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Sample records for zambia

  1. Zambia.

    PubMed

    1988-08-01

    Attention in this discussion of Zambia is directed to the following: geography; the people; history; government; the economy; foreign relations; defense; and relations between Zambia and the US. In 1986, the population totaled 7 million with an annual growth rate of 3.7%. The infant mortality rate is 87/1000 with a life expectancy of 51 years. Zambia, located in south-central Africa, is bordered by Zaire, Tanzania, Malawi, Mozambique, Zimbabwe, Botswana, Angola, and Namibia. The population is made up of over 70 Bantu-speaking tribes. Expatriates, mostly British (15,000 in 1986) or South African, live primarily in Lusaka where they are employed in mines and related activities. Some ancestors of present-day Zambians most likely arrived about 2000 years ago and eventually displaced or absorbed indigenous stone age hunters and gatherers. The major waves of Bantu-speaking immigrants began in the 15th century; the greatest influx occurred in the late 17th to the early 19th centuries. After the mid-19th century, the area was penetrated by Western explorers. In 1888, Northern and Southern Rhodesia (now Zambia and Zimbabwe) were proclaimed a British sphere of influence. Southern Rhodesia was annexed formally and granted self-government in 1923. Independence was realized on October 24, 1964. Zambia was the 1st British territory to become a republic immediately upon realizing independence. The constitution promulgated on August 25, 1973, abrogated the original 1964 constitution, and this new constitution and the national elections that followed in December 1973 were the final steps in achieving what is termed a "1-party participatory democracy." President Kenneth Kaunda is the major figure in the country's politics. He has wide popular support and traditionally has bridged the rivalries among the country's various regions and ethnic groups. The economy of Zambia is based primarily on its majority state-owned copper industry, which is the only significant source of foreign exchange. Copper production has dropped to less than 500,000 metric tons/year from a high of 720,000 in 1976. Beginning in late 1982, Zambian government leaders took several important steps to deal with the country's economic plight, including restricting public spending, reducing government subsidies, raising farm producer incentives, and devaluing the currency. The US maintains a substantial foreign assistance program in Zambia. PMID:12178072

  2. The Republic of Zambia.

    PubMed

    Hakkert, R; Wieringa, R

    1986-05-01

    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

  3. Country watch: Zambia.

    PubMed

    Sakala, F

    1996-01-01

    Zambia has experienced considerable economic decline over the past few decades. This decline has led to considerable hardship in both urban and rural areas. Zambian youth and women are particularly at risk from the consequent high crime rate, rape, teenage pregnancy, prostitution, abortion, and HIV/STDs. Moreover, the health of these individuals is heavily influenced by the prevalence of unprotected casual sex and the use of alcohol, cigarettes, and other drugs. Their rights to education, social support, health information, and legal protection therefore need to be emphasized, especially within the context of HIV/AIDS programs. Early marriage, female subservience to men, polygamy, obstacles to wife inheritance, and the ritual sexual cleansing of widows makes young women especially vulnerable to HIV/STDs. The Young Women's Christian Association (YWCA) of Zambia addresses many of the critical needs of young people and women through a series of programs and activities. Some of these programs and activities are described. PMID:12347177

  4. Catholic Schools in Zambia: 1891-1924.

    ERIC Educational Resources Information Center

    Carmody, Brendan

    1999-01-01

    Retraces the contribution of the Catholic Church to schooling in Northern Rhodesia (currently Zambia) from 1891-1924. Provides background on the development of the Church in Zambia. Discusses Catholic and government perspectives on schooling and conversion, Catholic schooling in Zambia, and the African response to Catholic schooling. (CMK)

  5. Attitudes toward abortion in Zambia.

    PubMed

    Geary, Cynthia Waszak; Gebreselassie, Hailemichael; Awah, Paschal; Pearson, Erin

    2012-09-01

    Despite Zambia's relatively progressive abortion law, women continue to seek unsafe, illegal abortions. Four domains of abortion attitudes - support for legalization, immorality, rights, and access to services - were measured in 4 communities. A total of 668 people were interviewed. Associations among the 4 domains were inconsistent with expectations. The belief that abortion is immoral was widespread, but was not associated with lack of support for legalization. Instead, it was associated with belief that women need access to safe services. These findings suggest that increasing awareness about abortion law in Zambia may be important for encouraging more favorable attitudes. PMID:22920619

  6. Zambia's Catholic Schools and Secularization.

    ERIC Educational Resources Information Center

    Carmody, Brendan

    2000-01-01

    Explores the origins and development of the Catholic Church's involvement in secular schooling in Zambia. Illustrates that at the primary level, government's secularization led to the hand over of these schools; but at the secondary level a more universal type of Catholic school developed. (CMK)

  7. Earth Science Education in Zambia

    NASA Astrophysics Data System (ADS)

    Nyambe, Imasiku Anayawa

    1999-05-01

    Mining in Zambia has been practised for centuries, and in the last 70 years Zambia has risen to become one of the world's leading Cu producers as a result of the exploitation of the Zambian Copperbelt orebodies. In contrast to this long history of mining, Zambia has a relatively short history of Earth Science Education. For the past 24 years, the earth sciences have been taught within the School of Mines in University of Zambia. The School started operation on 1st June, 1973, with the purpose of training professional geologists, extractive metallurgical/mineral processing engineers and mining engineers to service the needs of the mining industry in Zambia. The School consists of three departments Geology, Metallurgy and Mineral Processing, and Mining Engineering which deliver a five-year undergraduate programme. Students are admitted to the School after completing a one-year programme in the School of Natural Sciences of the University of Zambia. Students with an average of C+ or better in Biology, Chemistry, Mathematics and Physics are admitted into the School of Mines. The School of Mines has a total of 36 teaching positions 12 for each Department. To successfully complete their course, students must pass 40 courses over a period of five years. During this time, industrial training is mandatory in the vacation periods after the third and fourth years of study. This training is mainly within the mining industry who in most cases sponsor the students for their studies in the School. The School admits 50 students on average per year, of whom five students take up Geology as a career. So far only two female students have studied in the School of Mines, both of them in Geology. The student to staff ratio in the Geology Department is 3 to 1. The low enrolment in Geology is thought to be because of a lack of knowledge of geology as a possible career by prospective students and a perceived lack of progression, once employed in industry. This has lead to a 'Geoscience in Schools' project with the main aim of making secondary school students aware of geology as a career. The Geology Department enjoys close co-operation with geology departments in a number of universities around the world, with industry, government ministries and regional bodies. It is hoped that the current increase in employment prospects for Geology graduates in Zambia will attract more students to geology as a career.

  8. Winds of change in Zambia.

    PubMed

    Bond, V

    1992-05-01

    Participants at a 2-day workshop on AIDS in Zambia concluded that women must openly discuss high-risk sexual behavior with their partners, if they are to protect themselves and their children. Entitled "Basic facts about AIDS," the workshop identified marital infidelity as the greatest source of risk. Last year, a study revealed that, on average, men and women in Zambia had 2-3 sexual partners outside marriage. Demographic and cultural factors also contribute to the spread of AIDS. Zambia's sexually active population is large, since people marry at a very young age. The traditional practice of "dry sex" -- intercourse that involves male penetration of a tight, dry vagina -- causes internal abrasions, thereby facilitating the transmission of HIV. Even traditional sex education undermines efforts to control the spread of AIDS, since "bamachimbusas" (traditional sex educators) counsel girls to be subservient to their husbands and "never say no." Boys receive no sex education at all. Meanwhile, Zambia faces an alarming HIV and AIDS trend, according to statistics collected by the Society for Women and AIDS (SWAAZ): in 1991, 12.5% of blood donors in Lusaka and 7.5% of donors nationwide were infected with HIV; infection among pregnant urban women ranged from 25-29%; 21% of malnourished children and 32% of children with tuberculosis are infected. Furthermore, it is estimated that by 1990, the AIDS epidemic had already orphaned 80,000 children. By the year 2000, it is believed that 1/2 million children will have lost at least one parent to the disease. PMID:12317434

  9. Spontaneously Settled Refugees in Northwestern Province, Zambia.

    ERIC Educational Resources Information Center

    Freund, Paul J.; Kalumba, Katele

    1986-01-01

    Presents results of a socioeconomic survey and census of "spontaneously settled" Zairean and Angolan refugees in the Northwestern Province of Zambia. Finds refugees' difficulties to be caused by lack of a clear national policy and negative attitudes toward them, as well as Zambia's own deteriorating economic situation. (GC)

  10. Astronomy education: the current status in Zambia

    NASA Astrophysics Data System (ADS)

    Munyeme, Geoffrey; Kalebwe, Peter C.

    There are many interlocking factors determining the introduction of astronomy education in Zambia. The process of infusing this new subject into an education system so centralised as that of Zambia is extremely complex. At school level the process is more complex than at university level, as all syllabuses are developed by a central body, Curriculum Development Centre (CDC) whose priorities are determined by perceived social and economic needs of the country. The prevailing notion in Zambia is that astronomy has no direct bearing on future employment needs. It is therefore not surprising that astronomy is at the bottom of the priority list among school subjects. The recent upsurge of interest in astronomy at the University of Zambia opens up the necessary background for developing astronomy in both school and university curricula. The University has recently formed the Astronomical Society and the Working Group on Space Science in Zambia. Coupled to this are exchange visits and collaborative work between the Physics Department of the University of Zambia and the South-African Astronomical Observatory. In this paper we present a review of the current activities in space science in Zambia and how they relate to the development of astronomy education.

  11. MISR Images Zambia and Botswana

    NASA Technical Reports Server (NTRS)

    2000-01-01

    These MISR images of Zambia and Botswana, Africa were acquired on August 25, 2000 during Terra orbit 3655. The left image is a 'true' color view from the vertical-viewing (nadir) camera. True color means that the images acquired through MISR's red, green, and blue filters, respectively, are displayed as red, green, and blue when creating the digital image. The middle image combines data from the green, red, and near-infrared bands. The right image contains red band data only, but is a composite of imagery from the nadir (An), 70.5-degrees forward (Df), and 70.5-degrees aftward (Da) cameras. The color variations in the multi-angle composite arise not from how the different parts of the scene reflect light at different wavelengths, but rather, at different angles.

    The distinctive fan-like feature on the left of each image is the highly vegetated Okavango Delta, a mosaiced network of grasslands and water channels, observed here during the dry season. The town of Maunis at its southeastern edge. Note how the plant life, which is highly reflective in the near-infrared, shows up as bright red in the middle image. Vegetation also preferentially reflects light back toward the source of illumination, so in the right image, the Df camera image, which is displayed in green, is brighter in this region.

    The body of water in the upper right is the Itezhi-Tezhi Dam, fed by the Kafue River in Zambia. At the lower left, south of the Okavango Delta, is Lake Ngami. A smoke plume is present at the southern edge of the lake. This plume and others show up in shades of blue and purple in the multi-angle composite as a result of the manner in which the smoke particles scatter sunlight.

    Other landmarks include the Ntwetwe Pan, whose western edge is visible as the bright area in the lower right. The Zambezi River enters from the upper left and wends its way southeast, passing the Caprivi Strip, a narrow panhandle in northeast Namibia. The greater abundance of vegetation here testifies to the high rainfall that occurs during the wet season. Near the right-hand edge of the images is the location where the Zambezi plunges into Victoria Falls, considered to be among the most spectacular waterfalls in the world.

    MISR was built and is managed by NASA's Jet Propulsion Laboratory, Pasadena, CA, for NASA's Office of Earth Science, Washington, DC. The Terra satellite is managed by NASA's Goddard Space Flight Center, Greenbelt, MD. JPL is a division of the California Institute of Technology.

  12. Floodwaters Renew Zambia's Kafue Wetland

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Not all floods are unwanted. Heavy rainfall in southern Africa between December 2003 and April 2004 provided central Zambia with floodwaters needed to support the diverse uses of water within the Kafue Flats area. The Kafue Flats are home to about one million people and provide a rich inland fishery, habitat for an array of unique wildlife, and the means for hydroelectricity production. The Flats falls between two dams: Upstream to the west (not visible here) is the Izhi-tezhi, and downstream (middle right of the images) is the Kafue Gorge dam. Since the construction of these dams, the flooded area has been reduced and the timing and intensity of the inundation has changed. During June 2004 an agreement was made with the hydroelectricity company to restore water releases from the dams according to a more natural flooding regime. These images from NASA's Multi-angle Imaging SpectroRadiometer (MISR) illustrate surface changes to the wetlands and other surfaces in central Zambia resulting from an unusually lengthy wet season. The Kafue Flats appear relatively dry on July 19, 2003 (upper images), with the Kafue River visible as a slender dark line that snakes from east to west on its way to join the Zambezi (visible in the lower right-hand corner). On July 21, 2004 (lower images), well into the dry season, much of the 6,500-square kilometer area of the Kafue Flats remains inundated. To the east of the Kafue Flats is Lusaka, the Zambian capital, visible as a pale area in the middle right of the picture, north of the river. In the upper portions of these images is the prominent roundish shape of the Lukanga Swamp, another important wetland.

    The images along the left are natural-color views from MISR's nadir camera, and the images along the right are angular composites in which red band data from MISR's 46o forward, nadir, and 46o backward viewing cameras is displayed as red, green and blue, respectively. In order to preserve brightness variations among the various cameras, the data from each camera were processed identically. Here, color changes indicate surface texture, and are influenced by terrain, vegetation structure, soil type and soil moisture content. Wet surfaces or areas with standing water appear blue in this display because sun glitter makes smooth, wet surfaces look brighter at the backward camera's view angle. Mostly the landscape appears somewhat purple, indicating that most of the surfaces scatter sunlight in both backward and forward directions. Areas that appear with a slight greenish hue can indicate sparce vegetation, since the nadir camera is more likely to sight the gaps between the trees or shrubs, and since vegetation is darker (in the red band) than the underlying soil surface. Areas which preferentially exhibit a red or pink hue correspond with wetland vegetation. The plateau of the Kafue National Park, to the west of Lukanga Swamp, appears brighter in 2004 compared with 2003, which indicates weaker absorption at the red band. Overall, the 2004 image exhibits a subtle blue hue (preference for forward-scattering) compared with 2003, which indicates overall surface changes that may be a result of enhanced surface wetness.

    The Multiangle Imaging SpectroRadiometer observes the daylit Earth continuously and every 9 days views the entire globe between 82o north and 82o south latitude. These data products were generated from a portion of the imagery acquired during Terra orbits 19072 and 24421. The panels cover an area of 235 kilometers x 239 kilometers, and utilize data from blocks 100 to 103 within World Reference System-2 path 172.

    MISR was built and is managed by NASA's Jet Propulsion Laboratory, Pasadena, CA, for NASA's Office of Earth Science, Washington, DC. The Terra satellite is managed by NASA's Goddard Space Flight Center, Greenbelt, MD. JPL is a division of the California Institute of Technology.

  13. Zambia: Multi-Faith Religious Education?

    ERIC Educational Resources Information Center

    Carmody, Brendan

    2006-01-01

    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…

  14. OUTLINE OF VOCATIONAL TRAINING IN ZAMBIA.

    ERIC Educational Resources Information Center

    Australian Dept. of Labour and National Service, Perth.

    THE 1963 POPULATION OF ZAMBIA WAS APPROXIMATELY 3.5 MILLION. THE 8-YEAR PRIMARY EDUCATION PROGRAM IS FOLLOWED BY SECONDARY, SECONDARY TECHNICAL, AND TRADE SCHOOL OPTIONS. THERE IS AN INCREASE IN ADULT EDUCATION AT THE PRIMARY AND SECONDARY LEVELS. CRAFT AND TECHNICIAN LEVEL PROGRAMS ARE CONDUCTED AT NORTHERN TECHNICAL COLLEGE AND ITS ANCILLARY

  15. Zambia: Multi-Faith Religious Education?

    ERIC Educational Resources Information Center

    Carmody, Brendan

    2006-01-01

    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

  16. Religious Education and Pluralism in Zambia

    ERIC Educational Resources Information Center

    Carmody, Brendan

    2003-01-01

    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

  17. Viral diseases of livestock in Zambia.

    PubMed

    Mweene, A S; Pandey, G S; Sinyangwe, P; Nambota, A; Samui, K; Kida, H

    1996-08-01

    This review is to provide information on viral diseases of livestock in Zambia. The distribution of the diseases as well as the control measures and limited research that has been done, are described. Foot and mouth disease (FMD) causes serious economic losses in the cattle industry. So far five serotypes (SAT1, SAT2, SAT3, O and At of FMD virus have been isolated in Zambia. Other notifiable viral diseases are rabies, Rift Valley fever, Lumpy skin disease, African horse sickness, bluetongue, African swine fever, Newcastle disease, Marek's disease, fowlpox and infectious bursal disease. Based on the reports of clinical and/or serological diagnoses, these are widespread in the country, although their precise incidence rates are not known. With the establishment of a veterinary school equipped with modern diagnostic facilities and the increasing number of qualified veterinary personnel, this review would stimulate surveillance study on the viral diseases for the ultimate goal of achieving effective disease control measures. PMID:8870389

  18. Orthopoxvirus infection among wildlife in Zambia.

    PubMed

    Orba, Yasuko; Sasaki, Michihito; Yamaguchi, Hiroki; Ishii, Akihiro; Thomas, Yuka; Ogawa, Hirohito; Hang'ombe, Bernard M; Mweene, Aaron S; Morikawa, Shigeru; Saijo, Masayuki; Sawa, Hirofumi

    2015-02-01

    Human monkeypox is a viral zoonosis caused by monkeypox virus, an orthopoxvirus (OPXV). The majority of human monkeypox cases have been reported in moist forested regions in West and Central Africa, particularly in the Democratic Republic of the Congo (DRC). In this study we investigated zoonotic OPXV infection among wild animals in Zambia, which shares a border with DRC, to assess the geographical distribution of OPXV. We screened for OPXV antibodies in sera from non-human primates (NHPs), rodents and shrews by ELISA, and performed real-time PCR to detect OPXV DNA in spleen samples. Serological analysis indicated that 38 of 259 (14.7?%) rodents, 14 of 42 (33.3?%) shrews and 4 of 188 (2.1?%) NHPs had antibodies against OPXV. The OPXV DNA could not be detected in spleens from any animals tested. Our results indicated that wild animals living in rural human habitation areas of Zambia have been infected with OPXV. PMID:25319753

  19. Building opportunities and partnerships in Zambia, Africa

    SciTech Connect

    Decot, M.E.

