A review of interprovincial variations in HIV prevalence rates in Zimbabwe

Despite the proven remarkable decline of HIV prevalence in the sub-Saharan Africa region, both sub-regional and within-country disparities in HIV prevalence persist. This paper is a survey of literature on HIV prevalence and spread in Zimbabwe, focusing on provincial differences within the national picture of a decline in new infections. In particular, it raises the question of why prevalence and infection rates seem to be disproportionately higher in Matabeleland relative to other provinces of the country. This disparity cannot be adequately explained on the basis of national behavioural analyses as has been the case. The paper suggests possible additional nuances in the forms of analysis and proposes a change of focus in HIV-prevention strategies from national level to provincial considerations of the multiple factors influencing variations in HIV infection rates at provincial level. Using the different contextual conditions between provinces as a way to examine what might be the additional significant variables, the paper brings variations that go beyond sexual behaviour

Cultural competence: a framework for promoting voluntary medical male circumcision among VaRemba communities in Zimbabwe

Almost a decade after the formal introduction of voluntary medical male circumcision (VMMC) as an important technology for HIV prevention, its implementation is still fraught with acceptability challenges. This is especially true among ethnic groups where male circumcision is conducted as a rite of passage into adulthood. In this article we question why VMMC is being met with resistance despite widespread awareness of its promise to reduce HIV incidence in a culturally circumcising community in Zimbabwe. In-depth and key informant interviews were conducted with selected VaRemba initiation graduates and surgeons respectively in Mposi area in Mberengwa to explore why VMMC has not been readily accepted in their community. Findings suggest that male circumcision among VaRemba is not only the removal of prepuce but comprises a secretive and rich curriculum rooted in their culture and identity. Such a conceptualisation renders some social and programmatic impediments for VMMC uptake. To scale up VMMC uptake among VaRemba, we argue for a reorganisation and adaptation of VMMC services in a culturally competent way that accounts for local conceptions of circumcision and respect for the cultural beliefs and practices of VaRemba communities

Pubertal breast development in primary school girls in Sokoto, North-western Nigeria

Background. There is wide variation in normal pubertal timing among various populations. Objectives. To determine the mean age of pubertal stages of breast development and menarche, and the influence of nutrition and ethnicity on pubertal onset in primary school girls in Sokoto, North-Western Nigeria.Methods. A cross-sectional study using a multistage random sampling design was conducted on 994 primary school girls in grades 3 - 6. Weight and height measurements and Tanner breast staging were done. Body mass index (BMI) was calculated, and a BMI-for-age percentile was used to categorise nutritional status. There were four major ethnic groups. P≤0.05 was taken as showing statistical significance. Results. The participants' mean age was 10.23 years (standard deviation (SD) 1.70, range 6 - 15 years). Of the 994 girls, 628 (63.2%) were pre-pubertal, and 366 (36.8%) were pubertal. Of the latter, 158 (15.9%) were in breast stage 2, while 112 (11.3%), 70 (7.0%) and 26 (2.6%) were in breast stages 3, 4 and 5, respectively. The mean ages (SD; range) of pubertal onset and menarche were 10.50 (1.33; 8 - 13), and 12.67 (1.65; 11 - 15), years, respectively. The overnourished (overweight/obese) and Igbo ethnic group girls had early-normal pubertal onset (p=0.006 and p=0.001, respectively). Conclusion. The mean ages of Tanner breast stages 1 - 5 and menarcheal age of girls in Sokoto, North-Western Nigeria, were within the age ranges reported worldwide. Pubertal onset was influenced by nutrition

Ecological Association between HIV and Concurrency Point-Prevalence in South Africa's Ethnic Groups

HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the spread of HIV. Few studies have; however; investigated if differential concurrency rates could explain differential HIV spread within ethnic groups in South Africa. This ecological analysis; explores how much of the variation in HIV prevalence by ethnic group is explained by differential concurrency rates. Using a nationally representative survey (the South African National HIV Prevalence; HIV Incidence; Behaviour and Communication Survey; 2005) the HIV prevalence in each of eight major ethnic groups was calculated. Linear regression analysis was used to assess the association between an ethnic group's HIV prevalence and the point-prevalence of concurrency. Results showed that HIV prevalence rates varied considerably between South Africa's ethnic groups. This applied to both different racial groups and to different ethnic groups within the black group. The point-prevalence of concurrency by ethnic group was strongly associated with HIV prevalence (R2 = 0.83; p = 0.001). Tackling the key drivers of high HIV transmission in this population may benefit from more emphasis on partner reduction interventions

Ethnic Differences in Age of Onset and Prevalence of Disordered Eating Attitudes and Behaviours: a School-Based South African Study

