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NON-COMMUNICABLE DISEASES

Current Projects

The Non-Communicable Diseases Research Unit (NCDRU) was formed in 2013 during the revitalization of the South African Medical Research Council. The unit was established by merging three existing units which were previously conducting research in different areas of non-communicable diseases (NCDs), and by attracting additional staff from other units affected by the revitalization process. The three units merged to form the NCDRU were: (1) The Chronic Diseases of Lifestyle Research Unit (CDL), (2) The Diabetes Discovery Platform (DDP), (3) The National Collaborative Research Programme on Cardiovascular and Metabolic Diseases (NCRP CV&MD)

Thematic Area 1: Cardiovascular and Metabolic Diseases

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Cardiometabolic Diseases Risk Evaluation and Reduction in African People Living with HIV Infection (CaDERAL)

Project details
Principal investigator: Prof André P. Kengne
PACT ID Nr: PACTR201811878799717
Grant Agreement Nr: TMA2017GSF-1962-CaDERAL-TMA201GSF

Background: Care of people with HIV across sub-Saharan Africa (SSA) is provided through dedicated parallel health streams, primarily designed to address HIV and related infectious co-morbidities. Consequently, the opportunity of addressing co-morbid non-communicable disease (NCD) is not fully realized in this population in regular contacts with the health system. Integration of HIV and NCD care has been suggested to improve the co-detection and co-management of co-morbid HIV and NCDs. Key to the success of this integration is a better understanding of the burden and drivers of NCDs in people with HIV, and appropriate strategies for promoting their care without compromising HIV specific care.  

Project description: The Cardiometabolic Diseases Risk Evaluation and Reduction in African People Living with HIV Infection (CaDERAL) aims to enhance the understanding of common cardiovascular and metabolic diseases (CMDs), and improve their co-detection and co-management in African people living with HIV infection, through a program of research and capacity development based on a network of institutions led by the South African Medical Research Council (SAMRC), and comprising the Nigerian Institute of Medical Research (NIMR) and the Clinical Research Education, Networking and Consultancy (CRENC, Cameroon). Clicking on the project will provide more detail on the projects being carried out in the three countries under the leadership of Prof Kengne.

  • Project 1: Characterise the cardiometabolic profile of adult HIV-infected individuals at their baseline enrolment in Cameroon, using data from the Cameroon arm of the ongoing International Epidemiologic Databases to Evaluate AIDS (IeDEA).
  • Project 2: Assess the incidence and remission of dyslipidemia and impaired kidney function in people with HIV on ART in Nigeria, using data from the NIMR HIV cohort.
  • Project 3: Conduct a clinical trial to test the effectiveness of sending weekly SMS-text message in improving health outcomes and supporting medication adherence in South African adults with co-morbid HIV and hypertension. This will be augmented with process evaluation and cost-effectiveness analysis.

Capacity Development: The three research projects support the training of a PhD student in each of the three countries and are reinforcing the research capacities of junior and senior researchers where appropriate. 

SAMRC Team Member: Dr Kim A Nguyen

Publications

  1. Nguyen KA, Peer N, Kengne AP. Associations of gamma-glutamyl transferase with cardio-metabolic diseases in people living with HIV infection in South Africa. PLoS One. 2021 Feb 5;16(2):e0246131. DOI: 10.1371/journal.pone.0246131
  2. Peer N, de Villiers A, Jonathan D, Kalombo C, Kengne AP. Care and management of a double burden of chronic diseases: Experiences of patients and perceptions of their healthcare providers. PLoS ONE. 2020 Jul 16;15: e0235710. DOI: 10.1371/journal.pone.0235710

Contact person: Prof André P. Kengne (andre.kengne@mrc.ac.za)

Funding: This project is part of the EDCTP2 programme supported by the European Union

EDCTP

The South African Diabetes Prevention Programme (SA-DPP)

PI: Prof André P. Kengne

Short summary: The overall purpose of this project to develop and evaluate a culturally relevant model of diabetes prevention programme for South Africa, using evidence from successful diabetes prevention effectiveness and implementation programmes. Our expectations are to arrive at a model that will inform lifestyle interventions to prevent diabetes and other lifestyles related conditions at primary health care level in South Africa and serves as a prototype for adaptation in other countries in the region that are confronted to similar challenges like South Africa.

Collaborators: Prof Brian Oldenburg (University of Melbourne, Australia), Tandi Matsha (Cape Peninsula University of Technology, South Africa), Prof Rajiv Erasmus (University of Stellenbosch, South Africa), Prof Naomi Levitt (University of Cape Town, South Africa), Prof Thandi Puoane (University of Western Cape, South Africa), Prof Julia Goedecke (South African Medical Research Council, South Africa), Prof Nasheeta Peer (South African Medical Research Council, South Africa), Prof Pamela Naidoo (Human Sciences Research Council, South Africa), Esme Jordaan (South African Medical Research Council, South Africa), Prof Sanni Yaya (University of Ottawa, Canada)

SAMRC Team Members: Dr Jillian Hill, Sr Deborah Jonathan, Dr Cindy George, Dr Paul van Jaarsveld, Prof Mieke Faber

Students: Dezlynn Jansen (MSc ongoing, CPUT), Samukelisiwe Madlala (PhD 2023, UWC), Tatum Lopes (PhD 2023, US), Chad Africa (MPH 2023, UCT), Anne-Marie Aurousseau (MSc 2020, University of Bordeaux), Camille Lavigne-Delville (MSc 2020, University of Bordeaux)

