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Obesity as a Risk Factor for Hypertension and Diabetes among Truck Drivers in a Logistics Company, South Africa. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Despite the occupational nature of truckers predisposing them to cardiovascular diseases and risk factors, data is scarce on their prevalence of obesity and its association with developing hypertension (HBP) and diabetes in South Africa. Extracted from the original cross-sectional study of a sample of 312 employees in a logistics company, a census of 96 male truckers was used to determine the prevalence of obesity and its association with HBP and diabetes. WHO STEPwise approach was used to collect data, including systolic (SBP) and diastolic (DBP) blood pressure and anthropometry measurements. HBP is defined as SBP/DBP ≥ 140/90 mmHg, overweight/obesity as BMI ≥ 25 kg/m2, abdominal obesity by waist circumference as WC ≥ 90cm, waist-to-hip-ratio as WHR ≥ 0.90, and waist-to-height ratio as WHtR ≥ 0.5. Data were analysed using SPSS 22. The mean age of truckers was 46 years, 29% were smokers, and 57% alcohol users, while 26% were physically inactive. The prevalence of overweight (44%) and obesity (30%) were observed, while abdominal obesity was high; WC (59%), WHR (65%), and WHtR (80%). HBP (57%) was prevalent and diabetes was 14%. The odds of developing HBP were high for obese truckers by WC [AOR = 4.68; CI = 1.92–11.34)] and by WHtR [AOR = 5.49 CI = 1.74–17.27), while diabetes was associated with WHR (AOR = 1.19; CI = 1.19–31.21). This study showed an associative link between obesity, HBP, and diabetes among the truckers, which is informative for a relevant prevention programme tailored to their needs.
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Alhassan RK, Ketor CE, Ashinyo A, Ashinyo ME, Nutor JJ, Adjadeh C, Sarkodie E. Quality of antiretroviral therapy services in Ghana: Implications for the HIV response in resource-constrained settings. SAGE Open Med 2021; 9:20503121211036142. [PMID: 34377475 PMCID: PMC8326618 DOI: 10.1177/20503121211036142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Number of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach. Methods This is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019. Results Resources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators. Conclusion Observed quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention.
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Affiliation(s)
- Robert Kaba Alhassan
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Courage Edem Ketor
- Pharmacy Department, Jasikan District Hospital, Ghana Health Service, Jasikan, Ghana
| | - Anthony Ashinyo
- National AIDS/STI Control Programme, Ghana Health Service, Accra, Ghana
| | - Mary Eyram Ashinyo
- Department of Quality Assurance and Safety, Ghana Health Service, Accra, Ghana
| | - Jerry John Nutor
- Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Conrad Adjadeh
- Pharmacy Department, Margaret Marquart Catholic Hospital Kpando, Kpando, Ghana
| | - Emmanuel Sarkodie
- Pharmacy Department, Kwame Nkrumah University of Science and Technology (KNUST) Hospital, Kumasi, Ghana
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Makhakhe NF, Lane T, McIntyre J, Struthers H. Sexual transactions between long distance truck drivers and female sex workers in South Africa. Glob Health Action 2018; 10:1346164. [PMID: 28764585 PMCID: PMC5645692 DOI: 10.1080/16549716.2017.1346164] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Female sex workers (FSWs) and long distance truck drivers (LDTDs) are considered key populations at high risk for HIV transmission due to high prevalence. The intersection of these mobile populations presents unique challenges in the fight against HIV and the movement towards reducing new infections. Objective: The purpose of this study was to explore the nature of sex trade along a particular transport route. Sexual transactions and the vulnerabilities that exist between these two groups with regards to HIV/AIDS are described, with the purpose of furthering the agenda for targeted interventions. Methods: Qualitative in-depth interviews were conducted with 14 participants, seven FSWs and seven LDTDs. We recruited FSWs through snowballing, and LDTDs through intercepts at truck stops. Semi-structured interview guides were used for data collection, and thematic analysis was conducted. Results: The sex trade in this study is characterized by competition, fuelled by money-driven and age-disparate rivalry. Despite widespread HIV knowledge, FSWs contend with persistent challenges regarding condom use negotiation, induced by more money in the exchange for unsafe sex. Despite the placement of wellness centres in truck stops along the highway, LDTDs face stigma related challenges with regards to testing for HIV and personal acknowledgement of their involvement in the sex trade. Conclusion: The nature of the sex trade along the highway continues to be risky despite the availability of HIV testing and antiretroviral treatment (ART). The sex trade is perceived to be increasing along trucking routes, in spite of measures instituted to limit access to FSWs. FSWs struggle to cope with the pressure of unprotected sex because of the need to generate more income, as well as avoid incidents of violence and threats. Interventions along transport routes need to be inclusive of FSWs who could play a vital role in stigma reduction amongst LDTDs through peer education.
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Affiliation(s)
- Nosipho Faith Makhakhe
- a Department of Psychology, School of Applied Human Sciences , University of KwaZulu-Natal , Durban , South Africa
| | - Tim Lane
- b Department of Medicine , Center for AIDS Prevention Studies , San Francisco , CA , USA
| | - James McIntyre
- c Anova Health Institute , Johannesburg , South Africa.,d School of Public Health & Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Helen Struthers
- c Anova Health Institute , Johannesburg , South Africa.,e Division of Infectious Diseases & HIV Medicine, Department of Medicine , University of Cape Town , Cape Town , South Africa
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García PJ, Fazio B, Bayer AM, Lizarraga AG, Chiappe M, La Rosa S, Lazo M, López L, Valderrama M, Cárcamo CP. Sexual health knowledge and practices and STI/HIV prevalence among long-distance truck drivers in Peru. SAGE Open Med 2017; 5:2050312117746308. [PMID: 29276592 PMCID: PMC5734555 DOI: 10.1177/2050312117746308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 11/06/2017] [Indexed: 11/15/2022] Open
Abstract
Objectives HIV and other sexually transmitted infections remain a challenge globally and many key groups have yet to be studied. Evidence shows that truck drivers may have high-risk behaviors and higher sexually transmitted infection/HIV prevalence because they are a highly mobile population. However, there is little to no information on this group in Peru. Therefore, we explored the sexual health knowledge and practices and carried out sexually transmitted infection/HIV testing among male truck drivers and their assistants in Peru. Methods We conducted a cross-sectional study utilizing cell phone-based behavioral surveys and sexually transmitted infection testing, including HIV, syphilis, gonorrhea, and chlamydia, with truck drivers and their assistants who were traveling on two major international highways in Peru. Results A total of 1150 truck drivers and assistants participated. Participants were middle-aged men (average age = 39.8 years), 96.0% had complete secondary education, 78.4% were in stable relationships, and 88.7% earned more than minimum wage. The majority were aware of sexually transmitted infections/HIV, but very few recognized sexually transmitted infection symptoms. Few participants (under 5%) reported recent sexually transmitted infection symptoms. Prevalence of sexually transmitted infections was also low: no one had gonorrhea; 0.1% had HIV; 0.4% had recent syphilis infection (rapid plasma reagin ≥1:8); and 2.0% had chlamydia. The prevalence of these diseases is not different from that of the general population in Peru. Conclusion When compared to other truck drivers worldwide, Peruvian truck drivers appear to have a lower risk of HIV/sexually transmitted infections. This may be since Peruvian drivers are older, more educated, have higher income, and spend fewer days away from home than their peers globally.
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Affiliation(s)
- Patricía J García
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Boris Fazio
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angela M Bayer
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Aldo G Lizarraga
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marina Chiappe
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sayda La Rosa
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marcela Lazo
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lorena López
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Valderrama
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - César P Cárcamo
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Botão C, Horth RZ, Frank H, Cummings B, Inguane C, Sathane I, McFarland W, Fisher Raymond H, Young PW. Prevalence of HIV and Associated Risk Factors Among Long Distance Truck Drivers in Inchope, Mozambique, 2012. AIDS Behav 2016; 20:811-20. [PMID: 26395193 DOI: 10.1007/s10461-015-1194-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This is the first integrated biological and behavioral surveillance survey among long-distance truck drivers (LDTD) in Mozambique. Using modified time-location sampling in 2012 at a key transportation junction (Inchope), we enrolled 327 male LDTD. HIV prevalence was 15.4 % (95 % confidence interval : 11.4-19.4 %, n = 318 tested). Among HIV-positive LDTD, 83.7 % did not know their status. One-third of LDTD had never tested for HIV and three-quarters had not received free condoms, lubricants or HIV literature in the past 12 months. In that same period, 61.4 % of LDTD had at least four sexual partners and 27.1 % paid for sex. Among sexually-active LDTD, 76.5 % did not use a condom at last sex. HIV was associated (p < 0.05) with primary education or lower (AOR 2.1), residence in Mozambique (AOR 2.3) and never having tested for HIV (AOR 2.2). Our findings reveal that broader coverage of HIV prevention and comprehensive care services for LDTD are urgently needed.
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Affiliation(s)
- Carlos Botão
- National Institute of Health, Ministry of Health-Mozambique, Maputo, Mozambique.
| | - Roberta Z Horth
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Heidi Frank
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Beverley Cummings
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
| | - Celso Inguane
- International Training and Education Center for Health (I-TECH), Maputo, Mozambique
| | - Isabel Sathane
- International Training and Education Center for Health (I-TECH), Maputo, Mozambique
| | - Willi McFarland
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - H Fisher Raymond
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Peter W Young
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
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Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand. PLoS One 2014; 9:e100058. [PMID: 24949864 PMCID: PMC4064984 DOI: 10.1371/journal.pone.0100058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 05/21/2014] [Indexed: 12/02/2022] Open
Abstract
Background This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired. Methods In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP) guided this work. Results Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs). Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will. Discussion Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical and participatory practice in other parts of the world where biomedical HIV prevention trials occur, and where clinical trials in marginalized populations continue.
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