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Special Issue "Drivers of the Double Burden of Malnutrition and Related Disease Syndemic"

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 6 December 2023 | Viewed by 4994

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Special Issue Editors

Prof. Dr. Zandile June-Rose Mchiza

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Guest Editor

1. Non Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
2. School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
Interests: nutrition related disorders; obesity and the epidemiology of non-communicable diseases
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Prof. Dr. Perpetua Modjadji

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Guest Editor

Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
Interests: multimorbidity; health promotion; social determinants of health; chronic diseases management; food security
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Submissions are invited for the Special Issue on “Drivers of the Double Burden of Malnutrition and the Related Disease Syndemic” in the International Journal of Environmental Research and Public Health. For detailed information on the journal, I refer you to https://www.mdpi.com/journal/ijerph.

Numerous countries worldwide are now faced with the double burden of malnutrition, characterized by the coexistence of undernutrition along with overweight, obesity or diet-related noncommunicable diseases. These countries are experiencing a fast-evolving and more complex nutrition paradigm. Amidst several nutrition programmes, the double burden of malnutrition occurs throughout a life course at the individual, household, and population levels. The burden of undernutrition, especially persistent stunting, continues to exist, shifting progressively to overweight and obesity fuelled by nutrition transitions. The influence of economic and income growth, urbanization and globalization, a significant shift in the quality and quantity of human diets and nutrition-related epidemiology in the past few decades have something to tell. The double burden of malnutrition offers a focused point for multilevel, contextual and integrated intervention on all forms of malnutrition and the curbing of non-communicable diseases.

In 2008, non-communicable diseases overtook communicable diseases to become the world’s leading cause of mortality. Ever since, multiple burdens of disease, characterised by high rates of non-communicable diseases, such as cardiovascular diseases and diabetes, alongside infectious diseases such as HIV, AIDS and tuberculosis in the era of antiretroviral therapy, are becoming more visible, giving rise to a disease syndemic, especially within the context of persistent social and economic inequalities. This calls for expeditious investigations key to achieving the targets of the United Nations’ Sustainable Development Goals related to nutrition and wellbeing.

This Special Issue on “Drivers of the Double Burden of Malnutrition and the Related Disease Syndemic” welcomes papers with the intention to draw the attention of the government and stakeholders through rigorous interdisciplinary and epidemiologic methods in the following research areas: nutrition (i.e., eating habits, practices and patterns, undernutrition and overweight/obesity), non-communicable and communicable diseases, related-health services, community-based characteristics on disease rates, lifestyle factors including physical activity, tobacco, alcohol and other related factors, as well as research on relevant direct and integrated interventions.

Prof. Dr. Zandile June-Rose Mchiza
Prof. Dr. Perpetua Modjadji
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

undernutrition
overnutrition
overweight
obesity
double burden of malnutrition
underweight
stunting
nutrition syndemic
health syndemic
nutrient deficiencies
non-communicable diseases
food security
food insecurity
social determinants of health
health lifestyle
lifestyle diseases
physical activity
co-existence of communicable and non-communicable diseases
co-existence of infectious and non-infectious diseases

Published Papers (3 papers)

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Research

Open AccessArticle

Self-Management of Diabetes and Associated Factors among Patients Seeking Chronic Care in Tshwane, South Africa: A Facility-Based Study

Peter Modupi Mphekgwana

Andre Pascal Kengne

and

Zandile June-Rose Mchiza

Int. J. Environ. Res. Public Health 2023, 20(10), 5887; https://doi.org/10.3390/ijerph20105887 - 19 May 2023

