IntroductionLittle is known about the prevalence and predictors of chronic non-communicable diseases (NCDs) of older adults in South Africa. This study aims to investigate the self-reported prevalences of major chronic NCDs and their predictors among older South Africans.MethodsWe conducted a national population-based cross-sectional survey with a sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The outcome variable was the self-reported presence of chronic NCDs suffered, namely, arthritis, stroke, angina, diabetes, chronic lung disease, asthma, depression, and hypertension. The exposure variables were sociodemographic characteristics: age, gender, education, wealth status, race, marital status, and residence. Multivariate logistic regression was used to determine sociodemographic factors predictive of the presence of chronic NCDs.ResultsThe prevalence of chronic NCDs was 51.8%. The prevalence of multimorbidity (≥2 chronic conditions) was 22.5%. Multivariate logistic regression analysis showed that being female, being in age groups 60–79 and 70–79, being Coloured or Asian, having no schooling, having greater wealth, and residing in an urban area were associated with the presence of NCDs.ConclusionThe rising burden of chronic NCDs affecting older people places a heavy burden on the healthcare system as a result of increased demand and access to healthcare services. Concerted effort is needed to develop strategies for the prevention and management of NCDs, especially among economically disadvantaged individuals who need these services the most.

Ninety percent of the world's HIV-positive pregnant women live in 22 countries. These countries, including South Africa (SA), have prioritised the elimination of mother-to-child transmission of HIV (EMTCT), measured using three coverage and two impact indicators (Fig. 1). [1] The two impact indicators are the percentage motherto-child HIV transmission (MTCT) among HIV-positive mothers (MTCT risk) and the number of new paediatric HIV infections per 100 000 live births (MTCT case rate). The global target is <5% final MTCT in breastfeeding countries and ≤50 new paediatric HIV infections per 100 000 live births. Consequently, to achieve EMTCT, all 22 countries currently recommend lifelong antiretroviral treatment for all HIV-positive pregnant and lactating women. This is known as PMTCT Option B+. Between the 1980s and 2015 the discovery of more effective biomedical interventions to prevent mother-to-child transmission of HIV (PMTCT) accelerated the improvement of global and national PMTCT policies; such rapid advancements in policy required flexible, responsive health systems, services and staff to assure implementation. [1-6] For example, in 2001 the SA national This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

BackgroundPopulation ageing has become significant in South African society, increasing the need to improve understandings of health and well-being among the aged.ObjectiveTo describe the self-reported ratings of overall health and functioning, and to identify factors associated with self-rated health among older South Africans.DesignA national population-based cross-sectional survey, with a sample of 3,840 individuals aged 50 years and older, was completed in South Africa in 2008. Self-reported ratings of overall health and functioning were measured using a single self-reported health state covering nine health domains (used to generate the Study on Global Ageing and Adult Health (SAGE) composite health state score). Disability was measured using the World Health Organization Disability Assessment Schedule II (WHODAS-II) activities of daily living (ADLs), instrumental activities of daily living (IADLs), perceptions of well-being, and the World Health Organization Quality of Life index/metric (WHOQoL).ResultsOverall, more than three quarters (76.8%) of adults rated their health as moderate or good. On balance, men reported very good or good health more often than women (p<0.001). Older people (aged 70 years and above) reported significantly poorer health status than those aged 50–59 (adjusted odds ratio (AOR) 1.52; 95% confidence interval (CI) 1.00–2.30). Indians and Blacks were significantly more likely to report poorer health status at (AOR=4.01; 95% CI 1.27–12.70) and (AOR=0.42; 95% CI 0.18–0.98; 30 p <0.045), respectively, compared to Whites. Respondents with primary education (AOR=1.83; 95% CI 1.19–2.80) and less than primary education (AOR=1.94; 95% CI 1.37–2.76) were more likely to report poorer health compared to those with secondary education. In terms of wealth status, those in low wealth quintile (AOR=2.02; 95% CI 1.14–3.57) and medium wealth quintile (AOR=1.47; 95% CI 1.01–2.13) were more likely to report poorer health status than those in high wealth quintile. Overall, the mean WHODAS-II score was 20%, suggesting a low level of disability. The mean WHOQoL score for females (Mean=51.5; SD=12.2) was comparable to that of males (Mean=49.1; SD=12.6).ConclusionsThe depreciation in health and daily functioning with increasing age is likely to increase demand for health care and other services as people grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect, and promote the health and well-being of older people.

Background and objectiveUnhealthy lifestyle behaviours are important risk factors of morbidity and mortality. This study aimed to explore the sociodemographic predictors of multiple non-communicable disease (NCD) risk factors experienced by elderly South Africans.MethodsWe conducted a national population-based cross-sectional survey with a sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The outcome variable was the co-existence of multiple NCD risk factors (tobacco use, alcohol, physical inactivity, fruit and vegetable intake, overweight or obesity, and hypertension) in each individual. The exposure variables were sociodemographic characteristics, namely, age, gender, education, wealth status, population group, marital status, and residence. Multivariate linear regression was used to assess the association between sociodemographic variables and multiple NCD risk factors.ResultsThe mean number of NCD risk factors among all participants was three (95% confidence interval: 2.81–3.10). Multivariate linear regression analysis revealed that being female, being in the age group of 60–69 years, and being from the Coloured and Black African race were associated with a higher number of NCD risk factors. Marital status, educational level, wealth, and residence were not significantly associated with the number of NCD risk factors experienced.ConclusionsThe co-existence of multiple lifestyle NCD risk factors among the elderly is a public health concern. Comprehensive health-promotion interventions addressing the co-existence of multiple NCD risk factors tailored for specific sociodemographic groups are needed.

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