UWCScholar :: Browsing by Author "Puoane, Thandi"

Browsing by Author "Puoane, Thandi"

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Ability to manage diabetes – community health workers’ knowledge, attitudes and beliefs
(SEMDSA (Society for Endocrinology, Metabolism and Diabetes of SA), 2006) Hughes, Gail; Puoane, Thandi; Bradley, Hazel A.
BACKGROUND: Diabetes constitutes a significant health problem in South Africa. Early detection and good management can prevent or delay complications, with national guidelines for diabetes treatment now available to facilitate this. However, problems are being encountered with their implementation and there is evidence that preventive care is still inadequate in South Africa. Community health workers (CHWs) are lay personnel employed to serve as a link between professional health care staff and the community. They visit homes and can be a powerful force for diabetes prevention and adherence to treatment regimens, given appropriate knowledge. METHOD: We conducted a study to evaluate the knowledge, beliefs and attitudes of a group of CHWs serving a poor urban area, using focus groups and personal interviews. RESULTS: The CHWs did not have the requisite knowledge, attitudes and beliefs to make a positive impact on prevention and management of diabetes. For example, they cited eating sugar as a cause of diabetes. They advised folk remedies that purportedly diluted the blood sugar. Their patients took prescribed medication irregularly. Obesity was not considered an important risk factor. Poverty, however, was recognised as an obstacle to proper treatment. CONCLUSION: Training is clearly needed to empower the CHWs with skills to work within their communities to identify risk factors for diabetes and other non-communicable diseases, with emphasis on diet and physical activity.
Adapting the diabetes prevention program for low and middle-income countries: Protocol for a cluster randomised trial to evaluate lifestyle Africa
(BMJ, 2019) Puoane, Thandi
Low and middle-income countries like South Africa are experiencing major increases in burden of non-communicable diseases such as diabetes and cardiovascular conditions. However, evidence-based interventions to address behavioural factors related to these diseases are lacking.
Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town
(AOSIS OpenJournals Publishing AOSIS (Pty) Ltd, 2017) Solomons, Nasheetah; Kruger, Herculina Salome; Puoane, Thandi
Background: Chronic non-communicable diseases (CNCD) have become the greatest contributor to the mortality rate worldwide. Despite attempts by Governments and various non-governmental organisations to prevent and control the epidemic with various intervention strategies, the number of people suffering from CNCD is increasing at an alarming rate in South Africa and worldwide. Objectives: Study's objectives were to explore perceived challenges with implementation of, and adherence to health messages disseminated as part of a CNCD intervention programme; to gain an understanding of participants' expectations of CNCD intervention programmes;, and to explore the acceptability and preference of health message dissemination methods. In addition, participants' awareness of, and willingness to participate in CNCDs intervention programmes in their community was explored. Methods: Participants were recruited from the existing urban Prospective Urban Rural Epidemiology study site in Langa, Cape Town. Focus group discussions were conducted with 47 participants using a question guide. Summative content analysis was used to analyse the data. Results: Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants' expectations of intervention programmes; aspects influencing participants' acceptance of interventions; and their preferences for health message dissemination. The results of this study will be used to inform CNCDs intervention programmes. Conclusions: Our findings revealed that although participants found current methods of health message dissemination in CNCDs intervention acceptable, they faced real challenges with implementing and adhering to CNCDs to these messages.
Advancing the agenda on noncommunicable diseases: prevention and management at community level
(Health Systems Trust (HST), 2017) Puoane, Thandi; Egbujie, Bonaventure Amandi; Sanders, David; Tsolekile, Lungiswa Primrose; Lewy, Marc
South Africa is experiencing an increase in the prevalence of non-communicable diseases (NCDs), which imposes a heavy burden on healthcare services. The South African government has made great strides towards management and control of NCDs, including the development of management guidelines, healthpromotion and prevention policies intended to assist healthcare workers, facilities and communities in NCD care. However, it appears that the facility-based component of NCD management and control efforts has received more attention than the community-level components. The national strategic plan for NCDs highlights the importance of community-level interventions in chronic NCD care. Thus there is a need for community-based strategies for NCD prevention, control and management to complement facility-based health services. This chapter explores the advancement of the NCD agenda in South Africa through an emphasis on community-level prevention and management. It describes interventions that used community actors such as community health workers in NCD care. The chapter discusses some of the challenges of these interventions, and ends with possible suggestions for South Africa.
