A potential role of cockroaches in the transmission of pathogenic bacteria with antibiotic resistance: A scoping review.

INTRODUCTION: The role of cockroaches in the cause of disease or human infections is not immediately obvious. The present study aimed to review the currently available research on the potential role of cockroaches in the transmission of pathogenic bacteria and bacteria with antibiotic resistance. METHODOLOGY: A scoping review included the studies published for a period between January 2001 and December 2020. A search was performed through five databases, namely, PubMed, Sage, Springer, Sabinet, and Science Direct. A search strategy used was conducted according to the principles of Preferred Reporting Item for Systemic Reviews and Meta-Analyses (PRISMA). From 97 studies identified, 32 studies were included in the scoping review. RESULTS: The findings indicate that cockroaches may be a potential vector for a diverse range of pathogenic bacterial agents. Most bacterial agents isolated are antidrug-resistant and antibiotic-resistant which is considered the greatest threat to public health in the current period. CONCLUSIONS: Cockroach infestation should be considered as a serious concern, given the possible role of cockroaches as reservoirs of antibiotic-resistant bacteria. Further research is needed which can provide a comprehensive understanding of the role of cockroaches in transmitting human infections.

Risk factors for problematic alcohol use among male waste pickers and caddies in Johannesburg, South Africa: a cross-sectional study.

Informal workers may be prone to problematic substance use due to many factors, including adverse working conditions and low income. The aim of this secondary analysis was to investigate problematic alcohol use risk factors among male informal workers in Johannesburg, South Africa. Alcohol use among the two groups of informal workers in the analysis y golf caddies and waste pickers was measured using the World Health Organization (WHO) Alcohol Use Disorder Identification Test (AUDIT) tool. The WHO self-reporting questionnaire (SRQ) for common mental health disorders (CMD) was used to assess mental health. A multivariate logistic regression model was used to explore the predictors of problematic drinking in informal workers. The study consisted of 514 participants, of which 48.4% were golf caddies and 51.6%, waste pickers. Most participants were younger than 40 years (50.9%). Over half of the participants (54.7%) were alcohol consumers and 74.1% were smokers. Over 60% of the participants who were alcohol consumers had a probable drinking problem. Unstratified regression results showed that common mental distress (aOR = 1.06; 95%CI: 1.01-1.09), age: 30-40 years (aOR = 2.17; 95%CI: 1.18-3.97), smoking (aOR = 2.25; 95%CI: 1.34-3.79), and other water sources (aOR = 0.2; 95%CI: 0.04-0.99) were associated with a probable alcohol problem. Waste pickers (aOR = 0.33; 95%CI: 0.20-0.70) were less likely to be problematic drinkers compared to golf caddies. Problematic drinking in this study was common in both caddies and waste pickers along with smoking. Problematic alcohol use was associated with caddying, mental distress, age, and smoking. Measures such as providing counseling services to informal workers and improvement of working conditions may help change the behaviors of these vulnerable groups.

Ten-year risk of fatal cardiovascular disease and its association with metabolic risk factors among waste pickers in South Africa.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among non-communicable diseases in South Africa. Several metabolic risk factors contribute to the development of CVD. Informal workers such as waste pickers could be unhealthy lifestyle naive, and most public health research on CVD does not include this understudied population. This study estimated the 10-year risk of fatal CVD and its association with metabolic risk factors in an understudied study population of waste pickers in Johannesburg, South Africa. METHODS: A cross-sectional survey was conducted among waste pickers in two landfill sites in Johannesburg. We used the Systematic Coronary Risk Evaluation (SCORE) risk charts to estimate the 10-year risk of fatal CVD. We then employed ordinary least squares regression to assess the association between the 10-year risk of fatal CVD with metabolic risk factors. Other variables adjusted in the regression model were HIV status, education, income, injuries from work, clinic visits in the previous 12 months, and alcohol consumption. RESULTS: A total of 370 waste pickers were included in this analysis, 265 (73.41%) were males. The mean age of the participants was 34 years. The majority were between the age of 20 and 39 years. More than 55% of the waste pickers did not visit a clinic in the previous 12 months, and 68.57% were smoking. The 10-year survival probability from CVD was more than 99% for both males and females. In the multivariable regression model, elevated blood glucose showed a non-significant increase in the mean percentage of 10-year risk of fatal CVD. Waste pickers who were overweight/obese, and hypertensive had high statistically significant mean percentages of the 10-year risk of fatal CVD compared to those who did not have the metabolic risk factors. CONCLUSIONS: Prevention of 10-year risk of fatal CVD in this understudied population of waste pickers should target the control of obesity, hypertension, and diabetes. Health awareness and education for waste pickers will be an important step in reducing the burden of these metabolic risk factors. We further recommend that health systems should recognize waste pickers as a high-risk group and consider extensive CVDs surveillance.

Common Mental Health Disorders among Informal Waste Pickers in Johannesburg, South Africa 2018-A Cross-Sectional Study.

Waste-picking is an income-generating opportunity for individuals living in poverty. Waste picking is associated with a range of risk factors for common mental disorders (CMD). This study aimed to determine the prevalence and factors associated with CMD among waste pickers in Johannesburg. A cross-sectional study analyzed secondary data for 365 waste pickers. A validated Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. Multivariable logistic regression was fitted to identify factors associated with CMD. The overall prevalence of CMD among waste pickers was 37.3%. The odds of having CMD were 2.5 and 3.2 higher in females and cigarette smokers, respectively (p = 0.019 and p = 0.003). Life enjoyment (Adjusted odds ratio [aOR] 0.54, p = 0.02) and a good quality of life (aOR 0.34, p ≤ 0.001) were associated with lower odds of CMD. The high prevalence of CMD among waste pickers was significantly associated with cigarette smoking, being female, not enjoying life, and a poor quality of life. Mental health awareness of CMD will assist with the prevention, early detection, and comprehensive management of CMD among waste pickers.

Environmental Silica Dust Exposure and Pulmonary Tuberculosis in Johannesburg, South Africa.

BACKGROUND: Occupational crystalline silica dust exposure is associated with an elevated risk of pulmonary tuberculosis (PTB). However, there is less evidence for an association with environmental silica dust exposure. METHODS: A cross-sectional study of 310 participants was conducted in an exposed community living within 2 km of gold mine tailings and an unexposed population residing more than 10 km from the nearest gold mine tailing. Chest radiographs (n = 178) were read for PTB, past or current, by three readers. RESULTS: Past or current PTB was radiologically identified in 14.4% (95%CI 9.2-21.8) in the exposed and 7.5% (95%CI 2.8-18.7) in the unexposed groups. Multivariate logistic regression models suggested that PTB prevalence was independently associated with exposure to second-hand smoke (OR = 8.13, 95%CI 1.16-57.22), a lower body mass index (OR = 0.88, 95%CI 0.80-0.98), previous diagnosis and treatment of PTB (OR = 8.98, 95%CI 1.98-40.34), and exposure to dust in the workplace from sand, construction, and/or mining industries (OR = 10.2, 95%CI 2.10-50.11). CONCLUSION: We found no association between PTB and environmental exposure to gold mine tailing dust. However, workplace silica dust exposure is a significant risk factor for PTB in South Africa, and PTB patients of working age should be screened for silica exposure.

The significance of non-occupational asbestos exposure in women with mesothelioma.

Malignant mesothelioma is a rare and aggressive pleural or peritoneal tumour almost always caused by exposure to asbestos fibres. Exposure to asbestos can cause malignant mesothelioma 30-40 years after exposure. A description of sources of exposure is important for prevention and possible financial compensation. Three women with cases of histologically confirmed malignant mesothelioma diagnosed from non-occupational asbestos exposure are described. Patients were contacted for an interview to assess their exposure history to asbestos. All three cases had mixed exposure histories related to secondary, environmental contamination, and domestic exposure. This case series highlight how ubiquitous asbestos is in the environment and how diverse the exposures may be. It is anticipated that a significant number of cases of non-occupational mesothelioma will be seen in many countries for several decades given the extent of asbestos containing materials.

Tuberculosis Mortality by Occupation in South Africa, 2011⁻2015.

Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96⁻4.32), cleaners (MORadj = 3.44, 95% CI 2.91⁻4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88⁻4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83⁻4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65⁻4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.

Concentrations of arsenic and lead in residential garden soil from four Johannesburg neighborhoods.

The 2017 Lancet Commission on Pollution and Health identified soil as an important, daily route of public exposure to a variety of pollutants. Lead and arsenic are two potential soil contaminants associated with serious health effects including reductions in intelligence, behavioral effects and aggressive or violent behavior (lead), as well as skin changes, cancer of the skin, bladder, liver and lungs and developmental delays (arsenic). In this study soil samples were collected, using US EPA methods, from gardens in four Johannesburg neighborhoods, and analyzed for lead and arsenic content using a portable X-ray fluorescence spectrometer. The results showed widely varied concentrations of arsenic and lead in soil collected across the four neighborhoods. Concentrations of lead (range: 0.1-2141.0 mg/kg; mean: 241.7 mg/kg (SD 282.8); median 158.1 mg/kg) exceeding local and international reference levels were found in an inner city suburb, while raised arsenic concentrations (range: 0.1-65.3 mg/kg; mean: 18.3 mg/kg (SD 11.7); median: 19.1) were found in the gardens of a suburb located very close to a mine tailings facility. This study confirms the potential for high levels of exposure to toxic metals in residential gardens in an urban African setting. There is a pressing need for scaled up attention to the public health implications of exposure to soil pollution in developing countries.

Household Factors Associated with Self-Harm in Johannesburg, South African Urban-Poor Households.

INTRODUCTION: Low and middle income countries bear the majority burden of self-harm, yet there is a paucity of evidence detailing risk-factors for self-harm in these populations. This study aims to identify environmental, socio-economic and demographic household-level risk factors for self-harm in five impoverished urban communities in Johannesburg, South Africa. METHODS: Annual serial cross-sectional surveys were undertaken in five impoverished urban communities in Johannesburg for the Health, Environment and Development (HEAD) study. Logistic regression analysis using the HEAD study data (2006-2011) was conducted to identify household-level risk factors associated with self-harm (defined as a self-reported case of a fatal or non-fatal suicide attempt) within the household during the preceding year. Stepwise multivariate logistic regression analysis was employed to identify factors associated with self-harm. RESULTS: A total of 2 795 household interviews were conducted from 2006 to 2011. There was no significant trend in self-harm over time. Results from the final model showed that self-harm was significantly associated with households exposed to a violent crime during the past year (Adjusted Odds Ratio (AOR) 5.72; 95% CI 1.64-19.97); that have a member suffering from a chronic medical condition (AOR 8.95; 95% 2.39-33.56) and households exposed to indoor smoking (AOR 4.39; CI 95% 1.14-16.47). CONCLUSION: This study provides evidence on household risk factors of self-harm in settings of urban poverty and has highlighted the potential for a more cost-effective approach to identifying those at risk of self-harm based on household level factors.