To describe the incidence and transmission of SARS-CoV-2 infections in South African professional rugby union players in different phases of return-to-competition during a pandemic.
Prospective ...cohort study.
Players reported their history of SARS-CoV-2 infection before / during a national competition, using an online questionnaire (physician verified). Three periods of return to training/competition after a nation-wide complete lockdown during a pandemic were studied: 1) non-contact training, 2) contact training, 3) competition. The total period was 184 days (20/07/2020–20/01/2021) including 45 matches. Outcomes were: 1) incidence of SARS-CoV-2 infection (I: per 1000 player days; 95%CI) in each period (calculated using a Poisson distribution), 2) player symptoms, 3) median days to return-to-training following SARS-CoV-2 infection, 4) method of transmission, and 5) percentage matches cancelled due to SARS-CoV-2 infections.
185 players had 42 physician verified positive SARS-CoV-2 infections (I = 1.23; 95%CI: 0.86–1.61). Incidences during the three periods were: non-contact training = 0, contact training (I = 1.04; 0.36–1.71; mostly forwards), and competition (I = 1.54; 1.00–2.10). 83 % of the infected players were symptomatic and 52 % of the 42 positive players had systemic symptoms. Median return-to-training was 14 days. 22 (52 %) SARS-CoV-2 infections were rugby-related: 13 off-field (31 %), 9 on-field (21 %). 11 % of matches were cancelled due to SARS-CoV-2 infections.
As contact in rugby was introduced back into the game following lockdowns there was an increasing incidence of SARS-CoV-2 infection. On-field rugby activities were responsible for 21 % of SARS-CoV-2 infections and 11 % of matches had to be cancelled, indicating the need for risk mitigation strategies.
To describe the epidemiology of sports injury at the Pyeongchang 2018 Paralympic Winter Games.
567 athletes from 49 countries were monitored daily for 12 days over the Pyeongchang 2018 Paralympic ...Winter Games (6804 athlete days). Injury data were obtained daily from teams with their own medical support (41 teams and 557 athletes) and teams without their own medical support (8 teams and 10 athletes) through two electronic data capturing systems.
112 of 567 athletes (19.8%) reported a total of 142 injuries, with an injury incidence rate (IR) of 20.9 per 1000 athlete days (95% CI 17.4 to 25.0). The highest IR was reported for para snowboard (IR of 40.5 per 1000 athlete days 95% CI 28.5 to 57.5; p<0.02), particularly in the lower limb and head/face/neck anatomical areas. Across all sports at the Games, acute traumatic injuries (IR of 16.2 per 1000 athlete days 95% CI 13.2 to 19.8) and injuries to the shoulder/arm/elbow complex (IR of 5.7 per 1000 athlete days 95% CI 4.2 to 7.8) were most common. However, most injuries (78.9%) did not require time loss.
The new Paralympic Winter Games sport of Para snowboard requires attention to implement actions that will reduce injury risk. The shoulder was the most injured single joint-a consistent finding in elite para sport.
One of the biggest threats to early childhood development in Africa is poor maternal mental health. The present study reports on the relationships between clinical diagnoses of persistent maternal ...mental health disorders (at 3- and/or 6- and 18-month post-term age) and toddler neurodevelopment at 18 months of age. Eighty-three mother-toddler dyads from low socio-economic status settings in Cape Town, South Africa, were included. At the 3-, 6- and 18-month postnatal visits, clinician-administered structured diagnostic assessments were carried out according to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria. Toddler neurodevelopment at 18 months corrected age was assessed with the Bayley Scales of Infant and Toddler Development (BSID-III). No significant differences (
> 0.05) were found between toddlers with exposure to persistent mood or psychotic disorders in the different BSID-III domains compared to toddlers with no exposure. Toddlers exposed to persistent comorbid anxiety and mood disorders scored significantly higher on the cognitive (
= 0.049), motor (
= 0.013) and language (
= 0.041) domains and attained significantly higher fine motor (
= 0.043) and gross motor (
= 0.041) scaled scores compared to toddlers with no maternal mental health disorder exposure. Future investigations should focus on the role of protective factors to explain the pathways through which maternal mental health status is associated with positive toddler neurodevelopmental outcomes.
