29 results on '"Munthali, Richard J."'
Search Results
2. Factors associated with satisfaction and perceived helpfulness of mental healthcare: a World Mental Health Surveys report
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Harris, Meredith G., Kazdin, Alan E., Munthali, Richard J., Vigo, Daniel V., Stein, Dan J., Viana, Maria Carmen, Aguilar-Gaxiola, Sergio, Al-Hamzawi, Ali, Alonso, Jordi, Andrade, Laura Helena, Bunting, Brendan, Chardoul, Stephanie, Gureje, Oye, Hu, Chiyi, Hwang, Irving, Karam, Elie G., Navarro-Mateu, Fernando, Nishi, Daisuke, Orozco, Ricardo, Sampson, Nancy A., Scott, Kate M., Vladescu, Cristian, Wojtyniak, Bogdan, Xavier, Miguel, Zarkov, Zahari, and Kessler, Ronald C.
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- 2024
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3. Determinants of effective treatment coverage for posttraumatic stress disorder: findings from the World Mental Health Surveys
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Stein, Dan J., Kazdin, Alan E., Munthali, Richard J., Hwang, Irving, Harris, Meredith G., Alonso, Jordi, Andrade, Laura Helena, Bruffaerts, Ronny, Cardoso, Graça, Chardoul, Stephanie, de Girolamo, Giovanni, Florescu, Silvia, Gureje, Oye, Haro, Josep Maria, Karam, Aimee N., Karam, Elie G., Kovess-Masfety, Viviane, Lee, Sing, Medina-Mora, Maria Elena, Navarro-Mateu, Fernando, Posada-Villa, José, Stagnaro, Juan Carlos, ten Have, Margreet, Sampson, Nancy A., Kessler, Ronald C., and Vigo, Daniel V.
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- 2023
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4. Perceived helpfulness of service sectors used for mental and substance use disorders: Findings from the WHO World Mental Health Surveys
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Harris, Meredith G., Kazdin, Alan E., Munthali, Richard J., Vigo, Daniel V., Hwang, Irving, Sampson, Nancy A., Al-Hamzawi, Ali, Alonso, Jordi, Andrade, Laura Helena, Borges, Guilherme, Bunting, Brendan, Florescu, Silvia, Gureje, Oye, Karam, Elie G., Lee, Sing, Navarro-Mateu, Fernando, Nishi, Daisuke, Rapsey, Charlene, Scott, Kate M., Stagnaro, Juan Carlos, Viana, Maria Carmen, Wojtyniak, Bogdan, Xavier, Miguel, and Kessler, Ronald C.
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- 2022
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5. A platform for connecting social media data to domain-specific topics using large language models: an application to student mental health.
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Ruocco, Leonard, Zhuang, Yuqian, Ng, Raymond, Munthali, Richard J, Hudec, Kristen L, Wang, Angel Y, Vereschagin, Melissa, and Vigo, Daniel V
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- 2024
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6. HIV Incidence Among Pregnant and Nonpregnant Women in the FACTS-001 Trial: Implications for HIV Prevention, Especially PrEP Use
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Rees, Helen, Chersich, Matthew Francis, Munthali, Richard J., Brumskine, William, Palanee-Phillips, Thesla, Nkala, Busi, Ahmed, Khatija, Sebe, Modulakgotla, Mabude, Zonke, Nchabeleng, Maphoshane, Bekker, Linda-Gail, Kotze, Philip, Mogodiri, Thembisile, Naidoo, Ishana, Panchia, Ravindre, Myer, Landon, Lombard, Carl, Doncel, Gustavo F., Gray, Glenda, and Delany-Moretlwe, Sinead
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- 2021
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7. Patterns of anxiety, depression, and substance use risk behaviors among university students in Canada.
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Munthali, Richard J., Richardson, Chris G., Pei, Julia, Westenberg, Jean N., Munro, Lonna, Auerbach, Randy P., Prescivalli, Ana Paula, Vereschagin, Melissa, Clarke, Quinten K., Wang, Angel Y., and Vigo, Daniel
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Abstract
Objective: To identify subgroups of students with distinct profiles of mental health symptoms (MH) and substance use risk (SU) and the extent to which MH history and socio-demographics predict subgroup membership.Participants: University students (N = 10,935: 63% female).Methods: Repeated cross-sectional survey administered weekly to stratified random samples. Latent class analysis (LCA) was used to identify subgroups and multinomial regression was used to examine associations with variables of interest.Results: LCA identified an optimal 4-latent class solution: High MH–Low SU (47%), Low MH–Low SU (22%), High MH–High SU (19%), and Low MH–High SU (12%). MH history, gender, and ethnicity were associated with membership in the classes with high risk of MH, SU, or both.Conclusion: A substantial proportion of students presented with MH, SU, or both. Gender, ethnicity and MH history is associated with specific patterns of MH and SU, offering potentially useful information to tailor early interventions. [ABSTRACT FROM AUTHOR]- Published
- 2023
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8. Longitudinal patterns of physical activity, sedentary behavior and sleep in urban South African adolescents, Birth-To-Twenty Plus cohort
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Hanson, Sara K., Munthali, Richard J., Micklesfield, Lisa K., Lobelo, Felipe, Cunningham, Solveig A., Hartman, Terryl J., Norris, Shane A., and Stein, Aryeh D.
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- 2019
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9. Suicidal Ideation Amongst University Students During the COVID-19 Pandemic: Time Trends and Risk Factors.
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Jones, Laura B., Vereschagin, Melissa, Wang, Angel Y., Munthali, Richard J., Pei, Julia, Richardson, Chris G., Halli, Priyanka, Xie, Hui, Rush, Brian, Yatham, Lakshmi, Gadermann, Anne M., Pendakur, Krishna, Prescivalli, Ana Paula, Munro, Lonna, Bruffaerts, Ronny, Auerbach, Randy P., Mortier, Philippe, and Vigo, Daniel V.
