; Joseph W Hogan; Nina R Joyce; Sadson Harawa; Mark A Collinson; F Xavier Gómez-Olivé; Michael J White
    While expanded HIV testing is needed in South Africa, increasing accurate self-report of HIV status is an essential parallel goal in this highly mobile population. If self-report can ascertain true HIV-positive status, persons with HIV (PWH) could be linked to life-saving care without the existing delays required by producing medical records or undergoing confirmatory testing, which are especially burdensome for the country’s high prevalence of circular migrants. We used Wave 1 data from The Migration and Health Follow-Up Study, a representative adult cohort, including circular migrants and permanent residents, randomly sampled from the Agincourt Health and Demographic Surveillance System in a rural area of Mpumalanga Province. Within the analytic sample (n=1,918), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of self-report were calculated with dried blood spot (DBS) HIV test results as the standard. Among in-person participants (n=2,468), 88.8% consented to DBS-HIV testing. HIV prevalence was 25.3%. Sensitivity of self-report was 43.9% (95% CI: 39.5–48.5), PPV was 93.4% (95% CI: 89.5–96.0); specificity was 99.0% (95% CI: 98.3–99.4) and NPV was 83.9% (95% CI: 82.8–84.9). Self-report of an HIV-positive status was predictive of true status for both migrants and permanent residents in this high-prevalence setting. Persons who self-reported as living with HIV were almost always truly positive, supporting a change to clinical protocol to immediately connect persons who say they are HIV-positive to ART and counselling. However, 56% of PWH did not report as HIV-positive, highlighting the imperative to address barriers to disclosure.
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    Validity of selfreport for ascertaining HIV status among circular migrants and permanent residents in South Africa a crosssectional populationbased analysis
    (SPRINGER/PLENUM PUBLISHERS) R Yorlets; M Lurie; Carren Ginsburg; J Hogan; NR Joyce; Sadson Harawa; Mark Collinson; Francesc Gomez-Olive Casas; Michael White