Association between dietary adherence, anthropometric measurements and blood pressure in an urban black population, South Africa
(Taylor & Francis, 2018) Solomons, Nasheetah; Kruger, H Salome; Puoane, Thandi
Objectives: The aim was to determine participants’ dietary adherence by calculating a diet adherence score based on the Dietary Approaches to Stop Hypertension (DASH)-style diet; (2) to determine if there was an association between dietary adherence score, anthropometric measurements (waist circumference, body mass index (BMI), waist–hip ratio, waist-toheight- ratio) and blood pressure (BP) in a South African urban black population. Design: Cross-sectional secondary analysis of data collected for the PURE study was undertaken. Setting: Langa, the urban PURE study site in the Western Cape province, South Africa. Subjects: The PURE study Western Cape urban cohort, 454 participants, aged 32–81 years was utilised. Outcome measures: Dietary adherence scores were calculated and the BP and anthropometric measurements, respectively, of participants in the lowest and highest tertiles of dietary adherence scores were compared. Results: Positive correlations were found between age, for both men and women, and systolic and diastolic BP. A significant positive correlation between added sugar intake and systolic blood pressure (SBP) was present only in the women. A significant positive correlation was found between BMI, diastolic BP and SBP in men only. No significant differences existed between BP of men or women in the lowest and top tertile groups according to dietary adherence score, but a significant inverse correlation between the dietary adherence score and SBP was found in women. Conclusions: BMI was positively associated with BP in men, while dietary adherence score was negatively correlated with SBP in women. Summary: Non-adherence to dietary guidelines presenting overconsumption of unhealthy foods may be associated with high blood pressure.
Association between perceived built environmental attributes and physical activity among adults in South Africa
(BioMed Central Ltd., 2017) Malambo, Pasmore; Kengne, Andre P.; Lambert, Estelle V.; De Villiers, Anniza; Puoane, Thandi
Background: To investigate the association between perceived environmental attributes and leisure-time and transport-related physical activity. Methods: This was a cross-sectional survey involving 671 South Africans aged ?35 years from urban and rural settings. International Physical Activity Questionnaire and Neighbourhood Walkability Scale were used to collect data. Multivariable logistic regressions were used to investigate the associations. Results: Significant urban vs. rural differences were apparent in the distribution of most attributes of neighborhood environment. After adjusting for gender, age, setting and relevant interaction terms, proximity to local stores was significantly associated with leisure-time physical activity (OR: 4.26; 95% CI, 1.00-18.08); while proximity to transit stops (2.44; 1.48-4.02), pleasant scenery (1.93; 1.07-3.46), sidewalks (2.36; 1.25-4.44), shade from trees (2.14; 1.19-3.85), traffic (2.17; 91.21-3.91) and well-lit streets (2.01; 1.04-3.89) were significantly associated with walking for leisure. Four-way intersections (4.54; 1.54-13.43), pleasant scenery (3.84; 1.35-10.99), traffic (0.28; 0.09-0.89), sidewalks (3.75; 1.06-13.27) and crosswalks were associated with transport related physical activity. Proximity to transit stops (2.12; 1.17-3.84) and well maintained sidewalks (2.69; 2.20-10.02) were significantly associated with total physical activity. Significant interactions by setting were apparent in some of the associations. Conclusion: Some, but not all attributes of a neighborhood environment were significantly associated in expected directions with the three physical activity domains in this mixed urban and rural population. This study highlights the need for policy strategies aimed at improving or maintaining these perceived environmental attributes to promote physical activity.
Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study
(BMA, 2021) Narula, Neeraj; Wong, Emily C L; Puoane, Thandi
To evaluate the relation between intake of ultraprocessed food and risk of inflammatory bowel disease (IBD).21 low, middle, and high income countries across seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China).116087 adults aged 35-70 years with at least one cycle of follow-up and complete baseline food frequency questionnaire (FFQ) data (country specific validated FFQs were used to document baseline dietary intake). Participants were followed prospectively at least every three years.
Associations of perceived neighbourhood safety from traffic and crime with overweight/ obesity among South African adults of low socioeconomic status
(Public Library of Science, 2018) Malambo, Pasmore; De Villiers, Anniza; Lambert, Estelle V.; Puoane, Thandi; Kengne, Andre P.
BACKGROUND The relationship between perceived neighbourhood safety from traffic and crime with overweight/ obesity can provide intervention modalities for obesity, yet no relevant study has been conducted in sub-Saharan African contexts. We investigated the association between perceived neighbourhood safety from traffic and crime with overweight/obesity among urban South African adults. METHODS This cross-sectional study included 354 adults aged ~35 years drawn from the Prospective Urban Rural Epidemiology (PURE) cohort study. The Neighborhood Walkability Scale- Africa (NEWS-A) was used to evaluate the perceived neighbourhood safety. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine the associations between perceived neighborhood safety and overweight/obesity defined “normal weight” and “overweight/obese” using the 25 Kg/m2 cutoff criterion. RESULTS In the overall sample, adults who agreed that “the speed of traffic on most nearby roads in their neighborhood was usually slow” were less likely to be overweight/obese (adjusted OR = 0.42; 95%CI 0.23–0.76). Those who agreed that “there was too much crime in their neighborhood to go outside for walks or play during the day” were more likely to be overweight/ obese (OR = 2.41; 1.09–5.29). These associations were driven by significant associations in women, and no association in men, with significant statistical interactions. CONCLUSION Perceived neighborhood safety from traffic and crime was associated with overweight/obesity among South African adults. Our findings provide preliminary evidence on the need to secure safer environments for walkability. Future work should also consider perceptions of the neighbourhood related to food choice.
"Big Food", the consumer food environment, health and the policy response in South Africa
(Public Library of Science, 2012) Igumbor, Ehimario U.; Sanders, David; Puoane, Thandi; Tsolekile, Lungiswa; Schwarz, Cassandra; Purdy, Christopher; Swart, Rina; Durao, Solange; Hawkes, Corinna
Summary Points: * In South Africa, as in other jurisdictions, ‘‘Big Food’’ (large commercial entities that dominate the food and beverage environment) is becoming more widespread and is implicated in unhealthy eating. * ‘‘Small food’’ remains significant in the food environment in South Africa, and it is both linked with, and threatened by, Big Food. * Big Food in South Africa involves South African companies, some of which have invested in other (mainly, but not only, African) nations, as well as companies headquartered in North America and Europe. * These companies have developed strategies to increase the availability, affordability, and acceptability of their foods in South Africa; they have also developed a range of ‘‘health and wellness’’ initiatives. Whether these initiatives have had a net positive or net negative impact is not clear. The South African government should act urgently to mitigate the adverse health effects in the food environment in South Africa through education about the health risks of unhealthy diets, regulation of Big Food, and support for healthy foods.
'Big is beautiful' – an exploration with urban black community health workers in a South African township
(South African Journal of Clinical Nutrition, 2005) Puoane, Thandi; Fourie, J.M.; Shapiro, M.; Rosling, L.; Tshaka, N.C.; Oelefse, A.
