Esme R Jordaan

• MSc (Statistics)
• Researcher at South African Medical Research Council

Background The study was designed to establish a hypertensive nonhuman primate model to evaluate the role of dietary salt intake on blood pressure levels and gut microbiome regulation. Sixteen adult vervet monkeys were selected and assigned into two groups (control and experimental). The control group was given a maintenance diet (100 g), whereas t...

Objective Acute respiratory infections (ARinf), including SARS-CoV-2 infection, can affect multiple organ systems that may influence return to sport (RTS) in athletes. Factors associated with multiorgan involvement in athletes with ARinf are lacking. The aim of this study was to explore whether factors such as demographics, sport participation, his...

Background: Medical clearance is often recommended for athletes prior to endurance exercise. The primary aim was to determine the percentage (%) of race entrants that sought medical clearance prior to participation in endurance running events, describe the diagnostic modalities used by doctors to assess entrants seeking medical clearance, and the...

Purpose Performance indicators in women's rugby union are under-researched. The aim of this study was to describe the match activities and determine the predictors for winning/losing and points difference in the South African Rugby Union (SARU) Women's Premier Division competition. Methods During the 2021 and 2022 seasons, SARU-coded matches inclu...

Background Information on acute traumatic cycling injuries (ATCIs) in the 12 months prior to entry in a cycling race and the predisposing factors have not been well-researched. Objective Determine factors associated with a history of ATCIs sustained in the previous 12 months by race entrants of a 109 km cycling race. Methods Descriptive, cross-se...

The impact of climate change on human societies is now well recognised. However, little is known about how climate change alters health conditions over time. National level data around climate shocks and subsequent rates of intimate partner violence (IPV) could have relevance for resilience policy and programming. We hypothesise that climate shocks...

Objective: The aim of this study was to determine the incidence and nature (severity and type by organ system and specific diagnosis) of all medical encounters (MEs), including serious/life-threatening MEs (SLMEs) during a South African road marathon. Methods: This descriptive study was a retrospective analysis of data collected over 6 years at...

Objective To determine if any gradual onset running-related injury (GORRI) was associated with any allergies, multiple allergies (allergies to animals, plants, medication), and allergy medication use. Design Cross-sectional descriptive study. Setting Two Oceans Marathons (56 km, 21.1 km), South Africa. Participants A total of 76 654 race entrant...

This paper provides an overview of the HEAT (Healthy Environments for AthleTes) project, which aims to understand the impact of environmental conditions on athlete health and performance during major sporting events such as long-distance running, cycling, and triathlons. In collaboration with the SAFER (Strategies to Reduce Adverse Medical Events F...

Background: The prevalence of a history of exercise-associated muscle cramping (hEAMC) among ultramarathon runners is high. While the Comrades is one of the most popular mass community-based participation ultramarathons (90km) globally, research on the epidemiology, clinical characteristics, and risk factors of entrants' lifetime hEAMC are scarce....

Background Gradual‐onset Achilles tendon injuries (GoATIs) in runners are common. Data show that chronic diseases are associated with GoATI. Objective To determine risk factors associated with a history of GoATIs among long‐distance runners (21.1 and 56 km) entering a mass community‐based running event. Methods Online pre‐race medical screening q...

Background: Despite the numerous health benefits of distance running, it is also associated with the development of 'gradual onset running-related injuries' (GORRIs) one of which is Iliotibial Band Syndrome (ITBS). Novel risk factors associated with a history of ITBS (hITBS) have not been described in a large cohort of distance runners. Objective...

Background The severity of SARS-CoV-2 infection [days to return to sport (RTS)] in athletes has been associated with the total number of acute symptoms. Data on the association between acute symptoms and demographics, sport participation, co-morbidities/allergies and organ involvement are however lacking. Objective To explore if the number of acut...

Background Patellofemoral pain (PFP) is common in cyclists, but factors associated with PFP in cyclists have not been well studied. Objectives The study aimed to identify factors (lower limb functional and frontal plane knee kinematic variables) associated with PFP in cyclists. Design Matched case-control. Setting SEMLI Biomechanics laboratory,...

Background There is a high incidence of medical encounters (MEs) and serious/life-threatening MEs in marathon road running races but injury and illness risk factors associated with MEs in these events have not been well investigated and will assist with injury and illness prevention. Objective To determine the independent risk factors that are ass...

