Race, income, and infant mortality in Cape Town, South Africa.
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Death Certificates↗
Biomedical subjects
A R Sayed
Publications and source records attributed to A R Sayed.
Some spatial variations in South African mortality.
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Africa↗
The morbidity spectrum seen by general practitioners in South Africa.
Information was obtained from a survey of a representive sample of 8% of the medical practitioners in South Africa in 1985. Each practitioner recorded all reasons for contact, diagnoses, whether a contact was new or a repeat, and demographic details of the patients over a 1-week period. Tables are presented only for general practitioners for contact rates of 70 causes of morbidity (ICD abridged list) as well as a chronicity index for each condition (the ratio of repeat to new contacts for that condition). Acute respiratory infections and diseases of the genito-urinary system were the most common reasons for contact, while diabetes mellitus was the condition with the highest chronicity.
Adolescent↗
Urbanisation and women's health in Khayelitsha. Part I. Demographic and socio-economic profile.
Demographic and socio-economic data and information on migration patterns and urban/rural links was collected from 722 households in the formal housing area and the serviced and the unserviced site areas of Khayelitsha; 659 women and 61 men were interviewed. Thirty-eight per cent of the population were aged under 15 years and 77% under 35 years. There was a predominance of females in the 5-35-year age group. There was a mean of 4.9 persons per household, and 93.5% of sites contained 1 dwelling. Of the 659 female respondents, 7% had received no formal education, 39% had primary school education, and 54% had secondary school education. Unemployment among women was 45%. Domestic service accounted for 66.2% of formal employment. Of all women 86% were unskilled, 71.9% had been born in a 'homeland', and 69.7% had migrated to an urban area before 1985. Ties to the rural areas were strong, particularly in the 'shack' areas. 'New arrivals' to an urban area were young, mostly unemployed, and lived in the worst environmental conditions. In the unserviced 'shack' areas, 47.5% of women had migrated to an urban area in the last 5 years. There are important target areas for a study of the health effects of urbanisation and for possible interventions. This study tends to confirm the 'quadruple' oppression of women in Khayelitsha, on the basis of race, social class and gender and as new arrivals in an urban environment.
Adolescent↗
Urbanisation and women's health in Khayelitsha. Part II. Health status and use of health services.
A study was conducted among women in Khayelitsha to determine the relationship between urbanisation, health status and use of health services; 722 households were visited, and 659 female respondents provided information on acute and chronic illness for the 3,229 individuals who were members of their households. In addition, they provided information concerning their reproductive health, AIDS awareness, knowledge of cervical smears and use and knowledge of health services. Acute illness was reported for 4.3% of the study population, the commonest complaints being diarrhoea, abdominal pain and upper respiratory infections; 4.4% reported chronic illness, the commonest complaints being hypertension and tuberculosis; 16.2% of women reported gynaecological illness; 86% had of heard of AIDS (although their knowledge of transmission and prevention was poor); and 45% had heard of cervical smears. Patterns of illness and knowledge and use of health services vary in the different areas of residence of Khayelitsha. This appears to be related to urbanisation, age, and environmental and socio-economic factors.
Black or African American↗
The epidemiology of hypertension in family practice in Cape Town.
A prevalence study of hypertension in 8 family practices in low socio-economic areas of Cape Town examined 1,046 patients over the age of 15 years. The crude prevalence rate of hypertension was 20.26%. There was no significant sex difference. Systolic pressure, diastolic pressure and hypertensive status increased with age and body mass index (BMI). There were complex relationships with regard to sex in that the female sex was predictive of hypertensive status after the age of 45 years unexplained by differences in BMI. After adjusting for age, BMI and sex differences, widowhood, poor education, obesity, a family history of hypertension or stroke and a past history of hypertension were significant predictors of hypertensive status. Smoking status, occupational social class or property ownership were not predictive. Fifty-one per cent of hypertensive subjects were treated. Of those receiving treatment, 30% were controlled resulting in a control prevalence of only 18%. Younger male subjects were better controlled by treatment. A strong need for improved diagnosis and treatment of hypertension in family practice exists in this region.
Adolescent↗
The relationship between the hardness of treated water and cardiovascular disease mortality in South African urban areas.
A number of studies carried out in other countries have shown the existence of negative correlations between cardiovascular disease mortality and the hardness of water supplies. A study here showed negative correlation (P less than 0.10) between cardiovascular disease mortality for the South African urban white population and total water hardness (equivalent calcium carbonate mg/l). Negative correlations were also found to exist with the hardness-associated factors potassium (P less than 0.05), sulphate (P less than 0.05) and chloride (P less than 0.05) and manganese (P less than 0.10). The results are described in terms of existing studies and a number of local problems have been identified and discussed.
Cardiovascular Diseases↗
Birth defects surveillance. A pilot system in the Cape Peninsula.
A pilot birth defects surveillance system was established in 1982 as part of an epidemiological baseline study pertaining to potential changes in water quality in the Cape Peninsula. The methodology used for reporting birth defects for two information systems, one hospital-based and the other population-based, utilizing statutory notifications of births, is described. Preliminary birth defect rates by cause are presented for a hospital-based system and are consistent with rates reported internationally. The system based on statutory notifications showed gross under-reporting.
Congenital Abnormalities↗
Health aspects of the use of recycled water in Windhoek, SWA/Namibia, 1974-1983. Diarrhoeal diseases and the consumption of reclaimed water.
