Urban Township Research Articles

Determinants of delays in diagnosis and treatment of pulmonary tuberculosis in a new urban township in India: A cross-sectional study

Background: The period of infectiousness of a new sputum smear-positive pulmonary tuberculosis case is important in determining the risk of exposure faced by the community. Early detection and effective treatment of TB case reduces the period of transmission and the risk of exposure of the community. It is for this reason that the delay in TB diagnosis and treatment should be minimal to control disease transmission and patient suffering. Aims & Objective: To measure delays in diagnosis and treatment of pulmonary tuberculosis, and to identify and assess the risk factors associated with these delays. Material and Methods: A cross-sectional study was conducted of all new smear-positive pulmonary TB patients diagnosed between January 2012 and June 2013 at RNTCP clinic. The time from the onset of symptoms to first health care consultation (patient delay) and the time from first health care consultation to the date of TB diagnosis (health system delay) were analysed. Bivariate and logistics regression were applied to analyse the risk factors of delays. Results: A total of 122 patients with a mean age of 29.9 years were included in the study. Mean total delay between the onset of symptoms and treatment initiation was 53.42 days (median 50, range 14-128), with a mean patient delay of 29.24 days (median 25, range 5-94) and mean health system delay of 21.7 days (median 17, range 3–93). The mean treatment delay was 2.48 days (median 2, range 1-6). Factors independently associated with total delay were cough symptom (OR 3.36, P = 0.038), completed secondary school (OR 0.41, P = 0.018), good knowledge of TB symptoms (OR 0.39, P = 0.011), first visit to a public health facility (OR 0.45, P = 0.044), sputum testing at first health care consultation (OR 0.46, P = 0.048) and stigma attached to TB disease (OR 2.89, P = 0.021). Those associated with patient delay were male sex (OR 0.42, P = 0.020), large family size (OR 2.30, P = 0.027), completed secondary school (OR 0.43, P = 0.025) and good knowledge of TB symptoms (OR 0.45, P = 0.029); while those associated with health system delay were first visit to a public health facility (OR 0.31, P = 0.006), sputum testing at first health care consultation (OR 0.22, P = 0.001), number of health care consultations (OR 4.41, P < 0.001) and pre-diagnosis health care cost (OR 3.35, P = 0.001). Conclusion: Health system delay was an important problem in the area studied, with patient delay being of most concern. Key-Words: Pulmonary Tuberculosis; Patient Delay; Health System Delay; Treatment Delay; Risk Factors

Bana etlong retlobapala: examining children's musical games on a Soweto playground

This article reports on research that investigated the rich tradition of South African urban township children's games. Based on ethnographic observations and documentation of Soweto children's playground games over a period of six months, this study examines musical games children at one primary school played on one day, highlighting the particularities of their musicking in an urban cultural context. The article demonstrates the way in which games interact with township musics, dance and communicative practices, and highlights features that Soweto musical games share with musical games globally, particularly children's mobilisation of a range of multimodal resources for the purposes of musical play. The innovative, generative nature of township children's musical games is emphasised, particularly in relation to multimodality, in order to recommend that music education take cognisance of children's musicking outside the classroom. I argue that children's active engagement with music deserves attention by music educators and researchers, and that musical games be recruited as resources for pedagogy to develop the design capacities and skills that children's musical play embodies.

