ABSTRACT
Background. A universal goal of public health is to ensure that adolescents have a healthy transition to adulthood. In developing countries, a host of social, economic and political factors inhibit this from happening. The results of these challenges include an increasing disease prevalence among an age group (10 - 19-year-olds) that should be healthy. Objectives. The purpose of this study is to identify the most prevalent diseases and assess the relationship between disease and grade repetition among adolescents in South Africa (SA), and to assess the impact of disease on grade repetition. Methods. Data from the SA General Household Surveys (2009 - 2016) were analysed, and both adolescent (10 - 19 years) sexes from all geographical and racial groups were included. Frequencies, percentages and rates of infectious, non-communicable diseases (NCDs) and mental health outcomes were estimated. The relationship between disease and grade repetition was determined using logistic regression. Results. Infectious diseases, NCDs and mental illnesses are increasing in adolescents over time. In urban areas, rates of NCDs are higher than those of infectious diseases, while in rural areas a high burden of infectious disease persists. Among adolescents who repeated a grade, 7.07% had an infectious disease. In addition, infectious disease (odds ratio (OR) 1.17, p<0.05), younger adolescents, 15 - 19-year-olds (OR 1.52, p<0.05) and urban residence (OR 1.12, p<0.05) are associated with increased likelihood of grade repetition. Conclusion. Policies and programmes in SA which address the health of adolescents need to be more aware of the disease prevalence among school pupils in the country. Prolonged disease occurrences are contributing to the slow school progression and eventual matriculation of pupils