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Publication Open Access Screening and Brief Interventions for Hazardous and Harmful Alcohol Use among University Students in South Africa: Results from a Randomized Controlled TrialSupa Pengpid; Peltzer, Karl; Hendry van der Heever; Skaal, Linda; Mahidol University. ASEAN Institute for Health DevelopmentThe aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI) for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6...- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardousPublication Open Access Mental health, childhood abuse and HIV sexual risk behaviour among university students in Ivory Coast(2013) Peltzer, Karl; Supa Pengpid; Issaka Tiembre; Mahidol University. ASEAN Institute for Health Developmentat the Félix Houphouët Boigny University of Cocody. The sample included 824 university students (50% men and 50% women), with a mean age of 23.7 years (SD = 2.7). Results: Of the 824 university students who completed the survey, 17.6% reported depression, 10... the association between mental health, childhood abuse and HIV sexual risk behaviour among a sample of university students in Ivory Coast. Methods: A cross-sectional survey was conducted with undergraduate students that were recruited randomly from classesPublication Open Access Screening and brief interventions for hazardous and harmful alcohol use among hospital outpatients in South Africa: results from a randomized controlled trial(2013) Supa Pengpid; Peltzer, Karl; Skaal, Linda; Hendry Van der Heever; Mahidol University. ASEAN Institute for Health Developmentof the large access to patient populations each year. With this in mind, the primary purpose of this randomized controlled trial is to provide screening for alcohol misuse and to test the effectiveness of brief interventions in reducing alcohol intake amongPublication Open Access Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa(2014) Ramlagan, Shandir; Peltzer, Karl; Nancy Phaswana-Mafuya; Mahidol University. ASEAN Institute for Health Development50 years or older in South Africa. The questionnaire included socio-demographic characteristics, health variables, and anthropometric measurements. Linear multivariate regression analysis was performed to assess the association of social factors..., health variables and grip strength. Results: The mean overall hand grip strength was 37.9 kgs for men (mean age 61.1 years, SD = 9.1) and 31.5 kgs for women (mean age 62.0 years, SD = 9.7). In multivariate analysis among men, greater height, not beingPublication Open Access Screening and concurrent brief intervention of conjoint hazardous or harmful alcohol and tobacco use in hospital out-patients in Thailand: a randomized controlled trial(2015) Supa Pengpid; Peltzer, Karl; Apa Puckpinyo; Somchai Viripiromgool; Kriengsak Thamma-aphiphol; Kawinarat Suthisukhon; Dussanee Dumee; Thiprada Kongtapan; Mahidol University. ASEAN Institute for Health DevelopmentBackground: The aim of this study was to conduct a cluster randomized control trial to assess the efficacy of screening and brief intervention (SBI) for conjoint alcohol and tobacco use among hospital out-patients. Method: In all 620 hospital out-patients who screened positive for both tobacco and alcohol moderate risk in four hospitals were randomized into 2 control and 1 intervention condition using the hospital as a unit of randomization (2 intervention and 2 control hospitals) to 405 patients in the two control groups (tobacco only intervention, n = 199, and alcohol only intervention, n = 206) and 215 in the intervention group. The intervention or control consisted of three counselling sessions. Results: Results of the interaction (Group × Time) effects using GEE indicated that there were statistically significant differences between the three study groups over the 6-month follow-up on the ASSIST tobacco score (Wald χ2 = 8.43, P = 0.004), and past week tobacco use abstinence (Wald χ2 = 7.34, P = 0.007). Although there were no significant interaction effects on the other outcomes (Alcohol ASSIST score, low alcohol risk score, past week tobacco abstinence or low alcohol risk score, and past week tobacco abstinence and low alcohol risk score), the scores in all of the six outcome measures showed consistent improvements. For past week tobacco abstinence the tobacco only intervention was more effective than the alcohol only intervention and the integrated alcohol and tobacco intervention. For the outcome of low alcohol risk, the alcohol only intervention and the integrated alcohol and tobacco intervention was more effective than the tobacco only or alcohol only intervention. Conclusions: The study found that for past week tobacco abstinence the tobacco only intervention was more effective than the alcohol only intervention and the polydrug use (alcohol and tobacco) integrated intervention.Publication Open Access Screening and brief interventions for hazardous and harmful alcohol use among patients with active tuberculosis attending primary public care clinics in South Africa: results from a cluster randomized controlled trial(2013) Peltzer, Karl; Naidoo, Pamela; Louw, Julia; Matseke, Gladys; Zuma, Khangelani; Mchunu, Gugu; Tutshana, Bomkazi; Mabaso, Musawenkosi; Mahidol University. ASEAN Institute for Health DevelopmentBackground In 2008 the World Health Organization (WHO) reported that South Africa had the highest tuberculosis (TB) incidence in the world. This high incidence rate is linked to a number of factors, including HIV co-infection and alcohol use disorders. The diagnosis and treatment package for TB and HIV co-infection is relatively well established in South Africa. However, because alcohol use disorders may present more insidiously, making it difficult to diagnose, those patients with active TB and misusing alcohol are not easily cured from TB. With this in mind, the primary purpose of this cluster randomized controlled trial was to provide screening for alcohol misuse and to test the effectiveness of brief interventions in reducing alcohol intake in those patients with active TB found to be misusing alcohol in primary public health care clinics in three districts in South Africa. Methods Within each of the three provinces targeted, one district with the highest TB burden was selected. Furthermore, 14 primary health care facilities with the highest TB caseload in each district were selected. In each district, 7 of the 14 (50%) clinics were randomly assigned to a control arm and another 7 of the 14 (50%) clinics assigned to intervention arm. At the clinic level systematic sampling was used to recruit newly diagnosed and retreatment TB patients. Those consenting were screened for alcohol misuse using the Alcohol Use Disorder Identification Test (AUDIT). Patients who screened positive for alcohol misuse over a 6-month period were given either a brief intervention based on the Information-Motivation-Behavioural Skills (IMB) Model or an alcohol use health education leaflet. Results Of the 4882 tuberculosis patients screened for alcohol and agreed to participate in the trial, 1196 (24.6%) tested positive for the AUDIT. Among the 853 (71%) patients who also attended the 6-month follow-up session, the frequency of positive screening results at baseline/follow-up were 100/21.2% for the AUDIT (P < 0.001) for the control group and 100/16.8% (P < 0.001) for the intervention group. The intervention effect on the AUDIT score was statistically not significant. The intervention effect was also not significant for hazardous or harmful drinkers and alcohol dependent drinkers (AUDIT: 7–40), alcohol dependent drinkers and heavy episodic drinking, while the control group effect was significant for hazardous drinkers (AUDIT: 7–19) (P = 0.035). Conclusion The results suggest that alcohol screening and the provision of a health education leaflet on sensible drinking performed at the beginning of anti-tuberculosis treatment in public primary care settings may be effective in reducing alcohol consumption.Publication Open Access Implementing comprehensive prevention of mother-to-child transmission and HIV prevention for South African couples: study protocol for a randomized controlled trial(2014) Jones, Deborah; Peltzer, Karl; Weiss, Stephen M; Sifunda, Sibusiso; Dwane, Ntabozuko; Ramlagan, Shandir; Cook, Ryan; Matseke, Gladys; Maduna, Vincent; Spence, Andrew; Mahidol University. ASEAN Institute for Health DevelopmentBackground: In rural South Africa, only two-thirds of HIV-positive pregnant women seeking antenatal care at community health centers took full advantage of ‘prevention of mother-to-child transmission’ (PMTCT) services in 2010. Studies generally support male involvement to promote PMTCT, but the nature and impact of that involvement is unclear and untested. Additionally, stigma, disclosure and intimate partner violence pose significant barriers to PMTCT uptake and retention in care, suggesting that male involvement may be ‘necessary, but not sufficient’ to reduce infant HIV incidence. This study expands on a successful United States President's Emergency Plan for AIDS Relief (PEPFAR)-supported PMTCT couples intervention pilot study conducted in the Mpumalanga province, targeting HIV-positive pregnant women and their partners, the primary objective being to determine whether male partner involvement plus a behavioral intervention will significantly reduce infant HIV incidence. Methods/design: The study follows a cluster randomized controlled design enrolling two cohorts of HIV-positive pregnant women recruited from 12 randomly assigned Community Health Centers (CHC) (six experimental, six control). The two cohorts will consist of women attending without their male partners (n = 720) and women attending with their male partners (n = 720 couples), in order to determine whether the influence of male participation itself, or combined with a behavioral PMTCT intervention, can significantly reduce infant HIV infection ante-, peri- and postnatally. Discussion: It is our intention to significantly increase PMTCT participation from current levels (69%) in the Mpumalanga province to between 90 and 95% through engaging women and couples in a controlled, six session ante- and postnatal risk-reducing and PMTCT promotion intervention addressing barriers to PMTCT (such as stigma, disclosure, intimate partner violence, communication, infant feeding practices and safer conception) that prevent women and men from utilizing treatment opportunities available to them and their infants. Based upon the encouraging preliminary results from our pilot study, successful CHC adoption of the program could have major public health policy implications for containing the epidemic among the most vulnerable populations in rural South Africa: HIV-positive pregnant women and their infants. Trial registration: ClinicalTrials.gov NCT02085356 (registration date: 10 March 2014).Publication Open Access Sexual HIV risk behaviour and associated factors among pregnant women in Mpumalanga, South Africa(2013) Peltzer, Karl; Mlambo, Gladys; Mahidol University. ASEAN Institute for Health Developmentamong pregnant women in Mpumalanga, South Africa. Methods: A cross-sectional study was conducted among 1 502 pregnant women (age range 18–47 years, mean age 26.6 years, standard deviation (SD) 6.1, and the mean gestational age was 6.5 months (SD 1