The ‘uptake’ of a sport-for-development programme in South Africa

This article reports on the ‘uptake’ dynamics and resultant manifestations of a school-based, incentive-driven, sport-for-development programme in the South African context of poverty. The ecological systems theory of Brofenbrenner, the theory of complexity and a neo-liberal framework underpin the social constructions of local meanings associated with programme participation and involvement. Thirty-nine primary schools in the Western Cape Province and four schools in the Eastern Cape Province deliver the programme in partnership with a local foundation. A representative sample of 15 schools, from rural and urban (township) impoverished communities, were selected for a baseline study. A mixed-method approach of the Sport-in Development Impact Assessment Tool was adapted to collect comparative data through 57 interviews, 35 focus group sessions (with 75 teachers and 176 learners) and 159 questionnaires completed by learners and 29 by school and cluster coordinators. Various models of implementation render nuanced findings at meso-, exo- and micro-levels, where interrelated systems, demographic and developmental influences translate into culturally informed sense-making, pro- and anti-social associative behaviours, praxis, institutional empowerment and status-conferring identity constructions. All partners promote a neoliberal approach that limits changes to the underlying social systems, and mostly promote individual and group attributes within the institutional and social world settings of participants.

Whoonga: Potential Recreational Use of HIV Antiretroviral Medication in South Africa

Whoonga is a drug cocktail in South Africa rumored to contain illicit drugs and HIV antiretroviral (ARV) medication. Although its use may adversely impact adherence to HIV treatment and may have the potential to generate ARV resistance, there is a paucity of research characterizing whoonga. We learned of whoonga during semi-structured interviews about substance abuse and HIV risk at "club-events" known as inkwaris in an urban township of Durban, South Africa. Whoonga was an emerging theme spontaneously identified as a problem for the community by 17 out of 22 informants. Perceptions of whoonga suggest that it is highly addictive, contains ARVs (notably efavirenz), is used by individuals as young as 14, and poses a threat to the health and safety of those who use it, including increasing the risk of HIV infection. Our informants provide preliminary evidence of the dangers of whoonga and reinforce the need for further study.

Spatial clustering of all-cause and HIV-related mortality in a rural South African population (2000-2006).

BackgroundSub-Saharan Africa bears a disproportionate burden of HIV infection. Knowledge of the spatial distribution of HIV outcomes is vital so that appropriate public health interventions can be directed at locations most in need. In this regard, spatial clustering analysis of HIV-related mortality events has not been performed in a rural sub-Saharan African setting.Methodology and ResultsKulldorff’s spatial scan statistic was used to identify HIV-related and all-cause mortality clusters (p<0.05) in a population-based demographic surveillance survey in rural KwaZulu Natal, South Africa (2000–2006). The analysis was split pre (2000–2003) and post (2004–2006) rollout of antiretroviral therapy, respectively. Between 2000–2006 a total of 86,175 resident individuals ≥15 years of age were under surveillance and 5,875 deaths were recorded (of which 2,938 were HIV-related) over 343,060 person-years of observation (crude all-cause mortality rate 17.1/1000). During both time periods a cluster of high HIV-related (RR = 1.46/1.51, p = 0.001) and high all-cause mortality (RR = 1.35/1.38, p = 0.001) was identified in peri-urban communities near the National Road. A consistent low-risk cluster was detected in the urban township in both time periods (RR = 0.60/0.39, p = 0.003/0.005) and in the first time period (2000–2003) a large cluster of low HIV-related and all-cause mortality in a remote rural area was identified.ConclusionsHIV-related and all-cause mortality exhibit strong spatial clustering tendencies in this population. Highest HIV-related mortality and all-cause mortality occurred in the peri-urban communities along the National Road and was lowest in the urban township and remote rural communities. The geography of HIV-related mortality corresponded closely to the geography of HIV prevalence, with the notable exception of the urban township where high HIV-related mortality would have been expected on the basis of the high HIV prevalence. Our results suggest that HIV treatment and care programmes should be strengthened in easy-to-reach high density, peri-urban populations near National Roads where both HIV-related and all-cause mortality are highest.