    1998-07-01

    This paper explores opportunities in Zambia, Africa for the US and other developed nations to extend building technologies that can potentially reduce global greenhouse gas emissions and also support mutual economic development and environmental quality benefits. About ninety percent of the agrarian population in Zambia live in buildings constructed of wooden sticks and native grasses. Energy for these homes is primarily limited to wood and charcoal for heating and cooking. The countryside and ambient air are tainted by smoke from smoldering wood from production of charcoal for local and export markets. Cooking and heating appliances are extremely primitive, inefficient, and unhealthy. Opportunities exist to develop building technologies that use cleaner burning coal briquettes for fuel, improve efficiency of cooking stoves, improve conditions for human health, construct more energy-efficient buildings, and stimulate economic development. External financial and technical support for such development would yield investor benefits including market entry or expansion in a resource rich developing county, low capital investment costs, low labor costs, and greenhouse gas mitigation and offset opportunities. Zambia is too rich in natural and human resources to be so poor. Building infrastructure and community development can establish a foundation for sustainable economic development and environmental quality for the whole world to enjoy.

  20. Peace Corps/Zambia PST 1995 Special Lessons. Nyanja.

    ERIC Educational Resources Information Center

    Peace Corps (Zambia).

    This guide is designed for language teachers training Peace Corps volunteers in Nyanja for service in Zambia, and focuses on daily communication skills in that context. It consists of a language "survival kit" of useful phrases and vocabulary, conjugation of the verb "to be," the Zambia national anthem, extensive notes on verb tenses and

  1. Recasting Postcolonial Citizenship through Civic Education: Critical Perspectives on Zambia

    ERIC Educational Resources Information Center

    Abdi, Ali A.; Shizha, Edward; Bwalya, Ignatio

    2006-01-01

    Since the early 1990s and, perhaps, as one effect of the emergence of the uni-polar world, there have been a lot of "democratizing" activities in the Sub-Saharan context, with Zambia, a central African country of about 10 million, at the forefront of these processes. While democracy, in one form or another, has come to Zambia, socio-economic

  2. Perceptions of and Attitudes towards Ageing in Zambia

    ERIC Educational Resources Information Center

    Mapoma, Christopher C.; Masaiti, Gift

    2012-01-01

    This paper reflects part of the wider outlook on ageing in general in Zambia and was intended to investigate perceptions of and attitudes towards the aged and ageing in Zambia by members of the community who, by definition and chronologically are not classified as aged i.e. not yet 60 years and over. Focus Group Discussions (FGD) were used to…

  3. Improving paediatric asthma care in Zambia

    PubMed Central

    Jumbe-Marsden, Emilia; Mateyo, Kondwelani; Senkwe, Mutale Nsakashalo; Sotomayor-Ruiz, Maria; Musuku, John; Soriano, Joan B; Ancochea, Julio; Fishman, Mark C

    2015-01-01

    Abstract Problem In 2008, the prevalence of paediatric asthma in Zambia was unknown and the national treatment guideline was outdated. Approach We created an international partnership between Zambian clinicians, the Zambian Government and a pharmaceutical company to address shortcomings in asthma treatment. We did two studies, one to estimate prevalence in the capital of Lusaka and one to assess attitudes and practices of patients. Based on the information obtained, we educated health workers and the public. The information from the studies was also used to modernize government policy for paediatric asthma management. Local setting The health-care system in Zambia is primarily focused on acute care delivery with a focus on infectious diseases. Comprehensive services for noncommunicable diseases are lacking. Asthma management relies on treatment of acute exacerbations instead of disease control. Relevant changes Seven percent of children surveyed had asthma (255/3911). Of the 120 patients interviewed, most (82/120, 68%) used oral short-acting ?2-agonists for symptom control; almost half (59/120, 49%) did not think the symptoms were preventable and 43% (52/120) thought inhalers were addictive. These misconceptions informed broad-based educational programmes. We used a train-the-trainer model to educate health-care workers and ran public awareness campaigns. Access to inhalers was increased and the Zambian standard treatment guideline for paediatric asthma was revised to include steroid inhalers as a control treatment. Lessons learnt Joint activities were required to change paediatric asthma care in Zambia. Success will depend on local sustainability, and it may be necessary to shift resources to mirror the disease burden. PMID:26600616

  4. Detection and characterization of Clostridium species in soil of Zambia.

    PubMed

    Hang'ombe, B M; Isogai, E; Lungu, J; Mubita, C; Nambota, A; Kirisawa, R; Kimura, K; Isogai, H

    2000-10-01

    In the retrospective study of soil-borne diseases of cattle in Zambia, malignant edema and blackquarter were widespread. One hundred and sixty-five cases with malignant edema and 103 cases with blackquarter were reported between 1985 and 1997. It was found that specific soil-conditions associate the emergence of the soil-borne diseases. Soil samples from five areas in Zambia were examined for the presence of genus Clostridium. Direct immunofluorescent assay (IFA) examination showed that C. septicum, C. novyi and C. chauvoei were detected in the soil of specific areas in Zambia, respectively. Causal organisms such as C. perfringens were isolated from the soil samples. The information of area-specific distribution of Clositridium species may give an efficient program in protecting cattle and man. PMID:11038129

  5. Glycaemic control in diabetic patients in Zambia

    PubMed Central

    Musenge, Emmanuel Mwila; Manankov, Alexey; Mudenda, Boyd; Michelo, Charles

    2014-01-01

    Introduction The glycaemic control status of diabetic patients affects the management of their disorder. We examined the glycaemic control and clinical factors that may influence the achievement of the glycaemic control targets among diabetic out-patients. Methods This was a hospital based cross-sectional study carried out at the University Teaching Hospital diabetic clinic in Lusaka, Zambia. A simple random sample of 198 consenting participants was selected from diabetic out-patients between September and December 2013. A structured interview schedule was used to capture socio-demographic data as well as needed clinical data from clients’ medical records and laboratory results. Multivariate binary logistic regression analysis was carried out to examine factors that may be associated with the glycaemic control status of these diabetic patients. Results Overall (n = 198), mean (SD) age was 53.19±13.32 years. Majority (61.3%) of the patients had poor glycaemic control status (HbA1c≥49 mmol/mol). Insulin treatment (OR 0.13, 95% CI: 0.01 - 1.41), systolic blood pressure (OR 1.04, CI: 1.00 - 1.08) and fasting plasma glucose (previous; OR 0.81, CI: 0.72 - 0.90 and current; OR 0.85, CI: 0.78 - 0.93) were statistically significantly associated with glycaemic control. The poor glycaemic control observed in this study is similar to that reported in other published studies. Conclusion We found evidence of poor glycaemic control in the study population suggesting need to explore the reasons for this. Association of Insulin, systolic blood pressure and fasting plasma glucose with glycaemic control further suggests the efficiency of traditional basic monitoring parameters which should be exploited in sharpening primary preventive strategies especially those that support lifestyle modification. Such efforts should also be integrated in all information, education and communication strategies that target but not limited to hospital based patients too. PMID:25932067

  6. The current status of major tick borne diseases in Zambia.

    PubMed

    Makala, Levi Hakwale; Mangani, Peter; Fujisaki, Kozo; Nagasawa, Hideyuki

    2003-01-01

    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 their experimental stages, offer hope for the future. The use of acaricides is hampered by the development of acaricide resistance and live vaccines are dependent on cold chain facilities, which are a formidable obstacle in the poorly developed infrastructure in parts of Zambia where the vaccine is most needed. Amidst these drawbacks are the results of the recent research on parasites and vector recombinant vaccines which promise to circumvent these problems. The history, current status and attitudes regarding the control of these diseases, taking into account their complexity, are reviewed. The establishment of the well-designed Central Veterinary Research Institute (CVRI) and Japanese International Cooperation Agency (JICA) sponsored veterinary school, both have a potential for high quality research, with access to a wealth of specimens a veritable goldmine of research material. It is thus hoped that this review will stimulate the desire to maximize the value of the tick and tick-borne disease research in both Zambia and the international research community. PMID:12588682

  7. Cucumis zambianus (Cucurbitaceae): A New Species from Northwestern Zambia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    During germplasm explorations within Zambia in 1984, seven Cucumis accessions were collected that could not be identified to species. Two of the accessions were studied in-depth. Based on phenotypic characters, they were closest to Cucumis pustulatus. In ITS analyses of all available Cucumis spec...

  8. Textbooks and Learning Materials Program: Zambia. Final Report

    ERIC Educational Resources Information Center

    US Agency for International Development, 2009

    2009-01-01

    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

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

    ERIC Educational Resources Information Center

    Kapambwe, William M.

    2010-01-01

    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

  10. Next Steps at the University of Zambia in Implementing ESD

    ERIC Educational Resources Information Center

    Namafe, Charles M.

    2015-01-01

    By acting within a comfort zone formed by, first, its own institutional location and, second, the subsector of teacher education, the University of Zambia can be said to be succeeding in mainstreaming Education for Sustainable Development (ESD) and Environmental Education (EE). This article provides outline activities and lessons learnt along the

  11. Cost Sharing in Zambia's Public Universities: Prospects and Challenges

    ERIC Educational Resources Information Center

    Masaiti, Gift; Shen, Hong

    2013-01-01

    This research paper explores the concept of "cost sharing" which became more prominent in Zambia education with the advent of democratic form of governance in 1991. As a way of responding to the ever diminishing tax revenues, government through the education policy of 1996, allowed higher education institutions including public…

  12. Mapping the Geographical Distribution of Lymphatic Filariasis in Zambia

    PubMed Central

    Mwase, Enala T.; Stensgaard, Anna-Sofie; Nsakashalo-Senkwe, Mutale; Mubila, Likezo; Mwansa, James; Songolo, Peter; Shawa, Sheila T.; Simonsen, Paul E.

    2014-01-01

    Background Past case reports have indicated that lymphatic filariasis (LF) occurs in Zambia, but knowledge about its geographical distribution and prevalence pattern, and the underlying potential environmental drivers, has been limited. As a background for planning and implementation of control, a country-wide mapping survey was undertaken between 2003 and 2011. Here the mapping activities are outlined, the findings across the numerous survey sites are presented, and the ecological requirements of the LF distribution are explored. Methodology/Principal findings Approximately 10,000 adult volunteers from 108 geo-referenced survey sites across Zambia were examined for circulating filarial antigens (CFA) with rapid format ICT cards, and a map indicating the distribution of CFA prevalences in Zambia was prepared. 78% of survey sites had CFA positive cases, with prevalences ranging between 1% and 54%. Most positive survey sites had low prevalence, but six foci with more than 15% prevalence were identified. The observed geographical variation in prevalence pattern was examined in more detail using a species distribution modeling approach to explore environmental requirements for parasite presence, and to predict potential suitable habitats over unsurveyed areas. Of note, areas associated with human modification of the landscape appeared to play an important role for the general presence of LF, whereas temperature (measured as averaged seasonal land surface temperature) seemed to be an important determinant of medium-high prevalence levels. Conclusions/significance LF was found to be surprisingly widespread in Zambia, although in most places with low prevalence. The produced maps and the identified environmental correlates of LF infection will provide useful guidance for planning and start-up of geographically targeted and cost-effective LF control in Zambia. PMID:24587466

  13. Cigarette Price and Other Factors Associated with Brand Choice and Brand Loyalty in Zambia: Findings from the ITC Zambia Survey

    PubMed Central

    Salloum, Ramzi G.; Goma, Fastone; Chelwa, Grieve; Cheng, Xi; Zulu, Richard; Kaai, Susan C.; Quah, Anne C.K.; Thrasher, James F.; Fong, Geoffrey T.

    2015-01-01

    Objectives Little is known about cigarette pricing and brand loyalty in sub-Saharan Africa. This study examines these issues in Zambia, analyzing data from the International Tobacco Control (ITC) Zambia Survey. Methods Data from Wave 1 of the ITC Zambia Survey (2012) were analyzed for current smokers of factory-made (FM) cigarettes compared to those who smoked both FM and roll-your-own (RYO) cigarettes, using multivariate logistic regression models to identify the predictors of brand loyalty and reasons for brand choice. Results 75% of FM-only smokers and 64% of FM+RYO smokers reported having a regular brand. Compared with FM-only smokers, FM+RYO smokers were, on average, older (28% vs. 20% ≥ 40 years), low income (64% vs. 43%), and had lower education (76% vs. 44% < secondary). Mean price across FM brands was ZMW0.50 (USD0.08) per stick. Smokers were significantly less likely to be brand-loyal (>1 year) if they were aged 15-17 years (vs. 40-54 years) and if they had moderate (vs. low) income. Brand choice was predicted mostly by friends, taste, and brand popularity. Price was more likely to be a reason for brand loyalty among FM+RYO smokers, among ≥55 year old smokers, and among those who reported being more addicted to cigarettes. Conclusions These results in Zambia document the high levels of brand loyalty in a market where price variation is fairly small across cigarette brands. Future research is needed on longitudinal trends to evaluate the effect of tobacco control policies in Zambia. PMID:25631482

  14. The Role of Open and Distance Learning in the Implementation of the Right to Education in Zambia

    ERIC Educational Resources Information Center

    Siaciwena, Richard; Lubinda, Foster

    2008-01-01

    As a member of the United Nations, Zambia is committed to the observance of human rights enshrined in the Universal Declaration of Human Rights of 1948. This is evidenced, among others, by the fact that Zambia is a signatory to the Convention on the Rights of the Child and the African Charter on the Rights and Welfare of the Child. Zambia has a

  15. The Urgent Need to Train Teachers for Multigrade Pedagogy in African Schooling Contexts: Lessons from Uganda and Zambia

    ERIC Educational Resources Information Center

    Kivunja, Charles

    2014-01-01

    Our research project funded by the British Council on multigrade teaching capacity building in Uganda and Zambia found that Uganda does not have a single higher education institution training teachers in multigrade pedagogy and Zambia has only one located at Serenje village in rural Zambia. Yet the research found that in both countries many…

  16. [Memisa and home care for AIDS patients in Zambia].

    PubMed

    Reijer, P J

    1999-01-16

    Health care in Zambia has since long been receiving support from non-governmental organizations (NGOs) like Memisa. Church organizations bear responsibility for a considerable part of the national health services. During the last 15 years, growing attention has been given to improvement of basic services in the villages and to recruitment and organization of groups in the community active in the field of health care. The combat against AIDS is a major focus. Many NGOs give health education on HIV and AIDS, are coaching HIV-positive individuals and are trying to organize support for AIDS patients and their relatives and relief for women and children after the death of husband or father. The community home care projects established in the urban areas of Copperbelt province in Zambia provide a decent terminal phase for AIDS patients and assist the surviving families in maintaining a certain socioeconomic level of existence. PMID:10086134

  17. Patterns of Rift Valley fever activity in Zambia.

    PubMed Central

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

    1992-01-01

    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. PMID:1547835

  18. Health worker shortages in Zambia: an assessment of government responses.

    PubMed

    Gow, Jeff; George, Gavin; Mutinta, Given; Mwamba, Sylvia; Ingombe, Lutungu

    2011-11-01

    A dire health worker shortage in Zambia's national health programs is adversely impacting the quantity and quality of health care and posing a serious barrier to achieving Millennium Development Goals to improve population health. In 2005, Zambia's Ministry of Health developed a 10-year strategic plan for human resources for health to address the crisis through improved training, hiring, and retention. The plan has neither arrested nor reduced the shortage. We review the causes of the shortage, present results from a health worker survey showing that safe work conditions, manageable workloads, and career advancement opportunities matter more to respondents than financial compensation. We comment on the adequacy of government efforts to address the health worker shortage. PMID:21850054

  19. Virtual surgical pathology in underdeveloped countries: The Zambia Project.

    PubMed

    Pagni, Fabio; Bono, Francesca; Di Bella, Camillo; Faravelli, Agostino; Cappellini, Anna

    2011-02-01

    Only 1 surgical pathology laboratory is available in Zambia, a country with a population of 12 million people. Since 2004 the Italian association of pathologists Patologi Oltre Frontiera has been working to create a virtual laboratory through the use of telemedicine. The project has involved staining histologic preparations on site, with the interpretation of imaged slides performed abroad through telepathology. Starting in April 2007, all surgical specimens obtained in Mtendere Mission Hospital, Chirundu, Zambia, were submitted for microscopic examination through whole-slide scans. Two independent Italian pathologists evaluated the cases by means of satellite connection and the final diagnoses were sent to Zambian clinicians via the internet. This article describes the spectrum of diagnoses made via telepathology for the Zambian population. Also, we analyze the concordant and discordant data between this telepathology method and traditional microscopy in a developing country. Moreover, we provide possible solutions for providing pathology services in other underdeveloped countries. PMID:21284441

  20. AIDS education for a low literate audience in Zambia.

    PubMed

    Msimuko, A K

    1988-04-01

    A workshop funded by the USA Program for Appropriate Technology in Health (PATH) was an effort by Zambia toward prevention and control of AIDS. The lack of educational materials about AIDS for a low-literate audience was the major problem addressed by the workshop. Other problems include the lack of collaborative effort in the development of materials on AIDS, and the lack of skills needed in the development of such materials in Zambia. 1 of the objectives of the workshop was to launch the Planned Parenthood Association of Zambia's (PPAZ) materials development project. The scope of this project includes the production of educational materials on AIDS for low-literate audiences and a counseling handbook for family planning workers. Print materials should be simply written, using words, idioms, and graphics that are familiar to the target audience. Other workshop objectives included the establishment of collaborative relationships between organizations involved in existing AIDS educational activities in Zambia, and the development of practical skills needed to produce print materials. Education was identified as the most important strategy for the prevention and control of AIDS, and PPAZ should be the executing agency of the print materials project. Audience research, using focus group techniques, focus group discussions, behavioral messages, and pretesting of messages, should be the most effective means of reaching targeted audiences. PPAZ is contracted by PATH to begin development of educational materials, and 2 committees have formed to implement the project and to establish interagency collaboration. Audience research was begun between January and March of 1988, focusing on people's beliefs, practices, and ideas about AIDS. The final phase of the project will be the printing, distribution, and use of the AIDS materials and the training of family planning field workers in the proper use of these materials. PMID:12315435

  1. Use of Remote Sensing in Supporting Agriculture in Zambia

    NASA Astrophysics Data System (ADS)

    Nawa, K.; Ngoma, S.; Mulando, A.

    2001-05-01

    Rainfall is of crucial importance for all life in Zambia not only because it is a resource for human and livestock but also because it is the major limiting factor to plant growth. Between 80 to 90% of agriculture in Zambia is rain-fed and as a result, rainfall determines the food supply for both human and live stock populations. Rainfall in Zambia is highly irregular in space and time which makes cultivation difficult since small differences in the amounts and timing of rain received at a site may determine the success or failure of critical stages in Vegetation development and hence crop production. Determination of optimum planting dates as well as accompanying crop yield can be greatly improved by using satellite rainfall estimates. Rainfall measurements have traditionally come from a network of raingauges which in the past years have dwindled in number. Since raingauge measurements are only valid for a small area in the immediate vicinity of the instrument, Geo-stationary satellites such as the Meteosat provide data at a resolution sufficient for monitoring of rainfall events at a much wider scale. Currently different rainfall information is produced at the Zambian Meteorological Department using the TAMSAT methodology and is disseminated to various users ranging from farmers, researchers to decision makers.