OBJECTIVES: To explore perceptions about factors associated with body weight and body image among black female community health workers (CHWs) living and working in Khayelitsha, Cape Town. DESIGN: A descriptive, cross-sectional study. Setting. Khayelitsha, a black township in Cape Town, South Africa. SUBJECTS: Forty-four black, female, Xhosa-speaking CHWs working in Khayelitsha. Outcome measures. Anthropometric measures (height, weight, and waist circumference) were taken. Body mass index (BMI) was computed as a measure to estimate total body fat. Waist circumference was used as a measure of abdominal obesity. Focus groups were employed to explore beliefs and attitudes about body size. Information from the focus group discussions was used to develop a semi-structured questionnaire for individual interviews, which were conducted to validate the data from the focus groups, and to assess knowledge on causes and risk factors associated with obesity. A body satisfaction question was also included in the questionnaire. Body image was measured using body shape drawings (pictograms). RESULTS: Of the 44 women measured, 2 had normal weight (BMI 18.5 - 24.9 kg/m2), 2 were overweight (BMI 25 - 30 kg/m2), 25 were obese (BMI 30 - 40 kg/m2) and 15 were extremely obese (BMI ≥ ( 40 kg/m2). A moderately overweight shape (BMI 27 kg/m2) was preferred; this was associated with dignity, respect, confidence, beauty, and wealth. Perceived causes of obesity were eating the wrong food, skipping breakfast and worries about debts, husbands/partners and teenage children. Negative aspects of obesity included body aches and tiredness. CONCLUSION: This study emphasises the prevalence of obesity among urban black women in South Africa, particularly among CHWs. Socio-cultural, behavioural and environmental factors seem to influence the development of obesity in this population.
Built environment, selected risk factors and major cardiovascular disease outcomes: a systematic review
(Public Library of Science, 2016) Malambo, Pasmore; Kengne, Andre P.; De Villiers, Anniza; Lambert, Estelle V.; Puoane, Thandi
INTRODUCTION Built environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions. OBJECTIVE To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks. DATA SOURCE Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted. INCLUSION CRITERIA Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults. DATA EXTRACTION Author(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies. RESULTS Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes. CONCLUSION This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.
Challenges faced by the urban black South Africans in the prevention of non-communicable diseases
(Kamla-Raj Enterprises, 2008) Puoane, Thandi; Tsolekile, Lungiswa
This paper was conducted to describe some of the circumstances that increases the risk factors for non-communicable diseases amongst the previously disadvantaged South African population. The work presented here is based on an action research in an urban black township of Cape Town. The goal was to develop a Non- Communicable Disease model, which can be used to benefit an urban township community. Using a participatory process data was collected during each stage of the development and implenting interventions. Interviews, observations and situational assessment of resources available for promoting healthy lifestyle in the township were used to collect data. Although urbanisation seems to be a driving force in nutrition transition, there are underlying factors that influence lifestyle changes. These includes the environment in which people find themselves. The city provides variety of cheap unhealthy food at a lower price. Due to poverty and lack of knowledge, healthy foods become of less important. People tend to indulge in food rich in fat and sugars due to the belief that they have missed opportunities of enjoying these foods due to deprivation. This has lead to the increase in the prevalence of NCDs among poor South Africans. In conclusion, this work provided important information regarding the challenges faced by the urbanised poor population in South Africa. Although Khayelitsha was used to illustrate these challenges, the situation is similar to other urban townships of in South Africa.
