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This paper has the following aims: (i) to explore the extent to which students who received an intervention involving HIV/AIDS and sexuality perceived that their teacher cared for their health and well-being, (ii) to investigate the characteristics of students who reported to have caring teachers and (iii) to document the association between students’ perceptions of care and reported onset of sexual activity. Data were obtained from the second follow-up survey of a prospective study carried out among high school students in South Africa (Cape Town and Mankweng). We analyzed data from 3483 students who met the inclusion criteria. Students from the intervention group perceived greater care from teachers than students in the control group. Female students and students from Cape Town perceived having received more care, and their perception of care was associated with the number of lessons received, how often students expressed their opinions in class and how often teachers talked about HIV/AIDS, condoms and abstinence. Students who perceived that their teacher cared for their health and well-being were less likely to initiate sexual intercourse. This is the first paper to demonstrate the salience of the concept of care in studies of school-based HIV/AIDS prevention programs in sub-Saharan Africa. [ABSTRACT FROM PUBLISHER]

The prevalence of perinatal common mental disorders in South Africa is high, yet little is known about mental health service use among pregnant and postnatal women. This paper reports on pregnant women's patterns of use of a counselling service at a primary level obstetric facility in Cape Town, South Africa, between January 2010 and December 2011. It investigates whether these are associated with demographics, severity and risk of depressive symptoms. Participants ( N = 3311) were screened for psychological distress using the Edinburgh Postnatal Depression Scale ( EPDS) at their first antenatal visit. Risk factors for antenatal depression were assessed using a 11-item checklist. Questionnaires were self-administered, but some participants required assistance. Participants scoring positive (≥13) on the EPDS were offered referral to on-site, individual counselling, and assigned to one of three groups according to their service use: declined referral; accepted referral and attended counselling sessions; and accepted referral but defaulted all appointments. Consent to participate was received by 3437 (96.4%) participants who were offered screening, of which 627 (18.9%) screened positive on the EPDS. Of these, 363 (57.9%) attended counselling. Both bivariate analyses and regression analyses revealed that age and risk factor assessment score were associated with screening positive on the EPDS. Odds ratios ( OR) for accepting counselling were OR = 0.94 (95% CI = 0.92-0.97) for gestation, OR = 1.27 (95% CI = 1.15-1.39) for EPDS score and OR = 0.48 (95% CI = 0.23-0.99) for reporting three or more risk factors. OR for attending counselling were, for age: OR = 1.06 (95% CI = 1.00-1.12) and for reporting three or more risk factors: OR = 0.60 (95% CI = 0.37-0.97). While the majority of women with psychological distress accessed the counselling service provided, strategies to increase service use of younger pregnant women specifically are required. [ABSTRACT FROM AUTHOR]

