Saúde, estilo de vida e urbanização em Moçambique: problemas e perspectivas / Health, Lifestyle and urbanization in Mozambique: problems and perspectives

A irreversibilidade do processo de urbanização da população mundial está a atingir Moçambique de uma forma abrupta com múltiplas consequências para a saúde e bem, estar. Entre outros, o aumento da mecanização, o tempo de televisão, o uso do automóvel e o recurso a alimentação artificial, está a transformar, em poucos anos, uma população activa em pessoas sedentárias sujeitas à poluição e níveis de ansiedade até então desconhecidos. Os estudos disponíveis demonstram de forma clara uma enorme redução dos espaços para a recreação activa e uma concomitante redução do dispêndio energético por actividade física habitual. Como consequência, os dados epidemiológicos indicam um aumento, nas cidades, da obesidade, hipertensão e diabetes em adultos. Por seu turno, as crianças em idade escolar estão a conhecer um crescimento em todos os factores de risco de doença cardiovascular e uma redução do seu nível de desenvolvimento motor. A falta de planeamento no crescimento urbano está a ter consequências catastróficas na saúde da população urbana. Neste quadro, a denominada transição epidemiológica acontece sob a forma de acumulação, dado que a população continua muito permissiva a doenças transmissíveis e sofre agora a acumulação de um grupo de patologias associadas ao sedentarismo e desiquilíbrio nutricional.

The process of urbanization of the world population is reaching Mozambique rather abruptly with multiple consequences for the health and well-being. Increased mechanization, screen time, car use and use of fast food are causing, in a short time period, a dramatic changing in lifestyle. Population is reducing their activity levels, that used to be high, the stress levels are increasing as well as the environmental pollution. The available studies demonstrate a huge reduction of spaces for active recreation and a concomitant reduction of energy expenditure for physical activity. As a consequence, epidemiological data indicate an increase in the prevalence of obesity, hypertension and diabetes in adults. In turn, studies are demonstrating that the school aged children are increasing prevalence in all risk factors for cardiovascular disease and a reduction in their level of motor development. Lack of urban planning on urban growth seems to cause disastrous consequences on the health of the urban population. Thus, the so-called epidemiological transition are happening in the form of accumulation since the population remains very permissive to transmissible diseases adding to them an increased in the sedentary lifestyle and nutritional imbalance related diseases.

Effects of an Exercise Programme with People Living with HIV: Research in a Disadvantaged Setting

This study aimed to analyse the physical health effects of a community based 10-week physical activity programme with people living with HIV. It was developed; implemented and evaluated in a disadvantaged community in South Africa. A pre-post research design was chosen. Major recruitment and adherence challenges resulted in a small sample. Among the 23 participants who took part in both baseline and final testing; compliant participants (n = 12) were compared to non-compliant participants (n = 11). Immunological (CD4; viral load); anthropometric (height; weight; skinfolds and waist to hip ratio); muscular strength (h1RM) and cardiopulmonary fitness (time on treadmill) parameters were measured. The compliant and non-compliant groups were not different at baseline. Muscular strength was the parameter most influenced by compliance with the physical activity programme (F = 4.516; p = 0.047). Weight loss and improvement in cardiopulmonary fitness were restricted by the duration of the programme; compliance and influencing factors (e.g. nutrition; medication). The increase in strength is significant and meaningful in the context; as the participants' goals were to look healthy and strong to avoid HIV related stigma. The improvements in appearance were a motivational factor; especially since the changes were made visible in a short time. Practical implications for health promotion are described. More research contextualised in disadvantaged settings is needed

Prevalence of Tobacco Use and Physical Activity among Adult Sierra Leonean Population

