A Survival Analysis of South African Children Under the Age of Five Years

The South African Demographic Health Survey data set (SADHS) of 2003 contains massive individual-level information on South African children under the age of five years selected from a random sample of 7756 households. The data set contains data on socio-economic; demographic; health-related and sanitary variables gathered by using multistage cluster sampling. The objective of the study was to identify key predictors of mortality amongst children under the age of five years. Logistic regression analysis and Cox regression were used for data analysis. Under-five mortality was significantly influenced by three predictor variables (breastfeeding; marital status; and ownership of a flush toilet). The hazard ratio of the variable 'breastfeeding' was 3.09 with P = 0.000 and 95 confidence interval (CI) of (1.899; 5.033). The hazard ratio of the variable 'toilet' was 2.35 with P = 0.016 and 95 confidence interval of (1.172; 4.707). The hazard ratio of the variable 'marital status' was 1.74 with P = 0.035 and 95 confidence interval of (1.041; 2.912). Adjustment was factored in for the mother's level of education and wealth index

DDT and urogenital malformations in newborn boys in a malarial area.

OBJECTIVE: To determine the risk of external urogenital birth defects (UGBDs) in newborn boys from a malarial area currently sprayed with technical 1,1,1-trichloro-2,2-bis(4-chlorophenyl) ethane (DDT), as increased fetal oestrogenic or anti-androgenic exposure might be involved in the pathogenesis of increased prevalence of human male reproductive tract anomalies, and DDT and metabolites interact with both these receptors. SUBJECTS AND METHODS: We examined 3310 newborn baby boys and recorded external UGBDs. RESULTS: Of the newborn boys 10.8% (357) had UGBDs; a multivariate logistic model showed that mothers who lived in villages sprayed with DDT between 1995 and 2003 had a significantly greater chance (33%) of having a baby with a UGBD than mothers whose homes were not sprayed (odds ratio 1.33, 95% confidence interval 1.04-1.72). Being a homemaker instead of being employed further significantly increased the risk of having a baby with a UGBD by 41% (odds ratio 1.41, 1.13-1.77). CONCLUSIONS: Maternal exposure to DDT by living in a DDT-sprayed village was associated to having male offspring with one or more UGBDs. Monitoring the impact of indoor residual spraying on human and environmental health is imperative if DDT is being used, especially as climate change raises concerns about the global spread of malaria. Integrating adequate indoor residual spraying measures by malarial vector control programmes, and increased public awareness to limit personal exposure, are crucial components that need to be addressed.

Environmental determinants of asthma among school children aged 13-14 in and around Polokwane, Limpopo Province, South Africa.

Asthma has become a public health issue since the 1960's. Factors associated with asthma are environmental and genetic. This study is based on a random sample of 742 students aged 13-14 attending various schools at Polokwane, in the Province of Limpopo in South Africa. Survey logistic regression and multi-level analyses were used for data analysis. The study identifies three key determinants of asthma at the district, school and individual levels. The study shows that persistent cough (OR = 4.01), exposure to smoke at the household level (OR = 2.39) and lack of access to flush toileta at the household level (OR = 1.89) are key predictors of asthma in children. Variability at the level of districts accounts for 46% of total variance. Variability at the level of schools accounts for 33% of total variance.