The introduction of the use of reclaimed water in Windhoek, SWA/Namibia, prompted an epidemiological study to assess the health effects, if any, of its consumption. Analysis of more than 15,000 episodes of diarrhoeal disease during the period August 1976-March 1983 showed that their incidence in whites of similar socio-economic status was marginally lower in persons supplied with reclaimed water than those with water from conventional sources. Incidence rates were significantly higher in blacks and in coloureds, all of whom received conventional water only. Age-specific incidence rates in children of the various ethnic groups also showed differences characteristically associated with socio-economic stratification. It is concluded that the consumption of reclaimed water does not increase the risk of diarrhoeal diseases caused by waterborne infectious agents.
Adolescent↗
Morbidity patterns from general practice in Cape Town. A pilot study.
A pilot survey of morbidity patterns reflected in general practice was undertaken by a panel of physicians in Cape Town during 1984-1985. Acute upper respiratory tract infections, bronchitis and bronchiolitis were the commonest reasons for contact. A definite pattern of contacts by day of week was noted. The age distribution of the contacts closely matched that of the suburb in which the practice was situated.
Adolescent↗
Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part V. Hypertensive diseases.
An analysis was undertaken of mortality from hypertensive disease in the RSA between 1978 and 1982 among whites, coloureds and Asians. The age-specific mortality rates for each group are presented and comparisons are also made between these groups based on age-standardised mortality rates. As with a similar study undertaken for the period 1969-1971, marked variations are seen between the various population groups. The rates for Asians exceeded those for coloureds substantially, and both these groups had far higher rates than whites. These results demonstrate an interesting variation when compared with mortality from ischaemic heart disease and recent prevalence studies of hypertension. The possibility that this variation is due to better control of hypertension in whites or is a result of a different ratio of risk factors in each group studied is considered.
Adult↗
Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part VI. Ischaemic heart disease.
An analysis of ischaemic heart disease (IHD) mortality for the period 1978-1982 showed markedly different rates for the Asian, white and coloured population groups in the RSA. Age-specific and age-standardised rates for Asians were in general considerably higher than those for whites, and did not show the marked decline with time observed in rates for whites. Although coloureds were seen to have considerably lower age-standardized rates than Asians or whites of the same sex, an increase in the age-standardised rates for coloured males over a 10-year period and a slight decrease among females suggested that rates for coloureds may be in the process of approaching those for the other groups. The observed decline in IHD rates among whites of both sexes suggests that preventable major risk factors may be coming under control, apparently to a greater extent in this group than among Asians or coloureds.
Age Factors↗
Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part IV. Respiratory diseases.
Respiratory diseases are major causes of death in South Africa. The reported mortality rates (MRs) for: (i) pneumonia and influenza; (ii) chronic obstructive lung disease and allied conditions; (iii) pulmonary tuberculosis; and (iv) carcinoma of the lung and bronchus over a 5-year period are examined in relation to age, sex, ethnic group and year. Such data have not previously been reported in South Africa. MRs for all respiratory diseases (except lung carcinoma) were substantially higher in coloureds than in whites or Asians. In each ethnic group and for each disease category, MRs for males were higher than for females, especially in those over the age of 24 years. For all, except lung carcinoma, MRs were highest at the extremes of life. Changes in respiratory disease MRs over the 5-year period were examined by calculating the age standardised MRs for each condition in each of the 5 years. There was a clear decline in the MR for pneumonia over this period in all groups. The MR for chronic obstructive pulmonary disease rose in all groups, except Asian females. Similarly, the MR for carcinoma increased in all groups, except white females. The MR for tuberculosis was highest in coloured males (10 times greater than in Asian males and 100 times greater than in white females). The pattern of respiratory disease MRs in white South Africans is very similar to that in the USA, whereas in coloureds MRs for infectious diseases remain high and are added to by the burden of cigarette smoking-related deaths.
Adolescent↗
Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part I. All causes.
Previous reports, based largely on the 1970 census and the 8th revision of the International Classification of Diseases, (ICD-8) have suggested that marked differences in mortality exist between population groups in the RSA. In this article the ICD-9 classification of causes of death and 1980 census are used to assess whether the trends have continued through to the present time. Total mortality data in the RSA for whites, coloureds and Asians for the 5-year period 1978-1982 are presented. The 1980 national census provided the denominator population data. Annual age- and sex-specific mortality rates were higher for coloureds than for whites or Asians, the differences being most marked in childhood. There appears to have been little change in total standardised mortality rates among whites over the 5-year period, while increases have occurred among coloureds of both sexes and among Asian males. Analysis of proportional mortality stresses the relatively large proportion of deaths accounted for by external causes and infections among coloureds and by cardiovascular diseases among whites and Asians. There is an urgent need for the health services to take note of these data in order to provide for the varied needs of the population.
Adolescent↗
Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part II. Cerebrovascular disease.
An analysis was undertaken of mortality from cerebrovascular disease in the RSA between 1978 and 1982 in whites, coloureds and Asians. This article details the age-specific mortality rates for each group and also comparisons between groups based on age-standardised mortality rates. Marked differences are seen between the various population groups, the rates for Asians and coloureds (particularly females) far exceeding that for whites. Comparison of these data with those published previously by Wyndham suggest that while mortality from this cause may be falling among whites and Asians, the rate is remaining relatively static in the coloured population.
Adult↗
Variations in mortality of the coloured white and Asian population groups in the RSA, 1978-1982. Part III. Rheumatic heart disease.
An analysis was undertaken of mortality from rheumatic heart disease in the RSA between 1978 and 1982 in whites, coloureds and Asians. This article details the age-specific mortality rates (MRs) for each group and also comparisons between groups based on age-standardised MRs. The rates for Asians and coloureds markedly exceed those for whites, particularly in the lower age groups (under 45 years).
Adolescent↗
Mortality in the first two years of life.
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Black or African American↗
Decline in ischaemic heart disease mortality in South Africa, 1978-1984.
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Adult↗