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1

The Republic of Zambia.  

PubMed

In 1964, at independence, Zambia's economic future looked brighter than that of most other developing countries. Its copper production accounted for 8% of total world production, and only neighboring Zaire outpaced it in the production of cobalt. Its Central Province around Kabwe held rich deposits of both zinc and lead; uranium deposits also had been found, but their projected yield remained undetermined. Since 1974, the decline in the price of copper and the increase in the price of oil have played havoc with Zambia's balance of payments. Copper, which accounted for 40% of the gross national product (GNP) and 98% of all foreign exchange in 1964, shrank to 12% of the GNP in 1978 while still generating most of the foreign exchange. As a result, imports were cut back markedly from $1.5 billion in 1973 to $690 million in 1983. Although this trend is beginning to make a U-turn, Zambia's economic situation is grave. In 1984 the GNP continued to register negative growth and inflation stood at 25%. With its urbanization rate doubling from 21% in 1964 to 43% in 1985, Zambia is now the most urbanized country south of the Sahara. Zambia's 1985 population is estimated to be 6.8 million. Between 1963 and 1969, the average annual population growth rate was 2.5: it was 3.1% between 1969-80. The current birthrate of about 48/1000 is expected to decline only marginally in the next 15 years, but the death rate is declining more rapidly -- from 19/1000 in the late 1960s to 15/1000 in 1985. Life expectancy is expected to rise from the current 51 years to about 58 years. As a result of the high growth rate, Zambia's population is young, with a median age of about 16.3 years. Traditional African values stress the importance of large families. Zambia's total fertility rate was 6.9 in 1985. According to the World Bank, only 1% of married women of childbearing age in 1982 used contraceptives. Although tribal links are weakening, Zambia still counts 73 officially recognized tribes. Together, they speak about 40 different dialects. Zambia now apportions over 15% of its national budget to education. Despite some noticeable progress, the public health structure remains deficient. Principal health problems include malaria, tuberculosis, and, in Northern Province and Luapula Province, sleeping sickness and river blindness. About 2/3 of the labor force, an estimated 2.2 million persons in 1982, still work in agriculture. Female labor force participation is lower in Zambia than in many African nations. PMID:12267904

Hakkert, R; Wieringa, R

1986-05-01

2

Educational Television in Zambia  

Microsoft Academic Search

This article discusses the growth, development and use of television in Zambia's educational system. It represents information obtained from senior education authorities; broadcasting officials; educational television services; headmasters\\/headmistresses and teachers of primary and secondary schools, teacher training colleges, adult education centres, and technical institutes. It traces the use of television from the colonial era to present day, discussing its role,

Elizabeth Soremekun

1973-01-01

3

Nontuberculous Mycobacteria, Zambia  

PubMed Central

Clinical relevance of nontuberculous mycobacteria (NTM) isolated from 180 chronically ill patients and 385 healthy controls in Zambia was evaluated to examine the contribution of these isolates to tuberculosis (TB)–like disease. The proportion of NTM-positive sputum samples was significantly higher in the patient group than in controls; 11% and 6%, respectively (p<0.05). NTM-associated lung disease was diagnosed for 1 patient, and a probable diagnosis was made for 3 patients. NTM-positive patients and controls were more likely to report vomiting and diarrhea and were more frequently underweight than the NTM-negative patients and controls. Chest radiographs of NTM-positive patients showed deviations consistent with TB more frequently than those of controls. The most frequently isolated NTM was Mycobacterium avium complex. Multiple, not previously identified mycobacteria (55 of 171 NTM) were isolated from both groups. NTM probably play an important role in the etiology of TB-like diseases in Zambia.

van der Sande, Marianne A.B.; de Graaff, Cas S.; Parkinson, Shelagh; Verbrugh, Henri A.; Petit, Pieter L.C.; van Soolingen, Dick

2009-01-01

4

Zambia's early response to AIDS.  

PubMed

Recognizing the serious threat posed by the AIDS pandemic, the government of Zambia quickly launched a series of initiatives designed to control the spread of the disease. The first cases of AIDS in Zambia were reported in 1985. By April 1986, the disease had been included among the notifiable diseases, and by 1987, the government had already implemented a large coordinated program to combat AIDS. As the government quickly recognized, AIDS poses a great threat to national development. 3,115 cases of AIDS and 12,815 cases of AIDS related complex had been reported as of June 1990. Heterosexual sex and mother- to-child during pregnancy are the man AIDS transmission routes. Zambia's anti-AIDS efforts have led the establishment of The National AIDS Surveillance Committee, which includes members from the Ministry of Health, other ministries, and non-governmental organizations (NGOs). The committee has focused on the following measures for prevention and control: intersectorial health education, research and ethics, procurement and supplies, counseling, condoms, NGO networking, laboratory support and blood screening, and community participation. With assistance from the World Health Organization (WHO), Zambia has launched the Medium Term Plan. Furthermore, a nation-wide health education campaign has been in existence since 1986. Besides prevention measures, the campaign has attempted to promote compassion and care of AIDS patients. Sensitive to their concerns, the government has consulted with religious groups when developing condom promotion campaigns. 1989 and 1990 studies indicate an increased awareness and knowledge about AIDS. PMID:12284199

Nyaywa, S; Chirwa, B; Van Praag, E

5

Observations on abortion in Zambia.  

PubMed

This report describes the findings of a preliminary investigation of women who sought treatment for abortion from the Gynecological Emergency Ward at the University Teaching Hospital (UTH) in Lusaka, Zambia. Barriers to obtaining legal abortions are identified and the harsh experiences of women seeking treatment for complications of illegally induced abortion are discussed. The data contribute to an understanding of the intensity of abortion for Zambian women and draw attention to the value of small-scale, qualitative research on women's reproductive health care needs. It is suggested that a study be planned at UTH to determine how health care delivery can be improved for women who seek abortion. PMID:2219228

Castle, M A; Likwa, R; Whittaker, M

6

Leprosy trends in Zambia 1991-2009.  

PubMed

Objective? To document leprosy trends in Zambia over the past two decades to ascertain the importance of leprosy as a health problem in Zambia. Methods? Retrospective study covering the period 1991-2009 of routine national leprosy surveillance data, published national programme review reports and desk reviews of in-country TB reports. Results? Data reports were available for all the years under study apart from years 2001, 2002 and 2006. The Leprosy case notification rates (CNR) declined from 2.73/10?000 population in 1991 to 0.43/10?000 population in 2009. The general leprosy burden showed a downward trend for both adults and children. Leprosy case burden dropped from approximately 18?000 cases in 1980 to only about 1000 cases in 1996, and by the year 2000, the prevalence rates had fallen to 0.67/10?000 population. There were more multibacillary cases of leprosy than pauci-bacillary cases. Several major gaps in data recording, entry and surveillance were identified. Data on disaggregation by gender, HIV status or geographical origin were not available. Conclusion? Whilst Zambia has achieved WHO targets for leprosy control, leprosy prevalence data from Zambia may not reflect real situation because of poor data recording and surveillance. Greater investment into infrastructure and training are required for more accurate surveillance of leprosy in Zambia. PMID:22845796

Kapata, Nathan; Chanda-Kapata, Pascalina; Grobusch, Martin Peter; O'Grady, Justin; Bates, Matthew; Mwaba, Peter; Zumla, Alimuddin

2012-07-29

7

Gender differences in mathematics education in Zambia  

Microsoft Academic Search

This paper discusses whether gender differences in mathematics education exist in Zambia, and if so, what are their possible causes. Differences are found to be present both in terms of access, and in terms of performance. Possible reasons for such differences are examined, in the light of empirical data consisting of responses to an attitude questionnaire.

Roy Sayers

1994-01-01

8

Zambia: Multi-Faith Religious Education?  

ERIC Educational Resources Information Center

As countries' populations become more religiously diverse, a need to review the religious education syllabus that operates is often perceived. One such country is Zambia, which was not only traditionally religiously diverse but has become even more so with the advent of Christianity, Islam and Hinduism and other non-African faiths. This article…

Carmody, Brendan

2006-01-01

9

Zambia: Multi-Faith Religious Education?  

ERIC Educational Resources Information Center

|As countries' populations become more religiously diverse, a need to review the religious education syllabus that operates is often perceived. One such country is Zambia, which was not only traditionally religiously diverse but has become even more so with the advent of Christianity, Islam and Hinduism and other non-African faiths. This article…

Carmody, Brendan

2006-01-01

10

RELIGIOUS EDUCATION AND PLURALISM IN ZAMBIA  

Microsoft Academic Search

Today, Zambia has a comparatively unified, somewhat exceptional, approach to religious education despite a wide variety of predominantly Christian denominations. This article retraces the history of the development of religious education from when it was entirely confessional to the present time when it has become largely educational. In so doing it identifies some of the difficulties encountered and some of

Brendan Carmody

2003-01-01

11

Structural adjustment and drought in Zambia.  

PubMed

While drought is not uncommon in Zambia, the country is now facing the worst drought in history. The monetary and social costs will be enormous. Although it is too early to measure the economic and social costs of the drought on Zambia, it is obvious that the impact is catastrophic on a country whose economy is under pressure. The drought will affect the structural adjustment programme (SAP) unveiled by the new government which has embraced the market economy. The country has imported, and will continue to import, large quantities of maize and other foodstuffs, a situation likely to strain the balance of payments. Earlier targets with regard to export earnings, reductions in the budget deficit, and GDP growth as contained in the Policy Framework Paper (PFP) are no longer attainable due to the effects of the drought. PMID:7600062

Mulwanda, M

1995-06-01

12

The current status of major tick borne diseases in Zambia  

Microsoft Academic Search

Tick-borne diseases occurring in Zambia are assuming more importance as they continue to be a major economic problem not only in Zambia, but in many parts of Eastern, Southern and Central Africa. The current control methods, which include the use of toxic acaricides to kill ticks, and the virulent sporozoite infection and treatment method have limitations. Recombinant vaccines, currently in

Levi Hakwale

13

AIDS mobilisation in Zambia and Vietnam: explaining the differences  

Microsoft Academic Search

This article compares AIDS mobilisation in Zambia and Vietnam. It looks specifically at the goals of AIDS movements in the two countries, arguing that the Vietnamese movement has been more singular in its focus with its major objective being to achieve representation of people living with HIV (PLHIVs) in AIDS decision-making. In Zambia, the movement has had multiple agendas: human

Amy S. Patterson; David Stephens

2012-01-01

14

7 CFR 319.56-48 - Conditions governing the entry of baby squash and baby courgettes from Zambia.  

Code of Federal Regulations, 2010 CFR

...of baby squash and baby courgettes from Zambia. 319.56-48 Section 319.56-48...of baby squash and baby courgettes from Zambia. Baby squash (Curcurbita maxima ...into the continental United States from Zambia only under the conditions...

2009-01-01

15

7 CFR 319.56-48 - Conditions governing the entry of baby squash and baby courgettes from Zambia.  

Code of Federal Regulations, 2010 CFR

...of baby squash and baby courgettes from Zambia. 319.56-48 Section 319.56-48...of baby squash and baby courgettes from Zambia. Baby squash (Curcurbita maxima ...into the continental United States from Zambia only under the conditions...

2010-01-01

16

Financial deepening and poverty reduction in Zambia: an empirical investigation  

Microsoft Academic Search

Purpose – The purpose of this paper is to examine the inter-temporal causal relationship between financial sector development and poverty reduction in Zambia. The paper attempts to answer one critical question: does financial sector development in Zambia lead to poverty reduction? Design\\/methodology\\/approach – The paper uses the newly developed autoregressive distributed lag-bounds testing procedure, which has numerous advantages, especially when

Nicholas M. Odhiambo

2010-01-01

17

Rift Valley fever: Real or perceived threat for Zambia?  

PubMed

Rift Valley fever (RVF) in Zambia was first reported in 1974 during an epizootic of cattle and sheep that occurred in parts of Central, Southern and Copperbelt Provinces. In 1990, the disease was documented in nine districts of the provinces of Zambia. In the last two decades, there have been no reports of RVF. This long period without reported clinical disease raises questions as to whether RVF is a current or just a perceived threat. To address this question, World Organisation for Animal Health (OIE) disease occurrence data on RVF for the period 2005-2010 in the Southern Africa Development Community (SADC) was analysed. From the analysis, it was evident that most countries that share a common border with Zambia had reported at least one occurrence of the disease during the period under review. Due to the absence of natural physical barriers between Zambia and most of her neighbours, informal livestock trade and movements is a ubiquitous reality. Analysis of the rainfall patterns also showed that Zambia received rains sufficient to support a mosquito population large enough for high risk of RVF transmission. The evidence of disease occurrence in nearby countries coupled with animal movement, and environmental risk suggests that RVF is a serious threat to Zambia. In conclusion, the current occurrence of RVF in Zambia is unclear, but there are sufficient indications that the magnitude of the circulating infection is such that capacity building in disease surveillance and courses on recognition of the disease for field staff is recommended. Given the zoonotic potential of RVF, these measures are also a prerequisite for accurate assessment of the disease burden in humans. PMID:23327389

Dautu, George; Sindato, Calvin; Mweene, Aaron S; Samui, Kenny L; Roy, Polly; Noad, Robert; Paweska, Janusz; Majiwa, Phelix A O; Musoke, Antony

2012-06-20

18

Fertilizer Use on Smallholder Farms in Eastern Province, Zambia.  

National Technical Information Service (NTIS)

Use and diffusion of fertilizer have generally been disappointing in Africa, but in Eastern Province, Zambia, fertilizer has been the key to increased production. The study looks at how farmers make decisions on whether to use fertilizer, how much to appl...

D. Jha B. Hojjati

1993-01-01

19

Deschooling Language Study in East Africa: The Zambia Plan.  

ERIC Educational Resources Information Center

The second language learning methods of Southern Baptist missionaries in Zambia are described. Instead of studying the new language in a school setting, the student receives a week of orientation and is then placed in the community and expected to practice communicating with the native speakers at every opportunity. The student follows a course…

Roberts, David Harrill

20

Social Isolation and Aging in Zambia: Examining the Possible Predictors  

PubMed Central

This research paper examined social isolation and aging in Zambia by examining possible predictors. The paper produces evidence on risk factors likely to engender social isolation among the elderly population of Zambia. Snowball sampling was undertaken to select 690 adults aged 60 and over in communities as well as those living in homes for the aged. A structured questionnaire was used to solicit information from respondents. Results show that old people in Zambia experience forms of social isolation which exhibit themselves (but not limited to) through such factors as loss of appetite, stress, moody, hopeless, useless, unhappy, and lonely. On balance, however, the direction of association and the number of statistically significant findings suggest that associations between variables examined and risk factors associated with social isolation amongst older people in this analysis could explain the overall situation occuring currently in Zambia and probably other developing countries. In view of this, this study recommends that further work is needed to identify and explain details of factors of social isolation using techniques such as focus group discussions as well as in-depth interviews with key informants. Such approaches may even help to explain why, for example, sex seems not to be significant in determining indicators of social isolation.

Mapoma, Christopher Chabila; Masaiti, Gift

2012-01-01

21

The Use of Insects as Human Food in Zambia  

Microsoft Academic Search

Problem statement: The life cycle and culture structure of two commonl y eaten worms in Zambia (Isoberlinia paniculata and Miombo\\/Mopani) were evaluated. The worms were grown on an artificial medium to evaluate the potential of prod ucing them on a commercial scale. Approach: An interesting characteristic of the worms studied was that they reached their maximum weight and maximum length

A. E. Ghaly

2009-01-01

22

Sexual activity among junior secondary school girls in Zambia.  

PubMed

This paper proposes a causal model of sexual activity among a randomly selected sample of 305 Junio secondary school girls in Zambia. The results indicate that liberal sexual attitudes influence romantic involvement with boys. Emotional involvement is likely to result in sexual activity. Traditional courtship forms are slowly being replaced by modern patterns of courtship behaviour. Policy and programme implications are discussed. PMID:9881137

Pillai, V K; Barton, T; Benefo, K

1997-07-01

23

Cigarette smoking among school-going adolescents in Kafue, Zambia  

Microsoft Academic Search

Introduction: Cigarette smoking is a leading cause of global morbidity and mortality. Interest in developing countries smoking prevalence has been growing since 1999. Objectives: To estimate the prevalence of current cigarette smoking and associated factors among school-age adolescents in Kafue, Zambia. Methods: A cross sectional study was conducted using standard Global Youth Tobacco Survey (GYTS) methodology. Frequencies and odds ratios

Seter Siziya; Emmanuel Rudatsikira; Adamson S. Muula

2007-01-01

24

The Implementation of School Based Continuous Assessment (CA) in Zambia  

ERIC Educational Resources Information Center

In Zambia, continuous assessment (CA) is defined as an on-going, diagnostic, classroom-based process that uses a variety of assessment tools to measure learner performance (MOE, 2005:5). Over the years, examinations have been used for selection and certification, without formal considerations on school-based continuous assessment as a component in…

Kapambwe, William M.

2010-01-01

25

Textbooks and Learning Materials Program: Zambia. Final Report  

ERIC Educational Resources Information Center

The Mississippi Consortium for International Development's (MCID's) intervention involved the development, publication and distribution of an Integrated Foundations of Learning Kit, focused on numeracy. This intervention was aligned with Zambia's priorities and strategies and matched the requirements of the Textbooks and Learning Materials Program…

US Agency for International Development, 2009

2009-01-01

26

Status and Distribution of Cheetah in Zambia: A Preliminary Assessment  

Microsoft Academic Search

The historical and present day distribution of cheetah in Zambia appear to be similar, although the range has contracted. Liuwa Plains National Park, the northern section of the Kafue National Park and South Lu- angwa National Park still hold populations of cheetahs, although it was not possible to estimate population sizes. Cheetahs are reported from the Chimbwi plains area of

Gianetta Purchase

27

Internet in Rural Areas of Zambia: A User Study  

Microsoft Academic Search

Interviews in rural Zambia taught us how people use the internet and the benefits they experience. The study showed that people and communities in rural areas do benefit from ICT both socially and economically. Basically, they use the internet for the same purposes as people in Western countries, such as to communicate, to search for information and to buy things.

Paula VAN HOORIK

28

How interest groups lobby to influence budget outcomes in Zambia  

Microsoft Academic Search

This paper examines the nature of state–business relations and how interest groups utilise the budget process to lobby for tax and expenditure policies in Zambia, using information compiled from budget proposals interest groups submit towards the budget and lobbying activity data published in the daily newspapers between 2006 and 2008. The data shows a significant increase in interest groups formed

Samuel M. Bwalya; Ezekiel Phiri; Kelvin Mpembamoto

2011-01-01

29

BREAKING THE NET: FAMILY STRUCTURE AND STREET CHILDREN IN ZAMBIA  

Microsoft Academic Search

Drawing on original fieldwork in the slums of Ndola in Northern Zambia we study the role of family structure in caring for vulnerable children. We try to isolate those features of a child’s nuclear and extended family that put him most at risk of ending up on the streets. We find that older, male children and particularly orphaned children are

Claudia Olivetti; Francesco Strobbe; Mireille Jacobson

2011-01-01

30

Hunting behavior and strategies of the Valley Bisa in Zambia  

Microsoft Academic Search

This article describes the hunting tactics and prey selection of the Valley Bisa, a matrilineal, subsistence-oriented society in the Luangwa Valley of Zambia. Although Valley Bisa hunters explain their behavior in their own idioms, many of their tactics, including the stimuli for and timing of hunts, the circular morphology of their hunting patterns, and randomized searches, appear functionally related to

Stuart A. Marks

1977-01-01

31

Operational Paper Comparative study of rainwater quality in urban Zambia  

Microsoft Academic Search

Five rainwater harvesting systems were installed in two peri-urban areas of Lusaka, the capital city of Zambia, consisting of six ferrocement tanks. Water samples were collected from the direct rain, roof and tank. In order to compare the rainwater quality with water from other sources, samples were also collected from piped water, boreholes and shallow wells. Rainwater was of higher

Lubinga Handia

32

Patterns of Rift Valley fever activity in Zambia.  

PubMed Central

An hypothesis that there was an annual emergence of Rift Valley fever virus in Zambia, during or after the seasonal rains, was examined with the aid of sentinel cattle. Serum samples taken during 1974 and 1978 showed evidence of epizootic Rift Valley fever in Zambia, with more than 80% positive. A sentinel herd exposed from 1982 to 1986 showed that some Rift Valley fever occurred each year. This was usually at a low level, with 3-8% of the susceptible cattle seroconverting. In 1985-6 more than 20% of the animals seroconverted, and this greater activity was associated with vegetational changes--which could be detected by remote-sensing satellite imagery--which have also been associated with greater virus activity in Kenya.

Davies, F. G.; Kilelu, E.; Linthicum, K. J.; Pegram, R. G.

1992-01-01

33

Circumstances and motivations for fostering children in Zambia  

Microsoft Academic Search

This short report explores motivations and circumstances of fostering children at six sites in Zambia. Cross-sectional community household surveys using multistage random sampling (totalling 1503 households, reporting on 5009 children) and participatory qualitative research (focus groups and in-depth interviews) with adult and youth community members were conducted as part of baseline research for the US-funded RAPIDS (Reaching HIV\\/AIDS Affected People

Katie D. Schenk; Lewis Ndhlovu; Stephen Tembo; Andson Nsune; Chozi Nkhata; Batuke Walusiku; Charlotte Watts

2008-01-01

34

Focused maternal ultrasound by midwives in rural Zambia.  

PubMed

Point-of-care ultrasound is being increasingly implemented in resource-poor settings in an ad hoc fashion. We developed a focused maternal ultrasound-training program for midwives in a rural health district in Zambia. Four hundred forty-one scans were recorded by 21 midwives during the 6-month study period. In 74 scans (17%), the ultrasound findings prompted a change in clinical decision-making. Eight of the midwives were evaluated with a 14-question observed structured clinical examination (OSCE) and demonstrated a slight overall improvement with mean scores at 2 and 6 months of 10.0/14 (71%) and 11.6/14 (83%), respectively. Our pilot project demonstrates that midwives in rural Zambia can be trained to perform basic obstetric ultrasound and that it impacts clinical decision-making. Ultrasound skills were retained over the study period. More data is necessary to determine whether the introduction of ultrasound ultimately improves outcomes of pregnant women in rural Zambia. PMID:20691916

Kimberly, Heidi Harbison; Murray, Alice; Mennicke, Maria; Liteplo, Andrew; Lew, Jason; Bohan, J Stephen; Tyer-Viola, Lynda; Ahn, Roy; Burke, Thomas; Noble, Vicki E

2010-08-01

35

Strategies for Living with the Challenges of HIV and Antiretroviral Use in Zambia  

ERIC Educational Resources Information Center

This study sought to identify strategies for living with the challenges of HIV and antiretroviral (ARV) use among new medication users in urban Zambia. Participants (n = 160) were recruited from urban Lusaka, Zambia. Qualitative Data was drawn from monthly ARV treatment education intervention groups addressing HIV and antiretroviral use. Themes…

Jones, Deborah; Zulu, Isaac; Mumbi, Miriam; Chitalu, Ndashi; Vamos, Szonja; Gomez, Jacqueline; Weiss, Stephen M.

2009-01-01

36

Achieving Middle-Income Status by 2030: Is this the Most Appropriate Objective for Zambia?  

Microsoft Academic Search

On the backdrop of three important quotes and based on a wealth of underlying research, this article presents a systematic review of growth and development measurement in general and specifically in relation to Zambia’s prospects of achieving middle income status by 2030. It highlights what it takes to achieve middle income status and what the limitations of such ambitions are.

Venkatesh Seshamani

2010-01-01

37

FIELD STUDIES OF THE AFRICAN CRAKE CREX EGREGIA IN ZAMBIA AND KENYA  

Microsoft Academic Search

Taylor, P. B. 1985. Field studies of the African Crake Crex egregia in Zambia and Kenya. Ostrich 56: 170–185.Field observations were made of a breeding population of African Crake Crex egregia at Ndola, Zambia from 1975 to 1980 and of a nonbreeding population at Mombasa, Kenya in 1981. Both populations are migratory and the Kenyan birds are thought to breed

P. B. Taylor

1985-01-01

38

Evaluation of the use of insects for biological control of Lantana camara L. (Verbenaceae) in Zambia  

Microsoft Academic Search

The present status of the imported and naturally occurring insects pests of Lantana camara L. a noxious exotic weed in Zambia, was determined by survey. Of the seven insect species imported in 1969–74, only Teleonemia scrupulosa Stål has become established in Zambia and occurs today all over the country. Two other neotropical lantana insects, namely Ophiomyia lantanae (Froggat) and Lantanophaga

K. Löyttyniemi

1982-01-01

39

Why Context Matters: Understanding the Material Conditions of School-Based Caring in Zambia  

ERIC Educational Resources Information Center

|This study utilized in-depth interviewing, participant observation, and student diaries completed by participants to examine the quality of teacher-student relationships at a low-cost private school in the townships of Ndola, Zambia. Amidst economic decline and the HIV/AIDS epidemic facing Zambia today, teachers and students developed strong…

Bajaj, Monisha

2009-01-01

40

Microbiological evaluation of fresh-cut organic vegetables produced in Zambia  

Microsoft Academic Search

This study was undertaken to assess the microbiological quality of fresh-cut organic vegetables produced in Zambia. Fresh-cut organic mixed vegetables and green beans produced in Zambia were analysed for aerobic plate counts, coliforms, Enterobacteriaceae, Escherichia coli, Bacillus cereus, Clostridium perfringens, Listeria monocytogenes, Salmonella spp., Staphylococcus aureus, and yeast and mould counts. The study included 160 samples for most of the

Kabwit Nguz; John Shindano; Simbarashe Samapundo; André Huyghebaert

2005-01-01

41

7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 false Baby corn and baby carrots from Zambia. 319.56-43 Section... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked...consignments only. (b) Immature âbabyâ carrots (Daucus carota L. ssp....

2013-01-01

42

Harmful lifestyles' clustering among sexually active in-school adolescents in Zambia  

Microsoft Academic Search

BACKGROUND: HIV is a leading cause of morbidity and mortality in Zambia. Like many other African nations with high HIV burden, heterosexual intercourse is the commonest mode of HIV spread. The estimation of prevalence and factors associated with sexual intercourse among in-school adolescents has potential to inform public health interventions aimed at reducing the burden of sex-related diseases in Zambia.

Seter Siziya; Adamson S Muula; Lawrence N Kazembe; Emmanuel Rudatsikira

2008-01-01

43

Task-shifting HIV counselling and testing services in Zambia: the role of lay counsellors  

Microsoft Academic Search

BACKGROUND: The human resource shortage in Zambia is placing a heavy burden on the few health care workers available at health facilities. The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained

Parsa Sanjana; Kwasi Torpey; Alison Schwarzwalder; Caroline Simumba; Prisca Kasonde; Lameck Nyirenda; Paul Kapanda; Matilda Kakungu-Simpungwe; Mushota Kabaso; Catherine Thompson

2009-01-01

44

Child Abuse and Aids-Related Knowledge, Attitudes and Behavior among Adolescents in Zambia  

ERIC Educational Resources Information Center

|Objective: To research the correlation between physical and sexual abuse by family members and AIDS-related knowledge, attitudes, self-efficacy and behavior among urban and rural adolescents in Zambia. Sample: The sample comprises 3,360 adolescents, aged 10-19, from urban and rural Zambia; 2,160 of them attended school, while 1,200 of them did…

Slonim-Nevo, Vered; Mukuka, Lawrence

2007-01-01

45

Prevalence of trypanosomiasis in cattle in south-west Zambia.  

PubMed

A trypanosomiasis survey was conducted in South-West Zambia. From a total of 3,346 cattle sampled 342 cattle showed a positive trypanosomiasis parasitaemia. During the survey trypanosome species and PCV values were also recorded. With simple statistical analysis populations with higher and lower prevalence rates were differentiated. The results indicated that the Kwando River Basin Tsetse Fly Belt and the Kafue River Basin Tsetse Fly Belt infested a larger area than originally assumed and that a link-up between both belts occurred or will occur in the near future. PMID:3400114

Corten, J J; ter Huurne, A A; Moorhouse, P D; de Rooij, R C

1988-05-01

46

Telemedicine in Primary Health: The Virtual Doctor Project Zambia  

PubMed Central

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO]. This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront.

2011-01-01

47

Will savannas survive outside the parks? A lesson from Zambia  

NASA Astrophysics Data System (ADS)

Miombo woodlands cover the transition zone between dry open savannas and moist forests in Southern Africa. They cover about 2.7 million km2 in southern Africa and provide many ecosystem services that support rural life, including medical products, wild foods, construction timber and fuel. In Zambia, as in many of its neighbouring countries, miombo woodlands are currently experiencing accelerating degradation and clearing, mostly with charcoal production as the initial driver. Domestic energy needs in the growing urban areas are largely satisfied by charcoal, which is less energy-efficient fuel on a tree-to-table basis than the firewood that is used in rural areas, but has a higher energy density and is thus cheaper to transport. This study uses data from inventories and from eddy covariance measurements of carbon exchange to characterize the impact of charcoal production on miombo woodlands. We address the following questions: (i) how much carbon is lost at local as well as at national scale and (ii) does forest degradation result in the loss of a carbon sink? On the basis of our data we (iii) estimate the per capita emissions through deforestation and forest degradation in Zambia and relate it to fossil fuel emissions. Furthermore, (iv) a rough estimate of the energy that is provided by charcoal production to private households at a national level is calculated and (v) options for alternative energy supply to private households are discussed.

Kutsch, W.; Merbold, L.; Scholes, B.; Mukelabai, M.

2012-04-01

48

Predictors of Adherence to Antiretroviral Therapy in Rural Zambia  

PubMed Central

Background/Objective Antiretroviral therapy (ART) adherence levels of ?95% optimize outcomes and minimize HIV drug resistance. As such, identifying barriers to adherence is essential. We sought to assess travel to point-of-care for ART as a potential barrier to adherence in rural Zambia, within the context of patient demographics, perceived stigma, and selected clinical indices. Methods We studied 424 patients receiving ART from the Macha Mission Hospital (MMH). Interviews ascertained age, gender, education, perceived stigma, nearest rural health facility (RHF), and mode/cost/time of transport for each study participant. Motorcycle odometer and global positioning system way-points measured distance from the MMH to each of the RHFs, estimating patients’ home-to-MMH travel distances. Body mass index, World Health Organization HIV/AIDS stage, and pill counts were assessed from review of patients’ medical and pharmacy records. Results At least 95% adherence was documented for 83.7% of the patients in their first months of ART. Travel-related factors did not predict adherence. Adherence was higher for those on ART for a longer time (odds ratio = 1.04 per day; P = 0.002). Conclusions Patients in rural Zambia can achieve adherence rates compatible with good clinical outcomes despite long travel distances. The MMH was able to provide quality HIV/AIDS care by implementing programmatic features selecting for a highly adherent population in this resource-limited setting.

Carlucci, James G.; Kamanga, Aniset; Sheneberger, Robb; Shepherd, Bryan E.; Jenkins, Cathy A.; Spurrier, John; Vermund, Sten H.

2009-01-01

49

Bacteria Isolations from Broiler and Layer Chicks in Zambia  

PubMed Central

Chick mortality (CM) is one of the major constraints to the expansion of the poultry industry in Zambia. Of the 2,829 avian disease cases submitted to the national diagnostic laboratory based at the Central Veterinary Research Institute in Lusaka between 1995 and 2007, 34.39% (973/2,829) were from CM cases. The disease accounted for 40.2% (218,787/544,903) mortality in the affected flocks with 89.6% (196,112/218,787) of the affected birds dying within seven days. Major bacteria species involved were Escherichia coli, Salmonella gallinarum, and Proteus species being isolated from 84.58%, 46.15%, and 26.93% of the reported CM cases (n = 973), respectively. Detection of Salmonella typhimurium, Salmonella enteritidis, and Salmonella dublin indicates that poultry has the potential of transmitting zoonotic pathogenic bacteria to humans. The proportion of Salmonella gallinarum reactors in the adult breeding stock was generally low (<0.5%) throughout the study period although its prevalence in CM cases was correlated (r = 0.68, P < 0.011) with seroprevalence of the same pathogen in the adult breeding stock. Given that the disease accounts for a large proportion of the avian diseases in Zambia as shown in the present study (34.39%, n = 2,829), it is imperative that an effective disease control strategy aimed at reducing its occurrence should be developed.

Munang'andu, Hetron Mweemba; Kabilika, Swithine Hameenda; Chibomba, Oliver; Munyeme, Musso; Muuka, Geoffrey Munkombwe

2012-01-01

50

Study of familial Parkinson's disease in Russia, Uzbekistan, and Zambia  

PubMed Central

Objective: The aims of this study were (A) to determine inheritance patterns of familial Parkinson's disease in three different geographical areas (Russia, Uzbekistan, and Zambia); (B) compare clinical characteristics of familial with sporadic Parkinson's disease; and (C) assess whether there were ethnic differences in clinical manifestations of the disease. Methods: Fifty two index cases of familial Parkinson's disease in Moscow, 55 in Tashkent, and 27 in Lusaka were selected on the basis of the typical clinical features of Parkinson's disease with a familial history. The sex ratio, transmission patterns, and segregation ratio were determined by pedigree analysis. Results: Familial Parkinson's disease was found in all three countries (30 families in Russia, 12 in Uzbekistan, and seven in Zambia), and appeared more common in Russia. Both autosomal dominant and autosomal recessive patterns of inheritance were seen, but autosomal dominance was more common in all countries. Conclusions: In all three countries men have a higher risk of developing Parkinson's disease than women and there are ethnic differences in clinical manifestations of the disease. The onset of both familial and sporadic Parkinson's disease in Zambian patients occurs at a younger age and is associated with slow progression and a benign course, and generally responds well to levodopa treatment.

Atadzhanov, M; Zumla, A; Mwaba, P

2005-01-01

51

Epidemiological analysis of tick-borne diseases in Zambia.  

PubMed

Tick-borne diseases are a constraint to livestock production in many developing countries as they cause high morbidity and mortality, which results in decreased production of meat, milk and other livestock by-products. The most important tick-borne diseases of livestock in sub-Saharan Africa are East Coast fever (caused by Theileria parva), babesiosis (caused by Babesia bigemina and B. bovis), anaplasmosis (caused by Anaplasma marginale) and heartwater (caused by Ehrlichia ruminantium). Despite their economic importance, information on the epidemiology of these diseases in many countries, including Zambia, is often inadequate, making rational disease control strategies difficult to implement. In this study 18S and 16S rRNA gene PCR assays were used for a comprehensive epidemiological analysis of tick-borne disease of cattle in three provinces of Zambia (Lusaka, Central and Eastern). All the disease pathogens under study (T. parva, T. mutans, T. taurotragi, B. bovis, B. bigemina, Anaplasma spp and E. ruminantium) were prevalent in each of the provinces surveyed. However, variation was observed in prevalence between regions and seasons. There was no association between live vaccination against East Coast fever and being PCR positive for T. parva. A number of risk factors were shown to be associated with (a) the occurrence of tick-borne pathogens in cattle and (b) cattle tick burdens in the wet season. A negative association was observed between the number of co-infecting pathogens and the erythrocyte packed cell volume (PCV) of carrier cattle. PMID:21106294

Simuunza, Martin; Weir, William; Courcier, Emily; Tait, Andy; Shiels, Brian

2010-11-24

52

The reach and impact of social marketing and reproductive health communication campaigns in Zambia  

Microsoft Academic Search

BACKGROUND: Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV\\/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV\\/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV\\/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact

Ronan Van Rossem; Dominique Meekers

2007-01-01

53

Maize, food insecurity, and the field of performance in southern Zambia  

Microsoft Academic Search

This paper explores the interrelationship between maize farming, the discourse of modernity, and the performance of a modern\\u000a farmer in southern Zambia. The post-colonial Zambian government discursively constructed maize as a vehicle for expanding\\u000a economic modernization into rural Zambia and undoing the colonial government’s urban modernization bias. The pressures of\\u000a neo-liberal reform have changed this discursive construction in ways that

Nicholas Sitko

2008-01-01

54

Mutumwa Nchimi healers and wizardry beliefs in Zambia.  

PubMed

Mutumwa Nchimi practitioners in Zambia today are neotraditional healers who specialize in the diagnosis and curing of illnesses and misfortunes allegedly caused by wizardry (buloshi). Nchimi means 'witch-diviner' and Mutumwa means 'sent (by God)'. Their witch-divining practices are thus placed within the new biblical religious framework. Mutumwa Nchimi healers are contemporary African psychiatrists and psychotherapists who fully accept and work within the framework of the wizardry paradigm as the explanatory mechanism for a whole range of problems and illnesses experienced by a large number of Zambia's urban dwellers. Their success in attracting patients bears witness to the extent to which wizardry still persists as a paradigm for evil. The research data used is comprised of 143 complete tape-recorded cases of Mutumwa Nchimi diagnoses in addition to 1233 summaries of book-recorded cases. Buloshi is mentioned as the cause of illness and misfortune in 58% of the tape-recorded cases and in 55.9% of the book-recorded cases. Wizardry is perceived by Mutumwa Nchimi healers to relate to two dimensions which refer to the activity of witchcraft and of sorcery respectively. The former relates to witch spirits and fibanda ghosts; the latter relates to the use of bwanga magical charms. In addition to the need for prayer and reconciliation, psychotherapy requires the cleansing of one's body and of one's house from buloshi attack. The two dimensions of witchcraft and of sorcery, though distinct, are seen to be essentially related to one another. The dreams of patients, in which unconscious pressures come to the surface, are perceived to confirm the existence and reality of wizardry assault. Wizardry beliefs are placed firmly within the context of social relationships and social change in Zambia and psychosocial analysis is at the centre of the diagnostic process. Wizardry beliefs are seen by Mutumwa Nchimi healers to reflect the problems faced by urban dwellers in particular who, on the one hand, find themselves afflicted by feelings of shame or guilt with respect to failure to observe traditional morality and, on the other hand, by an awareness of suspected rival forces in the competitive urban environment. PMID:3393933

Dillon-Malone, C

1988-01-01

55

HIV stress in primary school teachers in Zambia.  

PubMed Central

A study was made of stress factors experienced by primary school teachers in Zambia after they had attended a course on stress management and counselling skills. Their pupils were significantly affected by poverty, death and illness of parents, fellow-pupils and teachers, teenage sex and pregnancy, violence in the home and, among girls, low self-esteem. The HIV epidemic had a major bearing on these factors, and there were wide-ranging effects on the teachers' own lives. Despite the training they had been given, many teachers felt that they could not adequately counsel their pupils on these matters. The teachers were in need of continuing support and training to enable them to cope with this aspect of their work.

Baggaley, R.; Sulwe, J.; Chilala, M.; Mashambe, C.

1999-01-01

56

Perinatal transmission of HIV-I in Zambia.  

PubMed Central

OBJECTIVE--To determine the occurrence of vertical transmission of HIV-I from women positive for the virus and the prognosis for their babies. DESIGN--Women presenting in labour were tested for HIV-I. Their newborn babies were also tested. Women positive for the virus were followed up with their babies for two years. SETTING--Teaching hospital in Lusaka, Zambia. SUBJECTS--1954 Women, of whom 227 were seropositive. Of 205 babies, 192 were positive for HIV-I. After birth 109 seropositive mothers and their babies and 40 seronegative mothers and their babies were available for follow up. MAIN OUTCOME MEASURES--Serological examination of mothers and their babies by western blotting. Birth weight and subsequent survival of babies. Women and babies were tested over two years for signs of seroconversion and symptoms of infection with HIV, AIDS related complex, and AIDS. RESULTS--Of the 109 babies born to seropositive mothers and available for follow up, 18 died before 8 months, 14 with clinical AIDS. Of the 91 remaining, 23 were seropositive at 8 months. By 24 months 23 of 86 surviving babies were seropositive, and a further five infected babies had died, four were terminally ill, 17 had AIDS related complex, and two had no symptoms. The overall rate of perinatal transmission was 42 out of 109 (39%). The overall mortality of infected children at 2 years was 19 out of 42 (44%). Before the age of 1 year infected children had pneumonia and recurrent coughs, thereafter symptoms included failure to thrive, recurrent diarrhoea and fever, pneumonia, candidiasis, and lymphodenopathy. All babies had received live attenuated vaccines before 8 months with no adverse affects. CONCLUSIONS--Vertical transmission from infected mothers to their babies is high in Zambia and prognosis is poor for the babies. Perinatal transmission and paediatric AIDS must be reduced, possibly by screening young women and counselling those positive for HIV-I against future pregnancy.

Hira, S. K.; Kamanga, J.; Bhat, G. J.; Mwale, C.; Tembo, G.; Luo, N.; Perine, P. L.

1989-01-01

57

Health worker perspectives on user fee removal in Zambia  

PubMed Central

Background User fees for primary care services were removed in rural districts in Zambia in 2006. Experience from other countries has suggested that health workers play a key role in determining the success of a fee removal policy, but also find the implementation of such a policy challenging. The policy was introduced against a backdrop of a major shortage in qualified health staff. Methods As part of a larger study on the experience and effect of user fee removal in Zambia, a number of case studies at the facility level were conducted. As part of these, quantitative and qualitative data were collected to evaluate health workers’ satisfaction and experiences in charging and non-charging facilities. Results Our findings show that health-care workers have mixed feelings about the policy change and its consequences. We found some evidence that personnel motivation was higher in non-charging facilities compared to facilities still charging. Yet it is unclear whether this effect was due to differences in the user fee policy or to the fact that a lot of staff interviewed in non-charging facilities were working in mission facilities, where we found a significantly higher motivation. Health workers expressed satisfaction with an apparent increase in the number of patients visiting the facilities and the removal of a deterring factor for many needy patients, but also complained about an increased workload. Furthermore, working conditions were said to have worsened, which staff felt was linked to the absence of additional resources to deal with the increased demand or replace the loss of revenue generated by fees. Conclusion These findings highlight the need to pay attention to supply-side measures when removing demand-side barriers such as user fees and in particular to be concerned about the burden that increased demand can place on already over-stretched health workers.

2012-01-01

58

“Health regains but livelihoods lag”: findings from a study with people on ART in Zambia and Kenya  

Microsoft Academic Search

Although ART is increasingly accessible and eases some stresses, it creates other challenges including the importance of food security to enhance ART-effectiveness. This paper explores the role livelihood strategies play in achieving food security and maintaining nutritional status among ART patients in Kenya and Zambia. Ongoing quantitative studies exploring adherence to ART in Mombasa, Kenya (n=118) and in Lusaka, Zambia

Fiona A. Samuels; Naomi Rutenberg

2011-01-01

59

University Adult Education in Independent Zambia: The Role of a Department of Extra-Mural Studies in National Development  

ERIC Educational Resources Information Center

|Like other African countries, Zambia's most pragmatic approach to national development must lie in adult education. The University of Zambia is one agency involved toward this goal and its emphasis is on rapid expansion of university-type education and the training of adult educators. (Author/JB)|

Okafor, Clement Abiazem

1971-01-01

60

The Zambia Children's KS-HHV8 Study: Rationale, Study Design, and Study Methods  

PubMed Central

The epidemic of human immunodeficiency virus in Zambia has led to a dramatic rise in the incidence of human herpesvirus-8 (HHV-8)–associated Kaposi's sarcoma in both adults and children. However, there is a paucity of knowledge about the routes of HHV-8 transmission to young children. The Zambia Children's KS-HHV8 Study, a large, prospective cohort study in Lusaka, Zambia, was launched in 2004 to investigate the role of household members as a source of HHV-8 infection in young children and social behaviors that may modify the risk of HHV-8 acquisition. This cohort is distinct from other epidemiologic studies designed to investigate HHV-8 incidence and transmission because it recruited and followed complete households in the urban central African context. Between July 2004 and March 2007, 1,600 households were screened; 368 households comprising 464 children and 1,335 caregivers and household members were enrolled. Follow-up of this population continued for 48 months postrecruitment, affording a unique opportunity to study horizontal transmission of HHV-8 and understand the routes and sources of transmission to young children in Zambia. The authors describe the study rationale, design, execution, and characteristics of this cohort, which provides critical data on the epidemiology and transmission of HHV-8 to young children in Zambia.

Minhas, Veenu; Crabtree, Kay L.; Chao, Ann; Wojcicki, Janet M.; Sifuniso, Adrian M.; Nkonde, Catherine; Kankasa, Chipepo; Mitchell, Charles D.; Wood, Charles

2011-01-01

61

Anthelmintic efficacy in captive wild impala antelope (Aepyceros melampus) in Lusaka, Zambia.  

PubMed

There has been an increase in the number of wild ungulates kept in captivity for ecotourism and conservation in Zambia and these animals are susceptible to a number of diseases including gastrointestinal helminth infections. Surveys to determine anthelmintic efficacy to gastrointestinal nematodes in captive-wildlife are not common and there have been no reports of anthelmintic resistance in captive-wildlife in Zambia. This study was carried out to determine the efficacy of the benzimidazole anthelmintic fenbendazole in captive wild impala (Aepyceros melampus) in Zambia. During the month of April 2011, at the end of the rainy season, the faecal egg count reduction test was performed at a private game facility for assessing anthelmintic efficacy of oral fenbendazole and the anthelmintic treatment showed an efficacy of 90%. Haemonchus spp. and Trichostrongylus spp. were the predominant genera present before treatment, but Haemonchus spp. larvae were the only genus recovered from the faecal cultures after anthelmintic treatment. This represents the first documentation of anthelmintic treatment failure in captive wild-antelopes in Zambia. It also demonstrated the ineffectiveness of the common traditional practice of deworming captive-wild antelopes at the end of the rainy season due to the rapid re-infection of impala that occurs due to high pasture infectivity. Suggestions on changes to current anthelmintic use/practices that will make them more efficacious and reduce the possibility of development of anthelmintic resistance in captive wild game in Zambia are also made. PMID:22115945

Nalubamba, King S; Mudenda, Ntombi B

2011-11-11

62

Scaling Up Malaria Control in Zambia: Progress and Impact 2005-2008  

PubMed Central

Zambia national survey, administrative, health facility, and special study data were used to assess progress and impact in national malaria control between 2000 and 2008. Zambia malaria financial support expanded from US$9 million in 2003 to US$ ~40 million in 2008. High malaria prevention coverage was achieved and extended to poor and rural areas. Increasing coverage was consistent in time and location with reductions in child (age 6–59 months) parasitemia and severe anemia (53% and 68% reductions, respectively, from 2006 to 2008) and with lower post-neonatal infant and 1–4 years of age child mortality (38% and 36% reductions between 2001/2 and 2007 survey estimates). Zambia has dramatically reduced malaria transmission, disease, and child mortality burden through rapid national scale-up of effective interventions. Sustained progress toward malaria elimination will require maintaining high prevention coverage and further reducing transmission by actively searching for and treating infected people who harbor malaria parasites.

Chizema-Kawesha, Elizabeth; Miller, John M.; Steketee, Richard W.; Mukonka, Victor M.; Mukuka, Chilandu; Mohamed, Abdirahman D.; Miti, Simon K.; Campbell, Carlos C.

2010-01-01

63

Priorities for Antiretroviral Therapy Research in Sub-Saharan Africa: A 2002 Consensus Conference in Zambia  

PubMed Central

Background A consensus conference was held to discuss priorities for antiretroviral therapy (ART) research in Zambia, one of the world’s most heavily HIV-afflicted nations. Zambia, like other resource-limited settings, has increasing access to highly active antiretroviral therapy (HAART) because of declining drug costs, use of government-purchased generic medications, and increased global donations. For sustained delivery of care with HAART in a resource-constrained medical and public health context, operational research is required and clinical trials are desirable. The priority areas for research are most relevant today given the increasing availability of HAART. Methods A conference was held in Lusaka, Zambia, in January 2002 to discuss priority areas for ART research in Zambia, with participants drawn from a broad cross section of Zambian society. State-of-the-art reviews and 6 intensive small group discussions helped to formulate a suggested research agenda. Results Conference participants believed that the most urgent research priorities were to assess how therapeutic resources could be applied for the greatest overall benefit and to minimize the impact of nonadherence and viral resistance. Identified research priorities were as follows: To determine when to initiate HAART in relation to CD4+ cell count To assess whether HIV/AIDS can be managed well without the use of costly frequent viral load measurements and CD4+ cell count monitoring To assess whether HIV/AIDS can be managed in the same fashion in patients coinfected with opportunistic infections such as tuberculosis and HIV-related chronic diarrhea, taking into consideration complications that may occur in tuberculosis such as immune reconstitution syndrome and medication malabsorption in the presence of diarrhea To carefully assess and characterize toxicities, adverse effects, and viral resistance patterns in Zambia, including studies of mothers exposed to prepartum single-dose nevirapine To conduct operational research to assess clinical and field-based strategies to maximize adherence for better outcomes of ART in Zambia To assess ART approaches most valuable for pediatric and adolescent patients in Zambia Conference participants recommended that HIV-related clinical care and research be integrated within home-based care services and operated within the existing health delivery structures to ensure sustainability, reduce costs, and strengthen the structures. Conclusion Our consensus was that antiretroviral clinical trials and operational research are essential for Zambia to address the new challenges arising from increasing ART availability. There is global consensus that antiretroviral clinical trials in resource-constrained countries are possible, and the capacity for such trials should be developed further in Africa.

Zulu, Isaac; Schuman, Paula; Musonda, Rosemary; Chomba, Elwyn; Mwinga, Kasonde; Sinkala, Moses; Chisembele, Maureen; Mwaba, Peter; Kasonde, Dorothy; Vermund, Sten H.

2009-01-01

64

Helminths and bot fly larvae of wild ungulates on a game ranch in central province, Zambia.  

PubMed

Helminths and bot fly larvae were collected from 11 wild ungulate species on a game ranch in the Central Province of Zambia. New host-parasite records are: Calicophoron sp. from defassa waterbuck Kobus ellipsiprymnus defassa and Kafue lechwe Kobus leche kafuensis; Avitellina centripunctata, Gaigeria pachyscelis and Gedoelstia cristata from tsessebe Damaliscus lunatus lunatus; Cooperia rotundispiculum from common reedbuck Redunca arundinum; Dictyocaulus filaria from greater kudu Tragelaphus strepsiceros; Dictyocaulus sp. from tsessebe and defassa waterbuck and Strobiloestrus sp. from sable antelope Hippotragus niger. Most of the other parasites collected are first records for Zambia and thus extend the distribution ranges of several species. PMID:9741058

Zieger, U; Boomker, J; Cauldwell, A E; Horak, I G

1998-06-01

65

Acceptability and uptake of neonatal male circumcision in Lusaka, Zambia.  

PubMed

Neonatal male circumcision (NMC) is an uncommon procedure in Southern Africa, but is being scaled up in Zambia for long-term HIV prevention. We conducted a cross-sectional survey on NMC with a convenience sample of mothers of newborn boys at two public clinics in Lusaka. Following the survey, mothers received information on availability of NMC, and uptake of the service was tracked. Predictors of uptake were assessed using bivariate and multivariate logistic regression. Of the 1,249 eligible mothers approached, 1000 (80%) agreed to participate. Although 97% of surveyed mothers said they definitely or probably planned to have their newborn son circumcised, only 11% of participants brought their newborn sons for NMC. Significant predictors of uptake in adjusted models included: Older maternal age (AOR 3.77, 95% CI 1.48-9.63 for age 36 and above compared to mothers age 25 and below), having attended antenatal care at an NMC site (AOR 2.13, 95% CI 1.32-3.44), older paternal age (AOR 4.36, 95% CI 1.28-14.91 for age 26-35 compared to fathers age 25 and below), and the infant's father being circumcised (AOR 2.21, 95% CI 1.35-3.62). While acceptability studies in Southern Africa have suggested strong support for MC among parents for having their sons circumcised, this may not translate to high uptake of newly-introduced NMC services. PMID:22968397

Waters, Emily; Li, Michelle; Mugisa, Bridget; Bowa, Kasonde; Linyama, David; Stringer, Elizabeth; Stringer, Jeffrey

2013-07-01

66

Implementing Educational Policies in Zambia. World Bank Discussion Papers No. 90. Africa Technical Department Series.  

