Genetic substructure and complex demographic history of South African Bantu speakers.

South Eastern Bantu-speaking (SEB) groups constitute more than 80% of the population in South Africa. Despite clear linguistic and geographic diversity, the genetic differences between these groups have not been systematically investigated. Based on genome-wide data of over 5000 individuals, representing eight major SEB groups, we provide strong evidence for fine-scale population structure that broadly aligns with geographic distribution and is also congruent with linguistic phylogeny (separation of Nguni, Sotho-Tswana and Tsonga speakers).

Descriptive epidemiology of objectively-measured, free-living sleep parameters in a rural African setting.

Objectives: To investigate the descriptive nature of objectively-measured, free-living sleep quantity and quality, and the relationship to adiposity, in a rural African setting in 145 adults (≥ 40 years, female: n = 104, male: n = 41). Wrist-mounted, triaxial accelerometry data was collected over 9 days. Measures of sleep quantity and quality, and physical activity were extracted from valid minute-by-minute data.

Regional Patterns and Association Between Obesity and Hypertension in Africa: Evidence From the H3Africa CHAIR Study.

Hypertension and obesity are the most important modifiable risk factors for cardiovascular diseases, but their association is not well characterized in Africa. We investigated regional patterns and association of obesity with hypertension among 30 044 continental Africans. We harmonized data on hypertension (defined as previous diagnosis/use of antihypertensive drugs or blood pressure [BP]≥140/90 mmHg/BP≥130/80 mmHg) and obesity from 30 044 individuals in the Cardiovascular H3Africa Innovation Resource across 13 African countries.

Kidney damage and associated risk factors in rural and urban sub-Saharan Africa (AWI-Gen): a cross-sectional population study.

Background: Rapid epidemiological health transitions occurring in vulnerable populations in Africa that have an existing burden of infectious and non-communicable diseases predict an increased risk and consequent prevalence of kidney disease. However, few studies have characterised the true burden of kidney damage and associated risk factors in Africans. We investigated the prevalence of markers for kidney damage and known risk factors in rural and urban settings in sub-Saharan Africa.

Classical Cardiovascular Risk Factors and HIV are Associated With Carotid Intima-Media Thickness in Adults From Sub-Saharan Africa: Findings From H3Africa AWI-Gen Study.

Background Studies on the determinants of carotid intima-media thickness ( CIMT ), a marker of sub-clinical atherosclerosis, mostly come from white, Asian, and diasporan black populations. We present CIMT data from sub-Saharan Africa, which is experiencing a rising burden of cardiovascular diseases and infectious diseases. Methods and Results The H3 (Human Hereditary and Health) in Africa's AWI-Gen (African-Wits-INDEPTH partnership for Genomic) study is a cross-sectional study conducted in adults aged 40 to 60 years from Burkina Faso, Kenya, Ghana, and South Africa.

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa.

Background: The study was conducted in the Dikgale Health and Demographic Surveillance System (DHDSS) site where we have observed increasing obesity levels, particularly in women, despite evidence of high physical activity (PA) and a relatively low daily energy intake.

Objective: This study aimed to assess the socio-demographic, behavioural and biological determinants of body mass index (BMI) in adult residents permanently residing in the DHDSS.

Methods: A cross-sectional study was conducted in which socio-demographic, behavioural and biological characteristics from 1143 participants (aged 40-60 years) were collected using a paper questionnaire and standard anthropometric measures.

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study.

There is an alarming tide of cardiovascular and metabolic disease (CMD) sweeping across Africa. This may be a result of an increasingly urbanized lifestyle characterized by the growing consumption of processed and calorie-dense food, combined with physical inactivity and more sedentary behaviour. While the link between lifestyle and public health has been extensively studied in Caucasian and African American populations, few studies have been conducted in Africa.

Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa.

Background: Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease management model in Dikgale, a rural area of Limpopo Province in South Africa.