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COVID-19 pandemic ,SUICIDAL ideation ,COLLEGE students ,MENTAL depression ,AT-risk students ,WORD frequency - Abstract
Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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10. Genetic risk score for adult body mass index associations with childhood and adolescent weight gain in an African population
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Munthali, Richard J., Sahibdeen, Venesa, Kagura, Juliana, Hendry, Liesl M., Norris, Shane A., Ong, Ken K., Day, Felix R., and Lombard, Zané
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- 2018
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11. Genetic variants in SEC16B are associated with body composition in black South Africans
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Sahibdeen, Venesa, Crowther, Nigel J., Soodyall, Himla, Hendry, Liesl M., Munthali, Richard J., Hazelhurst, Scott, Choudhury, Ananyo, Norris, Shane A., Ramsay, Michèle, and Lombard, Zané
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- 2018
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12. Findings from the WHO World Mental Health Surveys
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Harris, Meredith G., Kazdin, Alan E., Munthali, Richard J., Vigo, Daniel V., Hwang, Irving, Sampson, Nancy A., Al-Hamzawi, Ali, Alonso, Jordi, Andrade, Laura Helena, Borges, Guilherme, Bunting, Brendan, Florescu, Silvia, Gureje, Oye, Karam, Elie G., Lee, Sing, Navarro-Mateu, Fernando, Nishi, Daisuke, Rapsey, Charlene, Scott, Kate M., Stagnaro, Juan Carlos, Viana, Maria Carmen, Wojtyniak, Bogdan, Xavier, Miguel, Kessler, Ronald C., NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Centro de Estudos de Doenças Crónicas (CEDOC)
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Patient perspectives ,Service sectors ,Health service use ,Health Policy ,Public Health, Environmental and Occupational Health ,Healthcare providers ,Mental disorders ,Psychiatry and Mental health ,Treatment profiles ,Mental health services ,SDG 3 - Good Health and Well-being ,Perceived helpfulness ,Phychiatric Mental Health ,Substance use disorders - Abstract
Funding Information: Funding Information: The World Health Organization World Mental Health (WMH) Survey Initiative is supported by the United States National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the United States Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical Inc., GlaxoSmithKline, and Bristol-Myers Squibb. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. Funding Information: The Argentina survey − Estudio Argentino de Epidemiología en Salud Mental (EASM) − was supported by a grant from the Argentinian Ministry of Health (Ministerio de Salud de la Nación) − (Grant Number 2002-17270/13-5). The São Paulo Megacity Mental Health Survey is supported by the State of São Paulo Research Foundation (FAPESP) Thematic Project Grant 03/00204–3. The Bulgarian Epidemiological Study of common mental disorders—EPIBUL 2, is supported by the Ministry of Health and European Economic Area Grants. The Mental Health Study Medellín – Colombia was carried out and supported jointly by the Center for Excellence on Research in Mental Health (CES University) and the Secretary of Health of Medellín. Implementation of the Iraq Mental Health Survey (IMHS) and data entry were carried out by the staff of the Iraqi MOH and MOP with direct support from the Iraqi IMHS team with funding from both the Japanese and European Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF). The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013, H25-SEISHIN-IPPAN-006) from the Japan Ministry of Health, Labour and Welfare. The Mexican National Comorbidity Survey (MNCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544- H), with supplemental support from the Pan American Health Organization (PAHO). Te Rau Hinengaro: The New Zealand Mental Health Survey (NZMHS) is supported by the New Zealand Ministry of Health, Alcohol Advisory Council, and the Health Research Council. The Northern Ireland Study of Mental Health was funded by the Health & Social Care Research & Development Division of the Public Health Agency. The Peruvian World Mental Health Study was funded by the National Institute of Health of the Ministry of Health of Peru. The Polish project Epidemiology of Mental Health and Access to Care − EZOP Project (PL 0256) was carried out by the Institute of Psychiatry and Neurology in Warsaw in consortium with Department of Psychiatry—Medical University in Wroclaw and National Institute of Public Health-National Institute of Hygiene in Warsaw and in partnership with Psykiatrist Institut Vinderen – Universitet, Oslo. The project was funded by the European Economic Area Financial Mechanism and the Norwegian Financial Mechanism. EZOP project was co-financed by the Polish Ministry of Health. The Portuguese Mental Health Study was carried out by the Department of Mental Health, Faculty of Medical Sciences, NOVA University of Lisbon, with collaboration of the Portuguese Catholic University, and was funded by Champalimaud Foundation, Gulbenkian Foundation, Foundation for Science and Technology (FCT) and Ministry of Health. The Romania WMH study projects "Policies in Mental Health Area" and "National Study regarding Mental Health and Services Use" were carried out by National School of Public Health & Health Services Management (former National Institute for Research & Development in Health), with technical support of Metro Media Transilvania, the National Institute of Statistics-National Centre for Training in Statistics, SC Cheyenne Services SRL, Statistics Netherlands and were funded by Ministry of Public Health (former Ministry of Health) with supplemental support of Eli Lilly Romania SRL. The Saudi National Mental Health Survey (SNMHS) is conducted by the King Salman Center for Disability Research. It is funded by Saudi Basic Industries Corporation (SABIC), King Abdulaziz City for Science and Technology (KACST), Ministry of Health (Saudi Arabia), and King Saud University. Funding in-kind was provided by King Faisal Specialist Hospital and Research Center, and the Ministry of Economy and Planning, General Authority for Statistics. The Shenzhen Mental Health Survey is supported by the Shenzhen Bureau of Health and the Shenzhen Bureau of Science, Technology, and Information. The Psychiatric Enquiry to General Population in Southeast Spain – Murcia (PEGASUS-Murcia) Project has been financed by the Regional Health Authorities of Murcia (Servicio Murciano de Salud and Consejería de Sanidad y Política Social) and Fundación para la Formación e Investigación Sanitarias (FFIS) of Murcia. The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044,708), and the John W. Alden Trust. Publisher Copyright: © 2022, The Author(s). Background: Mental healthcare is delivered across service sectors that differ in level of specialization and intervention modalities typically offered. Little is known about the perceived helpfulness of the combinations of service sectors that patients use. Methods: Respondents 18 + years with 12-month DSM-IV mental or substance use disorders who saw a provider for mental health problems in the year before interview were identified from WHO World Mental Health surveys in 17 countries. Based upon the types of providers seen, patients were grouped into nine mutually exclusive single-sector or multi-sector ‘treatment profiles’. Perceived helpfulness was defined as the patient’s maximum rating of being helped (‘a lot’, ‘some’, ‘a little’ or ‘not at all’) of any type of provider seen in the profile. Logistic regression analysis was used to examine the joint associations of