  2. Zambia: A Country Guide Series Report from the AACRAO-AID Project.

    ERIC Educational Resources Information Center

    O'Neill, Holly A.

    This report on the educational system of Zambia contains information for university admissions officers and registrars in the United States on the credentials and other documentation that would be minimally required for student entry from Zambia to specified levels of study in the United States. A section of general information describes that

  3. Personal and Environmental Predictors of the Intention to Use Maternal Healthcare Services in Kalomo, Zambia

    ERIC Educational Resources Information Center

    Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H.; Ruiter, Robert A. C.

    2014-01-01

    Low maternal healthcare service utilization contributes to poor maternal and new born health outcomes in rural Zambia. The purpose of this study was to identify important factors influencing women's intention to use these services in Kalomo, Zambia. An interviewer-administered questionnaire was used to collect data from 1007 women of…

  4. 77 FR 48498 - Executive-Led Trade Mission to South Africa and Zambia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-14

    ... Sectors sections of the Notice of the Executive- Led Mission to Zambia and South Africa, 77 FR 31574, May... International Trade Administration Executive-Led Trade Mission to South Africa and Zambia AGENCY: International... the Notice published at 77 FR 31574, May 29, 2012, regarding the Executive- Led Trade Mission to...

  5. 77 FR 31574 - Executive-Led Trade Mission to South Africa and Zambia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... International Trade Administration Executive-Led Trade Mission to South Africa and Zambia AGENCY: International... Mission to South Africa and Zambia November 26--November 30, 2012, to help U.S. firms find business partners and sell equipment and services in Johannesburg and Cape Town, South Africa, and Lusaka,...

  6. 7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Baby corn and baby carrots from Zambia. 319.56-43... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked “baby” sweet corn (Zea mays L... consignments only. (b) Immature “baby” carrots (Daucus carota L. ssp. sativus) for consumption measuring 10...

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 5 2011-01-01 2011-01-01 false Baby corn and baby carrots from Zambia. 319.56-43... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked “baby” sweet corn (Zea mays L... consignments only. (b) Immature “baby” carrots (Daucus carota L. ssp. sativus) for consumption measuring 10...

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

    ERIC Educational Resources Information Center

    Bajaj, Monisha

    2009-01-01

    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

  9. Consultancy Report: Assessment of the Zambia College of Distance Education (ZACODE)

    ERIC Educational Resources Information Center

    Ellis, Justin

    2009-01-01

    This study was carried out at the request of the Ministry of Education, Zambia. The Commonwealth of Learning contracted Turning Points Consultancy CC, a Namibian company, who provided the services of the author, to "carry out an evaluation of the Zambia College of Distance Education (ZACODE) and submit recommendations to the Ministry of Education,

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

    ERIC Educational Resources Information Center

    Slonim-Nevo, Vered; Mukuka, Lawrence

    2007-01-01

    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

  11. Personal and Environmental Predictors of the Intention to Use Maternal Healthcare Services in Kalomo, Zambia

    ERIC Educational Resources Information Center

    Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H.; Ruiter, Robert A. C.

    2014-01-01

    Low maternal healthcare service utilization contributes to poor maternal and new born health outcomes in rural Zambia. The purpose of this study was to identify important factors influencing women's intention to use these services in Kalomo, Zambia. An interviewer-administered questionnaire was used to collect data from 1007 women of

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    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

  13. Bismarck in the Bush: Year 12 Write Zambia's History for Zambian Students

    ERIC Educational Resources Information Center

    Gray, Peter

    2011-01-01

    Peter Gray explains how his Year 12 students came to research and write a resource on the history of Zambia, for history teachers "in" Zambia. The construction of the resource stretched the Year 12 students in new ways: the Internet was useless and there were no easy digests in A-Level textbooks to get them started. They would have to read whole

  14. 77 FR 60966 - Executive-Led Trade Mission to South Africa and Zambia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... published at 77 FR 31574, May 29, 2012, regarding the Executive- Led Trade Mission to South Africa and... International Trade Administration Executive-Led Trade Mission to South Africa and Zambia AGENCY: International... Executive-Led Trade Mission to South Africa and Zambia. Recruitment for this mission will conclude no...

  15. Theatre for Development: An Appropriate Tool for Extension Communication and Non-Formal Education in Zambia.

    ERIC Educational Resources Information Center

    Dall, Frank

    1980-01-01

    Describes a workshop held in Zambia in August 1979, to disseminate among performing artists and rural development workers skills for using the performing arts to communicate information on problems related to agriculture, health, and community development. Over 70 participants from the U.S., Canada, Botswana, Lesotho, Tanzania, Kenya, and Zambia

  16. 7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 5 2013-01-01 2013-01-01 false Baby corn and baby carrots from Zambia. 319.56-43... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked “baby” sweet corn (Zea mays L... consignments only. (b) Immature “baby” carrots (Daucus carota L. ssp. sativus) for consumption measuring 10...

  17. 7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 5 2012-01-01 2012-01-01 false Baby corn and baby carrots from Zambia. 319.56-43... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked “baby” sweet corn (Zea mays L... consignments only. (b) Immature “baby” carrots (Daucus carota L. ssp. sativus) for consumption measuring 10...

  18. 7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 5 2014-01-01 2014-01-01 false Baby corn and baby carrots from Zambia. 319.56-43... § 319.56-43 Baby corn and baby carrots from Zambia. (a) Immature, dehusked “baby” sweet corn (Zea mays L... consignments only. (b) Immature “baby” carrots (Daucus carota L. ssp. sativus) for consumption measuring 10...

  19. Bovine clostridial infections in Zambia (1985-1994).

    PubMed

    Munang'andu, H M; Muyoyeta, P M; Mweene, A S; Kida, H

    1996-12-01

    Retrospective surveillance study of clostridial infections of cattle in Zambia, for the period 1985 to 1994, showed that out of the 318 cases observed, 62.8% and 24.2% were from Western and Southern provinces, respectively. Of the 6 clostridia species identified, Clostridium septicum (38.1%) followed by C. chauvoei (36.2%) and C. perfringens (13.2%) were dominant. Although the highest incidence for clostridial infections was in 1989 (75 cases) and 1990 (77 cases), the number of C. perfringens cases seemed to increase. More cases were found in the dry season until the onset of the rains, that is, the period August to December. PMID:8997878

  20. Carcinoma of penis in Zambia: associated problems in management.

    PubMed

    Nath, S; Desai, G; Munkonge, L

    1992-03-01

    Thirty-three case reports of patients with carcinoma of penis were scrutinised at the University Teaching Hospital, Lusaka, Zambia to look into the associated environmental problems causing an unacceptable level of morbidity and mortality. Due to social and personal reasons, late presentation and poor follow-up is common. Improvement in the poor outcome is only possible with change in social attitudes and alleviation of ignorance. Educating traditional healers will help. For the present radiotherapy may be the other option to improve the morbidity and survival rates in this potentially a curable cancer. PMID:1516117

  1. Inequalities in public health care delivery in Zambia

    PubMed Central

    2014-01-01

    Background Access to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documents, there is evidence suggesting that those needing health services are not receiving their fair share. This study seeks therefore, to assess if socioeconomic related inequalities/inequities in public health service utilisation in Zambia still persist. Methods The 2010 nationally representative Zambia Living Conditions and Monitoring Survey data are used. Inequality is assessed using concentration curves and concentrations indices while inequity is assessed using a horizontal equity index: an index of inequity across socioeconomic status groups, based on standardizing health service utilisation for health care need. Public health services considered include public health post visits, public clinic visits, public hospital visits and total public facility visits. Results There is evidence of pro-poor inequality in public primary health care utilisation but a pro-rich inequality in hospital visits. The concentration indices for public health post visits and public clinic visits are ?0.28 and ?0.09 respectively while that of public hospitals is 0.06. After controlling for need, the pro-poor distribution is maintained at primary facilities and with a pro-rich distribution at hospitals. The horizontal equity indices for health post and clinic are estimated at ?0.23 and ?0.04 respectively while that of public hospitals is estimated at 0.11. A pro-rich inequity is observed when all the public facilities are combined (horizontal equity index?=?0.01) though statistically insignificant. Conclusion The results of the paper point to areas of focus in ensuring equitable access to health services especially for the poor and needy. This includes strengthening primary facilities that serve the poor and reducing access barriers to ensure that health care utilisation at higher-level facilities is distributed in accordance with need for it. These initiatives may well reduce the observed inequities and accelerate the move towards universal health coverage in Zambia. PMID:24645826

  2. e-Government for Development Information Exchange (DIE): Zambia

    NASA Astrophysics Data System (ADS)

    Joseph, Bwalya Kelvin

    In most parts of the world, political systems which utilize authoritative rule and mostly employ top-down decision-making processes are slowly transcending towards democratic norms. Information Technology Systems have been identified and adopted as one of the most efficient vehicles for appropriate, transparent and inclusive / participatory decision making. Zambia has shown a higher propensity to indigenous knowledge systems which are full of inefficiencies, a lot of red tape in public service delivery, and prone to corrupt practices. Despite that being the case, it is slowly trying to implement e-government. The adoption of e-government promises a sharp paradigm shift where public institutions will be more responsive and transparent, promote efficient PPP (Public Private Partnerships), and empower citizens by making knowledge and other resources more directly accessible. This paper examines three cases from Zambia where ICT in support of e-government has been implemented for Development Information Exchange (DIE) - knowledge-based decision making. The paper also assesses the challenges, opportunities, and issues together with e-government adoption criteria regarding successful encapsulation of e-government into the Zambian contextual environment. I propose a conceptual model which offers balanced e-government adoption criteria involving a combination of electronic and participatory services. This conceptual e-government adoption model can later be replicated to be used at the Southern African Development Community (SADC) level given the similarity in the contextual environment.

  3. Predictors of Adherence to Antiretroviral Therapy in Rural Zambia

    PubMed Central

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

    2009-01-01

    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. PMID:18209678

  4. Will savannas survive outside the parks? A lesson from Zambia

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

    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.

  5. Telemedicine in Primary Health: The Virtual Doctor Project Zambia

    PubMed Central

    2011-01-01

    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. PMID:21569490

  6. Telemedicine in primary health: the virtual doctor project Zambia.

    PubMed

    Mupela, Evans N; Mustarde, Paul; Jones, Huw L C

    2011-01-01

    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. PMID:21569490

  7. A review of tuberculosis at the wildlife-livestock-human interface in Zambia

    PubMed Central

    2013-01-01

    Zambias estimated incidence of all forms of human tuberculosis (TB) is 707/100,000. High prevalence of bovine tuberculosis (BTB) infection with Mycobacterium bovis in cattle and the Kafue lechwe antelopes (Kobus leche Kafuensis) has been reported in the Kafue basin. Consumption of unpasteurised milk and meat products from infected animals poses a risk of transmitting zoonotic tuberculosis to people living at the human-animal interface. Despite the reported high prevalence of BTB in both livestock and wildlife, information on the proportion of human patients infected with M. bovis is unknown in Zambia. This paper reviews the available information in English on human, livestock and wildlife TB in Zambia with the purpose of assessing the burden of animal infections with M. tuberculosis complex and its public health implications. PMID:23849550

  8. Mutumwa Nchimi healers and wizardry beliefs in Zambia.

    PubMed

    Dillon-Malone, C

    1988-01-01

    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

  9. Mineralization types in the Mozambique Belt of eastern Zambia

    NASA Astrophysics Data System (ADS)

    Kamona, A. F.

    1994-10-01

    Several mineral occurences, that include massive, disseminated and vein types of mineralization, are found in Paleoproterozoic rocks of the Mozambique Belt of Eastern Zambia. Mineralization associated with mafic igneous activity is presented by ilmenite in gabbros, whereas muscovite, aquamarine and tourmaline are mined from numerous pegmatites, which intrude into basement schists and gneisses. Massive Zn-Cu sulphides are interbanded with amphibolites and paragneisses of the Mvuvye Group. The disseminated type of mineralization includes cooper associated with gold in schists and metavolcanics and with graphite in gneisses and granulites. Quartz veins in schists and quartzites are mineralized with gold, bismuth and copper. The gold is associated mainly with disseminated pyrite, bismutite and bismuthinite as well as wtih native copper, chalcopyrite or malachite. In addition, concentrations of alluvial gold derived from quartz veins have been worked from sands and gravels in the region.

  10. HIV stress in primary school teachers in Zambia.

    PubMed Central

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

    1999-01-01

    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. PMID:10212524

  11. Social factors affecting ART adherence in rural settings in Zambia

    PubMed Central

    Nozaki, Ikuma; Dube, Christopher; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B.

    2011-01-01

    The purpose of this study was to assess the factors that influence ART adherence arising in rural settings in Zambia. A survey was conducted with face-to-face interviews using a semi-structured questionnaire and written informed consent was obtained at ART sites in Mumbwa District in rural Zambia. The questionnaire included items such as the socio-demographic characteristics of respondents, support for adherence, ways to remember when to take ARVs at scheduled times, and the current status of adherence. Valid responses were obtained from 518 research participants. The mean age of the respondents was 38.3 years and the average treatment period was 12.5 months. More than half of the respondents (51%) were farmers, about half (49%) did not own a watch, and 10% of them used the position of the sun to remember when to take ARVs. Sixteen percent of respondents experienced fear of stigma resulting from taking ARVs at work or home, and 10% felt pressured to share ARVs with someone. Eighty-eight percent of the participants reported that they had never missed ARVs in the past four days. Multivariable logistic regression analysis identified age (38 years old or less, odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.34.8, p = 0.005), remembering when to take ARVs based on the position of the sun (OR = 3.3, 95% CI: 1.38.8, p = 0.016), and feeling pressured to share ARVs with someone (OR = 4.4, 95% CI: 1.612.0, p = 0.004) as independent factors for low adherence. As ART services expand to rural areas, program implementers should pay more attention to more specific factors arising in rural settings since they may differ from those in urban settings. PMID:21400314

  12. Prevention and Management of Neonatal Hypothermia in Rural Zambia

    PubMed Central

    Lunze, Karsten; Yeboah-Antwi, Kojo; Marsh, David R.; Kafwanda, Sarah Ngolofwana; Musso, Austen; Semrau, Katherine; Waltensperger, Karen Z.; Hamer, Davidson H.

    2014-01-01

    Background Neonatal hypothermia is increasingly recognized as a risk factor for newborn survival. The World Health Organization recommends maintaining a warm chain and skin-to-skin care for thermoprotection of newborn children. Since little is known about practices related to newborn hypothermia in rural Africa, this study's goal was to characterize relevant practices, attitudes, and beliefs in rural Zambia. Methods and Findings We conducted 14 focus group discussions with mothers and grandmothers and 31 in-depth interviews with community leaders and health officers in Lufwanyama District, a rural area in the Copperbelt Province, Zambia, enrolling a total of 171 participants. We analyzed data using domain analysis. In rural Lufwanyama, community members were aware of the danger of neonatal hypothermia. Caregivers' and health workers' knowledge of thermoprotective practices included birthplace warming, drying and wrapping of the newborn, delayed bathing, and immediate and exclusive breastfeeding. However, this warm chain was not consistently maintained in the first hours postpartum, when newborns are at greatest risk. Skin-to-skin care was not practiced in the study area. Having to assume household and agricultural labor responsibilities in the immediate postnatal period was a challenge for mothers to provide continuous thermal care to their newborns. Conclusions Understanding and addressing community-based practices on hypothermia prevention and management might help improve newborn survival in resource-limited settings. Possible interventions include the implementation of skin-to-skin care in rural areas and the use of appropriate, low-cost newborn warmers to prevent hypothermia and support families in their provision of newborn thermal protection. Training family members to support mothers in the provision of thermoprotection for their newborns could facilitate these practices. PMID:24714630

  13. Metallogenesis of the Nkana copper-cobalt South Orebody, Zambia

    NASA Astrophysics Data System (ADS)

    Brems, D.; Muchez, Ph.; Sikazwe, O.; Mukumba, W.

    2009-10-01

    The Central African Copperbelt is one of the largest and richest metallogenic provinces in the world. Despite the many studies, the genesis of the stratiform Cu-Co-mineralization remains a subject of intense discussion. A diagenetic, pre-folding origin is proposed for most ore deposits both in Zambia and the Democratic Republic of Congo. However, later mineralization and/or remobilization seem to be important in the enrichment of the ores. The geological mapping of the South Orebody mine at Nkana (Zambia) indicates a relation between the mineralization and the host rock but also with compressional deformation. The location of the rich ore bodies generally corresponds with the hinge zones of tight to isoclinal folds and with the contact between the sandstones and conglomerates of the Footwall Sandstone Formation and the overlying organic-rich shales of the Ore Formation. The circulation of the mineralizing/remobilizing fluids through the rocks was facilitated by fracturing, especially in the hinge zones of the folds resulting in a structural permeability. A petrographical study demonstrated that, in addition to disseminated sulphides, three successive vein generations occur at Nkana South Orebody, i.e. layer parallel veins, irregular, crosscutting veins and massive veins. These vein generations respectively formed during the initial phase of basin inversion, the main phase of deformation and a late phase of orogenesis or later extensional tensions. Early diagenetic disseminated framboidal pyrites were replaced by Cu-sulphides. The timing of this replacement could not be constrained. Silicification, K-feldspar alteration, albitization, carbonatization and replacement by anhydrite are the main alteration phases.