Challenges facing successful scaling up of effective screening for cardiovascular disease by community health workers in Mexico and South Africa: Policy implications
(iMED, 2016) Denman, CA; Gaziano, T.A.; Puoane, Thandi; Levitt, Naomi S.; Abrahams-Gessel, Shafika
The integration of community health workers (CHWs) into primary and secondary prevention functions in health programs and services delivery in Mexico and South Africa has been demonstrated to be effective. Task-sharing related to adherence and treatment, from nurses to CHWs, has also been effectively demonstrated in these areas. HIV/AIDS and TB programs in South Africa have seen similar successes in task-sharing with CHWs in the areas of screening for risk and adherence to treatment. In the area of non-communicable diseases (NCDs), there is a policy commitment to integrating CHWs into primary health care programs at public health facilities in both Mexico and South Africa in the areas of reproductive health and infant health. Yet current programs utilizing CHWs are not integrated into existing primary health care services in a comprehensive manner for primary and secondary prevention of NCDs. In a recently completed study, CHWs were trained to perform the basic diagnostic function of primary screening to assess the risk of suffering a CVD-related event in the community using a non-laboratory risk assessment tool and referring persons at moderate to high risk to local government clinics, for further assessment and management by a nurse or physician. In this paper we compare the experience with this CVD screening study to successful programs in vaccination, reproductive health, HIV/AIDS, and TB specifically to identify the barriers we identified as limitations to replicating these programs in the area of CVD diagnosis and management. We review barriers impacting the effective translation of policy into practice, including scale up issues; training and certification issues; integrating CHW to existing primary care teams and health system; funding and resource gaps. Finally, we suggest policy recommendations to replicate the demonstrated success of programs utilizing task-sharing with CHWs in infectious diseases and reproductive health, to integrated programs in NCD.
Chronic non-communicable diseases
(Health Systems Trust, 2008) Puoane, Thandi; Tsolekile, Lungiswa; Sanders, David; Parker, Whadiah
This chapter will examine the current actions, including lifestyle measures, for the prevention and management of non-communicable diseases within a South African context. It will also focus on the biological, behavioural and social determinants of health. Interventions and initiatives directed at primary, secondary and tertiary prevention of chronic non-communicable diseases are also discussed. This chapter ends with recommended lifestyle changes, which can be taken to influence the adoption of healthy lifestyles, and therefore reduce the risks for chronic non-communicable diseases.
Chronic pain in the community: A survey in a township in Mthatha, Eastern Cape, South Africa
(Medpharm Publications, 2011) Igumbor, Ehimario U.; Puoane, Thandi; Gansky, Stuart A.; Plesh, Octavia
Background: Comprehensive information is needed on the epidemiology and burden of chronic pain in the population for the development of appropriate health interventions. This study aimed to determine the prevalence, severity, risk indicators and responses of chronic pain among adults in Ngangelizwe, Mthatha, South Africa. Method: A cross-sectional survey utilising structured interviews of a sample of adult residents was used. Interviews elicited information on socio-demographic characteristics, general health status, and the prevalence, duration, frequency, severity, activity limitation and impact of chronic pain. Results: More than 95% (n = 473) of the sampled adults participated in the study. Of these, 182 [38.5%, 95% confidence interval (CI): 36.3-42.5%] reported chronic pain in at least one anatomical site. The most common pain sites were the back and head. The median pain score was 5 on a scale of 0 to 10 [interquartile range (IQR) = 4-7] and the median number of sites of pain was 1 (IQR = 1-2). Female gender [odds ratio (OR) = 2.6, 95% CI: 1.7-3.9] and being older than 50 years of age (OR = 3.5, 95% CI: 2.6-4.1) were identified as risk indicators for chronic pain in the sample. Over 65% of respondents reported that they self-treated; 92.1% had consulted with a doctor or nurse, 13.6% consulted a traditional healer, and 34.5% consulted a pharmacist because of their pain. Despite this, over 50% reported that relief of their pain was transient. Conclusion: Chronic pain is a common general complaint in this community, but there is a need for focused attention on women and the elderly.