sociodemographics, disorder types, and treatment profiles with being helped ‘a lot’. Results: Across all surveys combined, 29.4% (S.E. 0.6) of respondents with a 12-month disorder saw a provider in the past year (N = 3221). Of these patients, 58.2% (S.E. 1.0) reported being helped ‘a lot’. Odds of being helped ‘a lot’ were significantly higher (odds ratios [ORs] = 1.50–1.89) among the 12.9% of patients who used specialized multi-sector profiles involving both psychiatrists and other mental health specialists, compared to other patients, despite their high comorbidities. Lower odds of being helped ‘a lot’ were found among patients who were seen only in the general medical, psychiatrist, or other mental health specialty sectors (ORs = 0.46–0.71). Female gender and older age were associated with increased odds of being helped ‘a lot’. In models stratified by country income group, having 3 or more disorders (high-income countries only) and state-funded health insurance (low/middle-income countries only) were associated with increased odds of being helped ‘a lot’. Conclusions: Patients who received specialized, multi-sector care were more likely than other patients to report being helped ‘a lot’. This result is consistent with previous research suggesting that persistence in help-seeking is associated with receiving helpful treatment. Given the nonrandom sorting of patients by types of providers seen and persistence in help-seeking, we cannot discount that selection bias may play some role in this pattern. publishersversion published
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- 2022
13. Association Between Early Life Growth and Blood Pressure Trajectories in Black South African Children
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Kagura, Juliana, Adair, Linda S., Munthali, Richard J., Pettifor, John M., and Norris, Shane A.
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- 2016
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14. The World Mental Health International College Student Survey in Canada: Protocol for a Mental Health and Substance Use Trend Study.
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Jones, Laura B., Judkowicz, Carolina, Hudec, Kristen L., Munthali, Richard J., Prescivalli, Paula, Wang, Angel Y., Munro, Lonna, Hui Xie, Pendakur, Krishna, Rush, Brian, Gillett, James, Young, Marisa, Singh, Diana, Todorova, Antoaneta A., Auerbach, Randy P., Bruffaerts, Ronny, Gildea, Sarah M., McKechnie, Irene, Gadermann, Anne, and Richardson, Chris G.
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MENTAL health ,FOREIGN students ,EVIDENCE-based medicine ,SUBSTANCE abuse - Abstract
Background: The World Health Organization World Mental Health International College Student (WMH-ICS) initiative aims to screen for mental health and substance use problems among postsecondary students on a global scale as well as to develop and evaluate evidence-based preventive and ameliorative interventions for this population. This protocol paper presents the Canadian version of the WMH-ICS survey, detailing the adapted survey instrument, the unique weekly cross-sectional administration, the multitiered recruitment strategy, and the associated risk mitigation protocols. Objective: This paper aims to provide a methodological resource for researchers conducting cross-national comparisons of WMH-ICS data, as well as to serve as a useful guide for those interested in replicating the outlined cross-sectional methodology to better understand how mental health and substance use vary over time among university students. Methods: The online survey is based on the WMH-ICS survey instrument, modified to the Canadian context by the addition of questions pertaining to Canadian-based guidelines and the translation of the survey to Canadian French. The survey is administered through the Qualtrics survey platform and is sent to an independent stratified random sample of 350 students per site weekly, followed by two reminder emails. Upon survey closure every week, a random subsample of 70 nonresponders are followed up with via phone or through a personal email in an effort to decrease nonresponder bias. The survey is accompanied by an extensive risk mitigation protocol that stratifies respondents by the level of need and provides tailored service recommendations, including a facilitated expedited appointment to student counseling services for those at increased risk of suicide. The anticipated sample size is approximately 5500 students per site per year. Results: In February 2020, the Canadian survey was deployed at the University of British Columbia. This was followed by deployment at Simon Fraser University (November 2020), McMaster University (January 2021), and the University of Toronto (January 2022). Data collection at all 4 sites is ongoing. As of May 6, 2022, 29,503 responses have been collected. Conclusions: Based on international collaboration, the Canadian version of the WMH-ICS survey incorporates a novel methodological approach centered on the weekly administration of a comprehensive cross-sectional survey to independent stratified random samples of university students. After 27 months of consecutive survey administration, we have developed and refined a survey protocol that has proven effective in engaging students at four Canadian institutions, allowing us to track how mental health and substance use vary over time using an internationally developed university student survey based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). [ABSTRACT FROM AUTHOR]
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- 2022
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15. Association Between Early Life Growth and Blood Pressure Trajectories in Black South African ChildrenNovelty and Significance
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Munthali, Richard J., Kagura, Juliana, Norris, Shane A., Pettifor, John M., and Adair, Linda S.
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Early growth is associated with blood pressure measured on one occasion, but whether early life growth patterns are associated with longitudinal blood pressure trajectories is under-researched. Therefore, we sought to examine the association between early growth and blood pressure trajectories from childhood to adulthood. Blood pressure was measured on 7 occasions between ages 5 and 18 years in the Birth to Twenty cohort study, and conditional variables for growth in infancy and mid-childhood were computed from anthropometric measures (n=1937, 52% girls). We used a group-based trajectory modeling approach to identify distinct height-adjusted blood pressure trajectories and then tested their association with growth between birth and mid-childhood adjusting for several covariates. Three trajectory groups were identified for systolic and diastolic blood pressure: lower, middle, and upper in boys and girls, separately. In boys, predictors of the middle or upper systolic blood pressure trajectories versus the lower trajectory were in birth weight (odds ratio 0.75 [95% confidence interval 0.58-0.96] per SD) and relative weight gain in infancy (4.11 [1.25-13.51] per SD). In girls, greater relative weight gain and linear growth in both infancy and mid-childhood were consistently associated with an almost 2-fold higher likelihood of being in the upper versus lower systolic blood pressure trajectory. The associations for the diastolic blood pressure trajectories were inconsistent. These findings emphasize the importance of identifying children at risk of progression to high blood pressure. Accelerated growth in infancy and mid-childhood may be a key target for early life intervention in prevention of elevated blood pressure progression.
