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Naidoo S, Otoo S, Naidoo N. Physical activity interventions implemented for older people in sub-Saharan Africa: protocol for a scoping review. BMJ Open 2023; 13:e071127. [PMID: 37068909 PMCID: PMC10111889 DOI: 10.1136/bmjopen-2022-071127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION The global population of older people (OP) is on an upward trajectory, with predictions that the number of OP would surpass the population of younger people by 2050. In sub-Saharan Africa (SSA), death from infectious diseases in the younger population and lower fertility rates are influencing a double burden contributing to an exponential growth in the ageing population. Non-communicable diseases (NCDs) are the leading cause of mortality and disability in the population of OP in SSA. Physical activity (PA) has been proven to have positive benefits in reducing the prevalence of NCDs in OP. The objective of this scoping review is to summarise the evidence on the feasibility and effectiveness of PA interventions that have been implemented among OP to address PA levels, blood pressure, blood glucose levels, cognitive function, quality of life and body mass index in SSA. METHODS AND ANALYSIS The Joanna Briggs Insitute (JBI) methodology will be followed for this scoping review. An electronic search of PubMed, EBSCOhost (Academic Search Premier AfricaWide Information, CINAHL, Health Sources Premier Academic/Nursing), Scopus and ProQuest (grey literature) will be done from 2010 onwards to identify reports of randomised controlled studies published in English using relevant keywords. 2010 was selected as the cut-off point for inclusion in order to focus only on relatively recent evidence, as it is more likely to remain relevant and applicable to present-day settings. The searches will be performed by the primary reviewer in conjunction with a senior librarian. Full independent review of the uploaded articles will be done by two reviewers, by title and abstract, and thereafter by full text, based on specified inclusion and exclusion criteria. The reference list of included articles will be scanned for additional relevant articles. Disagreements will be arbitrated by a third reviewer. Results will be presented in a descriptive form as well as in tabular, graphical and diagrammatic formats, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. ETHICS AND DISSEMINATION The review will be extracting and reporting on data from published literature so there is no requirement for ethics approval. The findings of the review will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Shane Naidoo
- Health and Rehabilitation, University of Cape Town, Rondebosch, South Africa
| | - Samuel Otoo
- Health and Rehabilitation, University of Cape Town, Rondebosch, South Africa
| | - Niri Naidoo
- Division of Physiotherapy Department of Health and Rehabilitation Sciences, University of Cape Town, Rondebosch, South Africa
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Mostert CM, Mackay D, Awiti A, Kumar M, Merali Z. Does social pension buy improved mental health and mortality outcomes for senior citizens? Evidence from South Africa's 2008 pension reform. Prev Med Rep 2022; 30:102026. [PMID: 36310690 PMCID: PMC9596742 DOI: 10.1016/j.pmedr.2022.102026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022] Open
Abstract
The 2008 pension reform in South Africa improved access to healthcare. The 2008 pension reform improved mental health and 60-year-old deaths. The impact of the 2008 pension reform in averting 60-year-old deaths is higher in urban regions than rural regions.
In South Africa, men were traditionally eligible to receive government pensions at 65 years. However, that eligibility criterion was changed in 2008 to allow men to receive a pension payout at 60 years. This study is designed to quantify the impact of the 2008 pension reform on mental health outcomes (depression and traumatic stress) and deaths among 60-year-old men from disadvantaged households without advanced education. This analysis used secondary data issued by Statistic South Africa- General Household Survey. Men who reported earning a pension at 60 years from 2008 to 2014 were exposed to the 2008 pension reform and thus were classified as the treatment group. The 60-year-old men during 2002–2007 were ineligible to earn the pension, therefore considered the control group. We then used a Two-stage Least Squared Model (2SLS) to quantify the impact of the 2008 pension reform on healthcare utilization, depression cases, traumatic stress cases, and deaths among 60-year-old men. The model shows that the 2008 pension reform improved healthcare utilization by 3 % in the cohorts of men who benefitted from the 2008 reform. The 2008 pension reform averted depression cases, traumatic stress cases, and deaths among 60-year-old men by 3 %, 4 %, and 5 %, respectively. The impact of the 2008 pension reform in averting deaths among 60-year-old men was higher in urban regions than rural regions. We concluded that the 2008 pension reform successfully bought improved mental health outcomes and prevented depression, traumatic stress, and deaths among 60-year-old men.
