Human Sciences Research Council, Pretoria, South Africa.
Department of Psychology, University of Pretoria, Pretoria, South Africa.
PLoS One. 2019 Feb 8;14(2):e0209756. doi: 10.1371/journal.pone.0209756. eCollection 2019.
In many sub-Saharan African countries, confronting the dual epidemic of HIV and NCDs is a public health priority especially in high HIV burden countries such as South Africa. Evidence shows that poor health as a consequence of NCDs and HIV among the workforce increases absenteeism and leads to decrease in productivity. However, the prevalence of these co-occurring chronic conditions and associated factors is unknown in the educator workforce. Improved understanding has implications for their management and wellbeing of educators. This paper reports the prevalence of selected NCDs and associated factors among HIV positive educators in South Africa using the 2015/6 survey of Educators in Public Schools in South Africa.
This was a second-generation surveillance undertaken among educators in selected public schools in all nine provinces in South Africa. A multi-stage stratified cluster design with probability proportional to size sampling was used to draw a random sample of schools. Factors associated with presence of NCDs were determined using a multivariate backward stepwise logistic regression analysis.
A total of 1 365 schools were sampled within which 21 495 (85.5%) educators were interviewed. Out of 2691, HIV Positive educators that responded to the questions on NCDs, 36.9% reported having NCDs. The most commonly reported NCDs were high blood pressure (17.4%), and stomach ulcers (13.5%). The increased odds of reporting the presence of NCDs was significantly associated with being female than male [aOR = 1.5: 95% CI (1.1-1.9), p<0.002], age 45 to 54 years [aOR = 1.8: 95% CI (1.4-2.2), p = p<0.001], and age 55 years and older than those 18 to 24 years [aOR = 2.7: 95% CI (1.8-3.9), p<0.001). The decreased odds of reporting the presence of NCDs was significantly associated with not being absent from school for health reasons [aOR = 0.7: 95% CI (0.6-0.9), p = 0.003].
NCDs care and active screening should be an integral part of HIV programmes including interventions such as prevention, treatment, care and support amongst public school educators in SA. The education department will need to invest in health promotion intervention programmes to prevent and mitigate the negative impact of NCDs and HIV on the sector.
在许多撒哈拉以南非洲国家,应对艾滋病毒和非传染性疾病的双重流行是一项公共卫生重点,尤其是在南非等艾滋病毒负担沉重的国家。有证据表明,劳动力中非传染性疾病和艾滋病毒导致的健康状况不佳会导致旷工,从而降低生产力。然而,在教育工作者劳动力中,这些同时发生的慢性疾病及其相关因素的流行情况尚不清楚。更好地了解这些情况对他们的管理和教育工作者的健康都有影响。本文报告了使用 2015/6 年南非公立学校教育工作者调查,在南非艾滋病毒阳性教育工作者中选定的非传染性疾病的流行情况和相关因素。
这是在南非所有 9 个省的选定公立学校教育工作者中进行的第二代监测。采用多阶段分层聚类设计,按大小与概率成比例抽样,随机抽取学校样本。使用多元逐步向后逻辑回归分析确定与非传染性疾病存在相关的因素。
在总共抽取的 1365 所学校中,有 21495 名(85.5%)教育工作者接受了采访。在 2691 名回答非传染性疾病问题的艾滋病毒阳性教育工作者中,有 36.9%报告患有非传染性疾病。报告的最常见非传染性疾病是高血压(17.4%)和胃溃疡(13.5%)。与男性相比,报告存在非传染性疾病的可能性显著增加,女性为[优势比(OR)=1.5:95%置信区间(CI)(1.1-1.9),p<0.002],年龄在 45 至 54 岁的[OR=1.8:95% CI(1.4-2.2),p = p<0.001]和年龄在 55 岁及以上的[OR=2.7:95% CI(1.8-3.9),p<0.001]。与因健康原因未缺课的人相比,报告存在非传染性疾病的可能性显著降低[OR=0.7:95% CI(0.6-0.9),p=0.003]。
非传染性疾病的护理和主动筛查应成为艾滋病毒方案的一个组成部分,包括在南非公立学校教育工作者中开展预防、治疗、护理和支持等干预措施。教育部门将需要投资于健康促进干预方案,以预防和减轻非传染性疾病和艾滋病毒对该部门的负面影响。