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- 2016
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16. Body mass index trajectories from adolescent to young adult for incident high blood pressure and high plasma glucose.
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Ahanchi, Noushin Sadat, Ramezankhani, Azra, Munthali, Richard J., Asgari, Samaneh, Azizi, Fereidoun, and Hadaegh, Farzad
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HYPERTENSION ,BODY mass index ,PLASMA pressure ,ADOLESCENCE ,GLUCOSE ,YOUNG adults - Abstract
Objectives: To explore the association between sex-specific adiposity trajectories among Adolescents to early adulthood with incident high blood pressure (HBP) and high plasma glucose (HPG). Methods: We studied body mass index (BMI) trajectories among1159 (male = 517) and 664 (male = 263) Iranian adolescents, aged 12–20 years, for incident HPG and HBP, respectively. Latent Class Growth Mixture Modeling (LCGMM) on longitudinal data was used to determine sex-specific and distinct BMI trajectories. Logistic regressions were applied to estimate the relationship between latent class membership with HBP and HPG, considering normal trajectory as the reference. Results: For both HBP and HPG, LCGMM determined two and three distinct BMI trajectories in males and females, respectively. During a follow-up of 12Years 104 (male = 62) and 111(male = 59) cases of HPG and HBP were found, respectively. Among females, faster BMI increases (i.e. overweight to early obese trajectory) but not overweight (i.e. those with BMI = 27.3 kg/m
2 at baseline) trajectories increased the risk of HPG by adjusted odds ratios (ORs), 2.74 (1.10–5.80) and 0.79 (0.22–2.82), respectively; regarding HBP, the corresponding value for overweight to late obese trajectory was 3.72 (1.37–11.02). Among males, for HBP, the overweight trajectory increased the risk [2.09 (1.04–4.03)]; however, for incident HPG, none of the trajectories showed significant risk. Conclusions: Among females, trend of increasing BMI parallel with age can be a better predictor for risk of developing HPG and HBP than those with higher BMI at baseline. [ABSTRACT FROM AUTHOR]- Published
- 2019
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17. Stunting at 24 Months Is Not Related to Incidence of Overweight through Young Adulthood in an Urban South African Birth Cohort.
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Hanson, Sara K, Munthali, Richard J, Lundeen, Elizabeth A, Richter, Linda M, Norris, Shane A, and Stein, Aryeh D
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STUNTED growth , *OBESITY risk factors , *YOUNG adults , *BODY mass index , *DISEASE prevalence , *COMPARATIVE studies , *GROWTH disorders , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *NUTRITIONAL requirements , *OBESITY , *RESEARCH , *RESEARCH funding , *EVALUATION research , *DISEASE complications - Abstract
Background: The role that childhood stunting plays in the development of overweight and obesity later in life is not well understood, particularly in adolescence and young adulthood, because most studies have only followed up through midchildhood.Objective: The objective of this study was to examine the relation between stunting and age-specific patterns of overweight and obesity incidence from early childhood to young adulthood in the context of a country in the process of the nutrition transition while these children were growing up.Methods: We analyzed data from 895 participants in the Birth-to-Twenty Plus Cohort (Bt20+), an urban South African birth cohort initiated in 1990. Anthropometric data were collected at multiple ages and participants were included if they provided height at age 24 mo and ≥1 measure of body mass index [BMI; weight (kg)/height (m)2] in each of the following time periods: 4-8 y, 11-12 y, 13-15 y, 16-18 y, and 22-24 y. We defined stunting at age 24 mo as height-for-age z score <2 and overweight as BMI z score (BMIZ) >1 in childhood (4-8 y) and adolescence (11-12 y, 13-15 y, and 16-18 y) and BMI ≥25 in young adulthood (22-24 y). We compared BMI, BMIZ, and the prevalence of overweight by stunting status, stratified by sex.Results: Our sample was 93% black and 51% female. The prevalence of stunting at 24 mo was 26% in males and 19% in females. In young adulthood, the prevalence of overweight and obesity was 15.5% (men) and 47.5% (women). Among both males and females, neither mean BMI nor a combined measure of overweight and obesity in any subsequent period differed by stunting status at 24 mo (P ≥ 0.05).Conclusion: Stunting at 24 mo was not related to the risk of overweight or obesity in this cohort. Stunting may not be an important contributor to the increasing obesity rates in urban South Africa. [ABSTRACT FROM AUTHOR]- Published
- 2018
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18. Rural-urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa.
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Said-Mohamed, Rihlat, Prioreschi, Alessandra, Nyati, Lukhanyo H., van Heerden, Alastair, Munthali, Richard J., Kahn, Kathleen, Tollman, Stephen M., Gómez-Olivé, Francesc Xavier, Houle, Brian, Dunger, David B., and Norris, Shane A.