Spatial correlations between urbanization and river water pollution in the heavily polluted area of Taihu Lake Basin, China

Water pollution in the Taihu Lake Basin has been the focus of attention in China and abroad for a long time, due to its position in the forefront of urban development in China. Based on data gathering and processing from 84 monitoring sections in this heavily polluted area, this study first analyzes spatial patterns of urbanization and the distribution of river water pollution, and then uses the GeoDa bivariate spatial autocorrelation model to investigate the spatial correlation between urbanization and river water pollution at the scale of township units. The results show that urbanization has adverse impacts on water pollution, and the influence varies in different levels of development areas. The urban township units have the highest level of urbanization and highest pollution, but the best water quality; the suburban units have lower level of urbanization, but higher pollution and worse water quality; however the rural units have the lowest level of urbanization and lowest pollution, mainly affected by upstream pollution, but worst water quality. Lastly, urban and rural planning committees, while actively promoting the process of development in the region, should gradually resolve the issue of pollution control lagging behind urban life and urban development, giving priority to construction of centralized sewage treatment facilities and associated pipeline network coverage in the rural areas and suburban areas.

Evaluation of Green Roof System for Green Building Projects in Malaysia

The implementations of green roof have been widely used in the developed countries such as Germany, United Kingdom, United States and Canada. Green roof have many benefits such as aesthetic and economic value, ecological gain which are optimization of storm water management, urban heat island mitigation and energy conservation. In term of pollution, green roof can control the air and noise pollution in urban cities. The application of green roof in Malaysian building has been studied with the previous work on green roof either in Malaysia or other Asian region as like Indonesia, Singapore, Thailand, Taiwan and several other countries that have similar climate and environment as in Malaysia. These technologies of adapting green roof have been compared to the Green Building Index (GBI) of Malaysian buildings. The study has concentrated on the technical aspect of green roof system having focused on i) waste & recyclable materials ii) types of plants and method of planting and iii) green roof as tool to reduce storm water runoff. The finding of these areas will be compared to the suitability in achieving good practice of the GBI in Malaysia. Results show that most of the method are based on the countries own climate and environment. This suggests that the method of using green roof must adhere to the tropical climate of Malaysia. Suggestion of this research will be viewed in term of the sustainability of the green roof. Further research can be developed to implement the best method and application in Malaysian climate especially in urban cities and township.

Assessment of the uptake of neonatal and young infant referrals by community health workers to public health facilities in an urban informal settlement, KwaZulu-Natal, South Africa

BackgroundGlobally, 40% of the 7.6 million deaths of children under five every year occur in the neonatal period (first 28 days after birth). Increased and earlier recognition of illness facilitated by community health workers (CHWs), coupled with effective referral systems can result in better child health outcomes. This model has not been tested in a peri-urban poor setting in Africa, or in a high HIV context.MethodsThe Good Start Saving Newborn Lives (SNL) study (ISRCTN41046462) conducted in Umlazi, KwaZulu-Natal, was a community randomized trial to assess the effect of an integrated home visit package delivered to mothers by CHWs during pregnancy and post-delivery on uptake of PMTCT interventions and appropriate newborn care practices. CHWs were trained to refer babies with illnesses or identified danger signs. The aim of this sub-study was to assess the effectiveness of this referral system by describing CHW referral completion rates as well as mothers’ health-care seeking practices. Interviews were conducted using a structured questionnaire with all mothers whose babies had been referred by a CHW since the start of the SNL trial. Descriptive analysis was conducted to describe referral completion and health seeking behaviour of mothers.ResultsOf the 2423 women enrolled in the SNL study, 148 sick infants were referred between June 2008 and June 2010. 62% of referrals occurred during the first 4 weeks of life and 22% between birth and 2 weeks of age. Almost all mothers (95%) completed the referral as advised by CHWs. Difficulty breathing, rash and redness/discharge around the cord accounted for the highest number of referrals (26%, 19% and 17% respectively). Only16% of health workers gave written feedback on the outcome of the referral to the referring CHW.ConclusionsWe found high compliance with CHW referral of sick babies in an urban South African township. This suggests that CHWs can play a significant role, within community outreach teams, to improve newborn health and reduce child mortality. This supports the current primary health care re-engineering process being undertaken by the South African National Department of Health which involves the establishment of family health worker teams including CHWs.Trial registration numberISRCTN41046462