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Gebremeskel AT, Omonaiye O, Yaya S. Sex differences in HIV testing among elders in Sub-Saharan Africa: a systematic review protocol. Syst Rev 2022; 11:95. [PMID: 35578357 PMCID: PMC9109370 DOI: 10.1186/s13643-022-01968-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elders (age 50+) HIV demographic (age and sex) data are essential to better understand their HIV service utilization and develop appropriate evidence-based responses and policies. Despite a significant prevalence rate of HIV and growing numbers of this population group, data are still scarce, and studies have neglected them in Sub-Saharan Africa. The aim of this protocol is to outline the methodological process of a systematic review that will gather qualitative and quantitative data to critically examine sex differences in HIV testing among elders (age 50+) in Sub-Saharan Africa. METHODS This protocol adheres to the PRISMA-P reporting guidelines. We will conduct a systematic database search to retrieve all observational and qualitative studies. Electronic search strategies will be developed for MEDLINE, EMBASE, Web of Science, Global Health, and CINAHL for studies reporting HIV data. Two reviewers will independently screen all citations, full-text articles, and abstract data. The search strategy will consist of free-text and Medical Subject Headings (MeSH) terms. Search terms for elders (50+) will include the following: "elders", "older adults", "aged", "geriatric" and "seniors". The primary outcome of interest is sex differences in the uptake of HIV counselling and testing (HCT). The study methodological quality (or bias) will be appraised using appropriate tools. Screening, data extraction, and assessments of risk of bias will be performed independently by two reviewers. Narrative synthesis will be conducted with studies that are compatible based on population and outcome. As it will be a systematic review, without human participants' involvement, there will be no requirement for ethical approval. DISCUSSION The systematic review will present key evidence on sex differences in HIV testing among elders in Sub-Saharan Africa. The findings will be used to inform program developers, policymakers, and other stakeholders to enhance sex disaggregated HIV data to improve access to HIV counselling and testing service for elders in Sub-Saharan Africa. The final manuscript will be disseminated through a peer-reviewed journal and scientific conferences. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42020172737 .
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Affiliation(s)
- Akalewold T Gebremeskel
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Olumuyiwa Omonaiye
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Burwood, Melbourne, Victoria, Australia.,Centre for Nursing and Midwifery Research, James Cook University, Townsville, Queensland, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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Mojola SA, Angotti N, Schatz E, Houle B. "A NOWADAYS DISEASE": HIV/AIDS AND SOCIAL CHANGE IN A RURAL SOUTH AFRICAN COMMUNITY. AJS; AMERICAN JOURNAL OF SOCIOLOGY 2021; 127:950-1000. [PMID: 35967824 PMCID: PMC9365075 DOI: 10.1086/718234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and older adults, we consider the role of the life course and gendered sexuality in informing Africans' strategies of action, or inaction, and in differentially driving and stalling change in each cohort in response to the HIV/AIDS epidemic. Our study illuminates the unique challenges of adapting to social change that result from dynamic interactions among aging, prevailing social structures, and a cohort's socio-historical orientation to a new period.
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Affiliation(s)
- Sanyu A Mojola
- Princeton University and MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Angotti
- American University and MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Enid Schatz
- University of Missouri Columbia and MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Brian Houle
- The Australian National University and MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Duminy J, Cleland J, Harpham T, Montgomery MR, Parnell S, Speizer IS. Urban Family Planning in Low- and Middle-Income Countries: A Critical Scoping Review. Front Glob Womens Health 2021; 2:749636. [PMID: 34816250 PMCID: PMC8593933 DOI: 10.3389/fgwh.2021.749636] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Health agendas for low- and middle-income countries (LMICs) should embrace and afford greater priority to urban family planning to help achieve a number of the global Sustainable Development Goals. The urgency of doing so is heightened by emerging evidence of urban fertility stalls and reversals in some sub-Saharan African contexts as well as the significance of natural increase over migration in driving rapid urban growth. Moreover, there is new evidence from evaluations of large programmatic interventions focused on urban family planning that suggest ways to inform future programmes and policies that are adapted to local contexts. We present the key dimensions and challenges of urban growth in LMICs, offer a critical scoping review of recent research findings on urban family planning and fertility dynamics, and highlight priorities for future research.