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MENARCHE ,STATURE ,OBESITY ,WAIST circumference ,YOUNG women ,RURAL women ,URBAN women ,SOUTH Africans - Abstract
Background: The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health.Aims: This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban black South African young adult women, who are at different stages of the nutrition and epidemiologic transitions.Subjects and methods: We compared 18-23 year-old black South African women, 482 urban-dwelling from Soweto and 509 from the rural Mpumalanga province. Age at menarche, obstetric history and household socio-demographic and economic information were recorded using interview-administered questionnaires. Height, sitting-height, hip and waist circumference were measured using standardised techniques.Results: Urban and rural black South African women differed in their age at menarche (at ages 12.7 and 14.5 years, respectively). In urban women, a one-year increase in age at menarche was associated with a 0.65 cm and 0.16% increase in height and relative leg-length ratio, respectively. In both settings, earlier age at menarche and shorter relative leg-length were independently associated with an increase in waist circumference.Conclusions: In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood. [ABSTRACT FROM AUTHOR]- Published
- 2018
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19. The associations between adult body composition and abdominal adiposity outcomes, and relative weight gain and linear growth from birth to age 22 in the Birth to Twenty Plus cohort, South Africa.
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Prioreschi, Alessandra, Munthali, Richard J., Kagura, Juliana, Said-Mohamed, Rihlat, De Lucia Rolfe, Emanuella, Micklesfield, Lisa K., and Norris, Shane A.
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OBESITY , *BODY composition , *WEIGHT gain , *DISEASE prevalence - Abstract
Background: The growing prevalence of overweight and obesity in low- or middle-income countries precipitates the need to examine early life predictors of adiposity. Objectives: To examine growth trajectories from birth, and associations with adult body composition in the Birth to Twenty Plus Cohort, Soweto, South Africa. Methods: Complete data at year 22 was available for 1088 participants (536 males and 537 females). Conditional weight and height indices were generated indicative of relative rate of growth between years 0–2, 2–5, 5–8, 8–18, and 18–22. Whole body composition was measured at year 22 (range 21–25 years) using dual energy x-ray absorptiometry (DXA). Total fat free soft tissue mass (FFSTM), fat mass, and abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were recorded. Results: Birth weight was positively associated with FFSTM and fat mass at year 22 (β = 0.11, p<0.01 and β = 0.10, p<0.01 respectively). Relative weight gain from birth to year 22 was positively associated with FFSTM, fat mass, VAT, and SAT at year 22. Relative linear growth from birth to year 22 was positively associated with FFSTM at year 22. Relative linear growth from birth to year 2 was positively associated with VAT at year 22. Being born small for gestational age and being stunted at age 2 years were inversely associated with FFSTM at year 22. Conclusions: The importance of optimal birth weight and growth tempos during early life for later life body composition, and the detrimental effects of pre- and postnatal growth restriction are clear; yet contemporary weight-gain most strongly predicted adult body composition. Thus interventions should target body composition trajectories during childhood and prevent excessive weight gain in early adulthood. [ABSTRACT FROM AUTHOR]
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- 2018
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20. Understanding the Relationship between Socio-Economic Status, Physical Activity and Sedentary Behaviour, and Adiposity in Young Adult South AfricanWomen Using Structural Equation Modelling.
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Micklesfield, Lisa K., Munthali, Richard J., Prioreschi, Alessandra, Said-Mohamed, Rihlat, van Heerden, Alastair, Tollman, Stephen, Kahn, Kathleen, Dunger, David, and Norris, Shane A.
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- 2017
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21. Early Life Growth Predictors of Childhood Adiposity Trajectories and Future Risk for Obesity: Birth to Twenty Cohort.
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Munthali, Richard J., Kagura, Juliana, Lombard, Zané, and Norris, Shane A.
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- 2017
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22. Childhood adiposity trajectories are associated with late adolescent blood pressure: birth to twenty cohort.
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Munthali, Richard J., Kagura, Juliana, Lombard, Zané, and Norris, Shane A.
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CHILDHOOD obesity , *BLOOD pressure measurement , *HYPERTENSION in adolescence , *BODY mass index , *ANALYSIS of variance , *ADIPOSE tissues , *HUMAN body composition , *HYPERTENSION , *RESEARCH funding , *LOGISTIC regression analysis , *DISEASE prevalence , *DISEASE complications , *PREVENTION ,MEDICAL care for teenagers - Abstract
Background: Elevated blood pressure in childhood is a risk factor for adult hypertension which is a global health problem. Excess adiposity in childhood creates a predisposition to develop adult hypertension. Our aim was to explore distinct sex-specific adiposity trajectories from childhood to late adolescence and examined their association with blood pressure.Methods: Latent Class Growth Mixture Modeling (LCGMM) on longitudinal data was used to derive sex-specific and distinct body mass index (BMI: kg/m(2)) trajectories. We studied 1824 black children (boys = 877, girls = 947) from the Birth to Twenty (Bt20) cohort from Soweto, South Africa, and obtained BMI measures at ages 5 through 18 years. Participants with at least two age-point BMI measures, were included in the analysis. Analysis of variance (ANOVA), chi-square test, multivariate linear and standard logistic regressions were used to test study characteristics and different associations.Results: We identified three (3) and four (4) distinct BMI trajectories in boys and girls, respectively. The overall prevalence of elevated blood pressure (BP) was 34.9 % (39.4 % in boys and 30.38 % in girls). Boys and girls in the early onset obesity or overweight BMI trajectories were more likely to have higher BP values in late adolescence. Compared to those in the normal weight BMI trajectory, girls in early onset obesity trajectories had an increased risk of elevated BP with odds ratio (OR) of 2.18 (95 % confidence interval 1.31 to 4.20) and 1.95 (1.01 to 3.77). We also observed the weak association for boys in early onset overweight trajectory, (p-value = 0.18 and odds ratio of 2.39 (0.67 to 8.57)) CONCLUSIONS: Distinct weight trajectories are observed in black South African children from as early as 5 years. Early onset adiposity trajectories are associated with elevated BP in both boys and girls. It is important to consider individual patterns of early-life BMI development, so that intervention strategies can be targeted to at-risk individuals. [ABSTRACT FROM AUTHOR]- Published
- 2016
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23. Genetic risk score for adult body mass index associations with childhood and adolescent weight gain in an African population
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Munthali, Richard J, Sahibdeen, Venesa, Kagura, Juliana, Hendry, Liesl M, Norris, Shane A, Ong, Ken K, Day, Felix R, and Lombard, Zané
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2. Zero hunger - Abstract
Background Ninety-seven independent single nucleotide polymorphisms (SNPs) are robustly associated with adult body mass index (BMI kg/m2) in Caucasian populations. The relevance of such variants in African populations at different stages of the life course (such as childhood) is unclear. We tested whether a genetic risk score composed of the aforementioned SNPs was associated with BMI from infancy to early adulthood. We further tested whether this genetic effect was mediated by conditional weight gain at different growth periods. We used data from the Birth to Twenty Plus Cohort (Bt20+), for 971 urban South African black children from birth to 18 years. DNA was collected at 13 years old and was genotyped using the Metabochip (Illumina) array. The weighted genetic risk score (wGRS) for BMI was constructed based on 71 of the 97 previously reported SNPs. Results The cross-sectional association between the wGRS and BMI strengthened with age from 5 to 18 years. The significant associations were observed from 11 to 18 years, and peak effect sizes were observed at 13 and 14 years of age. Results from the linear mixed effects models showed significant interactions between the wGRS and age on longitudinal BMI but no such interactions were observed in sex and the wGRS. A higher wGRS was associated with an increased relative risk of belonging to the early onset obese longitudinal BMI trajectory (relative risk = 1.88; 95%CI 1.28 to 2.76) compared to belonging to a normal longitudinal BMI trajectory. Adolescent conditional relative weight gain had a suggestive mediation effect of 56% on the association between wGRS and obesity risk at 18 years. Conclusions The results suggest that genetic susceptibility to higher adult BMI can be tracked from childhood in this African population. This supports the notion that prevention of adult obesity should begin early in life. The genetic risk score combined with other non-genetic risk factors, such as BMI trajectory membership in our case, has the potential to be used to screen for early identification of individuals at increased risk of obesity and other related NCD risk factors in order to reduce the adverse health risk outcomes later.