Funding: SAMRC Baseline Funding

Publications:

  1. Hill J, Peer N, Oldenburg B, Kengne AP. Roles, responsibilities, and characteristics of lay community health workers involved in diabetes prevention programmes: A systematic review. PloS One. 2017 Dec 7;12(12):e0189069. DOI: 10.1371/journal.pone.0189069
  2. Hill J, Delville CL, Auorousseau AM, Jonathan D, Peer N, Oldenburg B, Kengne AP. Development of a tool to increase physical activity among people at risk for diabetes in low-resourced communities in Cape Town. International Journal of Environmental Research and Public Health. 2020 Jan 30;17(3):865. DOI: 10.3390/ijerph17030865
  3. Hill J, Peer N, Jonathan D, Mayige M, Sobngwi E, Kengne AP. Findings from community-based screenings for type 2 diabetes mellitus in at risk communities in Cape Town, South Africa: a pilot study. International Journal of Environmental Research and Public Health. 2020 Apr 21;17(8):2876. DOI: 10.3390/ijerph17082876
  4. Madlala SS, Hill J, Kunneke E, Kengne AP, Peer N, Faber M.  Dietary Diversity and its Association with Nutritional Status, Cardiometabolic Risk Factors and Food Choices of Adults at Risk for Type 2 Diabetes Mellitus in Cape Town, South Africa. Nutrients 2022, 14, 3191. https://doi.org/10.3390/nu14153191
  5. George C, Hill J, Nqebelele U, Peer N, Kengne AP. Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study. BMJ Open. 2023;13(1):e068672.
  6. Hill J, Faber M, Peer N, George C, Oldenburg B, Kengne AP. Adapting and Developing A Diabetes Prevention Intervention Programme for South Africa: Curriculum and Tools. International Journal of Environmental Research and Public Health, 2023. 20(5): 4463. https://doi.org/10.3390/ijerph20054463 
  7. Hill J, Faber M, George C, Peer N, Mulabisano T, Mostert S, Sobngwi E, Kengne AP. The Development of Text Messages to Support People at Risk of Diabetes in Low-Resourced Communities: The South African Diabetes Prevention Programme. Nutrients, 2023. 15 (21):4692. https://doi.org/10.3390/nu15214692 
  8. Peer N, Kotzé-Hörstmann L, Hill J, Kengne AP. Differential management and associations of dyslipidaemia and hypertension by glycaemic status in urban South Africans. South African Medical Journal, 2024: 114(3): e1315. https://doi.org/10.7196/SAMJ.2024.v114i3.1315

Contact persons: Prof André P. Kengne (André.kengne@mrc.ac.za) and Dr Jillian Hill (jillian.hill@mrc.ac.za)

The Eastern Cape Diabetes Prevention Programme (EC-DPP)

PIs: Dr Jillian Hill and Dr Yandi Yako (Walter Sisulu University)

Short summary: The purpose of this project is to implement and evaluate the suitability, applicability and appropriateness of the SA-DPP developed and tailored in urban populations in the Western Cape Province, in peri-urban populations in the Eastern Cape Province of South Africa.

Collaborators: Prof André P Kengne (South African Medical Research Council, South Africa), Prof Constance Rusike (Walter Sisulu University, South Africa), Dr Simthandile Toni (Mthatha General Hospital, South Africa), Dr Hannibal Musarurwa (Walter Sisulu University, South Africa)

SAMRC Team Members: Dr Cindy George

Funding: Strategic Health Innovation Partnerships: Precision Medicine, Grants Innovation and Product Development, South African Medical Research Council

Contact person: Dr Jillian Hill (jillian.hill@mrc.ac.za)

Cardiometabolic Outcomes, Mechanisms and Approach to Prevention of Dolutegravir Associated Weight Gain in South Africa (DTG Study)

PIs: Prof André P. Kengne and Prof Jean Nachega (Pittsburgh University, United States; University of Stellenbosch, South Africa)

Short summary: Studies investigating weight gain associated with switching from an efavirenz- to a DTG-containing anti-retroviral (ART) regimen are lacking and thus critically needed to provide important and novel insights. Thus, this 12-month prospective cohort study, including African men and women living with HIV (PLWH), aims to evaluate weight change in those who switch to DTG-based ART and those remaining on non-DTG-based ART in Cape Town, South Africa.

Co-I’s:

Dr Jillian Hill (South African Medical Research Council, South Africa); Prof Julia Goedecke (South African Medical Research Council, South Africa); Dr Eric Decloedt (Stellenbosch University, South Africa); Dr Marije Van Schalkwyk (Stellenbosch University, South Africa)

Consultants: Dr Sudipa Sarkar (Johns Hopkins University School of Medicine, United States); Prof Gregory D. Kirk (Johns Hopkins University, United States); Prof Todd T. Brown (Johns Hopkins Bloomberg School of Public Health, United States); Prof John W. Mellors (University of Pittsburgh Medical Center, United States); Dr Donald H. Skinner (Human Sciences Research Council, South Africa); Dr Rhoderick N. Machekano (Stellenbosch University, South Africa)

Funding: National Institute of Health (NIH)/Forgarty

Contact person: Prof André P. Kengne (andre.kengne@mrc.ac.za)

Cape Town Vascular and Metabolic Health (VMH) Study

PIs: Prof André P. Kengne, Prof Tandi Matsha (Cape Peninsula University of Technology, South Africa), Prof Rajiv Erasmus (University of Stellenbosch, South Africa)

Short summary: The overall purpose of this programme of research is to establish a population-based cohort, backed up by adequate biorepository, in order to quantify and track the burden of cardio-metabolic diseases in mixed-ancestry South Africans in Cape Town, with a particular focus on the role of emerging risk factors for cardiometabolic diseases.