The current burden of non-communicable diseases (NCDs) and their risk factors such as tobacco use and physical inactivity remain largely unknown in Sierra Leone. Thus; this study was conducted to document the prevalence of tobacco use and physical activity among the adult Sierra Leonean population with a specific objective of determining the sex and age prevalence. A cross sectional population based survey utilising the multi-stage cluster sampling strategy was used. A total of 5;483 individuals aged 25-64 years of both sexes were recruited into the survey. The World Health Organisation (WHO) STEPwise approach to surveillance instrument was adapted and questionnaire was administered to one individual in selected household. The data was analysed and graphed using Epi-Info software version 3.4.3 and graph pad prism version 5.1 respectively. The analyses showed that 34 of the respondents use tobacco products with 26 engaged in smoking tobacco products and 8 were smokeless tobacco users at the time of this study. The average age of commencing tobacco smoking was 21 years; with 92 and 96 of the male and female daily smokers smoking at least six manufactured tobacco respectively. Seventy four percent (74) and 69 of the non-smoking respondents were exposed to environmental tobacco smoke (ETS) at home and workplace respectively. The study further revealed that 15; 23 and 87 of the total respondents reported no work-; transport- or recreational- related physical activity respectively; and were therefore classified as physically inactive. The lowest level of physical activity was reported in the recreation domain. Even those who reported moderate physical activity at work or from travel; their median metabolic equivalent (MET) was not sufficient to achieve a level of physical activity that is beneficial to their health. In conclusion; a significant proportion of the population is exposed either directly or indirectly to tobacco smoke; and a large proportion of the adult population is physically inactivity. Thus; NCD prevention policy addressing lifestyle changes such as no smoking should not be limited to work places but should be population based

Effect of Music on Submaximal Cycling

OBJECTIVE. Athletes frequently report training to music; yet there have been relatively few studies that have addressed the benefit of exercising with music. Design. Volunteer men and women (N=30); aged between 18 and 40 years; performed an initial familiarisation session. Part of this session involved the measurement of maximal oxygen consumption. With at least a 48-hour intervening period; this was then followed by a first 20-minute submaximal cycling session; at 80of maximal oxygen consumption. At least 48 hours later a second submaximal cycling session was performed. Subjects were randomly divided into two groups. Group A cycled without music and group B cycled with music for the first submaximal cycling session. Subjects underwent the same testing procedure for the second submaximal cycling session; but this time group A cycled to music and group B cycled without music. Subjects served as their own controls. SETTING. The study was performed in the physiology exercise laboratory; at the University of the Witwatersrand. MAIN OUTCOME MEASURES. During the submaximal sessions heart rate; perceived exertion (Borg scale) and plasma lactate concentration were assessed. Subjects completed a post-test questionnaire once both submaximal cycling sessions were completed. RESULTS. There were no significant differences in physiological variables (change in plasma lactate and heart rate); nor were there any significant differences in Borg scale ratings when the subjects cycled with and without music. However; according to the post-test questionnaire 67of subjects identified the cycling session with music to be easier than the session without music. CONCLUSION. Listening to music while performing submaximal cycling resulted in no physiological benefit. Yet; the cycling session done in conjunction with music was deemed; by the majority of the subjects; to be easier than the cycling session without music

Valeurs erythrocytaires des jeunes footballeurs en période de compétition et de trêve au Bénin

Les valeurs erythrocytaires et le statut martial varient en fonction des periodes de la saison chez le sportif de haut niveau. Ces variations chez les pratiquants beninois n'ont jamais ete evaluees. La presente etude a pour objectif de comparer le niveau des parametres erythrocytaires entre de jeunes footballeurs et des non sportifs; en periode de competition et a la fin d'une treve de 2 semaines. Il s'agit d'une etude prospective et analytique; realisee sur 20 jeunes footballeurs de troisieme division (FB); engages dans deux competitions differentes (scolaire et civile) et 25 jeunes non sportifs (NS). Les parametres erythrocytaires ont ete mesures en simple aveugle; suite a 14 semaines d'entrai-nement et de competition (1er prelevement); puis apres une treve de 2 semaines succedant a 7 autres semaines de competition (2eme prelevement). Apres les 14 semaines d'entrainement et de competition; les parametres etudies etaient plus eleves chez les footballeurs que chez les non sportifs (p 0;05). Apres les 2 semaines de treve; les variations entre test et retest ont ete non significatives dans le groupe FB; de meme que les differences entre les groupes FB et NS (p 0;05). Les valeurs erythro- cytaires des joueurs de football etudies different de celles des non sportifs en periode de competition; mais pas en fin de trêve

Comparaison des facteurs de risque atherogene entre des joueuses de handball et des non sportives