Communication on sexual issues between migrant males and their partners: a study undertaken in rural South Africa
(University of the Western Cape, 2006) Hughes, Gail; Puoane, Thandi
INTRODUCTION: Women stay alone with their children in rural places while their husbands I partners work away from home for varying periods of time. Such fluctuating migration may cause difficulty in communications and may spread sexual transmittable infections (STI) and the human immunodeficiency virus (HIV). OBJECTIVE: This study explored ways in which black women in rural South Africa communicated with partners, who were migrant workers, on issues related to sexual matters. Method: This is a qualitative study where four focus groups were utilized to allow the women to describe their experiences, and to verbalize their feelings, beliefs, and perceptions in this area. PARTICIPANTS: Four focus groups consisting of six females between the ages of 16 - 48 who had partners that were employed as migrant labourers and do not live at home. Setting: A rural area in Hlabisa jurisdiction. DATA COLLECTION: An interview schedule with open questions were used to facilitate the focus group discussions Findings: The women, who saw their partners infrequently, were unlikely to communicate with them about sexual matters, including STI, HIV, and contraception to prevent unintended pregnancy. Poor communication severely constrained the possibility of reducing the risk of these outcomes. Raising the subject could be interpreted as a violation of the trust attached to the monogamous relationships of these Zulu women. The women felt they owed their returning husbands sexual intimacy and refusal was not an option because it was typically countered with force. CONCLUSION: The desire and need for sexual communication carried a price that was too high for women to pay. Control of their sexuality was mostly in the hands of their partners, upon whom they were economically and socially dependent. At this point in the HIV pandemic is it important to cultivate and identify the relevant social, cultural and behavioural norms that could reduce risk situations that tend to favour the spread of HIV.
Community insights into, and an international perspective on the role food environments and diet play in the self-management of type 2 diabetes mellitus in urban and rural South Africa
(The University of the Western Cpae, 2018) Spires, Mark Haydn; Puoane, Thandi
Type 2 diabetes mellitus (T2DM) and pre-diabetes contribute increasingly to the global burden of disease. Along with other behavioural risk factors, diet plays a key role in the onset and management of the disease, in turn largely determined by what foods are immediately accessible in local food environments. With this in mind, this thesis aims to answer the research question: What role do local food environments play in promoting or inhibiting access to healthy foods as part of the self - management of T2DM in urban and rural communities in South Africa, and what can be learned from an international perspective? Specific research objectives include, to: 1. Understand the current national-level policy context with regard to the observed rise in NCDs, their proximal determinants (specifically an observed change in diet patterns), and contributing environmental factors; 2. Identify the current food-related environmental factors associated with the onset and/or management of T2DM in an urban and a rural setting (as well as in four additional international settings in order to provide an international perspective); 3. Explore community perspectives of the role the local food environment plays in the self-management of T2DM in an urban and a rural setting; and, consequently 4. Recommend intervention- and/or policy-related actions that can be implemented based on study findings. A review of the literature and relevant policies was conducted towards achieving the first research objective. Quantitative data were systematically collected at an urban and rural site in South Africa through the creation of an ‘environmental profile’ in an attempt to achieve the second objective – comparable urban and rural data was also collected as part of a larger study at two other international sites (Kampala, Uganda and Stockholm, Sweden) to provide an international perspective. Included in the third objective is the collection of qualitative data through a community based participatory research method at the same urban and rural sites in South Africa. Finally, intervention and/or policy-related recommendations are developed based on study findings and in consultation with relevant stakeholders through interviews.
Community intervention for the emerging epidemic of non-communicable diseases
(MedPharm Publications, 2006) Puoane, Thandi; Bradley, Hazel A.
BACKGROUND: Community health workers (CHWs) are lay people trained to assist with health care in their communities. This study took place at two sites in Khayelitsha, a township in the Cape Peninsula, from 2000 to 2002. OBJECTIVES: To describe the process of developing an intervention programme for primary prevention of noncommunicable diseases (NCDs) in general and cardiovascular disease in particular, targeting CHWs. METHOD: Forty-four CHWs were assigned to either an intervention or a control group. The intervention group, living in Site C, received training on lifestyle modification with emphasis on healthy eating and physical activity, while the control group, living in Site B, did not receive any training until a year later. The process was undertaken in four stages. Stage 1 involved assessment of the CHWs’ risk factors by obtaining anthropometric measurements. CHWs were interviewed and focus group discussions were held on the socio-cultural factors associated with body weight and body image, and barriers to physical activity. Stage 2 involved developing and implementing a training programme for primary prevention of NCDs among CHWs. Stage 3, conducted at Site C, involved a situational assessment of available resources in the community for promoting healthy lifestyles. The fourth and final stage involved the implementation of community interventions by the CHWs. RESULTS: A large percentage of CHWs were overweight and obese, and therefore at risk for NCDs. They had misconceptions about causes and treatment of these diseases, and also lacked knowledge on nutrition and the risk of high fat intake. Easy access to cheap unhealthy food, rather than fresh fruit and vegetables, limited their ability to make healthy food choices. The findings from stage 1 led to a community participatory intervention. CONCLUSIONS: Developing community-targeted interventions for NCDs can be achieved by involving CHWs at the initial stage and utilising a multifaceted approach. Education of community members and CHWs does not guarantee behaviour modification. Unless the environment encourages healthy living, NCDs will continue to be a burden in the poor populations of South Africa.