ERIC Educational Resources Information Center

|At the time of independence from Britain in 1964, the educational system in Zambia was, as elsewhere in Africa, racially segregated and heavily biased against Africans. This paper briefly reviews the situation at independence before enumerating post-independence educational policy landmarks through both acts of Parliament and national development…

Achola, Paul Pius Waw

67

Population ecology of an afro-tropical savanna herb, Lapeirousia rivularis , in Zambia  

Microsoft Academic Search

Detailed demographic studies of herbaceuos plants in afro-tropicalsavannas are extremely rare in published literature. I studied phenology andpopulation dynamics of a perennial herb, Lapeirousiarivularis Wanntorp, at a savanna site in Zambia over a 4-yearperiod, from 1997 to 2001, using enumeration techniques in permanent andtemporary quadrants. The age of the plants was accurately determined frompersistent annual sheaths that accumulate around the

E. N. Chidumayo

2003-01-01

68

Of cabbages and King Cobra: Populist politics and Zambia's 2006 election  

Microsoft Academic Search

Zambia's 2006 election was won by incumbent President Levy Mwanawasa and his Movement for Multi-Party Democracy (MMD). However, it is argued here that the most important outcome of the campaign was the successful articulation of a new populist politics by Michael Sata's Patriotic Front (PF), which won a significant majority in urban areas. Sata's attacks on foreign investors (particularly from

Miles Larmer; Alastair Fraser

2007-01-01

69

Aquatic snails of the Bulinus africanus group in Zambia identified according to morphometry and enzymes  

Microsoft Academic Search

The Bulinus africanus species group (Planorbidae) of freshwater snails has been reported to be represented in Zambia by two species, B. africanus (Krauss) and B. globosus (Morelet), both named as intermediate hosts for Schistosoma haematobium. Uncertainty in identification of these snails from morphology led to the present investigation, combining morphometry (shell and copulatory organ) with enzyme analysis. Observations of both

D. S. Brown; D. Rollinson

1996-01-01

70

Predictors of Attitudes toward Intimate Partner Violence: A Comparative Study of Men in Zambia and Kenya  

ERIC Educational Resources Information Center

Attitudes toward intimate partner violence (IPV) were compared between Zambian and Kenyan men on sociodemographic, attitudinal, and structural predictors of such attitudes. Data were retrieved from the latest Demographic and Health Surveys in each country. The results showed that many men in Zambia (71%) and Kenya (68%) justified IPV to punish a…

Lawoko, Stephen

2008-01-01

71

Stigma, HIV\\/AIDS and prevention of mother-to-child transmission in Zambia  

Microsoft Academic Search

This report evaluates the extent of perceived and enacted HIV\\/AIDS-related stigma in a rural setting in Zambia. Stigmatisation is abundant, ranging from subtle actions to the most extreme degradation, rejection and abandonment. Women with HIV and pregnant women assumed to be HIV positive are repeatedly subjected to extensive forms of stigma, particularly once they become sick or if their child

Virginia Bond; Elaine Chase; Peter Aggleton

2002-01-01

72

Using Images to Promote Reflection: An Action Research Study in Zambia and Tanzania  

ERIC Educational Resources Information Center

This paper focuses on the use of images to promote reflection and analysis of inclusive practices. The image-based work was set in the context of a two-year action research study, which took place in Tanzania and Zambia, 2001-2003, in collaboration with researchers from the Enabling Education Network (EENET), based at the University of…

Miles, Susie; Kaplan, Ian

2005-01-01

73

Information Provision in Emergency Settings: The Experience of Refugee Communities in Zambia  

ERIC Educational Resources Information Center

This article identifies information provision services in emergency settings using Zambia as a case study by identifying innovative ways of providing library and information services. The thrust of the article is to analyze information management practices of organizations that work within refugee camps and how they take specific cognizance of the…

Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

2011-01-01

74

Seasonal Abundance and Distribution of Elephants in Sioma Ngwezi National Park, southwest Zambia  

Microsoft Academic Search

We conducted wet (January 2004) and dry (August 2004 and October 2005) season aerial surveys of African elephants (Loxodonta africana) in Sioma Ngwezi National Park (NP) in southwest Zambia. Most elephant herds occurred in the centre and northern portions of the park during the wet season when water was avail- able in seasonal pans. During the two dry season surveys,

Michael Chase; Curtice Griffin

75

Cost and financial sustainability of a household-based water treatment and storage intervention in Zambia  

Microsoft Academic Search

Providing safe water to .1 billion people in need is a major challenge. To address this need, the Safe Water System (SWS) - household water treatment with dilute bleach, safe water storage, and behavior change - has been implemented in .20 countries. To assess the potential sustainability of the SWS, we analyzed costs in Zambia of \\

Anyana Banerjee; Deborah A. McFarland; Ritu Singh; Robert Quick

2007-01-01

76

Beyond a Learning Society? It Is All to Be Done Again: Zambia and Zimbabwe  

ERIC Educational Resources Information Center

This article considers the ways in which educators and learning societies in Zambia and Zimbabwe have had to struggle to create independent, democratic and critical curricula in difficult circumstances over the last 50 years in the context of historical shifts in power, a declining British Empire and the re-emergence of reactionary forces at a…

Alexander, David

2006-01-01

77

Exploring understandings of inclusion in schools in Zambia and Tanzania using reflective writing and photography  

Microsoft Academic Search

In this article I explore insights gained from participating in an exploratory, small?scale study led by the Enabling Education Network (EENET) in 17 schools in northern Zambia and five schools in Tanzania. Facilitating South?based research, while based in a Northern university, raises complex ethical issues about voice and control which are discussed in the article. The main aim of the

Susie Miles

2011-01-01

78

Integrating mental health into primary health care in Zambia: a care provider's perspective  

Microsoft Academic Search

BACKGROUND: Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative

Lonia Mwape; Alice Sikwese; Augustus Kapungwe; Jason Mwanza; Alan Flisher; Crick Lund; Sara Cooper

2010-01-01

79

Stakeholders' perceptions of the main challenges facing Zambia's mental health care system: a qualitative analysis  

Microsoft Academic Search

Despite radical health transformations in Zambia over the last decade, mental health continues to be marginalized, as reflected in the un-coordinated and under-resourced mental health care system. This paper presents the qualitative results of a situation analysis conducted as part of the first phase of the Mental Health and Poverty Project. The aim of this paper was to explore what

Jason Mwanza; Sara Cooper; Augustus Kapungwe; Alice Sikwese; Lonia Mwape

2011-01-01

80

Fertilizer market development: a comparative analysis of Ethiopia, Kenya, and Zambia  

Microsoft Academic Search

This article synthesizes case studies from Kenya, Zambia, and Ethiopia to assess how differences in the implementation of fertilizer marketing policies have affected the costs and risks borne by marketing actors, the investment response by private traders, and fertilizer consumption.Financial cost accounting techniques indicate that domestic marketing costs account for 50% or more of farm-gate prices. The sum of importer,

T. S. Jayne; J. Govereh; M. Wanzala; M. Demeke

2003-01-01

81

Disease constraints for utilization of the African buffalo (Syncerus caffer) on game ranches in Zambia.  

PubMed

Eco-tourism depending on wildlife is becoming increasingly profitable and landowners are beginning to favor game farming and ecotourism. In these areas, large-scale translocation of wildlife involves a diversity of species and large populations. The African buffalo (Syncerus caffer) is one of the major tourist attractions in Zambia. It accounts for 8.7% and 12.4% of the total animal species hunted in the Game Management Areas and the total hunting revenue earned in Zambia, respectively. It is ecologically an important animal species essential for the purpose of habitat control and facilitating the provision of suitable grazing pastures. However, the rearing of the African buffalo on game ranches has been hampered by its carrier state of the Southern Africa Terroritory (SAT) serotypes of foot and mouth disease virus (FMD). The African buffalo is also known to be a carrier of Theileria parva lawrencei, the causative agent of corridor disease (CD) that continues to have devastating effects on the livestock industry in Zambia. In addition, the importation of buffaloes from countries with populations endemic to bovine tuberculosis is highly restricted. Veterinary regulations in Zambia, strongly advocate against the translocation of buffaloes from protected areas to private ranches for disease control purposes thereby mounting a considerable constraint on the economic and ecological viability of the industry. It is hoped that this review will motivate the relevant government authorities in exploiting ways in which this animal species play a central role in eco-tourism. PMID:16786973

Munang'andu, Hetron M; Munag'andu, Hetron M; Siamudaala, Victor M; Nambota, Andrew; Bwalya, John M; Munyeme, Musso; Mweene, Aaron S; Takada, Ayato; Kida, Hiroshi

2006-05-01

82

Addressing The Problem Of Drop - Out From The National Correspondence College In Zambia  

Microsoft Academic Search

The study looked at a few selected provinces in Zambia in particular (Central, Copperbelt and Lusaka) National Correspondence College (NCC) drop - outs of 1990,1991,1992,1993 and 1994. It investigated the courses of dropping out from the NCC Distance Education Courses using the appended questionnaire. Research findings from other cultural contexts and this study were used to make recommendations on indicated

Cosmas Katye Makunka

83

Fractured governance and local frictions: the exclusionary nature of a clandestine land market in southern Zambia  

Microsoft Academic Search

This article explores the ways in which efforts to expand private land tenure, coupled with the continued centrality of customary land administration in Zambia, produce a fractured system of land governance in which localized markets for land emerge but are forced to operate in a clandestine manner. Using ethnographic and archival data sources, I argue that despite the historical and

Nicholas J. Sitko

2010-01-01

84

Fractured governance and local frictions: the exclusionary nature of a clandestine land market in southern Zambia  

Microsoft Academic Search

:This article explores the ways in which efforts to expand private land tenure, coupled with the continued centrality of customary land administration in Zambia, produce a fractured system of land governance in which localized markets for land emerge but are forced to operate in a clandestine manner. Using ethnographic and archival data sources, I argue that despite the historical and

Nicholas J. Sitko

2010-01-01

85

The effects of religious affiliation on sexual initiation and condom use in Zambia  

Microsoft Academic Search

Purpose: To determine whether religious affiliation reduces HIV risk among young women in Zambia, and to examine the effects of religious affiliation on sexual initiation and on condom use during first sexual experience. Methods: Data from a representative probability sample of 5534 women aged 13-20 years was analyzed. The instrument included questions on sexual initiation, condom use during first sex,

Sohail Agha; Paul Hutchinson

2006-01-01

86

Developing a national health research system: participatory approaches to legislative, institutional and networking dimensions in Zambia  

PubMed Central

For many sub-Saharan African countries, a National Health Research System (NHRS) exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, we discuss the ongoing development of Zambia’s NHRS. We reflect on our experience in the ongoing consultative development of Zambia’s NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. We argue that three streams of concurrent activity are critical in developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system’s boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonize, unify and strengthen the overall capacities of the research community.

2012-01-01

87

Extremely Drug-Resistant Salmonella enterica Serovar Senftenberg Infections in Patients in Zambia  

PubMed Central

Two cases of extremely drug-resistant Salmonella enterica serovar Senftenberg isolated from patients in Zambia were investigated by utilizing MIC determinations and whole-genome sequencing. The isolates were resistant to, and harbored genes toward, nine drug classes, including fluoroquinolones and extended-spectrum cephalosporins, contained two plasmid replicons, and differed by 93 single-nucleotide polymorphisms.

Joensen, Katrine Grimstrup; Lukwesa-Musyani, Chileshe; Kalondaa, Annie; Leekitcharoenphon, Pimlapas; Nakazwe, Ruth; Aarestrup, Frank M.; Hasman, Henrik; Mwansa, James C. L.

2013-01-01

88

Inquiry-Based Science Education: A Scenario on Zambia's High School Science Curriculum  

ERIC Educational Resources Information Center

This paper is aimed at elucidating the current state of inquiry-based science education (IBSE) in Zambia's high school science curriculum. Therefore, we investigated Zambian teachers' conceptions of inquiry; determined inquiry levels in the national high school science curriculum materials, which include syllabi, textbooks and practical exams; and…

Chabalengula, Vivien M.; Mumba, Frackson

2012-01-01

89

Factors Contributing to the Failure to Use Condoms among Students in Zambia  

ERIC Educational Resources Information Center

|This study explored factors that may predict condom use among college and high school students in Zambia. Using the Social Cognitive Theory, this study examined the relationship of drinking behaviors, alcohol-sexual expectations, education level, and religion to condom use among 961 students. The results of the study show that condom use was low…

Mbulo, Lazarous; Newman, Ian M.; Shell, Duane F.

2007-01-01

90

Dynamic Modelling of Child Mortality in Developing Countries: Application for Zambia  

Microsoft Academic Search

Abstract In this paper, we analyse the causes of under five mortality in Zambia, with a particular emphasis on assessing possible time-variations in the ef- fects of covariates, i.e. whether the eects of certain covariates vary with the age of the child. The analysis is based on micro data from the 1992 De- mographic and health Survey. Employing a Bayesian

Ursula Berger; Ludwig Fahrmeir

91

Un/Doing Gender? A Case Study of School Policy and Practice in Zambia  

ERIC Educational Resources Information Center

|This article explores an attempt to disrupt gender inequality in a unique, low-cost private school in Ndola, Zambia. It examines deliberate school policies aimed at "undoing gender" or fostering greater gender equity. These include efforts to maintain gender parity at all levels of the school and the requirement that both young men and women…

Bajaj, Monisha

2009-01-01

92

The Information Marketing Concept and the Implementation of National Information Policy (NIP) in Zambia.  

ERIC Educational Resources Information Center

|This paper describes the purpose of a national information policy in general, the process that led to the formation of such a policy in Zambia, and the requirements for its successful implementation. Particular attention is paid to the concept of information marketing. It is argued that such a concept would be an implementation requirement if…

Lundu, Maurice C.

93

ENHANCING ACCESS TO ANIMAL HEALTH INFORMATION: ROLE OF INFORMATION SPECIALISTS IN ZAMBIA  

Microsoft Academic Search

This paper is a product of a larger study conducted between 2002 and 2004 on the state of libraries and use of Information Communication Technology (ICT) in research and academic libraries in Zambia. It examines the role of information professionals in enhancing access to animal health information under prevailing conditions. Animal health is an integral aspect of the agricultural sector,

Muyoyeta Simui

94

Socio-cultural factors surrounding mental distress during the perinatal period in Zambia: a qualitative investigation  

PubMed Central

Background The presence of mental distress during pregnancy and after childbirth imposes detrimental developmental and health consequences for families in all nations. In Zambia, the Ministry of Health (MoH) has proposed a more comprehensive approach towards mental health care, recognizing the importance of the mental health of women during the perinatal period. Aim The study explores factors contributing to mental distress during the perinatal period of motherhood in Zambia. Methods A qualitative study was conducted in Lusaka, Zambia with nineteen focus groups comprising 149 women and men from primary health facilities and schools respectively. Findings There are high levels of mental distress in four domains: worry about HIV status and testing; uncertainty about survival from childbirth; lack of social support; and vulnerability/oppression. Conclusion Identifying mental distress and prompt referral for interventions is critical to improving the mental health of the mother and prevent the effects of mental distress on the baby. Recommendation Strategies should be put in place to ensure pregnant women are screened for possible perinatal mental health problems during their visit to antenatal clinic and referral made to qualified mental health professionals. In addition further research is recommended in order to facilitate evidence based mental health policy formulation and implementation in Zambia.

2012-01-01

95

Vulnerability and Resilience Determinants of under-five mortality changes in Zambia  

Microsoft Academic Search

Trends in under-five mortality were favorable in Zambia in the twelve years following independence (1964-1975), as a result of favorable political and economic context and generous health, education and social policies, largely financed by the exports of copper minerals, the main economic resource of the country. In 1975, the international prices of copper decreased suddenly, and exports of copper continued

Michel GARENNE; Eneas GAKUSI

2004-01-01

96

Law as an Instrument of Social Change: The Constitution and Sexual Discrimination in Zambia  

Microsoft Academic Search

The paper looks at the process of achieving gender equity through law reform. By tracing the process of amending the Constitution and other overtly discriminating laws in Zambia. The paper questions the effectiveness of legal centralism in circumstances which clearly indicate the existence of legal pluralism.Whilst acknowledging the importance of a formal legal frame work with which to challenge the

Mulela Margaret Munalula

1995-01-01

97

Zambia: a church where Brothers are not brothers.  

PubMed

George grew up with no family and attended a Catholic Mission High School in Zaire. He joined an order of Brothers in Kabwe in the Copperbelt of Zambia. In December, 1992, the order required him to undergo an HIV test. In February, 1993, when on holiday, he received a letter' from a superior informing him that he was HIV positive. The superior wrote that George was no longer an acceptable and worthy person to spread God's word, and that he was expelled from the order. Yet, he had behaved well at the order and at the school. The expulsion left George with no food, shelter, money, or job. He was all alone. He had had his first and only sexual encounter at age 22, which was with an older female friend. He had had no more sexual relationships. This brief sexual encounter led to his contracting HIV. The Church's rejection of George is a loss for the Church because this good man could have educated people about HIV and helped reduce the stigma of HIV/AIDS through the Church. The center where he went in Lusaka has also counseled 36 nuns and 11 priests. Most report that superiors had coerced them to be tested for HIV. When they came to the center, they were emotionally unprepared to deal with a positive test. Some did not know that their blood was being tested for HIV and the results would go directly to their superiors. The superiors provided economic reasons to justify the HIV testing. The center concluded that no one should be coerced to undergo HIV testing pre and post test counseling should be provided, HIV test results must be confidential between the counselor and the patient, churches should be in the forefront of reducing the stigma linked to HIV/AIDS while exhibiting love and compassion, and HIV- positive religious leaders are not liabilities but can offer up to 10 years of valuable service. PMID:12318857

Baggaley, R

98

Brucellosis among smallholder cattle farmers in Zambia: public health significance.  

PubMed

A cross-sectional study was performed in Southern and Lusaka provinces of Zambia between March and September 2008 to estimate Brucella seroprevalence in cattle kept by smallholder dairy farmers (n = 185). Rose Bengal test (RBT) was used as a screening test followed by confirmation with competitive ELISA (c-ELISA). We investigated 1,323 cattle, of which 383 had a history of receiving vaccination against brucellosis and 36 had a history of abortion. Overall seroprevalence was 6.0% with areas where vaccination was practiced having low seroprevalence. Age was associated with Brucella seropositivity (P = 0.03) unlike cattle breed (P = 0.21) and sex (P = 0.32). At area level, there was a negative correlation (Corr. coeff = -0.74) between percentage of animals with brucellosis vaccination history (vaccination coverage) and level of brucellosis; percentage of animals with history of abortion (Corr. coeff. = -0.82) and brucellosis vaccination coverage. However, a positive correlation existed between brucellosis infection levels with percentage of animals having a history of abortion (Corr. coeff. = 0.72). History of vaccination against brucellosis was positively associated with a positive Brucella result on RBT (P = 0.004) whereby animals with history of vaccination against brucellosis were more likely to give a positive RBT test results (OR = 1.52). However, the results of c-ELISA were independent of history of Brucella vaccination (P = 0.149) but was positively associated with history of abortion (OR = 4.12). Our results indicate a relatively low Brucella seroprevalence in cattle from smallholder dairy farmers and that vaccination was effective in reducing cases of Brucella infections and Brucella-related abortions. Human exposure to Brucella through milk from smallholder farmers could result through milk traded on the informal market since that milk is not processed and there no quality and safety controls. PMID:21947888

Muma, John Bwalya; Pandey, Girja Shankar; Munyeme, Musso; Mumba, Chisoni; Mkandawire, Ethel; Chimana, Henry Mwelwa

2011-09-27

99

The reach and impact of social marketing and reproductive health communication campaigns in Zambia  

PubMed Central

Background Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use. Methods This paper assesses the reach of selected radio and television programs about family planning and HIV/AIDS and of communications about the socially marketed Maximum condoms in Zambia, as well as their impact on condom use, using data from the 2001–2002 Zambia Demographic and Health Survey. To control for self-selection and endogeneity, we use a two-stage regression model to estimate the effect of program exposure on the behavioural outcomes. Results Those who were exposed to radio and television programs about family planning and HIV/AIDS were more likely to have ever used a condom (OR = 1.16 for men and 1.06 for women). Men highly exposed to Maximum condoms social marketing communication were more likely than those with low exposure to the program to have ever used a condom (OR = 1.48), and to have used a condom at their last sexual intercourse (OR = 1.23). Conclusion Findings suggest that the reproductive health and social marketing campaigns in Zambia reached a large portion of the population and had a significant impact on condom use. The results suggest that future reproductive health communication campaigns that invest in radio programming may be more effective than those investing in television programming, and that future campaigns should seek to increase their impact among women, perhaps by focusing on the specific constrains that prevent females from using condoms.

Van Rossem, Ronan; Meekers, Dominique

2007-01-01

100

The role of context: neighbourhood characteristics strongly influence HIV risk in young women in Ndola, Zambia: The role of context  

Microsoft Academic Search

Summary objectives To examine the effect of neighbourhood socioeconomic factors on human immunodeficiency virus (HIV) prevalence in young women (aged 15-24 years) in Zambia. methods Re-analysis of a cross-sectional, population-based sero-survey of nearly 2000 adults con- ducted in 1997 ?1998 in Ndola, Zambia. Neighbourhood-level socioeconomic status (SES) was defined using the availability of running water and electricity in addition to

Sabine Gabrysch; Tansy Edwards; Judith R. Glynn

2008-01-01

101

Psychosocial aspects of unwed adolescent pregnancy in Lusaka, Zambia.  

PubMed

Adolescent pregnancy in Zambia contributed to 22.5% of the pregnancies seen at the University Teaching Hospital in Lusaka in 1979/80. Some of the psychosocial factors in teenage pregnancy are examined among 80 teenage unmarried adolescents appearing at the prenatal clinic of the University Teaching Hospital (40) and at a low-income prenatal clinic in Lusaka (40). Participants were matched with controls on the basis of age, education, and socioeconomic status. In-depth interviews were conducted in 1987, when the girls were in their second to fifth month of pregnancy. Analysis was conducted on sex socialization, knowledge of and attitudes toward contraception, socioeconomic factors, and family coherence as preventive aspects of teenage pregnancy. The reaction to the pregnancy and management of the pregnancy were also determined. The mean age of menarche was 13.2 and 13.5 years for the participants and controls, respectively, which is somewhat lower than reports among other African populations. A formal initiation ceremony was conducted for 3% of participants and 8% of controls. Participants had 2.4 sex partners, and controls had 0.5 sex partners. Motives for getting pregnant were: economic support (85%); being in love and hoping for marriage (67%); peer pressure (54%);l and three other reasons. Both groups were similar in their knowledge of, attitudes toward, and use of contraception. 28% of the pregnant girls reported knowing about "counting days," but only 1% knew how to do this. Only 6% had knowledge of contraception. About 75% came from low-income families. The average age of formal education was 6.2 years for participants and 6.8 years for controls. 68% were in school at the time of the pregnancy; 29% dropped out of school before the end of the pregnancy. 52% of the male partners were of low socioeconomic status. 61% of pregnant girls lived with both real parents. 6% reported wanting to become pregnant. 67% of male partners had a negative reaction to the pregnancy; 16% rejected the pregnancy. 63% of mothers agreed to care for the baby while their daughters returned to school. The control group appears to have had stronger responses to avoid sexual encounters. Traditional social control has been replaced by "ignorance and secrecy." There has been a breakdown in the means of acquiring information about healthy reproduction and about birth control. PMID:12318118

Peltzer, K; Likwa, R

1993-01-01

102

HIV-1 Effects on Neuropsychological Performance in a Resource-Limited Country, Zambia  

PubMed Central

Zambia has substantially been affected by the HIV/AIDS epidemic with prevalence rates at 14% in a population estimated at 12 million. Yet, the extent of HIV-associated neurocognitive disorders (HAND) in this population remains to be clearly understood. A series of culturally appropriate neuropsychological (NP) assessments [International HIV Dementia Scale (IHDS), Color Trails Test 1 and 2, Grooved pegboard Test, and Time Gait Test] were used to test the effects of HIV on NP performance of HIV seropositive and seronegative individuals. Twenty-two percent HIV positive individuals ARV naïve met the criteria for IHDS-defined NP impairment. Gender significantly influenced the performance on NP tests with females performing more poorly compared to males. Larger studies that will accommodate gender differences and age are necessary to generate appropriate norms in Zambia in order to better assess the prevalence of HAND in the developing country setting.

Holguin, Adelina; Banda, Mwanza; Willen, Elizabeth J.; Malama, Costantine; Chiyenu, Kaseya O.; Mudenda, Victor C.; Wood, Charles

2012-01-01

103

Active Management of Third Stage of Labour Saves Facility Costs in Guatemala and Zambia  

PubMed Central

This study calculated the net benefit of using active management of the third stage of labour (AMTSL) rather than expectant management of the third stage of labour (EMTSL) for mothers in Guatemala and Zambia. Probabilities of events were derived from opinions of experts, publicly available data, and published literature. Costs of clinical events were calculated based on national price lists, observation of resources used in AMTSL and EMTSL, and expert estimates of resources used in managing postpartum haemorrhage and its complications, including transfusion. A decision tree was used for modelling expected costs associated with AMTSL or EMTSL. The base case analysis suggested a positive net benefit from AMTSL, with a net cost-saving of US$ 18,000 in Guatemala (with 100 lives saved) and US$ 145,000 in Zambia (with 467 lives saved) for 100,000 births. Facilities have strong economic incentives to adopt AMTSL if uterotonics are available.

Frick, Kevin D.; Fogarty, Linda A.; Fishel, Joy D.; Vivio, Donna M.

2006-01-01

104

Pregnancy loss: spontaneous and induced abortions among young women in Lusaka, Zambia  

Microsoft Academic Search

An estimated 60% of all adolescent pregnancies in low-income countries are unintended. The present study was carried out at the university hospital in Lusaka, Zambia over a four-month period in 2005. The aim was to explore experiences of pregnancy loss and to ascertain the girl's contraceptive knowledge and use and their partner's involvement in the pregnancy\\/abortion. Eighty-seven girls aged 13–19

Elisabeth Dahlbäck; Margaret Maimbolwa; C. Bawa Yamba; Lackson Kasonka; Staffan Bergström; Anna-Berit Ransjö-Arvidson

2010-01-01

105

Adoption of improved fallow technology for soil fertility management in Zambia: Empirical studies and emerging issues  

Microsoft Academic Search

In the subsistence-agricultural region of eastern Zambia, less than 10% of the households have adequate supply of maize (Zea mays L.), the staple food, throughout the year. A major constraint to increasing crop production in the region is poor fertility\\u000a status of the soil. In order to address this problem, improved fallow has been introduced as a technology for improving

O. C. Ajayi; S. Franzel; E. Kuntashula; F. Kwesiga

2003-01-01

106

Impact of AIDS-Related Mortality on Farm Household Welfare in Zambia  

Microsoft Academic Search

This article uses nationally representative panel data on 5,420 rural households in Zambia, surveyed in 2001 and 2004, to measure the impacts of HIV\\/AIDS-related prime-age mortality on livelihoods. Using age group and drought shock interactions as instruments for prime-age mortality, we find that prime-age mortality is endogenous in pooled OLS models. However, differencing the time-invariant unobserved household characteristics largely addressed

Antony Chapoto; T. S. Jayne

2008-01-01

107

An Integrated Hydro-Economic Model for Economy-Wide Climate Change Impact Assessment for Zambia  

NASA Astrophysics Data System (ADS)

Zambia is a landlocked country in Southern Africa, with a total population of about 11 million and a total area of about 752 thousand square kilometers. Agriculture in the country depends heavily on rainfall as the majority of cultivated land is rain-fed. Significant rainfall variability has been a huge challenge for the country to keep a sustainable agricultural growth, which is an important condition for the country to meet the United Nations Millennium Development Goals. The situation is expected to become even more complex as climate change would impose additional impacts on rainwater availability and crop water requirements, among other changes. To understand the impacts of climate variability and change on agricultural production and national economy, a soil hydrology model and a crop water production model are developed to simulate actual crop water uses and yield losses under water stress which provide annual shocks for a recursive dynamic computational general equilibrium (CGE) model developed for Zambia. Observed meteorological data of the past three decades are used in the integrated hydro-economic model for climate variability impact analysis, and as baseline climatology for climate change impact assessment together with several GCM-based climate change scenarios that cover a broad range of climate projections. We found that climate variability can explain a significant portion of the annual variations of agricultural production and GDP of Zambia in the past. Hidden beneath climate variability, climate change is found to have modest impacts on agriculture and national economy of Zambia around 2025 but the impacts would be pronounced in the far future if appropriate adaptations are not implemented. Policy recommendations are provided based on scenario analysis.

Zhu, T.; Thurlow, J.; Diao, X.

2008-12-01

108

Fitting the HIV Epidemic in Zambia: A Two-Sex MicroSimulation Model  

Microsoft Academic Search

BackgroundIn describing and understanding how the HIV epidemic spreads in African countries, previous studies have not taken into account the detailed periods at risk. This study is based on a micro-simulation model (individual-based) of the spread of the HIV epidemic in the population of Zambia, where women tend to marry early and where divorces are not frequent. The main target

Pauline M. Leclerc; Alan P. Matthews; Michel L. Garenne; Nitika Pant Pai

2009-01-01

109

Ecology and epidemiology of anthrax in cattle and humans in Zambia.  

PubMed

Anthrax is endemic in Western and North-western Provinces of Zambia. The disease occurs throughout the year and impacts negatively on the economy of the livestock industry and public health in Zambia. During 1989-1995, there were 1626 suspected cases of anthrax in cattle in Western province and of these 51 were confirmed. There were 220 cases of human anthrax cases in 1990 alone and 248 cases during 1991-1998 with 19.1% and 7.7% case fatality rates, respectively. Interplay of the ecology of affected areas and anthropogenic factors seem to trigger anthrax epidemics. Anthrax has drawn considerable attention in recent years due to its potential use as a biological weapon. In this paper, the history, current status and approaches towards the control of the disease in Zambia are discussed. Quarantine measures restrict trade of livestock and exchange of animals for draught power resulting in poor food security at household levels. Challenges of anthrax control are complex and comprise of socio-political, economical, environmental and cultural factors. Inadequate funding, lack of innovative disease control strategies and lack of cooperation from stakeholders are the major constraints to the control of the disease. It is hoped that the information provided here will stimulate continued awareness for the veterinary and medical authorities to maintain their surveillance and capabilities against the disease. This may lead to a culminating positive impact on livestock and human health in the southern African region. PMID:16786974

Siamudaala, Victor M; Bwalya, John M; Munang'andu, Hetron M; Munag'andu, Hetron M; Sinyangwe, Peter G; Banda, Fred; Mweene, Aaron S; Takada, Ayato; Kida, Hiroshi

2006-05-01

110

Evidence of Yersinia pestis DNA from fleas in an endemic plague area of Zambia  

PubMed Central

Background Yersinia pestis is a bacterium that causes plague which infects a variety of mammals throughout the world. The disease is usually transmitted among wild rodents through a flea vector. The sources and routes of transmission of plague are poorly researched in Africa, yet remains a concern in several sub-Saharan countries. In Zambia, the disease has been reported on annual basis with up to 20 cases per year, without investigating animal reservoirs or vectors that may be responsible in the maintenance and propagation of the bacterium. In this study, we undertook plague surveillance by using PCR amplification of the plasminogen activator gene in fleas. Findings Xenopsylla species of fleas were collected from 83 rodents trapped in a plague endemic area of Zambia. Of these rodents 5 had fleas positive (6.02%) for Y. pestis plasminogen activator gene. All the Y. pestis positive rodents were gerbils. Conclusions We conclude that fleas may be responsible in the transmission of Y. pestis and that PCR may provide means of plague surveillance in the endemic areas of Zambia.

2012-01-01

111

Lusaka, Zambia, during SAFARI-2000: Convergence of local and imported ozone pollution  

NASA Astrophysics Data System (ADS)

In August and September, throughout south central Africa, seasonal clearing of dry vegetation and other fire-related activities lead to intense smoke haze and ozone formation. The first ozone soundings in the heart of the southern African burning region were taken at Lusaka, Zambia (15.5S, 28E) in early September 2000. Maximum surface ozone was over 90 ppbv and column tropospheric ozone exceeded 50 DU. These values are higher than concurrent measurements over Nairobi (1S, 38E) and Irene (25S, 28E, near Pretoria). At least 30% of Lusaka surface ozone appears to be from local sources. A layer at 800-500 hPa has ozone >120 ppbv and originates from trans-boundary recirculation. Starting out over Zambia, Angola, and Namibia, ozone-rich air travels east to the Indian Ocean, before heading back toward Mozambique, Zimbabwe and Zambia. Thus, Lusaka collects local and imported pollution, consistent with its location within the southern African gyre.

Thompson, Anne M.; Witte, Jacquelyn C.; Freiman, M. Tal; Phahlane, N. Agnes; Coetzee, Gert J. R.

2002-10-01

112

Genetic perspectives on the origin of clicks in Bantu languages from southwestern Zambia  

PubMed Central

Some Bantu languages spoken in southwestern Zambia and neighboring regions of Botswana, Namibia, and Angola are characterized by the presence of click consonants, whereas their closest linguistic relatives lack such clicks. As clicks are a typical feature not of the Bantu language family, but of Khoisan languages, it is highly probable that the Bantu languages in question borrowed the clicks from Khoisan languages. In this paper, we combine complete mitochondrial genome sequences from a representative sample of populations from the Western Province of Zambia speaking Bantu languages with and without clicks, with fine-scaled analyses of Y-chromosomal single nucleotide polymorphisms and short tandem repeats to investigate the prehistoric contact that led to this borrowing of click consonants. Our results reveal complex population-specific histories, with female-biased admixture from Khoisan-speaking groups associated with the incorporation of click sounds in one Bantu-speaking population, while concomitant levels of potential Khoisan admixture did not result in sound change in another. Furthermore, the lack of sequence sharing between the Bantu-speaking groups from southwestern Zambia investigated here and extant Khoisan populations provides an indication that there must have been genetic substructure in the Khoisan-speaking indigenous groups of southern Africa that did not survive until the present or has been substantially reduced.

Barbieri, Chiara; Butthof, Anne; Bostoen, Koen; Pakendorf, Brigitte

2013-01-01

113

Fitting the HIV Epidemic in Zambia: A Two-Sex Micro-Simulation Model  

PubMed Central

Background In describing and understanding how the HIV epidemic spreads in African countries, previous studies have not taken into account the detailed periods at risk. This study is based on a micro-simulation model (individual-based) of the spread of the HIV epidemic in the population of Zambia, where women tend to marry early and where divorces are not frequent. The main target of the model was to fit the HIV seroprevalence profiles by age and sex observed at the Demographic and Health Survey conducted in 2001. Methods and Findings A two-sex micro-simulation model of HIV transmission was developed. Particular attention was paid to precise age-specific estimates of exposure to risk through the modelling of the formation and dissolution of relationships: marriage (stable union), casual partnership, and commercial sex. HIV transmission was exclusively heterosexual for adults or vertical (mother-to-child) for children. Three stages of HIV infection were taken into account. All parameters were derived from empirical population-based data. Results show that basic parameters could not explain the dynamics of the HIV epidemic in Zambia. In order to fit the age and sex patterns, several assumptions were made: differential susceptibility of young women to HIV infection, differential susceptibility or larger number of encounters for male clients of commercial sex workers, and higher transmission rate. The model allowed to quantify the role of each type of relationship in HIV transmission, the proportion of infections occurring at each stage of disease progression, and the net reproduction rate of the epidemic (R0?=?1.95). Conclusions The simulation model reproduced the dynamics of the HIV epidemic in Zambia, and fitted the age and sex pattern of HIV seroprevalence in 2001. The same model could be used to measure the effect of changing behaviour in the future.

Leclerc, Pauline M.; Matthews, Alan P.; Garenne, Michel L.

2009-01-01

114

Victimization from bullying among school-attending adolescents in grades 7 to 10 in Zambia  

PubMed Central

Abstract: Background: Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying. Methods: The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also conducted weighted multivariate logistic regression analysis to determine independent factors associated with victimization from bullying, and report adjusted odds ratios (AOR) and their 95% confidence intervals (CI). Results: Of 2136 students who participated in the 2004 Zambia GSHS, 1559 had information on whether they were bullied or not. Of these, 1559 students, 62.8% (60.0% of male and 65.0% of female) participants reported having been bullied in the previous 30 days to the survey. We found that respondents of age less than 14 years were 7% (AOR=0.93; 95%CI [0.91, 0.95]) less likely to have been bullied compared to those aged 16 years or older. Being a male (AOR=1.07; 95%CI [1.06, 1.09]), lonely (AOR=1.24; 95%CI [1.22, 1.26]), worried (AOR=1.12; 95%CI [1.11, 1.14]), consuming alcohol (AOR=2.59; 95%CI [2.55, 2.64]), missing classes (AOR=1.30; 95%CI [1.28, 1.32]), and considering attempting suicide (AOR=1.20; 95%CI [1.18, 1.22]) were significantly associated with bullying victimization. Conclusions: Victimization from bullying is prevalent among in-school adolescents in grades 7 to 10 in Zambia, and interventions to curtail it should consider the factors that have been identified in this study.

Siziya, Seter; Rudatsikira, Emmanuel; Muula, Adamson S.

2012-01-01

115

An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia  

Microsoft Academic Search

Background  Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality\\u000a of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies\\u000a of Ghana, South Africa, Uganda and Zambia.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The WHO Mental Health Policy Checklist was used to evaluate

Edwige Faydi; Michelle Funk; Sharon Kleintjes; Angela Ofori-Atta; Joshua Ssbunnya; Jason Mwanza; Caroline Kim; Alan Flisher

2011-01-01

116

Challenges in the control of Human African Trypanosomiasis in the Mpika district of Zambia  

PubMed Central

Background Human African Trypanosomiasis is one of the Neglected Tropical Diseases that is targeted for elimination by the World Health Organization. Strong health delivery system in endemic countries is required for a control program to eliminate this disease. In Zambia, Human African Trypanosomiasis is lowly endemic in the northeastern part of the country. Findings We conducted a cross-sectional survey of health institutions in Mpika district in Northern Province of Zambia from 9th to 23rd November 2011. The aim of this study was to assess current health delivery system in the management of Human African Trypanosomiasis cases in Mpika district, Northern Province of Zambia. Ten health institutions were covered in the survey. Two structured questionnaires targeting health workers were used to collect the data on general knowledge on HAT and state of health care facilities in relation to HAT management from the surveyed health institution. Only 46% of the 28 respondents scored more than 50% from the questionnaire on general knowledge about Human African Trypanosomiasis disease. None of the respondents knew how to differentiate the two clinical stages of Human African Trypanosomiasis disease. There were only three medical doctors to attend to all Human African Trypanosomiasis cases and other diseases at the only diagnostic and treatment hospital in Mpika district. The supply of antitrypanosomal drugs to the only treatment centre was erratic. Only one refresher course on Human African Trypanosomiasis case diagnosis and management for health staff in the district had been organized by the Ministry of Health in conjunction with the World Health Organization in the district in 2009. The referral system for suspected Human African Trypanosomiasis cases from Rural Health Centres (RHCs) to the diagnostic/treatment centre was inefficient. Conclusions There are a number of challenges that have been identified and need to be addressed if Human African Trypanosomiasis is to be eliminated in a lowly endemic country such as Zambia. These include shortage of trained health workers, inadequate diagnostic and treatment centres, lack of more sensitive laboratory diagnostic techniques, shortage of trypanosomicides among others discussed in detail here.

2013-01-01

117

Factors associated with postpartum physical and mental morbidity among women with known HIV status in Lusaka, Zambia  

Microsoft Academic Search

The objective of our study was to investigate factors associated with postpartum physical and mental morbidity among women in Lusaka, Zambia with particular reference to known HIV status. Our study was part of the Breastfeeding and Postpartum Health (BFPH) longitudinal cohort study conducted between June 2001 and July 2003. Women were recruited at 34 weeks gestation and followed up to

S. M. Collin; M. M. Chisenga; L. Kasonka; A. Haworth; C. Young; S. Filteau; S. F. Murray

2006-01-01

118

Sedimentology of the Madumabisa Mudstone Formation (Late Permian), Lower Karoo Group, mid-Zambezi Valley Basin, southern Zambia  

Microsoft Academic Search

Sediments of the Upper Carboniferous to Lower Jurassic Karoo Supergroup (? 4.5 km thick) were deposited in the mid-Zambezi Valley Basin, southern Zambia. The Upper Palæozoic Lower Karoo Group in this area ends with a Late Permian sedimentary unit called the Madumabisa Mudstone Formation. The formation is 700 m thick and comprises four lithofacies grouped into two facies assemblages, collectively

Imasiku A. Nyambe; Owen Dixon

2000-01-01

119

Characterization of the optical properties of biomass burning aerosols in Zambia during the 1997 ZIBBEE field campaign  

Microsoft Academic Search

The physical and optical properties of biomass burning aerosols in a savanna region in south central Africa (Zambia) were analyzed from measurements made during the Zambian International Biomass Burning Emissions Experiment (ZIBBEE) during August-September 1997. Due to the large spatial extent of African savannas and the high frequency of occurrence of burning in the annual dry seasons, characterization of the

T. F. Eck; B. N. Holben; D. E. Ward; O. Dubovik; J. S. Reid; A. Smirnov; M. M. Mukelabai; N. C. Hsu; N. T. O'Neill; I. Slutsker

2001-01-01

120

Health Communication in Multilingual Contexts: A Study of Reading Preferences, Practices, and Proficiencies Among Literate Adults in Zambia  

Microsoft Academic Search

Comprehension of health materials and messages is a necessary, though not sufficient, condition for the development of health literacy; in the case of print materials, reading comprehension is elemental. Assessments of the population's ability to read and comprehend written materials are complex and highly salient in multilingual countries, such as Zambia, particularly when an excolonial language is but one of

Carol Underwood; Elizabeth Serlemitsos; Mubiana Macwangi

2007-01-01

121

Use of Principal Component Analysis (PCA) of Remote Sensing Images in Wetland Change Detection on the Kafue Flats, Zambia  

Microsoft Academic Search

The paper describes the use of Principal Component Analysis (PCA) of remote sensing images as a method of change detection for the Kafue Flats, an inland wetland system in southern Zambia. The wetland is under human and natural pressures but is also an important wildlife habitat. A combination of Landsat MSS and TM images were used. The images used were

Christopher Munyati

2004-01-01

122

Cultivating Kaunda's plan for self-sufficiency: Is urban agriculture finally beginning to receive support in Zambia?  

Microsoft Academic Search

Urban agriculture has become one of the key survival strategies for the urban poor in the developing world. Yet most cities do not have policy to support it and many actively discourage it. This paper reviews the situation in Zambia's four largest cities. During the 1960s–1970s, the Kaunda government attempted to create a supportive policy environment for urban agriculture, which

Alec Thornton; Etienne Nel; Godfrey Hampwaye

2010-01-01

123

The referral process and urban health care in sub-Saharan Africa: the case of Lusaka, Zambia  

Microsoft Academic Search

Much of the current reform of urban health systems in sub-Saharan Africa focuses upon the referral system between different levels of care. It is often assumed that patients are by-passing primary facilities which leads to congestion at hospital outpatient departments. Zambia is well advanced in its health sector reform and this case study from the capital, Lusaka, explores the patterns

Sarah Atkinson; Alasford Ngwengwe; Mubiana Macwan'gi; T. J. Ngulube; Andrew O'Connell

1999-01-01

124

A STUDY ON THE SHIFTING CULTIVATION SYSTEM IN KALAHARI WOODLAND, WESTERN ZAMBIA, WITH SPECIAL REFERENCE TO CASSAVA MANAGEMENT  

Microsoft Academic Search

The Kalahari Sands found all over southern Africa have been described as not being suitable for agriculture. However, Kalahari woodland developed on the same Kalahari sands of western Zambia and Angolan immigrants who escaped the war settled on the wood- land. Their livelihoods are dependent on growing cassava, their staple and cash crop. The cassava grown by the Angolan immigrants

Rumiko MURAO

2005-01-01

125

A survey of the relationship of genetic markers, tick-infestation level and parastic diseases in Zebu cattle in Zambia  

Microsoft Academic Search

This paper reports on a study of1,033 Angoni cattle in the Eastern Province of Zambia. The animals came from two areas, one of which had frequent outbreaks of trypanosomiasis whilst the other was relatively free of clinical trypanosomiasis. Whole body tick collections were made from each animal and blood samples taken together with data on colour, sex, age and skinfold

W. R. Carr; J. Macleod; B. Woolf; R. L. Spooner

1974-01-01

126

Why resort to illegal abortion in Zambia? Findings of a community-based study in Western Province  

Microsoft Academic Search

This article presents part of the findings of a community-based study on the causes and effects of unplanned pregnancies in four districts of Western Province, Zambia. The study broke the silence around abortion in Western Province and revealed that induced abortion poses a public health problem. Using innovative methodology of recording and analyzing histories of deaths from induced abortion, the

Winny Koster-Oyekan

1998-01-01

127

The impact of human immunodeficiency virus on mortality of patients treated for tuberculosis in a cohort study in Zambia  

Microsoft Academic Search

We have examined the impact of human immunodeficiency virus (HIV) on mortality of patients treated for tuberculosis in a prospective study in Lusaka, Zambia. Patients with sputum smear-positive, miliary, or meningeal tuberculosis were prescribed 2 months' daily streptomycin, thiacetazone, isoniazid, rifampicin, and pyrazinamide followed by 6 months thiacetazone and isoniazid; others, 2 months streptomycin, thiacetazone and isoniazid followed by 10

Alison M. Elliott; Benita Halwiindi; Richard J. Hayes; Nkandu Luo; Alwyn G. Mwinga; George Tembo; Lieve Machiels; Ger Steenbergen; Joseph O. M. Pobee; Paul Nunn; Keith P. W. J. McAdam

1995-01-01

128

Beyond Time: Temporal and Extra-Temporal Functions of Tense and Aspect Marking in Totela, a Bantu Language of Zambia  

ERIC Educational Resources Information Center

|This dissertation aims to characterize the relationship between the temporal and information-structuring functions of tense and aspect marking in Totela, an endangered Bantu language of Zambia and Namibia. To that end, I investigate and describe in detail the semantics and pragmatics of selected tense and aspect markers, showing for each that a…

Crane, Thera Marie

2011-01-01

129

Globalising Accessibility: Drawing on the Experiences of Developed Countries to Enable the Participation of Disabled People in Zambia  

ERIC Educational Resources Information Center

|This paper explores the accessibility situation in a developing country such as Zambia. The global view of accessibility for disabled people is provided to examine the accessibility situation in developed and developing countries, highlighting the role of the environment in achieving rights for disabled people. Recognition of disability rights…

Banda-Chalwe, Martha; Nitz, Jennifer C.; de Jonge, Desleigh

2012-01-01

130

Grassroot Soccer Resiliency Pilot Program: Building Resiliency through Sport-Based Education in Zambia and South Africa  

ERIC Educational Resources Information Center

Grassroot Soccer (GRS), a U.S.-based nonprofit organization, designed a curriculum and sport-based teaching model to build resiliency, targeting boys and girls in Lusaka, Zambia, and Johannesburg, South Africa, where most children are reminded daily of the devastation caused by AIDS and where many face chronic and acute hardship. Collaborating…

Peacock-Villada, Paola; DeCelles, Jeff; Banda, Peter S.

2007-01-01

131

Sowing the good seed. The interweaving of agricultural change, gender relations and religion in Serenje District, Zambia  

Microsoft Academic Search

In de periode 1963-64 verrichtte Norman Long onderzoek in een rurale gemeenschap in Chibale Chiefdom, een van de Lala Chiefdoms in Serenje District, Zambia. Zijn onderzoek richtte zich voornamelijk op de analyse van de differentiële reacties van verschillende groepen op veranderende agrarische, sociale en economische omstandigheden alsmede op interventie door de koloniale overheid.Een belangrijk thema in Long's werk was de

H. Seur

1992-01-01

132

Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia  

Microsoft Academic Search

BACKGROUND: The Ministry of Health (MOH) in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH) strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear.

Aaron Tjoa; Margaret Kapihya; Miriam Libetwa; Kate Schroder; Callie Scott; Joanne Lee; Elizabeth McCarthy

2010-01-01

133

Community attitudes towards childbearing and abortion among HIV-positive women in Nigeria and Zambia.  

PubMed

Although stigma towards HIV-positive women for both continuing and terminating a pregnancy has been documented, to date few studies have examined relative stigma towards one outcome versus the other. This study seeks to describe community attitudes towards each of two possible elective outcomes of an HIV-positive woman's pregnancy - induced abortion or birth - to determine which garners more stigma and document characteristics of community members associated with stigmatising attitudes towards each outcome. Data come from community-based interviews with reproductive-aged men and women, 2401 in Zambia and 2452 in Nigeria. Bivariate and multivariate analyses revealed that respondents from both countries overwhelmingly favoured continued childbearing for HIV-positive pregnant women, but support for induced abortion was slightly higher in scenarios in which anti-retroviral therapy (ART) was unavailable. Zambian respondents held more stigmatising attitudes towards abortion for HIV-positive women than did Nigerian respondents. Women held more stigmatising attitudes towards abortion for HIV-positive women than men, particularly in Zambia. From a sexual and reproductive health and rights perspective, efforts to assist HIV-positive women in preventing unintended pregnancy and to support them in their pregnancy decisions when they do become pregnant should be encouraged in order to combat the social stigma documented in this paper. PMID:23173695

Kavanaugh, Megan L; Moore, Ann M; Akinyemi, Odunayo; Adewole, Isaac; Dzekedzeke, Kumbutso; Awolude, Olutosin; Arulogun, Oyedunni

2012-11-23

134

Quality of relationship and sexual risk behaviors among HIV couples in Lusaka, Zambia.  

PubMed

Relationship quality and partner dynamics provide important insights into understanding sexual behavior within HIV sero-positive and sero-discordant couples. Individuals in long-term partnerships may be vulnerable to HIV/sexually transmitted infections (STI) within their relationships due to misperceptions of their partners risk behaviors and potential concurrent (e.g., extramarital, nonprimary) sexual partnerships. This study sought to examine relationship quality among HIV sero-positive and sero-discordant couples in Zambia, and its association with safer sex behavior. This study utilized data drawn from an ongoing translational study, The Partnership II Project - a couples-based sexual risk reduction intervention in Lusaka, Zambia. Couples (n=240) were assessed on demographics, relationship quality, and sexual risk behavior. Overall, couples perceiving their relationships more positively engaged in less risky sexual behavior (i.e., more condom use (b=0.011, t=3.14, p=0.002) and fewer partners (?(2)=11.4, p=0.003). Within the dyad, condom use was "actor driven," indicating that the association between relationship quality and condom use did not depend on the partner's evaluation of the relationship. Safer sex behavior was positively influenced by communication about condoms. Results support the paradigm shift from prevention strategies with HIV-positive and at-risk individuals to concentrated efforts addressing male-female dyads, and suggest that interventions to address the role of couples' relationship quality, a modifiable target for decreasing sexual risk behavior, are needed. PMID:23336258

Vamos, Szonja; Cook, Ryan; Chitalu, Ndashi; Mumbi, Miriam; Weiss, Stephen M; Jones, Deborah

2013-01-21

135

Non-Sexual Transmission of Trichomonas vaginalis in Adolescent Girls Attending School in Ndola, Zambia  

PubMed Central

Objectives To identify risk factors for trichomoniasis among young women in Ndola, Zambia. Method The study was a cross-sectional study among adolescent girls aged 13-16 years in Ndola, Zambia. Study participants were recruited from schools in selected administrative areas that represented the different socio-economic strata in town. Consenting participants were interviewed about their socio-demographic characteristics; sexual behaviour; and hygiene practices. Self-administered vaginal swabs were tested for Trichomonas vaginalis. HSV-2 antibodies were determined on serum to validate the self-reported sexual activity. Results A total of 460 girls participated in the study. The overall prevalence of trichomoniasis was 27.1%, 33.9% among girls who reported that they had ever had sex and 24.7% among virgins. In multivariate analysis the only statistically significant risk factor for trichomoniasis was inconsistent use of soap. For the virgins, none of the risk factors was significantly associated with trichomoniasis, but the association with use of soap (not always versus always) and type of toilet used (pit latrine/bush versus flush toilet) was of borderline significance. Conclusion We found a high prevalence of trichomoniasis in girls in Ndola who reported that they had never had sex. We postulate that the high prevalence of trichomoniasis in virgins in Ndola is due to non-sexual transmission of trichomoniasis via shared bathing water and inconsistent use of soap.