Sedentarity during adolescence is important therogenous risk factors in adults; but physical activity contributes to reducing the risk. Objectives: this study aimed at comparing Beninese handball players to non players; i.e. 1) factors associated with atherogenous risk; 2) frequency of athergenous risk factors; 3) determinants of indirect VO2 max. Methods: this cross sectional study; a case-control; was carried out on 100 girls about sixteen to twenty five. The case group (GS) was constituted of 50 handball players girls; who are involved very often in Beninese first division championship. Fifty girls non players constituted the control group (GC). Adiposity indexes; blood pressure; resting heart rate; plasma HDL-C and indirect VO2max were detriment in a single blind fashion and in the same conditions for both groups. Results: the values of plasma HDL-C and indirect VO2max were higher (P0.05) in the GS group than in GC (0.47+- 0.13 gl versus 0.36+- 0.13 g/l and 45.06 +- 6.32 ml.kg.min.-1 versus 33.96 +- 3.52 ml.kg-1.min-1). In GC; the frequency of the atherougenous risk factors was higher than in GC; for P0.05 (TT/TH : 72

Attitudes Towards the Risk of HIV Transmission in Sport: Original Research Article

Objective. There is a real risk of transmitting HIV through open wounds during participation in sport. The aim of this study was to investigate athlete s knowledge and attitudes towards HIV transmission in a competitive sport environment how their sporting codes; demographics; knowledge and interaction with colleagues influenced their attitudes. Design. A questionnaire was administered to elite athletes (N = 575) competing in 11 sport codes including high; medium and low-risk sports; and undergraduate students (N = 46) from a Sport Science Department. Athletes from all economic backgrounds; who competed at national; provincial or at first-division level; were included in this study. The questionnaire was distributed during national tournaments and training sessions. Results. Sixty-three per cent of athletes believed that a risk of HIV transmission exists in sport participation. Fiftyeight per cent believed that they had a right to know if a teammate/opponent was HIV-positive; and 62 believed that all athletes should be tested for HIV. Fifty per cent of the respondents indicated that they would participate against individuals who were HIV-positive. Most athletes (88) believed that more education on HIV transmission in sport was needed and 58 felt that HIV should be a notifiable disease in sport. Forty-six per cent of the athletes indicated that they would participate in competition even though they were HIV-positive. Conclusion. The threat of infection or transmission did not deter athletes who were afflicted or unafflicted with HIV from participating in competitive sports

L'asthme a l'ecole : connaissances et vecu des enseignants d'education physique et sportive

Cette etude s'est portee sur les connaissances et le vecu des enseignants d'education physique et sportive en matiere d'asthme. Elle a ete realisee dans quelques etablissements de la commune de Cocody sur une periode de 2 mois et 15 jours environ. Son objectif principal a ete d'evaluer les conditions de la prise en charge des eleves asthmatiques en cours d'education physique et sportive. Au terme de cette etude; il ressort les conclusions suivantes: *99;29pour cent des enseignants d'education physique et sportive n'ont pas recu d'enseignement sur l'asthme au cours de leur formation ; *la dispense de sport n'est pas indiquee par ces enseignants ; *l'effort physique est reconnu comme facteur declenchant des crises d'asthme a 82;86pour cent ; *l'encadrement d'eleves asthmatiques o deja ete effectue par 57;14pour cent des enseignants interroges ; *les eleves asthmatiques ne recoivent pas d'enseignement physique particulier dans 54;29pour cent des cas ; *s'il presente une crise pendant le cours; l'eleve est conduit a l'infirmerie dans 54;29pour cent des cas ; *26 enseignants sur les 35 interroges ont deja vecu une crise d'asthme pendant le cours soit un taux de 74;28pour cent ; *le desir. d'information est retrouve chez 97;14pour cent des enseignants d'education physique et sportive

Surveillance medicale d'une equipe masculine de football de division1 en Cote d'Ivoire : cas du Stella Club d 'Adjame bilan de la saison 2001-2002

La pratique du football faisant intervenir mus les organes du sportif necessite une parfaite adaptation de tous les appareils a savoir: respiratoire; cardiovasculaire; osteo-artjculaire et musculaire. Par consequent un suivi medical regulier du sportif en debut; en cours et en fin de saison permet de faire le bilan afin de prevenir; de detecter et de corriger les eventuelles anomalies qui pourraient survenir. Notre etude realisee de Fevrier a Novembre 2002 sur 25 joueurs de l'equipe masculine de division I du STELLa CLUB d'ADJAME avait pour principal objectif de faire le bilan global de suivi medical de la saison 200l-2002. Elle nous a permis de noter a travers le bilan fonctionnel et physiologique l'absence de perturbation majeure. Cependant ; un bilan morphometrique laisse apparaitre des faiblesses comparativement a l'equipe nationale togolaise lors de la coupe d'Afrique des nations en 2002 et de l'equipe nationale francaise championne du monde en 1998. L'ECG nous a revele des perturbations compatibles avec la pratique du sport. La spirometrie a pu mettre en evidence un syndrome obstructif chez un des footballeurs. Les resultats de l'ergometrie bien que satisfaisants; ont montre que la condition physique de nos joueurs peut encore etre amelioree. Quant au bilan sportif; il nous a permis de constater de tres bons resultats en debut de saison et des performances mitigees dans la deuxieme moitie du championnat. Enfin; le bilan traumatologique nous a permis de recenser 106 traumatismes dont 81 au cours des entrainements et 25 au cours des matchs. Les lesions ont necessite 651 jours de traitement et 458 jours d'arret sportif. Il ressort de cette etude que 86pour cent des lesions rencontrees etaient benignes. Une bonne prevention constitue le premier remede de ces lesions L'efficacite de cette prevention depend de la bonne entente existant entre le medecin de sport; le joueur et l'entraineur