  14. Developmental assessment, cultural context, gender, and schooling in Zambia.

    PubMed

    Serpell, Robert; Jere-Folotiya, Jacqueline

    2008-04-01

    Multiple perspectives on the assessment of children's development at the school-community interface in rural areas of Zambia are discussed in the light of several empirical studies conducted between 1974 and 2005. A longitudinal trace study of a cohort of 46 young people born into a rural, Chewa community in Katete District found that girls' scores in early childhood on a battery of ecoculturally grounded cognitive tests correlated less well than they did for boys with two educational outcomes: number of grades of schooling completed, and adult literacy scores. Conversely, ratings of the children on indigenous conceptions of intelligence by adults familiar with the children in the context of their home village lives predicted the same outcomes better for girls than for boys. A separate, linked experiment compared the performance of 76 Katete school children with that of 84 school children in the capital city of Lusaka on the US standardized Draw-a-Person Test (DPT) and the Panga Munthu Test (PMT), an expanded version of one of the tests developed for the Zambian trace study. Analysis of the correlations among scores on these two tests, age, and teacher ratings suggests that aptitudes evident in the home and school domains are less well integrated for rural girls than for urban boys, and that for a low-income, rural population, the PMT taps the domain of home cognition better than school cognition, while the converse is true of the DPT. Implications for educational assessment in Zambia are discussed, and supportive documentation is cited from two ongoing programs of test development. The authors conclude that if educational testing is to support the process of enhancing educational equity across gender, family socioeconomic status, and residential location, its focus should be broadened to include other dimensions of psychological development such as multilingual and personal-social competencies. PMID:22023603

  15. Social factors affecting ART adherence in rural settings in Zambia.

    PubMed

    Nozaki, Ikuma; Dube, Christopher; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B

    2011-07-01

    The purpose of this study was to assess the factors that influence ART adherence arising in rural settings in Zambia. A survey was conducted with face-to-face interviews using a semi-structured questionnaire and written informed consent was obtained at ART sites in Mumbwa District in rural Zambia. The questionnaire included items such as the socio-demographic characteristics of respondents, support for adherence, ways to remember when to take ARVs at scheduled times, and the current status of adherence. Valid responses were obtained from 518 research participants. The mean age of the respondents was 38.3 years and the average treatment period was 12.5 months. More than half of the respondents (51%) were farmers, about half (49%) did not own a watch, and 10% of them used the position of the sun to remember when to take ARVs. Sixteen percent of respondents experienced fear of stigma resulting from taking ARVs at work or home, and 10% felt pressured to share ARVs with someone. Eighty-eight percent of the participants reported that they had never missed ARVs in the past four days. Multivariable logistic regression analysis identified age (38 years old or less, odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.3-4.8, p=0.005), "remembering when to take ARVs based on the position of the sun" (OR = 3.3, 95% CI: 1.3-8.8, p=0.016), and "feeling pressured to share ARVs with someone" (OR = 4.4, 95% CI: 1.6-12.0, p=0.004) as independent factors for low adherence. As ART services expand to rural areas, program implementers should pay more attention to more specific factors arising in rural settings since they may differ from those in urban settings. PMID:21400314

  16. Provision of Learning and Teaching Materials for Pupils with Visual Impairment: Results from a National Survey in Zambia

    ERIC Educational Resources Information Center

    Akakandelwa, Akakandelwa; Munsanje, Joseph

    2012-01-01

    The aim of this study was to determine the provision of learning and teaching materials for pupils with visual impairment in basic and high schools of Zambia. A survey approach utilizing a questionnaire, interviews and a review of the literature was adopted for the study. The findings demonstrated that most schools in Zambia did not provide…

  17. Moving Towards Inclusive Education Policies and Practices? Basic Education for AIDS Orphans and Other Vulnerable Children in Zambia

    ERIC Educational Resources Information Center

    Robson, Sue; Kanyanta, Sylvester Bonaventure

    2007-01-01

    The global spread of HIV and AIDS has presented a major threat to development, affecting the health of the poor and many aspects of social and economic development. The greatest impact of the epidemic has been felt in sub-Saharan Africa, and Zambia ranks among the worst hit countries. The Free Basic Education Policy in Zambia upholds the right of

  18. Provision of Learning and Teaching Materials for Pupils with Visual Impairment: Results from a National Survey in Zambia

    ERIC Educational Resources Information Center

    Akakandelwa, Akakandelwa; Munsanje, Joseph

    2012-01-01

    The aim of this study was to determine the provision of learning and teaching materials for pupils with visual impairment in basic and high schools of Zambia. A survey approach utilizing a questionnaire, interviews and a review of the literature was adopted for the study. The findings demonstrated that most schools in Zambia did not provide

  19. Moving Towards Inclusive Education Policies and Practices? Basic Education for AIDS Orphans and Other Vulnerable Children in Zambia

    ERIC Educational Resources Information Center

    Robson, Sue; Kanyanta, Sylvester Bonaventure

    2007-01-01

    The global spread of HIV and AIDS has presented a major threat to development, affecting the health of the poor and many aspects of social and economic development. The greatest impact of the epidemic has been felt in sub-Saharan Africa, and Zambia ranks among the worst hit countries. The Free Basic Education Policy in Zambia upholds the right of…

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

    PubMed

    Nalubamba, King S; Mudenda, Ntombi B

    2012-05-25

    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

  1. Comparative Validity of Screening Instruments for Mental Distress in Zambia

    PubMed Central

    Chipimo, Peter J; Fylkesnes, Knut

    2010-01-01

    Background: The recognition of mental health as a major contributor to the global burden of disease has led to an increase in the demand for the inclusion of mental health services in primary health care as well as in community-based health surveys in order to improve screening, diagnosis and treatment of mental distress. Many screening instruments are now available. However, the cultural validity of these instruments to detect mental distress has rarely been investigated in developing countries. In these countries, limited trained staff and specialized psychiatric facilities hamper improvement of mental health services. It is therefore imperative to develop a quick, low cost screening instrument that does not require specialized training. We validated different well established screening instruments among primary health care clinic attendees in Lusaka, Zambia. We also assess the face, content and criterion validity of the SRQs and determined the most commonly reported symptoms for mental distress. Methods: The screening instruments, SRQ-20, SRQ-10 and GHQ-12 were used as concurrent criteria for each other and compared against a gold standard, DSM-IV. Their correlation, sensitivity and specificity were assessed. All instruments were administered to 400 primary health care clinic attendees. In-depth interviews were also conducted with 28 of these clinic attendees. Results: Both the SRQ-20 and SRQ-10 had high properties for identifying mental distress correctly with an AUC of 0.96 and 0.95 respectively while the GHQ-12 had modest properties (AUC, 0.81). The optimum cut-off points for this population were 7 and 3 for the SRQ and GHQ-12 respectively. The SRQ was also found to have good face and content validity. Conclusion: The study establishes the utility of the SRQ-20 for detecting mental distress cases and also underscores the importance of validating instruments to suit the context of the target population. It also validates the SRQ-10 as the first reliable abbreviated and easy-to-use screening instrument for mental distress in primary health care facilities in Zambia. PMID:20498698

  2. A review of tuberculosis at the wildlife-livestock-human interface in Zambia.

    PubMed

    Malama, Sydney; Muma, John Bwalya; Godfroid, Jacques

    2013-01-01

    Zambia's estimated incidence of all forms of human tuberculosis (TB) is 707/100,000. High prevalence of bovine tuberculosis (BTB) - infection with Mycobacterium bovis - in cattle and the Kafue lechwe antelopes (Kobus leche Kafuensis) has been reported in the Kafue basin. Consumption of unpasteurised milk and meat products from infected animals poses a risk of transmitting zoonotic tuberculosis to people living at the human-animal interface. Despite the reported high prevalence of BTB in both livestock and wildlife, information on the proportion of human patients infected with M. bovis is unknown in Zambia. This paper reviews the available information in English on human, livestock and wildlife TB in Zambia with the purpose of assessing the burden of animal infections with M. tuberculosis complex and its public health implications. PMID:23849550

  3. Experiences of the first female physics graduates of the University of Zambia

    NASA Astrophysics Data System (ADS)

    Mwewa, Chilufya; Namumba, Brenda; Mofya, Mwape

    2013-03-01

    Although the Department of Physics was established together with the University of Zambia in 1966, it has only graduated eight females to date. This calls for concern since the University of Zambia is the only institution that offers a physics degree program in Zambia. In this paper, three of these females discuss their understanding of the factors that have led to members of their gender shunning physics. They outline the way they themselves came to do physics and they discuss the problems they faced as they studied physics and the rewards they received from this. They propose ways and means of motivating other females to take up physics and of making studies easier and more fulfilling for those who opt to do so.

  4. Conceptualization of appropriate technology in Lundazi district of rural Zambia

    SciTech Connect

    Tembo, M.S.

    1987-01-01

    A sample of 144 people from the Lundazi District of the Eastern Province of rural Zambia in Central Africa responded to a questionnaire. The first objective of the study was to determine how men and women conceptualize and evaluated appropriate technology for food production, processing, preservation, and storage; second, to investigate if participation in modern institutions (COSISOCHINS) was related to conceptualization of appropriate technology. There were no significant gender differences in how men and women viewed appropriate technology. Participation in modern institutions was not significantly related to how people conceptualized and evaluated appropriate technology. There were significant gender differences in participation in modern institutions; men participated more than women. The findings remained the same when age, education, income and marital status held constant. Sex-role task overlap and exclusiveness in gender division of labor account for lack of significant gender differences. Modern institutions can be useful if they are effectively integrated with the social structure, gender division of labor, and social organization of the production process of the rural communities of the Third World.

  5. Thelazia rhodesii in the African buffalo, Syncerus caffer, in Zambia.

    PubMed

    Munang'andu, Hetron Mweemba; Chembensofu, Mweelwa; Siamudaala, Victor M; Munyeme, Musso; Matandiko, Wigganson

    2011-03-01

    We report 2 cases of Thelazia rhodesii infection in the African buffaloes, Syncerus caffer, in Zambia. African buffalo calves were captured from the livestock and wildlife interface area of the Kafue basin in the dry season of August 2005 for the purpose to translocate to game ranches. At capture, calves (n=48) were examined for the presence of eye infections by gently manipulating the orbital membranes to check for eye-worms in the conjunctival sacs and corneal surfaces. Two (4.3%) were infected and the mean infection burden per infected eye was 5.3 worms (n=3). The mean length of the worms was 16.4 mm (95% CI; 14.7-18.2 mm) and the diameter 0.41 mm (95% CI; 0.38-0.45 mm). The surface cuticle was made of transverse striations which gave the worms a characteristic serrated appearance. Although the calves showed signs of kerato-conjunctivitis, the major pathological change observed was corneal opacity. The calves were kept in quarantine and were examined thrice at 30 days interval. At each interval, they were treated with 200 µg/kg ivermectin, and then translocated to game ranches. Given that the disease has been reported in cattle and Kafue lechwe (Kobus lechwe kafuensis) in the area, there is a need for a comprehensive study which aims at determining the disease dynamics and transmission patterns of thelaziasis between wildlife and livestock in the Kafue basin. PMID:21461276

  6. Thelazia rhodesii in the African Buffalo, Syncerus caffer, in Zambia

    PubMed Central

    Chembensofu, Mweelwa; Siamudaala, Victor M.; Munyeme, Musso; Matandiko, Wigganson

    2011-01-01

    We report 2 cases of Thelazia rhodesii infection in the African buffaloes, Syncerus caffer, in Zambia. African buffalo calves were captured from the livestock and wildlife interface area of the Kafue basin in the dry season of August 2005 for the purpose to translocate to game ranches. At capture, calves (n=48) were examined for the presence of eye infections by gently manipulating the orbital membranes to check for eye-worms in the conjunctival sacs and corneal surfaces. Two (4.3%) were infected and the mean infection burden per infected eye was 5.3 worms (n=3). The mean length of the worms was 16.4 mm (95% CI; 14.7-18.2 mm) and the diameter 0.41 mm (95% CI; 0.38-0.45 mm). The surface cuticle was made of transverse striations which gave the worms a characteristic serrated appearance. Although the calves showed signs of kerato-conjunctivitis, the major pathological change observed was corneal opacity. The calves were kept in quarantine and were examined thrice at 30 days interval. At each interval, they were treated with 200 µg/kg ivermectin, and then translocated to game ranches. Given that the disease has been reported in cattle and Kafue lechwe (Kobus lechwe kafuensis) in the area, there is a need for a comprehensive study which aims at determining the disease dynamics and transmission patterns of thelaziasis between wildlife and livestock in the Kafue basin. PMID:21461276

  7. Impact of Drainage Networks on Cholera Outbreaks in Lusaka, Zambia

    PubMed Central

    Suzuki, Hiroshi; Fujino, Yasuyuki; Kimura, Yoshinari; Cheelo, Meetwell

    2009-01-01

    Objectives. We investigated the association between precipitation patterns and cholera outbreaks and the preventative roles of drainage networks against outbreaks in Lusaka, Zambia. Methods. We collected data on 6542 registered cholera patients in the 20032004 outbreak season and on 6045 cholera patients in the 20052006 season. Correlations between monthly cholera incidences and amount of precipitation were examined. The distribution pattern of the disease was analyzed by a kriging spatial analysis method. We analyzed cholera case distribution and spatiotemporal cluster by using 2590 cholera cases traced with a global positioning system in the 20052006 season. The association between drainage networks and cholera cases was analyzed with regression analysis. Results. Increased precipitation was associated with the occurrence of cholera outbreaks, and insufficient drainage networks were statistically associated with cholera incidences. Conclusions. Insufficient coverage of drainage networks elevated the risk of cholera outbreaks. Integrated development is required to upgrade high-risk areas with sufficient infrastructure for a long-term cholera prevention strategy. PMID:19762668

  8. Antiretroviral Therapy in Zambia: Do Partners on ART Enhance Adherence?

    PubMed Central

    Jones, Deborah; Cook, Ryan; Spence, Andrew; Weiss, Stephen M.; Chitalu, Ndashi

    2016-01-01

    Background Adherence to antiretroviral therapy (ART) is essential to optimize HIV treatment outcomes. Among individuals on ART, targeted peer support has been found to support adherence. This study of Zambian heterosexual couples living with HIV examined whether partners would exert a positive influence on each other's adherence, and compared adherence between couples in which either one or both members were on ART. Methods Couples (n = 446 participants), in which either or both member were on ART were assessed at baseline, 6 and 12 months. Results Most participants (64%, n = 263) were on ART; overall, uptake of ART increased to 74% at 12 months. At baseline, 76% reported near perfect adherence; at 6 and 12 months, 66% and 70% were adherent, respectively. A regression analysis indicated that the decline in adherence did not differ between those couples in which one or both partners were on ART [F (2, 624) = 0.37, p = .692]. Pairwise comparison indicated that adherence primarily decreased between baseline and 6 months (t = 2.72, p = .007), and was stable 6 to 12 months. Conclusions This study of couples in Zambia found adherence was not enhanced by having a partner on ART, and that adherence declined over time. Partners on ART may not necessarily provide support for adherence to each other. Partners may represent an untapped resource for optimizing adherence; results highlight the need for provider guidance and structured adherence interventions targeting partner adherence support. PMID:25294856

  9. Theileriosis control modelling (experiences from Southern Province, Zambia).

    PubMed

    Penne, K; D'Haese, L

    1999-09-01

    Effects of different tick-borne disease control strategies on cattle productivity are simulated based on a 30-year herd projection, calculated by a modified Markov Chain model. Input data can be grouped in technical, economic and epidemiological parameters. The output is a set of economic parameters such as benefit/cost ratio (BCR), net present value (NPV) of the profit, internal rate of return (IRR), total economic cost (TEC) as well as graphs showing animal production over time. Shadow prices are obtained for input and output in kind. Throughout the calculations a distinction is made between transactions in cash and transactions in kind. A case study was run for Southern Province, Zambia, to illustrate the model. Either vector control or treatment, or a combination of these, controls theileriosis at farm level after natural infection. Preventive immunization against the parasite is also possible. Although the calculations are based on a mixture of data obtained from literature, field experience, expert opinion and assumptions, the importance of theileriosis control is clearly indicated. Immunization gives better economic results than chemotherapy. Vector control can only be used as a last resort. PMID:10540313

  10. Diagnostic approaches to malaria in Zambia, 2009-2014.

    PubMed

    Mukonka, Victor M; Chanda, Emmanuel; Kamuliwo, Mulakwa; Elbadry, Maha A; Wamulume, Pauline K; Mwanza-Ingwe, Mercy; Lubinda, Jailos; Laytner, Lindsey A; Zhang, Wenyi; Mushinge, Gabriel; Haque, Ubydul

    2015-01-01

    Malaria is an important health burden in Zambia with proper diagnosis remaining as one of the biggest challenges. The need for reliable diagnostics is being addressed through the introduction of rapid diagnostic tests (RDTs). However, without sufficient laboratory amenities in many parts of the country, diagnosis often still relies on non-specific, clinical symptoms. In this study, geographical information systems were used to both visualize and analyze the spatial distribution and the risk factors related to the diagnosis of malaria. The monthly reported, district-level number of malaria cases from January 2009 to December 2014 were collected from the National Malaria Control Center (NMCC). Spatial statistics were used to reveal cluster tendencies that were subsequently linked to possible risk factors, using a non-spatial regression model. Significant, spatio-temporal clusters of malaria were spotted while the introduction of RDTs made the number of clinically diagnosed malaria cases decrease by 33% from 2009 to 2014. The limited access to road network(s) was found to be associated with higher levels of malaria, which can be traced by the expansion of health promotion interventions by the NMCC, indicating enhanced diagnostic capability. The capacity of health facilities has been strengthened with the increased availability of proper diagnostic tools and through retraining of community health workers. To further enhance spatial decision support systems, a multifaceted approach is required to ensure mobilization and availability of human, infrastructural and technological resources. Surveillance based on standardized geospatial or other analytical methods should be used by program managers to design, target, monitor and assess the spatio-temporal dynamics of malaria diagnostic resources country-wide. PMID:26054519

  11. Access, Quality, and Opportunity: A Case Study of Zambia Open Community Schools (ZOCS)

    ERIC Educational Resources Information Center

    Mwalimu, Michelle

    2011-01-01

    Community schools and other approaches to Alternative Primary Education or APE have increased access to primary education for underserved populations in Africa, Asia, and Latin America as a major goal of the Education for All (EFA) movement. In Zambia, a country where an estimated 20 percent of the basic education enrollment now attends community…

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

    ERIC Educational Resources Information Center

    Bajaj, Monisha

    2009-01-01

    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 carry

  13. Factors Related to Pre-Service Teachers' Attitudes towards Inclusion: A Case for Zambia

    ERIC Educational Resources Information Center

    Muwana, Florence Chuzu; Ostrosky, Michaelene M.

    2014-01-01

    Inclusive education has become a global trend in the provision of services for students with disabilities. In Zambia and other developing nations, international initiatives from UNESCO and other nongovernmental organisations have contributed to the consensus that all children have a right to a free and appropriate education and that all students…

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

    ERIC Educational Resources Information Center

    Bajaj, Monisha

    2009-01-01

    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 carry…

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

    ERIC Educational Resources Information Center

    Chabalengula, Vivien M.; Mumba, Frackson

    2012-01-01

    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…

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

    ERIC Educational Resources Information Center

    Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

    2011-01-01

    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…

  17. CORRESPONDENCE INSTRUCTION IN ETHIOPIA, KENYA, TANZANIA, MALAWI, ZAMBIA, AND UGANDA--EXPERIENCES, NEEDS, AND INTEREST.

