Dr Asanda Mtintsilana
RESEARCH PROJECT: Delineating the role of social vulnerability in the pathophysiology of non-communicable diseases (NCDs) and their prominent risk factors in middle-aged Black South African women.
Dr Mtintsilana is currently undertaking postdoctoral training in public health and epidemiology under the supervision of Professor Shane Norris at the South African Medical Research Council (SAMRC)/Wits University Developmental Pathways for Health Research Unit (DPHRU).
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Her research aims to explore the use of social vulnerability index (SVI), which was developed by the US Centre for Disease Control and adapted for a South African context, to understand the role of social vulnerability in the development of non-communicable diseases (NCDs) (obesity, hypertension, and T2D) and their prominent risk factors (e.g., dietary intake) in middle-aged Black South African women.
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She explains that, like many other low- and middle-income countries (LMICs), South Africa (SA) has seen an alarming increase in the prevalence of NCDs. These diseases are characterized as being chronic (long-lasting) and non-infectious (i.e., are not transmitted through contact). Regrettably, NCDs are the leading causes of death in LMICs. This is the case in SA, where six out of ten leading causes of death in 2016 were NCDs, including diabetes mellitus, hypertension, and cardiovascular diseases (e.g., stroke and heart diseases). Compared to men, NCD-related deaths are higher in South African women.
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By exploring the association between SVI and NCD risk, she hopes to assist in the development of policies and intervention strategies to fight the high burden of NCDs in Black South African women. She believes she will be first to investigate the relationship between social vulnerability and biological markers implicated in the development of NCDs in an African population.
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“I am hoping that the results from my research will advance our understanding about the role of social vulnerability in the development of NCDs in Black South African women. I am also anticipating that this knowledge might be used by policymakers and relevant stakeholders to develop evidence-based policies to prevent NCDs and invest in intervention strategies that promote optimal health, development, and lifetime wellbeing in Black South African women,” she explains.
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Her field of study has been influenced by childhood experiences. She says, growing up in Umtata and East London (Eastern Cape) it was very common to hear of people suffering or dying from high blood pressure, stroke, or T2D.
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“I came to know of these diseases without fully understanding their pathophysiology or why so many people, especially Black women in my family and community were affected and dying from them. Sadly, even today, these diseases remain a major health problem in SA, with women disproportionately more affected than men. This ignited my interest in health sciences and later propelled me to register for a PhD degree at Wits and undertook a project that sought to identify risk factors for T2D and elucidate putative biological mechanisms implicated in the pathophysiology of T2D in middle-aged urban Black South African women,” she explains.
Her PhD was novel and the findings showed that obesity - in particular central obesity (visceral adipose tissue) - is a key risk factor for developing insulin resistance and T2D in middle-aged Black South African women. Additionally, she was able to show that metabolites (or biomarkers), which are extensively linked to the development of T2D in Europeans, predicted the development of T2D in Black South African women, 13 years prior to the onset of the disease.
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The body of knowledge has been enriched by her many research articles (both published and under review) on diverse topics affecting human health and development. In addition to this, she has had the privilege of attending multiple international conferences and had opportunities to collaborate with international research groups.
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“Conducting this study and choosing this research direction has been motivated by my innate sense of social responsibility and aspirations to become a leading independent expert in NCD research in African populations, especially African women,” she says.
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Dr Mtintsilana goes on to explain the challenges faced by early-career researchers: “It can takes years to have financial security and to become an established and independent researcher. Also, a career in science is very competitive in terms of research grants and job opportunities, so to stand out one must work extremely hard.“
Dr Mtintsilana aspires to become a leading independent expert in NCD research in African populations and emphasizes her passion for women-centric research. “I have benefited immensely from the women in my family, and my dedicated female teachers, and supervisors. They have been very instrumental in empowering me in valuing education and choosing a career in science. Therefore, I hope I can also serve as a role model, to inspire and help retain a lot of young women to stay in STEM careers, so they can also inspire the next generation of female scientists. The world needs more women in science.”
Research Summary
Title: Delineating the role of social vulnerability in the pathophysiology of non-communicable diseases and their prominent risk factors in middle-aged Black South African women.
Although everyone is inherently at risk of suffering in a natural disaster, or developing infectious and chronic diseases, some people are at greater risk than others due to having unfavourable social, economic, and environmental exposures. This phenomenon is known as social vulnerability — defined as the attributes of society that make people and places susceptible to natural disasters, adverse health outcomes, and social inequalities.
South Africa (SA) is the most unequal country in the world, with Black South African women being the most socially vulnerable group. Black South African women are vulnerable to poverty and food insecurity, which in turn increase susceptibility to intimate-partner and gender-based violence, higher risk for HIV infection, and non-communicable diseases (NCDs) and related risk factors, with the latter being the focus of this study.
This study aims to explore the use of social vulnerability index (SVI), which was developed by the US Centre for Disease Control and adapted for a South African context, to address the role of social vulnerability in the development of NCDs (obesity and type 2 diabetes (T2D)) and their prominent risk factors (tobacco use and alcohol intake, dietary intake, and physical activity) in middle-aged Black South African women (n=221).