Reflexion sur un travail particulier : le sport professionnel

"La pratique du sport a nos jours; revet plusieurs aspects; dont l'un est le sport professionnel; sport de haut niveau. Celui-ci est devenu une activite economique; dans laquelle baigne l'athlete professionnel lie a son club par un contrat souvent juteux. Le sportif professionnel est donc un travailleur; ""le travailleur etant une personne qui accomplit des prestations; ayant une valeur economique en faveur d'une autre personne et sous la direction de celle-ci; en contrepartie desquelles elle percoit une remuneration "". Devant les enjeux financiers; l'esprit commercial dans le sport professionnel est devenu naturel. Ainsi; le joueur professionnel est un hybride entre un salarie de droit commun et un bien capitalise par le club employeur. La cascade de jurisprudences; dans la reglementation de ce milieu de sport professionnel; en dit long des interets contradictoires. La courte duree de la carriere du sportif professionnel; revele la precarite et le particularisme de cet emploi. Le milieu du sportif professionnel est donc complexe et parseme de derives. A ce niveau; l'Afrique en general; et la Cote d'Ivoire en particulier; est encore a l'etat de projet embryonnaire. Soutenant les objectifs de la sante au travail; la pluridisciplinarite les intervenants etatiques et les partenaires socio-economiques pourraient rendre cet emploi au mieux des normes du travail."

Suivi médical de l'équipe nationale togolaise de football, pendant la phase finale de la coupe d'Afrique des Nations 2002 au Mali : à propos des pathologies traumatiques et non traumatiques

"Nous avons suivi l'équipe nationale togolaise de football ""les Eperviers seniors"" pendant la phases de preparation et la phase finale de la Coupe d'Afrique des Nations 2002 au Mali. Au cours de ce suivi nous avons retenu les pathologies traumatiques et non traumatiques survenues au cours des 8 matchs et 46 entraînements sur 48 jours. Il ressort de ce suivi: *27 pathologies traumatiques dont 20 aux matchs et 7 aux entrainements sur 81 heures de jeu. *72 pathologies non traumatiques. *les matchs étaient plus traumatisants que les entraînements (2;5 pathologies traumatiques par match contre 0;15 pathologies traumatiques par entrainement). *les matchs de competition étaient plus traumatisants que les matchs amicaux. *Les contusions (44 pour cent) et les entorses (29;6 pour cent) étaient les pathologies traumatiques les plus fréquentes. *Le membre inférieur était le segment du corps le plus atteint. *Les diarrhées (15;2 pour cent) et les douleurs abdominales (11;36 pour cent) étaient les pathologies non traumatiques les plus fréquentes. Le suivi médical d'une équipe nationale de football pour la préparation d'une compétition est très important et nécessite des moyens matériels adéquats pour une bonne sélection et un bon suivi des sportifs."

Evaluation de la condition physique des joueurs de lequipe de football de l'Africa Sport national au debut de la saison sportive 2000-2001

Nous avons evalue la condition physique de 25 footballeurs de l'equipe de Africa Sport National au cours de la saison 2000 - 2001; a partir d'un test d'effort triangulaire a charge croissante. Les parametres ventilatoires; cardicirculatoires et morphologiques etudies revelent que les footballeurs de cette equipe ont un niveau d'aptitude moyen et inferieur aux donnees de la litterature.Par ailleurs; les defenseurs qui fournissent le plus d'effort au cours des matchs; presentent les meilleurs indices de performance.Aussi; les entraineurs devront tenir compte de la specificite de chaque poste et de chaque joueur