Heather J Zar

Biographic Data

ID	1730100
NAME	Heather J Zar
GIVEN NAMES	Heather J
FAMILY NAME	Zar
SIGNATURE	ZAR H J
AFFILIATIONS	University of Cape Town
ORCID	0000-0002-9046-759X
VERIFIED	Yes
TOTAL WORKS	34
TOTAL CITATIONS	7
AUTHOR COUNT	34
EDITOR COUNT	0
FIRST PUBLICATION YEAR	2015
LATEST PUBLICATION YEAR	2026
H-INDEX	1

Type and developmental timing of childhood adversity predicts psychopathology symptoms in a South African birth cohort
Open AccessSherief Y Eldeeb, Brooke G McKenna et al.ARTICLEJournal of Child Psychology and…2026
Background Childhood adversity is widespread globally and is one of the strongest predictors of later psychopathology. However, the differential effects of type and timing of childhood adversities on childhood psychopathology remain unclear, highlighting the need to explore which life-course hypotheses (sensitive periods, accumulation of exposure, and/or recency of exposure) best explain these associations. Of particular importance, there is a la…
Severe, primary, and incidental Covid-19 in hospitalised children, South Africa: 2020–2023
Open AccessAmeena Ebrahim Goga, Ameena Goga et al.ARTICLEJournal of Global Health2026
Background: Knowledge gaps persist regarding paediatric COVID-19 clinical presentation, treatment and outcomes in high HIV prevalence settings, with low COVID-19 vaccine coverage. Methods: An ambi-directional cohort study was conducted in 13 South African public sector hospitals. Hospitalised children with SARS-CoV-2 infection or post-infection syndrome were included. Main outcomes measures included severe disease and primary COVID-19 (hospitalis…
Characterising Maternal Sensitivity in a High Risk, Peri-urban LMIC Context: The Drakenstein Child Health Study
Open AccessAnita Prag, Nádia C Hoffman et al.ARTICLEChild Psychiatry & Human…2026
A prolific amount of data regarding maternal sensitivity and child development outcomes comes from high income, industrialised western contexts. Sparse attention has been paid to characterising patterns or unique expressions of sensitivity as an independent topic of study globally with a glaring dearth of comparative data from LMICs including sub-Saharan Africa. We aimed to detail maternal sensitivity within the dyadic interaction between mother …
Longitudinally investigating patterns of maternal psychological distress in a South African birth cohort
Open AccessRae MacGinty, Nadia Hoffman et al.ARTICLEBMC Public Health2025
Psychological distress, a broad construct that encompasses of a range of emotional difficulties—including depression and anxiety—is prevalent during pregnancy and postnatally with up to 25% of women experiencing psychological distress globally. However, this is mostly described in high income countries (HIC), with little data from low- and middle-income countries (LMICs). The aim of this study was to describe and determine latent trajectory class…
Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: A systematic analysis for the Global Burden of Disease Study 2021
Open AccessMichael Brauer, Gregory A Roth et al.ARTICLEThe Lancet2024
BACKGROUND: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 ri…
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: A systematic analysis for the Global Burden of Disease…
Open AccessMohsen Naghavi, Kanyin Liane Ong et al.ARTICLEThe Lancet2024
BACKGROUND: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mort…
Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (Dalys), and healthy life expectancy (Hale) for 371 diseases and injuries in 204 countries and territor…
Open AccessAlize J Ferrari, Damian Francesco Santomauro et al.ARTICLEThe Lancet2024
BACKGROUND: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to im…
Risk and rates of hospitalisation in young children: A prospective study of a South African birth cohort
Open AccessCatherine J Wedderburn, Julia Bondar et al.ARTICLEPLOS Global Public Health2024
Children in sub-Saharan Africa (SSA) are disproportionately affected by morbidity and mortality. There is also a growing vulnerable population of children who are HIV-exposed uninfected (HEU). Understanding reasons and risk factors for early-life child hospitalisation will help optimise interventions to improve health outcomes. We investigated hospitalisations from birth to two years in a South African birth cohort study. Mother-child pairs in th…
Honestly, this problem has affected me a lot”: A qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania
Open AccessUzochukwu Egere, Elizabeth H Shayo et al.ARTICLEBMC Public Health2023
Chronic respiratory diseases have substantial social and economic impacts among people with CRD and their families in Sudan and Tanzania. Stigma is particularly strong and appears to be driven partly by association of chronic cough with infectiousness. Context-appropriate measures to address economic impacts and chronic cough stigma are urgently needed as part of interventions for chronic respiratory diseases in these sub-Saharan African contexts
Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: A systematic analysis
Open AccessYou Li, Xin Wang et al.ARTICLEThe Lancet2022
BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated co…
Paediatric pneumonia research priorities in the context of Covid-19: An eDelphi study
Open AccessCarina King, K Scott Baker et al.ARTICLEJournal of Global Health2022
Background: Pneumonia remains the leading cause of infectious deaths in children under-five globally. We update the research priorities for childhood pneumonia in the context of the COVID-19 pandemic and explore whether previous priorities have been addressed. Methods: We conducted an eDelphi study from November 2019 to June 2021. Experts were invited to take part, targeting balance by: gender, profession, and high (HIC) and low- and middle-incom…
The association between mental health and metabolic outcomes in youth living with perinatally acquired HIV in the Cape Town Adolescent Antiretroviral Cohort