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Affiliation(s)
- James Duminy
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- African Centre for Cities, University of Cape Town, Cape Town, South Africa
| | - John Cleland
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Trudy Harpham
- School of Law and Social Sciences, London South Bank University, London, United Kingdom
| | - Mark R. Montgomery
- Department of Economics, Stony Brook University, Stony Brook, NY, United States
- Population Council, New York, NY, United States
| | - Susan Parnell
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- African Centre for Cities, University of Cape Town, Cape Town, South Africa
| | - Ilene S. Speizer
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
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Weinstein ER, Lee JS, Mendez NA, Harkness A, Safren SA, El-Sadr W. HIV/AIDS and aging: the new frontier for HIV/AIDS research and care. AIDS 2021; 35:2043-2045. [PMID: 34471073 PMCID: PMC9338435 DOI: 10.1097/qad.0000000000003000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
| | - Jasper S. Lee
- Department of Psychology, University of Miami, Miami, FL
| | | | - Audrey Harkness
- Department of Public Health Sciences, University of Miami, Miami, FL
| | | | - Wafaa El-Sadr
- ICAP, Columbia University’s Mailman School of Public Health, New York City, NY, USA
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Sex Differences in HIV Testing among Older Adults in Sub-Saharan Africa: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5599588. [PMID: 34513993 PMCID: PMC8427674 DOI: 10.1155/2021/5599588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/21/2021] [Accepted: 07/24/2021] [Indexed: 12/04/2022]
Abstract
Background Despite being sexually active and engaging in risky sexual behaviours similar to young adults, older adults (50 years or older) are less likely to receive HIV testing, and disaggregated data are still scarce about HIV prevention and treatment in this vulnerable population in sub-Saharan Africa (SSA). This systematic review is aimed at examining sex differences in HIV testing and counseling (HTC) among older adults in SSA. Methods A systematic search of four databases, namely, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and Global Health, was conducted from 2000 to January 2020. The primary outcome of interest for this study was gender differences in HTC among older adults in SSA. Observational studies including cross-sectional, retrospective, and prospective cohort studies were included. Eligible studies must have reported sex differences in HIV testing uptake in a standard HTC service among older adults in SSA. Results From the database search, 4143 articles were identified. Five studies were ultimately included in the final review. Of the 1189 participants, 606 (51.1%) and 580 (48.9%) were female and male, respectively. The review findings suggested that both men and women preferred HTC providers that are the same sex as them with women additionally preferring a provider who is also of a similar age. Men and women differed in their pathways to getting tested for HIV. The review documented mixed results with regard to the associations between sex of older adults and uptake of HTC. Older adult HTC uptake data are limited in scope and coverage in sub-Saharan Africa. Conclusion This review revealed shortage of evidence to evaluate optimum HTC utilization among older adults. Few studies examined sex differences in HIV testing among older adults in the region. There is a need for stakeholders working in the area of HIV prevention and treatment to focus on older adult health utilization evidence organization, disaggregated by age and sex. Hence, high-quality research designs are needed on the topic in order to generate good quality evidence for targeted interventions to improve HTC among older adults in sub-Saharan Africa.
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Moucheraud C, Paul-Schultz J, Mphande M, Banda BA, Sigauke H, Kumwenda V, Dovel K, Hoffman RM. A Multi-Dimensional Characterization of Aging and Wellbeing Among HIV-Positive Adults in Malawi. AIDS Behav 2021; 25:571-581. [PMID: 32880762 PMCID: PMC7855286 DOI: 10.1007/s10461-020-03020-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is relatively little research on aging with HIV and wellbeing in sub-Saharan Africa. A cross-sectional survey was implemented in Malawi; eligible respondents were ≥ 30 years old and on ART for ≥ 2 years. Univariate and multiple regression analyses were stratified by age (younger adults: aged 30-49; older adults: aged ≥ 50) and gender. The median age was 51 years (total sample n = 134). Viral suppression was less common among older respondents (83.7% versus 93.0% among younger respondents) although not significant in adjusted models. Despite exhibiting worse physical and cognitive functioning (any physical functioning challenge: aOR 5.35, p = 0.02; cognitive functioning score difference: - 0.89 points, p = 0.04), older adults reported less interpersonal violence and fewer depressive symptoms (mild depression: aOR 0.23 p = 0.002; major depression: aOR 0.16, p = 0.004); in gender-stratified models, these relationships were significant only for females. More research is needed to disentangle the interplay between aging, gender and HIV in high-burden contexts and develop interventions to support comprehensive wellbeing in this population.
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Affiliation(s)
| | | | | | | | | | | | - Kathryn Dovel
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Risa M Hoffman
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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