24. Body composition and physical activity as mediators in the relationship between socioeconomic status and blood pressure in young South African women: a structural equation model analysis
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David B. Dunger, Shane A. Norris, Richard J. Munthali, Juliana Kagura, Kathleen Kahn, F. Xavier Gómez-Olivé, Rihlat Said-Mohamed, Mercy Manyema, Stephen Tollman, Lisa K. Micklesfield, Munthali, Richard J [0000-0001-8492-7409], Kagura, Juliana [0000-0002-6608-6930], and Apollo - University of Cambridge Repository
- Subjects
Rural Population ,obesity ,hypertension ,Adolescent ,Urban Population ,Cross-sectional study ,Epidemiology ,Population ,physical activity ,body mass index ,Blood Pressure ,030204 cardiovascular system & hematology ,Overweight ,socioeconomic status ,03 medical and health sciences ,South Africa ,Young Adult ,0302 clinical medicine ,Risk Factors ,Medicine ,Humans ,030212 general & internal medicine ,Young adult ,education ,Socioeconomic status ,Exercise ,education.field_of_study ,business.industry ,Research ,structural equation model ,Public Health, Global Health, Social Medicine and Epidemiology ,General Medicine ,Anthropometry ,medicine.disease ,Obesity ,3. Good health ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Cross-Sectional Studies ,Social Class ,Latent Class Analysis ,Body Composition ,Female ,medicine.symptom ,business ,Body mass index ,Demography - Abstract
ObjectivesVarying hypertension prevalence across different socioeconomic strata within a population has been well reported. However, the causal factors and pathways across different settings are less clear, especially in sub-Saharan Africa. Therefore, this study aimed to compare blood pressure (BP) levels and investigate the extent to which socioeconomic status (SES) is associated with BP, in rural and urban South Africa women.SettingRural and urban South Africa.DesignCross-sectional.ParticipantsCross-sectional data on SES, total moderate and vigorous physical activity (MVPA), anthropometric and BP were collected on rural (n=509) and urban (n=510) young black women (18–23 years age). Pregnant and mentally or physically disabled women were excluded from the study.ResultsThe prevalence of combined overweight and obesity (46.5% vs 38.8%) and elevated BP (27.0% vs 9.3%) was higher in urban than rural women, respectively. Results from the structural equation modelling showed significant direct positive effects of body mass index (BMI) on systolic BP (SBP) in rural, urban and pooled datasets. Negative direct effects of SES on SBP and positive total effects of SES on SBP were observed in the rural and pooled datasets, respectively. In rural young women, SES had direct positive effects on BMI and was negatively associated with MVPA in urban and pooled analyses. BMI mediated the positive total effects association between SES and SBP in pooled analyses (ß 0.46; 95% CI 0.15 to 0.76).ConclusionsThough South Africa is undergoing nutritional and epidemiological transitions, the prevalence of elevated BP still varies between rural and urban young women. The association between SES and SBP varies considerably in economically diverse populations with BMI being the most significant mediator. There is a need to tailor prevention strategies to take into account optimising BMI when designing strategies to reduce future risk of hypertension in young women.
- Published
- 2018
25. Effectiveness of the Minder Mobile Mental Health and Substance Use Intervention for University Students: Randomized Controlled Trial.