    ERIC Educational Resources Information Center

    EDSTROEM, LARS-OLOF

    THIS REPORT ON THE SALIENT FEATURES AND CONCERNS OF CORRESPONDENCE INSTRUCTION IN ETHIOPIA, KENYA, TANZANIA, MALAWI, ZAMBIA, AND UGANDA--(1) DISCUSSES ADVANTAGES, DISADVANTAGES, AND REQUIREMENTS OF THE CORRESPONDENCE METHOD IN AN AFRICAN CONTEXT, (2) SURVEYS CONDITIONS AND FACILITIES (POSTAL SERVICES, ROADS, INSTRUCTIONAL RADIO AND TELEVISION,

  18. Redressing Gender Inequalities in Education. A Review of Constraints and Priorities in Malawi, Zambia, and Zimbabwe.

    ERIC Educational Resources Information Center

    Swainson, Nicola

    The causes and manifestations of gender inequalities in education in Malawi, Zambia, and Zimbabwe and policy options for redressing them were examined through a review of literature on the causes, nature, and extent of gender disparities in education in the study region and information on efforts to eliminate gender inequality. Special attention

  19. Standardization of the Panga Munthu Test--A Nonverbal Cognitive Test Developed in Zambia.

    ERIC Educational Resources Information Center

    Kathuria, Ravider; Serpell, Robert

    1998-01-01

    Describes the Panga Munthu test, a measure developed in Zambia to provide a more accurate and culturally appropriate assessment of intelligence for children in a non-Western society. Presents results of psychometric studies based on 3,231 children and describes two complementary approaches for deriving reference norms to guide interpretation of

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

    PubMed Central

    2012-01-01

    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. PMID:22954173

  1. Organization of Distance Education at the University of Zambia: An Analysis of the Practice.

    ERIC Educational Resources Information Center

    Nyirenda, Juma E.

    1989-01-01

    Discussion of two basic organizational models for distance education systems or institutions focuses on the mixed-mode organization at the University of Zambia. Highlights include the development, production, storage, and distribution of teaching materials; communication channels between students and teachers; and the record-keeping system. (11

  2. Exploring Understandings of Inclusion in Schools in Zambia and Tanzania Using Reflective Writing and Photography

    ERIC Educational Resources Information Center

    Miles, Susie

    2011-01-01

    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

  3. Developing a Nutrition and Health Education Program for Primary Schools in Zambia

    ERIC Educational Resources Information Center

    Sherman, Jane; Muehlhoff, Ellen

    2007-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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

  5. Folklore as an Instrument of Education among the Chewa People of Zambia

    ERIC Educational Resources Information Center

    Banda, Dennis; Morgan, W. John

    2013-01-01

    This article considers the folklore of the Chewa people of Zambia as an instrument of education. It suggests that there is only a fine distinction between Chewa culture ["mwambo wa a Chewa"] and Chewa education ["maphunziro ya Uchewa"]. The former comprises tribal "truths" to be imposed on the minds of the younger

  6. Access, Quality, and Opportunity: A Case Study of Zambia Open Community Schools (ZOCS)

    ERIC Educational Resources Information Center

    Mwalimu, Michelle

    2011-01-01

    Community schools and other approaches to Alternative Primary Education or APE have increased access to primary education for underserved populations in Africa, Asia, and Latin America as a major goal of the Education for All (EFA) movement. In Zambia, a country where an estimated 20 percent of the basic education enrollment now attends community

  7. Comparative Policy Brief: Status of Intellectual Disabilities in the Republic of Zambia

    ERIC Educational Resources Information Center

    Mung'omba, James

    2008-01-01

    In the Republic of Zambia, an estimated 256,000 persons have some form of disability, and of these, 5.4% have intellectual disabilities. Even now, traditional beliefs about the etiology of intellectual disabilities persist and considerable stigma is attached to the presence of persons with intellectual disabilities who are often excluded from

  8. Early Childhood Care and Education in Zambia: An Integral Part of Educational Provision?

    ERIC Educational Resources Information Center

    Thomas, Carolyn M.; Thomas, Matthew A. M.

    2009-01-01

    The field of international development has recently been consumed by a shift in contemporary educational discourse, one that moves Early Childhood Care and Education (ECCE) closer to the forefront of what is considered progressive policy formation. In Zambia, the current educational environment seems to indicate that the creation and continued

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

    ERIC Educational Resources Information Center

    Lawoko, Stephen

    2008-01-01

    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

  10. Gender, British Administration and Mission Management of Education in Zambia 1900-1939

    ERIC Educational Resources Information Center

    Allen, Julia

    2010-01-01

    This article discusses the impact of including gender in the analytical framework in a study of the management and provision of education in Zambia from 1900 to 1939. It shows that a focus on gender allows females to enter the historical narrative and the leadership of women such as Mabel Shaw, Hannah Frances Davidson and Julia Smith can be given

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

    ERIC Educational Resources Information Center

    Miles, Susie; Kaplan, Ian

    2005-01-01

    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

  12. Factors Related to Pre-Service Teachers' Attitudes towards Inclusion: A Case for Zambia

    ERIC Educational Resources Information Center

    Muwana, Florence Chuzu; Ostrosky, Michaelene M.

    2014-01-01

    Inclusive education has become a global trend in the provision of services for students with disabilities. In Zambia and other developing nations, international initiatives from UNESCO and other nongovernmental organisations have contributed to the consensus that all children have a right to a free and appropriate education and that all students

  13. HIV Testing among Adolescents in Ndola, Zambia: How Individual, Relational, and Environmental Factors Relate to Demand

    ERIC Educational Resources Information Center

    Denison, Julie A.; McCauley, Ann P.; Dunnett-Dagg, Wendy A.; Lungu, Nalakwanji; Sweat, Michael D.

    2009-01-01

    This study examined how individual, relational and environmental factors related to adolescent demand for HIV voluntary counseling and testing (VCT). A cross-sectional survey among randomly selected 16-19-year-olds in Ndola, Zambia, covered individual (e.g., HIV knowledge), environmental (e.g., distance), and relational factors (e.g., discussed

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

    ERIC Educational Resources Information Center

    Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

    2011-01-01

    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

  15. Education and Zambia's Democratic Development: Reconstituting "Something" from the Predatory Project of Neoliberal Globalization

    ERIC Educational Resources Information Center

    Abdi, Ali A.; Ellis, Lee

    2007-01-01

    Zambia, a central African country of about 10 million people, is currently exposed to the nonsubjective forces of globalization, including institutional weaknesses such as high unemployment rated and chronic levels of poverty that ipso facto problematize its governance and social development priorities. The first part of the article focuses on an

  16. The Nature and Role of Religious Studies at the University of Zambia: 1985-2005

    ERIC Educational Resources Information Center

    Carmody, Brendan

    2008-01-01

    The place of religion in higher education has been and remains a complex issue internationally. This article aims to outline the nature and development of Religious Studies at the University of Zambia in Lusaka (UNZA) as an instance of how religion entered higher education in an African setting. In doing so, it will also provide perspectives on

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

    ERIC Educational Resources Information Center

    Alexander, David

    2006-01-01

    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

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

    ERIC Educational Resources Information Center

    Alexander, David

    2006-01-01

    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…

  19. 77 FR 66797 - Executive-Led Trade Mission to South Africa and Zambia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ..., published at 77 FR 31574, May 29, 2012, to expand the eligibility to include U.S. trade associations and to... Africa and Zambia scheduled for November 26-30, 2012, announced in the Notice published at 77 FR 31574, May 29, 2012, as previously amended by notices at 77 FR 48498 (Aug. 14, 2012) adding the water...

  20. The Impact of an Unconditional Cash Transfer on Early Child Development: The Zambia Child Grant Program

    ERIC Educational Resources Information Center

    Seidenfeld, David; Prencipe, Leah; Handa, Sudhanshu; Hawkinson, Laura

    2015-01-01

    Little research has been conducted on unconditional cash transfers (UCTs) despite their growing prevalence in Africa, including South Africa, Zambia, Zimbabwe, Kenya, Malawi, Lesotho, and Uganda. In this study, researchers implemented a randomized control trial with over 2,500 households to investigate the impact of Africa's child grant program on…

  1. Exploring Understandings of Inclusion in Schools in Zambia and Tanzania Using Reflective Writing and Photography

    ERIC Educational Resources Information Center

    Miles, Susie

    2011-01-01

    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…

  2. The Growth of Co-Operatives in Zambia 1914-71.

    ERIC Educational Resources Information Center

    Lombard, C. Stephen

    Agricultural co-operatives in Zambia are discussed under the following topics: (1) Economic background, (2) Pre-independence co-operative developments, (3) Post-independence co-operative developments, and (4) Current developments and thinking. It is concluded that co-operative organization is the most suitable method of combining small farms into

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

    ERIC Educational Resources Information Center

    Lawoko, Stephen

    2008-01-01

    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…

  4. Report from the Field: Education under Structural Adjustment in Nigeria and Zambia.

    ERIC Educational Resources Information Center

    Babalola, Joel B.; Lungwangwa, Geoffrey; Adeyinka, Augustus A.

    1999-01-01

    Investigates the effects of the Structural Adjustment Program (SAP) on the educational systems in Nigeria and Zambia. Reports that SAP impacted the public expenditure on education, the purchasing power of the incomes earned by both learning institutions and their staff, and on access, equity, and quality indicators in education at all levels. (CMK)

  5. Genome Sequence of a Bacillus anthracis Outbreak Strain from Zambia, 2011.

    PubMed

    Ohnishi, Naomi; Maruyama, Fumito; Ogawa, Hirohito; Kachi, Hirokazu; Yamada, Shunsuke; Fujikura, Daisuke; Nakagawa, Ichiro; Hang'ombe, Mudenda B; Thomas, Yuka; Mweene, Aaron S; Higashi, Hideaki

    2014-01-01

    In August 2011, an anthrax outbreak occurred among Hippopotamus amphibius hippopotamuses and humans in Zambia. Here, we report the draft genome sequence of the Bacillus anthracis outbreak strain CZC5, isolated from tissues of H. amphibius hippopotamuses that had died in the outbreak area. PMID:24604644

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

    PubMed Central

    Van Rossem, Ronan; Meekers, Dominique

    2007-01-01

    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 20012002 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. PMID:18088437

  7. A project in Zambia: talking to children about AIDS.

    PubMed

    Baker, K

    1988-09-01

    Early in 1987, it became clear to this individual that children were a high priority group for Acquired Immune Deficiency Syndrome (AIDS) education. Preparation for providing AIDS education in Zambia included reading as much as possible about AIDS and AIDS education in schools, contacting the Health Education Unit at the Ministry of Health for their permission and advice, and making posters and preparing a list of 10 basic questions about AIDS. The 1st talks were at a boys' technical school and a large girls' day school. Following an introduction of the subject, the format included: a 10-minute quiz with students writing down their answers; a 35-40 minute talk, using posters as visual aids; a 20-30 minute open question time; and a repeat of the same quiz as a form of "posttest." The students responded positively, and there was a substantial increase in the percentage of correct answers after each talk. Subsequently, talks were given in other Lusaka secondary schools. After the 1st few talks, the pretest and posttest was discontinued as it was considered preferable to spend more time answering the students' questions. The talks varied depending on the audience, but posters were always included as visual aids. Initially, this AIDS education effort was voluntary and unfunded. Subsequently, and as the work grew, NORAD funded the project, paying for duplicating and printing as well as a salary on an hourly basis. A booklet on AIDS for secondary schools has been written and duplicated and accepted by the Intersectorial Committee on AIDS Health Education with minor changes. Late in 1987, the booklet was rewritten totally and expanded, with numerous illustrations. Throughout the booklet, human immunodeficiency virus (HIV) is carefully differentiated from AIDS disease. Talks also have been initiated at the Upper Primary School level. The format has been altered somewhat for these younger children as they tend to be noisy and excited. The primary project planned for 1988 is to talk to teachers and health educators, individually and in groups, informally and formally. Thus far, 58 talks have been given in 22 secondary schools and 11 primary schools along with 29 talks to nonschool groups. Culturally, it is much easier as a medically trained non-Zambian to talk about AIDS and AIDS-related concerns, but the message needs to be given more than once. It must be discussed both in the classroom and at home until it becomes a part of life. PMID:3169780

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

    PubMed Central

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

    2006-01-01

    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. PMID:17591351

  9. HIV-1 effects on neuropsychological performance in a resource-limited country, Zambia.

    PubMed

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

    2011-11-01

    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 nave 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. PMID:21744118

  10. Bacillus cereus from the environment is genetically related to the highly pathogenic B. cereus in Zambia

    PubMed Central

    OGAWA, Hirohito; OHNUMA, Miyuki; SQUARRE, David; MWEENE, Aaron Simanyengwe; EZAKI, Takayuki; FUJIKURA, Daisuke; OHNISHI, Naomi; THOMAS, Yuka; HANG’OMBE, Bernard Mudenda; HIGASHI, Hideaki

    2015-01-01

    To follow-up anthrax in Zambia since the outbreak in 2011, we have collected samples from the environment and the carcasses of anthrax-suspected animals, and have tried to isolate Bacillus anthracis. In the process of identification of B. anthracis, we collected two isolates, of which colonies were similar to B. anthracis; however, from the results of identification using the molecular-based methods, two isolates were genetically related to the highly pathogenic B. cereus, of which clinical manifestation is severe and fatal (e.g., pneumonia). In this study, we showed the existence of bacteria suspected to be highly pathogenic B. cereus in Zambia, indicating the possibility of an outbreak caused by highly pathogenic B. cereus. PMID:25797134

  11. Modeling flooding patterns in the Kafue Flats, Zambia

    NASA Astrophysics Data System (ADS)

    Meier, Philipp; Kinzelbach, Wolfgang

    2010-05-01

    The Kafue Flats is one of the most important wetlands in Zambia. In the early 70's the Kafue Gorge reservoir was built mainly for hydropower production not far downstream the outlet of the Kafue Flats. Only a few years later a dam was constructed upstream the Flats to extend the limited storage of Kafue Gorge. Besides its ecological value the Kafue Flats are also important economically. Around 700 000 people are dependent mainly on fisheries and flood recession agriculture. An increasing number of large irrigation schemes are drawing water from the Kafue river along the wetland. Floodplains in semi-arid and arid areas are often the only source of water supply available throughout the year. They provide numerous economical and ecological services of tremendous value. The ecological uniqueness of many wetlands results largely from a strong seasonality of flooding. As the pressure on water resources grows these natural seasonal patterns are often altered due to water abstractions or the construction of dams. Many efforts have been taken to restore more natural flooding patterns. To assess both, the effects of altered flow regimes and of restoration efforts, a hydrological model reproducing the dynamics of the flooding is required. However, in many cases hydrological modeling of these floodplains is often hampered by the poor availability of data. Data gathering is also limited by the large extent and the limited accessibility of the wetlands. Therefore the application of remote sensing techniques is an attractive approach. The model presented in this study is based on a relatively simple approach which was initially designed for the Okavango Delta. The model is based on the widely used software MODFLOW. However, due to a different environment and technical advances of the software there are some significant differences between the Okavango Delta model and the model presented hereafter. The model is based on MODFLOW 2005 and basically consists of two layers: a subsurface layer, representing the saturated flow in the groundwater, and a surface water layer, representing the flow on the flooded surface. In between these two layers the unsaturated zone is modeled using the kinematic wave approach of the MODFLOW UZF package. To couple the surface water layer and the UZF module, an additional module was developed in order to route excess infiltration water to either the surface layer or a river. Flow in the main river channel of the Kafue is implemented using the stream flow package. Model outputs are calculated on a daily basis. Input data for the model are derived mostly from globally available datasets. Since the purpose of the model is to predict the flooding patterns as accurate as possible, model parameters have to be calibrated against the measured extent of flooding. Images from the ENVISAT ASAR instrument are used to detect flooding patterns. These data provide a good compromise between spatial resolution, spatial coverage and temporal coverage. As additional calibration data measured water levels are available. The calibration is carried out using PEST. This model predictions can serve as a base to provide information on future effects of a changing inflow regime on the ecology as well as on the socio-economic system of the Kafue Flats.

  12. Structural study and geochronology in the Hook Batholith, Central Zambia

    NASA Astrophysics Data System (ADS)

    Naydenov, K.; Lehmann, J.; Saalmann, K.; Milani, L.; Kinnaird, J.; Charlesworth, G.; Frei, D.

    2013-12-01

    The Pan-African Hook batholith is emplaced N of the Mwembeshi dislocation, a regional scale structure at the contact between Zambezi Belt and Lufilian Arc in Central Zambia. Exposed over 12000 km2 the batholith is composed mainly of fine-grained and coarse-grained porphyritic granites and leucogranites affected by solid-state deformation along high-strain zones. Two main zones of deformation were investigated - the Itezhi-Tezhi Zone (ITZ) in the SW part of the batholith and the Nalusanga Zone (NZ) to the NE. The 2.5 km wide, N-S trending, subvertical ITZ is a medium-grade, pure shear dominated structure, reflecting probably regional scale E-W shortening. In the central part of the zone, augen-gneiss textures developed. Mineral lineations plunging ~40 S are recorded occasionally. The deformed feldspar porphyroclasts show symmetrical tails and rarely sinistral stair-stepping. In the SE part of the Hook batholith the continuation of the ITZ trends E-W. This orientation can be explained by rotation of the original ITZ trend by N-S shortening that also has been recorded in the siliciclastic metasediments S of the contact. S dipping, up to 15 cm wide thrust zones observed in the ITZ area were probably formed during this tectonic event. The 3 km wide NZ is a subvertical to steeply SSW dipping structure, parallel to the NE contact of the batholith, with well-developed foliation and mineral stretching lineations. Field and microstructural analyses defined the NZ as a medium-grade, non-coaxial, sinistral strike-slip shear zone. The transition from weak foliated granite to S-C mylonites and ultramylonites was observed. The sinistral shearing is consistent with E-W shortening in agreement with the tectonic framework of the ITZ. The low grade metasediments to the E of the granite are folded in N to NNW trending structures also implying E-W shortening. Temperature conditions during the deformation in ITZ and NZ inferred from microstructural analyses are about 500-550C. The metamorphism in the country rocks E of the batholith is in the lower greenschist facies indicating that deformation along the ITZ and NZ occurred during the cooling of the granite. U-Pb zircon LA-SF-ICP-MS analyses reveal that the coarse-grained and fine-grained granites in the NE part of the batholith have the same age of 5492 Ma. The age of an undeformed aplite that truncates the NZ's foliation brackets the strike-slip shearing between 5492 Ma and 5413 Ma. In the SE margin of the batholith deformed coarse-grained granite is dated at 5442 Ma and an undeformed granitic vein gave an age of 5433 Ma, thus relating the fabric formation to the same time interval. To the SW the deformed granite in the ITZ is dated at 5333 Ma indicating that the E-W shortening was still active at this time. This study reports two deformational stages recorded in the Hook batholith and its country rocks. E-W shortening folded the sediments form the E margin of the granite and formed the solid-state fabric in the batholith. The following N-S shortening cold be related to the final docking of the Zambezi sequence to the Lufilian Arc along the Mwembeshi dislocation.

