Browsing by Author "Richter, Linda"

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    Alcohol consumption among HIV-positive pregnant women in KwaZulu-Natal, South Africa : prevalence and correlates
    (Elsevier, 2012) Desmond, Katherine; Milburn, Norweeta; Richter, Linda; Tomlinson, Mark; Greco, Erin; Van Heerden, Alastair; Van Rooyen, Heidi; Comulada, W. Scott; Rotheram-Borus, Mary Jane
    Background: HIV-positive pregnant women who drink put their children at risk of both HIV and fetal alcohol spectrum disorders. The province of KwaZulu-Natal (KZN) has the highest prevalence of HIV in South Africa, but has not before been considered an area of high alcohol consumption among women. This paper analyzes a large sample of HIV+ pregnant women in KZN to examine alcohol consumption in that population. Methods: Data came from assessments of women enrolled in Prevention of Mother-To-Child Transmission programs at 8 clinics in KZN. Descriptive statistics and logistic regressions were used to examine the prevalence and correlates of alcohol consumption and binge drinking. Results: Of 1201 women assessed, 18% reported drinking during pregnancy, and 67% of drinkers usually binged when drinking (had 3+ drinks in one sitting). Over one-third of drinkers binged twice a month or more. Women living in urban and peri-urban locations were more likely to drink, as were those with indicators of higher economic status and greater social engagement. Married women were less likely to drink, while women who had poorer mental health, used tobacco, or had a greater history of sexual risk-taking were more likely to drink. Conclusion: Health care workers in KZN should be aware that pregnant women who drink are likely to do so at a level that is dangerous for their babies. Some factors associated with drinking indicate social/environmental influences that need to be counteracted by greater dissemination of information about the dangers of drinking, and greater support for abstinence or moderation.
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    Intergenerational transfer of health inequalities : exploration of mechanisms in the Birth to Twenty cohort in South Africa
    (BMJ, 2019) Von Fintel, Dieter; Richter, Linda
    South Africa’s history of colonialism and Apartheid contributed to its extreme levels of inequality. Twenty-five years after the transition to democracy, socio-economic and health inequalities continue to rank among the highest in the world. The Birth to Twenty+ study follows a cohort born in urban Johannesburg in 1990 through their early lives and into young adulthood. Also known as ‘Mandela’s Children’, these ‘children of the ‘90s’ were the first generation to be raised in a democratic society, whose elected government implemented policies to achieve greater socio-economic and health equality. Correlating early life outcomes to those of their parents provides a baseline estimate of intergenerational transmission of historical inequality. Analyses of their early life course indicates the potential breakdown in inequality in the first generation. This paper provides an overview of empirical results on intergenerational change in socio-economic status and health during South Africa’s political transition. Access to infrastructural services improved, and poverty reduced following the rapid expansion of unconditional cash transfers mainly to children and pensioners. However, unemployment remained high and job discrimination continued. Inequalities in health follow similar patterns, and progress did not equate to convergence. Some catch-up physical growth occurred—both across groups and over time—but not sufficient to bridge cognitive inequalities. Socio-economic and health inequalities continued as the children of the ‘90s reached young adulthood. Based on knowledge of other transitions, it is likely that these inequalities will only start to break down in later generations, provided social and economic progress holds steady.
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    Project Masihambisane : a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV
    (BioMed Central, 2011-01) Rotheram-Borus, Mary-Jane; Richter, Linda; Van Rooyen, Heidi; Van Heerden, Alastair; Tomlinson, Mark; Stein, Alan; Rochat, Tamsen; De Kadt, Julia; Mtungwa, Nonhle; Mkhize, Lungile; Ndlovu, Lindo; Ntombela, Lungile; Comulada, W. Scott; Desmond, Katherine A.; Greco, Erin
    Background: Pregnant women living with HIV (WLH) face daily challenges maintaining their own and their babies' health and mental health. Standard Prevention of Maternal to Child Transmission (PMTCT) programs are not designed to address these challenges. Methods/Design: As part of a cluster randomized controlled trial, WLH are invited to attend four antenatal and four postnatal small group sessions led by a peer WLH (a Peer Mentor). The WLH and their babies are assessed during pregnancy and at one week, six months, and twelve months post-birth. Mobile phones are used to collect routine information, complete questionnaires and remain in contact with participants over time. Pregnant WLH (N = 1200) are randomly assigned by clinic (N = 8 clinics) to an intervention program, called Masihambisane (n = 4 clinics, n = 600 WLH) or a standard care PMTCT control condition (n = 4 clinics; n = 600 WLH). Discussion: Data collection with cellular phones are innovative and effective in low-resource settings. Standard PMTCT programs are not designed to address the daily challenges faced by WLH; Peer Mentors may be useful in supporting WLH to cope with these challenges. Trial registration: ClinicalTrials.gov registration # NCT00972699
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    What the science of child and adolescent development contributes to understanding the impacts of COVID-19
    (ASSAf, 2021) Tomlinson, Mark; Richter, Linda; Slemming, Wiedaad
    As of 8 September 2020, there were 27 236 916 confirmed cases of COVID-19, including 891 031 deaths reported to the World Health Organization.1 The direct effects of SARS-CoV-2 (the virus) and COVID-19 (the disease caused by the virus) are infection (of which ~80% of people will have no or mild symptoms), serious illness (~15% requiring hospitalisation and ~5% ventilation) and death (<1%). Of all age groups, children (0–18 years of age) have the lowest risk of the direct effects of the virus and the disease. Understandably, because of this, much of the global focus has been on protecting the elderly and adults with co-morbidities and using country lockdowns to prevent community transmission. What has often been forgotten, however, is that children have the highest risk of all age groups of experiencing the indirect adverse effects of the pandemic and the effects to contain it. As ~20% of deaths occur amongst people over 65 years of age, many children will lose beloved grandparents and older relatives, and many will lose their primary caregiver. Newborn and young children may be separated from their mothers – an experience that can have long-term effects on children’s development.2 Other indirect effects result from actions and the knock-on effects of actions taken to prevent, control and treat the virus. These include societal lockdowns, isolation and quarantine with follow-on negative effects on income and food security, fear and panic, anxiety and depression, altered family and social relations, stigma and, in extreme cases, post-traumatic stress