Objectives: To determine the age of onset and prevalence figures for disordered eating for diverse ethnic groups among a sample of South African schoolgirls.Method: A cross-sectional design was implemented. Two questionnaires were used to elicit prevalence figures and attitudes towards eating.Results: The study population (n = 418) consisted of black and white schoolgirls in various educational phases. Black students were found to experience a significant increase in reported bulimia-associated behaviours in grades seven to nine (mean age 13.7 years) but did not report any significant increases in drive for thinness; body dissatisfaction or poor eating attitudes across the different phases. White students reported significant increases in all measured disordered eating attitudes and behaviours in grades 10-12 (mean age 16.7 years). In grades four to six; black and white students did not differ with respect to their reported disordered eating attitudes and behaviours. However; in grades seven to nine; black students were more likely to report bulimia-associated behaviours than their white counterparts. The most apparent differences emerged in grades 10-12. White students reported significantly higher drive for thinness; greater body dissatisfaction and poorer eating attitudes than their black counterparts. Furthermore; the ethnic differences that emerged during grades seven to nine with respect to bulimia disappeared in grades 10-12.Conclusion: This study fills the hiatus in the existing South African literature with respect to age of onset and prevalence of disordered eating attitudes and behaviours across ethnic boundaries. Furthermore; it creates a foundation for developing appropriate strategies to address eating disorders in the multicultural South African context

Effects of Smoking on the Lipoprotein Levels among Mauritian of Different Ethnic Groups and their Preponderance to Cardiovascular Threats

Disease progression and initiation has since long been known to be influenced by smoking and also genetic variability, owing to ethnic differences. Past studies conducted among Mauritian, have reported certain genetic preponderance to diseases. In the current study, effect of smoking on various cardiovascular parameters in two different ethnic groups of Mauritius was studied. Smokers and non-smokers volunteers were recruited from ethnic Asian and African population and blood sample collected by venipuncture. Myeloperoxidase, APOA1, OxLDL, HDL, TG, LDL, and cholesterol were assessed The level of cholesterol, TG, HDL, LDL, myeloperoxidase, APO A1, and OxLDL was 5.56±1.09, 2.13±1.70, 0.67±0.11, 4.07±0.93, 145.90±9.59, 0.42±0.13 and 74.55±13.73 mmol/L respectively in Asian smokers. Corresponding values in African smokers were respectively 4.65±0.88, 1.17±0.78, 1.18±0.42, 2.33±0.67, 172.50±15.55, 0.47±0.88 and 65.11±7.38. Results of our study indicate a significant difference (p<0.05) in cardiovascular parameters between Asian and African smokers. Furthermore, Asians were also observed to be prone to dyslipidaemia. On the other hand, smoking did not seem to influence cardiovascular parameters among African smokers, but rather seemed to have an underlying genetic protective effect against the deleterious effects of smoking.

Post-traumatic Stress Disorder and Exposure to Violence among Venda and Nothern Sotho Adolescents

In this study; two research questions were posed. In the first place; this study investigated the levels of exposure to violence among the adolescents as a total group (Venda- and Northern Sotho-speaking); as well as the exposure levels of the two ethnic groups. The relationship between the groups' exposure to violence and their post-traumatic stress disorder (PTSD) symptoms was investigated in the second place; as well as the question whether a difference existed between the two ethnic groups in respect of this relationship. The participants were comprised of 186 Venda and 151 Northern Sotho adolescents; who completed the Child PTSD Checklist (PTSDC) and the Child Exposure to Violence Form (CEVF). A large proportion of participants reported high levels of exposure to violence. Venda youth appeared to be subjected to a higher rate of victimisation than the Northern Sotho adolescents. A strong correlation was found between exposure to violence and PTSD symptoms

Prevalence of malocclusion among 12 year-old school children in Lagos State

Objectives: To determine the prevalence of dentofacial anomalies presenting as malocclusion in 12 year-old Nigerian school children in the Mainland Local Government Area of Lagos State; Nigeria. Methodology: The study; which involved a sample of 200 children; was carried out employing the World Health Organization Pathfinder Methodology for oral health surveys. Malocclusion was recorded as being absent; slight or moderate/severe based on the WHO criteria as outlined in the methodology. Results: Sixty-eight per cent (68) of the children had normal occlusion i.e. absence of malocclusion. Slight malocclusion was present in 22; while 10 had moderate to severe malocclusion. There was no sex predilection for malocclusion. Among the ethnic groups; there was no significant difference in prevalence of malocclusion. Conclusion: In view of the handicapping effects of dentofacial anomalies; which tend to affect a person's aesthetics; masticatory function; speech and indeed social acceptability; there is a need to institute measures; which would help in the prevention of some of the malocclusion types seen in the study. The establishment of school oral healthcare programme; which would also provide preventive orthodontic care; is advocated. However; the small number seen among some ethnic groups precludes the extrapolation of this finding to the larger population. There is a need to carry out national surveys