  13. Zambia : long-term generation expansion study - executive summary.

    SciTech Connect

    Conzelmann, G.; Koritarov, V.; Buehring, W.; Veselka, T.; Decision and Information Sciences

    2008-02-28

    The objective of this study is to analyze possible long-term development options of the Zambian electric power system in the period up to 2015. The analysis involved the hydro operations studies of the Zambezi river basin and the systems planning studies for the least-cost generation expansion planning. Two well-known and widely accepted computer models were used in the analysis: PC-VALORAGUA model for the hydro operations and optimization studies and the WASP-III Plus model for the optimization of long-term system development. The WASP-III Plus model is a part of the Argonne National Laboratory's Energy and Power Evaluation Model (ENPEP). The analysis was conducted in close collaboration with the Zambia Electricity Supply Corporation (ZESCO). On the initiative from The World Bank, the sponsor of the study, ZESCO formed a team of experts that participated in the analysis and were trained in the use of computer models. Both models were transferred to ZESCO free of charge and installed on several computers in the ZESCO corporate offices in Lusaka. In September-October 1995, two members of the ZESCO National Team participated in a 4-week training course at Argonne National Laboratory near Chicago, U.S.A., focusing on the long-term system expansion planning using the WASP and VALORAGUA models. The hydropower operations studies were performed for the whole Zambezi river basin, including the full installation of the Kariba power station, and the Cahora Bassa hydro power station in Mozambique. The analysis also included possible future projects such as Itezhi-Tezhi, Kafue Gorge Lower, and Batoka Gorge power stations. As hydropower operations studies served to determine the operational characteristics of the existing and future hydro power plants, it was necessary to simulate the whole Zambezi river basin in order to take into account all interactions and mutual influences between the hydro power plants. In addition, it allowed for the optimization of reservoir management and optimization of hydro cascades, resulting in the better utilization of available hydro potential. Numerous analyses were performed for different stages of system development. These include system configurations that correspond to years 1997, 2001, 2015 and 2020. Additional simulations were performed in order to determine the operational parameters of the three existing hydro power stations Victoria Falls, Kariba, and Kafue Gorge Upper, that correspond to the situation before and after their rehabilitation. The rehabilitation works for these three major power stations, that would bring their operational parameters and availability back to the design level, are planned to be carried out in the period until 2000. The main results of the hydro operations studies are presented in Table ES-1. These results correspond to VALORAGUA simulations of system configurations in the years 2001 and 2015. The minimum, average, and maximum electricity generation is based on the simulation of monthly water inflows that correspond to the chronological series of unregulated water inflows at each hydro profile in the period from April 1961 to March 1990. The recommended hydrology dataset provided in the Hydrology Report of the SADC Energy Project AAA 3.8 was used for this study.

  14. Provisioning of game meat to rural communities as a benefit of sport hunting in Zambia.

    PubMed

    White, Paula A; Belant, Jerrold L

    2015-01-01

    Sport hunting has reportedly multiple benefits to economies and local communities; however, few of these benefits have been quantified. As part of their lease agreements with the Zambia Wildlife Authority, sport hunting operators in Zambia are required to provide annually to local communities free of charge i.e., provision a percentage of the meat obtained through sport hunting. We characterized provisioning of game meat to rural communities by the sport hunting industry in Zambia for three game management areas (GMAs) during 2004-2011. Rural communities located within GMAs where sport hunting occurred received on average > 6,000 kgs per GMA of fresh game meat annually from hunting operators. To assess hunting industry compliance, we also compared the amount of meat expected as per the lease agreements versus observed amounts of meat provisioned from three GMAs during 2007-2009. In seven of eight annual comparisons of these GMAs, provisioning of meat exceeded what was required in the lease agreements. Provisioning occurred throughout the hunting season and peaked during the end of the dry season (September-October) coincident with when rural Zambians are most likely to encounter food shortages. We extrapolated our results across all GMAs and estimated 129,771 kgs of fresh game meat provisioned annually by the sport hunting industry to rural communities in Zambia at an approximate value for the meat alone of >US$600,000 exclusive of distribution costs. During the hunting moratorium (2013-2014), this supply of meat has halted, likely adversely affecting rural communities previously reliant on this food source. Proposed alternatives to sport hunting should consider protein provisioning in addition to other benefits (e.g., employment, community pledges, anti-poaching funds) that rural Zambian communities receive from the sport hunting industry. PMID:25693191

  15. Isolation and molecular characterization of Mycobacterium bovis from Kafue lechwe (Kobus leche kafuensis) from Zambia.

    PubMed

    Malama, Sydney; Johansen, Tone Bjordal; Muma, John Bwalya; Mwanza, Sydney; Djønne, Berit; Godfroid, Jacques

    2014-01-01

    Bovine tuberculosis (BTB) is a chronic bacterial disease caused by Mycobacterium bovis. Infections due to M. bovis, which serves as a stable reservoir, can pose serious challenge to control and eradicate in both wildlife and livestock at the interface. This study aimed at isolating and characterizing M. bovis from Kafue lechwe (Kobus leche kafuensis) and black lechwe (Kobus leche smithemani) at the animal/human interface in Zambia. The samples with lesions compatible with BTB collected during the hunting seasons of 2009 and 2010 were cultured for isolation of mycobacteria using Stonebrink with pyruvate (BD Diagnostics, MD, USA) and Middlebrook 7H10 (BD Diagnostics) slants. Isolated mycobacteria were identified using IS6110 polymerase chain reaction and deletion analysis. Molecular characterization of the isolates was performed using spoligotyping and mycobacteria interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) with nine loci. Data was analyzed using BioNumerics software 6.1. Out of the 39 samples, acid fast bacilli were detected in 27 (69.2 %) based on smear microscopy. Seven isolates were found to belong to Mycobacterium tuberculosis complex, and all were identified as M. bovis based on deletion analysis. All seven isolates were identical on spoligotyping as belonging to the SB0120 (SIT 482). MIRU-VNTR differentiated the isolates into five different patterns. This study has confirmed that M. bovis circulates in the Kafue lechwe, and non-tuberculous mycobacteria were detected in the black lechwe in Zambia which represents a wildlife reservoir, with a potential to spillover to cattle and humans. Isolates of M. bovis from lechwe antelopes are much conserved as only one spoligotype was detected. The study has shown that three loci differentiated fairly well. This option is cheap and less laborious, and hence a better option in resource-strained country like Zambia. The study further showed that some of the loci recommended by the European Reference Laboratory are not suitable for typing M. bovis in Zambia. PMID:24146292

  16. Provisioning of Game Meat to Rural Communities as a Benefit of Sport Hunting in Zambia

    PubMed Central

    White, Paula A.; Belant, Jerrold L.

    2015-01-01

    Sport hunting has reportedly multiple benefits to economies and local communities; however, few of these benefits have been quantified. As part of their lease agreements with the Zambia Wildlife Authority, sport hunting operators in Zambia are required to provide annually to local communities free of charge i.e., provision a percentage of the meat obtained through sport hunting. We characterized provisioning of game meat to rural communities by the sport hunting industry in Zambia for three game management areas (GMAs) during 2004–2011. Rural communities located within GMAs where sport hunting occurred received on average > 6,000 kgs per GMA of fresh game meat annually from hunting operators. To assess hunting industry compliance, we also compared the amount of meat expected as per the lease agreements versus observed amounts of meat provisioned from three GMAs during 2007–2009. In seven of eight annual comparisons of these GMAs, provisioning of meat exceeded what was required in the lease agreements. Provisioning occurred throughout the hunting season and peaked during the end of the dry season (September–October) coincident with when rural Zambians are most likely to encounter food shortages. We extrapolated our results across all GMAs and estimated 129,771 kgs of fresh game meat provisioned annually by the sport hunting industry to rural communities in Zambia at an approximate value for the meat alone of >US$600,000 exclusive of distribution costs. During the hunting moratorium (2013–2014), this supply of meat has halted, likely adversely affecting rural communities previously reliant on this food source. Proposed alternatives to sport hunting should consider protein provisioning in addition to other benefits (e.g., employment, community pledges, anti-poaching funds) that rural Zambian communities receive from the sport hunting industry. PMID:25693191

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

    PubMed Central

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

    2013-01-01

    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. PMID:22929022

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

    PubMed

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

    2013-04-01

    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. PMID:22929022

  19. Prevalence and Correlates for Psychosocial Distress Among In-School Adolescents in Zambia

    PubMed Central

    Siziya, Seter; Mazaba, Mazyanga Lucy

    2015-01-01

    There is scanty information on correlates for psychosocial distress in Zambia. Secondary analysis was conducted using the data collected in 2004 in Zambia during the global school-based health survey to determine the prevalence and correlates for psychosocial distress. Logistic regression analyses were used to estimate magnitudes of associations between exposure factors and the outcome, while the Yates corrected Chi-squared test was used to compare proportions at the 5% significance level. A total of 2257 students participated in the survey of which 54.2% were males. Males were generally older than females (p?Zambia appears to be common. There is a need to validate the psychosocial distress indicators that were used in the current study. PMID:26236704

  20. Notes from the field: severe environmental contamination and elevated blood lead levels among children - Zambia, 2014.

    PubMed

    Caravanos, Jack; Fuller, Richard; Robinson, Stephan

    2014-11-01

    Lead poisoning can have devastating health consequences, especially for children, with childhood lead exposure estimated to contribute to 600,000 new cases globally of children with intellectual disabilities every year. Lead exposure is entirely preventable, yet is estimated to account for 0.6% of the global burden of disease, with the highest burden in developing regions. Kabwe, the second largest city in Zambia with a population of approximately 203,000, is located in Zambia's Copperbelt. During 1904-1994, lead mining and smelting operations contaminated the soil in residential areas, but no extensive environmental health assessment was completed. In 2003, the World Bank funded the Copperbelt Environmental Project to assist the Government of Zambia in addressing environmental health problems related to the mining sector. Components of the project included removal of mining waste materials, soil remediation, resident evacuation, and treatment of lead-exposed children. During July 22-28, 2014, a team from PureEarth/Blacksmith Institute, the City University of New York School of Public Health, and Green Cross Switzerland conducted extensive surface soil testing and blood lead testing of children in six communities adjacent to the now-closed Kabwe mines and smelters. PMID:25375074

  1. Baseline study on the Integrated Project on Family Planning, Parasite Control and Nutrition in Zambia.

    PubMed

    1986-06-01

    Zambia's Integrated Project on Family Planning, Parasite Control, and Nutrition was set up in a government effort to adopt policies and projects to manage population growth. In Zambia, the population is expected to reach 11.5 million people by the year 2000--twice as large as the current population. 2 project areas were chosen to represent both rural and urban settings. Kapata, a typical rural area located on lake Bangweulu in the province of Luapula, was chosen as the 1st project site. The majority of its 15,000 inhabitants are engaged in fishing. In contrast, the Zambia Sugar Company, the 2nd project area is located in Ndola City in urban Kabushi. About 1200 people live within the sugar company compound. In May and July 1985, the integrated project in Zambia conducted a baseline study on these 2 project areas. The average number of members per household in both project areas was more than 5. 74.6% of the women in Kabushi said they were familiar with oral contraceptives (OCs), while only 30% of women in kapata indicated a knowledge of family planning methods. The practice of family planning was very low in both areas. Only 20.9% of the Kabushi respondents said that they practiced family planning (mainly using condoms); 11% of the Kapata respondents indicated the use of a family planning method. In both areas, women of childbearing age indicated that they did not use a contraceptive method cause of the unavailability of contraceptives. Foods rich in protein, carbohydrates, vitamins are minerals are available in the households in both areas. The quantitities and frequencies with which these foods were consumed varied considerablY. The families in Kabushi consumed more protein carbohydrates, and vegetables than the families in Kapata whose diets consisted mainly of cassava and fish. 64% of the mothers in Kabushi breast fed their babies from birth up to 1 year; only 33.3% of the women in Kapata breast fed their babies for the same period. All the families in Kabushi have access to latrines; this is the case for only 39% of the families in Kapata. Parasite infection was 42.9% in Kabushi and 35% in Kapata. The integrated project has been very successful in using parasite control as an entry point for other health interventions. The Zambia study has demonstrated the need for adopting strategies that will suit local conditions. In the case of Kabushi and Kapata, a different entry point was needed. By attending to 3 common health concerns such as eye problems, jigger, and foot infection among children, the project staff made family planning more acceptable to the people in the 2 areas. PMID:12340744

  2. Genetic diversity among Trypanosoma (Duttonella) vivax strains from Zambia and Ghana, based on cathepsin L-like gene

    PubMed Central

    Nakayima, Jesca; Nakao, Ryo; Alhassan, Andy; Hayashida, Kyoko; Namangala, Boniface; Mahama, Charles; Afakye, Kofi; Sugimoto, Chihiro

    2013-01-01

    Understanding the evolutionary relationships of Trypanosoma (Duttonella) vivax genotypes between West Africa and Southern Africa can provide information on the epidemiology and control of trypanosomosis. Cattle blood samples from Zambia and Ghana were screened for T. vivax infection using specie-specific PCR and sequencing analysis. Substantial polymorphism was obtained from phylogenetic analysis of sequences of cathepsin L-like catalytic domains. T. vivax from Ghana clustered together with West African and South American sequences, while T. vivax from Zambia formed one distinct clade and clustered with East African and Southern African sequences. This study suggests existence of distinct genetic diversity between T. vivax genotypes from West Africa and Zambia as per their geographical origins. PMID:23815966

  3. Molecular characterization of infectious bursal disease viruses detected in vaccinated commercial broiler flocks in Lusaka, Zambia.

    PubMed

    Ndashe, Kunda; Simulundu, Edgar; Hang'ombe, Bernard M; Moonga, Ladslav; Ogawa, Hirohito; Takada, Ayato; Mweene, Aaron S

    2016-03-01

    Infectious bursal disease (IBD) is an acute, highly contagious, and immunosuppressive viral disease of young chickens and remains one of the economically most important diseases threatening the poultry industry worldwide. In this study, 16 and 11 nucleotide sequences of the VP2 hypervariable region (VP2-HVR) and part of VP1, respectively, of IBD virus (IBDV) detected in vaccinated broiler chickens in Lusaka in 2012 were determined. Phylogenetic analysis revealed that these Zambian IBDVs separated into three genotypes of very virulent (VV) IBDVs. Although the majority of these viruses belonged to the African VV type (VV1), which consisted of viruses from West Africa, South Africa and Zambia, one virus belonged to the East African VV type (VV2). Interestingly, a Zambian IBDV belonging to the VV3 genotype (composed of viruses from several continents) clustered with attenuated vaccine strains. Although sequence analysis of VP2-HVR showed that all detected Zambian IBDVs had conserved putative virulence marker amino acids (i.e., 222A, 242I, 256I, 294I and 299S), one virus had two unique amino acid substitutions, N280S and E300A. This study demonstrates the diversity of Zambian IBDVs and documents for the first time the possible involvement of attenuated vaccine strains in the epidemiology of IBD in Zambia. Strict biosecurity of poultry farms, monitoring of live vaccine use in the field, surveillance and characterization of IBDV in poultry and development of a vaccine from local or regional IBDV field strains are recommended for improved IBD control in Zambia. PMID:26597187

  4. Premature adult mortality in urban Zambia: a repeated population-based cross-sectional study

    PubMed Central

    Timæus, Ian M; Banda, Richard; Thankian, Kusanthan; Banda, Andrew; Lemba, Musonda; Stringer, Jeffrey S A; Chi, Benjamin H

    2016-01-01

    Objectives To measure the sex-specific and community-specific mortality rates for adults in Lusaka, Zambia, and to identify potential individual-level, household-level and community-level correlates of premature mortality. We conducted 12 survey rounds of a population-based cross-sectional study between 2004 and 2011, and collected data via a structured interview with a household head. Setting Households in Lusaka District, Zambia, 2004–2011. Participants 43 064 household heads (88% female) who enumerated 123 807 adult household members aged between 15 and 60 years. Primary outcome Premature adult mortality. Results The overall mortality rate was 16.2/1000 person-years for men and 12.3/1000 person-years for women. The conditional probability of dying between age 15 and 60 (45q15) was 0.626 for men and 0.537 for women. The top three causes of death for men and women were infectious in origin (ie, tuberculosis, HIV and malaria). We observed an over twofold variation of mortality rates between communities. The mortality rate was 1.98 times higher (95% CI 1.57 to 2.51) in households where a family member required nursing care, 1.44 times higher (95% CI 1.22 to 1.71) during the cool dry season, and 1.28 times higher (95% CI 1.06 to 1.54) in communities with low-cost housing. Conclusions To meet Zambia's development goals, further investigation is needed into the factors associated with adult mortality. Mortality can potentially be reduced through focus on high-need households and communities, and improved infectious disease prevention and treatment services. PMID:26940113

  5. "These things are dangerous": Understanding induced abortion trajectories in urban Zambia.