SAMRC Team Members: Dr Cindy George, Dr Dipuo Motshwari

Funding: South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package and strategic funds from the SAMRC received from the South African National Department of Health. 

Publications (NCDRU-led):

  1. George C, Matsha TE, Davids SFG, Hon GM, Chikte U, Erasmus RT, Kengne AP. Association between dental and periodontal conditions with chronic kidney disease: A cross-sectional analysis of urban South Africans. South African Dental Journal. 2022;77(01). doi: 10.17159/2519-0105/2022/v77no1a1.
  2. George C, Matsha TE, Korf M, Zemlin AE, Erasmus RT, Kengne AP. The agreement between fasting glucose and markers of chronic glycaemic exposure in individuals with and without chronic kidney disease: a cross-sectional study. BMC Nephrol. 2020;21(1):32.
  3. George C, Matsha TE, Davidson FE, Goedecke JH, Erasmus RT, Kengne AP. Chronic Kidney Disease Modifies The Relationship Between Body Fat Distribution and Blood Pressure: A Cross-Sectional Analysis. International journal of nephrology and renovascular disease. 2020;13:107-18.
  4. George C, Matsha TE, Erasmus RT, Kengne AP. Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a cross-sectional study. BMJ Open. 2018;8(11):e025694. 
  5. Motshwari DD, George C, Matshazi DM, Weale CJ, Davids SFG, Zemlin AE, Erasmus RT, Kengne AP, Matsha TE. Expression of whole blood miR-126-3p, -30a-5p, -1299, -182-5p and -30e-3p in chronic kidney disease in a South African community-based sample. Scientific reports. 2022;12(1):4107.
  6. Motshwari DD, George C, Matshazi DM, Weale CJ, Davids SFG, Erasmus RT, Kengne AP, Matsha TE. Novel Whole Blood MicroRNAs Predicting Chronic Kidney Disease in South Africans with Hypertension and Diabetes Mellitus. Applied Sciences. 2021;11(16):7674.

Contact person: Prof André P. Kengne (andre.kengne@mrc.ac.za)

Cardiovascular Risk in Black South Africans (CRIBSA) Study

PI: Prof Nasheeta Peer

Co-I: Prof André P Kengne

Short summary: This study, which previously examined the prevalence of cardiovascular disease (CVD) risk factors in the black population of Cape Town, now aims to determine the biochemical and genetic markers, genes and level of renal impairment associated with these CVD risk factors.

Collaboration: University of Cape Town, University of Witwatersrand, Stellenbosch University, Cape Peninsula University of Technology, South Africa

Funding: South African Medical Research Council (SAMRC): SAMRC Intramural Research Fund: SAMRC-RFA-IRF-02-2016

Publications:

Current study:

  1. Ngwa NE, Matsha T, Lombard C, Levitt N, Sobngwi E, Kengne AP, Peer N. Cardiometabolic profile and leukocyte telomere length in a Black South African Population. Scientific Reports, 2022. Published online Feb 28. https://doi.org/10.1038/s41598-022-07328-8
  2. Peer N, George J, Lombard C, Steyn K, Levitt N, Kengne AP. Associations of glycated albumin and fructosamine with glycaemic status in urban black South Africans. Clin Chim Acta. 2021 Aug; 519:291-297. doi: 10.1016/j.cca.2021.05.014.  Epub 2021 May 19.  
  3. Peer N, George J, Lombard C, Steyn K, Levitt N, Kengne AP. Prevalence, concordance and associations of chronic kidney disease by five estimators in South Africa. BMC Nephrology. 2020 Aug 13;21(1):372. DOI: 10.1186/s12882-020-02018-x

Main study:

