Interpreting Mamelodi Community-Oriented Primary Care data on tuberculosis loss to follow-up through the lens of intersectionality

Ilunga, Blandine B.; Eales, Owen O.; Marcus, Tessa S.; Smith, Selma; Hugo, Jannie

doi:10.4102/phcfm.v12i1.2081

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…A study of tuberculosis patients in Mamelodi, South Africa, found that patients were less likely to continue treatment for the disease if they were "physically, socially, and institutionally 'out of place'" (Ilunga et al 2020:5). Specifically, patients were more likely to stop seeking treatment if they were older (i.e., >60 years of age), at risk of poverty (i.e., on the threshold of being "poor"), and had no South African identification documents (i.e., migrants) (Ilunga et al 2020). These factors, when viewed through an intersectional lens, generate a much richer picture of the social and structural factors that influence tuberculosis outcomes.…”

Section: Public Health and Epidemiologymentioning

confidence: 99%

Intersectionality and the Interpretation of Past Pandemics

Yaussy

2022

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Intersectionality refers to the potential for multiple axes of identity to overlap and interact within a single individual, whose lived experiences are further affected by structural forms of oppression that are perpetuated within their society. Intersectionality has been adapted by a variety of social science disciplines exploring the negative effects of multiple marginalization and systemic inequality in living populations, but remarkably few intersectional studies of health or pandemics in the past have been produced in bioarchaeology. Bioarchaeologists, specifically, are uniquely positioned to contribute to interdisciplinary discourse by expanding the contextual and temporal purviews of intersectionality scholarship, which currently focuses primarily on living populations from Western, industrialized contexts. The purpose of this review is to encourage and facilitate intersectionality research within bioarchaeology. To accomplish this goal, the article is divided into three sections: the first section provides a general overview of intersectionality, the second section discusses examples of intersectional scholarship from related disciplines that address health disparities and modern pandemics, and the third section considers the ways in which bioarchaeologists might integrate intersectionality in our empirical research on health and disease in the past. Given the potentially daunting task of using bioarchaeological data to investigate intersectionality and health in the past, the third section also highlights three quantitative methodologies that intersectionality scholars have used to investigate the independent, additive effects of individual social identities as well as the multiplicative effects of those same identities as they operate in conjunction with each other to produce patterns of health outcomes in living populations.

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Section: Public Health and Epidemiologymentioning

confidence: 99%

Intersectionality and the Interpretation of Past Pandemics

Yaussy

2022

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“…Nonadherence to DR‐TB treatment threatens TB elimination efforts and social determinants of health impact TB patients’ continuity and retention in care (Ilunga et al., 2020). The intersection between nursing care and patient‐related behavior and needs differ in hospitalized versus community‐based settings (Petersen et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Public health and hospital‐based nursing intersection: Case study of drug‐resistant tuberculosis patients

Pietersen

Anderson

Heijden

2022

Public Health Nursing

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Objective Public health nurses (PHN) are key partners in continuity of care for drug‐resistant tuberculosis (DR‐TB) patients. We examined complexities in DR‐TB care transition between community‐ and hospital‐based care. Design We conducted a case study using medical record data. Four patients were purposively selected to illustrate intersectional complexities in DR‐TB care transition involving PHN. Results Case A (HIV negative male) received PHN care at a community‐based facility 124 km from Cape Town. Cases B, C, and D (males living with HIV) received PHN community‐based care, averaging 25 km from the hospital. Treatment failed in cases A, B, and C; they subsequently died. Case D was cured. All cases were granted leave of absence at least once while hospitalized. None returned when expected mainly due to lack of transport funds. PHN played critical roles regarding patients’ return by conducting home visits, interacting with relatives, and assisting emergency officers to transport patients back to the hospital. PHN supported relatives to endure protracted patient hospitalizations. Conclusion The role of PHN in continuity of DR‐TB care in low‐middle income countries is unambiguous. PHN are key partners in the DR‐TB care cascade, namely facilitating retention in care between hospital and community‐based care. Effective DR‐TB control relies on effective partnerships among healthcare personnel, patients, and their families.

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Infrastructural Inequality and Household COVID-19 Vulnerability in a South African Urban Settlement

Marcus

2022

J Urban Health

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COVID-19 has highlighted the importance of household infrastructure in containing the spread of SARS-CoV-2, with Global South urban settlements particularly vulnerable. Targeted interventions have used area or dwelling type as proxies for infrastructural vulnerability, potentially missing vulnerable households. We use infrastructural determinants of COVID-19 (crowding, water source, toilet facilities, and indoor pollution) to create an Infrastructural Vulnerability Index using cross-sectional household data (2018–2019) from Mamelodi, a low-income urban settlement in South Africa. Households were stratified into vulnerability groups by index results; sociodemographic variables were assessed as predictors of index scores; and inequality analysis and decomposition were conducted. Thirty-three percent of households fell in the lowest risk group, 32% in the second, 21% in the third, and 14% in the highest. Dwelling type and geographical ward were associated with changes in index scores, with a shack (adjusted β (a β ) = 3.45, CI = 3.39–3.51) associated with highest increase compared to a house. Wards in more developed areas were not consistently associated with lower index scores in the final regression model. The infrastructural vulnerability of the top 10% of households was greater than the bottom 40%, and inequality was predominantly within (80%) rather than between (20%) wards, and more between (60%) than within (40%) dwelling types. Our results show a minority of households account for the majority of infrastructural vulnerability, with its distribution only partially explained by area and dwelling type. Efforts to contain COVID-19 can be improved by using local-level data, and a vulnerability index, to target infrastructural support to households in greatest need. Supplementary Information The online version contains supplementary material available at 10.1007/s11524-022-00625-7.

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Interpreting Mamelodi Community-Oriented Primary Care data on tuberculosis loss to follow-up through the lens of intersectionality

Cited by 4 publications

References 18 publications

Intersectionality and the Interpretation of Past Pandemics

Intersectionality and the Interpretation of Past Pandemics

Public health and hospital‐based nursing intersection: Case study of drug‐resistant tuberculosis patients

Infrastructural Inequality and Household COVID-19 Vulnerability in a South African Urban Settlement

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