Methods: A multifaceted intervention, called 'quality circles' (QCs) was developed to improve the quality and the management of chronic diseases in the Dikgale Health and Demographic Surveillance System (HDSS).

Regional and sex-specific variation in BMI distribution in four sub-Saharan African countries: The H3Africa AWI-Gen study.

Background: African populations are characterised by diversity at many levels including: demographic history, genetic ancestry, language, wealth, socio-political landscape, culture and behaviour. Several of these have a profound impact on body fat mass. Obesity, a key risk factor for cardiovascular and metabolic diseases, in the wake of the epidemiological and health transitions across the continent, requires detailed analysis together with other major risk factors.

Regional and Sex Differences in the Prevalence and Awareness of Hypertension: An H3Africa AWI-Gen Study Across 6 Sites in Sub-Saharan Africa.

Background: There is a high prevalence of hypertension and related cardiovascular diseases in sub-Saharan Africa, yet few large studies exploring hypertension in Africa are available. The actual burden of disease is poorly understood and awareness and treatment to control it is often suboptimal.

Objectives: The study sought to report the prevalence of measured hypertension and to assess awareness and control of blood pressure among older adults in rural and urban settings in 6 sites located in West, East, and Southern Africa.

Weight status and associated factors among HIV infected people on antiretroviral therapy in rural Dikgale, Limpopo, South Africa.

Background: Underweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD).

Aim: The study determined weight status and associated factors in people with HIV infection receiving ART.

Setting: Rural primary health care clinics in Dikgale, Limpopo province, South Africa.

The Prevalence and Determinants of Chronic Non-Communicable Disease Risk Factors amongst Adults in the Dikgale Health Demographic and Surveillance System (HDSS) Site, Limpopo Province of South Africa.

Background: The aim of the study was to determine the prevalence and determinants of chronic non-communicable disease (NCD) risk factors in a rural community in the Limpopo Province of South Africa.

Methods: This survey was conducted using the WHO "STEPwise approach to the surveillance of non-communicable diseases" (STEPS) methodology. Participants were residents of the Dikgale HDSS site and standardised international protocols were used to measure behavioural risk factors (smoking, alcohol consumption, fruit and vegetable intake and, physical activity) and physical characteristics (weight, height, waist and hip circumferences and blood pressure-BP).

Assessment of cardiovascular risk factors in people with HIV infection treated with ART in rural South Africa: a cross sectional study.

Background: The risk of cardiovascular diseases (CVD) in human immunodeficiency virus (HIV) infected people on antiretroviral therapy (ART) from some rural parts of Africa is not well known. We assessed CVD risk factors, the estimated 5-year Data collection on adverse effects of anti-HIV drugs (DA.) risk score and the 10-year Framingham risk score in persons with HIV infection on ART in a rural area in South Africa.

Conflicting effects of BMI and waist circumference on iron status.

The association between obesity and iron status has a long history and is still receiving attention. However comparative analysis of the association between general obesity (BMI) and visceral obesity (waist circumference) with iron status has not been extensively researched. The aim of the present study is thus to determine if body mass index and waist circumference have the same correlation with iron status.

The perceptions and perspectives of patients and health care providers on chronic diseases management in rural South Africa: a qualitative study.

Background: Preventive health care represents the future for health care delivery in South Africa to improve management of chronic diseases as this has been implemented for some time in several countries to tackle the increasing burden of chronic diseases. Individual person's health is unique, as they move in and out of chronic and acute health care phases, there is need to integrate chronic and acute care constructs to improve continuity of care and maximize health and improve wellbeing. The aim of this study was to determine the perceptions and perspectives of chronic patients' and nurses regarding chronic disease management in terms of barriers, facilitators and their experiences.

Prevalence of anaemia and its associated factors in African children at one and three years residing in the Capricorn District of Limpopo Province, South Africa.

Objective: The present study evaluated the prevalence of anaemia and its determinants in one- and three-year-old children from the Capricorn District of Limpopo Province, South Africa.