  1. Peer N, Lombard C, Steyn K, Levitt N. A high burden of adverse life events and poor coping mechanisms experienced by urban-dwelling black South Africans. PLoS ONE. 2020 Sep 10;15(9):e0238320. DOI: 10.1371/journal. pone.023832
  2. Peer N, Lombard C, Steyn K, Levitt N. Elevated resting heart rate is associated with several cardiovascular disease risk factors in urban-dwelling black South Africans. Scientific Reports. 2020 Mar 12;10(1):4605.DOI: 10.1038/s41598-020-61502-4
  3. Peer N, Lombard C, Steyn K, Levitt N. Waist-to-height ratio is a useful indicator of cardio-metabolic risk in South Africa. Family Practice. 2020 Feb;37(1):36-42. Epub 2019 Aug 29. DOI: 10.1093/fampra/cmz044
  4. Goedecke JH, George C, Veras K, Peer N, Lombard C, Victor H, Steyn K, Levitt NS. Sex differences in insulin sensitivity and insulin response with increasing age in black South African men and women. Diabetes Research and Clinical Practice. 2016 Dec;122:207-214. Epub 2016 Nov 17. DOI: 10.1016/j.diabres.2016.11.005
  5. Steyn NP, Jaffer N, Nel J, Levitt N, Steyn K, Lombard C, Peer N. Dietary Intake of the Urban Black Population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) Study. Nutrients. 2016 May 13;8(5). pii: E285. DOI: 10.3390/nu8050285
  6. Peer N, Lombard C, Steyn K, Levitt N. Differential associations of cardiovascular disease risk factors with relative wealth in urban-dwelling South Africans. Journal of Public Health (Oxf). 2016;38(1):175-82. Epub 2015 Oct 31. DOI: 10.1093/pubmed/fdv152
  7. Peer N, Steyn K, Levitt N. Differential obesity indices identify the metabolic syndrome in Black men and women in Cape Town: the CRIBSA study. Journal of Public Health (Oxf). 2016;38(1):175-82. Epub 2015 Jan 24.
  8. Peer N, Lombard C, Steyn K, Levitt N. High prevalence of metabolic syndrome in the Black population of Cape Town: the Cardiovascular Risk in Black South Africans (CRIBSA) study. European Journal of Preventive Cardiology. 2015;22(8):1036-42. Epub 2014 Sep 10. DOI: 10.1177/2047487314549744
  9. Peer N, Lombard C, Steyn K, Gaziano T, Levitt N. Comparability of total cardiovascular disease risk estimates using laboratory and non-laboratory-based assessments in urban-dwelling South Africans: the CRIBSA study. South African Medical Journal. 2014 Aug 13; 104(10):691-6. DOI: 10.7196/samj.8125.
  10. Peer N, Lombard C, Steyn K, Gwebushe N, Levitt N. Differing Patterns of Overweight and Obesity among Black Men and Women in Cape Town: The CRIBSA Study. PloS One. 2014 Sep 15;9(9):e107471. DOI: 10.1371/journal.pone.0107471.
  11. Peer N, Lombard C, Steyn K, Levitt N. Differential Patterns of Tobacco Use in Black Men and Women in Cape Town: The Cardiovascular Risk in Black South Africans Study. Nicotine & Tobacco Research. 2014 Apr 1;16(8):1104-11DOI: 10.1093/ntr/ntu042.
  12. Peer N, Lombard C, Steyn K, Levitt N. Rising alcohol consumption and a high prevalence of problem drinking in black men and women in Cape Town: the CRIBSA study. Journal of Epidemiology and Community Health. 2014 May 1;68(5):446-52. Epub 2014 Jan 8.DOI: 10.1136/jech-2013-202985
  13. Peer N, Steyn K, Lombard C, Gwebushe N, Levitt N. A High Burden of Hypertension in the Urban Black Population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) Study. PloS One. 2013 Nov 8; 8(11):e78567.DOI: 10.1371/journal.pone.0078567
  14. N, Steyn K, Lombard C, Gaziano T, Levitt N. Alarming rise in prevalence of atherogenic dyslipidaemia in the black population of Cape Town: the Cardiovascular Risk in Black South Africans (CRIBSA) study. European Journal of Preventive Cardiology. 2014 Dec;21(12):1549-56. Epub 2013 Jul 23. DOI: 10.1177/2047487313497865
  15. Peer N, Steyn K, Lombard C, Lambert EV, Vythilingum B, and Levitt NS. Rising Diabetes Prevalence among Urban-dwelling Black South Africans. PLoS One. 2012 Sep 4; 7(9): e43336.DOI: 10.1371/journal.pone.0043336.

Contact person: Prof Nasheeta Peer (Nasheeta.peer@mrc.ac.za)  

Comorbidities of childhood obesity at tertiary hospitals in Kwazulu-Natal, South-Africa: 1995 TO 2016

PI: Prof Nasheeta Peer

Co-I: Prof André P Kengne

Short summary: 1) To determine the number of obese children <12 years old who were assessed between January 1995 and December 2016 at King Edward Hospital and Inkosi Albert Luthuli Central Hospital in KwaZulu-Natal, and describe their obesity-related comorbidities, and 2) To determine any changes in body mass index and comorbidities at 1, 2 and 5 years post-initial presentation.

Collaboration: Inkosi Albert Luthuli Central Hospital

Contact person: Prof Nasheeta Peer (Nasheeta.peer@mrc.ac.za)

Exploring the status of non-communicable disease care during the COVID-19 Pandemic in 13 Countries

PI: Prof Nasheeta Peer

Co-Is: Prof André P. Kengne and Dr Anniza de Villiers (South African Medical Research Council, South Africa).

Short summary: The study relates to care for non-communicable diseases (NCD) during the COVID-19 pandemic. This is a multi-country study being conducted across 5 continents with the overall purpose of addressing the needs of key stakeholders (public health officials, health policy makers, health workers, and patients with NCDs) who are managing and/or informing on decisions to enable appropriate management of NCD care during the COVID-19 pandemic. The key stakeholders complete a questionnaire at a time of their choosing either electronically or through telephonic interview with the SAMRC Scientist, aiming to investigate their perceptions on their needs and expectations of NCD care during the COVID-19 pandemic and to determine health system preparedness for NCD care in pandemics in a multi-country study which includes South Africa.

Collaborators: University of Geneva, Switzerland and London School of Hygiene and Tropical Medicine, United Kingdom.