Crucitti, Tania; Jespers, Vicky; Mulenga, Chanda; Khondowe, Shepherd; Vandepitte, Judith; Buve, Anne

2011-01-01

136

The effect of seasonal variation on anthrax epidemiology in the upper Zambezi floodplain of western Zambia  

PubMed Central

Anthrax has become endemic throughout the upper Zambezi floodplain located in the Western Province of Zambia over the recent years. To date, no comprehensive study has been carried out to determine whether recurrence of anthrax outbreaks may be linked to differences in precipitation and human activities. Retrospective data for the period 1999 to 2007 showed that a total of 1,216 bovine cases of anthrax were reported. During the same period, 1,790 human anthrax cases and a corresponding case fatality rate of 4.63% (83/1,790) was documented in the upper Zambezi floodplain. Occurrence of human cases was highly correlated with cattle outbreaks (r = 0.94, p < 0.001). Differences in precipitation were significantly associated with the occurrence of anthrax outbreaks (?2 = 4.75, p < 0.03), indicating that the likelihood of outbreaks occurring was higher during the dry months when human occupancy of the floodplain was greater compared to the flooding months when people and livestock moved out of this region. Human dependency on the floodplain was shown to significantly influence the epidemiology of anthrax in the upper Zambezi floodplain of western Zambia. Methods for mitigating anthrax outbreaks by disrupting the cycle of transmission are herein highlighted.

Banda, Fredrick; Siamudaala, Victor Mukulule; Munyeme, Musso; Kasanga, Christopher Jacob; Hamududu, Byman

2012-01-01

137

MARS: Monitoring Agro-Ecological Resources with Remote Sensing and Simulation. Simulation Studies on the Limitations to Maize Production in Zambia.  

National Technical Information Service (NTIS)

A crop growth simulation model has been used to assess the potential for maize production in Zambia under various crop management systems, ranging from low input subsistence farming to large scale commercial farming using high input cropping technologies....

J. Huygen C. A. van Diepen C. H. van Immerzeel H. van Keulen F. de Koning

1990-01-01

138

Harmful lifestyles' clustering among sexually active in-school adolescents in Zambia  

PubMed Central

Background HIV is a leading cause of morbidity and mortality in Zambia. Like many other African nations with high HIV burden, heterosexual intercourse is the commonest mode of HIV spread. The estimation of prevalence and factors associated with sexual intercourse among in-school adolescents has potential to inform public health interventions aimed at reducing the burden of sex-related diseases in Zambia. Methods We carried out secondary analysis of the Zambia Global School-Based Health Survey (GSHS) 2004; a cross sectional survey that aims to study health-related behaviors among in-school adolescents. We estimated frequencies of relevant socio-demographic variables. The associations between selected explanatory variables and self-reported history of sexual intercourse within the last 12 months were assessed using logistic regression analysis. Results Data from 2136 in-school adolescents who participated in the Zambia Global School-Based Health Survey of 2004 were available for analysis. Out of these respondents, 13.4% reported that they had sexual intercourse in the past 12 months prior to the survey; 16.4% and 9.7% among males and females respectively. In multivariable logistic regression analysis, with age less than 15 years as the referent the adjusted odds ratio (AOR) of having engaged in sexual intercourse in adolescents of age 15 years, and those aged 16 years or more were 1.06 (95% CI 1.03–1.10) and 1.74 (95% 1.70–1.79) respectively. Compared to adolescents who had no close friends, adolescents who had one close friend were more likely to have had sexual intercourse, AOR = 1.28 (95% CI 1.24–1.32). Compared to adolescents who were not supervised by their parents, adolescents who were rarely or sometimes supervised by their parents were likely to have had sexual intercourse, and adolescents who were most of the time/always supervised by their parents were less likely to have had sexual intercourse; AORs 1.26 (95% CI 1.23–1.26) and 0.92 (95% CI 0.90–0.95) respectively. Compared to adolescents who did not smoke dagga, adolescents who smoked dagga 1 or 2 times, and those who smoked dagga 3 or more times in their lifetime were 70% and 25% more likely to have had sexual intercourse, respectively. Adolescents who drank alcohol in 1 or 2 days, and those who took alcohol in 3 or more days in a month preceding the survey were 12% and 9% more likely to have had sexual intercourse, respectively, compared to adolescents who did not drink alcohol in the 30 days prior to the survey. Furthermore, adolescents who had been drunk 1 or 2 times, and who had been drunk 3 or more times in a life time were 14% and 13% more likely to have had sexual intercourse compared to those who have never been drunk in their lifetime. Conclusion We identified a constellation of potentially harmful behaviours among adolescents in Zambia. Public health interventions aimed at reducing prevalence of sexual intercourse may be designed and implemented in a broader sense having recognized that sexually active adolescents may also be exposed to other problem behaviours.

Siziya, Seter; Muula, Adamson S; Kazembe, Lawrence N; Rudatsikira, Emmanuel

2008-01-01

139

The Impact of Cash Budgets on Poverty Reduction in Zambia: A Case Study of the Conflict between Well-Intentioned Macroeconomic Policy and Service Delivery to the Poor  

Microsoft Academic Search

Facing runaway inflation and budget discipline problems in the early 1990s, the Zambian government introduced the so-called cash budget in which government domestic spending is limited to domestic revenue, leaving no room for excess spending. Dinh, Adugna, and Myers review Zambia?s experience during the past decade, focusing on the impact of the cash budget on poverty reduction.They conclude that after

Hinh T. Dinh; Abebe Adugna; Myers. Bernard

2002-01-01

140

Estimating Loss to Follow-Up in HIV-Infected Patients on Antiretroviral Therapy: The Effect of the Competing Risk of Death in Zambia and Switzerland  

Microsoft Academic Search

BackgroundLoss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland.Methods and FindingsHIV-infected patients aged ?18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included.

Franziska Schöni-Affolter; Olivia Keiser; Albert Mwango; Jeffrey Stringer; Bruno Ledergerber; Lloyd Mulenga; Heiner C. Bucher; Andrew O. Westfall; Alexandra Calmy; Andrew Boulle; Namwinga Chintu; Matthias Egger; Benjamin H. Chi

2011-01-01

141

Intention to use the female condom following a mass-marketing campaign in Lusaka, Zambia.  

PubMed Central

OBJECTIVES: This report examines intention to use the female condom among men and women in Lusaka, Zambia, who were exposed to mass-marketing of the female condom. METHODS: The study used data from a representative sample of consumers at outlets that sell or distribute the female condom and the male condom. RESULTS: In spite of a high level of awareness of the female condom, use of this method in the last year was considerably lower than use of the male condom. Intention to use the female condom in the future was highest among respondents who had used only the female condom in the last year. CONCLUSIONS: The female condom is likely to be most important for persons who are unable or unwilling to use the male condom.

Agha, S

2001-01-01

142

Developing a nutrition and health education program for primary schools in Zambia.  

PubMed

School-based health and nutrition interventions in developing countries aim at improving children's nutrition and learning ability. In addition to the food and health inputs, children need access to education that is relevant to their lives, of good quality, and effective in its approach. Based on evidence from the Zambia Nutrition Education in Basic Schools (NEBS) project, this article examines whether and to what extent school-based health and nutrition education can contribute directly to improving the health and nutrition behaviors of school children. Initial results suggest that gains in awareness, knowledge and behavior can be achieved among children and their families with an actively implemented classroom program backed by teacher training and parent involvement, even in the absence of school-based nutrition and health services. PMID:17996629

Sherman, Jane; Muehlhoff, Ellen

143

Barriers and Resources to PMTCT of HIV: Luba-Kasai Men's Perspective in Lusaka, Zambia.  

PubMed

The purpose of this study was to describe the views of Luba-Kasai (a Congolese tribe) men on barriers inhibiting them from the prevention of mother-to-child transmission (PMTCT) of HIV and the resources they need to implement such prevention in Lusaka, Zambia. Twenty-one men were interviewed and the data were analyzed using qualitative content analysis. The barriers identified in the data were poverty, refugee status, absence of support arrangements, and the working culture in antenatal care, passivity, ignorance, marital disharmony, HIV-related stigma, and cultural characteristics, such as ways of being a man and religious beliefs. The resources were spiritual outlook on life, knowledge of HIV issues, support and availability of advanced health services, and satisfaction of basic needs. Improving male participation in PMTCT in this subpopulation presupposes cooperation between different sectors of society and inspiring trust in antenatal care. PMID:24070641

Auvinen, Jaana; Kylmä, Jari; Välimäki, Maritta; Bweupe, Max; Suominen, Tarja

2013-09-24

144

Trypanosoma brucei Infection in asymptomatic greater Kudus (Tragelaphus strepsiceros) on a game ranch in Zambia.  

PubMed

Trypomastogotes of Trypanosoma brucei were detected from 4 asymptomatic kudus (Tragelaphus strepsiceros) on a game ranch located approximately 45 km north east of Lusaka, Zambia. Blood smears examined from 14 wildlife species comprising of the impala (Aepyceros melampus), Kafue lechwe (kobus leche kafuensis), sable antelope (Hippotragus niger), tsessebe (Damaliscus lunatus), warthog (Phacochoerus aethiopicus), puku (Kobus vardoni), zebra (Equus burchelli), waterbuck (Kobus ellipsiprymnus), bushbuck (Tragelaphus scriptus), reedbuck (Redunca arundinum), wilderbeest (Connochaetes taurinus), hartebeest (Alcephelus lichtensteini), African buffalo (Syncerus caffer), and kudu (Tragelaphus strepsiceros) showed that only the kudu had T. brucei. Although game ranching has emerged to be a successful ex-situ conservation strategy aimed at saving the declining wildlife population in the National Parks, our findings suggest that it has the potential of aiding the re-distribution of animal diseases. Hence, there is a need for augmenting wildlife conservation with disease control strategies aimed at reducing the risk of disease transmission between wildlife and domestic animals. PMID:20333288

Munang'andu, Hetron Mweemba; Siamudaala, Victor; Munyeme, Musso; Nambota, Andrew; Mutoloki, Stephen; Matandiko, Wigganson

2010-03-18

145

GC-MS Determination of Targeted Pesticides in Environmental Samples from the Kafue Flats of Zambia.  

PubMed

Results of a GC-MS analysis for targeted pesticides i.e. dieldrin, endosulfan, pp-DDT, endrin, HCB, heptachlor, mirex and aldrin in the Kafue Flats of Zambia are presented. Analysis was done in soils, sediments, water and vegetation samples from the Lochinvar and Blue Lagoon National Parks along the Kafue River. A validated analytical method that was used gave recoveries in a spiked soil sample ranging between 60 % and 100 % with limits of detection (LODs) ranging from 0.94 to 8.0 ng/g. The targeted pesticides were not detected in all the samples i.e. were below LODs. Screening using the Automated Mass Spectral Deconvolution and Identification System (AMDIS) simplified the analysis due to its power of deconvolution and identification of analytes of interest. PMID:23995850

Sichilongo, Kwenga; Banda, Daniel

2013-09-01

146

Treatment and prevention of cryptosporidiosis: what options are there for a country like Zambia?  

PubMed

Cryptosporidiosis is a major infection of humans, leading to diarrhoea and growth failure in children, diarrhoea and malnutrition in immunocompromised adults, and is associated with increased mortality in all age groups. Using the country of Zambia as an example, I review the possible approaches to treatment and prevention in a tropical setting. The current optimal therapy for cryptosporidiosis is nitazoxanide which works well in HIV uninfected children, but treatment in patients with HIV infection remains remarkably difficult. No single drug has demonstrated efficacy in a randomised trial. No vaccine is available, so the best option for prevention for the moment is filtration and clean storage of drinking water. This would be expected to reduce cryptosporidiosis dramatically, but this needs to be demonstrated directly. Water filtration would have the added benefit of protection against many other pathogens, but the paucity of alternative approaches highlights the need for a better understanding of this important human pathogen. PMID:21320387

Kelly, Paul

2011-02-15

147

Trypanosoma brucei Infection in Asymptomatic Greater Kudus (Tragelaphus strepsiceros) on a Game Ranch in Zambia  

PubMed Central

Trypomastogotes of Trypanosoma brucei were detected from 4 asymptomatic kudus (Tragelaphus strepsiceros) on a game ranch located approximately 45 km north east of Lusaka, Zambia. Blood smears examined from 14 wildlife species comprising of the impala (Aepyceros melampus), Kafue lechwe (kobus leche kafuensis), sable antelope (Hippotragus niger), tsessebe (Damaliscus lunatus), warthog (Phacochoerus aethiopicus), puku (Kobus vardoni), zebra (Equus burchelli), waterbuck (Kobus ellipsiprymnus), bushbuck (Tragelaphus scriptus), reedbuck (Redunca arundinum), wilderbeest (Connochaetes taurinus), hartebeest (Alcephelus lichtensteini), African buffalo (Syncerus caffer), and kudu (Tragelaphus strepsiceros) showed that only the kudu had T. brucei. Although game ranching has emerged to be a successful ex-situ conservation strategy aimed at saving the declining wildlife population in the National Parks, our findings suggest that it has the potential of aiding the re-distribution of animal diseases. Hence, there is a need for augmenting wildlife conservation with disease control strategies aimed at reducing the risk of disease transmission between wildlife and domestic animals.

Siamudaala, Victor; Munyeme, Musso; Nambota, Andrew; Mutoloki, Stephen; Matandiko, Wigganson

2010-01-01

148

Environmental monitoring of the kafue river, located in the Copperbelt, Zambia.  

PubMed

Zambia is a country with an extensive mining industry with the majority of mines located in the Copperbelt province. Through this region of the country, the Kafue River drains and receives effluent water from mining activities as well as from other industrial point sources. In addition, production of agricultural products and pest control requires use of different pesticides in the area. Information on industrial and agricultural pollution has not been clearly identified in Zambia, and little attention has been paid to pollution control and possible impact of metals, pesticides, and other persistent compounds in the environment. The objective of this study was to introduce and to evaluate a few methodologies based on in situ bioassays for environmental assessment to promote sustainable and environmentally sound water resource management of the Kafue River. The results show that caged threespot tilapia exposed downstream of industrial points sources rapidly bioaccumulate several trace elements, i.e., Cd, Co, Cu, Cr, Ni. These elements also occurred in much higher concentrations in water samples downstream of the industrial area compared with a locality upstream. Furthermore, the use of a semipermeable membrane device (SPMD) for passive absorption of lipophilic pollutants in the water showed relatively high concentration of several pesticides, i.e., DDT with major metabolites, PCB, and dieldrin. The present study shows that only 2 weeks of in situ studies in waters contaminated by pollutants affects in situ exposed fish and that the correlation between water and tissue concentrations was relatively good. Both trace elements and persistent organic pollutants occurred in such high concentrations that they must be considered from ecotoxicological aspects and may affect aquatic animal health. PMID:10667931

Norrgren, L; Pettersson, U; Orn, S; Bergqvist, P

2000-04-01

149

Task-shifting: experiences and opinions of health workers in Mozambique and Zambia  

PubMed Central

Background This paper describes the task-shifting taking place in health centres and district hospitals in Mozambique and Zambia. The objectives of this study were to identify the perceived causes and factors facilitating or impeding task-shifting, and to determine both the positive and negative consequences of task-shifting for the service users, for the services and for health workers. Methods Data collection involved individual and group interviews and focus group discussions with health workers from the civil service. Results In both the Republic of Mozambique and the Republic of Zambia, health workers have to practice beyond the traditional scope of their professional practice to cope with their daily tasks. They do so to ensure that their patients receive the level of care that they, the health workers, deem due to them, even in the absence of written instructions. The “out of professional scope” activities consume a significant amount of working time. On occasions, health workers are given on-the-job training to assume new roles, but job titles and rewards do not change, and career progression is unheard of. Ancillary staff and nurses are the two cadres assuming a greater diversity of functions as a result of improvised task-shifting. Conclusions Our observations show that the consequences of staff deficits and poor conditions of work include heavier workloads for those on duty, the closure of some services, the inability to release staff for continuing education, loss of quality, conflicts with patients, risks for patients, unsatisfied staff (with the exception of ancillary staff) and hazards for health workers and managers. Task-shifting is openly acknowledged and widespread, informal and carries risks for patients, staff and management.

2012-01-01

150

Prevalence and Correlates of Alcohol Dependence Disorder among TB and HIV Infected Patients in Zambia  

PubMed Central

Objectives To determine the prevalence and correlates of alcohol dependence disorders in persons receiving treatment for HIV and Tuberculosis (TB) at 16 Primary Health Care centres (PHC) across Zambia. Methods 649 adult patients receiving treatment for HIV and/or TB at PHCs in Zambia (363 males, 286 females) were recruited between 1st December 2009 and 31st January 2010. Data on socio-demographic variables, clinical disease features (TB and HIV), and psychopathological status were collected. The Mini International Neuropsychiatric Interview (MINI) was used to diagnose alcohol dependence disorder. Correlates of alcohol dependence were analyzed for men only, due to low prevalence in women. Univariable and multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using general estimating equations to allow for within-PHC clustering. Results The prevalence of alcohol dependence was 27.2% (95%CI: 17.7-39.5%) for men and 3.9% (95%CI: 1.4-0.1%) for women. Factors associated with alcohol dependence disorder in men included being single, divorced or widowed compared with married (adjusted OR = 1.47, 95%CI: 1.00-2.14) and being unemployed (adjusted OR=1.30, 95%CI: 1.01-1.67). The highest prevalence of alcohol dependence was among HIV-test unknown TB patients (34.7%), and lowest was among HIV positive patients on treatment but without TB (14.1%), although the difference was not statistically significant (p=0.38). Conclusions Male TB/HIV patients in this population have high prevalence of alcohol dependence disorder, and prevalence differs by HIV/TB status. Further work is needed to explore interventions to reduce harmful drinking in this population.

O'Connell, Rebecca; Chishinga, Nathaniel; Kinyanda, Eugene; Patel, Vikram; Ayles, Helen; Weiss, Helen A.; Seedat, Soraya

2013-01-01

151

Causes of stillbirth, neonatal death and early childhood death in rural Zambia by verbal autopsy assessments  

PubMed Central

Summary OBJECTIVES To describe specific causes of the high rates of stillbirth, neonatal death and early child childhood death in Zambia. METHODS We conducted a household-based survey in rural Zambia. Socio-demographic and delivery characteristics were recorded, alongside a maternal HIV test. Verbal autopsy questionnaires were administered to elicit mortality-related information and independently reviewed by three experienced paediatricians who assigned a cause and contributing factor to death. For this secondary analysis, deaths were categorized into: stillbirths (foetal death ?28 weeks of gestation), neonatal deaths (?28 days) and early childhood deaths (>28 days to <2 years). RESULTS Among 1679 households, information was collected on 148 deaths: 34% stillbirths, 26% neonatal and 40% early childhood deaths. Leading identifiable causes of stillbirth were intrauterine infection (26%) and birth asphyxia (18%). Of 32 neonatal deaths, 38 (84%) occurred within the first week of life, primarily because of infections (37%) and prematurity (34%). The majority of early childhood deaths were caused by suspected bacterial infections (82%). HIV prevalence was significantly higher in mothers who reported an early childhood death (44%) than mothers who did not (17%; P < 0.01). Factors significantly associated with mortality were lower socio-economic status (P < 0.01), inadequate water or sanitation facilities (P < 0.01), home delivery (P = 0.04) and absence of a trained delivery attendant (P < 0.01). CONCLUSION We provide community-level data about the causes of death among children under 2 years of age. Infectious etiologies for mortality ranked highest. At a public health level, such information may have an important role in guiding prevention and treatment strategies to address perinatal and early childhood mortality.

Turnbull, Eleanor; Lembalemba, Mwila K.; Guffey, M. Brad; Bolton-Moore, Carolyn; Mubiana-Mbewe, Mwangelwa; Chintu, Namwinga; Giganti, Mark J.; Nalubamba-Phiri, Mutinta; Stringer, Elizabeth M.; Stringer, Jeffrey S. A.; Chi, Benjamin H.

2013-01-01

152

Knowledge, Use, and Concerns about Contraceptive Methods among Sero-Discordant Couples in Rwanda and Zambia  

PubMed Central

Abstract Objective The unique needs of sero-discordant couples are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in absence of the reduction of the risk of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Conversely, HIV testing and programs focus exclusively on condom use without discussion of more effective contraceptive methods. In order to provide information to inform the development of family planning services tailored to the unique needs of sero-discordant couples, this study examined the contraceptive knowledge, use, and concerns among sero-discordant couples in urban Rwanda and Zambia. Methods This article presents a comparison of family planning knowledge, use, and concerns about contraception among two cohorts of HIV sero-discordant study participants in Rwanda and Zambia. Results The results reveal an interesting profile of contraceptive knowledge and use among sero-discordant couples; in both settings, despite high levels of knowledge of contraception, use of contraceptive methods remains relatively low. There is a clear gender difference in both the reporting of knowledge and use of contraceptive methods, and there is evidence of clandestine contraceptive use by women. Conclusions Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet to needs and concerns of HIV-positive women or those with HIV positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on “dual method use,” combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy.

Grabbe, Kristina; Vwalika, Bellington; Ahmed, Yusuf; Vwalika, Cheswa; Chomba, Elwyn; Karita, Etienne; Kayitenkore, Kayitesi; Tichacek, Amanda; Allen, Susan

2009-01-01

153

Pesticide residues in adipose tissue from hippopotami (Hippopotamus amphibius L) living in and adjacent to the Luangwa River in Zambia.  

PubMed

The concentration of organochlorines (OCs) such as organochlorine pesticides and polychlorinated biphenyls were measured in adipose tissue collected from 14 male hippopotami at Mfuwe in the southern part of the Luangwa National Park, Zambia. The samples contained low levels of OCs, and the concentrations of OCs were comparable to or lower than reported for wild herbivores studied in other parts of the world. PMID:16137136

Flåøyen, A; Polder, A; Mwase, M; Almli, B; Musonda, M M

2005-06-01

154

Health impact and cost-effectiveness of a private sector bed net distribution: experimental evidence from Zambia  

PubMed Central

Background Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). Methods The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia’s cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme. Results The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia’s NMCP. Conclusions The results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial.

2013-01-01

155

Rb-Sr age from the Choma-Kalomo batholith, evidence for the irumide belt in southern Zambia, Africa  

Microsoft Academic Search

The northeast trending Irumide mobile belt (1100-1300 my) of eastern Zambia is generally believed to reappear southwest of the cross-cutting, west to northwest trending Zambezi-Katanga belt of Pan African age (350-700 my). The on-strike relationship of the two segments of the Irumide belt on either side of the Zambezi-Katanga belt is often cited as proof of an ensialic, rather than

H. K. Brueckner; K. C. Hardcastle; R. F. Hanson; T. J. Wilson

1985-01-01

156

Examining Specific Effects of Context on Adaptive Behavior and Achievement in Rural Africa: Six Case Studies from Southern Province, Zambia  

Microsoft Academic Search

Generally accepted as universal, the construct of adaptive behavior differs in its manifestations across different cultures\\u000a and settings. The Vineland-II (Sparrow et al., Vineland adaptive behavior scales. AGS Publishing, Circle Pines, MN, 2005)\\u000a was translated into Chitonga and adapted to the setting of rural Southern Province, Zambia. This version was administered\\u000a to the parents\\/caregivers of 114 children (grades 3-7, mean

Mei Tan; Jodi Reich; Lesley Hart; Philip E. Thuma; Elena L. Grigorenko

157

Barriers to Insecticide-Treated Mosquito Net Possession 2 Years after a Mass Free Distribution Campaign in Luangwa District, Zambia  

Microsoft Academic Search

Background and MethodsRoll Back Malaria set the goal of 100% of households in malaria endemic countries in Africa owning an insecticide-treated mosquito net (ITN) by 2010. Zambia has used mass free distribution campaigns and distribution through antenatal care (ANC) clinics to achieve high coverage.Methodology and Principal FindingsWe conducted a probability survey of 801 households in 2008 to assess factors associated

David A. Larsen; Joseph Keating; John Miller; Adam Bennett; Cynthia Changufu; Cecilia Katebe; Thomas P. Eisele; Abdisalan M. Noor

2010-01-01

158

Organic petrology, thermal maturity, geology, and petroleum source rock potential of Lower Permian coal, Karoo supersystem, Zambia  

SciTech Connect

This paper reports on data concerning organic petrology and thermal maturity of Lower Karoo coal measures (Lower Permian) which are of considerable importance in determining the hydrocarbon potential of sediments in the rift-valley and half-graben complexes of the Luangwa and Zambezi valleys of eastern and southern Zambia, respectively, and in the extensive sedimentary basin developed on relatively stable Precambrian basement in western Zambia, a total area in excess of 3000 km{sup 2}. Samples from seven outcrop and subsurface localities situated in the northeast (northern Luangwa Valley), east (mid-Luangwa Valley), south (mid-Zambezi Valley), and the Western Province of Zambia were studied. The coal measures are from 9 to 280 m thick, but individual coal seams are generally less than 6 m. The coal macerals contain an average of 60% vitrinite and 9% liptinite, enough to have potential to generate hydrocarbon. A few samples contain twice this amount of liptinite. Reflected-light microscopy and the thermal alteration index of spores were used to determine the thermal maturity. The organic matter in samples studied is within the oil generation zone (thermal alteration index 2{minus} to 2+; %R{sub 0} max = 0.5-0.9). The petrological and palynological data indicate that the organic matter consists of Types II (generally approximately 25% in carbonaceous shale samples), III, and IV, indicating source rock potential. Late Karoo ( ) and post-Karoo fault blocks with differential vertical displacements may have produced structural traps suitable for oil and gas accumulation.

Utting, J. (Institute of Sedimentary and Petroleum Geology, Calgary, AB (Canada)); Wielens, H. (Unocal Canada Exploration Ltd., 150 6th Av. SW, Calgary, Alberta (CA))

1992-10-01

159

Detection of Babesia spp. in Free-Ranging Pukus, Kobus vardonii, on a Game Ranch in Zambia  

PubMed Central

Babesia spp. were detected from 4 asymptomatic pukus captured on a game ranch in central Zambia in October 2008. Blood smears were examined in 4 species of aymptomatic free-ranging antelopes, namely the puku (Kobus vordanii), reedbuck (Redunca arundinum), bushbuck (Tragelaphus sylvaticus), and kudu (Tragelaphus strepsiceros), and showed the presence of Babesia parasites only in the puku. In the puku, the prevalence of babesiosis was estimated at 33.3% (n=12), while the overall prevalence in all examined animals was 8.5% (n=47). The parasites showed morphological characteristics of paired ring-like stages with the length varying between 1.61 µm and 3.02 µm (mean=2.12 µm, n=27; SD=0.76 µm). Both the infected and non-infected pukus showed good body condition scores (BCS), while the dominant tick species detected from all animals were Rhipicephalus appendiculatus, Rhipicephalus spp., and Boophilus spp. To our knowledge this is the first report of Babesia spp. infection in pukus in Zambia. These findings suggest that wildlife could play an important role in the epidemiology of babesiosis in Zambia.

Munyeme, Musso; Nambota, Andrew Mubila; Nalubamba, King Shimumbo; Siamudaala, Victor M.

2011-01-01

160

Cultural differences in acceptability of a vaginal microbicide: a comparison between potential users from Nashville, Tennessee, USA, and Kafue and Mumbwa, Zambia  

PubMed Central

Purpose We sought to determine the relationship between acceptability of a hypothetical vaginal microbicide, cultural factors, and perceived HIV risk among African-American women in Nashville, TN, USA, and African women in Kafue and Mumbwa, Zambia. Patients and methods Women in both sites completed a survey. Regression analyses were performed on valid samples (Nashville, 164; Zambia, 101) to determine cultural differences affecting microbicide acceptability. Regression analyses also tested whether individual risk perception affected acceptability. Results In Zambia, 89.6% of women were willing to use a microbicide versus 81.6% in Nashville (P < 0.0001). One cultural difference is that women in the Zambian cohort viewed risk of HIV infection as distinct from risk of acquiring STIs, with 48% believing they were certain to become infected with AIDS, compared to 4% of Nashville participants. Conclusion These results suggest a high degree of acceptability toward use of a vaginal microbicide to prevent HIV infection.

Rice, Valerie Montgomery; Maimbolwa, Margaret C; Nkandu, Esther Munalula; Hampton, Jacqueline Fleming; Lee, Jae-Eun; Hildreth, James EK

2012-01-01

161

Worlds apart 3: Botswana and Zambia. Secrets of success in southern Africa.  

PubMed

Botswana must close the gap between knowledge and practice if population growth is to be decreased. Community-based efforts have been partially successful, but obstacles are posed by cultural attitudes, misinformation and fear, teenage mistrust of family planning (FP) clinics, and slow FP service due to skilled labor shortages. The growth rate has declined from 3.5 in 1980 to 2.8, but population may still increase from 1.3 million in 1991 to 2.3 million by 2011. About 60% of the population is aged under 30 years. The increased population is expected to strain resources for social services, exacerbate employment absorption, and contribute to environmental degradation. Although fertility was still very high at 5.0 in 1991, the total fertility rate 10 years ago was 7.1. In 1988, 90% of women knew of a modern method, and contraceptive usage of a modern method increased to 33%. The government aimed to increase contraceptive prevalence to 40% between 1991 and 1997. Botswana, compared to the same-sized Zambia, has been able to rapidly reduce its fertility with only 33% of Zambia's arable land and lesser urbanization. The difference in these two countries may be in Botswana's work force, 33% of which is made up of women, and in the high female school enrollment. Government officials acted without an official population policy before voluntary FP associations were involved to encourage parents to space their children and use modern methods. The integration of maternal and child health and FP was responsible for much of the fertility decline. Family life education was initiated in school curriculums in the early 1980s. Male contraceptive use and parent education in communication with youth have received the attention of nongovernmental groups. 86% of the population lives within 15 km of a health center, and 73% lives within 8 km. Improvements are still needed in training health service staff to be sensitive to client concerns and to shorten waiting times. In 1987, the government approved dispensing of contraceptives to adolescents, who still fear clinics and reprisal from parents discovering their sexual activity or their contraceptive use. PMID:12345836

Hermans, T

1994-01-01

162

Human-animal anthrax outbreak in the Luangwa valley of Zambia in 2011.  

PubMed

There has been a reduction of incidences of anthrax in the developed countries but it is still a public health problem in the developing countries where communities live in interface areas with wildlife. An outbreak of anthrax in Hippopotamus amphibious was observed in Zambia. Following the death of hippopotamuses, suspected human cases were reported. The objective of this study was to isolate and confirm Bacillus anthracis and to determine the antimicrobial susceptibility for the management of the disease. Of the specimens collected, 29.4% (95% confidence interval [CI], 11.4-56.0) were from humans, 42.1% (95% CI, 21.1-66.0) were from hippopotamuses and 20.0% (95% CI, 6.61-44.3) from the soil were found to be positive were for B. anthracis. An antimicrobial susceptibility test revealed that all the isolates were found to be sensitive to the recommended antibiotics. The disease control was achieved by case management and by explaining to the communities that they should avoid contact with animals that die from unknown causes. PMID:22472314

Hang'ombe, Mudenda B; Mwansa, James C L; Muwowo, Sergio; Mulenga, Phillip; Kapina, Muzala; Musenga, Eric; Squarre, David; Mataa, Liywali; Thomas, Suzuki Y; Ogawa, Hirohito; Sawa, Hirofumi; Higashi, Hideaki

2012-04-03

163

Implementation of the Zambia Electronic Perinatal Record System for comprehensive prenatal and delivery care  

PubMed Central

Objective To characterize prenatal and delivery care in an urban African setting. Methods The Zambia Electronic Perinatal Record System (ZEPRS) was implemented to record demographic characteristics, past medical and obstetric history, prenatal care, and delivery and newborn care for pregnant women across 25 facilities in the Lusaka public health sector. Results From June 1, 2007, to January 31, 2010, 115 552 pregnant women had prenatal and delivery information recorded in ZEPRS. Median gestation age at first prenatal visit was 23 weeks (interquartile range [IQR] 19–26). Syphilis screening was documented in 95 663 (83%) pregnancies: 2449 (2.6%) women tested positive, of whom 1589 (64.9%) were treated appropriately. 111 108 (96%) women agreed to HIV testing, of whom 22% were diagnosed with HIV. Overall, 112 813 (98%) of recorded pregnancies resulted in a live birth, and 2739 (2%) in a stillbirth. The median gestational age was 38 weeks (IQR 35–40) at delivery; the median birth weight of newborns was 3000 g (IQR 2700–3300 g). Conclusion The results demonstrate the feasibility of using a comprehensive electronic medical record in an urban African setting, and highlight its important role in ongoing efforts to improve clinical care.

Chi, Benjamin H.; Vwalika, Bellington; Killam, William P.; Wamalume, Chibesa; Giganti, Mark J.; Mbewe, Reuben; Stringer, Elizabeth M.; Chintu, Namwinga T.; Putta, Nande B.; Liu, Katherine C.; Chibwesha, Carla J.; Rouse, Dwight J.; Stringer, Jeffrey S.A.

2011-01-01

164

Spermicide acceptability among patients at a sexually transmitted disease clinic in Zambia.  

PubMed Central

OBJECTIVE. This study assessed the acceptability of three nonoxynol-9 spermicides among persons attending a sexually transmitted disease clinic in Lusaka, Zambia. METHODS. Spermicidal foam, suppositories, and foaming tablets were evaluated. Women (n = 114) and men (n = 150) attending an sexually transmitted disease clinic were enrolled. After each participant used two products, each for 2 weeks, consistency of use and acceptability were evaluated. RESULTS. At admission, most women (74%) and men (58%) were not using any family planning method. Moreover, most women (85%) and men (98%) had at least one sexually transmitted disease or genital infection. During the study, the proportion of coital episodes protected by spermicide use was high, yet loss to follow-up and discontinuation were also substantial. Discontinuation was frequently unrelated to acceptability. Women and men rated all three products positively along several acceptability parameters. Foam was the least desirable delivery system due to excess messiness. CONCLUSIONS. The results of this study suggest that it is feasible to distribute spermicides to women and men at increased risk for sexually transmitted disease and that the products will be used. Further research should be done among different populations and include other spermicidal delivery mechanisms.

Hira, S K; Spruyt, A B; Feldblum, P J; Sunkutu, M R; Glover, L H; Steiner, M J

1995-01-01

165

Spatial Heteogeneity of Methane Ebullition in a Large Tropical Reservoir (Lake Kariba, Zambia/Zimbabwe)  

NASA Astrophysics Data System (ADS)

While ebullition has the capacity to be a significant methane (CH4) release pathway from reservoirs, it has not been systematically studied in most surveyed systems, due in part to ebullition's high spatiotemporal variability. We hypothesized that CH4 ebullition from littoral areas that are influenced by riverine organic carbon inputs contributes disproportionately to overall CH4 emissions from Lake Kariba (Zambia-Zimbabwe border), one of the world's largest reservoirs. Hydroacoustic measurements and traditional surface chamber surveys revealed substantially higher fluxes in river deltas (~10^3 mg CH4 m-2 d-1) compared to littoral zones with no river input (< 100 mg CH4 m-2 d-1). Hydroacoustic measurements additionally showed that ebullition frequency varied strongly between all sites and that flux events varied over several orders of magnitude (up to 10^5 mg CH4 m-2 d-1) in the ebullition hot spots. An ebullition estimate for the largest subbasin of Lake Kariba was two orders of magnitude more than potential atmospheric CH4 emissions from turbine degassing and surface diffusion combined. Thus, we suggest that CH4 ebullition emissions from river deltas should be explored in greater detail and their contribution included in the CH4 budgets of reservoirs, including even large tropical reservoirs.

Del Sontro, T.; Kunz, M.; Wuest, A.; Wehrli, B.; Senn, D. B.

2011-12-01

166

Risk analysis of an anthrax outbreak in cattle and humans of Sesheke district of Western Zambia.  

PubMed

An anthrax outbreak occurred in November 2010 in five villages of Sesheke district in Western Zambia. Control measures and data collection was carried out immediately the outbreak was reported. The prevalence of the disease in cattle was estimated at 7.4% (45/609) while the average herd size of infected cattle in affected villages was estimated at 121.8 (95% CI 48.8-194.8). Individual mortality per herd varied between 1.70% (3/179) and 20.25% (6/79). The relative risk of infection of cattle in the five affected villages varied between 0.18 (95% CI 0.4-5.7) and 3.7 (95% CI 1.99-6.68). In humans, the disease only affected three people and was characterized by cutaneous carbuncles. The ratio of infected persons per number of infected carcasses varied between 1:37 and 1:49 in affected villages while the overall ratio of people at risk to the number of carcasses was 42:1 indicating that despite availability of a large number of carcasses, human contact with infected carcasses was low. The findings of this study underline the importance of timely disease control measures in reducing the risk of human infections to anthrax in the face of an outbreak. PMID:22885011

Munang'andu, Hetron Mweemba; Banda, Fredrick; Chikampa, Webster; Mutoloki, Stephen; Syakalima, Michelo; Munyeme, Musso

2012-08-02

167

Hydrological and ecological impacts of dams on the Kafue Flats floodplain system, southern Zambia  

NASA Astrophysics Data System (ADS)

Developmental changes in river basins in Africa have become a reality. Many wetland ecosystems have been impacted by dams and other hydrological interventions resulting in both foreseen and unexpected consequences. The Kafue Flats in southern Zambia is an extensive floodplain system that lies within the middle Kafue river basin. The floodplain is about 255 km long and 60 km wide, covering an area of approximately 6,500 km2. It is currently sandwiched between two large dams which are approximately 270 km apart. These dams have completely altered the hydrological regime of the system. Backwater from the downstream dam and releases from upstream have created a permanently flooded area within the floodplain that was not present in the past. Elsewhere, flooding has been reduced. The ecological consequences of these changes for the floodplain, which hosts two national parks (both Ramsar sites), have been extensive. Hydrological and vegetation changes have impacted the habitat for important wildlife communities including the endemic antelope, Kobus leche kafuensis. The most dramatic change in vegetation is associated with the colonisation of parts of the floodplain by the invasive alien plant, Mimosa pigra. This paper discusses these changes and their potential consequences.

Mumba, M.; Thompson, J. R.

168

Tuberculosis in Kafue lechwe antelopes (Kobus leche Kafuensis) of the Kafue Basin in Zambia.  

PubMed

Tuberculosis (TB) has been reported in the Kafue lechwe antelopes (Kobus leche Kafuensis) of Zambia. However, previous reports are restricted to the southern parts in Lochinvar, where only old male animals were investigated. This study was conducted to gather epidemiological information on TB in Lechwe antelopes across sexes and age groups in relation to other explanatory variables of disease occurrence in the Kafue Basin. Animals were hunted under a special licence to investigate diseases in the Kafue Basin during the 2004, 2005 and 2008 hunting seasons. Histopathology, acid-fast staining and mycobacterial culturing from tissue samples were conducted. A total of 119 animals were slaughtered with an estimated age range of 2.5-20 years. Of these, 29 (24.3% [95% CI: 16.5, 32.3%]) had necropsy lesions suggestive of tuberculosis, of which 21 (17.6% [95% CI: 10.7, 24.6%]) tested positive on acid-fast staining while 33 (27.7% [95% CI: 19.6, 35.9%]) showed culture and colony morphological characteristics suggestive of Mycobacterium species. On univariate analysis, animals with poor body condition were twice as likely to have tuberculosis associated lesions as those having good body conditions (OR=2.3, 95% CI: 0.6, 9.3%). Based on lesion distribution, a respiratory route of mycobacterial infection is intimated. PMID:20417978

Munyeme, M; Muma, J B; Siamudaala, V M; Skjerve, E; Munang'andu, H M; Tryland, M

2010-04-24

169

Environmental and toenail metals concentrations in copper mining and non mining communities in Zambia.  

PubMed

Copper mining contributes to increased concentrations of metals in the environment, thereby increasing the risk of metals exposure to populations living in and around mining areas. This study investigated environmental and toenail metals concentrations of non-occupational human exposure to metals in 39 copper-mining town residents and 47 non-mining town residents in Zambia. Elevated environmental concentrations were found in samples collected from the mining town residents. Toenail concentrations of cobalt (GM 1.39mg/kg), copper (GM 132mg/kg), lead (21.41mg/kg) selenium (GM 0.38mg/kg) and zinc (GM 113mg/kg) were significantly higher in the mining area and these metals have previously been associated with copper mining. Residence in the mining area, drinking water, dust and soil metals concentrations were the most important contributors to toenail metals concentrations. Further work is required to establish the specific pathways of exposure and the health risks of elevated metals concentrations in the copper mining area. PMID:23623595

Ndilila, Wesu; Callan, Anna Carita; McGregor, Laura A; Kalin, Robert M; Hinwood, Andrea L

2013-03-30

170

Malaria control by residual insecticide spraying in Chingola and Chililabombwe, Copperbelt Province, Zambia.  

PubMed

Malaria is endemic in the whole of Zambia and is the leading cause of morbidity and mortality. Prior to 1980, effective malaria control was achieved in the northern mining towns of Chingola and Chililabombwe by means of annual residual spraying programmes. In the 1970s, incidence rates were as low as 20/1000 p.a., but by 2000 had increased to 68/1000 p.a. in Chingola and to 158/1000 p.a.in Chililabombwe. Konkola Copper Mines (KCM) initiated a malaria control programme in which all dwellings in the two towns and within a 10-km radius were sprayed with either dichlorodiphenyltrichloroethane or a synthetic pyrethroid (Icon by ZENECA or Deltamethrin by Aventis). Houses were sprayed in November and December 2000, at the start of the peak transmission period. There was a statistically significant reduction in malaria incidence recorded at KCM health facilities in the two towns, representing a protective incidence rate ratio of 0.65 (95% CI 0.44, 0.97) when comparing the post-spraying period with the corresponding period of the previous 2 years. This reduction followed a single round of house spraying during a year with higher rainfall than the preceding two and in an area where chloroquine was first-line treatment. This house-spraying programme is an example of private/public sector collaboration in malaria control. PMID:12225502

Sharp, Brian; van Wyk, Pieter; Sikasote, Janet B; Banda, Paul; Kleinschmidt, Immo

2002-09-01

171

Decline in Sexual Risk Behaviours among Young People in Zambia (2000-2009): Do Neighbourhood Contextual Effects Play a Role?  

PubMed Central

Objective This study examined trends in premarital sex, multiple partnership and condom use among young people (15–24 years) in Zambia from 2000 to 2009, and assessed the effects of individual and neighbourhood variables on these sexual behaviour indicators in 2000 and 2009. Methodology We analysed data from the Zambia Sexual Behaviour Survey, conducted in 2000, 2003, 2005 and 2009. Multi-stage cluster sampling was used to select 385 neighbourhoods, giving a population sample of 6,500 young people. Using linear-by-linear trend test, trends in the three indicators were examined. Multilevel logistic regression was used to assess the effects of individual and neighbourhood variables on the indicators. Results Premarital sex among young people decreased significantly from 51 to 42% between 2000 and 2009. Multiple partnerships of men also decreased from 26 to 14% during the same period. The use of condoms by young people remained stable during this period. Full multilevel regression models explained 29 and 34% of the neighbourhood variance of premarital sex in 2000 and 2009. For multiple partnerships and condom use, the explained variance was 29 and 18% in 2000; whereas in 2009 it was extremely low. Urban residence and living in neighbourhood with higher average duration of residence were associated with low premarital sex and higher condom use. Living in a neighbourhood with higher average level of comprehensive knowledge of HIV was associated with less risky sexual behaviour. Conclusion Declining trends in premarital sex and multiple partnerships are among the factors that might explain the decrease in HIV incidence in Zambia among young people. However, condom use among young people has remained low and stable over the years. The results also suggest that behaviour change interventions should take stock of the social context when introducing individual-level programmes because neighbourhood factors play a considerable role in influencing sexual behaviour.

Kayeyi, Nkomba; Fylkesnes, Knut; Wiium, Nora; Sand?y, Ingvild F.

2013-01-01

172

The political economy of maize production and poverty reduction in Zambia: analysis of the last 50 years.  

PubMed

Poverty and food security are endemic issues in much of sub-Saharan Africa. To eradicate extreme poverty and hunger in the region remains a key Millennium Development Goal. Many African governments have pursued economic reforms and agricultural policy interventions in order to accelerate economic growth that reduces poverty faster. Agricultural policy regimes in Zambia in the last 50 years (1964–2008) are examined here to better understand their likely impact on food security and poverty, with an emphasis on the political economy of maize subsidy policies. The empirical work draws on secondary sources and an evaluation of farm household data from three villages in the Kasama District of Zambia from 1986/87 and 1992/93 to estimate a two-period econometric model to examine the impact on household welfare in a pre- and post-reform period. The analysis shows that past interventions had mixed effects on enhancing the production of food crops such as maize. While such reforms were politically popular, it did not necessarily translate into household-level productivity or welfare gains in the short term. The political economy of reforms needs to respond to the inherent diversity among the poor rural and urban households. The potential of agriculture to generate a more pro-poor growth process depends on the creation of new market opportunities that most benefit the rural poor. The state should encourage private sector investments for addressing infrastructure constraints to improve market access and accelerate more pro-poor growth through renewed investments in agriculture, rural infrastructure, gender inclusion, smarter subsidies and regional food trade. However, the financing of such investments poses significant challenges. There is a need to address impediments to the effective participation of public private investors to generate more effective poverty reduction and hunger eradication programmes. This article also explores the opportunities for new public–private investments through South–South cooperation and Asia-driven growth for reducing poverty in Zambia. PMID:22213879

Hanjra, Munir A; Culas, Richard J

2011-01-01

173

Mapping Postgraduate Research at the University of Zambia: a review of dissertations for the Master of Medicine Programme  

PubMed Central

Background The publication of a dissertation is an integral part of the four-year postgraduate degree of Master of Medicine (in clinical disciplines) within the School of Medicine at the University of Zambia. The governing research policy states that the subject matter of the dissertation is expected to cover a topic relevant to health care in the Zambian context, that it be conducted in a way that is consistent with international ethical guidelines for biomedical research involving human subjects, and that research outcomes should be maximally utilized. The aim of the study is to explore the characteristics of the Masters of Medicine research at the University of Zambia. Methodology This descriptive study explores the subject matter and research methodology by type of clinical specialty of all dissertations from 1986 to 2009. Results The 132 dissertations included 36 (27.3%) in Surgery, 35 (26.5%) in Paediatrics, 32 (24.2%) in Internal Medicine, 24 (18.2%) in Obstetrics and Gynaecology, and 5 (3.8%) in Orthopaedic Surgery. Only 7 (5.3%) were interventional/experimental studies (4 of which were randomized controlled trials). Cross-sectional studies were the predominant type of the 125 observational studies (n=112, 84.8%). Thirty-three dissertations (25.0%) predominantly addressed HIV (16 Internal Medicine, 10 Paediatrics, 6 Surgery and 1 Obstetrics and Gynaecology); and 18 (13.6%) predominantly addressed infections, excluding TB (11 in Paediatrics). Other subjects included malignancy (n=6), TB (n=5), and diabetes mellitus (n=4). Over half of the dissertations (76, 57.6%) addressed the determinants of the cause, risk and development of diseases; and a third dealt with management and evaluation of diseases (26 and 18, respectively). Conclusions Few dissertations were based on experimental designs and most addressed determinants of the cause of diseases through cross-sectional studies. HIV and infections predominate as diseases reflecting the prevailing disease patterns in Lusaka in particular, and Zambia in general.

Ahmed, Y; Kanyengo, CW; Akakandelwa, Akakandelwa

2012-01-01

174

Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: A case study in Zambia  

PubMed Central

Background Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4) should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. Methods A 'fishbone' (Ishikawa) diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. Results The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. Conclusions The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical practice. A better understanding of the supply system and of the pattern of demand for MgSO4 in Zambia should enable policy makers and stakeholders to develop and implement appropriate interventions to improve the availability and use of MgSO4.

2010-01-01

175

Nutrition and inflammation serum biomarkers are associated with 12-week mortality among malnourished adults initiating antiretroviral therapy in Zambia  

Microsoft Academic Search

Background  A low body mass index (BMI) at antiretroviral therapy (ART) initiation is a strong predictor of mortality among HIV-infected\\u000a adults in resource-constrained settings. The relationship between nutrition and inflammation-related serum biomarkers and\\u000a early treatment outcomes (e.g., less than 90 days) in this population is not well described.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  An observational cohort of 142 HIV-infected adults in Lusaka, Zambia, with BMI under

John R Koethe; Meridith Blevins; Christopher Nyirenda; Edmond K Kabagambe; Bryan E Shepherd; C William Wester; Isaac Zulu; Janelle M Chiasera; Lloyd B Mulenga; Albert Mwango; Douglas C Heimburger

2011-01-01

176

Tuberculin sensitivity and HIV1 status of patients attending a sexually transmitted diseases clinic in Lusaka, Zambia: a cross-sectional study  

Microsoft Academic Search

A cross-sectional study to estimate the prevalence of latent tuberculosis (TB) in a group of Zambians at high risk of human immunodeficiency virus type 1 (HIV-1) infection and to examine the effect of HIV-1 infection on the tuberculin response was conducted in the University Teaching Hospital in Lusaka, Zambia during July to September 1990. Patients were selected from those presenting

Laurie E. Duncan; Alison M. Elliott; Richard J. Hayes; Subhash K. Hira; George Tembo; Grace T. Mumba; Shahul H. Ebrahim; Maria Quigley; Joseph O. M. Pobee; Keith P. W. J. McAdam

1995-01-01

177

'No sister, the breast alone is not enough for my baby' a qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern Zambia  

Microsoft Academic Search

BACKGROUND: Appropriate feeding practices are of fundamental importance for the survival, growth, development and health of infants and young children. The aim of the present study was to collect baseline information on current infant and young child feeding practices, attitudes and knowledge in Mazabuka, Zambia, using a qualitative approach. METHODS: The study was conducted in Mazabuka, 130 km south of

Eli Fjeld; Seter Siziya; Mary Katepa-Bwalya; Chipepo Kankasa; Karen Marie Moland; Thorkild Tylleskär

2008-01-01

178

Fortifying food in the field to boost nutrition: case studies from Afghanistan, Angola, and Zambia.  