Effect of atmospheric stability on the impact of domestic wood combustion to air quality of a small urban township in winter

In the winter of 2011, a field campaign was undertaken in the small township of Nelson, New Zealand to measure the vertical and horizontal distribution of concentrations of airborne particulate matter. The aim of this campaign was to improve our understanding of the causal factors which result in periods of very high concentrations of particulate pollution in small townships during winter where emissions are dominated by the combustion of wood for domestic heating. The results showed that mean hourly surface concentrations of particulates throughout the airshed were characterized by a distinctive diurnal cycle, with two peaks in concentration (one in the late evening and then, unusually, a second mid-morning). Although the timing and magnitude of hourly peak concentrations was variable throughout the valley, there was no evidence to suggest that regional or topographic flows played a significant role in the build-up of pollutants at any given location.Analysis of vertical profiles of black carbon showed that high concentrations of particulates were confined to the lowest 50 m of the boundary layer. Concentrations decreased with increasing height within this polluted surface layer. The atmosphere was very stable during the evening period. After midnight, a period of increased mixing was consistently identified throughout the lowest 100 m of the boundary layer and associated with the sudden cleansing of the surface and lower layers of the boundary layer. Throughout the observational period there was no evidence for the storage of pollutants aloft. Thus the vertical mixing of pollutants to the surface could not account for increased pollutant concentrations during the morning period. However, at this time the boundary layer remained stable and concentrations of black carbon were mixed through a very shallow layer. This suggests that despite lower domestic heating emissions in the morning, the reduced mixing volume is a likely cause of the observed marked peak in morning surface concentrations.

Cry, the beloved bottle: infant-feeding knowledge and the practices of mothers and caregivers in an urban township outside Bloemfontein, Free State province

Objectives: To investigate knowledge of and practices regarding bottle-feeding preparation, as well as the nutrient content and microbial safety of bottles that are prepared by mothers and caregivers for infants aged 0-24 months.Design: Cross-sectional descriptive survey.Setting: Urban township, Mangaung, outside Bloemfontein.Subjects: A sample of 189 mothers or caregivers of healthy infants aged 0-24 months, who were exclusively formula fed or mixed fed with breast milk and infant formula or cow’s milk, were randomly selected in a household survey.Outcome measures: An interviewer-administered questionnaire and/or observed practices were used for data collection. Bottle-feed samples were also collected and analysed for nutrient and microbial content.Results: Mother and caregiver knowledge on infant feeding was poor. An acceptable method for preparing a bottle feed in five steps was evaluated. Only 4.2% of the total sample applied all five steps. A total of 84.5% (n = 160) of all the collected feeds was contaminated with E coli. A lower level of maternal education was associated with a greater likelihood of feed contamination. The predominant source of bottle-feeding preparation information was clinic staff (28%).Conclusion: The findings were indicative of a lack of knowledge, and possibly resource limitations, to facilitate safe bottle-feeding practices. Acknowledgement of clinic staff as a source of infant-feeding information highlights the role of healthcare workers as facilitators of appropriate infant-feeding practices.

PHP14 The Implementation of Essential Medicine Policy in China: Pros and Cons

Establishing essential medicine policy (EMP) is one of 5 health system reform pillars in China in 2009. After three-year implementation, the strengthens and weaknesses of EMP need to be monitoring and evaluation. The paper reviews the process of listing, pricing, purchasing, utilization and reimbursement of essential medicines and discusses the achievements and issues of EMP. The EMLs are collected and compared from 31 provinces; the indictors of EDP are evaluated before and after implementation. Although national EDL only contains 307 essential medicines, the number of added EMs in provincial EDL are various from 64 through 455. The zero-markup policy of EDs conducted in public grass-roots health facilities (urban community health centers and rural township hospitals) have reached to 98.8%. More than 95% EDs can be reimbursement by medical insurance schemes. The average percentage of price cutting was 25%-50% after tender bidding and purchasing. Quality assurance and sufficient provision of ED became a problem. The number of essential medicines is still not meet the needs of outpatients so that patients flow back to the secondary and tertiary hospitals, the financial subsidies from government usually are not supported timely. Along with the expansion of EDP in village health posts and hospitals, how to incentive and maintain the income level of health professionals have to be considered. To promote the EMP, the adjustment of EDL is required in 2012. The criteria of selection on essential medicines in provincial level should be unified. The implementation of EMP will not be successful in village and urban hospital level until solving the problem of remuneration and payment system in health settings.

Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa

The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%'respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions -one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient's rationale for THP use. This study revealed a need to better understand factors involved in patients' choosing to use THP concurrently with ART.

'We eat together; today she buys, tomorrow I will buy the food': adolescent best friends' food choices and dietary practices in Soweto, South Africa.

To explore if and how female adolescents engage in shared eating and joint food choices with best friends within the context of living in urban Soweto, South Africa. A qualitative, exploratory, multiple case study was conducted using semi-structured duo interviews of best friend pairs to ascertain their eating patterns, friendship and social interactions around dietary habits. Participants were recruited from three high schools in the urban township of Soweto, South Africa. Fifty-eight female adolescents (twenty-nine friend pairs) still in high school (mean age of 18 years) were enrolled. Although overweight rates were high, no association between friends was found; neither did friends share dieting behaviours. Both at school and during visits to the shopping mall, foods were commonly shared and money pooled together by friends to make joint purchases. Some friends carefully planned expenditures together. Foods often bought at school were mostly unhealthy. Availability, price and quality were reported to affect choice of foods purchased at school. Preference shaped joint choices within the shopping mall environment. Food sharing practices should be investigated in other settings so as to identify specific behaviours and contexts for targeted and tailored obesity prevention interventions. School-based interventions focusing on price and portion size should be considered. In the Sowetan context, larger portions of healthy food may improve dietary intake of fruit and vegetables where friends are likely to share portions.

Teacher support - an exploration of how foundation-phase teachers facilitate language skills

The role of speech-language therapists (SLTs) has been redefined by White Paper 6, which emphasises the role of support to both teachers and learners. SLTs have expert knowledge and skills pertaining to communication and language, and therefore have much to contribute to the process of learning in teaching. This article builds on a previous article published in the 2010 edition of the journal, which reported on the process of supporting teachers to facilitate listening, language and numeracy skills in semi-rural and urban (township) contexts. In this follow-up article the focus is on the qualitative findings obtained from a specific section of the larger study. Where the overall study made use of a mixed methods approach to evaluate the process of providing support, and reported on the entire continued professional development (CPD) programme, this article focuses specifically on the qualitative data collected when the CPD programme addressed the facilitation of language. This article explores how the strategies were used in the classrooms, and the benefits of the support provided. The data discussed in this article were obtained from questionnaires, focus groups, and critical self-evaluation by teachers, as well as a research diary used by the programme facilitator. The results show that both the participants and their learners benefited from the support provided. The participants reportedly for the first time were able to meet curriculum outcomes which previously had been omitted, and showed an increased ability to plan their lessons. Several teachers experienced changes in their teaching practices and could reflect on their practices, which contributed to their professional development. These teachers became more empowered. Learning in the classroom was enhanced through increased participation of all learners, and enjoyment of the strategies.

Pathways of care-seeking during fatal infant illnesses in under-resourced South African settings

The purpose of this study was to examine care-seeking during fatal infant illnesses in under-resourced South African settings to inform potential strategies for reducing infant mortality. We interviewed 22 caregivers of deceased infants in a rural community and 28 in an urban township. We also interviewed seven local leaders and 12 health providers to ascertain opinions about factors contributing to infant death. Despite the availability of free public health services in these settings, many caregivers utilized multiple sources of care including allopathic, indigenous and home treatments. Urban caregivers reported up to eight points of care while rural caregivers reported up to four points of care. The specific pathways taken and combinations of care varied, but many caregivers used other types of care shortly after presenting at public services, indicating dissatisfaction with the care they received. Many infants died despite caregivers' considerable efforts, pointing to critical deficiencies in the system of care serving these families. Initiatives that aim to improve assessment, management and referral practices by both allopathic and traditional providers (for example, through training and improved collaboration), and caregiver recognition of infant danger signs may reduce the high rate of infant death in these settings.