Funding: SAMRC NCDRU baseline funding.

Contact person/s: Ms. Tshephang Mashiane (Tshephang.Mashiane@mrc.ac.za) or Professor Nasheeta Peer (Nasheeta.peer@mrc.ac.za)

Evaluating Smoking Cessation Approaches Among South Africans with HIV/AIDS: A Pilot Randomised Control Trial

PIs: Prof Nasheeta Peer and Dr Omar El-Shahawy (New York University Grossman School of Medicine)

Co-Is: Prof Andre-Pascal Kengne, Dr Jillian Hill, Dr Yusentha Balakrishna (SAMRC); Prof Scott Sherman, Dr Charles Cleland, Prof Emmanuel Peprah (New York University Grossman School of Medicine)

Project Manager: Dr Kamogelo Senyatsi

Short summary: Combustible cigarettes (CC) have profound health implications among people living with HIV/AIDS (PLWHA). There is an urgent need for novel feasible and efficacious strategies for CC cessation among PLWHA in general, and in South Africa in particular. This study aims to: 1) Adapt an existing telehealth intervention for reducing CC use in the South African context, and 2) Determine the feasibility and acceptability of the adapted intervention (primary outcomes) and estimate and compare the preliminary effects of E-cigarettes (EC) and nicotine replacement therapy (NRT) on CC reduction (secondary outcomes) using a pilot randomized controlled trial design. By addressing the unmet need for feasible and efficacious strategies for reducing CC use among PLWHA in South Africa, this study has the potential to significantly improve the health and long-term survival of PLWHA CC smokers.

Funding: National Institutes of Health, FOGARTY INTERNATIONAL CENTER: Grant number: 1R21TW012365-01

Contact person/s: Dr Kamogelo Senyatsi (Kamogelo.Senyatsi@mrc.ac.za) or Prof Nasheeta Peer (Nasheeta.peer@mrc.ac.za)

Exploring a Syndemic Approach to Understanding the Bi-Directional Link Between Type 2 Diabetes Mellitus and Depression, and Implications for the Integrated Care Process in South Africa and India: Comorbid Diabetes and Depression (CODAD) Study

PIs: Prof Nasheeta Peer and Dr Mercian Daniel (The George Institute – TGI)

Co-Is: Dr William Yang Zhao, Ms Sudha Kallakuri and Prof Rohina Joshi (The George Institute)

Short summary: The aim of this study is to explore the bi-directional associations and influences (such as socioeconomic, cultural, psychosocial factors, coexistent multi-morbidities, etc.) of diabetes and depression that contribute to care, the integration of care, and outcomes of diabetes and depression. This will be achieved by exploring 1) shared meanings of the disease process among people living with both diabetes and depression, 2) the association of depression with glycaemic control in people with diabetes and 3) the association of diabetes with depression treatment outcomes. This research will add to the evidence on screening for and management of depression in people with diabetes in the context of improving diabetes care in South Africa and Africa as well as in India and may likely contribute to diabetes policy and practice.

Funding: South African Medical Research Council (SAMRC) via the SAMRC-TGI Collaboration

Contact person: Prof Nasheeta Peer (Nasheeta.peer@mrc.ac.za)

Thematic area 2: Kidney Diseases research

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The Chronic Kidney Disease in Africa Consortium: CKD-Africa Collaboration

PI: Dr Cindy George

Co-Is: Prof André P. Kengne (South African Medical Research Council, South Africa), Prof Ikechi Okpechi (University of Alberta, Canada), Prof Mark Woodward (Imperial College, United Kingdom)

Short summary: Chronic kidney disease (CKD) is a global public health problem, affecting individuals from low- income and- middle- income countries (LMICs) disproportionately, especially in sub-Saharan Africa. Despite the growing evidence pointing to an increasing prevalence of CKD across Africa, there has not been an Africa-wide concerted effort to provide reliable estimates that could adequately inform health services planning and policy development to address the consequences of CKD. Therefore, we established the CKD in Africa (CKD- Africa) Collaboration. The CKD-Africa Collaboration is an African network of CKD studies that pools individual participant data to: (1) determine the burden of CKD in Africa more accurately, (2) create resources that would allow the burden of CKD to be easily tracked and (3) enable CKD projections to be made in the context of Africa. To date, the network has curated data from 46 studies conducted in 13 African countries, totalling 47 949 participants, of which most are from sub-Saharan Africa. We are, however, continuously seeking further collaborations with other groups who have suitable data to grow the network.

Collaboration: Africa, Europe, and USA

Students: Suzaan Stoker (MSc 2020, University of Stellenbosch)

Funding: Establishment of the consortium: National Research Foundation (NRF) Thuthuka instrument; SAMRC/TGI seed funding

Media/News: https://www.samrc.ac.za/news/samrc-led-consortium-tackle-chronic-kidney-disease-africa

Website: https://ckd-africa.samrc.ac.za/

Publications:

  1. George C, Stoker S, Okpechi I, Woodward M, Kengne AP. The Chronic Kidney Disease in Africa (CKD-Africa) collaboration: lessons from a new pan-African network. BMJ Global Health. 2021;6(8):e006454. doi: 10.1136/bmjgh-2021-006454.