Background The prevalence of exercise-associated muscle cramping (EAMC) among ultramarathon runners is high. While the Comrades is one of the most popular mass community-based participation ultramarathons (90km) globally, research on the risk factors of entrants’ lifetime history (hEAMC) is scarce. Objective Investigate selected risk factors of hE...

Background Running and cycling are two of the most popular forms of physical exercise worldwide, with increased participation by older and female athletes. Gradual onset injuries (GOIs) are common in these two sports, requiring individually targeted injury prevention strategies. Objective To determine differences in the period prevalence (12 month...

The incidence of acute respiratory infections (ARinf), including SARS-CoV-2, in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is unknown. The aim of the study was to determine the incidence of ARinf (including SARS-CoV-2) during non-contact and contact phases during...

Objective To describe the epidemiology of injuries and illnesses sustained during the Beijing 2022 Paralympic Winter Games, organised in a closed-loop environment to adhere with COVID-19 restrictions. Methods Injuries and illnesses from all teams were recorded on a daily basis by team medical staff on a web-based form and by local organising commi...

Objective Rugby union (‘rugby’) is popular globally, with the majority of its participants being amateur. Concern regarding sport-related concussion (SRC) sustained during rugby is increasing. SRC occurs most frequently in the tackle, yet few interventions have aimed to mitigate this risk factor. This study investigated the influence of a lowered l...

Objectives The relationship between sport-related injuries and Para athlete impairment type has not yet been comprehensively studied. This study aimed to describe injury incidence according to athlete impairment type during the London 2012 and Rio 2016 Summer Paralympic Games, by sex, age, Games period, chronicity and anatomical area. Methods A co...

Purpose 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. Methods Prospective cohort study with cross sectional analysis. A total of 84 athletes with confirmed SARS-CoV-2 infection assessed...

Objective To determine if two pre‐race screening tools (abbreviated tool of two open‐ended pre‐race medical screening questions [ABBR] vs. a full pre‐race medical screening tool [FULL]) identify running race entrants at higher risk for medical encounters (MEs) on race day. Methods 5771 consenting race entrants completed both an ABBR and a FULL pre...

Objective: Patellofemoral pain syndrome (PFPS) is a common running-related injury. Independent risk factors associated with PFPS have not been described in a large cohort of distance runners. Design: Descriptive, cross-sectional study. Setting: 21.1 and 56 km Two Oceans Marathon races (2012-2015). Participants: 60 997 race entrants. Assessm...

Context: SARS-CoV-2 infection can affect the exercise response in athletes. Factors associated with the exercise response have not been reported. Objective: This study aimed to: 1) describe heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE) responses to exercise in athletes with recent SARS-CoV-2 infection, an...

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...

BACKGROUND: The prevalence of a history of exercise-associated muscle cramps (hEAMC) among ultramarathon runners is high. While the Comrades is one of the most popular community-based mass participation ultramarathons (90km) globally, research on the epidemiology and clinical characteristics of entrants' lifetime hEAMC is scarce. PURPOSE: To descri...

Background: There is limited evidence available on contributing factors for gradual onset running-related injuries (GORRIs) in ultramarathon runners. The aim was to determine if selected risk factors were associated with a history of GORRIs in 90-km ultramarathon race entrants. Methods: Descriptive cross-sectional study. GORRI and medical data u...

Background: Gastrointestinal tract illness (GITill) in rugby players is underreported. The incidence, severity (% time loss illness, days lost per illness) and burden of GITill with/without systemic symptoms and signs in professional South African male rugby players during the Super Rugby tournament (2013-2017) are reported. Methods: Team physic...

Objectives: Currently there are five international screening tools that are recommended to identify individuals who require pre-exercise medical clearance to reduce the risk of medical encounters during exercise. Therefore, the aim was to determine the percentage of race entrants who are advised to obtain pre-exercise medical clearance and the obs...

COVID-19 has had far-reaching economic, social and health consequences, with vulnerable groups disproportionally affected. Even before the COVID-19 pandemic, concern was expressed about university students’ mental health, with global data suggesting students are more vulnerable than the general population to mental disorders. Yet, it is unclear wha...

Background: 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 Progra...

Background Very low birth weight (VLBW) and extremely low birth weight (ELBW) infants are known to be at high risk of growth failure and developmental delay later in life. The majority of those infants are born in low and middle income countries. Aim Growth monitoring in a cohort of infants born with a VLBW up to 18 months corrected age was conduc...