Influences on Healthcare-seeking during Final Illnesses of Infants in Under-resourced South African Settings

To examine how health caregivers in under-resourced South African settings select from among the healthcare alternatives available to them during the final illness of their infants. Qualitative interviews were conducted with 39 caregivers of deceased infants in a rural community and an urban township. Nineteen local health providers and community leaders were also interviewed to ascertain opinions about local healthcare and other factors impacting healthcare-seeking choices. The framework analysis method guided qualitative analysis of data. Limited autonomy of caregivers in decision-making, lack of awareness of infant danger-signs, and identification of an externalizing cause of illness were important influences on healthcare-seeking during illnesses of infants in these settings. Health system factors relating to the performance of health workers and the accessibility and availability of services also influenced healthcare-seeking decisions. Although South African public-health services are free, the findings showed that poor families faced other financial constraints that impacted their access to healthcare. Often there was not one factor but a combination of factors occurring either concurrently or sequentially that determined whether, when, and from where outside healthcare was sought during final illnesses of infants. In addition to reducing health system barriers to healthcare, initiatives to improve timely and appropriate healthcare-seeking for sick infants must take into consideration ways to mitigate contextual problems, such as limited autonomy of caregivers in decision-making, and reconcile local explanatory models of childhood illnesses that may not encourage healthcare-seeking at allopathic services.

Can the Health Club be Used Effectively to Promote Healthy Lifestyles? A Comparison of Health Club Members and Community Controls in Khayelitsha, Cape Town

KEYWORDS Urban Township. South Africa. Health Club. Healthy Lifestyles. Physical Activity. Eating Practices ABSTRACT In response to the increasing need to reduce the burden associated with chronic non-communicable diseases, a health club was developed in 2002 to promote healthy lifestyles in Khayelitsha, an urban township in Cape Town. The current study assessed the effectiveness of the health club in promoting healthy living by comparing club members practices of physical activity and eating habits with community controls. It also identified perceived barriers and enhancing factors in both groups. Data was collected through interviews using structured questionnaires. Fewer health club members (8%) than non-members (23%) walked for more than 30 minutes daily (p=0.025). Members were in general more active than non-members. Members (28%) spent more time than non- members (8%) engaged in light intensity daily activities for more than 2 hours (p=0.029). Fifty- eight percent of members and 20% of non-members spent more than 3 hours daily engaged in moderate physical activity (p=0.002). Members mostly made healthier food choices and cooking methods than non- members. Sixty- nine percent of club members always trimmed fat from red meat whereas 79 percent of non- members never trimmed fat (p = 0.000). More non-members (96%) than members (39%) ate soft rather than hard margarine (p=0.000). Thirty- six percent of members and 5 percent of non-members consumed less than 2 teaspoons of sugar in their tea/coffee (p= 0.000). This study indicates that the health club had a positive ef fect in influencing healthy living among its members. However, socio-economic and environmental factors pose significant barriers in the adoption of healthy behaviours.