PubMed

Deficiencies in micronutrients such as iron, vitamin A, and iodine affect billions of people worldwide, causing death, disease, and disability. The UN World Food Programme (WFP) has long been recognised for its ability to deliver food to some of the most remote locations, under the toughest conditions: refugees in border camps, populations cut off by conflict, extremely poor and marginalised people like ethnic minorities, orphans, and widows. Relatively little, however, is known about its efforts to ensure that the food it delivers not only provides enough calories for immediate survival but also provides the vitamins and minerals needed for healthy growth and development. Much of the food delivered by WFP is fortified with iron, vitamin A, and other micronutrients before being shipped. But there are several reasons to mill and fortify food as close to the beneficiaries as possible. For instance, milling and fortifying food locally helps to overcome the problems of the short shelf-life of whole fortified maizemeal. It also enhances the nutritional value of locally procured cereals. And it can foster demand for fortified foods among local consumers beyond WFP beneficiaries, thus nurturing an industry with potentially significant benefits for the health of entire communities. This paper outlines three approaches by WFP to fortifying cereals in Afghanistan, Angola, and Zambia. It examines the challenges faced and the outcomes achieved in an effort to share this knowledge with others dedicated to improving the nutritional status of poor and food-insecure people. In Afghanistan, attempts to mill and fortify wheat flour using small-scale chakki mills were successful but much larger-scale efforts would be needed to promote demand and reach the level of consumption required to address serious iron deficiencies across the country. In Angola, maize has been fortified to combat the persistent occurrence of pellagra, a micronutrient deficiency disease found among people whose diets are dominated by maize. By providing fortification equipment to a commercial mill at the port of Lobito and using a vitamin and mineral pre-mix provided by UNICEF, this project has overcome many of the difficulties common in countries emerging from conflict to provide monthly fortified maize rations to some 115,000 beneficiaries. In Zambia, iron deficiency anaemia was a serious problem among camp-restricted refugees. WFP and its partners imported, installed, and trained workers in the use of two containerized milling and fortification units (MFUs), halved iron-deficiency anaemia, and reduced vitamin A deficiency among camp residents. In addition, WFP dramatically reduced waiting times for refugees who used to have their whole grain maize rations milled at small local facilities with insufficient milling capacity. The context and scale of each of the three case-studies described in this paper was different, but the lessons learned are comparable. All projects were succesful in their own right, but also required a considerable amount of staff time and supervision as well as external technical expertise, limiting the potential for scaling up within the WFP operational context. In order to expand and sustain the provision of fortified cereal flour to WFP beneficiaries and beyond, getting the private milling sector as well as governments on board would be crucial. Where this is not possible, such as in very isolated, difficult to reach locations, strong, specialized partners are a prerequisite, but these are few in number. Alternatively, in such contexts or in situations where the need is urgent and cannot be met through local flour fortification in the short term, or through local purchases of fresh foods, other approaches to improve the diet, such as the use of multimicronutrient formulations, packed for individual or household use, may be more appropriate. PMID:17974369

van den Briel, Tina; Cheung, Edith; Zewari, Jamshid; Khan, Rose

2007-09-01

179

Sedimentary genesis and lithostratigraphy of Neoproterozoic megabreccia from Mufulira, Copperbelt of Zambia  

NASA Astrophysics Data System (ADS)

The Lufilian arc is an orogenic belt in central Africa that extends between Zambia and the Democratic Republic of Congo (DRC) and deforms the Neoproterozoic-Lower Palaeozoic metasedimentary succession of the Katanga Supergroup. The arc contains thick bodies of fragmental rocks that include blocks reaching several kilometres in size. Some megablocks contain Cu and Cu Co-mineralised Katangan strata. These coarse clastic rocks, called the Katangan megabreccias, have traditionally been interpreted in the DRC as tectonic breccias formed during Lufilian orogenesis due to friction underneath Katangan nappes. In mid-90th, several occurrences in Zambia have been interpreted in the same manner. Prominent among them is an occurrence at Mufulira, considered by previous workers as a ?1000 m thick tectonic friction breccia containing a Cu Co-mineralised megablock. This paper presents new results pertaining to the lower stratigraphic interval of the Katanga Supergroup at Mufulira and represented by the Roan Group and the succeeding Mwashya Subgroup of the Guba Group. The interval interpreted in the past as tectonic Roan megabreccia appears to be an almost intact sedimentary succession, the lower part of which consists of Roan Group carbonate rocks with siliciclastic intercalations containing several interbeds of matrix-supported conglomerate. A Cu Co-mineralised interval is not an allochthonous block but a part of the stratigraphic succession underlain and overlain by conglomerate beds, which were considered in the past as tectonic friction breccias. The overlying megabreccia is a syn-rift sedimentary olistostrome succession that rests upon the Roan strata with a subtle local unconformity. The olistostrome succession consists of three complexes typified by matrix-supported debris-flow conglomerates with Roan clasts. Some of the conglomerate beds pass upwards to normally graded turbidite layers and are accompanied by solitary slump beds. The three conglomeratic assemblages are separated by two intervals of sedimentary breccia composed of allochthonous Roan blocks interpreted as mass-wasting debris redeposited into the basin by high-volume sediment-gravity flows. Sedimentary features are the primary characteristics of the conglomerate interbeds in the Roan succession and of the overlying megabreccia (olistostrome) sequence. Both lithological associations are slightly sheared and brecciated in places, but stratigraphic continuity is retained throughout their succession. The olistostrome is deformed by an open fold, the upper limb of which is truncated by and involved in a shear zone that extends upwards into Mwashya Subgroup strata thrust above. Based on the sedimentary genesis of the megabreccia, local tectonostratigraphic relations and correlation with the succession present in the Kafue anticline to the west, the Mwashya Subgroup, formerly considered as a twofold unit, is redefined here as a three-part succession. The lower Mwashya consists of an olistostrome complex defined as the Mufulira Formation, the middle Mwashya (formerly lower Mwashya) is a mixed succession of siliciclastic and carbonate strata locally containing silicified ooids and tuff interbeds, and the term upper Mwashya is retained for a succession of black shales with varying proportions of siltstone and sandstone interlayers. The sedimentary genesis and stratigraphic relations of the megabreccia at Mufulira imply that the position and tectonostratigraphic context of the Katangan Cu and Cu Co orebodies hosted in megablocks associated with fragmental rocks, which were in the past interpreted as tectonic friction breccias, need to be critically re-assessed in the whole Lufilian arc.

Wendorff, Marek

2005-07-01

180

Development of a curriculum for training in One Health analytical epidemiology at the University of Zambia.  

PubMed

Recently, the world has witnessed emergence of novel diseases such as avian influenza, HIV and AIDS, West Nile Virus and Ebola. The evolution of these pathogens has been facilitated mainly by a constantly evolving animal-human interface. Whilst infectious disease control was previously conceptualised as either public health or animal health related issues, the distinction between disciplinary foci have been blurred by multiple causal factors that clearly traverse traditional disciplinary divides. These multiple evolutionary pressures have included changes in land use, ecosystems, human-livestock-wildlife interactions and antibiotic use, representing novel routes for pathogen emergence. With the growing realisation that pathogens do not respect traditional epistemological divides, the 'One Health' initiative has emerged to advocate for closer collaboration across the health disciplines and has provided a new agenda for health education. Against this background, the One Health Analytical Epidemiology course was developed under the auspices of the Southern African Centre for Infectious Diseases Surveillance by staff from the University of Zambia with collaborators from the London School of Hygiene and Tropical Medicine and the Royal Veterinary College in London. The course is aimed at equipping scientists with multidisciplinary skill sets to match the contemporary challenges of human, animal and zoonotic disease prevention and control. Epidemiology is an important discipline for both public and animal health. Therefore, this two-year programme has been developed to generate a cadre of epidemiologists with a broad understanding of disease control and prevention and will be able to conceptualise and design holistic programs for informing health and disease control policy decisions. PMID:23327398

Muma, J; Simuunza, Martin; Mwachalimba, K; Munyeme, M; Namangala, B; Hankanga, C; Sijumbila, G; Likwa Ndonyo, R; Sinkala, Yona; Mwanza, A; Simanyengwe Mweene, A

2012-06-20

181

The incidence of human cysticercosis in a rural community of Eastern Zambia.  

PubMed

A community-based longitudinal study was performed in the Eastern Province of Zambia, in which repeated serological samplings were done to determine the incidence of human cysticercosis. Three sampling rounds were carried out at six months intervals. A total of 867 participants presented for all three samplings. All samples were tested for the presence of cysticercus antigens using a monoclonal antibody-based enzyme-linked immunosorbent assay (sero-Ag-ELISA), while a randomly selected sub-sample of 161 samples from each sampling round was tested for specific antibodies using a commercial enzyme-linked immunoelectrotransfer blot (EITB) assay. Stool samples (n?=?226) were also collected during the final round of sampling for taeniosis diagnosis by coprology and coproantigen ELISA. Cysticercosis seroprevalence varied from 12.2% to 14.5% (sero-Ag) and from 33.5% to 38.5% (sero-Ab) during the study period. A taeniosis prevalence of 11.9% was determined. Incidence rates of 6300 (sero-Ag, per 100000 persons-year) and 23600 (sero-Ab, per 100000 persons-year) were determined. Seroreversion rates of 44% for sero-Ag and 38.7% for sero-Ab were recorded over the whole period. In conclusion, this study has shown the dynamic nature of T. solium infections; many of the people at risk become (re)infected due to the high environmental contamination, with a high number turning seronegative within a year after infection. An important number of infections probably never fully establish, leading to transient antibody responses and short-term antigen presence. PMID:23556026

Mwape, Kabemba E; Phiri, Isaac K; Praet, Nicolas; Speybroeck, Niko; Muma, John B; Dorny, Pierre; Gabriël, Sarah

2013-03-21

182

Creating a Knowledge Translation Platform: nine lessons from the Zambia Forum for Health Research  

PubMed Central

The concept of the Knowledge Translation Platform (KTP) provides cohesion and leadership for national–level knowledge translation efforts. In this review, we discuss nine key lessons documenting the experience of the Zambia Forum for Health Research, primarily to inform and exchange experience with the growing community of African KTPs. Lessons from ZAMFOHR’s organizational development include the necessity of selecting a multi-stakeholder and -sectoral Board of Directors; performing comprehensive situation analyses to understand not only the prevailing research-and-policy dynamics but a precise operational niche; and selecting a leader that bridges the worlds of research and policy. Programmatic lessons include focusing on building the capacity of both policy-makers and researchers; building a database of local evidence and national-level actors involved in research and policy; and catalyzing work in particular issue areas by identifying leaders from the research community, creating policy-maker demand for research evidence, and fostering the next generation by mentoring both up-and-coming researchers and policy–makers. Ultimately, ZAMFOHR’s experience shows that an African KTP must pay significant attention to its organizational details. A KTP must also invest in the skill base of the wider community and, more importantly, of its own staff. Given the very real deficit of research-support skills in most low-income countries – in synthesis, in communications, in brokering, in training – a KTP must spend significant time and resources in building these types of in-house expertise. And lastly, the role of networking cannot be underestimated. As a fully-networked KTP, ZAMFOHR has benefited from the innovations of other KTPs, from funding opportunities and partnerships, and from invaluable technical support from both African and northern colleagues.

2012-01-01

183

Compensation patterns following occupational injuries in Zambia: results from the 2009 Labour Survey  

PubMed Central

Background Occupational injuries have received limited research attention in the Southern African Development Community. Much of the published data come from South Africa and little has been reported elsewhere within the region. The present study was conducted to estimate the prevalence rates of occupational injuries and compensation; and to determine factors associated with occupational injuries and compensation. Methods Data were obtained from occupational health and injury questions added to the Zambian Labour Force Survey of 2009 by the Work and Health in Southern Africa programme. Logistic regression analyses were conducted to determine the degree of association between demographic, social and economic factors on one hand and injury and compensation on the other. Results Data on 61871 study participants were available for analysis, of whom 4998 (8.1%) reported having been injured (10.0% of males, and 6.2% of females) due to work in the previous 12 months to the survey. Of those injured, 60.5% reported having stayed away from work as a result. The commonest type of injury was "open wound" (81.6%). Male gender, being married or married before, being a paid employee, working for a private company and household were positively associated with serious injuries. Injuries also varied by geographical area. Factors positively associated with receiving compensation for work-related injuries were: male gender, Copperbelt and North-Western provinces, and unpaid family worker. Employer/self employed and having less than 5 employees in a workplace were negatively associated with compensation. Conclusion The prevalence of reported injury and its association with a significant level of absence from work, indicate that occupational hazards in Zambia have significant health and economic effects. Female workers should equally be compensated for injuries suffered as their male counterparts.

2010-01-01

184

The Influence of Distance and Level of Service Provision on Antenatal Care Use in Rural Zambia  

PubMed Central

Background Antenatal care (ANC) presents important opportunities to reach women with crucial interventions. Studies on determinants of ANC use often focus on household and individual factors; few investigate the role of health service factors, partly due to lack of appropriate data. We assessed how distance to facilities and level of service provision at ANC facilities in Zambia influenced the number and timing of ANC visits and the quality of care received. Methods and Findings Using the 2005 Zambian national Health Facility Census, we classified ANC facilities according to the level of service provision. In a geographic information system, we linked the facility information to household data from the 2007 DHS to calculate straight-line distances. We performed multivariable multilevel logistic regression on 2405 rural births to investigate the influence of distance to care and of level of provision on three aspects of ANC use: attendance of at least four visits, visit in first trimester and receipt of quality ANC (4+ visits with skilled health worker and 8+ interventions). We found no effect of distance on timing of ANC or number of visits, and better level of provision at the closest facility was not associated with either earlier ANC attendance or higher number of visits. However, there was a strong influence of both distance to a facility, and level of provision at the closest ANC facility on the quality of ANC received; for each 10 km increase in distance, the odds of women receiving good quality ANC decreased by a quarter, while each increase in the level of provision category of the closest facility was associated with a 54% increase in the odds of receiving good quality ANC. Conclusions To improve ANC quality received by mothers, efforts should focus on improving the level of services provided at ANC facilities and their accessibility.

Kyei, Nicholas N. A.; Campbell, Oona M. R.; Gabrysch, Sabine

2012-01-01

185

The dating and interpretation of a Mode 1 site in the Luangwa Valley, Zambia.  

PubMed

Flake based assemblages (Mode 1) comprise the earliest stone technologies known, with well-dated Oldowan sites occurring in eastern Africa between ~2.6-1.7 Ma, and in less securely dated contexts in central, southern and northern Africa. Our understanding of the spread and local development of this technology outside East Africa remains hampered by the lack of reliable numerical dating techniques applicable to non-volcanic deposits. This study applied the still relatively new technique of cosmogenic nuclide burial dating ((10)Be/(26)Al) to calculate burial ages for fluvial gravels containing Mode 1 artefacts in the Luangwa Valley, Zambia. The Manzi River, a tributary of the Luangwa River, has exposed a 4.7 m deep section of fluvial sands with discontinuous but stratified gravel layers bearing Mode 1, possibly Oldowan, artefacts in the basal layers. An unconformity divides the Manzi section, separating Mode 1 deposits from overlying gravels containing Mode 3 (Middle Stone Age) artefacts. No diagnostic Mode 2 (Acheulean) artefacts were found. Cosmogenic nuclide burial dating was attempted for the basal gravels as well as exposure ages for the upper Mode 3 gravels, but was unsuccessful. The complex depositional history of the site prevented the calculation of reliable age models. A relative chronology for the full Manzi sequence was constructed, however, from the magnetostratigraphy of the deposit (N>R>N sequence). Isothermal thermoluminescence (ITL) dating of the upper Mode 3 layers also provided consistent results (~78 ka). A coarse but chronologically coherent sequence now exists for the Manzi section with the unconformity separating probable mid- or early Pleistocene deposits below from late Pleistocene deposits above. The results suggest Mode 1 technology in the Luangwa Valley may post-date the Oldowan in eastern and southern Africa. The dating programme has contributed to a clearer understanding of the geomorphological processes that have shaped the valley and structured its archaeological record. PMID:21411121

Barham, Lawrence; Phillips, William M; Maher, Barbara A; Karloukovski, Vassil; Duller, Geoff A T; Jain, Mayank; Wintle, Ann G

2011-05-01

186

The Integrated Rural Nutrition Project, Kawambwa, Zambia: successes of a nutrition education programme.  

PubMed

This article presents some findings from an evaluation of the Integrated Rural Nutrition Project (IRNP) in Kawambwa, Zambia. The IRNP was initiated in 1985. The program relied on a multisectoral approach by the Ministries of Health, Education, Agriculture, and Community Development. The program aimed to reduce the rate of malnutrition. Breast feeding was encouraged, and farmers were encouraged to increase production of beans and groundnuts. Extension workers were trained. Findings indicate that nutrition education programs had a significant, positive effect on the nutritional status of children aged under 5 years. The nutrition education component, which aimed at improving knowledge, attitudes, and practices, was more successful than the activities that aimed at increasing food availability. A continuing question was raised by program staff about whether training of extension workers, social marketing, mass education, or direct extension were capable of having an impact on nutrition without addressing food productivity issues. The availability of legumes improved throughout the intervention period. The length of the hunger season was shortened. However, increased food availability did not improve anthropometric measurements, and some children, who were not part of the seed multiplication program, showed improved anthropometric measurements. Children in the intervention area were exposed to better breast-feeding practices: breast feeding for longer periods and fewer introductions to non-milk liquids. After the first month, under 20% of children in the project area and 80-95% in the non-project areas had received breast milk substitutes. Young children in the project area had better weight-for-height, after controlling for wealth, access to services, maternal and paternal education, gender, and age. 3-year-old children in the project area weighed 0.3 of a z-score more than non-project children. PMID:12293178

Friedrich, J

1997-12-01

187

Risk factors associated with the acquisition of sleeping sickness in north-east Zambia; a case-control study.  

PubMed

A case-control study identified 59 cases of Rhodesian sleeping sickness in the northern Luangwa valley of Zambia together with age- and sex-matched nearest neighbour and hospital controls. Birth outside the trypanosomiasis endemic area was not shown to increase the risk of acquiring sleeping sickness. Significantly more cases under the age of 20 years had lived outside the endemic area compared with neighbour controls, although this was not true for those over 20 years old. Ethnic group and main occupation did not differ between cases and neighbour controls. Fishing as an auxiliary occupation increased the risk infection. Members of the United Church of Zambia had a relative risk of acquiring trypanosomiasis twice as great as other religious groups, perhaps because their scattered churches involve more walking through tsetse-infected bush. Sleeping sickness cases said that there were zebras near their village significantly more often than controls, although zebras are not usually considered a likely source of infection. In a preliminary study there was no difference in blood groups or haemoglobin genotype between cases and controls. PMID:3865637

Wyatt, G B; Boatin, B A; Wurapa, F K

1985-08-01

188

"ARVs" as sickness and medicine: examining children's knowledge and experience in the HIV era in urban Zambia.  

PubMed

Since the roll out of no cost antiretroviral drugs (ARVs) in health centers in Zambia in 2004, the number of Zambians receiving treatment has substantially increased. While research has addressed adult responses to ARVs in Zambia and elsewhere, there is little known about how children experience and respond to the presence of treatment in their communities and households. The increasing acknowledgment that children provide care and treatment support to people with HIV in their households demands a better understanding of children's knowledge of HIV and ARVs. To examine children's ARV knowledge, this article focuses on three children's workshops carried out with 38 children ages 8-12, who participated in a yearlong ethnographic study in 2007 and 2008. All children lived in a low-income and heavily HIV-affected residential area in Lusaka, and many children lived with parents or guardians who had HIV. Findings suggest that, when the children discussed ARVs, they made two intersecting points: (1) local conditions make living with HIV, even while on antiretroviral therapy (ART), difficult; and (2) children face particular challenges, concerns, and insecurities when caring for and living with the ill. Children's discussions about ARVs offer a deeper understanding of experiences of HIV and childhood in a disproportionately HIV-affected and low-resource area. Such insights might productively inform future programming and research aimed at assisting children and adults. PMID:23256500

Hunleth, Jean

2012-12-20

189

Opt-out provider-initiated HIV testing and counselling in primary care outpatient clinics in Zambia  

PubMed Central

Abstract Objective To increase case-finding of infection with human immunodeficiency virus (HIV) in Zambia and their referral to HIV care and treatment by supplementing existing client-initiated voluntary counselling and testing (VCT), the dominant mode of HIV testing in the country. Methods Lay counsellors offered provider-initiated HIV testing and counselling (PITC) to all outpatients who attended primary clinics and did not know their HIV serostatus. Data on counselling and testing were collected in registers. Outcomes of interest included HIV testing coverage, the acceptability of testing, the proportion testing HIV-positive (HIV+), the proportion enrolling in HIV care and treatment and the time between testing and enrolment. Findings After the addition of PITC to VCT, the number tested for HIV infection in the nine clinics was twice the number undergoing VCT alone. Over 30 months, 44?420 patients were counselled under PITC and 31?197 patients, 44% of them men, accepted testing. Of those tested, 21% (6572) were HIV+; 38% of these HIV+ patients (2515) enrolled in HIV care and treatment. The median time between testing and enrolment was 6 days. The acceptability of testing rose over time. Conclusion The introduction of routine PITC using lay counsellors into health-care clinics in Lusaka, Zambia, dramatically increased the uptake and acceptability of HIV testing. Moreover, PITC was incorporated rapidly into primary care outpatient departments. Maximizing the number of patients who proceed to HIV care and treatment remains a challenge and warrants further research.

Chipukuma, Julien M; Chiko, Matimba M; Wamulume, Chibesa S; Bolton-Moore, Carolyn; Reid, Stewart E

2011-01-01

190

The SAZA study: implementing health financing reform in South Africa and Zambia.  

PubMed

This paper explores the policy-making process in the 1990s in two countries, South Africa and Zambia, in relation to health care financing reforms. While much of the analysis of health reform programmes has looked at design issues, assuming that a technically sound design is the primary requirement of effective policy change, this paper explores the political and bureaucratic realities shaping the pattern of policy change and its impacts. Through a case study approach, it provides a picture of the policy environment and processes in the two countries, specifically considering the extent to which technical analysts and technical knowledge were able to shape policy change. The two countries' experiences indicate the strong influence of political factors and actors over which health care financing policies were implemented, and which not, as well as over the details of policy design. Moments of political transition in both countries provided political leaders, specifically Ministers of Health, with windows of opportunity in which to introduce new policies. However, these transitions, and the changes in administrative structures introduced with them, also created environments that constrained the processes of reform design and implementation and limited the equity and sustainability gains achieved by the policies. Technical analysts, working either inside or outside government, had varying and often limited influence. In part, this reflected the limits of their own capacity as well as weaknesses in the way they were used in policy development. In addition, the analysts were constrained by the fact that their preferred policies often received only weak political support. Focusing almost exclusively on designing policy reforms, these analysts gave little attention to generating adequate support for the policy options they proposed. Finally, the country experiences showed that front-line health workers, middle level managers and the public had important influences over policy implementation and its impacts. The limited attention given to communicating policy changes to, or consulting with, these actors only heightened the potential for reforms to result in unanticipated and unwanted impacts. The strength of the paper lies in its 'thick description' of the policy process in each country, an empirical case study approach to policy that is under-represented in the literature. While such an approach allows only a cautious drawing of general conclusions, it suggests a number of ways in which to strengthen the implementation of financing policies in each country. PMID:12582106

Gilson, Lucy; Doherty, Jane; Lake, Sally; McIntyre, Di; Mwikisa, Chris; Thomas, Stephen

2003-03-01

191

The geology and geochemistry of the Lumwana Cu (± Co ± U) deposits, NW Zambia  

NASA Astrophysics Data System (ADS)

The Lumwana Cu (± Co ± U) deposits of NW Zambia are large, tabular, disseminated ore bodies, hosted within the Mwombezhi Dome of the Lufilian Arc. The host rocks to the Lumwana deposits are two mineralogically similar but texturally distinct gneisses, a granitic to pegmatitic gneiss and a banded to augen gneiss which both comprise quartz-feldspar ± biotite ± muscovite ± haematite ± amphibole and intervening quartz-feldspar ± biotite schist. The sulphide ore horizons are typically developed within a biotite-muscovite-quartz-kyanite schist, although mineralization locally occurs within internal gneiss units. Contacts between the ore and host rocks are transitional and characterized by a loss of feldspar. Kinematic indicators, such as S-C fabrics and pressure shadows on porphyroblasts, suggest a top to the north shear sense. The sulphides are deformed by a strong shear fabric, enclosed within kyanite or concentrated into low strain zones and pressure shadows around kyanite porphyroblasts. This suggests that the copper mineralization was introduced either syn- or pre-peak metamorphism. In addition to Cu and Co, the ores are also characterized by enrichments in U, V, Ni, Ba and S and small, discrete zones of uranium mineralization, occur adjacent to the hanging wall and footwall of the copper ore bodies or in the immediate footwall to the copper mineralization. Unlike typical Copperbelt mineralization, unmineralized units show very low background copper values. Whole rock geochemical analyses of the interlayered schist and ore schist, compared to the gneiss, show depletions in Ca, Na and Sr and enrichments in Mg and K, consistent with replacement of feldspar by biotite. The mineral chemistry of muscovite, biotite and chlorite reflect changes in the bulk rock chemistry and show consistent increases in X Mg as the schists develop. ?34S for copper sulphides range from +2.3 ‰ to +18.5 ‰, with pyrite typically restricted to values between +3.9 ‰ and +6.2 ‰. These values are atypical of sulphides precipitated by bacteriogenic sulphate reduction. ?34S data for Chimiwungo (Cu + Co) show a broader range and increased ?34S values compared to the Malundwe (Cu) mineralization. The Lumwana deposits show many characteristics which distinguish them from classical Copperbelt mineralization and which suggests that they are formed by metasomatic alteration, mineralization and shearing of pre-Katangan basement. Although this style of mineralization is reported elsewhere in the Copperbelt, sometimes associated with the more widely reported stratiform ores of the Lower Roan, none of the previously reported occurrences have so far developed the tonnages of ore reported at Lumwana.

Bernau, Robin; Roberts, Stephen; Richards, Mike; Nisbet, Bruce; Boyce, Adrian; Nowecki, James

2013-02-01

192

Evaluation of alternative mosquito sampling methods for malaria vectors in Lowland South - East Zambia  

PubMed Central

Background Sampling malaria vectors and measuring their biting density is of paramount importance for entomological surveys of malaria transmission. Human landing catch (HLC) has been traditionally regarded as a gold standard method for surveying human exposure to mosquito bites. However, due to the risk of human participant exposure to mosquito-borne parasites and viruses, a variety of alternative, exposure-free trapping methods were compared in lowland, south-east Zambia. Methods Centres for Disease Control and Prevention miniature light trap (CDC-LT), Ifakara Tent Trap model C (ITT-C), resting boxes (RB) and window exit traps (WET) were all compared with HLC using a 3?×?3 Latin Squares design replicated in 4 blocks of 3 houses with long lasting insecticidal nets, half of which were also sprayed with a residual deltamethrin formulation, which was repeated for 10 rounds of 3 nights of rotation each during both the dry and wet seasons. Results The mean catches of HLC indoor, HLC outdoor, CDC-LT, ITT-C, WET, RB indoor and RB outdoor, were 1.687, 1.004, 3.267, 0.088, 0.004, 0.000 and 0.008 for Anopheles quadriannulatus Theobald respectively, and 7.287, 6.784, 10.958, 5.875, 0.296, 0.158 and 0.458, for An. funestus Giles, respectively. Indoor CDC-LT was more efficient in sampling An. quadriannulatus and An. funestus than HLC indoor (Relative rate [95% Confidence Interval]?=?1.873 [1.653, 2.122] and 1.532 [1.441, 1.628], respectively, P?

2013-01-01

193

Maternal and infant health problems after normal childbirth: a randomised controlled study in Zambia  

PubMed Central

STUDY OBJECTIVES: The main aim of the study was to discover if a midwife home visiting programme has a significant effect on the prevalence of health problems and breast feeding behaviour of mothers who delivered normally and their healthy fullterm newborn babies, during a period of 42 days after delivery. Another aim was to compare the mothers', the midwife's, and the doctor's findings of prevalence of health problems at the end of the puerperium period. DESIGN: A randomised controlled trial was carried out. One group of mothers and their infants were randomly allocated to a home visiting group (Group A); the other group (Group B) was only visited at day 42. SETTING: The study was carried out at the University Teaching Hospital (UTH) in Lusaka, the capital city of Zambia. PARTICIPANTS: A total of 408 mothers who had a normal delivery and gave birth to a healthy fullterm infant, as assessed by the attending midwife, were randomised to two groups. Group A consisted of 208 mother/infant dyads who were visited by a midwife in their homes at days 3, 7, 28, and 42 after delivery and Group B consisted of 200 mother/infant dyads who were only visited at day 42. MAIN RESULTS: At day 42 an equal proportion (30%) of mothers in both groups perceived that they had health problems. The prevalence of infant health problems in Group B was significantly higher (p < 0.01) as perceived by mothers. There were more mothers in Group B (p < 0.01) perceiving insufficient milk production and giving supplementary feeding. At day 42, mothers in Group A (56%) took more actions than mothers in Group B (41%) to solve infant health problems (p < 0.03). In both groups the mothers' perceived own health problems, were significantly higher (p < 0.01) than those observed by the obstetrician and those observed by the midwife. The midwife found more infant health problems in Group B (p < 0.01) than in Group A and more infants with health problems in both groups compared with the paediatrician's findings (p < 0.01). CONCLUSIONS: There was a significant difference between the mothers' reported health problems and the health problems identified by the midwife and the doctors. The study shows that a midwife home visit and individual health education to mothers, reduce the prevalence of infant health problems, and enables the mother to more often take action when an infant health problem is identified. There is a need to re-evaluate the midwifery training curriculums with the intention to include more infant management care.  

Ransjo-Arvidson, A. B.; Chintu, K.; Ng'andu, N.; Eriksson, B.; Susu, B.; Christensson, K.; Diwan, V. K.

1998-01-01

194

Local problems; local solutions: an innovative approach to investigating and addressing causes of maternal deaths in Zambia's Copperbelt  

PubMed Central

Background Maternal mortality in developing countries is high and international targets for reduction are unlikely to be met. Zambia's maternal mortality ratio was 591 per 100,000 live births according to survey data (2007) while routinely collected data captured only about 10% of these deaths. In one district in Zambia medical staff reviewed deaths occurring in the labour ward but no related recommendations were documented nor was there evidence of actions taken to avert further deaths. The Investigate Maternal Deaths and Act (IMDA) approach was designed to address these deficiencies and is comprised of four components; identification of maternal deaths; investigation of factors contributing to the deaths; recommendations for action drawn up by multiple stakeholders and monitoring of progress through existing systems. Methods A pilot was conducted in one district of Zambia. Maternal deaths occurring over a period of twelve months were identified and investigated. Data was collected through in-depth interviews with family, focus group discussions and hospital records. The information was summarized and presented at eleven data sharing meetings to key decision makers, during which recommendations for action were drawn up. An output indicator to monitor progress was included in the routine performance assessment tool. High impact interventions were identified using frequency analysis. Results A total of 56 maternal deaths were investigated. Poor communication, existing risk factors, a lack of resources and case management issues were the broad categories under which contributing factors were assigned. Sixty three recommendations were drawn up by key decision-makers of which two thirds were implemented by the end of the pilot period. Potential high impact actions were related to management of AIDS and pregnancy, human resources, referral mechanisms, birth planning at household level and availability of safe blood. Conclusion In resource constrained settings the IMDA approach promotes the use of existing systems to reduce maternal mortality. In turn the capacity of local health officers to use data to determine, plan and implement relevant interventions that address the local factors contributing to maternal deaths is strengthened. Monitoring actions taken against the defined recommendations within the routine performance assessment ensures sustainability. Suggestions for further research are provided.

2011-01-01

195

Estimating Loss to Follow-Up in HIV-Infected Patients on Antiretroviral Therapy: The Effect of the Competing Risk of Death in Zambia and Switzerland  

PubMed Central

Background Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings HIV-infected patients aged ?18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells <100 cells/µl and 15.4% among patients starting with ?350 cells/µL. The estimates from CR cumulative incidence were 22.9% and 13.6%, respectively. Little difference was found between naïve and CR analyses in Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings.

Mwango, Albert; Stringer, Jeffrey; Ledergerber, Bruno; Mulenga, Lloyd; Bucher, Heiner C.; Westfall, Andrew O.; Calmy, Alexandra; Boulle, Andrew; Chintu, Namwinga; Egger, Matthias; Chi, Benjamin H.

2011-01-01

196

Examining Specific Effects of Context on Adaptive Behavior and Achievement in Rural Africa: Six Case Studies from Southern Province, Zambia  

PubMed Central

Generally accepted as universal, the construct of adaptive behavior differs in its manifestations across different cultures and settings. The Vineland-II was translated into Chitonga and adapted to the setting of rural Southern Province, Zambia. This version was administered to the parents/caregivers of 114 children (grades 3-7, mean age = 12.94, sd = 2.34). The relationships between these children's adaptive behavior, academic achievement and cognitive ability indicators are compared to those usually observed in US samples. Results reflect no association between adaptive behavior and cognitive ability indicators, but a strong relationship between high adaptive behavior and reading-related measures. Six case studies of children with high and low scores on the Vineland-II are presented to illustrate the possible factors affecting these outcomes.

Reich, Jodi; Hart, Lesley; Thuma, Philip E.

2011-01-01

197

Detection of Salmonella invA by isothermal and chimeric primer-initiated amplification of nucleic acids (ICAN) in Zambia.  

PubMed

The isothermal and chimeric primer-initiated amplification of nucleic acids (ICAN) is a new isothermal DNA amplification method composed of exo Bca DNA polymerase, RNaseH and DNA-RNA chimeric primers. We detected invA of Salmonella from chicken carcasses, egg yolk and cattle fecal samples. Fifty-three of 59 isolates were invA-positive in ICAN-chromatostrip detection. The result was consistent with those obtained by standard PCR. Salmonella invA was detected in 12 of 14 carcass rinses by ICAN, while in 7 of 14 rinses by standard PCR. These results indicate that ICAN is an efficient, sensitive and simple system to detect invA of Salmonella species in developing countries such as Zambia. PMID:16293310

Isogai, Emiko; Makungu, Chitwambi; Yabe, John; Sinkala, Patson; Nambota, Andrew; Isogai, Hiroshi; Fukushi, Hideto; Silungwe, Manda; Mubita, Charles; Syakalima, Michelo; Hang'ombe, Bernard Mudenda; Kozaki, Shunji; Yasuda, Jun

2005-11-15

198

Six-month hemoglobin concentration and its association with subsequent mortality among adults on antiretroviral therapy in Lusaka, Zambia  

PubMed Central

Little is known about changes in hemoglobin concentration early in the course of antiretroviral therapy (ART) and its subsequent relation to survival. We analyzed data for 40,410 HIV-infected adults on ART in Lusaka, Zambia. Our main exposure of interest was 6-month hemoglobin, but we stratified our analysis by baseline hemoglobin to allow for potential effect modification. Patients with a six-month hemoglobin <8.5 g/dL, regardless of baseline, had the highest hazard for death after six months (HR: 4.5; 95%CI: 3.3, 6.3). Future work should look to identify causes of anemia in settings such as ours and evaluat strategies for more timely diagnosis and treatment.

Giganti, Mark J.; Limbada, Mohammed; Mwango, Albert; Moyo, Crispin; Mulenga, Lloyd B.; Guffey, M. Brad; Mulenga, Priscilla L.; Bolton-Moore, Carolyn; Stringer, Jeffrey S. A.; Chi, Benjamin H.

2013-01-01

199

Six-month hemoglobin concentration and its association with subsequent mortality among adults on antiretroviral therapy in Lusaka, Zambia.  

PubMed

Little is known about changes in hemoglobin concentration early in the course of antiretroviral therapy and its subsequent relation to survival. We analyzed data for 40,410 HIV-infected adults on antiretroviral therapy in Lusaka, Zambia. Our main exposure of interest was 6-month hemoglobin, but we stratified our analysis by baseline hemoglobin to allow for potential effect modification. Patients with a 6-month hemoglobin <8.5 g/dL, regardless of baseline, had the highest hazard for death after 6 months (hazard ratio: 4.5; 95% confidence interval: 3.3 to 6.3). Future work should look to identify causes of anemia in settings such as ours and evaluate strategies for more timely diagnosis and treatment. PMID:22659648

Giganti, Mark J; Limbada, Mohammed; Mwango, Albert; Moyo, Crispin; Mulenga, Lloyd B; Guffey, M Brad; Mulenga, Priscilla L; Bolton-Moore, Carolyn; Stringer, Jeffrey S A; Chi, Benjamin H

2012-09-01

200

Frequency of Multiple Blood Meals Taken in a Single Gonotrophic Cycle by Anopheles arabiensis Mosquitoes in Macha, Zambia  

PubMed Central

Anopheles arabiensis is a major vector of Plasmodium falciparum in southern Zambia. This study aimed to determine the rate of multiple human blood meals taken by An. arabiensis to more accurately estimate entomologic inoculation rates (EIRs). Mosquitoes were collected in four village areas over two seasons. DNA from human blood meals was extracted and amplified at four microsatellite loci. Using the three-allele method, which counts ? 3 alleles at any microsatellite locus as a multiple blood meal, we determined that the overall frequency of multiple blood meals was 18.9%, which was higher than rates reported for An. gambiae in Kenya and An. funestus in Tanzania. Computer simulations showed that the three-allele method underestimates the true multiple blood meal proportion by 3–5%. Although P. falciparum infection status was not shown to influence the frequency of multiple blood feeding, the high multiple feeding rate found in this study increased predicted malaria risk by increasing EIR.

Norris, Laura C.; Fornadel, Christen M.; Hung, Wei-Chien; Pineda, Fernando J.; Norris, Douglas E.

2010-01-01

201

Ciliate protozoa in the rumen of Kafue lechwe, Kobus leche kafuensis, in Zambia, with the description of four new species.  

PubMed

The composition of the rumen ciliate fauna in 76 Kafue lechwe inhabiting a limited area in Zambia was surveyed and five genera containing 24 species with 16 formae belonging to the family Ophryoscolecidae were identified. Four new species belonging to Diplodiniinae were recognized and described as Diplodinium lochinvarense n. sp., Diplodinium leche n. sp., Diplodinium zambiense n. sp., and Metadinium ossiculi n. sp. In addition, Ostracodinium gracile form fissilaminatum Dogiel, 1932 was found for the second time and described as Metadinium fissilaminatum n. comb. The species composition was fairly unusual. Seven of the species have been found only in African wild antelopes and these species were found more frequently than cosmopolitan species. There was no evidence of isotrichid species. The average density of ciliates per 1 ml of the rumen fluid was 25.7 x 10(4), and the number of ciliate species per head of host was 10.8. PMID:1522538

Imai, S; Tsutsumi, Y; Yumura, S; Mulenga, A

202

The Paris Declaration in practice: challenges of health sector aid coordination at the district level in Zambia  

PubMed Central

Background The increasing resources available for and number of partners providing health sector aid have stimulated innovations, notably, the Paris Declaration on Aid Effectiveness, which aim to improve aid coordination. In this, one of the first studies to analyse implementation of aid coordination below national level, the aim was to investigate the effect of the Paris Declaration on coordination of health sector aid at the district level in Zambia. Methods The study was carried out in three districts of Zambia. Data were collected via interviews with health centre staff, district managers and officials from the Ministry of Health, and from district action plans, financial reports and accounts, and health centre ledger cards. Four indicators of coordination related to external-partner activity, common arrangements used by external partners and predictability of funding were analysed and assessed in relation to the 2010 targets set by the Paris Declaration. Findings While the activity of external partners at the district level has increased, funding and activities provided by these partners are often not included in local plans. HIV/AIDS support show better integration in planning and implementation at the district level than other support. Regarding common arrangements used for fund disbursement, the share of resources provided as programme-based support is not increasing. The predictability of funds coming from outside the government financing mechanism is low. Conclusion Greater efforts to integrate partners in district level planning and implementation are needed. External partners must improve the predictability of their support and be more proactive in informing the districts about their intended contributions. With the deadline for achieving the targets set by the Paris Declaration fast approaching, it is time for the signatories to accelerate its implementation.

Sundewall, Jesper; Forsberg, Birger C; Jonsson, Kristina; Chansa, Collins; Tomson, Goran

2009-01-01

203

Midwives' perspectives on male participation in PMTCT of HIV and how they can support it in Lusaka, Zambia.  

PubMed

OBJECTIVE: the purpose of this study is to describe midwives' perspectives on (1) male participation in Prevention of Mother-To-Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) and (2) the methods that could be used to improve male participation in the Lusaka District, Zambia. DESIGN: a qualitative descriptive study. Data were collected using 10 open-ended questions. SETTING: 25 public antenatal clinics in the Lusaka District, Zambia. PARTICIPANTS: midwives (n=45). FINDINGS: content analysis highlighted that a male partner can prevent his wife and his infant from being exposed to HIV by preventive behaviour in their intimate relationship and by utilising health-care services. Several barriers to male participation were identified. These were linked to the male partner himself, to health-care services and to society. Stigma as a multifaceted barrier was considered to permeate every level. The sources of the resources that a male partner needs to prevent Mother-To-Child Transmission (MTCT) were the male partner himself, health-care services and society. The methods that midwives can use to improve male participation were the following: first, influencing individuals, the community, employers and health personnel; second, intervening in risk behaviour; and third, providing disease intervention services. KEY CONCLUSION: male participation in PMTCT of HIV is diverse, not only in HIV testing at the beginning of pregnancy, and it is influenced by various dimensions. Midwives' methods to improve male participation were broad, extending outside the antenatal clinic. A shortage of midwives and other typical issues of limited resources of developing countries pose challenges to male participation in PMTCT of HIV. IMPLICATION FOR PRACTICE: the study showed that cultivating a male-friendly approach in antenatal care is urgent to protect infants. PMID:23522666

Auvinen, Jaana; Kylmä, Jari; Välimäki, Maritta; Bweupe, Max; Suominen, Tarja

2013-03-20

204

Retention in Care and Outpatient Costs for Children Receiving Antiretroviral Therapy in Zambia: A Retrospective Cohort Analysis  

PubMed Central

Background There are few published estimates of the cost of pediatric antiretroviral therapy (ART) in Africa. Our objective was to estimate the outpatient cost of providing ART to children remaining in care at six public sector clinics in Zambia during the first three years after ART initiation, stratified by service delivery site and time on treatment. Methods Data on resource utilization (drugs, diagnostics, outpatient visits, fixed costs) and treatment outcomes (in care, died, lost to follow up) were extracted from medical records for 1,334 children at six sites who initiated ART at <15 years of age between 2006 and 2011. Fixed and variable unit costs (reported in 2011 USD) were estimated from the provider’s perspective using site level data. Results Median age at ART initiation was 4.0 years; median CD4 percentage was 14%. One year after ART initiation, 73% of patients remained in care, ranging from 60% to 91% depending on site. The average annual outpatient cost per patient remaining in care was $209 (95% CI, $199–$219), ranging from $116 (95% CI, $107–$126) to $516 (95% CI, $499–$533) depending on site. Average annual costs decreased as time on treatment increased. Antiretroviral drugs were the largest component of all outpatient costs (>50%) at four sites. At the two remaining sites, outpatient visits and fixed costs together accounted for >50% of outpatient costs. The distribution of costs is slightly skewed, with median costs 3% to 13% lower than average costs during the first year after ART initiation depending on site. Conclusions Outpatient costs for children initiating ART in Zambia are low and comparable to reported outpatient costs for adults. Outpatient costs and retention in care vary widely by site, suggesting opportunities for efficiency gains. Taking advantage of such opportunities will help ensure that targets for pediatric treatment coverage can be met.

Scott, Callie A.; Iyer, Hari; Bwalya, Deophine Lembela; McCoy, Kelly; Meyer-Rath, Gesine; Moyo, Crispin; Bolton-Moore, Carolyn; Larson, Bruce; Rosen, Sydney

2013-01-01

205

Coprological survey of alimentary tract parasites in dogs from Zambia and evaluation of a coproantigen assay for canine echinococcosis.  

PubMed

Faecal samples were collected from the rectum of 540 domestic dogs from four districts (Lusaka, Katete, Petauke and Luangwa) in Zambia between 2005 and 2006 and prevalences of canine alimentary tract parasites were determined by coprological examination. Thirteen different ova and parasites including strongyle (43.3%), Spirocerca lupi (18.7%), taeniid (13.1%), Toxocara canis (7.6%), Sarcocystis sp.* (7.5%), Isospora sp.* (5.7%), Physaloptera sp.* (4.6%), Capillaria sp.* (2.8%), Dipylidium caninum (2.2%), Mesocestoides sp.* (2.0%), Ascaris sp.* (1.7%), Trichuris vulpis* (0.4%) and Schistosoma mansoni* (0.4%) were detected, Ascaris and Schistosoma probably originating from coprophagy. The species with asterisks and later-described Taenia multiceps are for the first time reported from dogs in Zambia. A coproantigen enzyme-linked immunosorbent assay (CoproAg-ELISA) developed for Echinococcus spp. revealed 43 positive dogs and 37 of these harboured taeniid eggs. From 63 of the 71 taeniid egg-positive samples, eggs and DNA thereof were isolated and subjected to a multiplex polymerase chain reaction for differentiating E. granulosus sensu lato, E. multilocularis and Taenia spp. Amplicons indicative for Taenia spp. were obtained from 60 samples. Sequencing of amplicons spanning part of the mitochondrial cytochrome c oxidase subunit 1 gene, which was possible with 38 samples, revealed 35 infections with T. hydatigena and 3 with T. multiceps. Therefore, the CoproAg-ELISA showed some positives, but concrete evidence for the existence of canine E. granulosus infection could not be established. Comparison of the results of the CoproAg-ELISA and Taenia species identification indicated that the CoproAg-ELISA cross-reacts with patent infections of T. hydatigena (57%) and T. multiceps (33%). PMID:22185947

Nonaka, N; Nakamura, S; Inoue, T; Oku, Y; Katakura, K; Matsumoto, J; Mathis, A; Chembesofu, M; Phiri, I G K

2011-10-01

206

Tuberculin sensitivity and HIV1 status of patients attending a sexually transmitted diseases clinic in Lusaka, Zambia: a cross-sectional study  

Microsoft Academic Search

A cross-sectional study to estimate the prevalence of latent tuberculosis (TB) in a group of Zambians at high risk of human immunodeficiency virus type 1 (HIV-l) infection and to examine the effect of HIV-l infection on the tuberculin response was conducted in the University Teaching Hospital in Lusaka, Zambia during July to September 1990. Patients were selected from those presenting

Laurie E. Duncanl; Alison M. Elliott; Richard J. Hayes; Subhash K. Hira; George Ten; Grace T. Mumba

1995-01-01

207

The role of Global HIV\\/AIDS Initiatives in policy implementation processes governing antiretroviral treatment (ART) roll-out in Zambia and South Africa  

Microsoft Academic Search

Abstract Global HIV\\/AIDS Initiatives (GHIs), suchas US PEPFAR and the Global Fund to Fight AIDS, TB and Malaria, have emerged as new mechanisms for development assistance in health. By 2008, GHIs were providing two-thirds of all external funding,for HIV\\/AIDS globally. In Zambia and ,South Africa over the past five years, US PEPFAR and the Global Fund have provided significant funding

Virginia Bond; Lucy Gilson; Gill Walt

2009-01-01

208

Supporting orphans and vulnerable children affected by AIDS: using community-generated definitions to explore patterns of children's vulnerability in Zambia  

Microsoft Academic Search

This study explores how communities in Zambia characterize vulnerable children in the context of HIV; demonstrates how estimates of vulnerability vary depending on definitions; and discusses the implications of these estimates for program delivery. Baseline research conducted in 2005 included cross-sectional community-based household surveys at six locations using multi-stage random sampling (totalling 1,503 households, reporting on 5,009 children) and participatory

K. Schenk; L. Ndhlovu; S. Tembo; A. Nsune; C. Nkhata; B. Walusiku; C. Watts

2008-01-01

209

Petrography, geochemistry, and geochronology of granitoid rocks in the Neoproterozoic-Paleozoic Lufilian–Zambezi belt, Zambia: Implications for tectonic setting and regional correlation  

Microsoft Academic Search

There are several pre-orogenic Neoproterozoic granitoid and metavolcanic rocks in the Lufilian–Zambezi belt in Zambia and Zimbabwe that are interpreted to have been emplaced in a continental-rift setting that is linked to the break-up of the Rodinia supercontinent. However, no geochemical data were previously available for these rocks in the Zambian part of the belt to support this model. We

Crispin Katongo; Friedrich Koller; Urs Kloetzli; Christian Koeberl; Francis Tembo; Bert De Waele

2004-01-01

210

Child physical abuse and neglect in Kenya, Zambia and the Netherlands: a cross-cultural comparison of prevalence, psychopathological sequelae and mediation by PTSS.  

PubMed

This study compared the prevalence of self-reported childhood physical abuse and neglect and the associated psychopathological sequelae among Kenyan, Zambian, and Dutch university students. In addition, we sought to find out the differentiated role of posttraumatic stress symptoms (PTSS) in mediating the associations between childhood maltreatment experiences and psychopathology symptoms. The sample consisted of 862 university students from Kenya (n?=?375), Zambia (n?=?182), and The Netherlands (n?=?305) who completed the Personal and Relationships Profile (PRP). Results showed that physical abuse was highly prevalent in Kenya (59%) and Zambia (40%), and that neglect was even more prevalent than physical abuse in Zambia and The Netherlands at 59%, 54%, and 42% for the Kenyan, Zambian, and Dutch samples respectively. Neglect was associated with psychopathological symptoms in all three samples, whereas physical abuse was associated with psychopathological sequelae in the Kenyan and Zambian samples only. PTSS mediated the association between neglect and psychopathology symptoms in the Dutch sample and between physical abuse and psychopathology symptoms in the Dutch and Kenyan samples. We conclude that physical abuse and neglect are associated with psychopathology symptoms independently of country and cultural context. However, the pathways through which physical abuse and neglect may lead to psychopathological sequelae may be dependent on perceptions of specific parental behavior in different sociocultural contexts. PMID:23597009

Mbagaya, Catherine; Oburu, Paul; Bakermans-Kranenburg, Marian J

2013-01-01

211

How informed are clients who consent? A mixed-method evaluation of comprehension among clients of male circumcision services in Zambia and Swaziland.  

PubMed

Comprehension is fundamental for informed consent--an individual's right to choose a medical procedure, such as male circumcision (MC). Because optimal benefits depend on post-surgical behaviors, comprehension is particularly critical for MC programs. We evaluated clients' comprehension of MC's risks and benefits, wound care instructions, and risk reduction post-MC using a true/false test (n = 1181) and 92 semi-structured interviews (SSIs) in Zambia and Swaziland. Most participants (89% Zambia, 93% Swaziland) passed the true/false test, although adolescents scored lower (significantly so in Swaziland) than adults and one-third (including nearly half of adolescents in Zambia) said MC has no risks. SSIs indicated confusion between "risk" of adverse surgical outcomes and reduced "risk" of HIV; most respondents acknowledged the 6 week abstinence period post-MC, yet few said resuming sex early increases HIV risk. Providers should distinguish between surgical "risks" and reduced HIV "risk," and emphasize that HIV risk increases with sex before complete healing. PMID:23392912

Friedland, Barbara A; Apicella, Louis; Schenk, Katie D; Sheehy, Meredith; Hewett, Paul C

2013-07-01

212

Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients  

PubMed Central

Background Around 70% of those living with HIV in need of treatment accessed antiretroviral therapy (ART) in Zambia by 2009. However, sustaining high levels of adherence to ART is a challenge. This study aimed to identify the predictive factors associated with ART adherence during the early months of treatment in rural Zambia. Methods This is a field based observational longitudinal study in Mumbwa district, which is located 150 km west of Lusaka, the capital of Zambia. Treatment naive patients aged over 15 years, who initiated treatment during September-November 2010, were enrolled. Patients were interviewed at the initiation and six weeks later. The treatment adherence was measured according to self-reporting by the patients. Multiple logistic regression analysis was performed to identify the predictive factors associated with the adherence. Results Of 157 patients, 59.9% were fully adherent to the treatment six weeks after starting ART. According to the multivariable analysis, full adherence was associated with being female [Adjusted Odds Ratio (AOR), 3.3; 95% Confidence interval (CI), 1.2-8.9], having a spouse who were also on ART (AOR, 4.4; 95% CI, 1.5-13.1), and experience of food insufficiency in the previous 30 days (AOR, 5.0; 95% CI, 1.8-13.8). Some of the most common reasons for missed doses were long distance to health facilities (n = 21, 53.8%), food insufficiency (n = 20, 51.3%), and being busy with other activities such as work (n = 15, 38.5%). Conclusions The treatment adherence continues to be a significant challenge in rural Zambia. Social supports from spouses and people on ART could facilitate their treatment adherence. This is likely to require attention by ART services in the future, focusing on different social influences on male and female in rural Zambia. In addition, poverty reduction strategies may help to reinforce adherence to ART and could mitigate the influence of HIV infection for poor patients and those who fall into poverty after starting ART.

2012-01-01

213

Promotion of couples' voluntary HIV counselling and testing in Lusaka, Zambia by influence network leaders and agents  

PubMed Central

Objectives Hypothesising that couples’ voluntary counselling and testing (CVCT) promotions can increase CVCT uptake, this study identified predictors of successful CVCT promotion in Lusaka, Zambia. Design Cohort study. Setting Lusaka, Zambia. Participants 68 influential network leaders (INLs) identified 320 agents (INAs) who delivered 29?119 CVCT invitations to heterosexual couples. Intervention The CVCT promotional model used INLs who identified INAs, who in turn conducted community-based promotion and distribution of CVCT invitations in two neighbourhoods over 18?months, with a mobile unit in one neighbourhood crossing over to the other mid-way through. Primary outcome The primary outcome of interest was couple testing (yes/no) after receipt of a CVCT invitation. INA, couple and invitation characteristics predictive of couples’ testing were evaluated accounting for two-level clustering. Results INAs delivered invitations resulting in 1727 couples testing (6% success rate). In multivariate analyses, INA characteristics significantly predictive of CVCT uptake included promoting in community-based (adjusted OR (aOR)=1.3; 95% CI 1.0 to 1.8) or health (aOR=1.5; 95% CI 1.2 to 2.0) networks versus private networks; being employed in the sales/service industry (aOR=1.5; 95% CI 1.0 to 2.1) versus unskilled manual labour; owning a home (aOR=0.7; 95% CI 0.6 to 0.9) versus not; and having tested for HIV with a partner (aOR=1.4; 95% CI 1.1 to 1.7) or alone (aOR=1.3; 95% CI 1.0 to 1.6) versus never having tested. Cohabiting couples were more likely to test (aOR=1.4; 95% CI 1.2 to 1.6) than non-cohabiting couples. Context characteristics predictive of CVCT uptake included inviting couples (aOR=1.2; 95% CI 1.0 to 1.4) versus individuals; the woman (aOR=1.6; 95% CI 1.2 to 2.2) or couple (aOR=1.4; 95% CI 1.0 to 1.8) initiating contact versus the INA; the couple being socially acquainted with the INA (aOR=1.6; 95% CI 1.4 to 1.9) versus having just met; home invitation delivery (aOR=1.3; 95% CI 1.1 to 1.5) versus elsewhere; and easy invitation delivery (aOR=1.8; 95% CI 1.4 to 2.2) versus difficult as reported by the INA. Conclusions This study demonstrated the ability of influential people to promote CVCT and identified agent, couple and context-level factors associated with CVCT uptake in Lusaka, Zambia. We encourage the development of CVCT promotions in other sub-Saharan African countries to support sustained CVCT dissemination.

Wall, Kristin M; Kilembe, William; Nizam, Azhar; Vwalika, Cheswa; Kautzman, Michelle; Chomba, Elwyn; Tichacek, Amanda; Sardar, Gurkiran; Casanova, Deborah; Henderson, Faith; Mulenga, Joseph; Kleinbaum, David; Allen, Susan

2012-01-01

214

Gender equality and education: Increasing the uptake of HIV testing among married women in Kenya, Zambia and Zimbabwe.  

PubMed

Gender equality and education are being promoted as strategies to combat the HIV epidemic in Africa, but few studies have looked at the role of gender equality and education in the uptake of a vital service - HIV testing. This study looks at the associations between education (a key input needed for gender equality) and key gender equality measures (financial decision making and attitudes toward violence) with ever tested for HIV and tested for HIV in the past year. The study focused on currently married women ages between15-24 and 25-34 in three countries - Kenya, Zambia, and Zimbabwe. The data came from the Demographic and Health Surveys. Logistic regression was used to study the role of gender equality and education on the HIV testing outcomes after controlling for both social and biological factors. Results indicated that education had a consistent positive relationship with testing for both age groups, and the associations were always significant for young women aged 15-24 years (p<0.01). The belief that gender-based violence is unacceptable was positively associated with testing for women aged 25-34 in all the three countries, although the associations were only significant in Kenya (among women reporting ever being tested: OR 1.58, p<0.00; among women reporting being tested in the past year: OR 1.34, p<0.05) and Zambia (among women reporting ever being tested: OR 1.24, p<0.10; among women reporting being tested in the past year: OR 1.29, p<0.05). High financial decision making was associated with testing for women aged 25-34 in Zimbabwe only (among women reporting ever being tested: OR 1.66, p<0.01). Overall, the findings indicate that the education and the promotion of gender equality are important strategies for increasing uptake of a vital HIV service, and thus are important tools for protecting girls and young women against HIV. PMID:23438082

Singh, Kavita; Luseno, Winnie; Haney, Erica

2013-02-26

215

Impact assessment of malaria vector control using routine surveillance data in Zambia: implications for monitoring and evaluation  

PubMed Central

Background Malaria vector control using long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), with pyrethroids and DDT, to reduce malaria transmission has been expansively implemented in Zambia. The impact of these interventions on malaria morbidity and mortality has not previously been formally assessed at the population level in Zambia. Methods The impact of IRS (15 urban districts) and LLINs (15 rural districts) implementation on severe malaria cases, deaths and case fatality rates in children below the age of five years were compared. Zambian national Health Management Information System data from 2007 to 2008 were retrospectively analysed to assess the epidemiological impact of the two interventions using odds ratios to compare the pre-scaling up year 2007 with the scaling-up year 2008. Results Overall there were marked reductions in morbidity and mortality, with cases, deaths and case fatality rates (CFR) of severe malaria decreasing by 31%, 63% and 62%, respectively between 2007 and 2008. In urban districts with IRS introduction there was a significant reduction in mortality (Odds Ratio [OR] = 0.37, 95% CI = 0.31-0.43, P = 0.015), while the reduction in mortality in rural districts with LLINs implementation was not significant (OR = 0.83, 95% CI = 0.67-1.04, P = 0.666). A similar pattern was observed for case fatality rates with a significant reduction in urban districts implementing IRS (OR = 0.34, 95% CI = 0.33-0.36, P = 0.005), but not in rural districts implementing LLINs (OR = 0.96, 95% CI = 0.91-1.00, P = 0.913). No substantial difference was detected in overall reduction of malaria cases between districts implementing IRS and LLINs (P = 0.933). Conclusion Routine surveillance data proved valuable for determining the temporal effects of malaria control with two strategies, IRS and LLINs on severe malaria disease in different types of Zambian districts. However, this analysis did not take into account the effect of artemisinin-based combination therapy (ACT), which were being scaled up countrywide in both rural and urban districts.

2012-01-01

216

Seasonal variations in the distribution and abundance of the tsetse fly, Glossina morsitans morsitans in eastern Zambia.  

PubMed

The seasonal changes in the distribution of Glossina morsitans morsitans Westwood (Diptera: Glossinidae) and its main host, cattle, were examined in a cultivated area of the plateau of eastern Zambia. During four consecutive years, the tsetse and cattle populations were monitored along a fly-round transect traversing the two main vegetation types in the study area. These were miombo, a one-storied open woodland with the genera Brachystegia and Julbernardia dominant, and munga, a one- or two-storied woodland where the principal tree genera were Acacia, Combretum and Terminalia. Concurrently, a capture/mark/release/recapture (CMRR) exercise was conducted along two other transects also traversing both vegetation types. The index of apparent abundance of tsetse (IAA) in miombo increased at the beginning of the rainy season (November), reached its peak at the end of the rainy season (April) and was low during the cold season (May to late August), but especially the hot dry season (September to late October). The IAA of tsetse in munga showed a pattern that was the reverse of that in miombo. The seasonal changes in the IAA of tsetse in both vegetation types were in accordance with changes in the movement patterns of tsetse between the two vegetation type as observed using CMRR. The distribution and abundance of cattle along the transect also showed a seasonal trend. This was especially so in munga, during the first three years of observations, where cattle abundance increased gradually from June onwards, reached a maximum at the end of the hot dry season (October-November) and declined steeply at the start of the rainy season (November-December). In both vegetation types, the monthly mean IAA of tsetse was positively correlated with the abundance of cattle in the previous month. It is concluded that the distribution of tsetse in cultivated area of the eastern plateau of Zambia undergoes substantial seasonal changes, which can partly be attributed to changes in the distribution of cattle. The implications of these observations for the control of tsetse are discussed. PMID:12109711

Van den Bossche, P; De Deken, R

2002-06-01

217

Hepatic and renal concentrations of 10 trace elements in crocodiles (Crocodylus niloticus) in the Kafue and Luangwa rivers in Zambia.  

PubMed

Hepatic and renal concentrations of the elements arsenic, cadmium, cobalt, copper, lead, manganese, mercury, molybdenum, selenium and zinc were determined in samples collected from four crocodiles from the Kafue River, Kafue National Park and five crocodiles from the Luangwa River, Luangwa National Park, Zambia. The concentrations of the essential elements were similar to those reported in other vertebrates. Arsenic and cadmium concentrations were low (medians below 0.05 microg As/g and below 0.16 microg Cd/g, wet wt.). Mercury and lead concentrations were several orders of magnitude higher (medians up to 3.7 microg Hg/g, and up to 8.7 microg Pb/g, all wet wt.) than in hippopotami from the same rivers, probably as a result of food-chain biomagnification. Judging by the results obtained in this study, pollution from the mining activity around the Kafue River drainage area in the Copperbelt region has not significantly influenced the trace element concentrations in tissues of the crocodiles in the Kafue National Park. The trace element concentrations measured may serve as reference values in future studies on crocodilians. PMID:15626380

Almli, Bjørn; Mwase, Maxwell; Sivertsen, Tore; Musonda, Mike M; Flåøyen, Arne

2005-01-20

218

Kinda baboons (Papio kindae) and grayfoot chacma baboons (P. ursinus griseipes) hybridize in the Kafue river valley, Zambia.  

PubMed

The ranges of small kinda (Papio kindae) and much larger grayfooted chacma (P. ursinus griseipes) baboons adjoin in the Kafue National Park, Zambia. In a visual survey of baboons at 48 sites in the Kafue River drainage we found that, contrary to previous reports, groups at the species interface near the town of Ngoma are phenotypically diverse and presumably formed by multigenerational hybridization. Mitochondrial and/or Y-chromosome genetic markers from fecal samples (N=164) collected at 29 sites support this conclusion. Groups with phenotypic signs of a history of hybridization also had taxon-specific mitochondria and Y-haplotypes from both parental species. Although the distribution of mitochondrial haplotypes largely mirrored that of external phenotypes, a significant proportion of male specimens from grayfoot as well as hybrid groups carried kinda Y-chromosomes, and kinda Y-chromosomes were involved in all observed cases of mitochondrial/Y-chromosome discordance. These observations are consistent with, though they do not prove, a population history in which the range of chacmas and the hybrid zone have advanced at the expense of the kinda range. They also suggest that, unexpectedly, kinda male×chacma female matings are much more common than the reciprocal cross in the ancestry of hybrids. We suggest that distinctive male kinda behavior and the "juvenile" appearance of kinda baboons of both sexes, perhaps combined with obstetric difficulties of a small kinda female carrying the large offspring of a chacma male, may account for this bias. PMID:21274900

Jolly, C J; Burrell, A S; Phillips-Conroy, J E; Bergey, C; Rogers, J

2010-11-23

219

Female sex workers, male circumcision and HIV: a qualitative study of their understanding, experience, and HIV risk in Zambia.  

PubMed

Several sub-Saharan African countries, including Zambia, have initiated national voluntary medical male circumcision (MC) programs to reduce HIV incidence. In-depth interviews were conducted with twenty female sex workers (FSWs) in Lusaka to examine their understanding of MC and experiences with circumcised clients. Knowledge of MC was derived primarily through informal sources, with very few FSWs reporting exposure to MC educational campaigns. MC was not widely believed to be protective against HIV, however it was viewed by some as protective against STIs. Three FSWs reported having sex with recently circumcised clients, and most reported that men often used their MC status to try to convince FSWs to forego condoms. Findings suggest that FSWs, already at high risk for HIV infection, may face additional pressure toward higher risk behavior as a result of MC. As MC services are expanded, programs should support FSWs' efforts to protect themselves by providing information about what MC can--and cannot--offer for HIV/STI infection prevention. PMID:23349745

Abbott, Sharon A; Haberland, Nicole A; Mulenga, Drosin M; Hewett, Paul C

2013-01-17

220

Climate variability and change or multiple stressors? Farmer perceptions regarding threats to livelihoods in Zimbabwe and Zambia.  

PubMed

Climate variability is set to increase, characterised by extreme conditions in Africa. Southern Africa will likely get drier and experience more extreme weather conditions, particularly droughts and floods. However, while climate risks are acknowledged to be a serious threat to smallholder farmers' livelihoods, these risks do not exist in isolation, but rather, compound a multiplicity of stressors. It was important for this study to understand farmer perceptions regarding the role of climate risks within a complex and multifarious set of risks to farmers' livelihoods. This study used both qualitative and quantitative methods to investigate farmers' perceptions regarding threats to livelihoods in southern Zambia and south-western Zimbabwe. While farmers report changes in local climatic conditions consistent with climate variability, there is a problem in assigning contribution of climate variability and other factors to observed negative impacts on the agricultural and socio-economic system. Furthermore, while there is a multiplicity of stressors that confront farmers, climate variability remains the most critical and exacerbate livelihood insecurity for those farmers with higher levels of vulnerability to these stressors. PMID:22425874

Mubaya, Chipo Plaxedes; Njuki, Jemimah; Mutsvangwa, Eness Paidamoyo; Mugabe, Francis Temba; Nanja, Durton

2012-03-22

221

The rise and fall of a second-generation CBNRM project in Zambia: insights from a project perspective.  

PubMed

Since the advent of community-based natural resource management (CBNRM) in the mid-1980s, scholars and practitioners have sought to explain the uneven performance of CBNRM programs. Most CBNRM assessments examine the underlying principles of community-based conservation, the local social and ecological contexts, and connections with larger political and historical patterns. In this article, I argue that analysis of the potential and pitfalls of CBNRM also requires an understanding of the institutional history and internal dynamics of projects that implement CBNRM reforms. Drawing upon theory and methods from development ethnography and public policy, I examine the rise and fall of CONASA, a second-generation CBNRM project in Zambia that operated from 2001 to 2004. CONASA was constituted from a merger of organizations and discourses to provide continuity with previous projects. Its ambitious suite of activities included support for household livelihoods, community-based resource management, policy analysis, advocacy, and conservation enterprises at local, national, and transboundary levels. While individual activities were largely successful, CONASA's hybrid origins and logframe-centric management created fissures between its holistic design and operational logics, and hindered its ability to develop a broader narrative and maintain key alliances. This case study illustrates the importance of understanding the interplay between project design and operational context to fully appreciate the possibilities and limitations of project-mode conservation. PMID:23263566

Lyons, Andrew

2012-12-22

222

Early Weaning Increases Diarrhea Morbidity and Mortality Among Uninfected Children Born to HIV-infected Mothers in Zambia  

PubMed Central

Background.?Early weaning may reduce human immunodeficiency virus (HIV) transmission but may have deleterious consequences for uninfected children. Here we evaluate effects of early weaning on diarrhea morbidity and mortality of uninfected children born to HIV-infected mothers. Methods.?HIV-infected women in Lusaka, Zambia, were randomly assigned to breastfeeding for 4 months only or to continue breastfeeding until the mother decided to stop. Replacement and complementary foods were provided and all women were counseled around feeding and hygiene. Diarrhea morbidity and mortality were assessed in 618 HIV-uninfected singletons alive and still breastfeeding at 4 months. Intent-to-treat analyses and comparisons based on actual feeding practices were conducted using regression methods. Results.?Between 4 and 6 months, diarrheal episodes were 1.8-fold (95% confidence interval (CI), 1.3–2.4) higher in the short compared with long breastfeeding group. Associations were stronger based on actual feeding practices and persisted after adjustment for confounding. At older ages, only more severe outcomes, including diarrhea-related hospitalization or death (relative hazard [RH], 3.2, 95% CI, 2.1–5.1 increase 4–24 months), were increased among weaned children. Conclusions.?Continued breastfeeding is associated with reduced risk of diarrhea-related morbidity and mortality among uninfected children born to HIV-infected mothers in this low-resource setting despite provision of replacement and complementary food and counseling. ?Clinical Trials Registration.?NCT00310726.

Fawzy, Ashraf; Arpadi, Stephen; Kankasa, Chipepo; Sinkala, Moses; Mwiya, Mwiya; Thea, Donald M.; Aldrovandi, Grace M.

2011-01-01

223

Application of Data-Driven Evidential Belief Functions to Prospectivity Mapping for Aquamarine-Bearing Pegmatites, Lundazi District, Zambia  

SciTech Connect

A case application of data-driven estimation of evidential belief functions (EBFs) is demonstrated to prospectivity mapping in Lundazi district (eastern Zambia). Spatial data used to represent recognition criteria of prospectivity for aquamarine-bearing pegmatites include mapped granites, mapped faults/fractures, mapped shear zones, and radioelement concentration ratios derived from gridded airborne radiometric data. Data-driven estimates EBFs take into account not only (a) spatial association between an evidential map layer and target deposits but also (b) spatial relationships between classes of evidences in an evidential map layer. Data-driven estimates of EBFs can indicate which spatial data provide positive or negative evidence of prospectivity. Data-driven estimates of EBFs of only spatial data providing positive evidence of prospectivity were integrated according to Dempster's rule of combination. Map of integrated degrees of belief was used to delineate zones of relative degress of prospectivity for aquamarine-bearing pegmatites. The predictive map has at least 85% prediction rate and at least 79% success rate of delineating training and validation deposits, respectively. The results illustrate usefulness of data-driven estimation of EBFs in GIS-based predictive mapping of mineral prospectivity. The results also show usefulness of EBFs in managing uncertainties associated with evidential maps.

Carranza, E. J. M., E-mail: carranza@itc.nl; Woldai, T. [International Institute for Geo-Information Science and Earth Observation (ITC), Department of Earth Systems Analysis (Netherlands); Chikambwe, E. M. [Geological Survey Department of Zambia (Zambia)

2005-03-15

224

Knowledge and Perceptions of Couples' Voluntary Counseling and Testing in Urban Rwanda and Zambia: A Cross-Sectional Household Survey  

PubMed Central

Background Most incident HIV infections in sub-Saharan Africa occur between cohabiting, discordant, heterosexual couples. Though couples' voluntary HIV counseling and testing (CVCT) is an effective, well-studied intervention in Africa, <1% of couples have been jointly tested. Methods We conducted cross-sectional household surveys in Kigali, Rwanda (n?=?600) and Lusaka, Zambia (n?=?603) to ascertain knowledge, perceptions, and barriers to use of CVCT. Results Compared to Lusaka, Kigali respondents were significantly more aware of HIV testing sites (79% vs. 56%); had greater knowledge of HIV serodiscordance between couples (83% vs. 43%); believed CVCT is good (96% vs. 72%); and were willing to test jointly (91% vs. 47%). Stigma, fear of partner reaction, and distance/cost/logistics were CVCT barriers. Conclusions Though most respondents had positive attitudes toward CVCT, the majority were unaware that serodiscordance between cohabiting couples is possible. Future messages should target gaps in knowledge about serodiscordance, provide logistical information about CVCT services, and aim to reduce stigma and fear.

Kelley, April L.; Karita, Etienne; Sullivan, Patrick S.; Katangulia, Francois; Chomba, Elwyn; Carael, Michel; Telfair, Joseph; Dunham, Steve M.; Vwalika, Cheswa M.; Kautzman, Michele G.; Wall, Kristin M.; Allen, Susan A.

2011-01-01

225

Fertility goal-based counseling increases contraceptive implant and IUD use in HIV discordant couples in Rwanda and Zambia  

PubMed Central

Background HIV discordant heterosexual couples are faced with the dual challenge of preventing sexual HIV transmission and unplanned pregnancies with the attendant risk of perinatal HIV transmission. Our aim was to examine uptake of two long-acting reversible contraceptive (LARC) methods – intrauterine devices (IUDs) and hormonal implants – among HIV discordant couples in Rwanda and Zambia. Study Design Women were interviewed alone or with their partner during routine cohort study follow-up visits to ascertain fertility goals; those not pregnant, not infertile, not already using LARC, and wishing to limit or delay fertility for ?3 years were counseled on LARC methods and offered an IUD and implant on-site. Results Among 409 fertile Rwandan women interviewed (126 alone, 283 with partners), 365 (89%) were counseled about LARC methods and 130 (36%) adopted a method (100 implant, 30 IUD). Of 787 fertile Zambian women interviewed (457 alone, 330 with partners), 528 (67%) received LARC counseling, of whom 177 (34%) adopted a method (139 implant, 38 IUD). In both countries, a woman’s younger age was predictive of LARC uptake. LARC users reported fewer episodes of unprotected sex than couples using only condoms. Conclusions Integrated fertility-goal based family planning counseling and access to LARC methods with reinforcement of dual-method use prompted uptake of IUDs and implants and reduced unprotected sex among HIV-discordant couples in two African capital cities.

KHU, Naw H.; VWALIKA, Bellington; KARITA, Etienne; KILEMBE, William; BAYINGANA, Roger A.; SITRIN, Deborah; ROEBER-RICE, Heidi; LEARNER, Emily; TICHACEK, Amanda C.; HADDAD, Lisa B.; WALL, Kristin M.; CHOMBA, Elwyn N.; ALLEN, Susan A.

2012-01-01

226

Financial analysis of East Coast fever control strategies in traditionally managed Sanga cattle in Central Province of Zambia.  

PubMed

Five different East Coast fever (ECF)-control strategies (involving ECF immunisation by the infection-and-treatment method) were tested in groups of traditionally managed Sanga cattle in the Central Province of Zambia over a period of 2.5 years. Two groups were under intensive tick control (weekly spraying with acaricide)--one group immunised and the other non-immunised. Two groups were under no tick control--one group immunised and the other non-immunised. The fifth group was under seasonal tick control (18 sprays/year) and was immunised against ECF. The input and output data were used to construct discounted cash flows for each group. The seasonally sprayed and immunised group gave the highest net present value, and the non-immunised group with no tick control, the lowest. A break-even analysis showed that the immunisation costs could rise to US$25.9 per animal before profitability was affected. For herds under intensive tick control, immunisation was of no financial benefit. The results demonstrate the value of immunisation, and indicate the importance of its combination with seasonal tick-control measures. PMID:10022051

Minjauw, B; Rushton, J; James, A D; Upton, M

1999-01-01

227

Determination of endocrine disruptors in Kafue lechwe (Kobus leche kafuensis) samples from the Lochinvar National Park of Zambia.  

PubMed

Analysis of serum, whole blood and liver tissue samples from Kafue lechwe in the Lochinvar National Park of Zambia for suspected endocrine disrupting compounds revealed high concentrations for some of the compounds. 45 samples of serum, whole blood and liver tissue were extracted by liquid-liquid extraction followed by an analysis using Gas Chromatography-Electron Capture Detection (GC-ECD). The following endocrine disruptors were analyzed: deltamethrin, aldrin, endosulfan, dieldrin, pp-DDD, heptachlor, d-t-allethrin, pp-DDE, endrin and pp-DDT. For all the samples, dieldrin showed the highest concentration ranging from 1.7 to 44.4 microg/ml in serum and whole blood sample extracts and 0.10-5.1 microg/g wet weight in liver sample extracts. The most frequently detected was deltamethrin in 62% of the samples. Percent recoveries in spiked laboratory blanks ranged between 60% and 100% while calculated detection limits ranged from 0.004 to 0.21 microg/ml for all the endocrine disruptors evaluated. Where endocrine disruptors were detected, the concentrations of most of them far exceeded the maximum residue limits (MRLs) and the extraneous maximum residue limits (EMRLs) set by the Codex Alimentarius of the United Nations (UN), Food and Agricultural Organization (FAO). PMID:16624410

Sichilongo, Kwenga; Torto, Nelson

2006-04-19

228

The referral process and urban health care in sub-Saharan Africa: the case of Lusaka, Zambia.  

PubMed

Much of the current reform of urban health systems in sub-Saharan Africa focuses upon the referral system between different levels of care. It is often assumed that patients are by-passing primary facilities which leads to congestion at hospital outpatient departments. Zambia is well advanced in its health sector reform and this case study from the capital, Lusaka, explores the patterns of health seeking behaviour of the urban population, the reasons behind health care choices, the functioning of the referral system and the users' evaluations of the care received. Data were collected across three levels of the system: the community, local health centres and the main hospital (both in- and out-patients). Results showed those who by-passed health centres were doing so because they believed the hospital outpatient department to be cheaper and/or better supplied with drugs (not because they believed they would receive better technical care). Few users were given information about their diagnosis or reason for referral. The most striking result was the degree of unmet need for health services and the large number of individuals who were self-medicating due to lack of money rather than the minor nature of their illness. The current upgrading of urban health centres into 'reference centres' may provide a capacity for unmet need rather than decongesting the hospital outpatient department as originally intended. PMID:10414838

Atkinson, S; Ngwengwe, A; Macwan'gi, M; Ngulube, T J; Harpham, T; O'Connell, A

1999-07-01

229

Prevalence and correlates for school truancy among pupils in grades 7-10: results from the 2004 Zambia Global School-based Health Survey  

PubMed Central

Background There are limited data on the prevalence and associated factors of truancy in southern Africa. Yet truancy should attract the attention of public health professionals, educators and policy makers as it may be associated with adolescent problem behaviours. The objectives of the study were to estimate the prevalence and determine correlates of school truancy among pupils in Zambia. Findings We used data collected in 2004 in the Zambia Global School-based Health Survey. Logistic regression analysis was conducted to identify factors associated with truancy. A total of 2257 pupils participated in the survey of whom 53.9% were male. Overall 58.8% of the participants (58.1% of males and 58.4% of females) reported being truant in the past 30 days. Factors associated with truancy were having been bullied (AOR = 1.34, 95% CI [1.32, 1.36]), current alcohol use (AOR = 2.19, 95% CI [2.16, 2.23]), perception that other students were kind and helpful (AOR = 1.12, 95% CI [1.10, 1.14]), being male and being from the lowest school grade. Pupils whose parents or guardians checked their homework (AOR = 0.91 95% CI, [0.89, 0.92]) and those who reported parental supervision (AOR = 0.94, 95% CI [0.92-0.95]) were less likely to report being truant. Conclusions We found a high prevalence of truancy among pupils in grades 7-10 in Zambia. Interventions aimed to reduce truancy should be designed and implemented with due consideration of the associated factors.

2012-01-01

230

Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia  

PubMed Central

Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff ?0.40, p?=?0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p?=?0.04) and service readiness (coeff 0.54, p?=?0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could be valuable in monitoring and evaluation of health systems.

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

231

"The problem is ours, it is not CRAIDS' ". Evaluating sustainability of Community Based Organisations for HIV/AIDS in a rural district in Zambia  

PubMed Central

Background While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs) for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP) in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. Methods In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18) and district stakeholders (n= 10) in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6) in 2011. Results Funding: All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. Funding opportunities for CBOs in Mumbwa in 2010 were scarce. Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics. Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers’ skills levels had reduced. Conclusions Whilst the World Bank espoused the idea of sustainability in their plans, it remained on the periphery of their Zambia strategy. Assessments of need on the ground and accurate costings for sustainable service delivery, building on existing community strengths, are needed before projects commence. This study highlights the importance of enabling and building the capacity of existing CBOs and community structures, rather than creating new mechanisms.

2012-01-01

232

False beliefs about ART effectiveness, side effects and the consequences of non-retention and non-adherence among ART patients in Livingstone, Zambia.  

PubMed

Beliefs about antiretroviral treatment (ART) are crucial for treatment success but not well documented in sub-Sahara African countries. We studied the frequency of false beliefs about ART in 389 ART patients in Livingstone, Zambia. Despite intensive pre-ART counseling, we find that more than half of the patients hold at least one false belief about ART effectiveness, side effects, or the consequences of ART non-retention or non-adherence. Commonly held false beliefs-e.g., pastors can cure HIV infection through prayer and ART can be stopped without harmful effects while taking immune-boosting herbs-are likely to decrease ART adherence and retention. PMID:22714115

Nozaki, Ikuma; Kuriyama, Mika; Manyepa, Pauline; Zyambo, Matilda K; Kakimoto, Kazuhiro; Bärnighausen, Till

2013-01-01

233

The impact of Global Health Initiatives at national and sub-national level – a policy analysis of their role in implementation processes of antiretroviral treatment (ART) roll-out in Zambia and South Africa  

Microsoft Academic Search

Global Health Initiatives (GHIs), such as the President's Emergency Plan For AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, TB and Malaria (the GFATM), have emerged as new mechanisms for development assistance in health. By 2008, GHIs were providing two-thirds of all external funding for HIV\\/AIDS globally. In Zambia and South Africa over the past five years, PEPFAR

Johanna Hanefeld

2010-01-01

234

Impact of organizational factors on adherence to laboratory testing protocols in adult HIV care in Lusaka, Zambia  

PubMed Central

Background Previous operational research studies have demonstrated the feasibility of large-scale public sector ART programs in resource-limited settings. However, organizational and structural determinants of quality of care have not been studied. Methods We estimate multivariate regression models using data from 13 urban HIV treatment facilities in Zambia to assess the impact of structural determinants on health workers’ adherence to national guidelines for conducting laboratory tests such as CD4, hemoglobin and liver function and WHO staging during initial and follow-up visits as part of Zambian HIV care and treatment program. Results CD4 tests were more routinely ordered during initial history and physical (IHP) than follow-up (FUP) visits (93.0?% vs. 85.5?%; p?

2012-01-01

235

Unintended Pregnancy among HIV Positive Couples Receiving Integrated HIV Counseling, Testing, and Family Planning Services in Zambia  

PubMed Central

Objective We describe rates of unintended pregnancy among HIV positive couples in Lusaka, Zambia. We also identify factors associated with unintended pregnancy among oral contraceptive pill (OCP) using couples in this cohort. Design Data were analyzed from couples randomized in a factorial design to two family planning intervention videos. Methods Rates of unintended pregnancy were stratified by contraceptive method used at time of pregnancy. Predictors of time to unintended pregnancy among OCP users were determined via multivariate Cox modeling. Results The highest rates of unintended pregnancy were observed among couples requesting condoms only (26.4/100CY) or OCPs (20.7/100CY); these rates were not significantly different. OCP users accounted for 37% of the couple-years (CY) observed and 87% of unintended pregnancies. Rates of unintended pregnancy for injectable (0.7/100CY) and intrauterine device (1.6/100CY) users were significantly lower relative to condom only users. No pregnancies occurred among contraceptive implant users or after tubal ligation. Factors associated (p<0.05) with time to unintended pregnancy among OCP users in multivariate analysis included the man wanting more children, the woman being HIV negative versus having stage IV HIV disease, and the woman reporting: younger age, no previous OCP use, missed OCPs, or sex without a condom. Conclusions Long-acting reversible contraceptive methods were effective in the context of integrated couples HIV prevention and contraceptive services. Injectable methods were also effective in this context. Given the high user failure rate of OCPs, family planning efforts should promote longer-acting methods among OCP users wishing to avoid pregnancy. Where other methods are not available or acceptable, OCP adherence counseling is needed, especially among younger and new OCP users. Trial registration ClinicalTrials.gov NCT00067522

Wall, Kristin M.; Haddad, Lisa; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2013-01-01

236

Research-policy partnerships - experiences of the Mental Health and Poverty Project in Ghana, South Africa, Uganda and Zambia  

PubMed Central

Background Partnerships are increasingly common in conducting research. However, there is little published evidence about processes in research-policy partnerships in different contexts. This paper contributes to filling this gap by analysing experiences of research-policy partnerships between Ministries of Health and research organisations for the implementation of the Mental Health and Poverty Project in Ghana, South Africa, Uganda and Zambia. Methods A conceptual framework for understanding and assessing research-policy partnerships was developed and guided this study. The data collection methods for this qualitative study included semi-structured interviews with Ministry of Health Partners (MOHPs) and Research Partners (RPs) in each country. Results The term partnership was perceived by the partners as a collaboration involving mutually-agreed goals and objectives. The principles of trust, openness, equality and mutual respect were identified as constituting the core of partnerships. The MOHPs and RPs had clearly defined roles, with the MOHPs largely providing political support and RPs leading the research agenda. Different influences affected partnerships. At the individual level, personal relationships and ability to compromise within partnerships were seen as important. At the organisational level, the main influences included the degree of formalisation of roles and responsibilities and the internal structures and procedures affecting decision-making. At the contextual level, political environment and the degree of health system decentralisation affected partnerships. Conclusions Several lessons can be learned from these experiences. Taking account of influences on the partnership at individual, organisation and contextual/system levels can increase its effectiveness. A common understanding of mutually-agreed goals and objectives of the partnership is essential. It is important to give attention to the processes of initiating and maintaining partnerships, based on clear roles, responsibilities and commitment of parties at different levels. Although partnerships are often established for a specific purpose, such as carrying out a particular project, the effects of partnership go beyond a particular initiative.

2012-01-01

237

Diarrhea is a Major killer of Children with Severe Acute Malnutrition Admitted to Inpatient Set-up in Lusaka, Zambia  

PubMed Central

Introduction Mortality of children with Severe Acute Malnutrition (SAM) in inpatient set-ups in sub-Saharan Africa still remains unacceptably high. We investigated the prevalence and effect of diarrhea and HIV infection on inpatient treatment outcome of children with complicated SAM receiving treatment in inpatient units. Method A cohort of 430 children aged 6-59 months old with complicated SAM admitted to Zambia University Teaching Hospital's stabilization centre from August to December 2009 were followed. Data on nutritional status, socio-demographic factors, and admission medical conditions were collected up on enrollment. T-test and chi-square tests were used to compare difference in mean or percentage values. Logistic regression was used to assess risk of mortality by admission characteristics. Results Majority, 55.3% (238/430) were boys. The median age of the cohort was 17 months (inter-quartile range, IQR 12-22). Among the children, 68.9% (295/428) had edema at admission. The majority of the children, 67.3% (261/388), presented with diarrhea; 38.9% (162/420) tested HIV positive; and 40.5% (174/430) of the children died. The median Length of stay of the cohort was 9 days (IQR, 5-14 days); 30.6% (53/173) of the death occurred within 48 hours of admission. Children with diarrhea on admission had two and half times higher odds of mortality than those without diarrhea; Adjusted OR = 2.5 (95% CI 1.50-4.09, P < 0.001). The odds of mortality for children with HIV infection was higher than children without HIV infection; Adjusted OR = 1.6 (95% CI 0.99-2.48 P = 0.5). Conclusion Diarrhea is a major cause of complication in children with severe acute malnutrition. Under the current standard management approach, diarrhea in children with SAM was found to increase their odds of death substantially irrespective of other factors.

2011-01-01

238

The burden of knowing: balancing benefits and barriers in HIV testing decisions. a qualitative study from Zambia  

PubMed Central

Background Client-initiated HIV counselling and testing has been scaled up in many African countries, in the form of voluntary counselling and testing (VCT). Test rates have remained low, with HIV-related stigma being an important barrier to HIV testing. This study explored HIV testing decisions in one rural and one urban district in Zambia with high HIV prevalence and available antiretroviral treatment. Methods Data were collected through 17 in-depth interviews and two focus group discussions with individuals and 10 in-depth interviews with counsellors. Interpretive description methodology was employed to analyse the data. Results 'To know your status' was found to be a highly charged concept yielding strong barriers against HIV testing. VCT was perceived as a diagnostic device and a gateway to treatment for the severely ill. Known benefits of prevention and early treatment were outweighed by a perceived burden of knowing your HIV status related to stigma and fear. The manner in which the VCT services were organised added to this burden. Conclusions This study draws on social stigma theory to enhance the understanding of the continuity of HIV related stigma in the presence of ART, and argues that the burden of knowing an HIV status and the related reluctance to get HIV tested can be understood both as a form of label-avoidance and as strong expressions of the still powerful embodied memories of suffering and death among non-curable AIDS patients over the last decades. Hope lies in the emerging signs of a reduction in HIV related stigma experienced by those who had been tested for HIV. Further research into innovative HIV testing service designs that do not add to the burden of knowing is needed.

2012-01-01

239

A Novel Approach for Measuring the Burden of Uncomplicated Plasmodium falciparum Malaria: Application to Data from Zambia  

PubMed Central

Measurement of malaria burden is fraught with complexity, due to the natural history of the disease, delays in seeking treatment or failure of case management. Attempts to establish an appropriate case definition for a malaria episode has often resulted in ambiguities and challenges because of poor information about treatment seeking, patterns of infection, recurrence of fever and asymptomatic infection. While the primary reason for treating malaria is to reduce disease burden, the effects of treatment are generally ignored in estimates of the burden of malaria morbidity, which are usually presented in terms of numbers of clinical cases or episodes, with the main data sources being reports from health facilities and parasite prevalence surveys. The use of burden estimates that do not consider effects of treatment, leads to under-estimation of the impact of improvements in case management. Official estimates of burden very likely massively underestimate the impact of the roll-out of ACT as first-line therapy across Africa. This paper proposes a novel approach for estimating burden of disease based on the point prevalence of malaria attributable disease, or equivalently, the days with malaria fever in unit time. The technique makes use of data available from standard community surveys, analyses of fever patterns in malaria therapy patients, and data on recall bias. Application of this approach to data from Zambia for 2009–2010 gave an estimate of 2.6 (95% credible interval: 1.5–3.7) malaria attributable fever days per child-year. The estimates of recall bias, and of the numbers of days with illness contributing to single illness recalls, could be applied more generally. To obtain valid estimates of the overall malaria burden using these methods, there remains a need for surveys to include the whole range of ages of hosts in the population and for data on seasonality patterns in confirmed case series.

Crowell, Valerie; Yukich, Joshua O.; Briet, Olivier J. T.; Ross, Amanda; Smith, Thomas A.

2013-01-01

240

Remobilisation features and structural control on ore grade distribution at the Konkola stratiform Cu-Co ore deposit, Zambia  

NASA Astrophysics Data System (ADS)

The Konkola deposit is a high grade stratiform Cu-Co ore deposit in the Central African Copperbelt in Zambia. Economic mineralisation is confined to the Ore Shale formation, part of the Neoproterozoic metasedimentary rocks of the Katanga Supergroup. Petrographic study reveals that the copper-cobalt ore minerals are disseminated within the host rock, sometimes concentrated along bedding planes, often associated with dolomitic bands or clustered in cemented lenses and in layer-parallel and irregular veins. The hypogene sulphide mineralogy consists predominantly of chalcopyrite, bornite and chalcocite. Based upon relationships with metamorphic biotite, vein sulphides and most of the sulphides in cemented lenses were precipitated during or after biotite zone greenschist facies metamorphism. New ?34S values of sulphides from the Konkola deposit are presented. The sulphur isotope values range from ?8.7‰ to +1.4‰ V-CDT for chalcopyrite from all mineralising phases and from ?4.4‰ to +2.0‰ V-CDT for secondary chalcocite. Similarities in ?34S for sulphides from different vein generations, earlier sulphides and secondary chalcocite can be explained by (re)mobilisation of S from earlier formed sulphide phases, an interpretation strongly supported by the petrographic evidence. Deep supergene enrichment and leaching occurs up to a km in depth, predominantly in the form of secondary chalcocite, goethite and malachite and is often associated with zones of high permeability. Detailed distribution maps of total copper and total cobalt contents of the Ore Shale formation show a close relationship between structural features and higher copper and lower cobalt contents, relative to other areas of the mine. Structural features include the Kirilabombwe anticline and fault zones along the axial plane and two fault zones in the southern limb of the anticline. Cobalt and copper behave differently in relation to these structural features. These structures are interpreted to have played a significant role in (re)mobilisation and concentration of the metals, in agreement with observations made elsewhere in the Zambian Copperbelt.

Torremans, K.; Gauquie, J.; Boyce, A. J.; Barrie, C. D.; Dewaele, S.; Sikazwe, O.; Muchez, Ph.

2013-03-01

241

A targetted intervention research on traditional healer perspectives of sexually transmitted illnesses in urban Zambia. Current research.  

PubMed

Interviews with 81 traditional healers from 4 Copperbelt towns in Zambia (Chililabombwe, Chingola, Luanshya, and Mufulira) investigated healers' understanding of, attitudes toward, and management of sexually transmitted diseases (STDs). In general, Zambian traditional healers had detailed constructs of the physiology and infective processes underlying syphilis, gonorrhea, chancroid, and AIDS. STDs were considered to be caused by "dirt" or contamination residing in sperm or vaginal fluids and were closely linked to violations of moral codes. Healers shared complex nosologies based on distinctions between symptoms of different STD pathologies that were more inclusive than biomedical categories. Although condom use was not promoted, healers understood the importance of preventing an infective agent from passing from one person to another. Except for AIDS, STDs were considered curable by expelling the dirt through purgatives or emetics. Modern medicine was perceived as treating only STD symptoms, not curing. Most traditional healers insisted that the infected partner bring the other partner for consultation or treatment was withheld. Since these findings identified some areas of compatibility between indigenous and biomedical models of STDs, the Traditional Medicine Unit of the Ministry of Health and the HIV/AIDS Prevention Project of the Morehouse School of Medicine (Lusaka) established a program in which traditional healers receive AIDS training and learn to counsel clients on safer sex behaviors. Follow-up entails monthly meetings between health professionals and traditional healers. Since program initiation in June 1994, 800 traditional healers and 70 health professionals have participated. Traditional healers now sell condoms to their clients through a social marketing program. PMID:12179374

Masauso Nzima, M; Romano, K; Anyangwe, S; Wiseman, J; Macwan'gi, M; Kendall, C; Green, E C

1996-07-01

242

Prevalence and source of trypanosome infections in field-captured vector flies (Glossina pallidipes) in southeastern Zambia.  

PubMed

The prevalence of trypanosome infections in tsetse flies, Glossina pallidipes, collected from Chiawa and Chakwenga in Zambia with endemic trypanosomosis was assessed by polymerase chain reaction (PCR). Out of the 550 G. pallidipes, 58 (10.5%) flies were found to harbor trypanosome DNA. Infection rates of tsetse with Trypanosoma vivax universal, Trypanosoma congolense savannah, T. congolense forest and T. congolense kilifi were 4.2% (23/550), 4.7% (26/550), 1.1% (6/550) and 1.6% (9/550), respectively. To determine the mammalian hosts of T. congolense and T. vivax infections from the tsetse flies, mammalian mitochondrion DNA of blood meal in these flies were analyzed by PCR and subsequent gene sequence analysis of the amplicons. Sequence analysis showed the presence of cytochrome b gene (cyt b) of 7 different mammalian species such as human, elephant, buffalo, goat, warthog, greater kudu and cattle. Goats which were main livestock in these areas were further examined to know the extent of its contribution in spreading the infection. We examined the prevalence of trypanosome infections in the domestic goat population in 6 settlements in Chiawa alone. Of the 86 goats sampled, 4 (4.6%), 5 (5.8%), 4 (4.6%) and 4 (4.6%) were positive for T. vivax universal, T. congolense savannah, forest and kilifi, respectively. These findings showed that the host-source of trypanosome infections in vector fly give a vital information about spread of infection. The result of this study will certainly contribute in elucidating more the epidemiology of trypanosomosis. PMID:18840966

Mekata, Hirohisa; Konnai, Satoru; Simuunza, Martin; Chembensofu, Mwelwa; Kano, Rika; Witola, William H; Tembo, Mwase E; Chitambo, Harrison; Inoue, Noboru; Onuma, Misao; Ohashi, Kazuhiko

2008-09-01

243

Vegetation and hydrological changes in the Kafue Flats, Zambia, associated with the construction of the Itezhi-tezhi and Kafue Gorge Dams.  

NASA Astrophysics Data System (ADS)

The Kafue River is the second largest river in Zambia with a length of about 1,500km. The river is a major tributary of the Zambezi and lies entirely in Zambia. The Kafue flats floodplain is an extensive floodplain of about 255 kilometers long and 60 kilometers wide, covering an area of more than 6,500km^2. The area has approximately 1.3 million inhabitants, within the flats and in its catchment. The lower Kafue is highly regulated that it is now essentially physically changed i.e. flood regime especially in the Kafue flats floodplain by the upstream dam, Itezhi-tezhi and a downstream one, the Kafue Gorge. Itezhi-tezhi dam was constructed as a storage dam for the Kafue Gorge. It is also significant because it was the first major dam in Africa that was designed and constructed to release an artificial flood for the maintenance of wetlands and the support of people dependent on them. However, there has been some indication of changes in the vegetation structure after the dams were constructed. This study is investigating in detail these changes in relation to the hydrological changes and also the spread of Mimosa pigra, an alien invasive weed in the Kafue Flats particularly the South bank.

Mumba, M.

2003-04-01

244

Detection of parasites and parasitic infections of free-ranging wildlife on a game ranch in zambia: a challenge for disease control.  

PubMed

Ex-situ conservancies are expanding alternatives to livestock production in Zambia albeit the lack of information on circulating infectious parasites from wildlife. Therefore, 12 wildlife species were examined on a game ranch were all species were found to be infected by Rhipecephalus spp. Haemoparasite infections were estimated at 7.37% (n = 95) with Babesia spp. detected in bushbuck (Tragelaphus scriptus); Anaplasma marginale in impala (Aepyceros melampus) and puku (Kobus vardonii) for the first time in Zambia. The majority of worm species isolated from bovids were not detected in equids and, vice versa. Our findings intimate ecological and behavioural patterns of some animals as deterministic to exposure. Kafue lechwe (Kobus leche kafuensis) had the widest range of worm species with more infected organs than other animals suggesting their semi aquatic nature contributory to prolonged worm exposure compared to other animals. On the other hand, Kafue lechwe had the least tick infections attributable more to shorter attachment periods as they spend prolonged periods submerged in water. Our findings indicate the vital role that wildlife plays in the epidemiology of parasitic diseases. To reduce the infection burden, control measures should be focused on reducing transmission to highly susceptible animal species as described herein. PMID:22701163

Munang'andu, Hetron Mweemba; Siamudaala, Victor M; Munyeme, Musso; Nalubamba, King Shimumbo

2012-05-31

245

Comparative Intradermal Tuberculin Testing of Free-Ranging African Buffaloes (Syncerus caffer) Captured for Ex Situ Conservation in the Kafue Basin Ecosystem in Zambia  

PubMed Central

Bovine tuberculosis (BTB) is endemic in African buffaloes (Syncerus caffer) in some National Parks in Southern Africa, whilst no studies have been conducted on BTB on buffalo populations in Zambia. The increased demand for ecotourism and conservation of the African buffalo on private owned game ranches has prompted the Zambian Wildlife Authority (ZAWA) and private sector in Zambia to generate a herd of “BTB-free buffaloes” for ex situ conservation. In the present study, 86 African buffaloes from four different herds comprising a total of 530 animals were investigated for the presence of BTB for the purpose of generating “BTB free” buffalo for ex-situ conservation. Using the comparative intradermal tuberculin test (CIDT) the BTB status at both individual animal and herd level was estimated to be 0.0% by the CIDT technique. Compared to Avian reactors only, a prevalence of 5.8% was determined whilst for Bovine-only reactors a prevalence of 0.0% was determined. These results suggest the likelihood of buffalo herds in the Kafue National Park being free of BTB.

Munang'andu, Hetron Mweemba; Siamudaala, Victor; Matandiko, Wigganson; Nambota, Andrew; Muma, John Bwalya; Mweene, Aaron Simanyengwe; Munyeme, Musso

2011-01-01

246

Comparative Intradermal Tuberculin Testing of Free-Ranging African Buffaloes (Syncerus caffer) Captured for Ex Situ Conservation in the Kafue Basin Ecosystem in Zambia.  

PubMed

Bovine tuberculosis (BTB) is endemic in African buffaloes (Syncerus caffer) in some National Parks in Southern Africa, whilst no studies have been conducted on BTB on buffalo populations in Zambia. The increased demand for ecotourism and conservation of the African buffalo on private owned game ranches has prompted the Zambian Wildlife Authority (ZAWA) and private sector in Zambia to generate a herd of "BTB-free buffaloes" for ex situ conservation. In the present study, 86 African buffaloes from four different herds comprising a total of 530 animals were investigated for the presence of BTB for the purpose of generating "BTB free" buffalo for ex-situ conservation. Using the comparative intradermal tuberculin test (CIDT) the BTB status at both individual animal and herd level was estimated to be 0.0% by the CIDT technique. Compared to Avian reactors only, a prevalence of 5.8% was determined whilst for Bovine-only reactors a prevalence of 0.0% was determined. These results suggest the likelihood of buffalo herds in the Kafue National Park being free of BTB. PMID:21776347

Munang'andu, Hetron Mweemba; Siamudaala, Victor; Matandiko, Wigganson; Nambota, Andrew; Muma, John Bwalya; Mweene, Aaron Simanyengwe; Munyeme, Musso

2011-06-16

247

Characterization of the optical properties of biomass burning aerosols in Zambia during the 1997 ZIBBEE field campaign  

NASA Astrophysics Data System (ADS)

The physical and optical properties of biomass burning aerosols in a savanna region in south central Africa (Zambia) were analyzed from measurements made during the Zambian International Biomass Burning Emissions Experiment (ZIBBEE) during August-September 1997. Due to the large spatial extent of African savannas and the high frequency of occurrence of burning in the annual dry seasons, characterization of the optical properties of the resultant biomass burning aerosols is important for the study of atmospheric radiative processes and for remote sensing of both surface and atmospheric properties in these regions. Aerosol Robotic Network Sun-sky radiometer spectral measurements of direct Sun observations and directional sky radiances were utilized to infer spectral aerosol optical depths (?a), aerosol size distributions, and single-scattering albedos. During the primary ZIBBEE study period, which coincided with the peak period of biomass burning in the region, there was a high correlation between the measured ?a and the total column water vapor or precipitable water vapor (PWV), suggesting transport of smoke aerosol from regions with higher PWV. Size distribution retrievals of the biomass burning smoke show that the accumulation mode dominated and a comparison with smoke from Amazonia (Bolivia) shows a shift toward smaller particles for African savanna smoke. This may be the result of differences in mode of combustion (flaming versus smoldering), fuel type and moisture content, and the aging processes of the aerosol. The single-scattering albedo (?0) of the aerosols were retrieved using several approaches, yielding average values of ?0 at ˜550 nm during ZIBBEE varying from ˜0.82 to ˜0.85, thus showing good agreement within the retrieval uncertainty of ˜0.03 of these methods. In general, ?0 was relatively constant as a function of aerosol loading, with very little change occurring for ?a at 440 nm ranging from 0.7 to 1.7. African savanna smoke exhibits significantly higher absorption than smoke from Amazonian forested regions and also a greater rate of decrease of ?0 with increasing wavelength. Variations in the spectral change of the Angström wavelength exponent were also investigated with respect to the degree of aerosol absorption and changes in the accumulation mode size distributions.

Eck, T. F.; Holben, B. N.; Ward, D. E.; Dubovik, O.; Reid, J. S.; Smirnov, A.; Mukelabai, M. M.; Hsu, N. C.; O'Neill, N. T.; Slutsker, I.

2001-02-01

248

Individual and contextual factors influencing patient attrition from antiretroviral therapy care in an urban community of Lusaka, Zambia  

PubMed Central

Introduction Despite the relatively effective roll-out of free life-prolonging antiretroviral therapy (ART) in public sector clinics in Zambia since 2005, and the proven efficacy of ART, some people living with HIV (PLHIV) are abandoning the treatment. Drawing on a wider ethnographic study in a predominantly low-income, high-density residential area of Lusaka, this paper reports the reasons why PLHIV opted to discontinue their HIV treatment. Methods Opened-ended, in-depth interviews were held with PLHIV who had stopped ART (n = 25), ART clinic staff (n = 5), religious leaders (n = 5), herbal medicine providers (n = 5) and lay home-based caregivers (n = 5). In addition, participant observations were conducted in the study setting for 18 months. Interview data were analysed using open coding first, and then interpreted using latent content analysis. The presentation of the results is guided by a social-ecological framework. Findings Patient attrition from ART care is influenced by an interplay of personal, social, health system and structural-level factors. While improved corporeal health, side effects and need for normalcy diminished motivation to continue with treatment, individuals also weighed the social and economic costs of continued uptake of treatment. Long waiting times for medical care and placing “defaulters” on intensive adherence counselling in the context of insecure labour conditions and livelihood constraints not only imposed opportunity costs which patients were not willing to forego, but also forced individuals to balance physical health with social integrity, which sometimes forced them to opt for faith healing and traditional medicine. Conclusions Complex and dynamic interplay of personal, social, health system and structural-level factors coalesces to influence patient attrition from ART care. Consequently, while patient-centred interventions are required, efforts should be made to improve ART care by extending and establishing flexible ART clinic hours, improving patient-provider dialogue about treatment experiences and being mindful of the way intensive adherence counselling is being enforced. In the context of insecure labour conditions and fragile livelihoods, this would enable individuals to more easily balance time for treatment and their livelihoods. As a corollary, the perceived efficacy of alternative treatment and faith healing needs to be challenged through sensitizations targeting patients, religious leaders/faith healers and herbal medicine providers.

Musheke, Maurice; Bond, Virginia; Merten, Sonja

2012-01-01

249

The seven Cs of the high acceptability of home-based VCT: Results from a mixed methods approach in Zambia.  

PubMed

HIV testing and counselling is a critical gateway to prevention and treatment. Yet, coverage remains insufficient, few couples are tested together and gender differences in access exist. We used an embedded mixed methods approach to investigate possible explanations for the high acceptance of home-based voluntary HIV counselling and testing (HB-VCT) in a pair-matched cluster-randomized trial in Zambia. A baseline survey included 1694 individuals in 36 clusters. Adults in 18 intervention clusters were offered HB-VCT by lay counsellors. Standard testing services were available in both trial arms. After the completion of the intervention, a follow-up survey was conducted in all trial clusters. In addition, 21 in-depth interviews and one focus group discussion were conducted with home-based VCT clients in the intervention arm. Informants favoured the convenience, confidentiality and credibility of HB-VCT. Counsellors were perceived as trustworthy owing to their closeness and conduct, and the consent process was experienced as convincing. Couple testing was selected by 70% of cohabiting couples and was experienced as beneficial by both genders. Levels of first-time testing (68% vs. 29%, p < 0.0001) and re-testing (94% vs. 74%, p < 0.0001) were higher in the intervention than in the control arm. Acceptance of HIV testing and counselling is dependent on stigma, trust and gender. The confidentiality of home-based VCT was essential for overcoming stigma-related barriers, and the selection of local counsellors was important to ensure trust in the services. The high level of couple counselling within HB-VCT may contribute to closing the gender gap in HIV testing, and has benefits for both genders and potentially for prevention of HIV transmission. The study demonstrates the feasibility of achieving high test coverage with an opt-in consent approach. The embedded qualitative component confirmed the high satisfaction with HB-VCT reported in the quantitative survey and was crucial to fully understand the intervention and its consequences. PMID:23972555

Jürgensen, Marte; Sandøy, Ingvild F; Michelo, Charles; Fylkesnes, Knut; Mwangala, Sheila; Blystad, Astrid

2013-08-08

250

Effects of river-floodplain exchange on water quality and nutrient export in the dam-impacted Kafue River (Zambia)  

NASA Astrophysics Data System (ADS)

Biogeochemical processes in river-floodplain ecosystems are strongly influenced by hydrology and, in particular, river-floodplain exchange. In tropical systems, where the hydrology is dominated by distinct dry and rainy seasons, annual flood waters trigger organic matter mineralization within and nutrient export from the dried and rewetted floodplain, and the magnitude of hydrological exchange between a river and its floodplain has the potential to substantially influence nutrient and carbon exports and water quality in the river. In this study we examined the extent and the effects of hydrological river-floodplain exchange in the Kafue River and its floodplain, the Kafue Flats, in Zambia. The Kafue Flats is a 7000 km2 seasonal wetland whose hydrological regime has been impacted by upstream and downstream large dams constructed in the 1970s, leading to changes in the flooding pattern in this high-biodiversity ecosystem. Field campaigns, carried out during flood recession (May 2008, 2009, 2010) and covering a ~400 km river stretch, revealed a steep decline in dissolved oxygen from 6 mg/L to 1 mg/L over a ~20 km stretch of river beginning approximately 200 km downstream from the first dam, with low oxygen persisting for an additional 150 km downstream. To further explore this phenomenon discharge measurements (ADCP) were conducted in May 2009 and May 2010. River discharge decreased from ~600 m3/s at the upstream dam to 100 m3/s midway through the Kafue Flats, and increased to >800 m3/s towards the end of the floodplain (400 km downstream). River cross section data indicate that the dramatic decrease in discharge occured primarily because of variations in channel area and channel carrying capacity, with channel constrictions forcing ~85% of the discharge out of the river channel and into the floodplain. Using specific conductivity and ?18O-H2O as tracers for floodplain water, we estimate that the downstream increases in flow occur through lateral inflows of receding floodplain waters, induced by an expansion of the river channel, and that 80% of the downstream flow came from the floodplain. Model calculations indicate that intense exchange between river and floodplain and the introduction of low-oxygen floodplain water into the river was the primary cause of the low dissolved oxygen levels observed in the river during flood recession in May 2008-2010. This exchange also appears to play an important role in nutrient and carbon export, with the floodplain acting as a net source of phosphate (220 tons/yr), total nitrogen (1300 tons/yr, of which ~90% was organic nitrogen) and total organic carbon (50,000 tons/yr) to downstream systems.

Zurbrugg, R.; Wamulume, J.; Blank, N.; Nyambe, I.; Wehrli, B.; Senn, D. B.

2010-12-01

251

Effect of river-floodplain exchange on OC and ON biogeochemistry in a tropical floodplain system (Kafue Flats, Zambia)  

NASA Astrophysics Data System (ADS)

Tropical floodplains are often highly productive ecosystems that produce, transform, and export large quantities of organic C (OC) and N (ON) to downstream systems and oceans. We studied OC and ON dynamics in the Kafue Flats, a 6,500-km2 floodplain system along the Kafue River in Zambia, the hydrology of which is substantially impacted by upstream and downstream dams. The goal of the study was to explore the quality and bioavailability of OC and ON, and how river-floodplain exchange influences both the net export of organic matter (OM) and its composition. We collected samples along a 410 km transect along the Kafue River downstream of Itezhi-Tezhi dam in 2009 and 2010 with a focus on the flood recession period, and determined concentrations and stable isotopes of dissolved and particulate OC (DOC, POC) and ON (DON, PON), as well as spectrofluorometric properties (excitation emission spectroscopy; EEMs) of dissolved OM (DOM). During flood recession, the Kafue Flats and Kafue River undergo intense river floodplain exchange (i.e., >80% of the stream flow passing through the floodplain), and DON and DOC loads increased 2.5-fold along the main river channel. The vast majority of fixed nitrogen was present as in organic form (~94% of the total N including 80% DON and 14% PON). Despite the large contribution of floodplain-derived DOM, measured variables of DOM quality remained relatively constant (DOC:DON ~8; ?15N-DON = +1.5 ± 1.0%) along the river. A modest decrease in the ?13C-DOC (from -22 to -24%) was observed as floodplain-derived DOC became increasingly dominant. EEMs results further suggest that overall DOM composition remained fairly constant along the river despite quantitative injection of floodplain-derived DOM. ?13C-POC, ?15N-PON, and POC:PON (-28.3 ± 0.8%, +2.8 ± 1.2%, and ~20, respectively) differed considerably with respect to the same parameters for DOC and DON, indicating that the particulate and dissolved OM pools derive from very different sources or suggesting fundamental compositional and isotopic changes during initial OM breakdown along the flow path. This presentation will explore potential underlying causes of the fairly constant DOM composition and the distinct DOM and POM pools, and what these observations imply about OM cycling in this system.

Zurbrügg, R.; Suter, S.; Lehmann, M. F.; Wehrli, B.; Senn, D. B.

2011-12-01

252

Hepatic and renal concentrations of copper and other trace elements in hippopotami (Hippopotamus amphibius L) living in and adjacent to the Kafue and Luangwa Rivers in Zambia.  

PubMed

Hepatic and renal concentrations of the elements arsenic, cadmium, cobalt, copper, lead, manganese, mercury, molybdenum, selenium and zinc were studied in samples collected from hippopotami from the Kafue River in the Kafue National Park and the Luangwa River in the Southern Luangwa National Park in Zambia. There were no significant differences between trace element concentrations in the tissues of the hippopotami taken in the Kafue River and the Luangwa River. The concentrations of copper and other essential elements were similar to those reported in normal domestic and wild ruminants. Judging by the results obtained in this study, pollution from the mining activity around the Kafue River drainage area in the Copperbelt region has not led to any accumulation of elements in tissues of the hippopotami in the Kafue National Park. The trace element concentrations observed may serve as reference for similar future studies on hippopotami. PMID:12356167

Mwase, M; Almli, B; Sivertsen, T; Musonda, M M; Flåøyen, A

2002-09-01

253

The (Mis)Reporting of Male Circumcision Status among Men and Women in Zambia and Swaziland: A Randomized Evaluation of Interview Methods  

PubMed Central

Background To date, male circumcision prevalence has been estimated using surveys of men self-reporting their circumcision status. HIV prevention trials and observational studies involving female participants also collect data on partners' circumcision status as a risk factor for HIV/STIs. A number of studies indicate that reports of circumcision status may be inaccurate. This study assessed different methods for improving self- and partner reporting of circumcision status. Methods/Findings The study was conducted in urban and rural Zambia and urban Swaziland. Men (N?=?1264) aged 18–50 and their female partners (N?=?1264), and boys (N?=?840) aged 13–17 were enrolled. Participants were recruited from HIV counseling and testing sites, health centers, and surrounding communities. The study experimentally assessed methods for improving the reporting of circumcision status, including: a) a simple description of circumcision, b) a detailed description of circumcision, c) an illustration of a circumcised and uncircumcised penis, and d) computerized self-interviewing. Self-reports were compared to visual examination. For men, the error in reporting was largely unidirectional: uncircumcised men more often reported they were circumcised (2–7%), depending on setting. Fewer circumcised men misrepresented their status (0.05–5%). Misreporting by women was significantly higher (11–15%), with the error in both directions. A sizable number of women reported that they did not know their partner's circumcision status (3–8%). Computerized interviewing did not improve accuracy. Providing an illustration, particularly for illiterate participants, significantly improved reporting of circumcision status, decreasing misreporting among illiterate participants from 13% to 10%, although misreporting was not eliminated. Conclusions Study results suggest that the prevalence of circumcision may be overestimated in Zambia and Swaziland; the error in reporting is higher among women than among men. Improved reporting when a description or illustration is provided suggests that the source of the error is a lack of understanding of male circumcision.

Hewett, Paul C.; Haberland, Nicole; Apicella, Lou; Mensch, Barbara S.

2012-01-01

254

Relationships between antenatal and postnatal care and post-partum modern contraceptive use: evidence from population surveys in Kenya and Zambia  

PubMed Central

Background It is often assumed, with little supportive, empirical evidence, that women who use maternal health care are more likely than those who do not to use modern contraceptives. This study aims to add to the existing literature on associations between the use of antenatal (ANC) and post-natal care (PNC) and post-partum modern contraceptives. Methods Data come from the most recent Demographic and Health Surveys (DHS) in Kenya (2008–09) and Zambia (2007). Study samples include women who had a live birth within five years before the survey (3,667 in Kenya and 3,587 in Zambia). Multivariate proportional hazard models were used to examine the associations between the intensity of ANC and PNC service use and a woman’s adoption of modern contraceptives after a recent live birth. Results Tests of exogeneity confirmed that the intensity of ANC and PNC service use and post-partum modern contraceptive practice were not influenced by common unobserved factors. Cox proportional hazard models showed significant associations between the service intensity of ANC and PNC and post-partum modern contraceptive use in both countries. This relationship is largely due to ANC services; no significant associations were observed between PNC service intensity and post-partum FP practice. Conclusions While the lack of associations between PNC and post-partum FP use may be due to the limited measure of PNC service intensity, the study highlights a window of opportunity to promote the use of modern contraceptives after childbirth through ANC service delivery. Depending on the availability of data, further research should take into account community- and facility-level factors that may influence modern contraceptive use in examining associations between ANC and PNC use and post-partum FP practice.

2013-01-01

255

The impact of an immunization programme administered through the Growth Monitoring Programme Plus as an alternative way of implementing Integrated Management of Childhood Illnesses in urban-slum areas of Lusaka, Zambia  

Microsoft Academic Search

A time-lag study design was used to examine the effects of an immunization programme implemented through an integrated community-based child health approach called the Growth Monitoring Programme Plus (GMP+) in peri-urban areas of Lusaka, Zambia. The immunization coverage and sociodemographic data of eligible children and households were obtained from three repeated surveys in two intervention areas. Logistic regression analysis was

Kumiko Igarashi; Satoshi Sasaki; Yasuyuki Fujino; Naohito Tanabe; Clara Mbwili Muleya; Bushimbwa Tambatamba; Hiroshi Suzuki

2010-01-01

256

Effect on treatment coverage of adding community-directed treatment to the health facility-based approach of delivering anthelminthic drugs to under-five children during child health week in Mazabuka District, Zambia  

Microsoft Academic Search

The current approach of delivering anthelminthic drugs to children aged 12–59 months through health facilities during child health week (CHW) results in low treatment coverage in certain areas of Zambia. This study was designed to determine the impact on treatment coverage of adding community-directed treatment (ComDT) to the health facility (HF) approach. Treatment coverage was compared in two areas, one

Hikabasa Halwindi; Pascal Magnussen; Dan Meyrowitsch; Ray Handema; Seter Siziya; Annette Olsen

257

Paleomagnetism of the 765 Ma Luakela Volcanics in NW Zambia and Implications for Neoproterozoic Positions of the Congo Craton  

NASA Astrophysics Data System (ADS)

Owing to the scarcity of reliable paleopoles, the Neoproterozoic position of the Congo craton (incorporating the Sao Francisco, Tanzania, and Bangweulu blocks) is very poorly known. We report new paleomagnetic data for the 765 ± 5 Ma Luakela volcanics, a NE-trending belt of basaltic to andesitic flows in NW Zambia (Key et al., 2001, J. Afr. Earth Sci., 33, 503-528). The volcanics are up to 0.8 km thick and occur within a 2 km thick succession of siliciclastic rocks that unconformably overlies Neoarchean and Paleoproterozoic rocks of the Congo craton margin, and is correlated with the Roan and Mwashia Groups of the Katanga Supergroup (Key et al., 2001). The strata are essentially undeformed, and either subhorizontal or dip shallowly to the SE. Although no metamorphic mineral growth is observed in fine-grained sedimentary rocks, alteration has strongly affected plagioclase and pyroxene in the volcanic rocks, and magnetite has been partially altered to hematite (Key et al., 2001). AF and thermal analysis of 65 samples from nine sites isolated three magnetisation components. Component A, carried mainly by SD magnetite, is directed very shallowly to the SE. Component B, carried mainly by hematite, is oriented shallowly SW-up. A low stability component C is directed very steeply downward. Some samples contain only component A, others only component B, and some contain both A and B. Component A is likely to be primary, because it is carried by SD magnetite (which petrography indicates is primary), does not resemble younger magnetisations from the Congo craton, and because the rocks have not been thermally metamorphosed. Component B, carried by hematite, we consider to be an overprint, possibly acquired during Pan-African deformation in the Lufilian Arc. Component C is similar to Permo-Carboniferous paleodirections from the region, and may have been acquired at that time. Paleopoles for components A and B (LVA and LVB) are about 90° apart, and similar to those from the Tanzania block. LVA coincides with a reliable pole for the Mbozi complex (Meert et al., 1995, Precamb. Res., 69, 113-131), for which several K-Ar results are within uncertainty of a U-Pb age of 748 ± 6 Ma (Mbede et al., 2004, ICESA Conf: The East African Rift, Addis Ababa, PDF abst.). The LVA and Mbozi poles place Congo at the equator at 765-750 Ma. LVB falls within uncertainty of a pole for the Gagwe lavas (Meert et al., 1995), which have an Ar-Ar cooling age of 795 ± 7 Ma (Deblond et al., 2001, J. Afr. Earth Sci., 32, 435-449). LVB cannot be older than 765 Ma, however. If the Tanzania block has not moved significantly relative to the Congo craton since at least 800 Ma, either the 795 Ma age is incorrect, or the Gagwe pole represents a younger overprint. The latter possibly implies that models which invoke a 90° CCW rotation of Congo between 800 and 750 Ma are no longer supported. Instead, the Congo craton rotated in the opposite direction between 750 Ma and the time of component B acquisition. The Luakela volcanics are overlain by 200 m of siltstones, followed by an unknown thickness of poorly-exposed diamictite, correlated with the `Grand Conglomerat', a widespread glaciogenic unit of Sturtian age at the base of the Kundelungu Group. The diamictite is younger than the 765 Ma volcanics, and older than volcanic pods, dated at 735 Ma, in contact with the diamictite (Key et al., 2001). The Congo craton occupied equatorial latitudes at 765-750 Ma, suggesting that the diamictite, the `Grand Conglomerat', and other Sturtian glaciogenic rocks in the Congo craton, represent a low-latitude glaciation.

Wingate, M. T.; Pisarevsky, S. A.; de Waele, B.

2004-12-01

258

The Influence of Distance and Level of Care on Delivery Place in Rural Zambia: A Study of Linked National Data in a Geographic Information System  

PubMed Central

Background Maternal and perinatal mortality could be reduced if all women delivered in settings where skilled attendants could provide emergency obstetric care (EmOC) if complications arise. Research on determinants of skilled attendance at delivery has focussed on household and individual factors, neglecting the influence of the health service environment, in part due to a lack of suitable data. The aim of this study was to quantify the effects of distance to care and level of care on women's use of health facilities for delivery in rural Zambia, and to compare their population impact to that of other important determinants. Methods and Findings Using a geographic information system (GIS), we linked national household data from the Zambian Demographic and Health Survey 2007 with national facility data from the Zambian Health Facility Census 2005 and calculated straight-line distances. Health facilities were classified by whether they provided comprehensive EmOC (CEmOC), basic EmOC (BEmOC), or limited or substandard services. Multivariable multilevel logistic regression analyses were performed to investigate the influence of distance to care and level of care on place of delivery (facility or home) for 3,682 rural births, controlling for a wide range of confounders. Only a third of rural Zambian births occurred at a health facility, and half of all births were to mothers living more than 25 km from a facility of BEmOC standard or better. As distance to the closest health facility doubled, the odds of facility delivery decreased by 29% (95% CI, 14%–40%). Independently, each step increase in level of care led to 26% higher odds of facility delivery (95% CI, 7%–48%). The population impact of poor geographic access to EmOC was at least of similar magnitude as that of low maternal education, household poverty, or lack of female autonomy. Conclusions Lack of geographic access to emergency obstetric care is a key factor explaining why most rural deliveries in Zambia still occur at home without skilled care. Addressing geographic and quality barriers is crucial to increase service use and to lower maternal and perinatal mortality. Linking datasets using GIS has great potential for future research and can help overcome the neglect of health system factors in research and policy. Please see later in the article for the Editors' Summary

Gabrysch, Sabine; Cousens, Simon; Cox, Jonathan; Campbell, Oona M. R.

2011-01-01

259

Taking ART to Scale: Determinants of the Cost and Cost-Effectiveness of Antiretroviral Therapy in 45 Clinical Sites in Zambia  

PubMed Central

Background We estimated the unit costs and cost-effectiveness of a government ART program in 45 sites in Zambia supported by the Centre for Infectious Disease Research Zambia (CIDRZ). Methods We estimated per person-year costs at the facility level, and support costs incurred above the facility level and used multiple regression to estimate variation in these costs. To estimate ART effectiveness, we compared mortality in this Zambian population to that of a cohort of rural Ugandan HIV patients receiving co-trimoxazole (CTX) prophylaxis. We used micro-costing techniques to estimate incremental unit costs, and calculated cost-effectiveness ratios with a computer model which projected results to 10 years. Results The program cost $69.7 million for 125,436 person-years of ART, or $556 per ART-year. Compared to CTX prophylaxis alone, the program averted 33.3 deaths or 244.5 disability adjusted life-years (DALYs) per 100 person-years of ART. In the base-case analysis, the net cost per DALY averted was $833 compared to CTX alone. More than two-thirds of the variation in average incremental total and on-site cost per patient-year of treatment is explained by eight determinants, including the complexity of the patient-case load, the degree of adherence among the patients, and institutional characteristics including, experience, scale, scope, setting and sector. Conclusions and Significance The 45 sites exhibited substantial variation in unit costs and cost-effectiveness and are in the mid-range of cost-effectiveness when compared to other ART programs studied in southern Africa. Early treatment initiation, large scale, and hospital setting, are associated with statistically significantly lower costs, while others (rural location, private sector) are associated with shifting cost from on- to off-site. This study shows that ART programs can be significantly less costly or more cost-effective when they exploit economies of scale and scope, and initiate patients at higher CD4 counts.

Marseille, Elliot; Giganti, Mark J.; Mwango, Albert; Chisembele-Taylor, Angela; Mulenga, Lloyd; Over, Mead; Kahn, James G.; Stringer, Jeffrey S. A.

2012-01-01

260

Uptake, Outcomes, and Costs of Antenatal, Well-Baby, and Prevention of Mother-to-Child Transmission of HIV Services under Routine Care Conditions in Zambia  

PubMed Central

Background Zambia adopted Option A for prevention of mother-to-child transmission of HIV (PMTCT) in 2010 and announced a move to Option B+ in 2013. We evaluated the uptake, outcomes, and costs of antenatal, well-baby, and PMTCT services under routine care conditions in Zambia after the adoption of Option A. Methods We enrolled 99 HIV-infected/HIV-exposed (index) mother/baby pairs with a first antenatal visit in April-September 2011 at four study sites and 99 HIV-uninfected/HIV-unexposed (comparison) mother/baby pairs matched on site, gestational age, and calendar month at first visit. Data on patient outcomes and resources utilized from the first antenatal visit through six months postpartum were extracted from site registers. Costs in 2011 USD were estimated from the provider’s perspective. Results Index mothers presented for antenatal care at a mean 23.6 weeks gestation; 55% were considered to have initiated triple-drug antiretroviral therapy (ART) based on information recorded in site registers. Six months postpartum, 62% of index and 30% of comparison mother/baby pairs were retained in care; 67% of index babies retained had an unknown HIV status. Comparison and index mother/baby pairs utilized fewer resources than under fully guideline-concordant care; index babies utilized more well-baby resources than comparison babies. The average cost per comparison pair retained in care six months postpartum was $52 for antenatal and well-baby services. The average cost per index pair retained was $88 for antenatal, well-baby, and PMTCT services and increased to $185 when costs of triple-drug ART services were included. Conclusions HIV-infected mothers present to care late in pregnancy and many are lost to follow up by six months postpartum. HIV-exposed babies are more likely to remain in care and receive non-HIV, well-baby care than HIV-unexposed babies. Improving retention in care, guideline concordance, and moving to Option B+ will result in increased service delivery costs in the short term.

Scott, Callie A.; Iyer, Hari S.; Lembela Bwalya, Deophine; Bweupe, Maximillian; Rosen, Sydney B.; Scott, Nancy; Larson, Bruce A.

2013-01-01

261

Trematode infections in freshwater snails and cattle from the Kafue wetlands of Zambia during a period of highest cattle-water contact.  

PubMed

A total of 984 snails, comprising nine species, were collected from six areas in the Kafue wetlands between August and October 2003 to assess larval trematode infections. Of these, 135 (13.7%) were positive. Most trematode infections were recorded from Lymnaea natalensis (42.8%), which harboured four of the five morphologically different cercariae found. No trematodes were recovered from Bellamya capillata, Biomphalaria pfeifferi, Melanoides tuberculata, Physa acuta and Cleopatra nswendweensis. One snail (0.2%) of 416 Bulinus snails shed brevifurcate-apharyngeate distome cercariae while three (0.7%) shed amphistomes. Gymnocephalous and longifurcate-pharyngeate distome were the commonest types of cercariae recorded while xiphidiocercaria was the least common. The highest prevalence rates of F. gigantica (68.8%) and amphistomes (50.0%) in cattle (n = 101) were in Chiyasa while those in Kaleya had the lowest (9.1 and 18.2%, respectively). In most habitats, infections were recorded in both cattle and snails. Critical determinants of infection may have been the distance of settlements and/or cattle kraals, the number of animals in nearby homesteads and the presence of susceptible host snails. This study suggests that fascioliasis and amphistomiasis could be major constraints of cattle production in the Kafue wetlands because favourable factors were available to introduce and maintain the infections. It further provides a starting point for some comprehensive studies on snail-related aspects of transmission and snail host ecology in Zambia. PMID:17381873

Phiri, A M; Phiri, I K; Chota, A; Monrad, J

2007-03-01

262

Drinking Water Quality, Feeding Practices, and Diarrhea among Children under 2 Years of HIV-Positive Mothers in Peri-Urban Zambia  

PubMed Central

In low-income settings, human immunodeficiency virus (HIV)-positive mothers must choose between breastfeeding their infants and risking transmission of HIV or replacement feeding their infants and risking diarrheal disease from contaminated water. We conducted a cross-sectional study of children < 2 years of age of 254 HIV-positive mothers in peri-urban Zambia to assess their exposure to waterborne fecal contamination. Fecal indicators were found in 70% of household drinking water samples. In a multivariable analysis, factors associated with diarrhea prevalence in children < 2 years were mother having diarrhea (adjusted odds ratio [aOR] = 5.18, 95% confidence interval [CI] = 1.65–16.28), child given water in the past 2 days (aOR = 4.08, 95% CI = 1.07–15.52), child never being breastfed (aOR = 2.67, 95% CI = 1.06–6.72), and rainy (versus dry) season (aOR = 4.60, 95% CI = 1.29–16.42). Children born to HIV-positive mothers were exposed to contaminated water through direct intake of drinking water, indicating the need for interventions to ensure microbiological water quality.

Peletz, Rachel; Simuyandi, Michelo; Sarenje, Kelvin; Baisley, Kathy; Kelly, Paul; Filteau, Suzanne; Clasen, Thomas

2011-01-01

263

Moving beyond the "male perpetrator, female victim" discourse in addressing sex and relationships for HIV prevention: peer research in Eastern Zambia.  

PubMed

Despite the resources put into HIV education programmes with young people in sub-Saharan Africa in the past two decades, there is little clear evidence of impact. Many programmes continue to be oriented towards individual behaviour change (and in reality, often sexual abstinence) with insufficient focus on understanding how societies constrain or enable individual agency in sexual decision-making and how this is affected by social norms. If education programmes do address gender they often reinforce a "male perpetrator, female victim" discourse, where girls and women are held responsible for boys' and men's sexuality as well as their own. This paper discusses the discourses around gender, sexuality and HIV constructed by young women and men (aged 16-29) in a rural Eastern Zambia village. Data on young women's and men's narratives were gathered using a participatory peer approach. Research uncovered numerous and sometimes conflicting discourses (cultural, moral, economic, and sexual) influencing young women's and men's thinking about sexuality and sexual behaviour, in particular the limited possibilities for safe consensual sex, and thus their vulnerability to HIV. The research suggests that the realities young people face are much more complex than HIV prevention strategies address. We recommend a more nuanced approach, tailored to the community contexts involved. PMID:23684205

Heslop, Jo; Banda, Rabecca

2013-05-01

264

Nutritional evaluation of Zambia indigenous soy bean (Glycine max) and sunflower (Helianthus annus) as protein sources in poultry and pigs diets.  

PubMed

Two trials were carried out to compare the nutritional values of two Zambian indigenous plant protein sources--soy bean cake (SBC) and sunflower meal (SFM) in the diets of broilers and growing pigs. In trial 1, 120 one week old chickens (Abbor acre strain) were used. There were no differences (P > 0.05) between chickens on SBC and SFM in voluntary feed intake. Average daily gain of SBC chickens differed (P < 0.05) from those of SFM. The protein source had an effect (P < 0.05) on N retained [g/day]. Carcasses dry matter and crude protein were higher (P < 0.05) in SBC chickens, but ash, ether extract, Ca and P were the same as SFM. In trial 2, 12 Large white x Landrace growing barrows 1-2 months old were used. In this trial, SBC diet was consumed more than SFM. Pigs on SBC and SFM gained 0.526 and 0.284 g/head/day, respectively (P < 0.05). Nutrient digestibility was higher (P < 0.05) in SBC diet. Trial 1, demonstrated that SBC and SFM could be used for broilers without adverse effect on growth rate and body conformation. However, for growing pigs SBC is a better protein source than SFM in the tropical environment of Zambia. Finally, results obtained seem to suggest that SBC and SFM can be used as plant protein sources, but SFM is not an ideal plant protein source for growing pigs. PMID:9829266

Aregheore, E M

1998-10-01

265

A case-control study of stillbirths at a teaching hospital in Zambia, 1979-80: serological investigations for selected infectious agents  

PubMed Central

Sera were obtained from 266 mothers of singleton stillborn babies (cases) and 266 mothers of live-born babies (controls), matched for parity, who delivered at the University Teaching Hospital, Lusaka, Zambia, between October 1979 and April 1980. Tests were performed on 262 samples from cases and 261 from controls. The microhaemagglutination assay for Treponema pallidum (MHA-TP) was reactive in 54% of cases and 29% of controls; the rapid plasma reagin (RPR) 18-mm circle card test was reactive at a dilution of 1:16 or greater in 29% of cases and in 3.5% of controls. Both these differences are highly significant. Sera from cases and controls were further examined for evidence of cytomegalovirus, human (alpha) herpesvirus, hepatitis B virus, toxoplasma, and plasmodium infections. The only difference between sera from cases and controls was that cytomegalovirus antibody titres ? 1:1024 occurred more often among cases. There was no relationship between antibody titre and birth weight. The results of this study emphasize the importance of screening pregnant women for syphilis. Treatment of those found to be infected should help prevent stillbirths due to syphilis.

Watts, Theresa E.; Larsen, Sandra A.; Brown, Stuart T.

1984-01-01

266

River-floodplain exchange and its effects on the fluvial oxygen regime in a large tropical river system (Kafue Flats, Zambia)  

NASA Astrophysics Data System (ADS)

Hydrological exchange between a river and its floodplain plays a critical role in maintaining key ecosystem services like habitat formation, nutrient transformation, and flood attenuation. We studied the spatial and temporal patterns of river-floodplain exchange in the Kafue Flats, a 6500-km2, dam-impacted floodplain ecosystem in Zambia. In addition, we characterized the effects of floodplain runoff on river biogeochemistry and assessed dam-related changes in the hydrological regime. The basic flood pulse concept poorly describes conditions in the Kafue Flats. Instead, high resolution measurements of discharge and tracers (specific conductivity,?18O-H2O) along 410 km of river revealed substantial spatial variations in both the magnitude and direction of river-floodplain exchange. During peak discharge, a river channel constriction, 230 km into the floodplain, diverted as much as 80% of the river's ˜700 m3 s-1discharge into the floodplain. As a net result, >80% of the water exiting the Kafue Flats via the river, either passed through the floodplain or originated from precipitation on the floodplain. This floodplain-derived water had a strong impact on river water quality, resulting in a seasonally recurring sharp decline in dissolved oxygen levels to <50?M that persisted for 150 km downstream. A comparison with historical flow data showed that concurrent bank overflow and floodplain inflows were a sustained pattern during the wet season. However, lateral exchange over an annual cycle has been reduced by as much as 50% due to dam operation.

Zurbrügg, Roland; Wamulume, Jason; Kamanga, Romas; Wehrli, Bernhard; Senn, David B.

2012-09-01

267

Metal and metalloid levels and bio-accumulation characteristics in soil, sediment, land plants and hippopotami (Hippopotamus amphibius L) from the South Luangwa National Park, Zambia.  

PubMed

Hippopotami (Hippopotamus amphibius L) are large semi-aquatic mammals that can be exposed to metals and metalloid from both terrestrial and aquatic environments. Therefore, knowledge of metal and metalloid accumulation characteristics in hippopotami living in the national park is important from ecotoxicological point of view. Levels of toxic metals (Cd, Pb and Hg) and metalloid (As) in hippopotami liver from the South Luangwa National Park in Zambia were far lower compared to the established values of toxic levels in cattle. No temporal variations of metal levels in hippopotami were observed, probably because of good management condition and the lack of anthropogenic activities around the national park. However, hippopotami liver accumulated significantly higher concentrations of Hg compared to soil, sediment and their food (plants), most likely due to a process of biomagnification throughout a trophic chain. Moreover, hippopotami liver and land plants showed significantly higher Cd levels than those of soil. These results strongly suggest that hippopotami liver accumulate higher levels of these metals if surrounding environment is contaminated. Levels of Cr and Ni in hippopotami liver were higher compared to other toxic metals. Since this is the first report to show the Cr and Ni levels and bio-accumulation characteristics of Hg and Cd in hippopotami, we concluded that continuous monitoring and evaluation of toxic effects of these metals on hippopotami should be conducted. PMID:22521811

Nakayama, Shouta M M; Ikenaka, Yoshinori; Muzandu, Kaampwe; Choongo, Kennedy; M'kandawire, Ethel; Yasuda, Jun; Ishizuka, Mayumi

2012-04-20

268

Helminth parasites of the Kafue lechwe antelope ( Kobus leche kafuensis): a potential source of infection to domestic animals in the Kafue wetlands of Zambia.  

PubMed

The Kafue lechwe antelope (Kobus leche kafuensis), a medium-sized, semi-aquatic antelope, grazes extensively on pastures accessed by livestock in and around Lochinvar and Blue Lagoon national parks in the Kafue wetlands of Zambia. This interaction has a potential for bi-modal transmission of a wide range of parasitic helminths between lechwe and domestic ruminants. A survey was conducted to investigate the status of helminths in the Kafue lechwe during the 2008 (July-December) hunting season, involving 65 animals hunted under special research licences. Worm identification was based on morphological features using standard identification keys. Eleven different types of helminths were identified in the animals studied; namely, Oesophagostomum, Bunostomum, Cooperia, Dictyocaulus, Marshallagia, Stilesia, Setaria, Trichuris, Fasciola, amphistomes and Schistosoma. Amphistomes (100%) and Oesophagostomum (60.9%) were the most common while Fasciola (7.8%) and Stilesia (1.6%) were the least of the identified helminths. There was no evidence that helminths, at intensities observed, adversely affected the health of the lechwe. The degree of worm infection was observed to vary between the two study areas, with Blue Lagoon recording higher infection levels compared to Lochinvar. The host range of many of the helminths found in the Kafue lechwe is broad and could serve as a potentially stable source of infection to domestic animals such as goats and cattle. Therefore, issues concerning livestock management and conservation may arise. PMID:20388247

Phiri, A M; Chota, A; Muma, J B; Munyeme, M; Sikasunge, C S

2010-04-14

269

Tuberculosis in Kafue lechwe (Kobus leche kafuensis) and in a bushbuck (Tragelaphus scriptus) on a game ranch in central province, Zambia.  

PubMed

Mycobacteriosis was diagnosed for the first time outside a national park in free-ranging wild animals on a game ranch in Zambia. A Kafue lechwe (Kobus leche kafuensis) was found dead with tuberculous lesions on a ranch near Lusaka. Acid-fast bacilli were found in the affected organs. Mycobacteria were isolated from these tissues. A bushbuck (Tragelaphus scriptus) was found dead on the same ranch with multiple superficial abscesses in the neck region, extensive granulomatous lesions in the lung, the bronchial and mediastinal lymph nodes and several nodular lesions in the spleen. Few acid-fast bacilli were found in the exudate from the abscesses and lesions in the affected organs. Histologically the lesions resembled those of tuberculosis, but mycobacteria could not be isolated. In addition, 1 Kafue lechwe among 37 wild ungulates of 13 species shot on the ranch showed typical tuberculous lesions in the lungs, but the diagnosis was not confirmed by bacterial isolation. The role of the Kafue lechwe as maintenance host for tuberculosis as well as in the possible spread of this disease to other wildlife are discussed. PMID:9850514

Zieger, U; Pandey, G S; Kriek, N P; Cauldwell, A E

1998-09-01

270

Prevalence of bovine tuberculosis and animal level risk factors for indigenous cattle under different grazing strategies in the livestock/wildlife interface areas of Zambia.  

PubMed

A cross-sectional study was conducted to investigate the prevalence and animal level risk factors for bovine tuberculosis (BTB) in indigenous cattle of the livestock/wildlife interface areas in Zambia. A total of 944 cattle from 111 herds were investigated. The comparative intradermal tuberculin test (CIDT) was used to identify reactor animals for BTB. Animal level data on sex, age, parity and body condition score were registered. The overall animal prevalence of BTB as determined by the CIDT was 6.8% (95% CI: 4.2, 9.5%). In Lochinvar and Blue Lagoon areas, animal level prevalence were observed at 5.2% (95% CI: 2.2, 8.2%) and 9.6% (95% CI: 6.1, 13.2%), respectively. Kazungula, an area outside the livestock/wildlife interface, had a prevalence of only 0.8% (95% CI: 0.0, 2.3%). The age of the animal, its body condition score and the type of management system, were predictive of its BTB status. The study revealed that BTB was relatively high in the livestock/wildlife interface areas of Lochinvar and Blue Lagoon compared to Kazungula. These findings should raise a serious public health concern considering the extent to which the communities of the study areas are in contact with their animals and the levels at which they use untreated milk. PMID:18536998

Munyeme, M; Muma, J B; Samui, K L; Skjerve, E; Nambota, A M; Phiri, I G K; Rigouts, L; Tryland, M

2008-06-08

271

Mortality and virologic outcomes following access to antiretroviral therapy among a cohort of HIV-infected women who received single-dose nevirapine in Lusaka, Zambia  

PubMed Central

Objectives Single-dose nevirapine (SDNVP) for prevention of mother-to-child HIV transmission selects mutations conferring resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy. We investigated mortality and virologic and clinical outcomes following introduction of antiretroviral treatment (ART) among a cohort of women given SDNVP. Methods When ART programs were introduced in 2004 in Lusaka, Zambia, we were completing a trial of infant feeding which involved following HIV-infected women who received SDNVP between 2001 and 2005. Women still in follow-up or who could be contacted were evaluated for eligibility for ART (CD4 count <200 or <350 and WHO stage ? 3) and started on NNRTI-based therapy if eligible. We compared mortality in the cohort of women before and after ART access, and examined, among women initiating ART, whether virologic response was better allowing a longer time to elapse between SDNVP and treatment initiation. Results In the cohort of 872 women, mortality more than halved after ART became available (relative hazard [RH] = 0.46 95% CI: 0.23–0.91 p=0.03). Of 161 SDNVP-exposed women followed on NNRTI-based ART, 70.8% suppressed (viral load <400 copies/ml). Only 3/8 (37.5%) women SDNVP-exposed <6 months of starting therapy suppressed compared to 13/22 (59.1%) who started 6–12 months, 44/61 (72.1 %) 12–24 months, and 54/70 (77.1%) >24 months post-exposure (chi-square trend p=0.01). Conclusions Most SDNVP-exposed women respond well to NNRTI-based therapy but there was an attenuation of therapy efficacy that persisted to 12 months after exposure. Women should be screened for ART eligibility during pregnancy and started on effective regimens before delivery.

Kuhn, Louise; Semrau, Katherine; Ramachandran, Shobana; Sinkala, Moses; Scott, Nancy; Kasonde, Prisca; Mwiya, Mwiya; Kankasa, Chipepo; Decker, Don; Thea, Donald M.; Aldrovandi, Grace M.

2009-01-01

272

Effects of home-based voluntary counselling and testing on HIV-related stigma: findings from a cluster-randomized trial in Zambia.  

PubMed

HIV-related stigma continues to be a prominent barrier to testing, treatment and care. However, few studies have investigated changes in stigma over time and the factors contributing to these changes, and there is no evidence of the impact of HIV testing and counselling on stigma. This study was nested within a pair-matched cluster-randomized trial on the acceptance of home-based voluntary HIV counselling and testing conducted in a rural district in Zambia between 2009 and 2011, and investigated changes in stigma over time and the impact of HIV testing and counselling on stigma. Data from a baseline survey (n = 1500) and a follow-up survey (n = 1107) were used to evaluate changes in stigma. There was an overall reduction of seven per cent in stigma from baseline to follow-up. This was mainly due to a reduction in individual stigmatizing attitudes but not in perceived stigma. The reduction did not differ between the trial arms (? = -0.22, p = 0.423). Being tested for HIV was associated with a reduction in stigma (? = -0.57, p = 0.030), and there was a trend towards home-based Voluntary Counselling and Testing having a larger impact on stigma than other testing approaches (? = -0.78, p = 0.080 vs. ? = -0.37, p = 0.551), possibly explained by a strong focus on counselling and the safe environment of the home. The reduction observed in both arms may give reason to be optimistic as it may have consequences for disclosure, treatment access and adherence. Yet, the change in stigma may have been affected by social desirability bias, as extensive community mobilization was carried out in both arms. The study underscores the challenges in measuring and monitoring HIV-related stigma. Adjustment for social desirability bias and inclusion of qualitative methods are recommended for further studies on the impact of HIV testing on stigma. PMID:23422056

Jürgensen, Marte; Sandøy, Ingvild Fossgard; Michelo, Charles; Fylkesnes, Knut

2013-01-22

273

Utilization of Cervical Cancer Screening Services and Trends in Screening Positivity Rates in a 'Screen-And-Treat' Program Integrated with HIV/AIDS Care in Zambia  

PubMed Central

Background In the absence of stand-alone infrastructures for delivering cervical cancer screening services, efforts are underway in sub-Saharan Africa to dovetail screening with ongoing vertical health initiatives like HIV/AIDS care programs. Yet, evidence demonstrating the utilization of cervical cancer prevention services in such integrated programs by women of the general population is lacking. Methods We analyzed program operations data from the Cervical Cancer Prevention Program in Zambia (CCPPZ), the largest public sector programs of its kind in sub-Saharan Africa. We evaluated patterns of utilization of screening services by HIV serostatus, examined contemporaneous trends in screening outcomes, and used multivariable modeling to identify factors associated with screening test positivity. Results Between January 2006 and April 2011, CCPPZ services were utilized by 56,247 women who underwent cervical cancer screening with visual inspection with acetic acid (VIA), aided by digital cervicography. The proportion of women accessing these services who were HIV-seropositive declined from 54% to 23% between 2006–2010, which coincided with increasing proportions of HIV-seronegative women (from 22% to 38%) and women whose HIV serostatus was unknown (from 24% to 39%) (all p-for trend<0.001). The rates of VIA screening positivity declined from 47% to 17% during the same period (p-for trend <0.001), and this decline was consistent across all HIV serostatus categories. After adjusting for demographic and sexual/reproductive factors, HIV-seropositive women were more than twice as likely (Odds ratio 2.62, 95% CI 2.49, 2.76) to screen VIA-positive than HIV-seronegative women. Conclusions This is the first ‘real world’ demonstration in a public sector implementation program in a sub-Saharan African setting that with successful program scale-up efforts, nurse-led cervical cancer screening programs targeting women with HIV can expand and serve all women, regardless of HIV serostatus. Screening program performance can improve with adequate emphasis on training, quality control, and telemedicine-support for nurse-providers in clinical decision making.

Kapambwe, Sharon; Shepherd, Bryan E.; Chibwesha, Carla; Pfaendler, Krista S.; Mkumba, Gracilia; Vwalika, Belington; Hicks, Michael L.; Vermund, Sten H.; Stringer, Jeffrey SA.; Parham, Groesbeck P.

2013-01-01

274

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia  

PubMed Central

Background Unsafe drinking water presents a particular threat to people living with HIV/AIDS (PLHIV) due to the increased risk of opportunistic infections, diarrhea-associated malabsorption of essential nutrients, and increased exposure to untreated water for children of HIV-positive mothers who use replacement feeding to reduce the risk of HIV transmission. This population may particularly benefit from an intervention to improve water quality in the home. Methods and Findings We conducted a 12-month randomized, controlled field trial in Zambia among 120 households with children <2 years (100 with HIV-positive mothers and 20 with HIV-negative mothers to reduce stigma of participation) to assess a high-performance water filter and jerry cans for safe storage. Households were followed up monthly to assess use, drinking water quality (thermotolerant coliforms (TTC), an indicator of fecal contamination) and reported diarrhea (7-day recall) among children <2 years and all members of the household. Because previous attempts to blind the filter have been unsuccessful, we also assessed weight-for-age Z-scores (WAZ) as an objective measure of diarrhea impact. Filter use was high, with 96% (596/620) of household visits meeting the criteria for users. The quality of water stored in intervention households was significantly better than in control households (3 vs. 181 TTC/100 mL, respectively, p<0.001). The intervention was associated with reductions in the longitudinal prevalence of reported diarrhea of 53% among children <2 years (LPR?=?0.47, 95% CI: 0.30–0.73, p?=?0.001) and 54% among all household members (LPR?=?0.46, 95% CI: 0.30–0.70, p<0.001). While reduced WAZ was associated with reported diarrhea (?0.26; 95% CI: ?0.37 to ?0.14, p<0.001), there was no difference in WAZ between intervention and control groups. Conclusion In this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was highly effective in improving drinking water quality, and was protective against diarrhea. Trial Registration Clinicaltrials.gov NCT01116908

Peletz, Rachel; Simunyama, Martin; Sarenje, Kelvin; Baisley, Kathy; Filteau, Suzanne; Kelly, Paul; Clasen, Thomas

2012-01-01

275

Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia  

PubMed Central

Background Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms. Methods Qualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies. Results Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection. Conclusions Patient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals.

2011-01-01

276

Finding parasites and finding challenges: improved diagnostic access and trends in reported malaria and anti-malarial drug use in Livingstone district, Zambia  

PubMed Central

Background Understanding the impact of malaria rapid diagnostic test (RDT) use on management of acute febrile disease at a community level, and on the consumption of anti-malarial medicines, is critical to the planning and success of scale-up to universal parasite-based diagnosis by health systems in malaria-endemic countries. Methods A retrospective study of district-wide community-level RDT introduction was conducted in Livingstone District, Zambia, to assess the impact of this programmed on malaria reporting, incidence of mortality and on district anti-malarial consumption. Results Reported malaria declined from 12,186 cases in the quarter prior to RDT introduction in 2007 to an average of 12.25 confirmed and 294 unconfirmed malaria cases per quarter over the year to September 2009. Reported malaria-like fever also declined, with only 4,381 RDTs being consumed per quarter over the same year. Reported malaria mortality declined to zero in the year to September 2009, and all-cause mortality declined. Consumption of artemisinin-based combination therapy (ACT) dropped dramatically, but remained above reported malaria, declining from 12,550 courses dispensed by the district office in the quarter prior to RDT implementation to an average of 822 per quarter over the last year. Quinine consumption in health centres also declined, with the district office ceasing to supply due to low usage, but requests for sulphadoxine-pyrimethamine (SP) rose to well above previous levels, suggesting substitution of ACT with this drug in RDT-negative cases. Conclusions RDT introduction led to a large decline in reported malaria cases and in ACT consumption in Livingstone district. Reported malaria mortality declined to zero, indicating safety of the new diagnostic regime, although adherence and/or use of RDTs was still incomplete. However, a deficiency is apparent in management of non-malarial fever, with inappropriate use of a low-cost single dose drug, SP, replacing ACT. While large gains have been achieved, the full potential of RDTs will only be realized when strategies can be put in place to better manage RDT-negative cases.

2012-01-01

277

Couple experiences of provider-initiated couple HIV testing in an antenatal clinic in Lusaka, Zambia: lessons for policy and practice  

PubMed Central

Background Couple HIV testing has been recognized as critical to increase uptake of HIV testing, facilitate disclosure of HIV status to marital partner, improve access to treatment, care and support, and promote safe sex. The Zambia national protocol on integrated prevention of mother-to-child transmission of HIV (PMTCT) allows for the provision of couple testing in antenatal clinics. This paper examines couple experiences of provider-initiated couple HIV testing at a public antenatal clinic and discusses policy and practical lessons. Methods Using a narrative approach, open-ended in-depth interviews were held with couples (n?=?10) who underwent couple HIV testing; women (n?=?5) and men (n?=?2) who had undergone couple HIV testing but were later abandoned by their spouses; and key informant interviews with lay counsellors (n?=?5) and nurses (n?=?2). On-site observations were also conducted at the antenatal clinic and HIV support group meetings. Data collection was conducted between March 2010 and September 2011. Data was organised and managed using Atlas ti, and analysed and interpreted thematically using content analysis approach. Results Health workers sometimes used coercive and subtle strategies to enlist women’s spouses for couple HIV testing resulting in some men feeling ‘trapped’ or ‘forced’ to test as part of their paternal responsibility. Couple testing had some positive outcomes, notably disclosure of HIV status to marital partner, renewed commitment to marital relationship, uptake of and adherence to treatment and formation of new social networks. However, there were also negative repercussions including abandonment, verbal abuse and cessation of sexual relations. Its promotion also did not always lead to safe sex as this was undermined by gendered power relationships and the desires for procreation and sexual intimacy. Conclusions Couple HIV testing provides enormous bio-medical and social benefits and should be encouraged. However, testing strategies need to be non-coercive. Providers of couple HIV testing also need to be mindful of the intimate context of partner relationships including couples’ childbearing aspirations and lived experiences. There is also need to make antenatal clinics more male-friendly and responsive to men’s health needs, as well as being attentive and responsive to gender inequality during couselling sessions.