Objective: To determine independent risk factors associated with a history of exercise-associated muscle cramps (hEAMCs) in distance runner race entrants in a community-based mass participation event. Design: Cross-sectional study. Setting: 2012 to 2015, Two Oceans marathon races (21.1 and 56 km), South Africa. Participants: Seventy six thou...

Objective To describe the incidence and burden of illness at the Tokyo 2020 Paralympic Games, which was organised with strict COVID-19 countermeasures. Methods Daily illnesses were recorded via the web-based injury and illness surveillance system (teams with their own medical staff; n=81), and local polyclinic services (teams without their own med...

Objective To describe the epidemiology of injuries at the Tokyo 2020 Paralympic Games, including injuries sustained in the new sports of badminton and taekwondo. Methods Injury data were obtained daily via the established web-based injury and illness surveillance system (WEB-IISS; 81 countries, 3836 athletes) and local organising committee medical...

Objective Rugby union (‘rugby’) is popular globally, with most of its participants being amateur. Concern regarding sport-related concussion (SRC) sustained during rugby is increasing. SRC occurs most frequently in the tackle, yet few interventions have aimed to mitigate this risk factor. This study investigated the influence of a lowered legal tac...

Objective: Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events. Design: Cross-sectional study. Setting: 2016-2020 Cape Town Cycle Tour. Parti...

The paper introduces the Healthy Environments for Athletes field campaign to measure environmental conditions (heat stress and allergenic agents) associated with endurance events.

Objective Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community...

Maternal mental health disorders and the adverse consequences for infant neurodevelopment have received substantial research attention in high-income countries over the past five decades. In Africa, where relatively little work has been done on this topic, researchers have largely focused on infant physical health outcomes. This longitudinal study...

Purpose: To determine factors predictive of prolonged return to training (RTT) in athletes with recent SARS-CoV-2 infection. Methods: Cross-sectional descriptive study. Athletes not vaccinated against COVID-19 (n = 207) with confirmed SARS-CoV-2 infection (predominantly ancestral virus and beta-variant) completed an online survey detailing the f...

Background: In South Africa (SA), road traffic injuries, homicides and burns are the leading causes of injury-related deaths among children. Injury-related deaths are well documented for SA, but this is not the case for non-fatal injuries. Objectives: To describe the non-fatal injuries sustained among children aged 0 - 13 years, to identify any...

Objective 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. Design Prospective cohort study. Methods Players reported their history of SARS-CoV-2 infection before / during a national competition, using an online ques...

Background: Exercise associated collapse (EAC) is a common medical encounter at distance running events. Risk factors associated with EAC are not well documented. The objective is to determine the overall incidence of EAC and identify risk factors associated with EAC in 21.1km and 56km runners. Methods: A cross-sectional analysis of 153208 race...

Introduction 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. Aim To assess the moto...

Mother–infant dyads in low- and middle-income countries (LMICs) may be exposed to a range of factors associated with suboptimal development. Optimal infant development is likely supported by synchronicity in the early mother–infant relationship, but limited corroborative research is available in LMICs. The Drakenstein Child Health Study (DCHS) prov...

Background Medial Tibial Stress Syndrome (MTSS) is one of the most common causes of exercise-associated lower leg pain in distance runners. Aim To identify risk factors predictive of a history of MTSS in distance runners entering the Two Oceans Marathon races (21.1km and 56km). Design Cross-sectional study Setting 2012 to 2015 Two Oceans Maratho...

Objective: To determine if scientifically based social network (Facebook) lifestyle interventions reduce 10-year cardiovascular disease (CVD) risk. Methods: Financial sector employees (n = 300) were equally randomly assigned: Facebook plus Health Professionals (FB+HP), Facebook (FB), or control (C). We report changes in 10-year Framingham risk s...

Objective: To determine whether the lifetime prevalence and clinical characteristics of exercise-associated muscle cramping (EAMC) differ between runners entering a 21.1- versus 56-km road race. Design: Cross-sectional study. Setting: The 2012 to 2015 Two Oceans Marathon races (21.1 and 56 km), South Africa. Participants: Participants were c...

Objectives To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an increased risk of race-day medical encounters (MEs). Methods Data from two voluntary open-ended pre-race medical screening questions (Q1 – history of allergies; Q2 -...

Objective There are limited data on factors that predict an increased risk of multiple injuries among distance runners. The objective of this study is to determine risk factors that are predictive of individual runners with a high annual multiple injury risk (MIR). Methods A retrospective, cross-sectional study at 4 annual (2012–2015) Two Oceans 2...

