Background: The primary purpose of introducing the COVID-19 vaccine was to fight the pandemic. However, the vaccine was not well received worldwide. This challenge has threatened the effective implementation and roll-out of COVID-19 immunization campaigns. The challenge of vaccine hesitancy was reported to be more prevalent in rural areas due to various factors such as cultural beliefs, misinformation, poverty, lack of education, and distrust of vaccines. Yet there seems to be a scarcity of studies determining the prevalence of vaccine hesitancy in deep rural areas of Limpopo. Purpose: The study aimed to explore the prevalence of COVID-19 hesitancy among the rural black population in South Africa. Study Methods: A longitudinal quantitative study was conducted with data from the DIMAMO Health and Demographic Surveillance Site (HDSS) database for 2020 to 2022. A non-probability total sampling technique was used to select the respondents. Trained fieldworkers collected data using an electronic data capture questionnaire. A comparison of categorical variables was performed using Chi-Square in SPSS version 26 and the statistical significance was set at p < 0.05, with a 95% confidence interval to analyze the data. Results: The limited availability of vaccination sites in Limpopo Province, South Africa, was associated with a reduced certainty that the vaccine would be accepted, as reported in the current study. The prevalence of visiting traditional healers was significantly higher in non-vaccinated than vaccinated participants among the rural black population, indicating a different cultural belief among the rural black population that existed before and during the COVID-19 pandemic. Conclusion: The present study findings show diverse factors of concern associated with vaccination hesitancy for COVID-19 among rural black people. Lack of education, gender, not being diagnosed with COVID-19, not being a Christian, visiting traditional healers, vaccine mistrust, unknown side effects, and a lack of confidence in the vaccine itself. Conspiracy theories were factors that impacted vaccine acceptance among black people living in rural areas. The prevalence of visiting traditional healers was significantly higher in non-vaccinated than vaccinated participants. Therefore, the present study findings emphasize the need to collectively integrate and utilize the traditional healers in the South African healthcare system.

Background: Childhood obesity has become the most important and growing public health problem in the world. They add to public health challenges by increasing the burden of chronic non-communicable diseases. However, in spite of its importance, there is limited literature that evaluates the prevalence of obesity among rural adolescents in sub-Saharan Africa. We report the first study to present an insight into rural black overweight South African children and the physical characteristics and socio-economic status of the household head. A quantitative cross-sectional population study was conducted involving 51 selected primary villages within the DIMAMO surveillance area in the Capricorn District of Limpopo Province, South Africa. The study involved 294 adolescents, 154 girls and 140 boys, who were under the age of 18. Of these participants, 127 (43%) were within the normal weight range, and 167 (57%) were overweight. Gender made a significant difference, with more girls being overweight than boys. Adolescents who did not receive child grants and whose heads of household were 45–54 years old, poor, and overweight had a higher prevalence of obesity (p-value < 0.05). This study suggests that public health interventionists need to target both the heads of household and their children in hopes of reducing the prevalence of overweight and obese South African children. We further propose a better understanding of the causes of childhood overweight and obesity to guide policy development and implementation in rural settings.

In the past, it has been reported that the black South African population may have a cardio-protective lipid profile; however, this may no longer be the case with urbanization, industrialization, and the nutritional transition that occurred in South Africa. Although these transitions may be low in rural areas, one would expect this influence to be lower in the rural populations; however, they are not immune to these changes. Hence, the present study aimed to determine the association of serum lipid profiles and lipid ratios with kidney dysfunction. This cross-sectional retrospective study used the AWI-Gen 1 dataset. This study consisted of 1399 participants who took part in the AWI-Gen phase 1. Participants aged below 40 years, pregnant women, mentally disturbed and participants with incomplete information to answer the aims and objectives of this study were excluded in the analysis of this study. The data were analyzed using SPSS. In the present study, the prevalence of kidney dysfunction was 11.7%, with women having a significantly higher prevalence as compared to men. Women with kidney dysfunction had significantly higher TC, TG, TG/HDL-C, and TC/HDL-C compared to those without kidney dysfunction. However, in men, there was no association between the two groups. TC, and LDL/HDL-C were associated with kidney dysfunction in women only. TG/HDL-C was associated with kidney dysfunction in both women and men. Elevated TC, LDL/HDL-C, TC/HDL-C, and TG/HDL-C were the risk factors for kidney dysfunction, particularly in women. This suggests that TC, TC/HDL-C, and TG/HDL-C levels may be useful for risk stratification and a potential target to reduce the risk of developing kidney dysfunction, particularly in women. Upcoming longitudinal studies examining the causal connection between serum lipids, and lipid ratios with the risk of kidney dysfunction are necessary to fully understand the potential relationship between TG/HDL-C, TC, and TC/HDL-C levels and kidney dysfunction.