    PubMed

    Coast, Ernestina; Murray, Susan F

    2016-03-01

    Unsafe abortion is a significant but preventable cause of global maternal mortality and morbidity. Zambia has among the most liberal abortion laws in sub-Saharan Africa, however this alone does not guarantee access to safe abortion, and 30% of maternal mortality is attributable to unsafe procedures. Too little is known about the pathways women take to reach abortion services in such resource-poor settings, or what informs care-seeking behaviours, barriers and delays. In-depth qualitative interviews were conducted in 2013 with 112 women who accessed abortion-related care in a Lusaka tertiary government hospital at some point in their pathway. The sample included women seeking safe abortion and also those receiving hospital care following unsafe abortion. We identified a typology of three care-seeking trajectories that ended in the use of hospital services: clinical abortion induced in hospital; clinical abortion initiated elsewhere, with post-abortion care in hospital; and non-clinical abortion initiated elsewhere, with post-abortion care in hospital. Framework analyses of 70 transcripts showed that trajectories to a termination of an unwanted pregnancy can be complex and iterative. Individuals may navigate private and public formal healthcare systems and consult unqualified providers, often trying multiple strategies. We found four major influences on which trajectory a woman followed, as well as the complexity and timing of her trajectory: i) the advice of trusted others ii) perceptions of risk iii) delays in care-seeking and receipt of services and iv) economic cost. Even though abortion is legal in Zambia, girls and women still take significant risks to terminate unwanted pregnancies. Levels of awareness about the legality of abortion and its provision remain low even in urban Zambia, especially among adolescents. Unofficial payments required by some providers can be a major barrier to safe care. Timely access to safe abortion services depends on chance rather than informed exercise of entitlement. PMID:26921835

  6. Evaluation of recruitment and retention strategies for health workers in rural Zambia

    PubMed Central

    2014-01-01

    Background In response to Zambias critical human resources for health challenges, a number of strategies have been implemented to recruit and retain health workers in rural and remote areas. Prior to this study, the effectiveness of these strategies had not been investigated. The purpose of this study was to determine the impacts of the various health worker retention strategies on health workers in two rural districts of Zambia. Methods Using a modified outcome mapping approach, cross-sectional qualitative and quantitative data were collected from health workers and other stakeholders through focus group discussions and individual interview questionnaires and were supplemented by administrative data. Key themes emerging from qualitative data were identified from transcripts using thematic analysis. Quantitative data were analyzed descriptively as well as by regression modelling. In the latter, the degree to which variation in health workers self-reported job satisfaction, likelihood of leaving, and frequency of considering leaving, were modelled as functions of participation in each of several retention strategies while controlling for age, gender, profession, and district. Results Nineteen health worker recruitment and retention strategies were identified and 45 health care workers interviewed in the two districts; participation in each strategy varied from 0% to 80% of study participants. Although a salary top-up for health workers in rural areas was identified as the most effective incentive, almost none of the recruitment and retention strategies were significant predictors of health workers job satisfaction, likelihood of leaving, or frequency of considering leaving, which were in large part explained by individual characteristics such as age, gender, and profession. These quantitative findings were consistent with the qualitative data, which indicated that existing strategies fail to address major problems identified by health workers in these districts, such as poor living and working conditions. Conclusions Although somewhat limited by a small sample size and the cross-sectional nature of the primary data available, the results nonetheless show that the many health worker recruitment and retention strategies implemented in rural Zambia appear to have little or no impact on keeping health workers in rural areas, and highlight key issues for future recruitment and retention efforts. PMID:25860844

  7. Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in zambia

    PubMed Central

    2010-01-01

    Background Malaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT), a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR) approach to priority setting in Zambia, Tanzania and Kenya. Methods This paper is based on baseline in-depth interviews (IDIs) conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD) with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership. Results Conflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both planning and delivery. Conclusion Poor status of the AFR conditions of relevance, publicity, appeals and leadership corresponds well to the differing perceptions of fairness and unfairness among outpatient attendees and decision-makers. This may have been re-enforced by existing disagreements between the two groups regarding who the legitimate stakeholders to involve during service delivery were. Conflicts identified in this study could be resolved by promoting application of approaches such as AFR during priority setting in the district. PMID:21040552

  8. Understanding the Psychosocial and Environmental Factors and Barriers Affecting Utilization of Maternal Healthcare Services in Kalomo, Zambia: A Qualitative Study

    ERIC Educational Resources Information Center

    Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H.; Ruiter, Robert A. C.

    2014-01-01

    This qualitative study aimed to identify psychosocial and environmental factors contributing to low utilization of maternal healthcare services in Kalomo, Zambia. Twelve focus group discussions (n = 141) and 35 in-depth interviews were conducted in six health centre catchment areas. Focus group discussions comprised women of reproductive age…

  9. Advancing cervical cancer prevention initiatives in resource-constrained settings: insights from the Cervical Cancer Prevention Program in Zambia.

    PubMed

    Mwanahamuntu, Mulindi H; Sahasrabuddhe, Vikrant V; Kapambwe, Sharon; Pfaendler, Krista S; Chibwesha, Carla; Mkumba, Gracilia; Mudenda, Victor; Hicks, Michael L; Vermund, Sten H; Stringer, Jeffrey S A; Parham, Groesbeck P

    2011-05-01

    Groesbeck Parham and colleagues describe their Cervical Cancer Prevention Program in Zambia, which has provided services to over 58,000 women over the past five years, and share lessons learned from the program's implementation and integration with existing HIV/AIDS programs. PMID:21610859

  10. Factors Associated with School Teachers' Perceived Needs and Level of Adoption of HIV Prevention Education in Lusaka, Zambia

    ERIC Educational Resources Information Center

    Henning, Margaret; Chi, Chunheui; Khanna, Sunil K.

    2011-01-01

    Objective: The purpose of this study was to evaluate the socio-cultural variables that may influence teachers' adoption of classroom-based HIV/AIDS education within the school setting and among school types in Zambia's Lusaka Province. Method: Mixed methods were used to collect original data. Using semi-structured interviews (n=11) and a survey…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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…

  12. "Lukwesa Ne Ciwa"--The Story of Lukwesa and Iciwa: Musical Storytelling of the Bemba of Zambia

    ERIC Educational Resources Information Center

    Ng'andu, Joseph; Herbst, Anri

    2004-01-01

    This article describes "inshimi"--a musical storytelling practice of the Bemba people in Zambia. It gives a general perspective on the whole practice and some details on the "MUSIC" as contained in the practice. The article further encourages the idea that "inshimi" represents a nucleus of the "MUSIC"

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

    ERIC Educational Resources Information Center

    Crane, Thera Marie

    2011-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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

  15. Understanding the Psychosocial and Environmental Factors and Barriers Affecting Utilization of Maternal Healthcare Services in Kalomo, Zambia: A Qualitative Study

    ERIC Educational Resources Information Center

    Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H.; Ruiter, Robert A. C.

    2014-01-01

    This qualitative study aimed to identify psychosocial and environmental factors contributing to low utilization of maternal healthcare services in Kalomo, Zambia. Twelve focus group discussions (n = 141) and 35 in-depth interviews were conducted in six health centre catchment areas. Focus group discussions comprised women of reproductive age

  16. A Library Response to the Massification of Higher Education: The Case of the University of Zambia Library

    ERIC Educational Resources Information Center

    Kanyengo, Christine Wamunyima

    2009-01-01

    This paper looks at the challenges that libraries in Africa face in responding to massification of higher education by discussing the University of Zambia library's response in library and information resources provision. As a result of massification of higher education, libraries have been forced not only to employ new and different strategies to

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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

  18. An Audit of Skills and Qualifications in Preservation and Conservation Techniques: The Case of the University of Zambia Libraries

    ERIC Educational Resources Information Center

    Shameenda, Kimbo Lemmy; Kanyengo, Christine Wamunyima

    2012-01-01

    This article establishes the level of skills and experience in preservation and conservation management using a case study methodological approach conducted in the 3 university libraries at the University of Zambia. The findings revealed that 20 (57%) of the library staff had not received formal training in preservation and conservation of library

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

    ERIC Educational Resources Information Center

    Crane, Thera Marie

    2011-01-01

    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…

  20. A Qualitative Assessment of the Risk of Introducing Peste des Petits Ruminants into Northern Zambia from Tanzania

    PubMed Central

    Chazya, R.; Muma, J. B.; Mwacalimba, K. K.; Karimuribo, E.; Mkandawire, E.; Simuunza, M.

    2014-01-01

    A qualitative risk assessment was performed to evaluate the risk of introducing Peste des petits ruminants virus into northern Zambia from Tanzania via live goat trade. Data was collected during a mission to Tanzania and northern Zambia and also from literature and interviews with experts. The risk of PPRV introduction was evaluated as a function of the probability of hazard (PPRV) release, exposure of susceptible hosts, and the consequences of spread using the following parameters: prevalence of infection, volume of trade, C-ELISA and quarantine screening missing an infected animal, PPRV viability (remaining infective) in transit, and the virus potential for infection. The magnitude of the consequences was derived from the probability of transmission and spread and the impact of PPRV introduction and establishment. Accordingly, the probability of occurrence of PPRV in northern Zambia from Tanzania was rated as high and the economic consequences were also rated as high. Finally, the overall risk of introducing PPRV into northern Zambia from Tanzania at the time of the assessment was rated high. It was concluded that import of goats and sheep be prohibited until efficient and adequate measures to reduce the risk have been put in place. PMID:24558632

  1. Personal and environmental predictors of the intention to use maternal healthcare services in Kalomo, Zambia.

    PubMed

    Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H; Ruiter, Robert A C

    2014-12-01

    Low maternal healthcare service utilization contributes to poor maternal and new born health outcomes in rural Zambia. The purpose of this study was to identify important factors influencing women's intention to use these services in Kalomo, Zambia. An interviewer-administered questionnaire was used to collect data from 1007 women of reproductive age (15-45 years) from 13 rural health centres with the lowest service utilization rates in the district. Questions included measures of (past) healthcare seeking behaviour, psychosocial variables (attitude, perceived social norms, perceived behavioural control), logistical barriers (e.g., distance to the clinic) and sociodemographic variables (e.g., age, income and education level). Overall, our findings showed that most respondents had high intention to use healthcare services. Intention was positively associated with attitude, personal norms, behavioural control, education and income levels. Conversely, intention was negatively related to perceived social norms, age and distance. Multivariate regression analysis showed that, together, these variables accounted for 41.8% of the variance in intention, with perceived behavioural control being the strongest predictor of intention, followed by geographical distance and perceived social norms. These findings suggest that public health programmes mitigating these important factors are likely to motivate pregnant women to use maternal healthcare services. PMID:25274723

  2. Lusaka, Zambia during SAFARI-2000: A Collection Point for Ozone Pollution

    NASA Technical Reports Server (NTRS)

    Thompson, Anne M.; Witte, Jacquelyn C.; Freiman, M. Tal; Phahlane, N. Agnes; Coetzee, G. J. R.; Bhartia, P. K. (Technical Monitor)

    2002-01-01

    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 (155 deg S, 28 deg E) in early September 2000. Over 90 ppbv ozone was recorded at the surface (1.3 km elevation) and column tropospheric ozone was greater than 50 DU during a stagnant period. These values are much higher than concurrent measurements over Nairobi (1 deg S, 38 deg E) and Irene (25 deg S, 28 deg E, near Pretoria). The heaviest ozone pollution layer (800-500 hPa) over Lusaka is due to recirculated trans-boundary ozone. Starting out over Zambia, Angola, and Namibia, ozone heads east to the Indian Ocean, before turning back over Mozambique and Zimbabwe, heading toward Lusaka. Thus, Lusaka is a collection point for pollution, consistent with a picture of absolutely stable layers recirculating in a gyre over southern Africa.

  3. Strengthening Faculty Recruitment for Health Professions Training in Basic Sciences in Zambia

    PubMed Central

    Simuyemba, Moses; Talib, Zohray; Michelo, Charles; Mutale, Wilbroad; Zulu, Joseph; Andrews, Ben; Katubulushi, Max; Njelesani, Evariste; Bowa, Kasonde; Maimbolwa, Margaret; Mudenda, John; Mulla, Yakub

    2014-01-01

    Zambia is facing a crisis in its human resources for health (HRH), with deficits in the number and skill mix of health workers. The University of Zambia School of Medicine (UNZA SOM) was the only medical school in the country for decades, but recently it was joined by three new medical schoolstwo private and one public. In addition to expanding medical education, the government has also approved several allied health programs, including pharmacy, physiotherapy, biomedical sciences, and environmental health. This expansion has been constrained by insufficient numbers of faculty. Through a grant from the Medical Education Partnership Initiative (MEPI), UNZA SOM has been investing in ways to address faculty recruitment, training, and retention. The MEPI-funded strategy involves directly sponsoring a cohort of faculty at UNZA SOM during the five-year grant, as well as establishing more than a dozen new masters programs, with the goal that all sponsored faculty are locally trained and retained. Because the issue of limited basic science faculty plagues medical schools throughout Sub-Saharan Africa, this strategy of using seed funding to build sustainable local capacity to recruit, train, and retain faculty could be a model for the region. PMID:25072591

  4. The construction and testing of a solar food drier in Zambia

    SciTech Connect

    Kok, R.; Kwendakwema, N.

    1983-12-01

    A small scale, forced convection, indirect solar food drier was designed, built and tested in Zambia. The drier consisted of five modules: a solar collector, a drying cabinet, a fan housing, a heat storage and a control unit. The construction methods and materials used were selected so as to match the level of technological development in the denser populated areas of Zambia. Practically all the materials were acquired locally. The drier could be run in three main operating modes (straight-through, heat storage, heat recovery) and a number of air recycling submodes by means of manipulating simple slide valves. The food was dried indirectly. A set of eight experiments was first carried out to determine the energy collection and heat transfer characteristics of the equipment in its various operating modes and submodes. Okra, cabbage and beef were then dried. Although the experiments were done during the Zambian 'winter', these foods could be dried to below 15% moisture in two or three operating days.

  5. National malaria control and scaling up for impact: the Zambia experience through 2006.

    PubMed

    Steketee, Richard W; Sipilanyambe, Naawa; Chimumbwa, John; Banda, James J; Mohamed, Abdirahman; Miller, John; Basu, Suprotik; Miti, Simon K; Campbell, Carlos C

    2008-07-01

    With its 2006-2011 National Malaria Strategic Plan, Zambia committed to control malaria at a national scale. This scale-up for impact approach was facilitated by sound business planning and financing in 2006 of approximately US$35 million. Compared with surveys in 2001 and 2004, a 2006 national survey of 14,681 persons in 2,999 households at the end of the transmission season showed substantial coverage increases for preventive interventions. Ownership and use rates of insecticide-treated mosquito nets (ITNs) among vulnerable groups doubled, with 44% of households owning ITNs and 23% of children less than five years of age and 24% of pregnant women using them. Roll Back Malaria Abuja targets for intermittent preventive treatment in pregnancy (IPTp) were exceeded, with 62% of pregnant women receiving at least two doses of IPTp. As of 2006, Zambia is demonstrating substantial progress toward the national targets (80% population coverage rates for the interventions) and aspires to show that malaria need not be its leading health problem, and that malaria control is a sound national investment. PMID:18606763

  6. An Evaluation of Trauma Focused Cognitive Behavioral Therapy for Children in Zambia

    PubMed Central

    Murray, Laura K; Familiar, Itziar; Skavenski, Stephanie; Jere, Elizabeth; Cohen, Judy; Imasiku, Mwiya; Mayeya, John; Bass, Judith K; Bolton, Paul

    2013-01-01

    Objectives To monitor and evaluate the feasibility of implementing Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to address trauma and stress-related symptoms in orphans and vulnerable children (OVC) in Zambia as part of ongoing programming within a non-governmental organization (NGO). Methods As part of ongoing programming, voluntary care-workers administered locally validated assessments to identify children who met criteria for moderate to severe trauma symptomatology. Local lay counselors implemented TF-CBT with identified families, while participating in ongoing supervision. Fifty-eight children and adolescents aged 5–18 completed the TF-CBT treatment, with pre- and post-assessments. Results The mean number of traumas reported by the treatment completers (N=58) was 4.11. Post assessments showed significant reductions in severity of trauma symptoms (p<0.0001), and severity of shame symptoms (p<0.0001). Conclusions Our results suggest that TF-CBT is a feasible treatment option in Zambia for OVC. A decrease in symptoms suggests that a controlled trial is warranted. Implementation factors monitored suggest that it is feasible to integrate and evaluate evidence-based mental health assessments and intervention into programmatic services run by an NGO in low/middle resource countries. Results also support the effectiveness of implementation strategies such as task shifting, and the apprenticeship model of training and supervision. PMID:23768939

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

    PubMed Central

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

    2011-01-01

    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. PMID:21305023

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

    PubMed

    Chanda-Kapata, Pascalina; Campbell, Sandy; Zarowsky, Christina

    2012-01-01

    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. PMID:22672331

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

    PubMed

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

    2013-01-01

    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

  10. Characterization of Mycobacterium bovis from Humans and Cattle in Namwala District, Zambia

    PubMed Central

    Johansen, Tone Bjordal; Muma, John Bwalya; Munyeme, Musso; Mbulo, Grace; Muwonge, Adrian; Djnne, Berit

    2014-01-01

    Tuberculosis remains a major public health problem in Zambia. While human to human transmission of Mycobacterium tuberculosis is of major importance in driving the tuberculosis epidemic, the impact of Mycobacterium bovis transmission from infected cattle is largely unknown. This cross-sectional study aimed at molecular characterization of M. bovis in humans and cattle. A total of 100 human sputum samples and 67 bovine tissues were collected and analyzed for the presence of mycobacteria. Of 65 human samples that harbored acid fast bacteria (AFB), 55 isolates were obtained of which 34 were identified as M. tuberculosis and 2 as M. bovis. AFB-positive bovine samples (n = 67) yielded 47 mycobacterial isolates among which 25 were identified as M. bovis and no M. tuberculosis was found. Among the M. bovis isolates, spoligotyping revealed a high homogeneity in genotypes circulating in Namwala district. Human and cattle isolates shared identical MIRU-VNTR genotypes, suggesting that transmission between the two hosts may occur. Therefore, this study has documented zoonotic TB in human patients in Namwala district of Zambia. However, further molecular epidemiological studies in the study area are recommended. PMID:24847441

  11. An evaluation of trauma focused cognitive behavioral therapy for children in Zambia.

    PubMed

    Murray, Laura K; Familiar, Itziar; Skavenski, Stephanie; Jere, Elizabeth; Cohen, Judy; Imasiku, Mwiya; Mayeya, John; Bass, Judith K; Bolton, Paul

    2013-12-01

    To monitor and evaluate the feasibility of implementing Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to address trauma and stress-related symptoms in orphans and vulnerable children (OVC) in Zambia as part of ongoing programming within a non-governmental organization (NGO). As part of ongoing programming, voluntary care-workers administered locally validated assessments to identify children who met criteria for moderate to severe trauma symptomatology. Local lay counselors implemented TF-CBT with identified families, while participating in ongoing supervision. Fifty-eight children and adolescents aged 5-18 completed the TF-CBT treatment, with pre- and post-assessments. The mean number of traumas reported by the treatment completers (N=58) was 4.11. Post assessments showed significant reductions in severity of trauma symptoms (p<0.0001), and severity of shame symptoms (p<0.0001). Our results suggest that TF-CBT is a feasible treatment option in Zambia for OVC. A decrease in symptoms suggests that a controlled trial is warranted. Implementation factors monitored suggest that it is feasible to integrate and evaluate evidence-based mental health assessments and intervention into programmatic services run by an NGO in low/middle resource countries. Results also support the effectiveness of implementation strategies such as task shifting, and the Apprenticeship Model of training and supervision. PMID:23768939