Convincing evidence supports the effectiveness of lifestyle interventions in preventing the occurrence of diabetes in high-income countries, however little is known about appropriate interventions ...for use in African countries, where there are higher relative increases in diabetes prevalence. The South African Diabetes Prevention Programme (SA-DPP) was initiated with the aim of preventing or delaying the occurrence of diabetes among South Africans (SAs), through interventions, targeting lifestyle changes related to diet and physical activity. The purpose of the current project is to implement and evaluate the suitability and applicability 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 SA.
The SA-DPP, which is an cluster randomized control trial, will be implemented in adults aged 30-65 years residing in the OR Tambo district, Eastern Cape, SA. Participants will be recruited using self-selected sampling techniques and 24 clusters across peri-urban communities will be randomly allocated to participate in the lifestyle intervention, facilitated by non-professional health workers (NPHW). The diabetes risk screening will follow a two-staged approach, including the community-based screening, using the African diabetes risk score (ADRS), followed by a clinic-based risk status assessment by an oral glucose tolerance test (OGTT) to exclude unknown diabetes. The lifestyle-change objectives of the current programme relate to, 1) < 30% of total energy intake from fat; 2) < 10% of total energy intake from saturated fat; 3) > 15 g of fibre/1000 kcal; 4) > 4 h/week moderate level of physical activity; and 5) > 2% body mass index (BMI) reduction.
The SA-DPP could represent a successful model for the prevention of diabetes and potentially other lifestyle-related diseases in SA and other countries in the region that are confronted with similar challenges.
PACTR202205591282906.
•Clinicians are now able to identify a specific sub-group of runners who are at higher risk of multiple injuries (average > 1 injury/year) (multiple injury risk (MIR) runners).•The prevalence of MIR ...runners is 0.4% (1 in 250 race entrants).•Independent risk factors predictive of MIR runners are older age (> 40 years), a longer history of running recreationally (> 20 years), and longer race distances (ultra-marathons).•Novel risk factors predictive of MIR runners are histories of chronic diseases and histories of allergies.
There are limited data on factors that predict an increased risk of multiple injuries among distance runners. The objective of this study was to determine risk factors that are predictive of individual runners with a high annual multiple injury risk (MIR).
A retrospective, cross-sectional study at 4 annual (2012–2015) Two Oceans 21.1 km and 56.0 km races in South Africa with 75,401 consenting race entrants. Running-related injury data were collected retrospectively through an online pre-race medical screening questionnaire. The average number of injuries for each runner every year was calculated by taking a runner's race entry history and injury history into account and categorizing entrants into 4 MIR categories (high, intermediate, low, and very low (reference)). Multiple logistic regression modeling (odds ratios) was used to determine whether the following factors were predictive of a high MIR (average > 1 injury/year): demographics, training and racing, chronic-disease history (composite chronic disease score (CCDS)), and history of allergies.
Of all entrants, 9.2% reported at least 1 injury, and 0.4% of entrants were in the high MIR category; the incidence rate was 2.5 injuries per 10 runner-years (95% confidence interval (95%CI): 2.4–2.7). Significant factors predictive of runners in the high MIR category were: running for > 20 years: OR = 2.0 (95%CI: 1.3–3.1; p = 0.0010); a higher CCDS: OR = 2.2 (95%CI: 2.0–2.4; p < 0.0001); and a history of allergies: OR = 2.8 (95%CI: 2.0–3.8; p < 0.0001).
Runners who have been running recreationally for > 20 years and those with multiple chronic diseases or a history of allergies were at higher risk of multiple running-related injuries. This high-risk group can be targeted for further study and possible injury-prevention interventions.
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Over the past five decades the bulk of research on exposure to maternal mental health disorders and infant neurodevelopment has been generated in high-income countries. The current study included ...infants, residing in low-income communities in South Africa, born to mothers with a history of psychiatric disorders.
To assess the motor behavior of 10- to 20-week-old infants exposed to maternal mental health disorders, and a subgroup of infants with prenatal psychotropic medication exposure.
The present study is a cross-sectional descriptive study, with a longitudinal subgroup analysis. General Movement Assessment (GMA), including the Motor Optimality Score-Revised (MOS-R), was used at 10–20 weeks corrected age to assess infant motor behavior.
