Mohlago Ablonia Seloka

Background: There is a dearth of evidence on the roles and views of stakeholders regarding the sexually transmitted infections (STIs) service provision among key and priority populations (KPPs) within primary healthcare (PHC) settings. Aim: This study assessed the roles and views of stakeholders regarding the STI services scope, content, accessibility, quality, affordability, and availability, as well as associated gaps and successes among KPP within PHC facilities in the Capricorn District of Limpopo Province in South Africa. Methods: An exploratory research design was used. In-depth face-to-face interviews with 18 STI stakeholders were conducted. The STI stakeholders were purposively selected from five PHC facilities. An inductive analytical approach was employed to develop themes and sub-themes. Tesch’s step analysis informed the development of the thematic analysis process. Results: The presence of peer counsellors, home-based caregivers, and the operation of STI services day and night in two selected facilities enhanced access and availability of STI services. Consistent in-service training for service providers was implemented to improve service quality and maintain professional competency. Barriers that prevented adequate STI service provision in this study included staff shortages, inadequate filing systems, lack of advanced-diagnostic equipment, and patients’ noncompliance with treatment regimens. The successes of the STI service provision were effective STI treatment and services integration within the facilities. Conclusions: The findings of this study have unveiled several methods to increase access and availability to STI services among KPPs in the selected PHC facilities. We recommend gathering responses and experiences from STI service users regarding the current STI service provision to foster innovative and targeted approaches within PHC facilities in Limpopo Province.

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV responses among KPs in South Africa. Objective: This study aimed to leverage and harness big heterogeneous data on HIV among KPs and harmonize and analyze it to inform a targeted HIV response for greater impact in Sub-Saharan Africa. Methods: The Boloka data repository initiative has 5 stages. There will be engagement of a wide range of stakeholders to facilitate the acquisition of data (stage 1). Through these engagements, different data types will be collated (stage 2). The data will be filtered and screened to enable high-quality analyses (stage 3). The collated data will be stored in the Boloka data repository (stage 4). The Boloka data repository will be made accessible to stakeholders and authorized users (stage 5). Results: The protocol was funded by the South African Medical Research Council following external peer reviews (December 2022). The study received initial ethics approval (May 2022), renewal (June 2023), and amendment (July 2024) from the University of Johannesburg (UJ) Research Ethics Committee. The research team has been recruited, onboarded, and received non–web-based internet ethics training (January 2023). A list of current and potential data partners has been compiled (January 2023 to date). Data sharing or user agreements have been signed with several data partners (August 2023 to date). Survey and routine data have been and are being secured (January 5, 2023). In (September 2024) we received Ghana Men Study data. The data transfer agreement between the Pan African Centre for Epidemics Research and the Perinatal HIV Research Unit was finalized (October 2024), and we are anticipating receiving data by (December 2024). In total, 7 abstracts are underway, with 1 abstract completed the analysis and expected to submit the full article to the peer-reviewed journal in early January 2024. As of March 2025, we expect to submit the remaining 6 full articles. Conclusions: A truly “complete” data infrastructure that systematically and rigorously integrates diverse data for KPs will not only improve our understanding of local epidemics but will also improve HIV interventions and policies. Furthermore, it will inform future research directions and become an incredible institutional mechanism for epidemiological and public health training in South Africa and Sub-Saharan Africa. International Registered Report Identifier (IRRID): DERR1-10.2196/63583

Primary healthcare facilities lack routine diagnostic screening due to resource limitations and dependence on syndromic management, resulting in an unprecedented prevalence and incidence of sexually transmitted infections (STIs), particularly among key and priority populations. Specific focuses are essential to strengthen current STI control measures. Therefore, this article describes the protocol for evaluating STI programme among key and priority populations in selected primary healthcare facilities in South Africa. We will employ an exploratory, descriptive research design to assess the STI programme in terms of its facility operations, functions, scope, gaps, delivery services, STI surveillance methods, and indicators in the selected primary healthcare facilities. A purposive sample of 15–20 STI programme stakeholders will be selected from five primary healthcare facilities in Limpopo Province, South Africa. The programme evaluation will use the World Health Organization assessment checklist tool, a globally recognised and validated instrument comprising open- and closed-ended questions to assess the STI programme. This tool, known for its credibility and reliability, ensures the study’s validity. Quantitative data will be captured on STATA software (College Station, TX, USA) version 18 for descriptive analysis and presented as the mean and standard deviation for continuous variables, proportions and percentages for categorical variables. A p ≤ 0.05 will demonstrate a statistically significant level. Thematic content analysis will be conducted for the qualitative data using Atlas. ti software (Technical University, Berlin, Germany) version 23.1. The study’s results will inform new approaches to strengthen STI coverage, service delivery, and linkage to care.

