Wits University Research Outputs
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Browsing Wits University Research Outputs by Faculty "Health Sciences"
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Item Classical Cardiovascular Risk Factors and HIV are Associated With Carotid IntimaMedia Thickness in Adults From SubSaharan Africa Findings From H3Africa AWIGen Study(2019-06-07) Boua P; Ali S; Soo CBackground-—Studies on the determinants of carotid intima-media thickness (CIMT), a marker of sub-clinical atherosclerosis, mostly come from white, Asian, and diasporan black populations. We present CIMT data from sub-Saharan Africa, which is experiencing a rising burden of cardiovascular diseases and infectious diseases. Methods and Results-—The H3 (Human Hereditary and Health) in Africa’s AWI-Gen (African-Wits-INDEPTH partnership for Genomic) study is a cross-sectional study conducted in adults aged 40 to 60 years from Burkina Faso, Kenya, Ghana, and South Africa. Cardiovascular disease risk and ultrasonography of the CIMT of right and left common carotids were measured. Multivariable linear and mixed-effect multilevel regression modeling was applied to determine factors related to CIMT. Data included 8872 adults (50.8% men), mean age of 50 6 years with age- and sex-adjusted mean ( SE) CIMT of 640 123lm. Participants from Ghana and Burkina Faso had higher CIMT compared with other sites. Age (b = 6.77, 95%CI [6.34–7.19]), body mass index (17.6[12.5–22.8]), systolic blood pressure (7.52[6.21–8.83]), low-density lipoprotein cholesterol (5.08[2.10–8.06]) and men (10.3[4.75– 15.9]) were associated with higher CIMT. Smoking was associated with higher CIMT in men. High-density lipoprotein cholesterol (12.2 [17.9– 6.41]), alcohol consumption (–13.5 [19.1–7.91]) and HIV (8.86 [15.7–2.03]) were inversely associated with CIMT. Conclusions-—Given the rising prevalence of cardiovascular diseases risk factors in sub-Saharan Africa, atherosclerotic diseases may become a major pan-African epidemic unless preventive measures are taken particularly for prevention of hypertension, obesity, and smoking. HIV-specific studies are needed to fully understand the association between HIV and CIMT in sub-Saharan AfricaItem Strategies to strengthen the provision of mental health care at the primary care setting An evidence map(2019-09-06) Mapanga W; Casteleijn J; Ramiah CAbstract In a deinstitutionalised mental health care system, those with mental illness require complex, multidisciplinary and intersectoral care at the primary or community service setting. This paper describes an Evidence Map of different strategies to strengthen the provision of mental health care at the primary health care (PHC) setting, the quality of the evidence, and knowledge gaps. Electronic and reference searching yielded 2666 articles of which 306 qualified for data extraction. A systematic review methodology identified nine different strategies that strengthen the provision of mental healthcare and these strategies are mapped in line with the outcomes they affect. The top three strategies that were reported the most, included strategies to empower families, carers and patients; integration of care or collaborative interventions; and e-health interventions. The least reported strategy was task shifting. The Evidence Map further shows the amount and quality of evidence supporting each of the listed strategies, and this helps to inform policy design and research priorities around mental health. This is the first systematic Evidence Map to show the different strategies that strengthen the provision of mental healthcare at PHC setting and the impact these strategies have on patient, hospital and societal level indicators.