Consumption patterns of street food consumers in Cape Town
(South African Association of Family Ecology and Consumer Sciences (SAAFECS)., 2016) Hill, Jillian; Mchiza, Zandile; Fourie, Jean; Puoane, Thandi; Steyn, Nelia
Street foods (SF) contribute significantly to the diet of people living in low- and middle-income countries, however there is a paucity of data on consumption patterns of SF. Since many South Africans consume SF regularly, it is important to determine their purchasing habits, food choices, and nutrition knowledge. A cross-sectional survey conducted in Cape Town metropolitan area, with trained fieldworkers using a structured questionnaire on 1121 SF consumers. The first ten clients who visited a randomly-sampled SF vendor were approached and invited to participate. Data were analysed using IBM Statistics SPSS version 23. Most consumers were black, male, single, and had some high-school education and/or matriculated. Main findings indicated that 38% of these consumers consumed SF almost daily, 43.3% consumed SF frequently (2-3 times per week) and 29% spent between R600 and R899 per month on SF. Items purchased most often in descending order of frequency were fruit, foods and baked products, cold drinks, sweets, peanuts, crisps, fruit juice, biscuits, and chocolates. If healthier SF were available, 96% consumers indicated they would purchase these, with fruit, meat/chicken and vegetable stew, yoghurt and nuts being preferred options. There is a large market for SF consumers in Cape Town. However, most food items consumed, with the exception of fruit and peanuts, are unhealthy by virtue of their high sugar and fat content. SF consumers are however, willing to purchase healthier foods, should these be available.
Determinants of obesity in an urban township of South Africa
(MedPharm Publications, 2008) Puoane, Thandi
OBJECTIVE: To estimate the prevalence of overweight and obesity, and identify factors associated with Body Mass Index (BMI) and waist circumference (WC) among adults residing in an urban township in South Africa. DESIGN: Cross-sectional study. SETTING: Khayelitsha, a large black township located in Cape Town. SUBJECTS: 107 males and 530 females, aged ≥ 18 years. METHODS: The prevalence of overweight/obesity (BMI ³ 25 kg/m2) and abdominal obesity (WC ≥ 94 cm for men and ≥ 80 cm for women), and their relationship with factors previously found to increase the risk of obesity, such as age, gender, marital status, educational level, employment status, immigrant status from rural to urban, and physical activity level, were assessed using logistic regression analyses. RESULTS: The prevalence of obesity (BMI ³ 30 kg/m2) was 53.4% and 18.7%, and that of abdominal obesity was 71.5% and 23.4%, among women and men respectively. However, more women (21.3%) than men (11.2%) reported walking more than 45 minutes per day. Female gender and being married were associated with a high BMI and large WC. Recent migration was associated with a smaller WC. The level of physical activity was not associated with BMI or WC. CONCLUSIONS: These findings suggest that physical activity may play less of a role in obesity control, or that more than 45 minutes of physical activity per day is required to reduce the risk of obesity, especially in women. At least among South African women, obesity control focused on nutritional interventions may be more beneficial than increasing the intensity or duration of physical activity.

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