Research Articles (Statistics & Population Studies)
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Item Covid-19 demography in France and South Africa: a comparative study of morbidity and mortality in 2020–2022(Public Library of Science, 2024) Garenne, Michel; Stiegler, NancyBackground Covid-19 epidemics raged around the world in years 2020–2022. The dynamics of the epidemics and their mortality varied by country depending on prevention, treatments, vaccination and health status of the population. Objective The study compares Covid-19 morbidity and mortality in South-Africa and in France, two countries with similar population size and with reliable reporting systems, in order to better understand the dynamics and impacts of the epidemics and the effects of health policies and programs. Data and methods Data on cases, deaths, hospitalizations, vaccinations were drawn from national statistics. Published data on cases and deaths were corrected for undercount. Results Results show a different epidemiology in the two countries in the first three years of the epidemic (2020–2022). Incidence was higher in South Africa, and some 44% more people were infected by December 2022 than in France. Mortality and case-fatality were also higher in South Africa despite a favourable age structure. The age pattern of mortality showed higher values in South Africa among the young adults. Young women appeared somewhat disadvantaged in South Africa. Lastly, vaccination appeared to have had no effect on incidence, but a large effect on case-fatality in France. Conclusions Despite about the same population size and the same crude death rate at baseline, South Africa exhibited more cases and more deaths from Covid-19 over the 2020–2022 period. Prevention strategies (lockdown and vaccination) appear to have had large impacts on morbidity and mortality.Item A high incidence of serious life-threatening cardiovascular medical encounters during a marathon (2014–2019) calls for prevention strategies: SAFER XL(Taylor and Francis Ltd., 2024) Jordaan, Esmè; Green, Darren; Sewry, Nicola; Derman, WayneObjective: The aim of this study was to determine the incidence and nature (severity and type by organ system and specific diagnosis) of all medical encounters (MEs), including serious/life-threatening MEs (SLMEs) during a South African road marathon. Methods: This descriptive study was a retrospective analysis of data collected over 6 years at the Cape Town Marathon from 2014 to 2019, which included 40 446 starters. All MEs were collected and described as per the consensus statement for mass community-based sporting events. Incidences (I; per 1000 starters; 95% CI) are described for all MEs, SLMEs, and by organ system and specific diagnosis. Results: The incidence of all MEs was 8.7 (95% CI: 7.8–9.6) per 1000 starters. The largest contributor to all MEs, by organ system affected, was cardiovascular-related, with an incidence of 1.8 (95% CI: 1.4–2.2), where exercise-associated postural hypotension was the most common specific diagnosis (I = 1.3; 95% CI: 1.0–1.7). The incidence of all SLMEs was 1.0 (95% CI: 0.7–1.4) making up 11.7% (41/350) of all MEs. The incidence of SLMEs by organ system was highest in the cardiovascular system (I = 0.4; 95% CI: 0.3–0.7), with acute coronary syndrome (ACS) (I = 0.2; 95% CI: 0.1–0.4) the most common specific diagnosis. There were no sudden cardiac deaths (SCD) nor sudden cardiac arrests (SCA). Conclusion: There was a high proportion of cardiovascular-related medical encounters, as well as SLMEs. We recommend that event organizers and race medical directors investigate prevention strategies to mitigate against risk of SLMEs, specifically acute cardiovascular SLMEs.Item Healthy environments for athletes (heart): environmental conditions along a 90 km ultra‑marathon event, South Africa(International Journal of Biometeorology, 2024) Havenga, Henno; Jordaan, Esme; Gharbi, DorraThis paper provides an overview of the HEAT (Healthy Environments for AthleTes) project, which aims to understand the impact of environmental conditions on athlete health and performance during major sporting events such as long-distance running, cycling, and triathlons. In collaboration with the SAFER (Strategies to reduce Adverse medical events For the ExerciseR) initiative, the HEAT project carried out a field campaign at the 2022 Comrades Marathon in the KwaZulu-Natal province of South Africa. The measurement campaign deployed seven weather stations, seven PM2.5 monitors and one spore trap along the 90 