Cohort profile: Mandela's children: The 1990 birth to twenty study in South Africa
Cohort profile: Mandela's children: The 1990 birth to twenty study in South Africa
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DOI：
10.1093/ije/dym016
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发表时间：
2007-06-01
影响因子：
7.7
通讯作者：
Cameron, Noel
中科院分区：
文献类型：
--
作者：
Richter, Linda;Norris, Shane;Cameron, Noel
1980年代后期是南非社会政治发生深刻变化的时期。很明显，阿帕尼亚州正在崩溃，在以“斗争”为特征的公民不服从行为中，黑人非洲人开始无视限制他们生活和工作的限制性立法。非常迅速的无计划的城市化开始了，棚户区在以前的白色城镇周围如雨后春笋般涌现。据估计，这种快速的城市化将对儿童的健康和发展产生深远的影响，当时的城市增长率估计为每年3.5%。虽然改善城市地区获得保健、教育和就业的机会可以减少可预防的儿童发病率和死亡率，但政府无力建立和维持各种服务以满足不断增长的城市人口的需要，可能会加剧现有的传染病，如艾滋病毒/艾滋病和结核病。与生活方式、城市压力源和社会文化变化的相互作用有关的非传染性疾病，例如儿童伤害、物质使用和肥胖，预计会增加。1988年，由于对这些问题的讨论，威特沃特斯兰德大学的诺埃尔卡梅隆和南非医学研究理事会（MRC）的德里克·亚奇（Derek Yach）向当时的MRC主席安德里斯·布林克（Andries Brink）寻求资金，以便与同样来自威特沃特斯兰德大学的露西·瓦格斯塔夫（Lucy Wagstaff）开始在索韦托-约翰内斯堡进行一项出生队列研究。目的是跟踪一组城市儿童10年，当时不知道这些儿童也将是第一批出生在民主南非的儿童。起初，这项研究被称为“出生到十岁”（BT 10），但在2000年，当我们达到10年随访目标并决定继续研究到20岁时，这项研究改为“出生到二十岁”（BT 20）。这些孩子后来被通俗地称为曼德拉的孩子，因为他们出生在1990年2月11日纳尔逊曼德拉获释后的7周内，这一事件预示着激进的社会和政治变革。琳达里希特是最初的调查小组的一员。Shane Norris自2001年以来一直担任项目经理。有了种子资金，我们进行了几项试点研究，以确定该地区出生的季节性和招募到出生队列研究的最佳月份;常规收集的卫生服务数据的性质和准确性;以及从出生到六个月的儿童随访率。[4]出生队列的登记日期定在2月，但全国医院罢工推迟了登记，从1990年4月23日推迟到6月8日。
The late 1980s were a period of profound sociopolitical change in South Africa. It was clear that the Apartheid state was crumbling and, amongst acts of civil disobedience which characterized ‘the struggle’, Black Africansy began to disregard restrictive legislation that constrained where they lived and worked. Very rapid unplanned urbanization began, and shanty towns mushroomed around formerly White cities and towns. It was anticipated that this rapid urbanization, with urban growth estimated at the time to be 3.5% per year1, 2 would have profound effects on children’s health and development. While improved access to health care, education and employment in urban areas could decrease preventable childhood morbidity and mortality, the inability of government to establish and maintain services to meet the needs of the growing urban population could exacerbate existing infectious diseases, such as HIV/AIDS and tuberculosis. Non-infectious conditions related to the interaction of lifestyle, urban stressors and socio-cultural changes—for example, childhood injuries, substance use and obesity—were predicted to increase. In 1988, as a result of discussions on these issues, Noel Cameron at the University of the Witwatersrand, and Derek Yach at the South African Medical Research Council (MRC) approached the then MRC President, Andries Brink, for funds to begin a birth cohort study in Soweto-Johannesburg with Lucy Wagstaff, also from the University of the Witwatersrand. The aim was to track a group of urban children for 10 years, not knowing at the time, that these children would also be the first cohort born into a democratic South Africa. At the start, the study was called Birth to Ten (BT10), but changed to Birth to Twenty (BT20) in 2000 when we reached the 10-year follow-up goal and resolved to continue the study to age 20. The children came to be known colloquially as Mandela’s Children3 because they were born in the 7 weeks following Nelson Mandela’s release from prison on the February 11, 1990, an event that heralded in radical social and political changes. Linda Richter was part of the original investigator group. Shane Norris has been the Project Manager since 2001. With seed funding, we undertook several pilot studies to determine, amongst other things, the seasonality of births in the area and the optimum months for recruitment into a birth cohort study; the nature and accuracy of routinely collected health service data; and follow-up rates of children from birth to six months. 4 The date for enrolling the birth cohort was set for February, but a national hospital strike delayed enrolment, which occurred from April 23 to June 8, 1990.