2013-01-01

278

Temporal and spatial patterns of serologic responses to Plasmodium falciparum antigens in a region of declining malaria transmission in southern Zambia  

PubMed Central

Background Critical to sustaining progress in malaria control is comprehensive surveillance to identify outbreaks and prevent resurgence. Serologic responses to Plasmodium falciparum antigens can serve as a marker of recent transmission and serosurveillance may be feasible on a large scale. Methods Satellite images were used to construct a sampling frame for the random selection of households enrolled in prospective longitudinal and cross-sectional surveys in two study areas in Southern Province, Zambia, one in 2007 and the other in 2008 and 2009. Blood was collected and stored as dried spots from participating household members. A malaria rapid diagnostic test (RDT) was used to diagnose malaria. An enzyme immunoassay (EIA) was used to detect IgG antibodies to asexual stage P. falciparum whole parasite lysate using serum eluted from dried blood spots. The expected mean annual increase in optical density (OD) value for individuals with a documented prior history of recent malaria was determined using mixed models. SatScan was used to determine the spatial clustering of households with individuals with serological evidence of recent malaria, and these households were plotted on a malaria risk map. Results RDT positivity differed markedly between the study areas and years: 28% of participants for whom serologic data were available were RDT positive in the 2007 study area, compared to 8.1% and 1.4% in the 2008 and 2009 study area, respectively. Baseline antibody levels were measured in 234 participants between April and July 2007, 435 participants between February and December 2008, and 855 participants between January and December 2009. As expected, the proportion of seropositive individuals increased with age in each year. In a subset of participants followed longitudinally, RDT positivity at the prior visit was positively correlated with an increase in EIA OD values after adjusting for age in 2007 (0.261, p = 0.003) and in 2008 (0.116, p = 0.03). RDT positivity at the concurrent visit also was associated with an increase in EIA OD value in 2007 (mean increase 0.177, p = 0.002) but not in 2008 (?0.063, p =0.50). Households comprised of individuals with serologic evidence of recent malaria overlapped areas of high malaria risk for serologic data from 2009, when parasite prevalence was lowest. Conclusions Serological surveys to whole asexual P. falciparum antigens using blood collected as dried blood spots can be used to detect temporal and spatial patterns of malaria transmission in a region of declining malaria burden, and have the potential to identify focal areas of recent transmission.

2012-01-01

279

Feasibility of using a World Health Organization-standard methodology for Sample Vital Registration with Verbal Autopsy (SAVVY) to report leading causes of death in Zambia: results of a pilot in four provinces, 2010  

PubMed Central

Background Verbal autopsy (VA) can be used to describe leading causes of death in countries like Zambia where vital events registration does not produce usable data. The objectives of this study were to assess the feasibility of using verbal autopsy to determine age-, sex-, and cause-specific mortality in a community-based setting in Zambia and to estimate overall age-, sex-, and cause-specific mortality in the four provinces sampled. Methods A dedicated census was conducted in regions of four provinces chosen by cluster-sampling methods in January 2010. Deaths in the 12-month period prior to the census were identified during the census. Subsequently, trained field staff conducted verbal autopsy interviews with caregivers or close relatives of the deceased using structured and unstructured questionnaires. Additional deaths were identified and respondents were interviewed during 12 months of fieldwork. After the interviews, two physicians independently reviewed each VA questionnaire to determine a probable cause of death. Results Among the four provinces (1,056 total deaths) assessed, all-cause mortality rate was 17.2 per 1,000 person-years (95% confidence interval [CI]: 12.4, 22). The seven leading causes of death were HIV/AIDS (287, 27%), malaria (111, 10%), injuries and accidents (81, 8%), diseases of the circulatory system (75, 7%), malnutrition (58, 6%), pneumonia (56, 5%), and tuberculosis (50, 5%). Those who died were more likely to be male, have less than or equal to a primary education, and be unmarried, widowed, or divorced compared to the baseline population. Nearly half (49%) of all reported deaths occurred at home. Conclusions The 17.2 per 1,000 all-cause mortality rate is somewhat similar to modeled country estimates. The leading causes of death -- HIV/AIDS, malaria, injuries, circulatory diseases, and malnutrition -- reflected causes similar to those reported for the African region and by other countries in the region. Results can enable the targeting of interventions by region, disease, and population to reduce preventable death. Collecting vital statistics using standardized Sample Vital Registration with Verbal Autopsy (SAVVY) methods appears feasible in Zambia. If conducted regularly, these data can be used to evaluate trends in estimated causes of death over time.

2011-01-01

280

Country Profile: Zambia, 2007. Enterprise Surveys.  

National Technical Information Service (NTIS)

The Enterprise Surveys focus on the many factors that shape the decisions of firms to invest. These factors can be accommodating or constraining and play an important role in whether a country will prosper or not. An accommodating business environment is ...

2007-01-01

281

Conference on Afican Health Initiatives: Lusaka, Zambia.  

National Technical Information Service (NTIS)

Todays White House Office of Faith-Based and Community Initiatives Conference is offered as part of the continued expansion of President Bushs vision for compassion in action around the world. Its objective is to highlight, honor, and expand the work of w...

2008-01-01

282

Country Commercial Guide: Zambia, Fiscal Year 2001.  

National Technical Information Service (NTIS)

Country Commercial Guides (CCG) contain the market information you need to successfully conduct business in foreign markets. Available for over 100 countries, each CCG presents a comprehensive look at the country's commercial environment through economic,...

2000-01-01

283

Teacher Shocks and Student Learning: Evidence from Zambia  

ERIC Educational Resources Information Center

|A large literature examines the link between shocks to households and the educational attainment of children. We use new panel data to estimate the impact of shocks to teachers on student learning in Mathematics and English. Using absenteeism in the 30 days preceding the survey as a measure of these shocks, we find no impact for the full sample,…

Das, Jishnu; Dercon, Stefan; Habyarimana, James; Krishnan, Pramila

2007-01-01

284

Fiscal Governance and Public Services: Evidence from Tanzania and Zambia  

Microsoft Academic Search

Does a government's source of revenue explain its policies? The predominate view in development studies contends that policy variation results directly from institutional variation. Building on a literature which we label fiscal theories of governance, we argue that a government's sources of revenue strongly affect its public expenditures, independent of institutions. Using data from local government budgets in Tanzania and

Barak D. Hoffman; Clark C. Gibson

285

Assessing Farmer Innovations in Agroforestry in Eastern Zambia  

ERIC Educational Resources Information Center

This paper describes farmer innovations on improved fallows developed by researchers to replenish soil fertility. The reasons for the innovations and how these innovations are facilitating wide adoption of improved fallows are discussed. Research designed trial results to evaluate the ecological robustness of these innovations are also analyzed in…

Katanga, R.; Kabwe, G.; Kuntashula, E.; Mafongoya, P. L.; Phiri, S.

2007-01-01

286

Anthrax in wildlife in the Luangwa Valley, Zambia.  

PubMed

An abnormally high mortality among hippos (Hippopotamus amphibius) in the Luangwa River valley between June and November 1987 and estimated to number more than 4000 deaths was attributed to anthrax. Several other species, particularly Cape buffalo (Syncerus caffer) and elephant (Loxodonta africana), appear to have been affected. A smaller outbreak of anthrax in hippos occurred between August and September 1988, approximately 100 km up-river. A field study was arranged in August 1989 to assess the extent of environmental contamination by Bacillus anthracis and the risks to people in the area, to study possible methods of control and to equip local laboratory staff for continued monitoring of the disease. The study confirmed the enzootic status of the region. The characteristics of the outbreaks of anthrax in 1987 and 1988, and the results of the field study are described. PMID:1907048

Turnbull, P C; Bell, R H; Saigawa, K; Munyenyembe, F E; Mulenga, C K; Makala, L H

1991-04-27

287

Health and human rights of women imprisoned in Zambia  

PubMed Central

Background The healthcare needs and general experience of women in detention in sub-Saharan Africa are rarely studied and poorly understood. Methods A mixed-methods study was conducted including in-depth interviews with 38 adult female prisoners and 21 prison officers in four Zambian prisons to assess the health and human rights concerns of female detainees. Key informant interviews with 46 officials from government and non-governmental organizations and a legal and policy review were also conducted. Results Despite special protection under international and regional law, incarcerated women's health needs–including prenatal care, prevention of mother-to-child transmission of HIV, and nutritional support during pregnancy and breastfeeding–are not being adequately met in Zambian prisons. Women are underserved by general healthcare programs including those offering tuberculosis and HIV testing, and reported physical and sexual abuse conducted by police and prison officers that could amount to torture under international law. Conclusions There is an urgent need for women's healthcare services to be expanded, and for general prison health campaigns, including HIV and tuberculosis testing and treatment, to ensure the inclusion of female inmates. Abuses against women in Zambian police and prison custody, which violate their rights and compromise their health, must be halted immediately.

2011-01-01

288

Breaking the Net: Family Structure and Street Children in Zambia  

Microsoft Academic Search

The safety net provided by the African extended family has traditionally been the basis for the assertion that “there is no such thing as an orphan in Africa” (Foster 2000). The assumption is that even families lacking sufficient resources to properly care for existing members are predisposed to take in orphans. Chronic poverty, coupled with an increasing malaria burden and

Francesco Strobbe; Claudia Olivetti; Mireille Jacobson

2010-01-01

289

Burn prevention in Zambia: a targeted epidemiological approach.  

PubMed

The aim of this study is to assess primary burn prevention knowledge in a rural Zambian population that is disproportionately burdened by burn injuries. A 10-question survey was completed by youths, and a 15-question survey was completed by adults. The survey was available in both English and Nyanja. The surveys were designed to test their knowledge in common causes, first aid, and emergency measures regarding burn injuries. Logistic regression analysis was used to explore relationships between burn knowledge, age, school, and socioeconomic variables. A burn prevention coloring book, based on previous local epidemiological data, was also distributed to 800 school age youths. Five hundred fifty youths and 39 adults completed the survey. The most significant results show knowledge deficits in common causes of burns, first aid treatment of a burn injury, and what to do in the event of clothing catching fire. Younger children were more likely to do worse than older children. The adults performed better than the youths, but still lack fundamental burn prevention and treatment knowledge. Primary burn prevention data from the youths and adults surveyed demonstrate a clear need for burn prevention and treatment education in this population. In a country where effective and sustainable burn care is lacking, burn prevention may be a better investment to reduce burn injury than large investments in healthcare resources. PMID:23292574

Heard, Jason P; Latenser, Barbara A; Liao, Junlin

290

Surgery, surgical pathology and HIV infection: lessons learned in Zambia.  

PubMed

HIV (human immunodeficiency virus) infection is prevalent in many areas of sub-Saharan Africa. Seropositivity rates reach 10-15% in urban adults, 21% in critically ill adults and 30% in surgical inpatients aged 21-40 years. AIDS (acquired immune deficiency syndrome) is a multisystem disease which presents to the surgeon with a wide range of pathologies including Kaposi's sarcoma, lymphadenopathy and sepsis. The more common sites for sepsis are the female genital tract, anorectum, pleural cavity, soft tissues (necrotizing fasciitis) and bone and joints. To prevent iatrogenic HIV infection more use should be made of autologous blood. Occupational exposure to HIV infection can be minimized by double-gloving, protecting the eyes when operating and ensuring that theatre gowns are waterproof. The risk of HIV infection from a needlestick injury is 0.4%. Although contact with blood during a surgical procedure is common, the risk is lower than for a hollow needlestick injury. PMID:7863725

Watters, D A

1994-03-01

291

Pupils' Projects from Zambia. Third World Science. A Collection of Third Form Science Projects from Lubushi Seminary, Kasama, Zambia as Written and Drawn by the Pupils Themselves.  

ERIC Educational Resources Information Center

|The Third World Science Project (TWSP) is designed to add a multicultural element to existing science syllabi (for students aged 11-16) in the United Kingdom. The project seeks to develop an appreciation of the: boundless facination of the natural world; knowledge, skills, and expertise possessed by men/women everywhere; application of knowledge…

University Coll. of North Wales, Bangor (United Kingdom). School of Education.

292

Impact of HIV on mortality from acute lower respiratory tract infection in rural Zambia  

Microsoft Academic Search

AIMSTo establish the prevalence and clinical correlates of HIV among children with acute lower respiratory tract infection.METHODSChildren admitted to a rural Zambian hospital were studied over an eight month period. The diagnosis of acute lower respiratory tract infection was made clinically, according to World Health Organisation (WHO) criteria. Clinicians, who were unaware of the children’s HIV status, prescribed antibiotic and

A Smyth; C Y W Tong; H Carty; C A Hart

1997-01-01

293

Impact of integrated community case management on health-seeking behavior in rural Zambia.  

PubMed

Provision of integrated community case management (iCCM) for common childhood illnesses by community health workers (CHWs) represents an increasingly common strategy for reducing childhood morbidity and mortality. We sought to assess how iCCM availability influenced care-seeking behavior. In areas where two different iCCM approaches were implemented, we conducted baseline and post-study household surveys on healthcare-seeking practices among women who were caring for children ? 5 years in their homes. For children presenting with fever, there was an increase in care sought from CHWs and a decrease in care sought at formal health centers between baseline and post-study periods. For children with fast/difficulty breathing, an increase in care sought from CHWs was only noted in areas where CHWs were trained and supplied with amoxicillin to treat non-severe pneumonia. These findings suggest that iCCM access influences local care-seeking practices and reduces workload at primary health centers. PMID:23136285

Seidenberg, Philip D; Hamer, Davidson H; Iyer, Hari; Pilingana, Portipher; Siazeele, Kazungu; Hamainza, Busiku; MacLeod, William B; Yeboah-Antwi, Kojo

2012-11-01

294

Poverty Reduction in Zambia: A Conceptual Analysis of the Zambian Poverty Reduction Strategy Paper  

ERIC Educational Resources Information Center

Poverty reduction strategy papers (PRSPs) present a recipient country's program of intent for the utilization of World Bank loans and grants to alleviate debt under the bank's programs of action for poverty reduction in highly indebted poor countries (HIPCs). This article argues that structural transformation is a prerequisite for poverty…

Imboela, Bruce Lubinda

2005-01-01

295

Participatory Appropriation of Health Science by Primary School Students in Rural Zambia.  

ERIC Educational Resources Information Center

|The Child-to-Child (CtC) project involved school-age African children in monitoring younger children's weight and health (since much of the daily infant care in Africa is performed by preadolescents). CtC emphasizes local autonomy and is based on respect for children as morally responsible community members with a basic right to health and…

Mwape, Gertrude; Serpell, Robert

296

Analysis of the level of comprehension of chemical hazard labels: a case for Zambia.  

PubMed

We have surveyed the impact of chemical hazard label elements on four target sectors, i.e. the agricultural, industrial, transport and the consumer (the general public) sectors, in order to assess the type of reactions the respondents perceive to a given chemical label element such as symbol, hazard phrase, color, and hazard signal word. The survey revealed that the level of education, gender and/or age did not influence the respondents' perception of the extent of hazard but rather familiarity or frequency of use of the chemicals and acquaintance with chemical label elements was significant in the assessment of the extent of perceived hazard posed by a given chemical. Symbols such as the St Andrews Cross--though common--is virtually not understood by more than 80% of the respondents in all the sectors. We noted that respondents appreciate symbols they can relate to, which are flame-like, ghost-like and exert immediate impacts to respondents. Color codes have found use in the agriculture sector because of their ease to be recalled especially by the majority of illiterate farm workers. The survey revealed that red in agricultural circles is well associated with high toxicity while other colors such as yellow and blue can not clearly be associated with hazard. The word "toxic" is not used in the industry and transport sectors where the most hazard signal word is "danger". The Globally Harmonized System (GHS) classification adopted "danger" and "warning" for use as signal words. The survey revealed that effective chemical hazard symbols must not be too abstract to the client but should contain features that are known or easily comprehended. PMID:16426665

Banda, Samuel F; Sichilongo, Kwenga

2006-01-19

297

Acceptability of male circumcision for prevention of HIV infection in Zambia  

Microsoft Academic Search

Numerous observational studies and three clinical trials have shown male circumcision (MC) to be partially protective against HIV acquisition in heterosexual men. This has led to consideration of introducing circumcision as an HIV prevention strategy in parts of sub-Saharan Africa. This study assesses the acceptability of male circumcision as an intervention to improve male genital hygiene and reduce sexually transmitted

M. D. Lukobo; R. C. Bailey

2007-01-01

298

Successes and Challenges of Food Market Reform: Experiences from Kenya, Mozambique, Zambia, and Zimbabwe  

Microsoft Academic Search

This paper describes the different food policy courses pursued in recent years by four countries in Eastern and Southern Africa, and documents their differential effects on farmer and consumer behavior. Results are based primarily on a survey and synthesis of recent analysis. The paper highlights lessons learned from the different policy paths pursued in each country, and thus provides insights

David L. Tschirley; Mulinge Mukumbu; Michael T. Weber; Ballard Zulu; Robert C. Johansson; Paula Mota Santos; David Soroko

1999-01-01

299

Analysis of the level of comprehension of chemical hazard labels: A case for Zambia  

Microsoft Academic Search

We have surveyed the impact of chemical hazard label elements on four target sectors, i.e. the agricultural, industrial, transport and the consumer (the general public) sectors, in order to assess the type of reactions the respondents perceive to a given chemical label element such as symbol, hazard phrase, color, and hazard signal word. The survey revealed that the level of

Samuel F. Banda; Kwenga Sichilongo

2006-01-01

300

Inductive Reasoning in Zambia, Turkey, and the Netherlands Establishing Cross-Cultural Equivalence.  

ERIC Educational Resources Information Center

|Administered tasks of inductive reasoning to 704 Zambian, 877 Turkish, and 632 Dutch students from the highest 2 grades of primary and the lowest 2 grades of secondary school. Results show strong evidence for structural equivalence and partial evidence for measurement unit equivalence, but did not support full score equivalence. (SLD)|

van de Vijver, Fons J. R.

2002-01-01

301

Encouraging Minerals Investment Using GIS: The establishment of Minerals GIS in Zambia and Mauritania  

Microsoft Academic Search

Geographical Information Systems provide the ideal tool to help manage and advertise the mineral potential of a country. Information on a particular mineral occurrence which is stored within a database can be displayed and queried spatially through the use of a GIS. It also enables the mineral locality to be placed in context by displaying further information such as local

J. M. Mankelow; K. Eden; J. S. Coats; A. K. Liyungu

302

Preservation and Conservation of Information Resources in the University of Zambia Library  

ERIC Educational Resources Information Center

Preservation and conservation of library materials is an important aspect of library and information management. Their importance and necessity are more paramount in countries where resources are limited and libraries need to balance them with the needs of an ever increasing number of students hoping to use them. This article reports on the…

Kanyengo, Christine Wamunyima

2009-01-01

303

Widows’ Land Security in the Era of HIV\\/AIDS: Panel Survey Evidence from Zambia  

Microsoft Academic Search

In areas of Africa hard hit by HIV\\/AIDS, there are growing concerns that many women lose access to land after the death of their husbands. However, there remains a dearth of quantitative evidence on the proportion of widows who lose access to their deceased husband’s land, whether they lose all or part of that land, and whether there are factors

Antony Chapoto; T. S. Jayne; Nicole M. Mason

2011-01-01

304

The Association between Household Socioeconomic Position and Prevalent Tuberculosis in Zambia: A Case-Control Study  

Microsoft Academic Search

BackgroundAlthough historically tuberculosis (TB) has been associated with poverty, few analytical studies from developing countries have tried to: 1. assess the relative impact of poverty on TB after the emergence of HIV; 2. explore the causal mechanism underlying this association; and 3. estimate how many cases of TB could be prevented by improving household socioeconomic position (SEP).Methods and FindingsWe undertook

Delia Boccia; James Hargreaves; Bianca Lucia De Stavola; Katherine Fielding; Ab Schaap; Peter Godfrey-Faussett; Helen Ayles

2011-01-01

305

Feasibility Study of Regional Station Connectivity Project. Part 3. Zambia Earth Station.  

National Technical Information Service (NTIS)

The feasibility study looks at a Proposed Regional Earth Station Connectivity Project for the Southern Africa Transport and Communications Commission (SATCC) under the terms of a grant from the U.S. Trade and Development Program (TDP). The study examines ...

1990-01-01

306

Mental health policy process: a comparative study of Ghana, South Africa, Uganda and Zambia  

Microsoft Academic Search

BACKGROUND: Mental illnesses are increasingly recognised as a leading cause of disability worldwide, yet many countries lack a mental health policy or have an outdated, inappropriate policy. This paper explores the development of appropriate mental health policies and their effective implementation. It reports comparative findings on the processes for developing and implementing mental health policies in Ghana, South Africa, Uganda

Maye A Omar; Andrew T Green; Philippa K Bird; Tolib Mirzoev; Alan J Flisher; Fred Kigozi; Crick Lund; Jason Mwanza; Angela L Ofori-Atta

2010-01-01

307

Inequality and the polarizing impact of microcredit: evidence from Zambia's copperbelt  

Microsoft Academic Search

While much research has addressed the impact of microcredit on poverty, less attention has been paid to inequality. This paper draws on research on the Zambian Copperbelt to show how impact on income distribution depends upon who obtains loans, who graduates to larger loans, who exits and group dynamics. Some initial levelling up of business income was found, but the

James Copestake

2002-01-01

308

Elephants, people, parks and development: the case of the Luangwa Valley, Zambia  

Microsoft Academic Search

New ideas about conserving wildlife are emerging to compete with conventional national park policies. But methods of analyzing wildlife conservation problems in Africa are inadequate for the analysis of complex issues of policy. Much of the analysis of conservation policy attempts to be ‘apolitical’ on issues charged with social conflict. Analyses are too often ahistorical when history can say a

Nick Abel; Piers Blaikie

1986-01-01

309

Associations between sexual behaviour change in young people and decline in HIV prevalence in Zambia  

Microsoft Academic Search

BACKGROUND: Evidence suggests that HIV prevalence amongst young Zambians has declined recently, especially in higher-education groups. We studied trends in key sexual behaviour indicators among 15–24 year-olds from 1995 to 2003, including the associations between sexual behaviour change and education. METHODS: The data stem from a series of three population-based surveys conducted in 1995 (n = 1720), 1999 (n =

Ingvild F Sandøy; Charles Michelo; Seter Siziya; Knut Fylkesnes

2007-01-01

310

Barriers and outcomes: TB patients co-infected with HIV accessing antiretroviral therapy in rural Zambia.  

PubMed

The vulnerabilities that underlie barriers faced by the rural poor whilst trying to access and adhere to "free" antiretroviral treatment (ART) demand more attention. This paper highlights barriers that poor rural Zambians co-infected with tuberculosis (TB) and HIV and their households faced in accessing ART between September 2006 and July 2007, and accounts for patient outcomes by the end of TB treatment and (more sporadically) beyond October 2009. The analysis draws on findings from wider anthropological fieldwork on the converging impact of TB, HIV and food insecurity, focusing for the purpose of this paper on ethnographic case-studies of seven newly diagnosed TB patients co-infected with HIV and their six households (one household had two TB patients). Economic barriers included being pushed into deeper poverty by managing TB, rural location, absence of any external assistance, and mustering time and extended funds for transport and "special food" during and beyond the end of TB. In the case of death, funeral costs were astronomical. Social barriers included translocation, broken marriages, a sub-ordinate household position, gender relations, denial, TB/HIV stigma and the difficulty of disclosure. Health facility barriers involved understaffing, many steps, lengthy procedures and inefficiencies (lost blood samples, electricity cuts). By the end of TB treatment, outcomes were mixed; two co-infected patients had died, three had started ART and two had yet to start ART. The three on ART underwent a striking transformation in the short term. By October 2009, two more had died and three were doing well. The study advocates nutritional support and other material support (especially transport funds) for co-infected TB patients until ART is accessed and livelihood regained. More prompt diagnosis of TB and reducing steps and increasing the reach of the ART programme in rural areas are also recommended. PMID:20680860

Chileshe, Muatale; Bond, Virginia Anne

2010-01-01

311

77 FR 31574 - Executive-Led Trade Mission to South Africa and Zambia  

Federal Register 2010, 2011, 2012, 2013

...technologies [cir] Clean coal technology [cir] Transmission...production equipment and machinery [cir] Irrigation equipment...S. exports include machinery, transportation equipment...the sector since the mines were privatized starting...nickel, manganese, coal, and gemstones,...

2012-05-29

312

Comparative outcomes of tenofovir- and zidovudine-based antiretroviral therapy regimens in Lusaka, Zambia  

PubMed Central

Background Although tenofovir (TDF) is a common component of antiretroviral therapy (ART), recent evidence suggests inferior outcomes when it is combined with nevirapine (NVP). Methods We compared outcomes among patients initiating TDF+emtricitabine or lamivudine (XTC)+NVP, TDF+XTC+efavirenz (EFV), zidovudine (ZDV)+lamuvidine (3TC)+NVP, and ZDV+3TC+EFV. We categorized drug exposure by initial ART dispensation, by a time-varying analysis that accounted for drug substitutions, and by predominant exposure (>75% of drug dispensations) during an initial window period. Risks for death and program failure were estimated using Cox proportional hazard models. All were regimens were compared to ZDV+3TC+NVP. Results Between July 2007 and November 2010, 18,866 treatment-naïve adults initiated ART: 18.2% on ZDV+3TC+NVP, 1.8% on ZDV+3TC+EFV, 36.2% on TDF+XTC+NVP, and 43.8% on TDF+XTC+EFV. When exposure was categorized by initial prescription, patients on TDF+XTC+NVP (adjusted hazard ratio [AHR]:1.45; 95%CI:1.03–2.06) had a higher post-90 day mortality. TDF+XTC+NVP was also associated with an elevated risk for mortality when exposure was categorized as time-varying (AHR:1.51; 95%CI:1.18–1.95) or by predominant exposure over the first 90 days (AHR:1.91, 95%CI:1.09–3.34). However, these findings were not consistently observed across sensitivity analyses or when program failure was used as a secondary outcome. Conclusion TDF+XTC+NVP was associated with higher mortality when compared to ZDV+3TC+NVP, but not consistently across sensitivity analyses. These findings may be explained in part by inherent limitations to our retrospective approach, including residual confounding. Further research is urgently needed to compare the effectiveness of ART regimens in use in resource-constrained settings.

Chi, Benjamin H.; Mwango, Albert; Giganti, Mark J.; Sikazwe, Izukanji; Moyo, Crispin; Schuttner, Linnaea; Mulenga, Lloyd B.; Bolton-Moore, Carolyn; Chintu, Namwinga T.; Sheneberger, Robert; Stringer, Elizabeth M.; Stringer, Jeffrey S. A.

2011-01-01

313

The relationship of Plasmodium falciparum humeral immunity with HIV-1 immunosuppression and treatment efficacy in Zambia  

PubMed Central

Background HIV-1 infection affects malaria humeral immunity during pregnancy, but data for non-pregnant adults are lacking. This study reports the impact of HIV-1 infection and other variables on the level of malaria humeral immunity in adults with clinical malaria and whether humeral immune suppression was a risk factor for treatment failure. Methods Sera of 224 HIV-1 infected and 115 uninfected adults were compared for IgG to merozoite antigens AMA-1 and MSP2 (3D7 and FC27 types) determined by ELISA, and for IgG to the Variant Surface Antigens (VSA) of three different parasite line E8B, A4 and HCD6 determined by flow cytometry. Results Compared to HIV-1 uninfected adults, AMA-1 IgG was lower in HIV-1 infected (P = 0.02) and associated with low CD4 count AMA-1 IgG (P = 0.003). Low IgG to all three merozoite antigens was associated with less anemia (P = 0.03). High parasite load was associated with low MSP2 IgG 3D7 and FC27 types (P = 0.02 and P = 0.08). Antibody levels to VSA did not differ between HIV-1 infected and uninfected adults. However, low VSA IgGs were associated with high parasite load (P ? 0.002 for each parasite line) and with treatment failure (P ? 0.04 for each parasite line). Conclusion HIV-1 affects humeral responses to AMA-1, but seems to marginally or not affect humeral responses to other merozoite antigens and VSAs. The latter were important for controlling parasite density and predict treatment outcome.

2009-01-01

314

Chemical Composition of Flower and Leaf Oils of Cymbopogon densiflorus Stapf from Zambia  

Microsoft Academic Search

The flower and leaf oils of Cymbopogon densiflorus Stapf were analyzed by GC and GC\\/MS. Twelve and seventeen compounds were identified in the flower and leaf oils respectively. The flower oil was dominated by limonene (52.1%), trans-p-mentha-2,8-dien-1-ol (10.0%), verbenol (9.7%) and perillyl alcohol (7.2%) while the major components in the leaf oil were trans-p-mentha-2,8-dien-1-ol (22.4%), verbenol (18.0%), perillyl alcohol (17.2%)

Esmort H. Chisowa

1997-01-01

315

Promoting Social Interaction and Status of Children with Intellectual Disabilities in Zambia.  

ERIC Educational Resources Information Center

|Play-skills training, provided to eight Zambian elementary children with intellectual disabilities, resulted in more substantial increases in interaction between subjects and nondisabled children when coupled with teacher prompts, compared to training alone. Having a nondisabled child take the initiator role increased and maintained social…

Ronning, John A.; Nabuzoka, Dabie

1993-01-01

316

Working Together to Improve the Lives of People Affected by Epilepsy in Zambia  

ERIC Educational Resources Information Center

Epilepsy is a neurologic disorder that results in recurrent, unprovoked seizures. The biomedical burden of epilepsy can be substantial, but for many the social consequences may be just as extreme, with epilepsy victims suffering from social abandonment as well as economic and physical vulnerabilities. Since its founding in 2000, the Chikankata…

Birbeck, Gretchen L.

2012-01-01

317

VILLAGE--A Minimum Structure Simulation Game Developed for Agricultural Extension Training in Central Africa (Zambia).  

ERIC Educational Resources Information Center

Discusses training needs of agricultural students and the process, activities, and resources utilized by a simulation game designed to encourage development of appropriate conflict resolution and communications skills and to create awareness of agricultural extension needs. Summarizes results of field test evaluation of VILLAGE and deficiencies in…

Dall, Frank

1984-01-01

318

Popularization of Science. Report of a Commonwealth Regional Workshop (Lusaka, Zambia, April 15-19, 1985).  

ERIC Educational Resources Information Center

The workshop on the popularization of science was the first of what the organizing institutions hoped would be a series of workshops on this important theme. It was held to complement the efforts of various institutions and organizations in the whole area of technological acculturation so that the benefits of science may be understood by and…

Commonwealth Secretariat, London (England).

319

AIDS and cultural practices in Africa: the case of the Tonga (Zambia)  

Microsoft Academic Search

The fight against AIDS in Africa is often presented as a fight against “cultural barriers” that are seen as promoting the spread of the HIV virus. This attitude is based on a long history of Western prejudices about sexuality in Africa, which focus on its exotic aspects only (polygamy, adultery, wife-exchange, circumcision, dry sex, levirate, sexual pollution, sexual cleansing, various

Quentin Gausset

2001-01-01

320

An investigation of heavy metal exposure and risks to wildlife in the Kafue flats of Zambia.  

PubMed

Exposure and ecological risks to heavy metals (copper, zinc, manganese, iron) at Lochnivar and Blue Lagoon National Parks in wildlife dependent on the Kafue river contaminated with mining waste was evaluated. Samples included water, fish, grasses and Kafue Lechwe (Kobus leche kafuensis) liver. At both parks copper ranged from 0.03-0.04 mg/l; 3.0-6.0 mg/kg; 11.0-44.0 mg/kg; trace -199.0 mg/kg; while zinc was 0.01 mg/l; 32.0-82.0 mg/kg; 15.0-21.0 mg/kg; and 52.0-138.0 mg/kg; in water, fish, grasses and lechwe, respectively. Manganese ranges were 0.15-0.16 mg/l; 7.0-18.0 mg/kg; 51.0-145.0 mg/kg; and 40.0-53.0 mg/kg while iron ranges were 0.13-0.14 mg/l; 26.0-134.0 mg/kg; 1766.0-1797.0 mg/kg; and 131.0-856.0 mg/kg; in water, fish, grasses and lechwe, respectively. Levels in all samples except water were high indicating potential for adverse effects. PMID:11307933

Syakalima, O; Choongo, K; Nakazato, Y; Onuma, M; Sugimoto, C; Tsubota, T; Fukushi, H; Yoshida, M; Itagaki, T; Yasuda, J

2001-03-01

321

7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.  

Code of Federal Regulations, 2010 CFR

...babyâ sweet corn (Zea mays...subpart: (1) The production site, which is a field, where the corn has been grown must...inspections. (5) The corn may be imported in...conditions: (1) The production site, which...

2009-01-01

322

7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.  

Code of Federal Regulations, 2010 CFR

...babyâ sweet corn (Zea mays...subpart: (1) The production site, which is a field, where the corn has been grown must...inspections. (5) The corn may be imported in...conditions: (1) The production site, which...

2010-01-01

323

Bantu Plant Names as Indicators of Linguistic Stratigraphy in the Western Province of Zambia  

Microsoft Academic Search

1 It is based on fieldwork I undertook, with the kind assistance of the Livingstone Museum, in July-August 2005 in the neighbourhood of two minor towns in the southern part of the WP, i.e. Sioma and Shangombo. I worked with native speakers of Mbunda (K15), Kwamashi (K34), Kwamulonga (K351), Shanjo (K36), Fwe (K402), and Mbwera (L61). The field notes, which

Koen Bostoen

324

The relationship of Plasmodium falciparum humeral immunity with HIV1 immunosuppression and treatment efficacy in Zambia  

Microsoft Academic Search

BACKGROUND: HIV-1 infection affects malaria humeral immunity during pregnancy, but data for non-pregnant adults are lacking. This study reports the impact of HIV-1 infection and other variables on the level of malaria humeral immunity in adults with clinical malaria and whether humeral immune suppression was a risk factor for treatment failure. METHODS: Sera of 224 HIV-1 infected and 115 uninfected

Jean-Pierre Van Geertruyden; Erika Van Eijk; Francisca Yosaatmadja; Webster Kasongo; Modest Mulenga; Umberto D'Alessandro; Stephen Rogerson

2009-01-01

325

How HIV\\/AIDS scale-up has impacted on non- HIV priority services in Zambia  

Microsoft Academic Search

BACKGROUND: Much of the debate as to whether or not the scaling up of HIV service delivery in Africa benefits non-HIV priority services has focused on the use of nationally aggregated data. This paper analyses and presents routine health facility record data to show trend correlations across priority services. METHODS: Review of district office and health facility client records for

Ruairí Brugha; Joseph Simbaya; Aisling Walsh; Patrick Dicker; Phillimon Ndubani

2010-01-01

326

The energetics of the common mole rat Cryptomy? , a subterranean eusocial rodent from Zambia  

Microsoft Academic Search

Body temperature, oxygen consumption, respiratory and cardiac activity and body mass loss were measured in six females and four males of the subterranean Zambian mole rat Cryptomys sp. (karyotype 2 n=68), at ambient temperatures between 10 and 35°C. Mean body temperature ranged between 36.1 and 33.2°C at ambient temperatures of 32.5–10°C and was lower in females (32.7°C) than in males

S. Marhold; A. Nagel

1995-01-01

327

Mortality among HIV-1- and Human Herpesvirus Type 8-Affected Mother-Infant Pairs in Zambia  

PubMed Central

Objective To determine the respective trends in mortality of Zambian mother-infant pairs based on maternal infection with HIV-1 and human herpesvirus type 8 (HHV-8). Methods A prospective cohort study was done on Zambian mother-infant pairs, stratified by maternal serologic status and followed from 6 weeks postdelivery for 48 months. Statistical analysis of the differences in the calculated mortality rates among the four groups was done using Stata 7.0. Kaplan-Meier analysis and Cox proportional hazard models were used to measure subject survival time. Results Between September 1998 and March 2002, a total of 1,425 mother-infant pairs were enrolled. The crude mortality rate among children born to dually infected mothers was ~9 times higher (245.90 deaths per 1,000 live births) when compared with the death ratio of children born to seronegative mothers (24.63 deaths per 1,000 live births). The incidence rate for death was 0.34/1,000 in infants of co-infected mothers in comparison with 0.32/1,000 among HIV-1–infected mothers, 0.0336/1,000 among uninfected mothers, and 0.0403/1,000 among HHV-8–infected mothers (?2 = 154.56; P < 0.01). Infants of co-infected mothers had a comparable risk of death in comparison with infants infected with HIV-1 alone {hazard ratio, 9.91 [95% confidence interval (95% CI), 5.08–19.37] for co-infected versus 9.26 [95% CI, 4.75–18.07] for HIV-1–infected alone}. Infants of mothers infected only with HHV-8 also had comparable survival in comparison with uninfected infants (hazard ratio, 1.21; 95% CI, 0.56–2.61). Conclusion Infants born to mothers dually infected with both HIV-1 and HHV-8 have comparable survival with infants exposed to HIV-1 alone. Infants born to mothers infected only with HHV-8 have comparable survival with uninfected infants.

Wojcicki, Janet; Mwanahamuntu, Mulindi; Minhas, Veenu; Djokic, Boris; Kankasa, Chipepo; Klaskala, Winslow; Brayfield, Brad; Phiri, Saul; Wood, Charles; Mitchell, Charles D.

2010-01-01

328

The Participatory Research Approach in Non-Western Countries: Practical Experiences from Central Asia and Zambia  

ERIC Educational Resources Information Center

This paper focuses on the application of the participatory research approach in non-Western contexts. The aim is to provide critical insights into the participatory research discourse through an examination of its theory and practice based on our own experiences of using this approach in our doctoral research in five Central Asian countries and…

Katsui, Hisayo; Koistinen, Mari

2008-01-01

329

Correlates of Syphilis Seroreactivity Among Pregnant Women: The HIVNET 024 Trial in Malawi, Tanzania, and Zambia  

PubMed Central

Objective The objectives of this cross-sectional study were to determine correlates of syphilis seroprevalence among HIV-infected and -uninfected antenatal attendees in an African multisite clinical trial, and to improve strategies for maternal syphilis prevention. Results A total of 2270 (86%) women were HIV-infected and 366 (14%) were HIV-uninfected. One hundred seventy-five (6.6%) were syphilis-seropositive (7.3% among HIV-infected and 2.6% HIV-uninfected women). Statistically significant correlates included geographic site (odds ratio [OR] = 4.5, Blantyre; OR = 3.2, Lilongwe; OR = 9.0, Lusaka vs. Dar es Salaam referent); HIV infection (OR = 3.3); age 20 to 24 years (OR = 2.5); being divorced, widowed, or separated (OR = 2.9); genital ulcer treatment in the last year (OR = 2.9); history of stillbirth (OR = 2.8, one stillbirth; OR = 4.3, 2–5 stillbirths); and history of preterm delivery (OR = 2.7, one preterm delivery). Conclusion Many women without identified risk factors were syphilis-seropositive. Younger HIV-infected women were at highest risk. Universal integrated antenatal HIV and syphilis screening and treatment is essential in sub-Saharan African settings.

Potter, Dara; Goldenberg, Robert L.; Read, Jennifer S.; Wang, Jing; Hoffman, Irving F.; Saathoff, Elmar; Kafulafula, George; Aboud, Said; Martinson, Francis E. A.; Dahab, Maysoon; Vermund, Sten H.

2009-01-01

330

Farmers’ perceptions of tree mortality, pests and pest management practices in agroforestry in Malawi, Mozambique and Zambia  

Microsoft Academic Search

Pest management research within the context of agroforestry is in its infancy, and it is often difficult to say when a particular\\u000a pest justifies investment in research to establish facts. Understanding the potentials and drawbacks of farmers’ indigenous\\u000a ecological knowledge (ethnoecology) may form the basis for constructive collaboration between farmers, agroforestry scientists\\u000a and extension staff. Therefore, the objectives of the

Gudeta Weldesemayat Sileshi; Elias Kuntashula; Patrick Matakala; Philip O. Nkunika

2008-01-01

331

Effects of river-floodplain exchange on water quality and nutrient export in the dam-impacted Kafue River (Zambia)  

Microsoft Academic Search

Biogeochemical processes in river-floodplain ecosystems are strongly influenced by hydrology and, in particular, river-floodplain exchange. In tropical systems, where the hydrology is dominated by distinct dry and rainy seasons, annual flood waters trigger organic matter mineralization within and nutrient export from the dried and rewetted floodplain, and the magnitude of hydrological exchange between a river and its floodplain has the

R. Zurbrugg; J. Wamulume; N. Blank; I. Nyambe; B. Wehrli; D. B. Senn

2010-01-01

332

HIV/AIDS Prevention in Zambia: A Preliminary Study of Obstacles to Behavior Change in the Copperbelt.  

National Technical Information Service (NTIS)

Since the 1980s, HIV prevention programs around the world have continuously expanded in attempts to meet challenges in the fight against HIV/AIDS. These programs are generally based on primary prevention, which uses Information Education and Communication...

J. R. Nyerges

2006-01-01

333

Transmission Attributes of Periurban Malaria in Lusaka, Zambia, Precedent to the Integrated Vector Management Strategy: An Entomological Input  

PubMed Central

Globalization and urbanization with their inherent developmental activities and ecological transformations impact on malaria epidemiology. Entomological factors involved in malaria transmission in periurban Lusaka were assessed prior to vector control reintroduction. Data was collected through standard entomological and epidemiological protocols and a pretested structured questionnaire. Larval habitats were characterized as transient (43%), semipermanent (36%), and permanent (21%). Anopheles arabiensis and An. gambiae ss. were the only vectors identified. A shift in vector population was noted, with the later outnumbering the former. Plasmodium falciparum monoinfection rates were 25.6% (95% CI: 20.9–30.7) (n = 297). Parasitaemia was 31.8% (95% CI: 23.2–42.2), 25.7% (95% CI: 13.5–41.3), and 23.3% (95% CI: 17.4–29.6) in under 5, 5 to 14, and above 15 age groups, respectively. Low knowledge levels on vector control tools with an average of 7 residents per household were also observed. This study confirmed a local malaria transmission paradigm. The epidemiology necessitated deployment of an integrated vector management strategy with intensified information education and communication.

Chanda, Emmanuel; Baboo, Kumar S.; Shinondo, Cecilia J.

2012-01-01

334

7 CFR 319.56-48 - Conditions governing the entry of baby squash and baby courgettes from Zambia.  

Code of Federal Regulations, 2013 CFR

...immediately prohibit that greenhouse from exporting baby...prohibition will remain in effect until the Zambian NPPO...immediately prohibit that greenhouse from exporting baby...prohibition will remain in effect until the Zambian NPPO... (2) Outside the greenhouse. (i) Approved...

2013-01-01

335

Combined prevalence of impaired glucose level or diabetes and its correlates in Lusaka urban district, Zambia: a population based survey  

Microsoft Academic Search

BACKGROUND: Developing countries are undergoing an epidemiological transition, from Communicable or Infectious to 'Non-Communicable' diseases (NCDs), such that cardiovascular disease, chronic respiratory diseases, cancer, and diabetes were responsible for 60% of all deaths globally in 2005, with more than 75% of these deaths occurring in developing countries. A survey was conducted to determine among other objectives the prevalence of diabetes

Mutale Nsakashalo-Senkwe; Seter Siziya; Fastone M Goma; Peter Songolo; Victor Mukonka; Olusegun Babaniyi

2011-01-01

336

National policy development for cotrimoxazole prophylaxis in Malawi, Uganda and Zambia: the relationship between Context, Evidence and Links  

Microsoft Academic Search

Background  Several frameworks have been constructed to analyse the factors which influence and shape the uptake of evidence into policy\\u000a processes in resource poor settings, yet empirical analyses of health policy making in these settings are relatively rare.\\u000a National policy making for cotrimoxazole (trimethoprim-sulfamethoxazole) preventive therapy in developing countries offers\\u000a a pertinent case for the application of a policy analysis lens.

Eleanor Hutchinson; Justin Parkhurst; Sam Phiri; Di M Gibb; Nathaniel Chishinga; Benson Droti; Susan Hoskins

2011-01-01

337

Demographic implications of life-history stage characteristics in two African acacias at a Makeni savanna plot in Zambia  

Microsoft Academic Search

Aims In spite of the importance of African acacias in vegetation succession and provision of goods and services, little is known about life-history variations within and among species. Much of the work done on Af- rican acacias has focused on seed predation and germination and seedling establishment, especially of Acacia tortilis, Acacia nilotica and Acacia karroo. The primary aim of

Emmanuel Ngulube Chidumayo

2008-01-01

338

IMPACT OF MAIZE-GRAIN YIELD AND PRICE ON NET MARGIN AT MECHANIZED GROWING TECHNOLOGY IN ZAMBIA  

Microsoft Academic Search

The farm machinery is a system that is used by high er or lower efficiency and impacted by production c osts, especially farm machinery prices and other technolo gic inputs. On the opposite side there are outputs which can generally be designed as proceeds. The proceeds esp ecially are the yield and price of the product. Bot h of them

B. HAVRLAND; K. SRNEC

2005-01-01

339

Predictors of cigarette smoking among adolescents in rural Zambia: results from a cross sectional study from Chongwe district  

Microsoft Academic Search

Available from: http:\\/\\/www.rrh.org.au A B S T R A C T Introduction: Cigarette smoking is a leading cause of morbidity and mortality globally. There are limited data on the prevalence of and factors associated with smoking among in-school adolescents in developing countries. Objectives: To estimate prevalence of those who have smoked cigarettes and to identify associated socio-demographic factors among adolescents

S Siziya; E Rudatsikira; AS Muula

340

HMIS and decision-making in Zambia: re-thinking information solutions for district health management in decentralized health systems  

Microsoft Academic Search

At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective health management information systems (HMIS) were widely acknowledged and adopted as a critical element of district health management strengthening programmes. The focal concern was about the performance and long-term sustainability of

RICHARD I MUTEMWA

2005-01-01

341

Integrating HIV treatment with primary care outpatient services: opportunities and challenges from a scaled-up model in Zambia  

PubMed Central

Background Integration of HIV treatment with other primary care services has been argued to potentially improve effectiveness, efficiency and equity. However, outside the field of reproductive health, there is limited empirical evidence regarding the scope or depth of integrated HIV programmes or their relative benefits. Moreover, the body of work describing operational models of integrated service-delivery in context remains thin. Between 2008 and 2011, the Lusaka District Health Management Team piloted and scaled-up a model of integrated HIV and general outpatient department (OPD) services in 12 primary health care clinics. This paper examines the effect of the integrated model on the organization of clinic services, and explores service providers’ perceptions of the integrated model. Methods We used a mixed methods approach incorporating facility surveys and key informant interviews with clinic managers and district officials. On-site facility surveys were carried out in 12 integrated facilities to collect data on the scope of integrated services, and 15 semi-structured interviews were carried out with 12 clinic managers and three district officials to explore strengths and weaknesses of the model. Quantitative and qualitative data were triangulated to inform overall analysis. Findings Implementation of the integrated model substantially changed the organization of service delivery across a range of clinic systems. Organizational and managerial advantages were identified, including more efficient use of staff time and clinic space, improved teamwork and accountability, and more equitable delivery of care to HIV and non-HIV patients. However, integration did not solve ongoing human resource shortages or inadequate infrastructure, which limited the efficacy of the model and were perceived to undermine service delivery. Conclusion While resource and allocative efficiencies are associated with this model of integration, a more important finding was the model’s demonstrated potential for strengthening organizational culture and staff relationships, in turn facilitating more collaborative and motivated service delivery in chronically under-resourced primary healthcare clinics.

Topp, Stephanie M; Chipukuma, Julien M; Chiko, Matimba M; Matongo, Evelyn; Bolton-Moore, Carolyn; Reid, Stewart E

2013-01-01

342

Detection of Salmonella invA by isothermal and chimeric primer-initiated amplification of nucleic acids (ICAN) in Zambia  

Microsoft Academic Search

The isothermal and chimeric primer-initiated amplification of nucleic acids (ICAN) is a new isothermal DNA amplification method composed of exo Bca DNA polymerase, RNaseH and DNA–RNA chimeric primers. We detected invA of Salmonella from chicken carcasses, egg yolk and cattle fecal samples. Fifty-three of 59 isolates were invA-positive in ICAN-chromatostrip detection. The result was consistent with those obtained by standard

Emiko Isogai; Chitwambi Makungu; John Yabe; Patson Sinkala; Andrew Nambota; Hiroshi Isogai; Hideto Fukushi; Manda Silungwe; Charles Mubita; Michelo Syakalima; Bernard Mudenda Hang'ombe; Shunji Kozaki; Jun Yasuda

2005-01-01

343

Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study  

PubMed Central

Background Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results Some 483 active clinical staff completed the questionnaire (84% response rate), 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2–1.6) and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3–2.2). Reasons for co-worker attrition included: better pay (40%), feeling overworked or stressed (21%), moving away (16%), death (8%) and illness (5%). When asked about HIV testing, 370 of 456 (81%) reported having tested; 240 (50%) tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability.

Kruse, Gina R; Chapula, Bushimbwa Tambatamba; Ikeda, Scott; Nkhoma, Mavis; Quiterio, Nicole; Pankratz, Debra; Mataka, Kaluba; Chi, Benjamin H; Bond, Virginia; Reid, Stewart E

2009-01-01

344

Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia  

PubMed Central

Abstracts Background With regards to equity, the objective for health care systems is “equal access for equal needs”. We examined associations of predisposing, enabling and need factors with health facility utilization in areas with high HIV prevalence and few people being aware of their HIV status. Methods The data is from a population-based survey among adults aged 15years or older conducted in 2003. The current study is based on a subset of this data of adults 15–49 years with a valid HIV test result. A modified Health behaviour model guided our analytical approach. We report unadjusted and adjusted odds ratios and their 95% confidence intervals from logistic regression analyses. Results Totals of 1042 males and 1547 females in urban areas, and 822 males and 1055 females in rural areas were included in the study. Overall, 53.1% of urban and 56.8% of rural respondents utilized health facilities past 12 months. In urban areas, significantly more females than males utilized health facilities (OR=1.4 (95% CI [1.1, 1.6]). Higher educational attainment (10+ years of schooling) was associated with utilization of health facilities in both urban (OR=1.7, 95% CI [1.3, 2.1]) and rural (OR=1.4, 95% CI [1.0, 2.0]) areas compared to respondents who attained up to 7 years of schooling. Respondents who self-rated their health status as very poor/ poor/fair were twice more likely to utilize health facilities compared to those who rated their health as good/excellent. Respondents who reported illnesses were about three times more likely to utilize health facilities compared to those who did not report the illnesses. In urban areas, respondents who had mental distress were 1.7 times more likely to utilize health facilities compare to those who had no mental distress. Compared to respondents who were HIV negative, respondents who were HIV positive were 1.3 times more likely to utilize health facilities. Conclusion The health care needs were the factors most strongly associated with health care seeking. After accounting for need differentials, health care seeking differed modestly by urban and rural residence, was somewhat skewed towards women, and increased substantially with socioeconomic position.

2012-01-01

345

The Use of Mass Media in the Education of Adults: Conference (Lusaka, Zambia, January 3-8, 1965).  

ERIC Educational Resources Information Center

|At this 1965 Central and East African conference, lectures and reports were given on radio and television in correspondence education; uses of films, radio, the printed word, and television in adult education in general; and principles of effective and efficient mass media communication. Emphasis was on the value of combined visual and aural…

1965

346

The ethical and legal regulation of HIV-vaccine research in Africa: lessons from Cameroon, Malawi, Nigeria, Rwanda and Zambia  

Microsoft Academic Search

Ethical and legal frameworks are important for ensuring that the goals of scientific research are realised while at the same time the rights and welfare of human participants are adequately protected. A balance in attaining these two goals can be achieved if such frameworks provide for legally binding structures and processes to oversee, regulate, and monitor research on human participants

Pamela Andanda; Paschal Awah; Paul Ndebele; Olanrewaju Onigbogi; Daniel Udatinya; Malala Mwondela

2011-01-01

347

Men, women and the trouble with condoms: problems associated with condom use by migrant workers in rural Zambia  

Microsoft Academic Search

Understanding cultural attitudes to condoms is of the utmost importance in promoting their use as a means of protection against HIV transmission. This article examines condom use in relation to what people see as the purpose of sex, what good sex entails and how this relates to ideas of being a proper woman or man. It seems that the underlying

Virginia Bond; Paul Dover

1997-01-01

348

Democratic Development and the Role of Citizenship Education in Sub-Saharan African with a Case Focus on Zambia  

Microsoft Academic Search

In addressing issues related to problems of democratisation in Africa, this paper attempts to relate the issue to the need for citizenship education and the role that can play in social development. Citizenship should be central to the formation of viable civil societies that claim a tangible stake in national public spaces in post-Cold War Africa. These and related topics

Ali A. Abdi; Lee Ellis; Edward Shizha

2005-01-01

349

Strengthening Health Systems at Facility-Level: Feasibility of Integrating Antiretroviral Therapy into Primary Health Care Services in Lusaka, Zambia  

Microsoft Academic Search

IntroductionHIV care and treatment services are primarily delivered in vertical antiretroviral (ART) clinics in sub-Saharan Africa but there have been concerns over the impact on existing primary health care services. This paper presents results from a feasibility study of a fully integrated model of HIV and non-HIV outpatient services in two urban Lusaka clinics.MethodsIntegration involved three key modifications: i) amalgamation

Stephanie M. Topp; Julien M. Chipukuma; Mark Giganti; Linah K. Mwango; Like M. Chiko; Bushimbwa Tambatamba-Chapula; Chibesa S. Wamulume; Stewart Reid; Landon Myer

2010-01-01

350

Social Acceptance of Children with Intellectual Disabilities in an Integrated School Setting in Zambia: A Pilot Study.  