km route to capture spatially representative measurements of complex micro-climates, allergenic aerospora, and particulate matter exposure. The results indicate that runners were exposed to moderate risk heat stress conditions.Item An examination of the mortality rate associated with teenage pregnancy in South Africa(SAGE Publications Ltd, 2024) Sithole, Tronic; Appunni, Sathiya SusumanThis study investigates factors contributing to teenage pregnancy in South Africa and their impact on maternal mortality. Twenty participants were purposively sampled for one-on-one interviews using a mixed-methods and descriptive study design. SPSS software analysed the data, revealing reduced risk factors through educational policies. Teenage mortality rates from pregnancy and maternal health issues are lower than the rates in adults, with high blood pressure, abortion and injuries being the leading causes of adolescent death. The study emphasises a significant public health concern in South Africa, influencing women’s life expectancy due to socioeconomic barriers and insufficient awareness of danger signs, urging prioritised policies and programmes.Item The factors determining female unemployment in South Arica: Evidence from the 2021 labour force survey(Union for African Population Studies, 2024) Mfubu, Anele; Philomene, NsengiyumvaThe persistent high unemployment confronting South Africa, in particular among women continues to be a cause of concern. The study set out to look at the factors driving female unemployment in South Africa in an attempt to contribute to efforts to find a solution to the problem of female unemployment. This study estimated the prevalence of female unemployment and identified its predictors in South Africa. Quarterly Labour Force Survey covering the fourth quarter of 2021 and a weighted sample of 13322 women aged 15-64 years were used. The dependent variable of interest was unemployment, while the independent variables were the age, population group, marital status, level of education, province of residence and geographic type. The analysis was conducted at bivariate and multivariate levels. It was found that female unemployment rates are significantly influenced by factors that include level of education, women in youth age category, differed among population group and marital status. The female unemployment varied significantly among provinces of residence and geographic type, with the highest prevalence rates observed in Eastern Cape, KwaZulu Natal, Gauteng and Limpopo. The study further found high unemployment rate in urban areas while traditional areas had high rates of discouraged job seekers.Item Risk factors associated with a history of iliotibial band syndrome (hitbs) in distance runners: A cross-sectional study in 76 654 race entrants – a safer xxxiii study(Taylor and Francis Group, 2024) Jordaan, Esme Renette; Marais, Jandre; van Rensburg, Audrey JansenBackground: Despite the numerous health benefits of distance running, it is also associated with the development of ‘gradual onset running-related injuries’ (GORRIs) one of which is Iliotibial Band Syndrome (ITBS). Novel risk factors associated with a history of ITBS (hITBS) have not been described in a large cohort of distance runners. Objective: To identify risk factors associated with hITBS in distance runners. Design: Descriptive cross-sectional study. Setting: 21.1 km and 56 km Two Oceans Marathon races (2012–2015). Participants: 106 743 race entrants completed the online pre-race medical screening questionnaire. A total of 1 314 runners confirmed an accurate hITBS diagnosis. Methods: Selected risk factors associated with hITBS explored included: demographics (race distance, sex, age groups), training/running variables, history of existing chronic diseases (including a composite chronic disease score) and history of any allergy. Prevalence (%) and prevalence ratios (PR; 95% CI) are reported (uni- & multiple regression analyzes). Results: 1.63% entrants reported hITBS in a 12-month period. There was a higher (p < 0.0001) prevalence of hITBS in the longer race distance entrants (56 km), females, younger entrants, fewer years of recreational running (PR = 1.07; p = 0.0009) and faster average running speed (PR = 1.02; p = 0.0066). When adjusted for race distance, sex, age groups, a higher chronic disease composite score (PR = 2.38 times increased risk for every two additional chronic diseases; p < 0.0001) and a history of allergies (PR = 1.9; p < 0.0001) were independent risk factors associated with hITBS.