Background Race starting time is often staggered over several hours in large mass-participation endurance sports events. Athlete exposure to environmental conditions changes as wet-bulb-globe-temperature (WBGT) changes during race day. Slower participants may be exposed to changing environmental conditions for a longer duration. In most studies env...

Background Risk factors associated with overuse injuries in cyclists (OICs) in recreational cyclists have not been well-studied. Objective To determine risk factors associated with OICs in recreational cyclists participating in a mass community-based cycling event. Design Cross-sectional study. Setting Cape Town Cycle Tour (CTCT) 2016. Patients...

Background Injury-related medical encounters (injMEs) are common in mass community-based participation cycling events, but there are limited data on the risk factors associated with injuries in endurance cycling events. Objective To determine the risk factors associated with injMEs in a mass community-based endurance cycling event. Design Retrosp...

Background Pre-race medical screening at endurance events has recently been suggested, but there are limited data on the use of pre-race questionnaire data to predict adverse events (defined as medical encounters or not finishing a race). Objective To determine if risk factors, that are identified from a pre-race medical screening questionnaire, a...

Background Illness-related medical encounters (illMEs) are common in mass community-based participation cycling events, but there are limited data on risk factors associated with illMEs in endurance cycling events. Objective To determine the independent risk factors associated with illMEs in a mass community-based endurance cycling event. Design...

Background Running experience and training may be risk factors for exercise associated muscle cramping (EAMC). However, multiple experience and training variables are inter-dependent. A latent class variable may be used to test associations between multiple experience and training variables and EAMC. Objective Is there an association between EAMC...

Background Recent data indicate that pre-race medical screening and education can reduce medical encounters (MEs) at an endurance running event. However, the relationship between the risk of MEs and specific risk factors from pre-race medical screening, together with race day factors, and has not been explored. Objective To determine the independe...

Background: Infants in lower middle income countries are often exposed to early adversities which may lead to suboptimal caregiving environments and place them at risk of not achieving their developmental potential. Synchrony and positive engagement in the mother-infant relationship plays a critical role in buffering the impact of early adversity....

Introduction Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered m...

Objectives: To identify risk factors that predict gradual onset running-related injuries (GORRIs) in ultramarathon runners entering a mass community-based event. Design: Descriptive cross-sectional study. Setting: Two Oceans 56 km ultramarathon 2012 to 2015. Participants: Race entrants (n = 42 003) completed a compulsory pre-race medical his...

Objective: To determine if repeat annual health risk assessments (RAHRAs) with intervention reduce 10-year cardiovascular disease (CVD) risk in financial sector employees. Methods: Retrospective analysis from RAHRAs in 13737 employees over 4-years. We report changes in 10-year Framingham risk score (FRS) for CVD (%) and risk factors after 1 (GR1...

Objectives To document incidence rate and severity of specific sub-categories of respiratory tract illness (RTill) in rugby players during the Super Rugby tournament. Design Cross-sectional study. Methods Team physicians completed daily illness logs in 537 professional male rugby players from South African teams participating in the Super Rugby U...

Objective: To determine the incidence and nature of illness-related medical encounters (MEs) at a 90-km, ultramarathon, mass, community-based, endurance running event. Design: Retrospective, descriptive epidemiological study. Setting: Comrades Marathon (90 km), South Africa. Participants: One lakh three thousand one hundred thirty-one race s...

Background: Limited data support pre-race medical screening to identify risk factors for not finishing an endurance running race. The aim of the study was to determine risk factors associated with not finishing an ultramarathon. Methods: A prospective, cross-sectional study of Two Oceans ultramarathon (56km) race starters who completed a pre-rac...

Background There are no data relating symptoms of an acute respiratory illness (ARI) in general, and COVID-19 specifically, to return to play (RTP). Objective To determine if ARI symptoms are associated with more prolonged RTP, and if days to RTP and symptoms (number, type, duration and severity) differ in athletes with COVID-19 versus athletes wi...

Background: Schizophrenia is a debilitating mental health condition affecting the lives of many South Africans. The origins of the heterogeneity in the presentation of the illness remain uncertain. Aim: This cross-sectional study performed a retrospective data analysis to determine the usefulness of digit ratio as an endophenotype in a South Afric...

Background: Gastrointestinal illness-related (GITill) medical encounters during distance running range from mild to debilitating. The objective is to identify factors that may predict GITill among 21.1km and 56km race starters. Methods: This is a cross-sectional analysis of data collected prospectively over 8 years at the Two Oceans 56km and 21....