Methods: A prospective cohort study conducted in rural villages in the Capricorn District of Limpopo Province, South Africa. At birth, a cohort of 219 children was followed until they were one and three years of age.

Causes of deaths in children under-five years old at a tertiary hospital in Limpopo province of South Africa.

Objective: Accurate and timely information on the causes of child deaths is essential in guiding efforts to improve child survival, by providing data from which health profiles can be constructed and relevant health policies formulated. The purpose of this study was to identify causes of death in children younger than 5 years-old in a tertiary hospital in South Africa.

Methods: Death certificates from the Pietersburg/Mankweng hospital complex, for the period of January 1, 2008 through December 31, 2010, were obtained for all patients younger than 5 years and were retrospectively reviewed.

Influence of cut-points on patterns of accelerometry-measured free-living physical activity in rural and urban black South African women.

Background: We describe the effect of 2 different accelerometer cut-points on physical activity (PA) patterns in rural and urban black South African women.

Methods: Hip-mounted uni-axial accelerometers were worn for 6 to 7 days by rural (n = 272) and urban (n = 16) participants. Twenty-hour (4 AM to 12 AM) PA counts (cts) and volumes (min·day⁻¹) were extracted: sedentary (SED, <100 cts·min⁻¹), light (100-759 cts·min⁻¹), moderate-1 (MOD1, 760-1951 cts·min⁻¹), moderate-2 to vigorous (MOD2VG, ≥1952 cts·min⁻¹), and bouts ≥10 min for ≥760 cts·min⁻¹ (MOD1VGbt) and ≥1952 cts·min⁻¹ (MOD2VGbt).

Compliance with physical activity guidelines in rural, black South Africans in the Limpopo Province: an energy expenditure approach.

Objective: The authors used an energy expenditure-based approach to determine the non-compliance and compliance with public health physical activity (PA) guidelines in rural, black South Africans.

Methods: The authors analysed 7-day objectively measured PA data (NL-2000 pedometer) in 508 females and 267 males. Compliance was defined for the American College of Sports Medicine guideline (ACSM: ≥7.

Spatial and temporal clustering of mortality in Digkale HDSS in rural northern South Africa.

Background: Mortality data are frequently presented at the overall population level, possibly obscuring small-scale variations over time and space and between different population sub-groups.

Objective: Analysis of mortality data from the Dikgale Health and Demographic Surveillance System, in rural South Africa, over the period 1996-2007, to identify local clustering of mortality among the eight villages in the observed population.

Design: Mortality data and person-time of observation were collected annually in an open-cohort population of approximately 8,000 people over 12 years.

Descriptive epidemiology of ambulatory activity in rural, black South Africans.

Purpose: We investigated the distribution of objectively measured ambulation levels and the association of ambulation levels to adiposity levels in a convenience sample of adolescent and adult, rural black South Africans.

Methods: We analyzed 7-d pedometry data, collected over a period of nine consecutive days, in 789 subjects (women, n = 516; men, n = 273). Adiposity measures included body mass index (BMI) and waist circumference (WC).

Development of a four-item physical activity index from information about subsistence living in rural African women: a descriptive, cross-sectional investigation.

Background: We investigated the criterion validity of a physical activity index (PAI) derived from socio-demographic variables obtained from convenience samples of rural African women.

Methods: We used a sample (N = 206) from a larger dataset which surveyed adult rural Africans during 1997, and data collected during 2003/4 from 138 adult rural African women. A three-point PAI (low-, medium- and high-subsistence) was constructed from four socio-demographic questions related to electricity, cooking methods, water collection and availability of motorized transport.

All-cause mortality trends in Dikgale, rural South Africa, 1996-2003.

Aims: The Dikgale Demographic Surveillance System (DDSS) site, established in 1995, is one of three rural surveillance sites in South Africa. This paper describes detailed mortality patterns of a rural African population in the central region of Limpopo Province.

Methods: These data were based on yearly household visits to collect data on vital events, covering 63, 873 person-years of observation over eight years.