Objective: Lactating women and their infants are susceptible to iodine deficiency and iodine excess. In South Africa, no data exist on the iodine status and thyroid function of these vulnerable groups. Methods: In a cross-sectional study, urinary iodine concentrations (UIC), thyroid function, and breast-milk iodine concentrations (BMIC) were assessed in 100 lactating women from a South African township and their 2-4-month-old breastfed infants. Potential predictors of UIC, thyroid function, and BMIC, including household salt iodine concentrations (SIC) and maternal sodium excretion, were also investigated. Results: The median (25th-75th percentile) UIC was 373 (202-627) μg/L in infants and 118 (67-179) μg/L in mothers. Median household SIC was 44 (27-63) ppm. Household SIC and maternal urinary sodium excretion predicted UIC of lactating mothers. Median BMIC was 179 (126-269) μg/L. Age of infants, SIC, and maternal UIC predicted BMIC. In turn, infant age and BMIC predicted UIC of infants. Forty-two percent of SIC values were within the South African recommended salt iodine fortification level at production of 35-65 ppm, whilst 21% of SIC were >65 ppm. Thyroid-stimulating hormone, total thyroxine, and thyroglobulin concentrations in the dried whole blood spot specimens from the infants were 1.3 (0.8-1.9) mU/L, 128±33 mmol/L, and 77.1 (56.3-105.7) μg/L, respectively, and did not correlate with infant UIC or BMIC. Conclusion: Our results suggest that the salt fortification program in South Africa provides adequate iodine to lactating women and indirectly to their infants via breast milk. However, monitoring of salt iodine content of the mandatory salt iodization program in South Africa is important to avoid over-iodization of salt. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress predisposes the human and animal body to diseases like cancer, diabetes, arthritis, rheumatoid arthritis, atherosclerosis and chronic inflammatory disorders. Hence, this study seeks to determine the antioxidant, anti-inflammatory and anti-arthritic activities of acetone leaf extracts of nine South African medicinal plants that have been used traditionally to treat arthritis and inflammation. Methods: The anti-inflammatory activity of the extracts was determined by investigating inhibition of nitric oxide production in lipopolysaccharide activated RAW 264.7 macrophages as well as 15-lipoxygenase enzyme inhibition. An anti-protein denaturation assay was used to determine the anti-arthritic properties of the extracts. The antioxidant activity was determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis (3-ethyl-benzthiazoline-6-sulfonic acid) (ABTS) radical scavenging assays and ferric reducing antioxidant power (FRAP). The total phenolic and total flavonoid concentration of extracts were determined by using standard methods. Results: All extracts inhibited nitric oxide production in a dose-dependent manner in the LPS-stimulated RAW 264.7 macrophages. Extracts of Maesa lanceolata and Heteromorpha arborescens inhibited NO production by 99.16 % and 89.48 % at a concentration of 30 µg/ml respectively. Elaeodendron croceum and Calpurnia aurea extracts had strong activity against 15-lipoxygenase activity with IC50 values of 26.23 and 34.70 µg/ml respectively. Morus mesozygia and Heteromorpha arborescens extracts had good in vitro anti-arthritic activity with IC50 values of 11.89 and 53.78 µg/ml, the positive control diclofenac sodium had IC50 value of 32.37 µg/ml. The free radical scavenging activity of the extracts in DPPH assays ranged between 7.72 and 154.77 µg/ml. Trolox equivalent antioxidant capacity (TEAC) and FRAP values ranged from 0.06 to 1.32 and 0.06 to 0.99 respectively. Conclusions: Results from this study support the traditional use of the selected medicinal plants in the management of arthritis and other inflammatory conditions. The free radical scavenging capacity of the extracts may be related to an immune boosting potential. [ABSTRACT FROM AUTHOR]

Characteristics of learners who become peer educators are rarely explored despite the potential relevance to the success of peer education programmes. Fifteen high schools selected to implement peer education HIV prevention programmes in South Africa were recruited. A total of 2339 Grade 10 learners were surveyed and comparisons were made between socio-demographic characteristics, key skills, school experience and sexual behaviour of those students who had volunteered or been chosen by teachers to be peer educators (n = 295) and their fellow students (n = 2044), the potential recipients of the programme. On most of the socio-demographic variables, school experiences, aspirations, sexual debut and use of condoms at last sex or whether they had been tested for HIV status, there were no significant differences between the two groups. Volunteers and teacher-chosen peer educators tended to be younger than their classmates (16.19 versus 16.52, P < 0.0001), score higher on a goal-orientation scale (3.27 versus 3.15, P =< 0.0001) and had more access to basic resources [electricity (97.9% versus 94.0%, P = 0.006), a bicycle (41.9% versus 32.7%, P = 0.004) or car (50.2% versus 41.0%, P = 0.005)]. Further research is needed to explore specific peer educator characteristics and recruitment and selection approaches that are associated with effective HIV prevention interventions. [ABSTRACT FROM AUTHOR]

A 14-item human immunodeficiency virus/acquired immunodeficiency syndrome knowledge scale was used among school students in 80 schools in 3 sites in Sub-Saharan Africa (Cape Town and Mankweng, South Africa, and Dar es Salaam, Tanzania). For each item, an incorrect or don't know response was coded as 0 and correct response as 1. Exploratory factor analyses based on polychoric correlations showed two separate factors for all sites. Two-parameter item response theory (IRT) analysis (bifactorial multiple indicators multiple causes confirmatory factor analysis models) consistently showed a general first factor and a second ‘method' factor. One single global latent variable seemed to sufficiently well capture most of the systematic variation in knowledge. Some items did not discriminate well between levels of the underlying knowledge latent variable and information values were highest for low levels of knowledge. The scale might be improved by adding items, in particular items that are more difficult to answer. Some differential item functioning effects related to site and socioeconomic status were identified. Scores on the latent knowledge variable were particularly low among females in Dar es Salaam and Mankweng, and were negatively associated with socioeconomic status. This study illustrates advantages of using IRT analysis instead of more conventional approaches to examining psychometric properties of knowledge scales. [ABSTRACT FROM AUTHOR]