Objective To determine the prevalence of chronic prescription medication (CPM) use in distance runners (by age and sex) and to compare CPM use in 21.1km vs. 56km race entrants. Methods A cross-sectional study of 76654 race entrants who completed a pre-race medical screening questionnaire during race registration, which included questions on the us...

Background Neonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, d...

Background: Lay health workers (LHWs) are critical in linking communities and primary healthcare (PHC) facilities. Effective communication between facilities and LHWs is key to this role. We implemented a mobile health (mHealth) system to improve communication and continuity of care for chronically ill clients. The system focused on requests from f...

Background: Multiple masculinities have been explicated through latent class analysis (LCA) in South Africa, and a question arises as to whether men can be similarly grouped by their behaviour in very different cultural contexts, and whether an analysis would point to similar origins to men's use of violence against women. The UN Multi-country Stu...

Objective: To determine the prevalence of non-communicable disease (NCD) risk factors, total NCD risk category and 10-year risk for cardiovascular diseases (CVD) in financial sector employees. Methods: This descriptive observational cross-sectional analysis, data from 36 074 employees was analysed. NCD risk factor data was obtained from health r...

Objectives: Risk factors related to Gradual onset injuries (GOIs) in cyclists need to be identified to enable effective injury prevention strategies. We aim to determine risk factors related to GOIs in cyclists participating in mass community-based events. Design: Cross-sectional study. Setting: Cape Town Cycle Tour. Participants: Race entra...

Objectives Prevalence, clinical characteristics and severity of gradual onset injuries (GOIs) in cyclists are poorly documented. We determine the prevalence, anatomical regions/sites affected and severity of GOIs among entrants in a community-based mass participation event. Design Cross-sectional study; Setting Cape Town Cycle Tour; Participants...

Objectives Risk factors related to Gradual onset injuries (GOIs) in cyclists need to be identified to enable effective injury prevention strategies. We aim to determine risk factors related to GOIs in cyclists participating in mass community-based events. Design Cross-sectional study. Setting Cape Town Cycle Tour Participants Race entrants (n=35...

Background There are limited data on acute injury-related medical encounters (injuries) in endurance cycling events. Objective To determine the risk factors for injuries during a mass community-based endurance cycling event. Design Retrospective, cross-sectional study. Setting Cape Town Cycle Tour (109 km), South Africa. Participants 102 251 ra...

Background: Maternal Mortality is a global health concern. The lack of suicide data, particularly in low and middle income countries, is concerning and needs to be addressed. Aim: This study assessed suicidality and associated factors during pregnancy and the postpartum period amongst women with known psychiatric diagnoses. Setting: The study sam...

Purpose: There are limited data on risk factors associated with illness-related medical encounters (illMEs) in cycling events. The aim was to determine risk factors associated with illMEs in mass community-based endurance cycling events. Methods: A retrospective, cross-sectional study in the Cape Town Cycle Tour (109km), South Africa with 102251...

Background This paper examines the degree of agreement among simple dichotomous self-report, validated screening results, and biochemical screening results of prenatal alcohol and other drug use among pregnant women. Method Secondary analysis was conducted on a cohort of pregnant women 16 years or older, presenting for prenatal care in the greater...

Background: Pre-race screening and risk stratification in recreational endurance runners may predict adverse events (AEs) during a race. Aim: To determine if pre-race screening and risk stratification predicts AEs during a race. Methods: 29585 participants (Male 71.1%, average age=42.1years; Female 28.9%, average age=40.2years) at the Two Ocea...

Objectives: Results from multinational WHO studies suggest that schizophrenia patients in developing countries may have more favorable prognoses and morbidity outcomes than those in developed settings. This study serves to establish whether mortality outcomes in South African Xhosa-speaking schizophrenia patients are more favorable than in the gene...

Collision sports, such as Rugby Union (“Rugby”) have a particularly high risk of injury. Of all injuries common to collision sports, concussions have received the most attention due to the potentially negative cognitive effects in the short- and long-term. Despite non-professional Rugby players comprising the majority of the world’s playing populat...

DOI: https://doi.org/10.17159/2078-516X/2019/v31i1a7466 Introduction: Rugby union is a contact sport resulting in injuries, which may increase the risk of future injury. This study aimed to investigate whether a player who sustained an injury in a previous season, had a higher risk of sustaining an injury in the following season. Methods: A prospe...