  12. High Schistosoma mansoni Disease Burden in a Rural District of Western Zambia

    PubMed Central

    Mutengo, Mable M.; Mwansa, James C. L.; Mduluza, Takafira; Sianongo, Sandie; Chipeta, James

    2014-01-01

    Schistosoma mansoni disease is endemic in most parts of rural Zambia, and associated complications are common. We conducted a cross-sectional study among 754 people in rural communities of Kaoma District, western Zambia to determine the burden of S. mansoni infection and associated morbidity. Parasitology and ultrasonography assessments were conducted on consenting participants. The overall prevalence of S. mansoni infection and geometric mean egg count (GMEC) were 42.4% (304) and 86.6 eggs per gram (95% confidence interval = 75.6–99.6), respectively. Prevalence was highest in the age group of 15–19 years old (adjusted prevalence ratio = 1.70, P = 0.017). S. mansoni-related portal fibrosis was detected in 26% of the participants screened. Participants above 39 years old were 2.93 times more likely to have fibrosis than the 7–9 years old age group (P = 0.004). The study highlights the high burden of S. mansoni disease in this area and calls for immediate interventions to avert complications associated with the disease. PMID:25246696

  13. Underperformance of African protected area networks and the case for new conservation models: insights from Zambia.

    PubMed

    Lindsey, Peter A; Nyirenda, Vincent R; Barnes, Jonathan I; Becker, Matthew S; McRobb, Rachel; Tambling, Craig J; Taylor, W Andrew; Watson, Frederick G; t'Sas-Rolfes, Michael

    2014-01-01

    Many African protected areas (PAs) are not functioning effectively. We reviewed the performance of Zambia's PA network and provide insights into how their effectiveness might be improved. Zambia's PAs are under-performing in ecological, economic and social terms. Reasons include: a) rapidly expanding human populations, poverty and open-access systems in Game Management Areas (GMAs) resulting in widespread bushmeat poaching and habitat encroachment; b) underfunding of the Zambia Wildlife Authority (ZAWA) resulting in inadequate law enforcement; c) reliance of ZAWA on extracting revenues from GMAs to cover operational costs which has prevented proper devolution of user-rights over wildlife to communities; d) on-going marginalization of communities from legal benefits from wildlife; e) under-development of the photo-tourism industry with the effect that earnings are limited to a fraction of the PA network; f) unfavourable terms and corruption which discourage good practice and adequate investment by hunting operators in GMAs; g) blurred responsibilities regarding anti-poaching in GMAs resulting in under-investment by all stakeholders. The combined effect of these challenges has been a major reduction in wildlife densities in most PAs and the loss of habitat in GMAs. Wildlife fares better in areas with investment from the private and/or NGO sector and where human settlement is absent. There is a need for: elevated government funding for ZAWA; greater international donor investment in protected area management; a shift in the role of ZAWA such that they focus primarily on national parks while facilitating the development of wildlife-based land uses by other stakeholders elsewhere; and new models for the functioning of GMAs based on joint-ventures between communities and the private and/or NGO sector. Such joint-ventures should provide defined communities with ownership of land, user-rights over wildlife and aim to attract long-term private/donor investment. These recommendations are relevant for many of the under-funded PAs occurring in other African countries. PMID:24847712

  14. The spatial distribution of health resources within countries and communities: examples from India and Zambia.

    PubMed

    Akhtar, R; Izhar, N

    1986-01-01

    "Between one country and another, one province and another and even one locality and another there will always exist a certain inequality in the conditions of life, which it will be possible to reduce to a minimum but never entirely remove", Friedrich Engels, 1875, Quoted from D. M. Smith's Where the Grass is Greener; Geographical Perspectives on Inequality. London, 1979. And it is true that there are wide disparities in the availability of welfare facilities including health at international, national, regional and inter-regional levels. At the same time such disparities are increasing over time. In terms of spatial distribution, not only the developing world but even developed countries such as the U.S.A. and the United Kingdom, face problems resulting from wide imbalances in the provision of welfare facilities. In this paper, an attempt has been made to study inequalities in the distribution of health facilities in India and Zambia. PMID:3092360

  15. Un/doing Gender? a Case Study of School Policy and Practice in Zambia

    NASA Astrophysics Data System (ADS)

    Bajaj, Monisha

    2009-11-01

    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 carry out cleaning tasks generally viewed as "women's work". Observations, interviews, student diaries and surveys from this school and from government schools provide the basis for a comparison, indicating how the former strives to interrupt the transmission of gender inequalities as well as how students respond to these practices. The findings suggest that the pedagogical practices deployed by this school have generally succeeded in destabilising norms of gender subordination and gender-based violence, though the replicability of these practices is interrogated given broader questions about the country's public resources and political will.

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

    PubMed

    Kelly, Paul

    2011-10-01

    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

  17. Gwembe Coal Formation, Karoo Supergroup, Mid-Zambezi valley, southern Zambia; a fluvial plain environment

    SciTech Connect

    Nyambe, I.A.; Dixon, O. )

    1993-03-01

    The Gwembe Coal Formation of Permian age belongs to the Lower Karoo Group of the Karoo Supergroup (Permo-Carboniferous to early Jurassic), which crops out in the mid-Zambezi Valley, southern Zambia. The formation has a maximum thickness of 280 m. It was formed in a fluvial depositional environment in which sandstones, siltstones and mudstones were deposited in channels and flood plains. One sandstone body (A Sandstone) indicates a change in fluvial style from a proximal braided system to a high-sinuosity meandering stream system. The productive coals (Main Seam) with thicknesses from 5 to 12 m were deposited in shallow swampy areas of the flood plain. Peat deposition was interrupted by channel, crevasse channel and splay, levee and overbank deposition. Rootlets observed in basal sandstones indicate an insitu origin for the Main Seam.

  18. Transdisciplinary Project Communication and Knowledge Sharing Experiences in Tanzania and Zambia through a One Health Lens.

    PubMed

    Bagnol, Brigitte; Clarke, Elizabeth; Li, Mu; Maulaga, Wende; Lumbwe, Hilda; McConchie, Robyn; de Bruyn, Julia; Alders, Robyn Gwen

    2016-01-01

    The project "Strengthening food and nutrition security through family poultry and crop integration in Tanzania and Zambia" brings together animal, crop, and human health specialists, economists, ecologists, social scientists, and practitioners to work with participating communities. It aims to increase poultry value chain, crop farming systems efficiency, and household food and nutrition security and thus requires understanding of, and ability to work effectively within, complex systems. In this context, communication knowledge sharing and synthesis between stakeholders from diverse backgrounds and a range of experiences, perspectives, agendas, and knowledge is a challenge. To address this situation, communication is conceived as a dialog and a participatory process bringing together all stakeholders. This process results in unanticipated and unexpected results that require a high degree of flexibility and adaptability from team members. The paper analyses the approach and aim of the communication strategy developed for the project and the challenges faced. PMID:26904532

  19. Follow-Up Study to Assess the Use and Performance of Household Filters in Zambia

    PubMed Central

    Peletz, Rachel; Simuyandi, Michelo; Simunyama, Martin; Sarenje, Kelvin; Kelly, Paul; Clasen, Thomas

    2013-01-01

    Effective household water treatment can improve drinking water quality and prevent disease if used correctly and consistently over time. One year after completion of a randomized controlled study of water filters among households in Zambia with children < 2 years old and mothers who were human immunodeficiency virus (HIV)-positive, we conducted a follow-up study to assess use and performance of new filters distributed at the conclusion of the study; 90% of participating households met the criteria for current users, and 75% of participating households had stored water with lower levels of fecal contamination than source water. Microbiologically, the filters continued to perform well, removing an average of 99.0% of fecal indicator bacteria. Although this study provides some encouraging evidence about the potential to maintain high uptake and filter performance, even in the absence of regular household visits, additional research is necessary to assess whether these results can be achieved over longer periods and with larger populations. PMID:24100635

  20. Effects Of Land Cover Change On The Hydrologic Regime Of Kabompo River Basin, Zambia

    NASA Astrophysics Data System (ADS)

    Kampata, J. M.; Rientjes, T. H. M.; Timmermans, J.

    2013-12-01

    Over the past decades, the Kabompo River Basin in Zambia is affected by deforestation and land degradation as a consequence of intensified agriculture and mining. Changes presumably have affected the hydrological catchment behaviour and related seasonal flow regimes. Impact assessments are unknown for the basin. In this study multi-decadal time series of rainfall and stream flow were evaluated by trend analysis, change point detection methods and analysis on high and low flow exceedance probabilities. Results are combined with satellite based land cover observations for 1984, 1994, 2001 and 2009. Unsupervised classification of the Landsat images indicate pronounced land cover changes. Preliminary results of this study show that i) precipitation time series are not directly affected by climate change and ii) changes in stream flow can be linked to changes in land cover.

  1. Children’s Roles in Tuberculosis Treatment Regimes: Constructing childhood and kinship in urban Zambia

    PubMed Central

    Hunleth, Jean

    2013-01-01

    In Zambia, the burden of HIV-related diseases such as tuberculosis has received substantial international attention. Zambians experience and participate in a range of globally produced programs to manage TB and cure TB sufferers. Guided by the WHO’s Directly Observed Treatment, Short-course (DOTS) protocol, TB treatment regimens now emphasize adherence to medications as the primary way to achieve cure. This article aims to understand how adherence models enter into the daily lives of children who live with and care for adult TB patients in an area disproportionately affected by the disease. I suggest that children domesticate adherence models, using them as strategies to safeguard identities, relationships, livelihoods, and futures that are increasingly under threat in the age of HIV. They draw on TB treatment and the hope and agency it affords to hold onto a version of childhood in which they are cared for by adults who will advocate for their wellbeing. PMID:23804398

  2. Assessing Zambia's industrial fortification options: getting beyond changes in prevalence and cost-effectiveness.

    PubMed

    Fiedler, John L; Lividini, Keith; Kabaghe, Gladys; Zulu, Rodah; Tehinse, John; Bermudez, Odilia I; Jallier, Vincent; Guyondet, Christophe

    2013-12-01

    Background. Since fortification of sugar with vitamin A was mandated in 1998, Zambia's fortification program has not changed, while the country remains plagued by high rates ofmicronutrient deficiencies. Objective. To provide evidence-based fortification options with the hope of reinvigorating the Zambian fortification program. Methods. Zambia's 2006 Living Conditions Monitoring Survey is used to estimate the apparent intakes of vitamin A, iron, and zinc, as well as the apparent consumption levels and coverage of four fortification vehicles. Fourteen alternativefoodfortification portfolios are modeled, and their costs, impacts, average cost-effectiveness, and incremental cost-effectiveness are calculated using three alternative impact measures. Results. Alternative impact measures result in different rank orderings of the portfolios. The most cost-effective portfolio is vegetable oil, which has a cost per disability-adjusted life-year (DALY) saved ranging from 12% to 25% of that of sugar, depending on the impact measure used. The public health impact of fortified vegetable oil, however, is relatively modest. Additional criteria beyond cost-effectiveness are introduced and used to rank order the portfolios. The size of the public health impact, the total cost, and the incremental cost-effectiveness of phasing in multiple vehicle portfolios over time are analyzed. Conclusions. Assessing fortification portfolios by measuring changes in the prevalence of inadequate intakes underestimates impact. A more sensitive measure, which also takes into account change in the Estimated Average Requirement (EAR) gap, is provided by a dose-response-based approach to estimating the number ofDALYs saved. There exist highly cost-effective fortification intervention portfolios with substantial public health impacts and variable price tags that could help improve Zambians' nutrition status. PMID:24605698

  3. Risk Assessment for Yellow Fever in Western and North-Western Provinces of Zambia

    PubMed Central

    Babaniyi, Olusegun A.; Mwaba, Peter; Mulenga, David; Monze, Mwaka; Songolo, Peter; Mazaba-Liwewe, Mazyanga L.; Mweene-Ndumba, Idah; Masaninga, Freddie; Chizema, Elizabeth; Eshetu-Shibeshi, Messeret; Malama, Costantine; Rudatsikira, Emmanuel; Siziya, Seter

    2015-01-01

    Background: North-Western and Western provinces of Zambia were reclassified as low-risk areas for yellow fever (YF). However, the current potential for YF transmission in these areas is unclear. Aims: To determine the current potential risk of YF infection. Setting and Design: A cross sectional study was conducted in North-Western and Western provinces of Zambia. Materials and Methods: Samples were tested for both YF virus-specific IgG and IgM antibodies by the ELISA and YF virus confirmation was done using Plaque Reduction Neutralization Test. The samples were also tested for IgG and IgM antibodies against other flaviviruses. Results: Out of the 3625 respondents who participated in the survey, 46.7% were males and 9.4% were aged less than 5 years. Overall, 58.1% of the participants slept under an impregnated insecticide-treated net and 20.6% reported indoor residual spraying of insecticides. A total of 616 (17.0%) samples were presumptive YF positive. The prevalence for YF was 0.3% for long-term infection and 0.2% for recent YF infection. None of the YF confirmed cases had received YF vaccine. Prevalence rates for other flaviviruses were 149 (4.1%) for Dengue, 370 (10.2%) for West Nile and 217 (6.0%) for Zika. Conclusion: There is evidence of past and recent infection of YF in both provinces. Hence, they are at a low risk for YF infection. Yellow fever vaccination should be included in the EPI program in the two provinces and strengthen surveillance with laboratory confirmation. PMID:25722614

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

    PubMed Central

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

    2013-01-01

    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. PMID:24069309

  5. Prevalence of canine gastrointestinal helminths in urban Lusaka and rural Katete Districts of Zambia.

    PubMed

    Bwalya, Eugene C; Nalubamba, King S; Hankanga, C; Namangala, B

    2011-07-01

    Faecal samples were collected from January 2010 through September 2010 to determine the prevalence of gastrointestinal (GI) helminths infestation in dogs in urban Lusaka and rural Katete Districts of Zambia. A total of 452 faecal samples (n=160 Katete, n=292 Lusaka) were examined by faecal flotation for the presence of helminth eggs and 82.5% of dogs were positive for GI helminths in Katete compared to 76% for Lusaka. Positive results with the presence of at least one parasite corresponded to 72.9% Ancylostoma caninum, 11% Toxocara canis, 4.8% Toxascaris leonina, 2.4% Dipylidium caninum, 0.7% Taeniidae and 0.3% T. vulpis, species for Lusaka while Katete recorded 70.6% A. caninum, 18.1% T. vulpis, 11.1% T. canis, 13.1% D. caninum, 3.8% T. leonina, and 0.6% Taeniidae. Except for T. vulpis and D. caninum (p<0.05) the results indicated no significant difference in the prevalence of the identified GI helminth between Lusaka and Katete. There was no significant difference in the prevalence between genders of GI helminth infestation demonstrated in this study and only A. caninum showed significant difference in prevalence by age category. The study also showed the presence of zoonotic intestinal helminths A. caninum, T. canis and D. caninum. The study highlights that there was no significant difference in spectrum and prevalence of GI helminths between urban and rural areas in Zambia. It further brings to light the importance of educating owners of dogs on the importance of regular deworming of dogs and control of ectoparasites in order to minimise the risk that these dogs pose to them and the public. PMID:21612833

  6. Urban waste landfill planning and karstic groundwater resources in developing countries: the example of Lusaka (Zambia)

    NASA Astrophysics Data System (ADS)

    De Waele, J.; Nyambe, I. A.; Di Gregorio, A.; Di Gregorio, F.; Simasiku, S.; Follesa, R.; Nkemba, S.

    2004-06-01

    Lusaka, the capital city of Zambia with more than two million inhabitants, derives approximately 70% of its water requirements from groundwater sourced in the underlying karstic Lusaka aquifer. This water resource is, therefore, extremely important for the future of the population. The characteristics of the aquifer and the shallow water table make the resource vulnerable and in need of protection and monitoring. A joint project between the Geology Departments of the University of Cagliari and the School of Mines of the University of Zambia, to investigate the "Anthropogenic and natural processes in the Lusaka area leading to environmental degradation and their possible mitigation" was carried out in July 2001. The main objective of the study was to evaluate the extent of the present environmental degradation, assessing the vulnerability of the carbonatic aquifer and the degree of pollution of the groundwater and to make proposals to mitigate adverse environmental effects. Analyses of water samples collected during project indicate some areas of concern, particularly with respect to the levels of ammonia, nitrates and some heavy metals. As groundwater quality and quantity are prerogatives for a healthy and sustainable society, the study offers guidelines for consideration by the local and national authorities. Uptake of these guidelines should result in a number of initiatives being taken, including: (a) closure or reclamation of existing waste dumps; (b) upgrading of existing waste dumps to controlled landfills; (c) establishing new urban waste landfills and plants in geo-environmentally suitable sites; (d) local waste management projects in all compounds (residential areas) to prevent and reduce haphazard waste dumping; (e) enlarging sewerage drainage systems to all compounds; (f) enforcing control on groundwater abstraction and pollution, and demarcation of zones of control at existing drill holes; (g) providing the city with new water supplies from outside the Lusaka well-field; and (h) in increasing environmental education in schools and to all citizens.

  7. A 12-Month Study of Food Crops Contaminated by Heavy Metals, Lusaka, Zambia

    NASA Astrophysics Data System (ADS)

    Holden, J. A.; Malamud, B. D.; Chishala, B. H.; Kapungwe, E.; Volk, J.; Harpp, K. S.

    2009-04-01

    We investigate heavy-metal contamination of irrigation water used for urban agriculture and subsequent contamination of food crops in Chunga, NW Lusaka, the capital of Zambia. Inhabitants of the Chunga area rely on urban agriculture as both a major source of income and food. From August 2004 to July 2005, monthly samples of irrigation water used and edible portions of food crops were taken from a farmer's plot at Chunga. The food crops (cabbage, Chinese cabbage, pumpkin leaves, rape, sweet potato leaves and tomatoes) are grown using irrigation throughout the year. Irrigation water samples and digested food crop samples were analysed using ICP-MS at the Department of Geology, Colgate University, USA for Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Cd, Ba, Hg, Tl, Pb, and U. We find heavy-metal concentrations present in both irrigation water and food crop samples. Zambian sample concentrations were compared to Zambian and international legislative and guideline limits for concentrations of heavy metals in industrial effluent, heavy metals in irrigation water and heavy metals in foods. In irrigation water samples recommended national and/or international legislative limits for Al, Cr, Mn, Fe, Cu, Hg, Pb and U were exceeded. Limits for Hg were exceeded by up to 130 times. There were heavy-metal concentrations above recommended limits in food crops for Cr, Fe, Ni, Cu, Zn, Cd, Hg and Pb throughout the different food crops grown and throughout the year. In all 14 samples recommended limits for Cr, Fe and Hg were exceeded. