A systematic comparison of additive and interaction approaches to modeling the effects of syndemic problems on HIV outcomes in South Africa.

Much of the research on the effects of syndemics on HIV outcomes has utilized an additive approach. However, interaction effects may better account for syndemic synergy than an additive approach, but it remains difficult to specify interaction effects without empirical guidance. We sought to systematically compare additive and interaction effects approaches to modeling the effects of syndemic problems on antiretroviral therapy (ART) using empirically specified interaction terms.

Mapping the consumer foodshed of the Kampala city region shows the importance of urban agriculture.

Due to rapid urbanisation, food systems in sub-Saharan African cities are increasingly under pressure. Through the lens of a foodshed, this paper quantitatively analyses the spatial extent of the food provisioning area for consumers of different socio-economic status in Kampala (Uganda). Based on a primary dataset of surveys with households and food vendors, we map the foodshed by registering where consumers obtain their food, and the origin of where it is grown.

Assessment of environmental exposure factors on child diarrhea and systemic inflammation in the Eastern Cape.

Poor environmental technologies and gastrointestinal illnesses have been hypothesized to be a primary cause to the lack of impact of child health programs on child stunting rates (low height-for-age) in South Africa. This study assessed correlations between environmental exposures (water source, water treatment, sanitation, refuse), diarrheal occurrences, and systemic inflammation proxies among female and male children under five years of age in the Eastern Cape. A conceptual model was hypothesized using structural equation (SE) modeling and two sex-specific (female and male) datasets were subsequently generated from the data and applied to the hypothesized SE model.

A comparative analysis of socioeconomic inequities in stunting: a case of three middle-income African countries.

Background: Despite increased economic growth and development, and existence of various policies and interventions aimed at improving food security and nutrition, majority of countries in sub-Saharan Africa have very high levels of child malnutrition. The prevalence of stunting, an indicator of chronic malnutrition, is especially high.

Methods: In this paper, we use Demographic and Health Survey datasets from three countries in the region that obtained middle-income status over the last decade (Ghana, Kenya and Zambia), to provide a comparative quantitative assessment of stunting levels, and examine patterns in stunting inequalities between 2007 and 2014.

Keystones affecting sub-Saharan Africa's prospects for achieving food security through balanced diets.

Socio-economic dynamics determine the transition from diets characterized by the risk of famine, to those characterized by the risk of diet-related non-communicable disease (DR-NCD). This transition is of particular concern in Sub-Saharan Africa (SSA) in which key socio-economic interactions that influence diet include economic growth and rapid urbanization; inequality and a growing middle class; and obesogenic food environments and an increasing prevalence of DR-NCD. In each case, countries in SSA are among those experiencing the most rapid change in the world.

The economic impacts of premature adult mortality: panel data evidence from KwaZulu-Natal, South Africa.

Measuring the household level economic impacts of AIDS-related deaths is of particular salience in South Africa, a country struggling with a legacy of poverty and economic inequality in the midst of an HIV epidemic. Household panel data that span more than a decade permit us to resolve many of the statistical problems that make it difficult to determine these impacts. After allowing for the impact of demographic adjustments and other coping strategies, we found evidence that these impacts are quite different across different types of households, and that the largest and most persistent effects were in the middle ranges of the South African income distribution, that is, households just above the poverty line.

The impact of life skills education on adolescent sexual risk behaviors in KwaZulu-Natal, South Africa.

Purpose: To assess the impact of exposure to life skills education by youth in KwaZulu-Natal Province (KZN, South Africa) on knowledge and behaviors associated with the spread of HIV/AIDS.

Methods: Data come from a panel study of 2222 youth from several population subgroups in KZN. The youth were aged 14-24 years when interviewed in 1999 and 2001.

Communities, opportunities, and adolescents' sexual behavior in KwaZulu-Natal, South Africa.

In 2002, the prevalence of HIV among South African clinic attendees under the age of 20 was 15 percent, suggesting a correspondingly high level of unprotected sex and risky sexual behavior. Past research focused on the dynamics of individuals' and partners' sexual decisionmaking without accounting for the larger context in which such decisions are made. Do adolescents' opportunities for schooling, work, and other community activities make a difference? This study uses data collected from a representative sample of young people living in KwaZulu-Natal, South Africa, to explore these questions.