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Abstract

The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients in Tshwane, South Africa. An adapted validated questionnaire was used to collect data on sociodemography, diabetes knowledge, and summaries of diabetes self-management activities measured in the previous seven days, and over the last eight weeks. Data were analysed using STATA 17. A final sample of 402 diabetes out-patients was obtained (mean age: 43 ± 12 years) and over half of them were living in poor households. The mean total diabetes self-management of score was 41.5 ± 8.2, with a range of 21 to 71. Almost two thirds of patients had average self-management of diabetes, and 55% had average diabetes knowledge. Twenty-two percent of patients had uncontrolled glucose, hypertension (24%) was the common comorbidity, and diabetic neuropathy (22%) was the most common complication. Sex [male: AOR = 0.55, 95% CI: 0.34–0.90], race [Coloured: AOR = 2.84, 95% CI: 1.69–4.77 and White: AOR = 3.84, 95% CI: 1.46–10.1], marital status [divorced: AOR = 3.41, 95% CI: 1.13–10.29], social support [average: AOR = 2.51, 95% CI: 1.05–6.00 and good: AOR = 4.49, 95% CI: 1.61–7.57], body mass index [obesity: AOR = 0.31, 95% CI: 0.10–0.95], diabetes knowledge [average: AOR = 0.58, 95% CI: 0.33–0.10 and good: AOR = 1.86, 95% CI: 0.71–4.91], and uncontrolled glucose [AOR = 2.97, 95% CI: 1.47–5.98] were factors independently predictive of diabetes self-management. This study emphasizes that the self-management of diabetes was mostly on average among patients and was associated with the aforementioned factors. Innovative approaches are perhaps needed to make diabetes education more effective. Face-to-face sessions delivered generally during clinic visits should be better tailored to the individual circumstances of diabetes patients. Considerations should be given to the options of leveraging information technology to ensure the continuity of diabetes education beyond clinic visits. Additional effort is also needed to meet the self-care needs of all patients. Full article

(This article belongs to the Special Issue Drivers of the Double Burden of Malnutrition and Related Disease Syndemic)

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Open AccessArticle

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

and

Int. J. Environ. Res. Public Health 2023, 20(10), 5799; https://doi.org/10.3390/ijerph20105799 - 12 May 2023

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Abstract

Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21–33%), hypertension (32–43%), diabetes (34–47%), and HIV (31–45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa. Full article

(This article belongs to the Special Issue Drivers of the Double Burden of Malnutrition and Related Disease Syndemic)

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Open AccessArticle

Meals on Wheels: Promoting Food and Nutrition Security among Older Persons in Cape Town, South Africa

Magnifique Nkurunziza

Zandile June-Rose Mchiza

and

Yanga Zembe

Int. J. Environ. Res. Public Health 2023, 20(3), 2561; https://doi.org/10.3390/ijerph20032561 - 31 Jan 2023

Viewed by 1810

Abstract

Food insecurity (FI) prevails in Sub-Saharan Africa. Yet, in South Africa, although many people, including the elderly, are vulnerable to FI, little is known about the experiences of older persons (OPs) with FI and the interventions thereof. In South Africa, Meals on Wheels Community Service (MOWCS) provides readymade home meal deliveries for OPs through 209 branches across the country. Therefore, this study investigated MOWCS’ role in the promotion of food security among the OPs at the Brooklyn branch, Cape Town. The study was grounded within the food security framework and focused on the availability, accessibility, utilization, and stability of food at Brooklyn MOWCS. Using qualitative research methods, 10 semi-structured interviews and one focus group discussion (N = 5) were conducted with Brooklyn MOWCS beneficiaries, in addition to three key personnel interviews conducted with staff. Data were analysed using Open Code 4.03. The findings showed Brooklyn MOWCS as a stable source of affordable and nutritious meals to OPs. The portion size satisfied hunger; occasionally, one portion sufficed for two meals. Respondents admitted the meal ingredients represented various food groups and rated them as “healthy”. However, some financial challenges hindered the extension of MOWCS services to the wider community. For instance, they only had three paid employees and were overcrowded within church premises. Findings also showed race and gender disparity among respondents; 90% were White and 10% were of Mixed Ancestry, with no Black or Asian OPs represented, and only 10% were male. These outcomes are typical of the current ethnic profile of the overall Brooklyn MOWCS beneficiaries in SA. This calls, therefore, for such interventions to be extended to all South African demographic groups as an initiative to alleviate food and nutrition insecurity among all OPs. Full article

(This article belongs to the Special Issue Drivers of the Double Burden of Malnutrition and Related Disease Syndemic)

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