Sana Mahtab, Jennifer Jao et al.ARTICLEAIDS Care2022
Youth living with perinatally acquired HIV (YLPHIV) have been found to have a range of mental disorders. Some adult HIV studies have linked mental health to adverse metabolic outcomes due to dysregulation of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, but this association has not previously been explored in YLPHIV.We investigated the association of mental health measures with metabolic outcomes in YLPHIV and HIV-uninfe…
Youth perinatal HIV-associated neurocognitive disorders: Association with functional impairment
Nicole Phillips, Kevin GF Thomas et al.ARTICLEAIDS Care2022
HIV-associated functional impairment may cause cognitive impairment secondary to the viral infection, hence, associations between cognitive impairment and functional impairment in youth living with HIV are important to assess. We sought to determine whether cognitive impairment is associated with functional impairment and if it carries higher risk for also having functional impairment. We collected parent-rated information regarding youth functio…
Influence of Maternal Childhood Trauma on Perinatal Depression, Observed Mother–Infant Interactions, and Child Growth
Open AccessKimburley Wy Choi, Christy A Denckla et al.ARTICLEMaternal and Child Health Journal2022
Health trends, inequalities and opportunities in South Africa’s provinces, 1990–2019: Findings from the Global Burden of Disease 2019 Study
Open AccessTom Achoki, Benn Sartorius et al.ARTICLEJournal of Epidemiology and…2022References: 30
BACKGROUND: Over the last 30 years, South Africa has experienced four 'colliding epidemics' of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), we evaluated national and provincial health trends and progress towards imp…
Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burd…
Open AccessMarissa B Reitsma, Parkes J Kendrick et al.ARTICLEThe Lancet2021
BACKGROUND: Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. METHODS: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global B…
Pupillary and Attentional Responses to Infant Facial Expressions in Mothers Across Socioeconomic Variations
Open AccessSanteri Yrttiaho, Belinda Bruwer et al.ARTICLEChild Development2021
Maternal responses to infant facial expressions were examined in two socioeconomically diverse samples of South African mothers (Study I, N = 111; and Study II, N = 214; age: 17–44 years) using pupil and gaze tracking. Study I showed increased pupil response to infant distress expressions in groups recruited from private as compared to public maternity clinics, possibly reflecting underlying differences in socioeconomic status (SES) across the gr…
The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study
Open AccessTatini Mal-Sarkar, Katherine M Keyes et al.ARTICLESSM - Population Health2021
Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes
Childhood Trauma and Mental Health in the Cape Town Adolescent Antiretroviral Cohort
Open AccessTatum Sevenoaks, Jean‐Paul Fouché et al.ARTICLEJournal of Child & Adolescent…2021
Intimate partner violence and growth outcomes through infancy: A longitudinal investigation of multiple mediators in a South African birth cohort
Open AccessWhitney Barnett, Raymond T Nhapi et al.ARTICLEMaternal and Child Nutrition2021
Intimate partner violence (IPV) has been linked to poor fetal and infant growth. However, factors underlying this relationship are not well understood, particularly in the postnatal time period. In a South African cohort, we investigated (1) associations between IPV in pregnancy and growth at birth as well as postnatal IPV and child growth at 12 months and (2) whether maternal depression, tobacco or alcohol use or infant hospitalizations mediated…
HIV-Related Stigma and Psychological Adjustment Among Perinatally HIV-Infected Youth in Cape Town, South Africa
Open AccessAlexander Pérez, Kirsty Brittain et al.ARTICLEAIDS and Behavior2021
Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000-2018
Open AccessNatalia V Bhattacharjee, Lauren E Schaeffer et al.ARTICLENature Human Behaviour2021Cited by: 1References: 32
Exclusive breastfeeding (EBF)-giving infants only breast-milk for the first 6 months of life-is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of E…
Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017
Open AccessJoan B Soriano, Parkes J Kendrick et al.ARTICLEThe Lancet Respiratory Medicine2020
BACKGROUND: Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. METHODS: Using data from the Global Burden of Disease…
Characterization of Pneumococcal Colonization Dynamics and Antimicrobial Resistance Using Shotgun Metagenomic Sequencing in Intensively Sampled South African Infants
Open AccessRendani I Manenzhe, Felix S Dube et al.ARTICLEFrontiers in Public Health2020
There remains a significant proportion of deaths due to pneumococcal pneumonia in infants from low- and middle-income countries despite the marginal global declines recorded in the past decade. Monitoring changes in pneumococcal carriage is key to understanding vaccination-induced shifts in the ecology of carriage, patterns of antimicrobial resistance, and impact on health. We longitudinally investigated pneumococcal carriage dynamics in PCV-13 v…
Protecting children in low-income and middle-income countries from Covid-19
Open AccessSalahuddin Ahmed, Tisungane Mvalo et al.ARTICLEBMJ Global Health2020
A saving grace of the COVID-19 pandemic in high-income and upper middle-income countries has been the relative sparing of children. As the disease spreads across low-income and middle-income countries (LMICs), long-standing system vulnerabilities may tragically manifest, and we worry that children will be increasingly impacted, both directly and indirectly. Drawing on our shared child pneumonia experience globally, we highlight these potential im…