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Vereschagin M, Wang AY, Richardson CG, Xie H, Munthali RJ, Hudec KL, Leung C, Wojcik KD, Munro L, Halli P, Kessler RC, and Vigo DV
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- Humans, Mental Health, Universities, Anxiety Disorders, Alcoholism, Cannabis
- Abstract
Background: University attendance represents a transition period for students that often coincides with the emergence of mental health and substance use challenges. Digital interventions have been identified as a promising means of supporting students due to their scalability, adaptability, and acceptability. Minder is a mental health and substance use mobile app that was codeveloped with university students., Objective: This study aims to examine the effectiveness of the Minder mobile app in improving mental health and substance use outcomes in a general population of university students., Methods: A 2-arm, parallel-assignment, single-blinded, 30-day randomized controlled trial was used to evaluate Minder using intention-to-treat analysis. In total, 1489 participants were recruited and randomly assigned to the intervention (n=743, 49.9%) or waitlist control (n=746, 50.1%) condition. The Minder app delivers evidence-based content through an automated chatbot and connects participants with services and university social groups. Participants are also assigned a trained peer coach to support them. The primary outcomes were measured through in-app self-assessments and included changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured using the 7-item General Anxiety Disorder scale, 9-item Patient Health Questionnaire, and US Alcohol Use Disorders Identification Test-Consumption Scale, respectively, from baseline to 30-day follow-up. Secondary outcomes included measures related to changes in the frequency of substance use (cannabis, alcohol, opioids, and nonmedical stimulants) and mental well-being. Generalized linear mixed-effects models were used to examine each outcome., Results: In total, 79.3% (589/743) of participants in the intervention group and 83% (619/746) of participants in the control group completed the follow-up survey. The intervention group had significantly greater average reductions in anxiety symptoms measured using the 7-item General Anxiety Disorder scale (adjusted group mean difference=-0.85, 95% CI -1.27 to -0.42; P<.001; Cohen d=-0.17) and depressive symptoms measured using the 9-item Patient Health Questionnaire (adjusted group mean difference=-0.63, 95% CI -1.08 to -0.17; P=.007; Cohen d=-0.11). A reduction in the US Alcohol Use Disorders Identification Test-Consumption Scale score among intervention participants was also observed, but it was not significant (P=.23). Statistically significant differences in favor of the intervention group were found for mental well-being and reductions in the frequency of cannabis use and typical number of drinks consumed. A total of 77.1% (573/743) of participants in the intervention group accessed at least 1 app component during the study period., Conclusions: In a general population sample of university students, the Minder app was effective in reducing symptoms of anxiety and depression, with provisional support for increasing mental well-being and reducing the frequency of cannabis and alcohol use. These findings highlight the potential ability of e-tools focused on prevention and early intervention to be integrated into existing university systems to support students' needs., Trial Registration: ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601., International Registered Report Identifier (irrid): RR2-10.2196/49364., (©Melissa Vereschagin, Angel Y Wang, Chris G Richardson, Hui Xie, Richard J Munthali, Kristen L Hudec, Calista Leung, Katharine D Wojcik, Lonna Munro, Priyanka Halli, Ronald C Kessler, Daniel V Vigo. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 27.03.2024.)
- Published
- 2024
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26. Evaluating the Effectiveness of a Codeveloped e-Mental Health Intervention for University Students: Protocol for a Randomized Controlled Trial.
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Wang AY, Vereschagin M, Richardson CG, Xie H, Hudec KL, Munthali RJ, Munro L, Leung C, Kessler RC, and Vigo DV
- Abstract
Background: University life typically occurs during a period of life transition, where the incidence of mental health and substance use problems and disorders peaks. However, relatively few students obtain effective treatment and support. e-Interventions have proven effective in improving the psychological outcomes of university students and have the potential to provide scalable services that can easily integrate into existing models of care. Minder is a mobile app codeveloped with university students that offers users a collection of evidence-based interventions tailored to help university students maintain their mental health and well-being and manage their substance use., Objective: This paper describes the protocol for a randomized controlled trial (RCT) that aims to assess the effectiveness of the Minder app in improving the mental health and substance use outcomes of university students., Methods: This study is a 2-arm, parallel assignment, single-blinded, 30-day RCT with 1 intervention group and 1 waitlist control group. Overall, 1496 (748 per trial arm) university students from the University of British Columbia Vancouver Campus (N=54,000) who are aged ≥17 years, have a smartphone with Wi-Fi or cellular data, and speak English will be recruited via a variety of web-based and offline strategies. Participants will be randomized into the intervention or control group after completing a baseline survey. Those randomized into the intervention group will gain immediate access to the Minder app and will be assessed at 2 weeks and 30 days. Those randomized into the control group will be given access to the app content after their follow-up assessment at 30 days. The primary outcomes are measured from baseline to follow-up at 30 days and include changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured by the General Anxiety Disorder 7-Item scale, Patient Health Questionnaire 9-Item scale, and US Alcohol Use Disorders Identification Test-Consumption Scale, respectively. Secondary outcomes include measures related to changes in the frequency of substance use, mental well-being, self-efficacy in managing mental health and substance use, readiness to change, and self-reported use of mental health services and supports (including referral) from baseline to follow-up at 30 days., Results: Trial recruitment and data collection began in September 2022, and the completion of data collection for the trial is anticipated by June 2023. As of May 10, 2023, a total of 1425 participants have been enrolled., Conclusions: The RCT described in this protocol paper will assess whether the Minder app is effective in improving the mental health and substance use outcomes of a general population of Canadian university students. Additional secondary outcome research aims to explore additional outcomes of interest for further research and better understand how to support students' general mental well-being., Trial Registration: ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601., International Registered Report Identifier (irrid): DERR1-10.2196/49364., (©Angel Y Wang, Melissa Vereschagin, Chris G Richardson, Hui Xie, Kristen L Hudec, Richard J Munthali, Lonna Munro, Calista Leung, Ronald C Kessler, Daniel V Vigo. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 30.08.2023.)
- Published
- 2023
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27. HIV Incidence Among Pregnant and Nonpregnant Women in the FACTS-001 Trial: Implications for HIV Prevention, Especially PrEP Use.