Contact person: Dr Cindy George (cindy.george@mrc.ac.za)

Leveraging Interventions Implemented for Other Non-Communicable Diseases to Improve Screening and Prevention for Chronic Kidney Disease

PI: Dr Cindy George

Short summary: In the early stages of chronic kidney disease (CKD), the disease presents with no or non-specific symptoms and consequently, CKD is commonly diagnosed opportunistically from screening tests for other diseases, or when the disease has progressed, causing symptoms to appear. Screening for CKD is important to detect the presence of disease early, as early diagnosis and initiation of preventive therapies can slow the rate of kidney function loss and reduce morbidity and mortality. Although the concept of “to screen or not to screen for CKD at community level” remains controversial, it is an accepted practice to screen people at-risk (hypertension and diabetes) at community level. For the current study, we will use existing studies (SA-DPP and EC-DPP) as pilot programmes to test our hypotheses. We hypothesis that a great proportion of people with early-stage CKD can be identified by using an opportunistic approach of including biomarkers of kidney function into the plethora of biomarkers already collected in an existing diabetes prevention programme. Further, we hypothesis that early awareness and the initiation of the intervention programme could slow the rate of kidney function loss, over a one-year period. The outcome of this study will provide evidence to support (or not) the inclusion of CKD risk screening in already implemented screening programmes. Furthermore, by using the specimens in the SA-DPP and EC-DPP biobank, we aim to assess the diagnostic and/or prognostic utility of novel biomarkers of CKD with a focus on serum cystatin C-based estimators of kidney function and microRNAs previously shown to be associated with CKD risk. We will therefore validate the utility of these previously identified miRNAs in African populations.

Collaborators: Prof André P. Kengne (South African Medical Research Council, South Africa), Prof Tandi Matsha (Cape Peninsula University of Technology, South Africa), Prof Glenda Davison (Cape Peninsula University of Technology, South Africa)

Funding: NRF - Support for Y-rated Researchers

SAMRC Team Members: Dr Dipuo Motshwari

Contact person: Dr Cindy George (cindy.george@mrc.ac.za)

Thematic area 3: Social and developmental origins and consequences of Cardio-metabolic disorders: focus on the Environment & Lifecourse malnutrition

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Food-SAMSA - Food environment that Promote NCDs in Africa: Addressing malnutrition using a syndemics approach

PI: Prof Zandile J Mchiza

Co-PIs: Dr Jillian Hill (South African Medical Research Council, South Africa), Prof Peter von Philipsborn (Ludwig-Maximilians-Universität München, Germany), Prof Eva Rehfuess (Ludwig-Maximilians-Universität München, Germany), Prof Peter Delobelle (University of the Western Cape, South Africa), Dr Martina Lembani (University of the Western Cape, South Africa), Prof Vicki Lambert (University of Cape Town, South Africa), Dr Olufunke Alaba (University of Cape Town, South Africa)

Short Summary: This project aims to investigate the role of food environment in promoting the development of non-communicable diseases (NCDs) in Africa. The focus is on measuring malnutrition in all its forms, including over- and undernutrition, and also assessing its determinants and also exploring interventions to curb malnutrition at the macro (policy), the meso (community) and the micro (interpersonal) level.

Collaboration: Ludwig-Maximilians-Universität München (LMU Munich), Germany, University of the Western Cape’s School of Public Health (SOPH) and University of Cape Town’s CDIA and HPALS

Students: Ms Carmen Klinger (LMU), Annalie Wentzel (SAMRC), Hlolisiso Nonkeneza (UCT), Ms Nicole Holliday (LMU)

Funding: German Federal Ministry for Food and Agriculture (BMEL)

Contact persons: Prof Zandile Mchiza (zandile.mchiza@mrc.ac.za) and Dr Jillian Hill (jillian.hill@mrc.ac.za)

Street Food Project: Cardio metabolic profile and concomitant blood omega-3 fatty acid, carotenoid and vitamin E statuses of taxi drivers in the Cape Town Metropole area

PI: Prof Zandile J Mchiza

Co-PI: Prof Maretha Opperman (Cape Peninsula University of Technology, South Africa)

Short Summary: This project is aimed at assessing the dietary intake, metabolic syndrome and its risk factors, as well as blood levels of omega-3 FA, carotenoids and vitamin E among taxi drivers who operate in the Cape Town Metropole area.

Collaboration: Cape Peninsula University of Technology (CPUT) and Human Sciences Research Council (HSRC)

Students: Mr Derrick Sekgala (PhD, UWC), Ms Buhle Mpahleni (MSc, CPUT)

Funding: National Research Foundation, CPUT and SAMRC

Publications:

  1. Steyn NP, Mchiza Z, Hill J, Davids YD, Venter I, Hinrichsen E, Opperman M, Rumbelow J, Jacobs P. Nutritional contribution of street foods to the diet of people in developing countries: a systematic review. Public Health Nutrition. 2014;17(6):1363-74. Epub 2013 May 17.
  2. Hill J, Mchiza Z, Fourie J, Puoane T, Steyn N. Consumption patterns of street food consumers in Cape Town. Journal of Family Ecology and Consumer Sciences. 2016 Jan 01 (Special edition):  25-35
  3. Hill J, Mchiza Z, Puoane T, Steyn NP. Food sold by street-food vendors in Cape Town and surrounding areas: a focus on food and nutrition knowledge as well as practices related to food preparation of street-food vendors. Journal of Hunger & Environmental Nutrition. 2018 Feb 15:1-15. DOI: 10.1080/19320248.2018.1434104
  4. Hill J, Mchiza Z, Puaone T, Steyn N. The development of an evidenced based street-food vending model for vulnerable groups within Cape Town, South Africa. South African Journal of Clinical Nutrition. 2018 Sep 30;31(3 (Suppl 1)): S11.
  5. Hill J, Mchiza Z, Puoane T, Steyn N. The development of an evidence-based street food vending model within a socioecological framework: a guide for African countries. PLoS ONE. 2019 Oct 22;14(10):e0223535.DOI: 10.1371/journal.pone.0223535
  6. Sekgala MD, Opperman M, Mpahleni B and Mchiza ZJ-R (2022) Anthropometric indices and cut-off points for screening of metabolic syndrome among South African taxi drivers. Front. Nutr. 9:974749doi: 10.3389/fnut.2022.974749 

Contact person: Prof Zandile Mchiza (zandile.mchiza@mrc.ac.za)

Tracking food and beverage advertising in South Africa

PI: Prof Zandile J Mchiza

Co-PI’s: Prof Nelia Steyn (University of Cape Town, South Africa), Prof Norman Temple (Athabasca University, Canada), Dr Whadi-ah Parker (Human Sciences Research Council, South Africa), Dr Zulfa Abrahams (University of Cape Town, South Africa), Dr Jeroen De Man (University of Antwerp, Belgium), Dr Sunday Onagbye (University of the Western Cape, South Africa)

Short Summary: This project is aimed at compiling the audits of food and beverage advertising in South Africa: investigating food advertising in popular print Media and Television Broadcasting Channels  

Collaboration: UWC, UCT, HSRC and Athabasca University

Student: Daniel Awusi Yamoah (MPH, UWC) 

Funding: Athabasca University

Publications:

  1. Mchiza ZJ, Temple NJ, Steyn NP, Abrahams Z, Clayford M. Content analysis of television food advertisements aimed at adults and children in South Africa. Public Health Nutrition, 2013, 16(12): 2213-2220. Epub 2013 Aug 7. DOI: 10.1017/S136898001300205X

Contact person: Prof Zandile Mchiza (zandile.mchiza@mrc.ac.za)

Impact of the COVID-19 pandemic on Health

PI: Prof Zandile J Mchiza

Co-PIs: Prof Charlotte De Backer (University of Antwerp, Belgium), Dr Yandisa Ngqangashe (Australian National University, Australia), Dr Sunday Onagbye (University of the Western Cape, South Africa)

Short Summary: This project aims at investigating the role played by current global COVID-19 pandemic on shopping, cooking, food consumption, mental health and physical activity of individuals occurring globally. It also explores complementary and conventional interventions that could prove beneficial in ameliorating some of the respiratory difficulties associated with COVID-19 infections amidst the scarcity of vaccines and specific drugs to prevent and treat this disease, especially in countries in sub-Saharan Africa.

Collaboration: University of Antwerp, and Katholieke Universiteit (KU) Leuven Co-Investigators, University of Auckland, University of the Western Cape SOPH and Sport, Recreation and Exercise Science & 38 international countries

Funding: University of Antwerp

Website: https://soph.uwc.ac.za/project-item/covid19-corona-cooking/

Contact person: Prof Zandile Mchiza (zandile.mchiza@mrc.ac.za)

Body size, Mental health, and Inequalities (BMI): a life course approach

PI: Prof Zandile J Mchiza

Co-PIs: Prof Ilona Koupil (Stockholm University, Sweden), Dr Whadi-ah Parker (Human Sciences Research Council, South Africa), Ms Amy Heshmati (Stockholm University, Sweden), Dr Daniel Falkstedt (Karolinska Institut, Sweden), Prof Demetre Labadarios (Human Sciences Research Council, South Africa), Dr Sunday Onagbye (University of the Western Cape, South Africa), Dr Anton Lager (Stockholm University, Sweden), Prof Christina Dalman (Karolinska Institute, Sweden), Prof Gita Mishra (University of Queensland, Australia), Prof Anna Goodman (London School of Hygiene and Tropical Medicine, England)

Short Summary: This project aims to use complementary existing sources of information from surveys, cohort studies and register data linkages to measure the burden of overweight and obesity and its strong social patterning in South Africa and Sweden. It also applies modern methods from life course epidemiology to investigate and address the social and developmental origins and consequences of overweight and obesity, negative body image, disordered eating and related psychological problems across the life course and across generations.