The study included 112 infants. No significant difference (p = 0.523) was found on the MOS-R between infants exposed to maternal mental health disorders (n = 70) and the comparison group (n = 42). Both the exposed and comparison groups scored within the mildly reduced range on the MOS-R. No significant differences were found in a subgroup of infants with prenatal exposure to multi-class psychotropic medication (n = 17), mono-class psychotropic medication (n = 35) or valproate exposure (n = 10) (p > 0.1).
No association was found between exposure to maternal mental health disorders or exposure to psychotropic medication and infant motor behavior at 10–20 weeks post-term age on the MOS-R. Future research should focus on the contribution of exposure to specific classes and types of psychotropic medication on neurodevelopmental outcome of infants in larger cohorts.
•Impact of maternal mental health disorders (MMHD) on early motor behavior in African•MMHD were not significantly associated with a lower Motor Optimality Score (MOS).•Prenatal psychotropic exposure had no significant effect on infant motor behavior.•The role of African cultural caregiving on motor behavior merits further research.
•Total number of acute symptoms is the most significant factor associated with prolonged return to full performance after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in ...athletes.•Number of systemic symptoms is also strongly associated with prolonged return to full performance.•Females, endurance athletes, and those with a history of co-morbidities also experienced a prolonged return to full performance.
The aim of the study was to identify factors associated with prolonged time to return to full performance (RTFP) in athletes with recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Prospective cohort study with cross sectional analysis. A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age, sex, type/level of sport, co-morbidities, pre-infection training hours, and 26 acute SARS-CoV-2 symptoms from 3 categories (“nose and throat”, “chest and neck”, and “whole body”/systemic). Data on days to RTFP were obtained by structured interviews. Factors associated with RTFP were demographics, sport participation, history of co-morbidities, pre-infection training history, and acute symptoms (type, number). Outcomes were: (a) days to RTFP (median, interquartile range (IQR)) in asymptomatic (n = 7) and symptomatic athletes (n = 77), and (b) hazard ratios (HRs; 95% confidence interval) for symptomatic athletes with vs. without a factor (univariate, multiple models). HR < 1 was predictive of higher percentage chance of prolonged RTFP. Significance was p < 0.05.
Days to RTFP were 30 days (IQR: 23–40) for asymptomatic and 64 days (IQR: 42–91) for symptomatic participants (p > 0.05). Factors associated with prolonged RTFP (univariate models) were: females (HR = 0.57; p = 0.014), endurance athletes (HR = 0.41; p < 0.0001), co-morbidity number (HR = 0.75; p = 0.001), and respiratory disease history (HR = 0.54; p = 0.026). In symptomatic athletes, prolonged RTFP (multiple models) was significantly associated with increased “chest and neck” (HR = 0.85; p = 0.017) and “nose and throat” (HR = 0.84; p = 0.013) symptoms, but the association was more profound between prolonged RFTP and increased total number of “all symptoms” (HR = 0.91; p = 0.001) and “whole body”/systemic (HR = 0.82; p = 0.007) symptoms.
A larger number of total symptoms and specifically “whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.
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In this study we describe (1) the implementation of a novel web-based injury and illness surveillance system (WEB-IISS) for use by a team of physicians at multisport events and (2) the incidence and ...characteristics of injuries and illness in athletes during the London 2012 Paralympic Games.
Overall, 3565 athletes from 160 of the 164 participating countries were followed daily over a 14-day period, consisting of a precompetition period (3 days), and a competition period (11 days) (49 910 athlete-days). Daily injury and illness data were obtained from teams with their own medical support (78 teams, 3329 athletes) via the WEB-IISS, and without their own medical support through the London Organising Committee of the Olympic Games and Paralympic Games database (82 teams and 236 athletes).
There were no differences between incidence rates (IR) of injury and illness, or between the precompetition and competition periods. The IR of injury during the competition period was 12.1/1000 athlete-days, with an incidence proportion (IP) of 11.6% (95% CI 11.0% to 13.3%). Upper limb injuries (35%), particularly of the shoulder (17%) were most common. The IR of illness during the competition period was 12.8/1000 athlete-days (95% CI 12.18 to 1421), with an IP of 10.2%. The IP was highest in the respiratory system (27.4%), skin (18.3%) and the gastrointestinal (14.5%) systems.
During the competition period, the IR and IP of illness and injury at the Games were similar and comparable to the observed rates in other elite competitions. In Paralympic athletes, the IP of upper limb injuries is higher than that of lower limb injuries and non-respiratory illnesses are more common.
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