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Rees H, Chersich MF, Munthali RJ, Brumskine W, Palanee-Phillips T, Nkala B, Ahmed K, Sebe M, Mabude Z, Nchabeleng M, Bekker LG, Kotze P, Mogodiri T, Naidoo I, Panchia R, Myer L, Lombard C, Doncel GF, Gray G, and Delany-Moretlwe S
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- Adolescent, Adult, Female, HIV Infections transmission, Humans, Incidence, Pregnancy, Pregnancy Complications, Infectious epidemiology, Pregnant Women, Risk Factors, Sexual Behavior, South Africa epidemiology, Tenofovir therapeutic use, Young Adult, HIV Infections epidemiology, HIV Infections prevention & control, Infectious Disease Transmission, Vertical prevention & control, Pre-Exposure Prophylaxis statistics & numerical data, Pregnancy Complications, Infectious prevention & control, Tenofovir administration & dosage
- Abstract
Background: During pregnancy and postpartum period, the sexual behaviors of women and their partners change in ways that may either increase or reduce HIV risks. Pregnant women are a priority population for reducing both horizontal and vertical HIV transmission., Setting: Nine sites in 4 South African provinces., Methods: Women aged 18-30 years were randomized to receive pericoital tenofovir 1% gel or placebo gel and required to use reliable modern contraception. We compared HIV incidence in women before, during, and after pregnancy and used multivariate Cox Proportional hazards models to compare HIV incidence by pregnancy status., Results: Rates of pregnancy were 7.1 per 100 woman-years (95% confidence interval [CI]: 6.3 to 8.1) and highest in those who reported oral contraceptive use (25.1 per 100 woman-years; adjusted hazard ratio 22.97 higher than other women; 95% CI: 5.0 to 105.4) or had 2 children. Birth outcomes were similar between trial arms, with 59.8% having full-term live births. No difference was detected in incident HIV during pregnancy compared with nonpregnant women (2.1 versus 4.3%; hazard ratio = 0.56, 95% CI: 0.14 to 2.26). Sexual activity was low in pregnancy and the early postpartum period, as was consistent condom use., Conclusions: Pregnancy incidence was high despite trial participation being contingent on contraceptive use. We found no evidence that rates of HIV acquisition were elevated in pregnancy when compared with those in nonpregnant women. Risks from reductions in condom use may be offset by reduced sexual activity. Nevertheless, high HIV incidence in both pregnant and nonpregnant women supports consideration of introducing antiretroviral-containing pre-exposure prophylaxis for pregnant and nonpregnant women in high HIV prevalence settings., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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28. Body composition and physical activity as mediators in the relationship between socioeconomic status and blood pressure in young South African women: a structural equation model analysis.
- Author
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Munthali RJ, Manyema M, Said-Mohamed R, Kagura J, Tollman S, Kahn K, Gómez-Olivé FX, Micklesfield LK, Dunger D, and Norris SA
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- Adolescent, Cross-Sectional Studies, Female, Humans, Hypertension epidemiology, Risk Factors, Rural Population statistics & numerical data, South Africa, Urban Population, Young Adult, Blood Pressure, Body Composition, Exercise, Latent Class Analysis, Social Class
- Abstract
Objectives: Varying hypertension prevalence across different socioeconomic strata within a population has been well reported. However, the causal factors and pathways across different settings are less clear, especially in sub-Saharan Africa. Therefore, this study aimed to compare blood pressure (BP) levels and investigate the extent to which socioeconomic status (SES) is associated with BP, in rural and urban South Africa women., Setting: Rural and urban South Africa., Design: Cross-sectional., Participants: Cross-sectional data on SES, total moderate and vigorous physical activity (MVPA), anthropometric and BP were collected on rural (n=509) and urban (n=510) young black women (18-23 years age). Pregnant and mentally or physically disabled women were excluded from the study., Results: The prevalence of combined overweight and obesity (46.5% vs 38.8%) and elevated BP (27.0% vs 9.3%) was higher in urban than rural women, respectively. Results from the structural equation modelling showed significant direct positive effects of body mass index (BMI) on systolic BP (SBP) in rural, urban and pooled datasets. Negative direct effects of SES on SBP and positive total effects of SES on SBP were observed in the rural and pooled datasets, respectively. In rural young women, SES had direct positive effects on BMI and was negatively associated with MVPA in urban and pooled analyses. BMI mediated the positive total effects association between SES and SBP in pooled analyses (ß 0.46; 95% CI 0.15 to 0.76)., Conclusions: Though South Africa is undergoing nutritional and epidemiological transitions, the prevalence of elevated BP still varies between rural and urban young women. The association between SES and SBP varies considerably in economically diverse populations with BMI being the most significant mediator. There is a need to tailor prevention strategies to take into account optimising BMI when designing strategies to reduce future risk of hypertension in young women., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2018
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29. Understanding the Relationship between Socio-Economic Status, Physical Activity and Sedentary Behaviour, and Adiposity in Young Adult South African Women Using Structural Equation Modelling.
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Micklesfield LK, Munthali RJ, Prioreschi A, Said-Mohamed R, van Heerden A, Tollman S, Kahn K, Dunger D, and Norris SA
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- Adolescent, Adult, Black People, Body Mass Index, Cross-Sectional Studies, Female, Humans, Overweight epidemiology, Prevalence, Rural Population, South Africa, Urban Population, Waist Circumference, Young Adult, Adiposity, Exercise, Models, Theoretical, Sedentary Behavior, Social Class
- Abstract
Socio-economic status (SES) is an important predictor of obesity, but how it is associated with differences in physical activity and sedentary behaviour is less clear. This cross-sectional study examined the association between SES (sum of household assets), physical activity and sedentary time, and how they predict adiposity. Socio-demographic, anthropometric, and physical activity data on rural ( n = 509) and urban ( n = 510) South African women (18-23 years) were collected. Overweight and obesity prevalence, and sedentary time, were higher; and moderate-vigorous intensity physical activity (MVPA) was lower, in the urban sample. Structural equation models (SEMs) were constructed for BMI and waist circumference. In the urban sample SES had a direct inverse effect on MVPA (ß; 95% CI, -41.69; -73.40 to -9.98), while in the rural sample SES had a direct effect on BMI (ß; 95% CI, 0.306; 0.03 to 0.59). In the pooled sample, SES had a direct inverse effect on MVPA (ß; 95% CI, -144; -170.34 to -119.04), and MVPA was directly associated with BMI (ß; 95% CI, 0.04; 0.01 to 0.08). The influence of SES, and the role of physical activity and sedentary time on adiposity differs between the urban and rural samples, and the importance of other environmental and behavioural factors must be considered in the development of obesity and the design of effective interventions., Competing Interests: The authors declare no conflict of interest.
- Published
- 2017
- Full Text
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