The impact of the caregiver mobility on child HIV care in the Manhiça District, Southern Mozambique: A clinical based study

"Health Outcomes of Grandparents Caring for Double Orphans in South Africa": What Are the Determinants?

In the 21st century, grandparenthood is a significant phenomenon in the fields of demography, gerontology, and sociology. It is mainly explored in the context of ageing, as it is poised to become one of the most significant demographic phenomena and social issues in contemporary South Africa. Therefore, this study examined the determinants associated with grandparents who are parenting as caregivers and the health challenges they are exposed to as caregivers. The National Income Dynamics Study (NIDS) Wave 5 dataset was utilised, and a total of 302,476 grandparents aged 25 years and older, who were reported to be primary caregivers of double orphans, were included in the analysis. Both bivariate and multivariate binary logistic regressions were performed to determine the predictors of the determinants of grandparents parenting as caregivers and their health challenges in South Africa. Estimated odds ratios (ORs) with 95% confidence intervals (CIs) were used, and the threshold for statistical significance was established at ρ < 0.05. A majority of the male and female grandparent caregivers were aged 24-34 years, were Black Africans (69.8%), had secondary education (46.9%), reported health challenges (HC) (59.7%), with 26.4% reporting headaches in the last 30 days. Logistic regression revealed that grandparent caregivers aged 55-64 years were 8.9 times more likely to report health challenges compared to those aged 25-34 years. Non-Black African grandparent caregivers were found to be 0.61 times less likely to report health challenges, compared to Black African grandparent caregivers. Those with perceived poor health status were 3.3 times more likely to report health challenges, compared to those with excellent perceived health status. Therefore, there is an urgent need to redesign health interventions to address these health burdens among grandparent caregivers and to take cognisance of providing economic and social support for these vulnerable populations.

Impact of rotavirus vaccination on diarrheal hospitalizations in children younger than 5 years of age in a rural southern Mozambique

BACKGROUND

Rotavirus vaccine(Rotarix®) was introduced in Mozambique through its Expanded Program of Immunization in September 2015. We assessed the impact of rotavirus vaccination on childhood gastroenteritis-associated hospitalizations post-vaccine introduction in a high HIV prevalence rural setting of southern Mozambique.

METHODS

We reviewed and compared the trend of hospitalizations (prevalence) and incidence rates of acute gastroenteritis (AGE), and rotavirus associated-diarrhea (laboratory confirmed rotavirus) in pre- (January 2008-August 2015) and post-rotavirus vaccine introduction periods (September 2015-December 2020), among children <5 years of age admitted to Manhiça District Hospital.

RESULTS

From January 2008 to December 2020, rotavirus vaccination was found to contribute to the decline of the prevalence of AGE from 19% (95% CI: 18.14-20.44) prior to the vaccine introduction to 10% (95% CI: 8.89-11.48) in the post-introduction period, preventing 40% (95 % IE: 38-42) and 84% (95 % IE: 80-87) of the expected AGE and laboratory confirmed rotavirus cases, respectively, among infants. Similarly, the overall incidence of rotavirus was 11.8-fold lower in the post-vaccine introduction period (0.4/1000 child-years-at-risk [CYAR]; 95% CI: 0.3-0.6) compared with the pre-vaccination period (4.7/1000 CYAR; 95% CI: 4.2-5.1) with the highest reduction being observed among infants (16.8-fold lower from the 15.1/1000 CYAR in the pre-vaccine to 0.9/1000 CYAR in the post-vaccine eras).

CONCLUSIONS

We documented a significant reduction in all-cause diarrhea hospitalizations and rotavirus positivity after vaccine introduction demonstrating the beneficial impact of rotavirus vaccination in a highly vulnerable population.