Background: South Africa has been experiencing a persistently high unemployment rate among young people. This high youth unemployment is a stressor to young people, which may culminate in mental health issues. Aim: The study aimed to describe the self-reported mental health effects of unemployment among young people in Mdantsane township, Eastern Cape province. Setting: The study was conducted in Mdantsane township, at the Lingomso Youth Centre in the Eastern Cape province, South Africa. Methods: A descriptive qualitative approach was used. Participants were recruited purposively until data saturation. Data were collected through individual face-to-face interviews. Thematic analysis was conducted using a six-step approach. Results: The sample comprised 19 young people aged between 19 years and 29 years, and most were men. Two themes emerged: theme one was negative effects, which were characterised by substance use, feelings of worthlessness, stress and anxiety, masking of personality, and social isolation; theme two was that social support buffered the potential adverse effects of unemployment, and this was supported by interdependent role relationships that protected individuals from the effects of unemployment. Conclusion: There is a need to recognise mental health issues emanating from unemployment, like social isolation, to enable comprehensive, appropriate interventions for young people. Contribution: This study contributes to understanding mental health issues experienced by unemployed young people. Findings can be used to develop targeted interventions in a large township, such as Mdantsane, in South Africa.

Introduction/Objectives: Cervical cancer screening is a vital preventive strategy, yet the extent of healthcare workers’ knowledge, attitudes, and practices (KAP) can significantly influence its uptake, especially in rural settings. This study aimed to explore the knowledge, attitudes, and practices regarding cervical cancer screening among nurses in selected rural health facilities of the Eastern Cape province, South Africa. Methods: A cross-sectional, quantitative study was conducted among 108 nurses selected from 12 health facilities across two districts in the Eastern Cape. All participants had received some training on cervical cancer screening. Structured questionnaires were used to assess knowledge, attitudes, and practices. Comparisons between professional nurses (higher academic qualification) and enrolled nurses (lower academic qualification) were made using appropriate statistical tests. Results: Findings revealed significant disparities in knowledge and attitudes between professional and enrolled nurses. Professional nurses demonstrated significantly better knowledge and more positive attitudes towards cervical cancer screening than enrolled nurses, who showed inadequate knowledge (p = 0.021) and negative attitudes (p = 0.023). Despite universal training, the level of academic qualification remained a key factor influencing KAP. Conclusions: Academic qualification is closely linked to knowledge and attitudes regarding cervical cancer screening among nurses. Health workforce policies and programmatic initiatives should prioritize targeted training for enrolled nurses, focusing on addressing specific knowledge and skill gaps. Tailored interventions are recommended to enhance competencies and improve cervical cancer screening practices among all nursing cadres.

Background: Drug-resistant tuberculosis (DR-TB) remains a major public health challenge in South Africa, particularly in rural settings with high HIV co-infection rates. Understanding predictors of treatment response among people living with HIV is essential for improving clinical management and programmatic outcomes. This study aimed to identify socio-demographic and clinical predictors of treatment outcomes among HIV-positive individuals diagnosed with multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) in rural Eastern Cape Province, South Africa. Methods: A retrospective cohort study was conducted using routinely collected clinical records of DR-TB patients initiated on treatment between January 2020 and December 2024 at two public healthcare facilities. A total of 239 patients with complete treatment outcome data were included. Treatment outcomes were classified as favourable (cured or treatment completed) or unfavourable (death, treatment failure, or loss to follow-up). Descriptive statistics were used to summarise patient characteristics, while univariate and multivariable logistic regression analyses were performed to identify factors associated with treatment outcomes. Results: Most participants were aged ≤ 39 years (58%), male (60%), unemployed (90%), and without income (80%). MDR-TB accounted for 40% of cases, rifampicin-resistant-TB (RR-TB) for 53%, and XDR-TB for 7.1%. Multivariable analysis showed that XDR-TB was the strongest independent predictor of unfavourable treatment outcome (AOR = 0.18; 95% CI: 0.06–0.58; p = 0.004). Income status was also significantly associated with outcome, with participants reporting some incomes having lower odds of favourable outcomes (AOR = 0.46; 95% CI: 0.23–0.92; p = 0.036). The model demonstrated modest predictive performance (AUC = 0.67). Conclusions: These findings highlight the dominant influence of resistance phenotype, particularly XDR-TB, on treatment prognosis among HIV-positive DR-TB patients in rural Eastern Cape. Integrating early resistance profiling, intensified clinical management of XDR-TB, and socioeconomic support mechanisms may improve treatment outcomes in high-burden rural settings.

