Prevalence of non-communicable diseases (NCDs) and associated factors among HIV positive educators: Findings from the 2015/6 survey of Health of Educators in Public Schools in South Africa

Abstract

IntroductionIn 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.MethodsThis 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.ResultsA 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].ConclusionNCDs 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.

Trends, prevalence and factors associated with hypertension and diabetes among South African adults living with HIV, 2005–2017

“…The high prevalence in women may be as a result of an underestimation in men reflecting more on their health-seeking behaviour than disease prevalence itself [ 14 , 18 , 34 , 35 , 41 , 42 ]. The impact of urbanisation has also been documented in studies such as the 2012 SANHANES study and the South African cross-sectional study on HIV positive educators which suggest that urban living leads to easy access to unhealthy diets and a sedentary lifestyle [ 34 , 35 ]. In 2008 and 2017, we further see that those who had primary education and below also had a high prevalence of hypertension and diabetes as supported by Ntuli et al [ 43 ].…”

Expanding the Vision for Differentiated Service Delivery: A Call for More Inclusive and Truly Patient-Centered Care for People Living With HIV

“…20 Chronic NCDs such as diabetes, hypertension, and mental health disorders are also a major issue. Among adults on ART in South Africa, more than 15% have hypertension, more than 5% have diabetes, 21 and, as a recent review emphasized, there is a real risk that poor quality of care for such NCDs may undermine the investments made to strengthen HIV programs. 22 …”

Study on the Status of Health Literacy and its Relationship with Chronic Diseases in Poor Areas

“…NCDs (such as cardiovascular disease, cancer, and diabetes) are the major source of the global burden of disease and mortality, and their share of the total global disease burden has steadily increased from 44% in 1990 to 61% in 2016 [11,26] . Multiple chronic conditions (MCC) further reduce the quality of life of patients and cause a huge economic burden [27] .…”