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ABSTRACTThe personal health behaviours, including physical activity, of healthcare professionals influence their counselling practices as they relate to non-communicable diseases (NCDs). However, despite the importance of producing healthy, physically active graduates, there are limited data on the physical fitness of future healthcare professionals. This cross-sectional observational study determined the prevalence of below-average fitness in the four components of fitness in first-year university medical students. 152 participants (46 male, 106 female, 20.16 ± 2.69 years) completed cardiorespiratory fitness tests (submaximal step test), flexibility (sit-and-reach test), muscle strength (handgrip), and muscle endurance tests (sit-ups, push-ups). Sex differences were reported using one-way ANOVA or Chi square test and significance was set at p < 0.05. The prevalence (%) of below-average fitness was 69.54% for cardiorespiratory, 25.66% for handgrip strength, 65.79% for sit-ups, 23.03% for push-ups and 7.24% for flexibility. Physical fitness parameters (mean±standard deviation (SD)) were compared between sexes, where it was found that females were more flexible than males (40.61 ± 8.40 cm vs 36.70 ± 9.31 cm, p = 0.012). Males had better handgrip strength (88.96 ± 12.04 kg vs 59.34 ± 10.36 kg, p < 0.001), muscle endurance sit-ups (33.46 ± 9.04 vs 24.48 ± 12.18, p < 0.001) and push-ups (30.28 ± 13.95 vs 24.27 ± 12.35, p = 0.009). First-year medical students have poor physical fitness, notably cardiorespiratory fitness and muscle strength, which are important markers for NCD risk assessment. Tertiary institutions training healthcare professionals should consider developing interventions to improve students’ physical fitness thereby influencing their health, wellbeing, academic performance and future counselling practices.

ObjectivesWe aimed to identify individual and sexual partnership characteristics associated with partner notification (PN) among people with STI. We hypothesised that PN would be less likely in more casual sexual partnerships and in partnerships with intimate partner violence (IPV).MethodsWe conducted an observational study among the first 330 patients with STI enrolled in a trial of a behavioural intervention to reduce STI incidence, at a clinic in a poor, Cape Town community. We included 195 index patients (those reporting STI symptoms), and conducted longitudinal analyses using participant-completed questionnaires on the day of diagnosis and 2 weeks later. Using partnership data for five recent sexual partners, we assessed factors associated with reported PN with logistic regressions, adjusting for repeated measurements on the same participant for each partner.ResultsThe sample included 99 males with 303 partners and 96 females with 158 partners. Males reported perpetrating IPV in 46.2% of partnerships. Females reported being IPV victims in 53.2% of partnerships. Males notified 58.1%, females 75.4% of partners during the 2 weeks following diagnosis. Type of partner was an independent correlate of PN for males and females, with the odds of PN lower in more casual partnerships. For males, reporting physical IPV perpetration in the partnership was an independent correlate of PN. For females, there was no association between IPV victimisation in a partnership and PN.ConclusionsEfforts to decrease the pool of infectious partners need to have a strong focus on the promotion of PN in casual relationships and one-night stands. IPV was not identified as a barrier to PN. In future, we need to investigate the association between IPV with an objective measure of PN success such as partner testing or treatment, or index patient reinfection.Clinical trial registrationPACTR201606001682364; Pre-results.

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The full eventual effects of current smoking patterns cannot yet be seen in Africa. In South Africa, however, men and women in the coloured (mixed black and white ancestry) population have smoked for many decades. We assess mortality from smoking in the coloured, white, and black (African) population groups.

Little information is available on the response of vervet monkeys to different housing conditions or on the suitability of enrichment devices or methods for vervet monkeys. In this study, the authors evaluated the occurrence of stereotyped behavior in adult vervet monkeys under various conditions of housing and enrichment. The variables included cage size, cage level (upper or lower), enrichment with a foraging log, enrichment with an exercise cage and presence of a mate. The authors first determined the incidence of stereotyped behavior in captive-bred, singly housed adult female and male vervet monkeys. They then exposed monkeys to different housing and enrichment situations and compared the incidence of stereotyped behavior among the monkeys. The authors found that more females than males engaged in stereotyped behavior and that females, on average, engaged in such behavior for longer periods of time than males. Stereotyped behavior was most often associated with a small, single cage. The average amount of observed stereotyped activity in monkeys housed in a small cage was significantly lower when the monkeys had access to either a foraging log or an exercise cage. Stereotyped behavior was also lower in female monkeys that were housed (either with a male or without a male) in a larger cage. The least amount of abnormal behavior was associated with the largest, most complex and enriched housing situation. Males and females housed in cages on the lower level of two-level housing engaged in more stereotyped behavior than did monkeys housed in the upper level, regardless of the presence or type of enrichment provided.