ERIC Educational Resources Information Center

|Investigation of the social acceptance of 15 Zambian primary school children with intellectual disabilities by two groups of nondisabled children found that nondisabled boys who had experienced contact with the disabled children had more positive attitudes than boys with no contact. No exposure effects were observed among girls. Among the…

Nabuzoka, Dabie; Ronning, John A.

1997-01-01

351

Evaluation of Trauma and Critical Care Training Courses on the Knowledge and Confidence of Participants in Kenya and Zambia  

Microsoft Academic Search

Background  Trained health-care personnel are essential for improved outcomes for injured and critically ill patients. The highest injury-related\\u000a mortality is seen in sub-Saharan Africa, where there is a paucity of skilled personnel. Therefore, the College of Surgeons\\u000a of East, Central, and Southern Africa (COSECSA) along with Emory University provided an acute trauma care (ATC) and fundamental\\u000a critical care support course (FCCS).

Jana B. A. MacLeodMoses; Moses Okech; Mohammed Labib; Paul Aphivantrakul; Emanual Lupasha; Mzaza Nthele

2011-01-01

352

Evaluation of endocrine disruptor levels in Kafue Lechwe (Kobus leche kafuensis) samples from the Blue Lagoon National Park of Zambia.  

PubMed

The concentrations of endocrine disruptors were determined in 36 liver tissue, serum and whole blood sample extracts drawn from 15 Blue Lagoon National Park Kafue lechwe. Out of 10 analytes evaluated, 89% of the sample extracts showed very high dieldrin concentrations of between 0.08–100 ?g/mL in serum, 0.08–24.8 ?g/mL in whole blood and 0.08–4.6 ?g/g wet weight in liver tissue extracts. pp-DDE was detected in 83% of the sample extracts at 0.006–5.1 ?g/mL in serum, 0.006–8.5 ?g/mL in whole blood and 0.006–0.12 ?g/g wet weight in liver tissue extracts. There was strong correlation between pp-DDE and dieldrin in all the three matrices. Deltamethrin and endosulfan detected at 50% frequency each. Percent recoveries in spiked laboratory blanks ranged between 60–100% while calculated detection limits ranged from 0.004 to 0.21 ?g/mL for all the endocrine disruptors evaluated. PMID:19669681

Sichilongo, Kwenga; Torto, Nelson

2009-12-01

353

Perinatal Outcomes of Multiple-Gestation Pregnancies in Kenya, Zambia, Pakistan, India, Guatemala, and Argentina: A Global Network Study.  

PubMed

Aim To determine the rates of multiple gestation, stillbirth, and perinatal and neonatal mortality and to determine health care system characteristics related to perinatal mortality of these pregnancies in low- and middle-income countries.Methods Pregnant women residing within defined geographic boundaries located in six countries were enrolled and followed to 42 days postpartum.Results Multiple gestations were 0.9% of births. Multiple gestations were more likely to deliver in a health care facility compared with singletons (70 and 66%, respectively, p < 0.001), to be attended by skilled health personnel (71 and 67%, p < 0.001), and to be delivered by cesarean (18 versus 9%, p < 0.001). Multiple-gestation fetuses had a relative risk (RR) for stillbirth of 2.65 (95% confidence interval [CI] 2.06, 3.41) and for perinatal mortality rate (PMR) a RR of 3.98 (95% CI 3.40, 4.65) relative to singletons (both p < 0.0001). Neither delivery in a health facility nor the cesarean delivery rate was associated with decreased PMR. Among multiple-gestation deliveries, physician-attended delivery relative to delivery by other health providers was associated with a decreased risk of perinatal mortality.Conclusions Multiple gestations contribute disproportionately to PMR in low-resource countries. Neither delivery in a health facility nor the cesarean delivery rate is associated with improved PMR. PMID:23512321

Marete, Irene; Tenge, Constance; Pasha, Omrana; Goudar, Shivaprasad; Chomba, Elwyn; Patel, Archana; Althabe, Fernando; Garces, Ana; McClure, Elizabeth M; Saleem, Sarah; Esamai, Fabian; Kodkany, Bhala S; Belizan, Jose M; Derman, Richard J; Hibberd, Patricia L; Krebs, Nancy; Buekens, Pierre; Goldenberg, Robert L; Carlo, Waldemar A; Wallace, Dennis; Moore, Janet; Koso-Thomas, Marion; Wright, Linda L; Liechty, Edward A

2013-03-19

354

Cost effectiveness of community-based therapeutic care for children with severe acute malnutrition in Zambia: decision tree model  

Microsoft Academic Search

BACKGROUND: Children aged under five years with severe acute malnutrition (SAM) in Africa and Asia have high mortality rates without effective treatment. Primary care-based treatment of SAM can have good outcomes but its cost effectiveness is largely unknown. METHOD: This study estimated the cost effectiveness of community-based therapeutic care (CTC) for children with severe acute malnutrition in government primary health

Max O Bachmann

2009-01-01

355

Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study  

Microsoft Academic Search

BACKGROUND: Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. METHODS: From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers

Gina R Kruse; Bushimbwa Tambatamba Chapula; Scott Ikeda; Mavis Nkhoma; Nicole Quiterio; Debra Pankratz; Kaluba Mataka; Benjamin H Chi; Virginia Bond; Stewart E Reid

2009-01-01

356

Issues in the design of a clinical trial with a behavioral intervention—the Zambia exclusive breast-feeding study  

Microsoft Academic Search

Purpose: We present the rationale and design of the Zambian Exclusive Breast-feeding Study (ZEBS), a randomized trial evaluating the efficacy of short-duration exclusive breast-feeding (EBF) as a strategy to reduce postnatal human immunodeficiency virus (HIV) transmission while preserving the other health benefits of this important mode of infant feeding. Methods: One thousand two hundred HIV-positive pregnant women were recruited in

Donald M Thea; Cheswa Vwalika; Prisca Kasonde; Chipepo Kankasa; Moses Sinkala; Katherine Semrau; Erin Shutes; Christine Ayash; Wei-Yann Tsai; Grace Aldrovandi; Louise Kuhn

2004-01-01

357

Esther Phiri and the Moutawakel effect in Zambia: an analysis of the use of female role models in sport-for-development  

Microsoft Academic Search

In the burgeoning field of sport and development, ‘role models’ have been invoked as an important element to increase the participation of girls and women in sport. Grounded in the African sport-in-development experience and in a case study of Zambian women's sports and the boxer, Esther Phiri, this essay examines the discourse around the use of ‘role models’ and begins

Marianne Meier; Martha Saavedra

2009-01-01

358

Genomic sequence of an infectious bursal disease virus isolate from Zambia: classical attenuated segment B reassortment in nature with existing very virulent segment A.  

PubMed

We determined the complete nucleotide sequence of an infectious bursal disease (IBD) virus (IBDV) isolate (designated KZC-104) from a confirmed IBD outbreak in Lusaka in 2004. The genome consisted of 3,074 and 2,651 nucleotides in the coding regions of segments A and B, respectively. Alignment of both nucleotide and deduced amino acid sequences and phylogenetic analysis revealed that the genome segment A of KZC-104 was derived from a very virulent (VV) strain, whereas its segment B was derived from a classical attenuated strain. On BLAST search, the full-length segment A and B sequences showed 98 % nucleotide sequence identity to the VV strain D6948 and 99.8 % nucleotide sequence identity to the classical attenuated strain D78. This is a unique IBDV reassortant strain that has emerged in nature, involving segment B of a cell-culture-adapted attenuated vaccine. PMID:23129132

Kasanga, C J; Yamaguchi, T; Munang'andu, H M; Ohya, K; Fukushi, H

2012-11-06

359

To Feed Ourselves. A Proceedings of the First Eastern, Central and Southern Africa Regional Maize Workshop Held at Lusaka, Zambia, March 10-17, 1985.  

National Technical Information Service (NTIS)

Proceedings from a March 1985 workshop on maize research and production in the eastern, central, and southern Africa regions are presented. Eighteen country reports are provided by scientists from Angola, Burundi, Ethiopia, Kenya, Lesotho, Madagascar, Mal...

1985-01-01

360

Use of intermediate modes of transport for patient transport: a literature review contrasted with the findings of the Transaid Bicycle Ambulance Project in Eastern Zambia  

Microsoft Academic Search

Access to efficient, affordable and safe transport in the developing world is limited and directly impacts upon the ability of individuals to seek timely health services. More than 60% of people in poor countries live more than eight kilometres from a healthcare facility. The link between the distance that an individual lives from a health facility and worsening maternal mortality

Gary Forster; Victor Simfukweb; Caroline Barber

361

Impact of community-directed treatment on soil transmitted helminth infections in children aged 12 to 59 months in Mazabuka District, Zambia.  

PubMed

This study assessed the impact of adding community-directed treatment (ComDT) to the routine health facility (HF)-based treatment on prevalence and intensity of soil transmitted helminth (STH) infections among children aged 12 to 59 months. Repeated cross-sectional surveys were conducted among randomly selected children of this age group from the intervention area (HF+ComDT area) and the comparison area (HF area) at baseline (n=986), 12 months (n=796) and 18 months (n=788) follow-up. The prevalence of Ascaris lumbricoides was significantly higher in the HF+ComDT as compared to the HF area at baseline (P=0·048), but not at 12 and 18 months follow-up. At baseline the HF+ComDT area had significantly higher intensities of A. lumbricoides compared to the HF area (P<0·001), but not at 12 and 18 months follow-ups. Prevalence and intensity of hookworm did not differ significantly between treatment arms at any time. Analysis of trends showed a significant decrease in prevalence of A. lumbricoides and hookworm in the HF+ComDT area (P<0·001), of hookworm in the HF area (P<0·05), but not of A. lumbricoides in the HF area. It is concluded that the ComDT approach generally enhanced the treatment effect among under-five year children and that this alternative approach may also have advantages in other geographical settings. PMID:21320386

Halwindi, Hikabasa; Magnussen, Pascal; Siziya, Seter; Handema, Ray; Meyrowitsch, Dan W; Olsen, Annette

2011-02-15

362

Communities' views on prerequisites for collaboration between modern and traditional health sectors in relation to STI\\/HIV\\/AIDS care in Zambia  

Microsoft Academic Search

Traditional, complementary and alternative medicine (TM\\/CAM) is globally increasing in popularity. The World Health Orga- nization (WHO) has advocated for the integration of TM\\/CAM in national public health policies to enhance health care resources. Interest in collaboration between traditional and biomedical health sectors has been renewed in attempts to strengthen control of the AIDS epidemic. However, studies exploring communities' views

Berthollet Bwira Kaboru; Torkel Falkenberg; Jane Ndulo; Maureen Muchimbac; Kashita Solo; Elisabeth Faxelid

2005-01-01

363

Neonatal Intensive Care: A Global Perspective of Similarities and Differences in Selected Neonatal Intensive Care Units in Brazil, Chile, the United States, and Zambia  

Microsoft Academic Search

Nurses working in neonatal intensive care units (NICUs) worldwide share common goals of providing high quality care and promoting healthy outcomes for high-risk newborns and their families. There are wide differences across the globe, however, in the specific challenges that NICU nurses face in meeting these common goals and in the ways in which nursing care is provided to address

Lynda Wilson; Mary Beth Bodin; Patricia Fernandez; Guillermo Godoy; Carolina Sambuceti; Regis Squarre; Margaret Maimbolwa; Catherine Ngoma; Edi Toma; Claudia Viera; Ana Cristina Bastidas; Orienta Cabezas; Monica Morgues

2011-01-01

364

A verbal audit to determine the consequences of domestic violence among 50 women at a shelter for abused women in Lusaka, Zambia  

Microsoft Academic Search

Summary50 women were enlisted with ages ranging between 18 and 49 years Verbal threats physical beatings, verbal abuse and non-consensual sexual intercourse were the forms Domestic violence took.MethodA semistructured schedule based on Convenience sampling Method was used. The 50 women were drawn from a drop-in centre for abused women in Lusaka.Results29 out of 50 or 58% were married, 7 or

R E Mtonga

2010-01-01

365

A method of active case detection to target reservoirs of asymptomatic malaria and gametocyte carriers in a rural area in Southern Province, Zambia  

Microsoft Academic Search

BACKGROUND: Asymptomatic reservoirs of malaria parasites are common yet are difficult to detect, posing a problem for malaria control. If control programmes focus on mosquito control and treatment of symptomatic individuals only, malaria can quickly resurge if interventions are scaled back. Foci of parasite populations must be identified and treated. Therefore, an active case detection system that facilitates detection of

Gillian H Stresman; Aniset Kamanga; Petros Moono; Harry Hamapumbu; Sungano Mharakurwa; Tamaki Kobayashi; William J Moss; Clive Shiff

2010-01-01

366

Effects of traditional and discovery instructional approaches on learning outcomes for learners of different intellectual development: A study of chemistry students in Zambia  

Microsoft Academic Search

This study examined the differential effectiveness of traditional and discovery methods of instruction for the teaching of science concepts, understandings about science, and scientific attitudes, to learners at the concrete and formal level of cognitive development. The dependent variables were achievement, understanding science, and scientific attitude; assessed through the use of the ACS Achievement Test (high school chemistry, Form 1979),

Moses M. Mulopo; H. Seymour Fowler

1987-01-01

367

SYNERGISTIC USE OF OPTICAL AND RADAR REMOTE SENSING FOR MAPPING AND MONITORING FLOODING SYSTEM IN KAFUE FLATS WETLAND OF SOUTHERN ZAMBIA  

Microsoft Academic Search

These Wetlands are lands with characteristics between aquatic and terrestrial ecosystems. They generally consist of grasslands, swamps, marshes, peat bogs, willows, mangroves, etc. Some wetlands are found in shallow slow flowing or percolating waters with hydric soils and hydrophytic vegetation. These characteristics ensure the biological diversity and uniqueness of wetland ecosystems. However, as population increases there is increased need to

Michael Aduah; Ben Maathuis; Yousif Ali Hussin

368

How late is too late? Timeliness to scheduled visits as an antiretroviral therapy adherence measure in Nairobi, Kenya and Lusaka, Zambia.  

PubMed

Collecting self-reported data on adherence to highly active antiretroviral therapy (HAART) can be complicated by patients' reluctance to report poor adherence. The timeliness with which patients attend visits might be a useful alternative to estimate medication adherence. Among Kenyan and Zambian women receiving twice daily HAART, we examined the relationship between self-reported pill taking and timeliness attending scheduled visits. We analyzed data from 566 Kenyan and Zambian women enrolled in a prospective 48-week HAART-response study. At each scheduled clinic visit, women reported doses missed over the preceding week. Self-reported adherence was calculated by summing the total number of doses reported taken and dividing by the total number of doses asked about at the visit attended. A participant's adherence to scheduled study visits was defined as "on time" if she arrived early or within three days, "moderately late" if she was four-seven days late, and "extremely late/missed" if she was more than eight days late or missed the visit altogether. Self-reported adherence was <95% for 29 (10%) of 288 women who were late for at least one study visit vs. 3 (1%) of 278 who were never late for a study visit (odds ratios [OR] 10.3; 95% confidence intervals [95% CI] 2.9, 42.8). Fifty-one (18%) of 285 women who were ever late for a study visit experienced virologic failure vs. 32 (12%) of 278 women who were never late for a study visit (OR 1.7; 95% CI 1.01, 2.8). A multivariate logistic regression model controlling for self-reported adherence found that being extremely late for a visit was associated with virologic failure (OR 2.0; 95% CI 1.2, 3.4). Timeliness to scheduled visits was associated with self-reported adherence to HAART and with risk for virologic failure. Timeliness to scheduled clinic visits can be used as an objective proxy for self-reported adherence and ultimately for risk of virologic failure. PMID:20711886

Blacher, Rachel J; Muiruri, Peter; Njobvu, Lungowe; Mutsotso, Winnie; Potter, Dara; Ong'ech, John; Mwai, Paul; Degroot, Alain; Zulu, Isaac; Bolu, Omotayo; Stringer, Jeffrey; Kiarie, James; Weidle, Paul J

2010-11-01

369

New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data  

Microsoft Academic Search

Summary Background Sub-Saharan Africa has a high rate of HIV infection, most of which is attributable to heterosexual transmission. Few attempts have been made to assess the extent of HIV transmission within marriages, and HIV-prevention eff orts remain focused on abstinence and non-marital sex. We aimed to estimate the proportion of heterosexual transmission of HIV which occurs within married or

Kristin L Dunkle; Rob Stephenson; Etienne Karita; Elwyn Chomba; Kayitesi Kayitenkore; Cheswa Vwalika; Lauren Greenberg; Susan Allen

2008-01-01

370

Rural Africa Development Project, A Survey Technique for Identifying the Needs of Small Farmers, and an Example of Its Use in Zambia.  

National Technical Information Service (NTIS)

This paper is written in two sections. In part 1, the need to make a survey and identify farmers' real problems before trying to introduce new techniques is explained. An annotated checklist of factors which should be considered in such a survey is given,...

R. D. Mann

1974-01-01

371

An overview of industrial wastewater treatment and analysis as means of preventing pollution of surface and underground water bodies---the case of Nkana Mine in Zambia  

Microsoft Academic Search

The wastewaters coming from mining operations usually have low pH (acidic) values and high levels of metal pollutants depending on the type of metals being extracted. If unchecked, the acidity and metals will have an impact on the surface water. The organisms and plants can adversely be affected and this renders both surface and underground water unsuitable for use by

F. W. Ntengwe

2005-01-01

372

An overview of industrial wastewater treatment and analysis as means of preventing pollution of surface and underground water bodies—the case of Nkana Mine in Zambia  

Microsoft Academic Search

The wastewaters coming from mining operations usually have low pH (acidic) values and high levels of metal pollutants depending on the type of metals being extracted. If unchecked, the acidity and metals will have an impact on the surface water. The organisms and plants can adversely be affected and this renders both surface and underground water unsuitable for use by

F. W. Ntengwe

2005-01-01

373

Trace gas emissions from the production and use of domestic biofuels in Zambia measured by open-path Fourier transform infrared spectroscopy  

Microsoft Academic Search

Domestic biomass fuels (biofuels) were recently estimated to be the second largest source of carbon emissions from global biomass burning. Wood and charcoal provide approximately 90% and 10% of domestic energy in tropical Africa. In September 2000, we used open-path Fourier transform infrared (OP-FTIR) spectroscopy to quantify 18 of the most abundant trace gases emitted by wood and charcoal cooking

Isaac T. Bertschi; Robert J. Yokelson; Darold E. Ward; Ted J. Christian; Wei Min Hao

2003-01-01

374

Urbanising Africa: the city centre revisited: Experiences with inner-city revitalisation from Johannesburg (South Africa), Mbabane (Swaziland), Lusaka (Zambia), Harare and Bulawayo (Zimbabwe)  

Microsoft Academic Search

Drawing on practical experiences of almost 15 years working within Gauteng Province and the City of Johannesburg my paper will focus on the location of poor communities within Johannesburg in relation to selected Inner-City areas and public transportation networks.\\u000aThe introduction notes the historical foundations and spatial legacies of the City (for example, the mining industry, pre and post apartheid

Ahmad P; Chirisa I; Magwaro-Ndiweni L; Michundu M. W; Ndela W. N; Nkonge M; Sachs D

2010-01-01

375

Improving community health worker use of malaria rapid diagnostic tests in Zambia: package instructions, job aid and job aid-plus-training  

Microsoft Academic Search

BACKGROUND: Introduction of artemisinin combination therapy (ACT) has boosted interest in parasite-based malaria diagnosis, leading to increased use of rapid diagnostic tests (RDTs), particularly in rural settings where microscopy is limited. With donor support, national malaria control programmes are now procuring large quantities of RDTs. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that

Steven A Harvey; Larissa Jennings; Masela Chinyama; Fred Masaninga; Kurt Mulholland; David R Bell

2008-01-01

376

15 CFR Supplement No. 2 to Part 745 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...  

Code of Federal Regulations, 2013 CFR

...United Arab Emirates Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia...

2013-01-01

377

8 CFR 1236.1 - Apprehension, custody, and detention.  

Code of Federal Regulations, 2010 CFR

...Korea Tajikistan Tanzania Tonga Trinidad/Tobago Turkmenistan Tuvalu Ukraine United Kingdom 3 3 British dependencies...Kyrgyzstan, Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. Uzbekistan Zambia...

2009-01-01

378

Donor-Driven Initiatives and Media Training in Africa.  

ERIC Educational Resources Information Center

|Uses an interdisciplinary policy analysis framework to examine the United States Agency for International Development (AID) program to consolidate democracy in Zambia. Argues that, despite shortcomings, AID has made significant contributions to capacity-building in Zambia's mass media industry, and that it may have succeeded in laying the…

Ogundimu, Folu Folarin

1997-01-01

379

Donor-Driven Initiatives and Media Training in Africa.  

ERIC Educational Resources Information Center

Uses an interdisciplinary policy analysis framework to examine the United States Agency for International Development (AID) program to consolidate democracy in Zambia. Argues that, despite shortcomings, AID has made significant contributions to capacity-building in Zambia's mass media industry, and that it may have succeeded in laying the…

Ogundimu, Folu Folarin

1997-01-01

380

Civil Society and Democracy: A Zambian Case Study  

Microsoft Academic Search

At the beginning of the 1990s, theorists talked of an 'international momentum' of democracy, and focused on the central role of civil society in advancing the democratic process. This approach was used to explore the transition in Zambia, but a close reading of events before and after Zambia's 1991 election indicates that 'older political logics' do not disappear merely because

David M. C. Bartlett

2000-01-01

381

Secondary Wood Processing in the Eastern African Countries.  

National Technical Information Service (NTIS)

The report examines the secondary wood processing industry in the East African countries of Ethiopia, Kenya, Madagascar, Malawi, Swaziland, Tanzania, Zambia and Zimbabwe. It covers indigenous forests, plantations, financial aspects, training, marketing, m...

C. R. Francis

1990-01-01

382

Negotiating and Programming Food Aid: A Review of Successes. Final Report on Results of Five Evaluative Case Studies.  

National Technical Information Service (NTIS)

The report summarizes the conclusions and recommendations of five studies of the Public Law 480 food aid program--Haiti, Mali, Pakistan, Tunisia and Zambia. The studies stress the process of identification, negotiation, implementation and reporting on the...

A. L. Morton R. R. Newberg

1986-01-01

383

Negotiating and Programming Food Aid: Lessons from Experience. Final Report on Results of Five Evaluative Case Studies.  

National Technical Information Service (NTIS)

The report summarizes the conclusions and recommendations of five studies of Public Law (PL) 480 food aid programs in Haiti, Mali, Pakistan, Tunisia, and Zambia. The studies stress the process of identification, negotiation, implementation, and reporting ...

A. Morton R. R. Newberg

1989-01-01

384

Higher Education: Labor Market Linkage.  

ERIC Educational Resources Information Center

Examines the methodology of three case studies investigating the linkage between higher education and the world of work in the Sudan, Zambia, and Tanzania. Summarizes 12 main findings. Suggests the studies remain traditional human resources planning efforts. (NEC)

Asayeghn, Desta

1982-01-01

385

Risk Poster II, v1.2  

Center for Biologics Evaluation and Research (CBER)

Text Version... or lived in: Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea, Gabon, Niger, Nigeria, Senegal, Togo, Zambia, Benin or Kenya ... More results from www.fda.gov/downloads/biologicsbloodvaccines/bloodbloodproducts

386

8 CFR 1236.1 - Apprehension, custody, and detention.  

Code of Federal Regulations, 2013 CFR

...Tanzania Tonga Trinidad/Tobago Turkmenistan Tuvalu Ukraine United Kingdom 3 3 British dependencies are also covered...Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. Uzbekistan Zambia (f)...

2013-01-01

387

Alinia (nitazoxanide) tablets and oral suspension  

Center for Drug Evaluation (CDER)

Text Version... failed to submit the sales aid to FDA ... caused by Cryptosporidium parvum in HIV-infected or ... acquired immune deficiency syndrome (AIDS) in Zambia ... More results from www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation

388

Karen E. Mark, MD, MPH  

Center for Biologics Evaluation and Research (CBER)

Text Version... October 24- 27, 2002, Chicago, Illinois. (Oral presentation on October 26, 2002.) 6. Mark KE, Rwanda/Zambia HIV Research Group. ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

389

National Food Security Stock Policies and Procedures in Sub-Saharan Africa: Case Studies.  

National Technical Information Service (NTIS)

The report includes case studies of Chad, Malawi, Mali, and Zambia, which demonstrates a diversity of policies and procedures promoting food security in sub-Saharan Africa. The subjects examined include food security objectives, organizations, use of the ...

K. E. Neils J. D. Lea C. Reed

1992-01-01

390

Communist Chinese Influence in Central Africa.  

National Technical Information Service (NTIS)

The extent of Communist Chinese influence in Central Africa is obviously growing. Although Zambia's president, Kenneth Kaunda, has indicated his concern about outside intervention in the affairs of his country, there is every reason to believe that the Ch...

R. K. Swab

1971-01-01

391

48 CFR 52.225-5 - Trade Agreements.  

Code of Federal Regulations, 2010 CFR

...the United States-Caribbean Basin Trade Partnership Act of 2000...the United States-Caribbean Basin Trade Partnership Act; and...Comoros, Democratic Republic of Congo, Djibouti, East Timor...Zambia); or (4) A Caribbean Basin country (Antigua and...

2009-10-01

392

78 FR 57885 - Report on the Criteria and Methodology for Determining the Eligibility of Candidate Countries for...  

Federal Register 2010, 2011, 2012, 2013

...Sao Tome and Principe 42. Senegal 43. Sierra Leone 44. Solomon Islands 45. Somalia 46. South Sudan 47. Sudan 48. Tajikistan 49. Tanzania 50. Togo 51. Uganda 52. Uzbekistan 53. Vietnam 54. Yemen 55. Zambia 56. Zimbabwe Lower Middle...

2013-09-20

393

76 FR 69290 - Report on Countries That Are Candidates for Millennium Challenge Account Eligibility in Fiscal...  

Federal Register 2010, 2011, 2012, 2013

...Nicaragua Niger Nigeria Pakistan Papua New Guinea Rwanda Sao Tome and Principe Senegal Sierra Leone Solomon Islands Somalia Tajikistan Tanzania Timor-Leste Togo Uganda Vietnam Yemen Zambia Candidate Countries: Lower Middle Income Category Angola...

2011-11-08

394

76 FR 55419 - Report on Countries That Are Candidates for Millennium Challenge Account Eligibility in Fiscal...  

Federal Register 2010, 2011, 2012, 2013

...Nicaragua, Niger, Nigeria, Pakistan, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Solomon Islands, Somalia, Tajikistan, Tanzania, Timor-Leste, Togo, Uganda, Vietnam, Zambia Candidate Countries: Lower Middle Income Category...

2011-09-07

395

Sub-Saharan Africa Report.  

National Technical Information Service (NTIS)

This report constains translations/transcriptions of articles and/or broadcasts on sub-Saharan Africa. Titles include: PCP Militants Reportedly Assist foreign Secret Agents; Zimbabew, Tanzania, Zambia to Step Up Aid to Fight Renamo; Infulene Valley Projec...

1987-01-01

396

Management of Spent and Disused Radiation Sources - The Zambian Experience  

SciTech Connect

Zambia like all other countries in the world is faced with environmental problems brought about by a variety of human activities. In Zambia the major environmental issues as identified by Nation Environmental Action Plan (NEAP) of 1994 are water pollution, poor sanitation, land degradation, air pollution, poor waste management, misuse of chemicals, wildlife depletion and deforestation. Zambian has been using a lot of radioactive materials in its various industries. The country has taken several projects with help of external partners. These partners however left these projects in the hands of the Zambians without developing their capacities to manage these radioactive sources. The Government recognized the need to manage these sources and passed legislation governing the management of radioactive materials. The first act of Parliament on Radiation Protection work was passed in 1975 to legislate the use of ionizing radiation. However, because of financial constraints the Country is facing, these regulations have remained unimplemented. Fortunately the international Community has been working in partnership with the Zambian Government in the Management of Radioactive Material. Therefore this paper will present the following aspects of radioactive waste management in Zambia: review Existing Legislation in Zambia regarding management of spent/radioactive sources; capacity building in the field of management of radioactive waste; management of spent and disused radiation sources; existing disposal systems in Zambia regarding spent/orphaned sources; existing stocks of radioactive sources in the Zambian industries.

Chabala, F.

2002-02-26

397

Rehabilitation in Seven Sub-Saharan African Countries: Personnel Education and Training  

ERIC Educational Resources Information Center

|This article outlines rehabilitation personnel education and training in seven countries representing a geo-culturally contiguous region of sub-Saharan Africa: Botswana, Cameroon, Rwanda, South Africa, Tanzania, Zambia, and Zimbabwe. It identifies and explicates practices to inform similar or parallel rehabilitation practices in the United States…

Mpofu, Elias; Jelsma, Jennifer; Maart, Soraya; Levers, Lisa Lopez; Montsi, Mercy M. R.; Tlabiwe, Pinkie; Mupawose, Anniah; Mwamwenda, Tuntufye; Ngoma, Mary Shilalukey; Tchombe,Therese Mungah S.

2007-01-01

398

Gender and the New Free Market: Using International Frameworks to Assess Developments in the U.S  

Microsoft Academic Search

In the bustling and colorful outdoor markets of Zambia, where women shopping for food strolled among stalls displaying regional produce and caught up on local gossip, shoppers had quite a shock in 1985. In that year, the price of maize rose by fifty percent after the Zambian government eliminated a subsidy that had earlier controlled the cost of the popular

Jane Berger

399

Sexual Risk Intervention In Multiethnic Drug And Alcohol Users 1  

Microsoft Academic Search

Abstract: An estimated 38.6 million persons globally are living with HIV, of whom over 1.1 million reside in Zambia. Of the 2 million cases in the US, 64% of new cases among women are among African Americans. Alcohol and drug use represents a significant risk factor for HIV transmission among both Zambians and African Americans. In addition, gender dynamics in

Deborah L. Jones; Stephen M. Weiss; Ndashi Chitalu; Olga Villar; Mahendra Kumar; Violet Bwalya; Maureen Mumbi

2008-01-01

400

A Cross-Cultural Examination of Organizational Structure and Control: The Zambian Agricultural Sector  

Microsoft Academic Search

This article examines modified scales of Hage and Aiken's constructs of centralization and formalization. The modified scales were tested in 16 relatively heterogeneous agricultural plan ning and service organizations in Central Province, Zambia. Overall, the revised scales per formed as well cross-culturally as the original scales have in various institutional settings in the United States.The results of correlation and partial

Robert E. Meyer

1992-01-01

401

Distance Education for Health Personnel: New Strategies.  

ERIC Educational Resources Information Center

|An intercountry workshop on distance learning (DL) was conducted at the University of Khartoum, Sudan, in November 1991. Individuals involved in the World Health Organization's (WHO's) Health Learning Materials network in nine African countries (Sudan, Ethiopia, Guyana, Kenya, Mauritius, Tanzania, Uganda, Zambia, and Zimbabwe) met to share their…

Mwakilasa, Amos

402

Predictors of welfare and child outcomes in female-headed households in sub-Saharan Africa  

Microsoft Academic Search

This study examines correlates of household welfare in female-headed households in three countries of sub-Saharan Africa – Tanzania, Zambia, and Zimbabwe – using data from the 2004 wave of the Afrobarometer survey (n?=?3525). More specifically, we assess the role government interventions and informal assistance might play in predicting household welfare. The association between female headship of a household and aspirations

Margaret Lombe; Najwa Safadi; Chrisann Newransky

2011-01-01

403

Notes on the socio-economic and cultural factors influencing the transmission of HIV in Botswana  

Microsoft Academic Search

Botswana currently has one of the highest recorded incidences of HIV infection in Africa although AIDS was only first publicly recognized in 1985. By this time other countries in the region such as Malawi, Zambia and Uganda were already showing signs of epidemic levels of HIV. The rapid transmission of HIV in Botswana has been due to three main factors;

David S. Macdonald

1996-01-01

404

Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities  

Microsoft Academic Search

BACKGROUND: Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT) is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia. METHODS: Influence Network Agents (INAs) from the health, religious, non-governmental, and private sectors were

Susan Allen; Etienne Karita; Elwyn Chomba; David L Roth; Joseph Telfair; Isaac Zulu; Leslie Clark; Nzali Kancheya; Martha Conkling; Rob Stephenson; Brigitte Bekan; Katherine Kimbrell; Steven Dunham; Faith Henderson; Moses Sinkala; Michel Carael; Alan Haworth

2007-01-01

405

Developing Research Skills in Mathematics, Science and Technology Educators in Southern Africa: The Role of a Professional Organisation  

Microsoft Academic Search

An established professional organisation for researchers in mathematics, science and technology education (MSTE) in southern Africa initiated a program, Skills for Development, aimed at developing research skills for novice MSTE researchers in Mozambique, Swaziland and Zambia. Through case studies for each of these countries this paper seeks to identify relationships between aspects in the contexts of implementing MSTE research, and

Fred Lubben

2005-01-01

406

Transforming rural hunters into conservationists: An assessment of community-based wildlife management programs in Africa  

Microsoft Academic Search

The failure of conventional wildlife management in Eastern and Southern Africa has led several countries to implement community-based wildlife programs. We examine the assumptions these initiatives make about rural hunters, and describe how the programs attempt to induce individuals away from illegal hunting. Using game theory and a case study from Zambia, we find that these programs misunderstand some of

Stuart A. Marks

1995-01-01

407

AED in Africa.  

ERIC Educational Resources Information Center

|For 30 years, the Academy for Educational Development (AED) has worked to support African development. In Uganda, Tanzania, and Botswana AED promoted some of Africa's first AIDS prevention programs. AED is funding research in Ethiopia, Tanzania, and perhaps Zambia that will target stigma and its role in AIDS prevention. Working with governments…

Academy for Educational Development, Washington, DC.

408

Child labor and schooling in Africa : a comparative study  

Microsoft Academic Search

This paper analyzes the determinants of child labor in Africa as inferred from recent empirical studies. The empirical analysis is based upon three country studies undertaken in three different African countries, namely Cote d'Ivoire, Ghana, and Zambia. Some support is found for the popular belief of poverty as a determinant of child labor, however other determinants are of similar importance.

Sudharshan Canagarajah; Helena Skyt Nielsen

1999-01-01

409

Comparative insecticidal efficacy of five raw African diatomaceous earths against three tropical stored grain Coleopteran pests: Sitophilus zeamais, Tribolium castaneum and Rhyzopertha dominica  

Microsoft Academic Search

Five raw African diatomaceous earth (DE) samples collected from Tanzania, Zimbabwe, Zambia and South Africa were compared in laboratory bioassays at the Natural Resources Institute, UK and the University of Zimbabwe, to determine their potential as locally available grain protectants. A commercially available DE sample, Protect-It®, and an untreated control were included in the study for comparison. In UK, each

B. M. Mvumi; T. E. Stathers; V. Kaparadza; F. Mukoyi; P. Masiiwa; P. Jowah; W. Riwa

410

A study of integrated learning and the value of science in remote education: using the Internet to relay the total solar eclipse of 2001 June 11 in Africa  

Microsoft Academic Search

A total solar eclipse was observed on 2001 June 21 in Angola, Zambia, and Zimbabwe in Africa. For the purpose of promotion of science education using a solar eclipse as an educational project, the whole image and an enlarged image of the Sun, that showed the process of an eclipse and how things went in the observation area, were broadcast

N. Takahashi; H. Agata; K. Maeda; M.. Okyudo; Y. Yamazaki

2002-01-01

411

Susceptibility to intestinal infection and diarrhoea in Zambian adults in relation to HIV status and CD4 count  

Microsoft Academic Search

BACKGROUND: The HIV epidemic in sub-Saharan Africa has had a major impact on infectious disease, and there is currently great interest in the impact of HIV on intestinal barrier function. A three year longitudinal cohort study in a shanty compound in Lusaka, Zambia, carried out before anti-retroviral therapy was widely available, was used to assess the impact of HIV on

Paul Kelly; Jim Todd; Sandie Sianongo; James Mwansa; Henry Sinsungwe; Max Katubulushi; Michael J Farthing; Roger A Feldman

2009-01-01

412

Play-mothering: The Relations between Juvenile Females and Young Infants among Free-ranging Vervet Monkeys (Cevcopithecus aethiops)  

Microsoft Academic Search

In a study of social behavior of free-ranging vervet monkeys living along the Zambezi River near Livingstone, Zambia, 295 observations were made in which a juvenile female directed some type of maternal behavior toward an infant. Juvenile females showed a high degree of interest in young infants and would touch, cuddle, carry and groom infants whenever they could. This opportunity

Jane B. Lancaster

1971-01-01

413

Indigenous Models of Helping in Nonwestern Countries: Implications for Multicultural Counseling.  

ERIC Educational Resources Information Center

Examined indigenous models of helping in selected non-Western countries (Barbados, Korea, Nigeria, Pakistan, Singapore, Sudan. and Zambia) to investigate status of psychology, counseling, and related mental health professions in these countries. Findings from mental health professionals in these countries revealed three types of problems for which…

Lee, Courtland C.; And Others

1992-01-01

414

Modelling the Effects of Trade on Women, at Work and at Home: Comparative Perspectives  

Microsoft Academic Search

The effects of trade on women vary by socio-economic characteristics, sector and country. This paper assesses how well such effects can be captured by a gendered social accounting matrix (SAM) and computable general equilibrium (CGE) model. The model is applied comparatively to Bangladesh and Zambia to highlight how differences in resource endowments, labour market characteristics and socio-cultural norms shape the

Marzia Fontana

2004-01-01

415

Gemmology, geology and origin of the Sandawana emerald deposits, Zimbabwe  

Microsoft Academic Search

As one of the most valuable gemstones, emeralds are known to occur in several countries of the world, such as Colombia, Zambia, Brazil, Pakistan, Afghanistan, Russia, Madagascar and Zimbabwe. The emerald deposits at Sandawana, Zimbabwe, are described, the emeralds from this deposit characterised and a model of emerald formation presented; this is compared with existing models. The emeralds from Sandawana,

J. C. Zwaan

2006-01-01

416

Participatory Evaluation of Development AssistanceDealing with Power and Facilitative Learning  

Microsoft Academic Search

This article addresses two issues: the theoretical strengthening of the participatory evaluation concept, and the strengths and weaknesses in practice of this approach. It demonstrates how participatory evaluation can be strengthened conceptually and theoretically if based on fourth-generation evaluation and Giddens's structuration theory. Through an analysis of two evaluations in Zambia and Swaziland, strengths and weaknesses of applying the approach

Claus C. Rebien

1996-01-01

417

Intergenerational Perspectives on Education and Employment in the Zambian Copperbelt  

ERIC Educational Resources Information Center

|This article explores intergenerational perspectives on the link between secondary schooling and employment held by students, parents, and teachers in Ndola, Zambia. The author argues that the differentiated meanings of schooling must be understood in light of the economic effects of the shift away from a state-controlled economy during the…

Bajaj, Monisha

2010-01-01

418

Food aid, domestic policy and food security: Contrasting experiences from South Asia and sub-Saharan Africa  

Microsoft Academic Search

Food aid, both for short-term emergency relief and as program food aid that helps address medium-term food “deficits”, is often a major component of food security strategies in developing countries. This study reviews the experience with food aid of four major recipients of food aid (India, Bangladesh, Ethiopia and Zambia) regarding food production, trade, markets, consumption and safety nets, as

Carlo del Ninno; Paul A. Dorosh; Kalanidhi Subbarao

2007-01-01

419

Language policy and practice in the multilingual Southern African Development Community  

Microsoft Academic Search

This study explores the language policy and practice of the Southern African Development Community (SADC), an African regional economic organisation made up of 14 member states (Angola, Botswana, Democratic Republic of Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, United Republic of Tanzania, Zambia and Zimbabwe). The SADC operates a trilingual policy that recognises English, French and Portuguese

Theophilus Mooko

2009-01-01

420

Evaluation Report on Survey of Language Use and Language Teaching of Eastern Africa.  

ERIC Educational Resources Information Center

A survey was conducted from 1967 to 1970 with the following goals: (1) to gather information on the use and teaching of languages in Ethiopia, Kenya, Tanzania, Uganda, and Zambia; (2) to stimulate research and development in linguistics and language pedagogy in East Africa; (3) to assist in strengthening the resources of East African institutions…

Abdulaziz, Mohamed H.; Fox, Melvin J.

421

CRC handbook of agricultural energy potential of developing countries  

SciTech Connect

The contents of this book are: Introduction; Kenya; Korea (Republic of); Lesotho; Liberia; Malagasy; Malawi; Mali; Mauritania; Mexico, Mozambique, Nepal; Nicaragua; Niger; Nigeria; Pakistan; Panama; Paraguay; Peru; Philippines; Rwanda; Senegal; Sierra Leone; Somalia; Sri Lanka; Sudana; Surinam; Swaziland; Tanzania; Thailand; Togo; Uganda; Uruguay; Venezuela; Zaire; Zambia; Appendix I. Conventional and Energetic Yields; Appendix II, Phytomass Files; and References.

Duke, J.A.

1986-01-01

422

The P and S wave velocity structure of the mantle beneath eastern Africa and the African superplume anomaly  

NASA Astrophysics Data System (ADS)

P and S relative arrival time residuals from teleseismic earthquakes recorded on over 60 temporary AfricaArray broadband seismic stations deployed in Uganda, Tanzania, and Zambia between 2007 and 2011 have been inverted, together with relative arrival time residuals from earthquakes recorded by previous deployments, for a tomographic image of mantle wave speed variations extending to a depth of 1200 km beneath eastern Africa. The image shows a low-wave speed anomaly (LWA) well developed at shallow depths (100-200 km) beneath the Eastern and Western branches of the Cenozoic East African rift system and northwestern Zambia, and a fast wave speed anomaly at depths ? 350 km beneath the central and northern parts of the East African Plateau and the eastern and central parts of Zambia. At depths ?350 km the LWA is most prominent under the central and southern parts of the East African Plateau and dips to the southwest beneath northern Zambia, extending to a depth of at least 900 km. The amplitude of the LWA is consistent with a ˜150-300 K thermal perturbation, and its depth extent indicates that the African superplume, originally identified as a lower mantle anomaly, is likely a whole mantle structure. A superplume extending from the core-mantle boundary to the surface implies an origin for the Cenozoic extension, volcanism, and plateau uplift in eastern Africa rooted in the dynamics of the lower mantle.

Mulibo, Gabriel D.; Nyblade, Andrew A.

2013-08-01

423

Review of SISA Student Dissertations on Library and Information Systems and Services in Eastern and Southern Africa.  

ERIC Educational Resources Information Center

Analyzes student dissertations at the School of Information Studies for Africa (SISA) at Addis Ababa University (Ethiopia) in order to present an overview of the library and information systems and services available in seven eastern and southern African countries: Ethiopia, Kenya, Malawi, Sudan, Tanzania, Uganda, and Zambia. (Author/LRW)

Chowdhury, G. G.; Tadesse, Taye T.

1995-01-01

424

Knowledge Management Practices and Challenges in International Networked NGOs: The Case of One World International  

Microsoft Academic Search

This paper is based on the outcomes of a study that explored the knowledge management practices and challenges in an international NGO network. The investigation constituted comparative case studies of two centres (one in Zambia and the other in the Netherlands) belonging to a single international network. An empirically grounded framework of knowledge management practices based on the taxonomy proposed

J Gretchen Smith; Patricia Mweene Lumba

425

Television for Development. The African Experience. IDRC Manuscript Report.  

ERIC Educational Resources Information Center

|Based on visits to and interviews in 14 countries (Senegal, The Gambia, Niger, Ivory Coast, Nigeria, Zaire, Congo, Zambia, Zimbabwe, Cameroon, the United States, France, Italy, and Canada) this report provides a detailed accounting of the present and potential use of television to support development through non-formal educational programming in…

McLellan, Iain

426

High-tech and low-tech orthopaedic surgery in Sub-Saharan Africa  

Microsoft Academic Search

BACKGROUND: Zambia's governmental health system suffers from shortage of surgical supplies and poor management skills for the sparse resources at hand. The situation has been worsened by the dual epidemics of HIV disease and tuberculosis. On the other hand the private medical sector has benefited greatly from less bureaucracy under the goverment of the Movement for Multi-party Democracy. DISCUSSION: The

Wolfram H Kluge; Heike I Bauer

2002-01-01

427

Making Space for Adult Education in Independent Namibia  

ERIC Educational Resources Information Center

|Namibia is a vast and arid African country neighbouring South Africa, Botswana, Zimbabwe, Zambia, Angola and the Atlantic Ocean, with a population of only two million. Namibia achieved its independence in 1990 after a protracted and brutal struggle, latterly against South African occupation, but rooted in the resistance to German colonisation…

Ellis, Justin

2004-01-01

428

Summary of Safety and Effectiveness Data  

Center for Biologics Evaluation and Research (CBER)

Text Version... United States (4), Thailand (2), Brazil (1) B 7 7 (100.00) 7 (100.00) 4/4 Uganda (2), Zambia (1), Ethiopia (1), Senegal (1), Somalia (1) ... More results from www.fda.gov/downloads/biologicsbloodvaccines/bloodbloodproducts

429

Guidelines for the Preparation of General Guides to National Archives: A RAMP Study.  

ERIC Educational Resources Information Center

Based on a comparative study of guides from the Bahamas, Barbados, France, Italy, the Netherlands, Rhodesia, Spain, the United Kingdom, the United States, West Germany, and Zambia, this handbook provides guidelines for the organization and content of a general guide to archives, particularly national archives. It is noted that the handbook is…

Hildesheimer, Francoise

430

Role orientations of Third World urban planners  

Microsoft Academic Search

Although urban planners in Third World countries enjoy relatively high levels of power and autonomy, little is known about their values, attitudes, and professional role orientations. The findings are reported of a questionnaire survey designed to elicit information on the professional culture of planners from Barbados, India, Jamaica, Zambia, and Zimbabwe. Particular attention is given to respondents' perceived attributes of

P L Knox; C O Masilela

1990-01-01

431

Assessment of the Farm Level Financial Profitability of the Magoye RipperiIn Maize and Cotton Production in Southern and Eastern Provinces  

Microsoft Academic Search

With the risk of the drought in the agricultural production areas of Zambia, conservation farming (CF) was introduced as a set of technologies that can improve productivity while reducing plant stress due to moisture constraints. Under animal traction, CF involves using the Magoye ripper to minimize soil disturbance in land preparation and to help improve water conservation, thus enhancing farmers’

Stephen Kabwe; Cynthia Donovan; David Samazaka

2007-01-01

432

Methyl Halide Emissions From Experimental Fires With Southern African Biofuels  

Microsoft Academic Search

Under the auspices of SAFARI 2000, biofuels (savanna grasses, shrubs, woody plants, litter, agricultural waste, and charcoal) were sampled in the savannah of Kruger National Park, the Kalahari of Etosha National Park and the Miombo woodlands in Zambia and Malawi. More than 50 sub-samples were burned in 60 experiments under semi-controlled conditions at the biomass burning facility of the Max

J. M. Lobert; W. C. Keene; P. J. Crutzen; D. H. Scharffe; J. R. Maben; J. Williams

2001-01-01

433

Development Communication in an Urban Setting.  

ERIC Educational Resources Information Center

|The application of lessons gained from rural experience with development communications to the problems of delivering social services to the poorer segments of the urban areas is described in a report on the squatter upgrading project in Lusaka, the capital of Zambia. A Project Support Communications Unit established to provide communication…

Development Communication Report, 1980

1980-01-01

434

An application of goal programming to production planning in the crushed stone industry  

Microsoft Academic Search

The problems facing the aggragate stone industry in Zambia such as low capacity utilization, failure to meet customer requirements, unnecessarily high operating costs, poor inventory control practices, heavy borrowing and overall poor economic performance are as a result of subjective decision-making related to production planning. This is also true of the industry in nearly all member countries of the SADDC(Southern

E. C. K. Chanda

1990-01-01

435

The Place of the Information User in the Planning Process for Information Communication: The Zambian Experience.  

ERIC Educational Resources Information Center

|This paper discusses human communication and information in the context of Zambia's national environment, with an emphasis on the relationship between human communication and information transmission using modern technology. The place of the information user in the planning process is considered, and the important roles of internal and external…

Lundu, Maurice C.

436

African mining  

SciTech Connect

This book contains papers presented at a conference addressing the development of the minerals industry in Africa. Topics covered include: A review - past, present and future - of Zimbabwe's mining industry; Geomorphological processes and related mineralization in Tanzania; and Rock mechanics investigations at Mufulira mine, Zambia.

Not Available

1987-01-01

437

Implementing a hospital based injury surveillance system in Africa: lessons learned  

Microsoft Academic Search

A multinational injury surveillance pilot project was carried out in five African countries in the first half of 2007 (Democratic Republic of the Congo, Kenya, Nigeria, Uganda and Zambia). Hospitals were selected in each country and a uniform methodology was applied in all sites, including an injury surveillance questionnaire designed by a joint programme of the Pan American Health Organization

Diego E. Zavala; Simon Bokongo; I. A. John; Ismail Mpanga Senoga; Robert E. Mtonga; A. Z. Mohammed; Walter Odhiambo Anjango; Peter Olupot-Olupot

2008-01-01

438

Distance Education for Health Personnel: New Strategies.  

ERIC Educational Resources Information Center

An intercountry workshop on distance learning (DL) was conducted at the University of Khartoum, Sudan, in November 1991. Individuals involved in the World Health Organization's (WHO's) Health Learning Materials network in nine African countries (Sudan, Ethiopia, Guyana, Kenya, Mauritius, Tanzania, Uganda, Zambia, and Zimbabwe) met to share their…

Mwakilasa, Amos

439

Indigenous Models of Helping in Nonwestern Countries: Implications for Multicultural Counseling.  

ERIC Educational Resources Information Center

|Examined indigenous models of helping in selected non-Western countries (Barbados, Korea, Nigeria, Pakistan, Singapore, Sudan. and Zambia) to investigate status of psychology, counseling, and related mental health professions in these countries. Findings from mental health professionals in these countries revealed three types of problems for…

Lee, Courtland C.; And Others

1992-01-01

440

Guidelines for the Preparation of General Guides to National Archives: A RAMP Study.  

ERIC Educational Resources Information Center

|Based on a comparative study of guides from the Bahamas, Barbados, France, Italy, the Netherlands, Rhodesia, Spain, the United Kingdom, the United States, West Germany, and Zambia, this handbook provides guidelines for the organization and content of a general guide to archives, particularly national archives. It is noted that the handbook is…

Hildesheimer, Francoise