Background: Extreme Weather Events (EWEs) disrupt the Earth’s delicate ecosystem balance and stability, negatively impacting planetary health. The study sought to identify and map existing global research evidence on effects of heatwaves, excessive rainfall/floods and drought on human health and health inequalities, discussing reported determinants, observed patterns, and existing gaps, serving as critical lessons for informing future research, preparedness and response efforts. Methods: Grey literature and electronic databases such as Google Scholar, Scopus, MEDLINE (Ovid) and ProQuest were searched for relevant English language articles published before February 2025, using a Boolean search strategy. Results: Guided by the PRISMA statement, a total of 38 articles were selected for analysis. Commonly reported effects were mortality; injuries, exacerbation of existing diseases and conditions; heat stress; nutritional deficiency conditions; negative maternal and child health outcomes; mental health conditions; vector-borne, water-and food-borne diseases, as either direct or indirect effects. Low- and middle-income countries (LMICs) and lower socioeconomic population groups are more fragile and experience more vulnerability due to inadequate resources for preparedness, mitigation and response. There is limited research evidence from implementation science reporting effectiveness of adaptation measures against EWEs, and data surveillance information on climate-sensitive diseases/conditions, particularly in LMICs. Conclusions: Given the alarming global warming trends, existing climate change evidence is an abundant invaluable capital to urgently leverage resilience-enhancing interventions. LMICs can adapt lessons learnt from climate-resilient economies or invest in enhancing resilience using tested and proven community co-constructed approaches to protect the public from health and social effects of EWEs, and to evaluate adaptation strategies.

There is a growing burden of substance use among older adolescents and young people in South Africa, which has adverse social, mental and physical well-being. The study aimed to explore the factors influencing substance use among older adolescents in Mdantsane township, South Africa. A qualitative approach with a descriptive design was used. Purposive sampling and snowballing were done to select older adolescents who used substances. Data were collected using semi-structured interviews and analysed thematically using Tesch’s eight steps of thematic analysis. The sample of older adolescents consisted of 19 participants, and most (84.2%) were male. The study found that protective factors were parental disapproval and health education. Factors that influenced substance use were adolescent free time, extended family who used substances, socio-cultural aspects and peer pressure. From this study, it is concluded that health education and context-specific interventions can prevent substance use among older adolescents in Mdantsane. Future studies may include parents of substance using older adolescents.

Background: Hypertension is a leading modifiable risk factor for cardiovascular diseases globally, disproportionately affecting low- and middle-income countries (LMICs), including South Africa. Primordial prevention targeting normotensive individuals plays a key role in reducing lifetime risk. Aim: To assess knowledge, attitudes and practices (KAP) and social determinants of health related to primordial hypertension prevention among normotensive adults in OR Tambo District, Eastern Cape province. Methods: A community-based cross-sectional study was conducted among 245 randomly selected normotensive adults. A validated questionnaire captured socio-demographic characteristics and KAP levels. Data analysis included descriptive statistics, Cronbach’s alpha, and chi-square tests (p < 0.05). Results: Participants demonstrated moderate knowledge (53.9%), highly positive attitudes (86.1%), and fair preventive practices (59.6%), highlighting a clear knowledge–practice gap. Higher knowledge was significantly associated with female gender (p < 0.001), older age (p < 0.001), and family history of hypertension (p = 0.001). Positive attitudes correlated with older age (p = 0.018) and higher education (p = 0.008). Knowledge level significantly predicted both positive attitudes (p < 0.001) and preventive practices (p = 0.009). Conclusions: Despite moderate knowledge and positive attitudes, a clear knowledge–practice gap was evident, possibly influenced by social and structural constraints. Strengthening primordial hypertension prevention in rural South Africa requires integrated strategies combining context-specific health education with interventions addressing structural barriers to enable sustainable behaviour change.