This paper describes how an up-to-date national population register recording deaths by age and sex, whether deaths were due to natural or unnatural causes, and the offices at which the deaths were recorded can be used to monitor excess death during the SARS-CoV-2 pandemic, both nationally, and sub-nationally, in a country with a vital registration system that is neither up to date nor complete. Apart from suggesting an approach for estimating completeness of reporting at a sub-national level, the application produces estimates of the number of deaths in excess of those expected in the absence of the SARS-CoV-2 epidemic that are highly correlated with the confirmed number of COVID-19 deaths over time, but at a level 2.5 to 3 times higher than the official numbers of COVID-19 deaths. Apportioning the observed excess deaths more precisely to COVID, COVID-related and collateral deaths, and non-COVID deaths averted by interventions with reduced mobility and gatherings, etc., requires access to real-time cause-of-death information. It is suggested that the transition from ICD-10 to ICD-11 should be used as an opportunity to change from a paper-based system to electronic capture of the medical cause-of-death information.

Tuberculous (TB) meningitis is sometimes difficult to diagnose in young children. The decision to start anti-TB treatment of TB meningitis is usually made on clinical grounds and results of special investigations, such as cerebrospinal fluid examination and cranial computerized tomography (CT), because bacteriologic yield is low and the results delayed.

Objectives:To ascertain the anthropometric profile and determinants of obesity in South Africans who participated in the Demographic and Health Survey in 1998. Research Methods and Procedures:A sample of 13,089 men and women (age, ≥15 years) were randomly selected and then stratified by province and urban and nonurban areas. Height, weight, mid‐upper arm circumference, and waist and hip circumference were measured. Body mass index (BMI) was used as an indicator of obesity, and the waist/hip ratio (WHR) was used as an indicator of abdominal obesity. Multivariate regression identified sociodemographic predictors of BMI and waist circumference in the data. Results:Mean BMI values for men and women were 22.9 kg/m2and 27.1 kg/m2, respectively. For men, 29.2% were overweight or obese (≥25 kg/m2) and 9.2% had abdominal obesity (WHR ≥1.0), whereas 56.6% of women were overweight or obese and 42% had abdominal obesity (WHR >0.85). Underweight (BMI <18.5 kg/m2) was found in 12.2% of men and 5.6% of women. For men, 19% of the variation of BMI and 34% of the variation in waist circumference could be explained by age, level of education, population group, and area of residence. For women, these variables explained 16% of the variation of BMI and 24% of the variation in waist circumference. Obesity increased with age, and higher levels of obesity were found in urban African women. Discussion:Overnutrition is prevalent among adult South Africans, particularly women. Determinants of overnutrition include age, level of education, ethnicity, and area of residence.

To determine smoking patterns in South Africa, and to identify groups requiring culturally appropriate smoking cessation programmes.

To determine the prevalence and treatment status of hypertension in South Africa.

Background: Non-communicable chronic diseases (NCDs) have increased in South Africa over the past 15 years. While these usually manifest during mid-to-late adulthood, the development of modifiable risk factors that contribute to NCDs are usually adopted early in life.Objective: To describe the urban–rural and gender patterns of NCD risk factors in black adolescents and young adults (15- to 24-year-olds) from two South African Demographic and Health Surveys conducted 5 years apart.Design: An observational study based on interviews and measurements from two cross-sectional national household surveys. Changes in tobacco and alcohol use, dietary intake, physical inactivity, and overweight/ obesity among 15- to 24-year-olds as well as urban–rural and gender differences were analysed using logistic regression. The ‘Surveyset’ option in Stata statistical software was used to allow for the sampling weight in the analysis.Results: Data from 3,186 and 2,066 black 15- to 24-year-old participants in 1998 and 2003, respectively, were analysed. In males, the prevalence of smoking (1998: 21.6%, 2003: 19.1%) and problem drinking (1998: 17.2%, 2003: 15.2%) were high and increased with age, but in females were much lower (smoking – 1998: 1.0%, 2003: 2.1%; problem drinking – 1998: 4.2%, 2003: 5.8%). The predominant risk factors in females were overweight/obesity (1998: 29.9%, 2003: 31.1%) and physical inactivity (2003: 46%). Urban youth, compared to their rural counterparts, were more likely to smoke (odds ratio (OR): 1.39, 95% confidence interval (CI): 1.09–1.75), have high salt intake (OR: 1.75, 95% CI: 1.12–2.78), be overweight/obese (OR: 1.39, 95% CI: 1.14–1.69), or be physically inactive (OR: 1.45, 95% CI: 1.12–1.89). However, they had lower odds of inadequate micronutrient intake (OR: 0.46, 95% CI 0.34–0.62), and there was no overall significant urban– rural difference in the odds for problem drinking but among females the odds were higher in urban compared to rural females.Conclusion: Considering that the prevalence of modifiable NCD risk factors was high in this population, and that these may persist into adulthood, innovative measures are required to prevent the uptake of unhealthy behaviours, and regular surveillance is needed.

BackgroundGlobal Burden of Diseases, Injuries, and Risk Factors Study 2010 results show continued limitations of data quality and availability in most of the African region. Focused efforts in South Africa, however, have contributed to improved completeness and availability of mortality data, such that South Africa is currently undertaking a second National Burden of Disease Study. Mortality estimates have been developed nationally and for the nine provinces for 1997–2009.