Who Gets Tested for HIV in a South African Urban Township? Implications for Test and Treat and Gender-Based Prevention Interventions

With increasing calls for linking HIV-infected individuals to treatment and care via expanded testing, we examined sociodemographic and behavioral characteristics associated with HIV testing among men and women in Soweto, South Africa. We conducted a cross-sectional household survey involving 1539 men and 1877 women as part of the community-randomized prevention trial Project ACCEPT/HPTN043 between July 2007 to October 2007. Multivariable logistic regression models, stratified by sex, assessed factors associated with HIV testing and then repeated testing. Most women (64.8%) and 28.9% of men reported ever having been tested for HIV, among whom 57.9% reported repeated HIV testing. In multivariable analyses, youth and students had a lower odds of HIV testing. Men and women who had conversations about HIV/AIDS with increasing frequency and who had heard about antiretroviral therapy were more likely to report HIV testing, and repeated testing. Men who had ≥ 12 years of education and who were of high socioeconomic status, and women who were married, who were of low socioeconomic status, and who had children under their care had a higher odds of HIV testing. Women, older individuals, those with higher levels of education, married individuals, and those with children under their care had a higher odds of reporting repeated HIV testing. Uptake of HIV testing was not associated with condom use, having multiple sex partners, and HIV-related stigma. Given the low uptake of HIV testing among men and youth, further targeted interventions could facilitate a test and treat strategy among urban South Africans.

Perceptions of body size and its association with HIV/AIDS

Objective: To explore the perception among black South African women that people who are thin are infected with HIV or have AIDS.Setting: Khayelitsha, an urban township in Cape Town.Subjects: 513 women aged 18–65 years.Methods: This was an exploratory study employing both quantitative and qualitative research methodology. Data were collected in two phases. The first phase involved collecting quantitative data among 513 participants. During the second phase, qualitative data were collected in a purposely selected sub-sample of 20 women. For the qualitative data collection, participants were shown eight body figures, ranging from thin to obese, and asked to choose a figure representing the ideal figure, a preferred figure and a figure thought to symbolise health. They were also invited to choose a figure that they thought represented a person infected with HIV or who had AIDS. They had the option of saying that they did not associate any of the figures with people infected with HIV or who had AIDS. Weight and height measurements were also taken. After the quantitative analysis was completed, focus group discussions explored perceptions about body image and the relation to HIV among purposely selected participants. Data were summarised by content based on questions discussed.Results: Sixty-nine per cent of the participants associated a thin figure with a person infected with HIV, or who had AIDS. Only 10.2% thought the thin figure symbolised health. Fifty per cent preferred a normal-weight figure, while 34.2% thought that normal weight symbolised health. Only 2% thought that people in the normal-weight category were infected with HIV or had AIDS.Thirty-four per cent preferred to be overweight and 31% thought that being overweight symbolised health. None of the participants thought the overweight figure represented people infected with HIV or who had AIDS. Only 8% preferred the obese figure. The results of the qualitative data analysis suggested that participants preferred to be overweight and at risk of acquiring cardiovascular diseases, rather than being thin and stigmatised as a person infected with HIV or who had AIDS.Conclusion: This study revealed that the stigma associated with HIV and AIDS may undermine strategies for prevention of chronic non-communicable diseases among urban black South African women.

Efficacy of sticky and standard ovitraps for Aedes aegypti in Trinidad, West Indies

The double sticky trap (DST) is described for the first time and is evaluated along with standard ovitraps and sticky traps (STs) to determine population densities of Ae. aegypti in the urban township of St. Augustine and the rural community of Tamana, Trinidad, West Indies. Ten houses were selected at each study site. At each of the ten houses, one ovitrap, one ST, and one DST were placed using the criteria established for placement of ovitraps. The results showed the three trapping methods successfully collected Ae. aegypti mosquitoes. All three traps collected significantly more adults or eggs in St. Augustine than in Tamana. DSTs collected 2,286 adults from St. Augustine vs 316 adults from Tamana (p < 0.002), STs collected 1,480 and 220 adults, respectively (p < 0.01), and the ovitraps collected 2,735 and 517 eggs, respectively from St. Augustine and Tamana (p < 0.002). Based on these results, the DSTs collected significantly (P < 0.02) more adults than the STs. The DSTs and STs collected both adult and immature stages which can be used for toxicology, virology, and PCR studies and are suitable alternative Ae. aegypti surveillance tools for the Caribbean and Latin American region.