Associated factors of diabetic retinopathy in type 1 and 2 diabetes in Limpopo province in South Africa.

Background: Diabetic retinopathy (DR) is the major cause of vision impairment or blindness in individuals who have diabetes. It has accounted for 2.6% of all cases of blindness, and 1.9% of all cases of vision impairments globally. There is a lack of data on the prevalence of diabetic retinopathy and its associated factors amongst diabetic rural populations. Hence, the current study aimed to determine factors associated with diabetic retinopathy (DR) among diabetes mellitus (DM) patients undergoing diabetic therapy. Methods: The study was cross-sectional in design and the participants were selected using convenient sampling. STATA version 15 software was used for data analysis. Chi-square was used to compare proportions. Logistic regression was used to determine the relationship between DR and associated risk factors. Results: The prevalence of DR was 35.3%, of which 32% were mild and 3.4% were moderate non-proliferative DR (NPDR). Females were more unemployed than males (32.1% versus 16.8%, p=0.0058). Males were found to drink alcohol (21.8% versus 1.9%, p<0.001) and smoke cigarettes (4% versus 0.3%, p=0.0034) more than females. Being aged ≥ 55 years (OR: 2.7, 95% CI: 1.6-4.4), with matric qualification (OR: 0.6; 95% CI: 0.4-1.0); employed (OR: 1.4, 95% CI: 1.2-1.6); having high systolic blood pressure (OR=1.4, 95%CI=1.1-1.7) were the independent determinants of DR. Conclusions: The prevalence of diabetic retinopathy was 34%. DR was determined by high systolic blood pressure, old age, and employment. Although not statistically significant, gender, hyperglycemic state, poor glycemic control, smoking, and increased body mass index (BMI) were associated with increased risk of developing DR.

Determinants of central obesity in children and adolescents and associated complications in South Africa: a systematic review.

Background: Central obesity in children is a global health concern associated with cardiovascular risk factors. In 2019 the World Obesity Federation predicted that in 2025, 206 million children and adolescents aged 5 to 19 will be obese, and the number is estimated to reach 254 million by 2030. There is limited literature on the factors that are associated with the development of central obesity in children. We report a systematic review, aimed to describe the current literature on determinants of central obesity and its associated health outcomes in children and adolescents in the South African population. Methods: We searched for peer-reviewed studies in Google Scholar, PubMed, and Science Direct search engines, and about seven studies were included. This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42023457012). This systematic review was conducted and reported according to an updated version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The quality of the included studies was assessed by following guidelines from the Newcastle-Ottawa Scale (NOS). The method considered three main domains: selection, comparability, and outcome across different study designs. Results: The prevalence of central obesity in children and adolescents by waist-to-height ratio (WHtR) ranged from 2.0 to 41.0%; waist-to-hip [WHR ranged from 10 to 25%; waist circumference (WC) ranged from 9 to 35%]. Central obesity was associated with age, physical inactivity, gender socio, and demographic profiles of the household. Central obesity in children was associated with cardiovascular diseases and mental health issues. Conclusion: Central obesity in children and adolescents was determined by gender, pubertal development, and age of the parents, households with high socioeconomic status, dietary practices, and overweight/obesity. Given the high prevalence of central obesity in children which can ultimately result in cardiometabolic diseases, cardiovascular risk factors, and mental health issues. This highlights the need for systems, jointly initiated by healthcare providers, policymakers, and the general society aimed at reducing the burden of central obesity such as introducing children and adolescents to health-promoting lifestyles.

Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa.

Background: Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa. Methodology: A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively. Results: Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%). Discussion: Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.

Exploring Roles of Stakeholders in Combating Substance Abuse in the DIMAMO Surveillance Site, South Africa.

Background: The increasing prevalence of substance abuse in rural areas of Limpopo Province is a concern for most stakeholders including the families, South Africa Police Service, and social workers. Combating Substance Abuse requires the active roles of various stakeholders in the rural community, due to limited resources for prevention, treatment, and recovery. Purpose: To report on the roles of stakeholders in tackling Substance Abuse during the awareness campaign conducted in the deep rural community of Limpopo Province, DIMAMO surveillance area. Methods: Qualitative narrative design was adopted to explore the roles of stakeholders in combating Substance Abuse during the awareness campaign conducted in the deep rural community. The population consisted of different stakeholders who play an active role in reducing Substance Abuse. The triangulation method was used for data collection (interviews, observations, and taking field notes during presentations). Purposive sampling was used to select all the available stakeholders who actively combat substance abuse in the communities. Thematic narrative analysis was used to analyze the interviews conducted with and content presented by the stakeholders to generate the themes. Results: The prevalence of Substance Abuse among the youth in the Dikgale community is high with a growing trend of Crystal Meth, "nyaope," and Cannabis(marijuana). The prevalence is worsened by the diverse challenges experienced by the families and stakeholders which impact the strategies targeted to combat Substance Abuse. Conclusion: The findings indicated the need for strong collaborations among the stakeholders (including school leadership) to successfully combat Substance Abuse in rural areas. The findings demonstrated a need for a well-capacitated healthcare services with adequate rehabilitation centers and well-trained healthcare providers for combating Substance Abuse to minimize victim stigmatization.