Background: Metabolic syndrome (MetS) is the key risk factor for cardiovascular disease (CVD) development. However, lifestyle habits including high consumption of sugar-sweetened beverages (SSBs) contribute to its onset. The current study was aimed at investigating the association between SSBs consumption and MetS components among young adults aged 22 to 30 years. Methods: This was a cross-sectional study where a total of 596 young adults (307 females and 287 males) participated. Blood pressure, biochemical assessment, and anthropometric measurements were taken following protocols. A validated 24 h recall questionnaire and food manuals were used to collect SSBs data. Binary logistic regression was applied to determine the association between SSBs consumption and MetS components. Results: In males, high SSBs consumption increased the risk of high fasting blood glucose (FBG) (p < 0.05). In females, high and low SSBs consumption decreased the risk of reduced high-density lipoprotein cholesterol (HDL-C), whereas only high SSBs consumption was associated with decreased risk of high triglycerides (TG) (p < 0.05). In conclusion, high TG, reduced HDL-C and high FBG was significantly associated with high consumption of SSBs. Longitudinal studies are recommended to further investigate the extent to which SSBs influences components of MetS.

Metabolic syndrome (MetS) is a cluster of metabolic conditions that aggravate the likelihood of cardiovascular diseases and type 2 diabetes mellitus. This study was aimed to identify the best obesity index to determine MetS. This was a cross-sectional study and part of the Ellisras Longitudinal Study where 593 (289 males and 304 females) adults aged 22–30 years took part. Confirmatory factor analysis was used to test the single-factor models of MetS defined by mid arterial pressure, fasting blood glucose, triglycerides and commonly selected obesity indices such as Neck circumference (NC), Body mass index (BMI), Waist circumference (WC) and Waist to height ratio (WHtR) as indicators of MetS. It was found that a single model fit built based on WC and WHtR suggested a better fit index than NC and BMI in males, whereas, a model built on NC obtained a better fit index for females than other factor models. In conclusion, the result of the present study suggests that in rural Ellisras adult’s, WC and WHtR are the best obesity indices for determining MetS in males and NC in females than other indices. Hence, longitudinal studies are recommended to allow causality to be drawn between obesity indices and MetS.

Background: Evidence is lacking on the effects of binge alcohol consumption on metabolic syndrome in the rural South African population. The purpose of this study was to investigate the association between binge drinking and components of metabolic syndrome (MetS) amongst Ellisras rural young adults aged 21 to 31 years who are part of the Ellisras Longitudinal Study. Methods: Logistic regression analysis was applied to a total of 624 participants (306 males and 318 females) aged 21 to 31 years who took part in the Ellisras Longitudinal Study (ELS). The model was adjusted for covariates, including smoking, age, and gender. Binge alcohol consumption was assessed using a standardised questionnaire that was validated for the Ellisras rural community. A standardised method of determining the components MetS was used after fasting blood samples were collected from all the participants. Results: Binge drinking remained significantly associated with low levels of high-density lipoprotein cholesterol (HDL-C) (OR = 2.64, 95% CI = 1.23–5.65), after being adjusted for smoking, age, and gender. Other MetS components were not predicted. Instead, gender remained significantly associated with all MetS components, except triglycerides, at multivariate analysis. Age retained significance at multivariate analysis with waist girth (OR = 2.13, 95% CI = 1.37–3.34), triglycerides (OR = 2.30, 95% CI = 1.05–5.02), and the MetS composite (OR = 1.65, 95% CI = 1.12–2.41). Conclusion: Binge drinking was significantly associated with lower levels of HDL-C. Future studies should investigate the relationship between alcohol abuse and the components of incident MetS in this population.