Collaboration: Stockholm University and Karolinska Institut, Sweden and HSRC

Students: Zakir Hossin (Stockholm University), Menghan Gao (Stockholm University)

Funding: SAMRC/FORTE Swedish Council for Health

Publications:

  1. Mchiza ZJ, Parker WA, Hossin MZ, Heshmati A, Labadarios D, Falkstedt D, Koupil I. Social and psychological predictors of body mass index among South Africans 15 years and older: SANHANES-1. International Journal of Environmental Research and Public health. 2019 Oct 15;16(20):3919. DOI: 10.3390/ijerph16203919
  2. Mchiza ZJ, Parker WA, Sewpaul R, Onagbiye SO, Labadarios D. Body image and the double burden of nutrition among South Africans from diverse sociodemographic backgrounds: SANHANES-1. International Journal of Environmental Research and Public Health. 2020 Jan 31;17(3):887. DOI: 10.3390/ijerph17030887

Contact person: Prof Zandile Mchiza (zandile.mchiza@mrc.ac.za)

Links:

  1. https://www.facebook.com/BMILifecourse/
  2. https://soph.uwc.ac.za/project-item/body-size-mental-health-and-inequality-a-life-course-approach
  3. https://sasuf2020.sched.com/event/fQLU/m3-body-size-mental-health-and-inequalities-new-partnerships-for-research-and-education-in-life-course-and-health-equity-studies
MM-EE - multi-media entertainment-education project

PI: Prof Zandile J Mchiza

Co-PIs: Prof Charlotte De Backer (University of Antwerp, Belgium), Dr Yandisa Ngqangashe (Australian National University, Australia), Prof Heidi Vandebosch (University of Antwerp, Belgium), Prof Christophe Matthys (Katholieke Universiteit Leuven, Belgium)

Short Summary: This project aims to develop and validate a multi-media education-entertainment (MM-EE) program to improve food and nutrition literacy, as well as body image of South African community health workers (CHWs) who operate in 3 townships (Gugulethu, Nyanga and Kensington).

Collaboration: University of Antwerp, and Katholieke Universiteit (KU) Leuven Co-Investigators & Ludwig-Maximilians-Universität München (LMU Munich), Germany, University of the Western Cape’s (UWC) SOPH, South Africa & University of Cape Town’s CDIA & HPALS, South Africa

Students: Ms Asiphe Ketelo (MPH, UWC)

Funding: VLIR-UOS (Belgium, Flanders)

Contact person: Prof Zandile Mchiza (zandile.mchiza@mrc.ac.za)

Growth patterns and societal cultural beliefs and practices in Dikgale, Limpopo Province: A mixed method study of primary school children and their mothers 

PI: Prof Perpetua Modjadji 

Co-PI: Prof Sphiwe Madiba (University of Limpopo, South Africa) 

Short summary: Considering that malnutrition is one of the major problems in South Africa, a country with vast cultural and societal diversity, this project determined the nutritional status and growth patterns of primary school children and maternal factors influencing those growth patterns and explored the influence of cultural beliefs and practices of mothers on the nutrition and growth of the children in Dikgale. A child-mother pair study was conducted using convergent (concurrent) mixed-methods design. The project suggested (1) a need to address the dual problems of undernutrition and rapidly rising trends of overweight/obesity, (2) evidence-based and feasible nutrition program for school children, especially those in rural schools, (3) evidence-based strategies that focus on strengthening the social aspects, while addressing overweight and obesity among mothers of primary school children, and (4) timing of nutritional interventions for children and context-specific health promotion and health education programs to improve the knowledge of mothers on child growth.   

Funding: Research Development Grant, Sefako Makgatho Health Sciences University (SMU), South Africa 

Contact person/s: Prof Perpetua Modjadji (Perpetua.modjadji@mrc.ac.za) or Prof Sphiwe Madiba (Sphiwe.madiba@ul.ac.za)

The impact of Nyaope use on the nutritional status and inflammatory markers of adolescent boys in the Townships of South Africa: A National Study 

PI: Prof Perpetua Modjadji 

Co-PI: Prof Kebogile Elizabeth Mokwena (National Research Foundation (NRF) Research Chair: Substance Abuse & Population Mental Health, Sefako Makgatho Health Sciences University (SMU), South Africa). 

Short summary: This project aims to determine the nutritional status and inflammatory markers, and their association with nyaope use among male adolescents in the townships in South Africa. Nyaope is an easily accessible highly addictive drug common in the streets of South Africa, and the primary active ingredient is low-grade heroin. The novelty of this project lies in the strength to generate a baseline information on the nutritional status and inflammatory markers, and their relationship with nyaope among male adolescents in the townships of South Africa. 

Funding: South African Medical Research Council, RCDI 

Contact person/s: Prof Perpetua Modjadji (Perpetua.modjadji@mrc.ac.za) or Prof Kebogile Mokwena (kebogile.mokwena@smu.ac.za) 

The impact of COVID-19 on household food security, nutritional status and socioeconomic status in rural Limpopo Province, South Africa 

PI: Prof Perpetua Modjadji 

Co-PI: Prof Eric Maimela (University of Limpopo (UL), South Africa) 

Short summary: This project aims to assess the impact of Covid-19 on the food security, nutritional status and the socioeconomic status of households in the population of rural DIMAMO Population Health Research Centre (DIMAMO PHRC) in Limpopo province. The restriction of lockdown has affected the income of most of the residents in DIMAMO PHRC due to closure of small businesses and loss of domestic and retail jobs. In addition, closure of schools has also affected supply of nutritious meals to school children through School Feeding Schemes, ultimately compromising optimal feeding for children living in households with low food availability. The already existing poor socio-economic status in this area might have been intensified in the Covid-19 era, suggestive of aggravated food security and nutritional status.   

Funding: SEED Funding, Sefako Makgatho Health Sciences University (SMU), South Africa 

Collaboration: University of Limpopo (UL), South Africa 

Contact person/s: Prof Perpetua Modjadji (Perpetua.modjadji@mrc.ac.za) or Prof Eric Maimela (Eric.maimela@ul.ac.za)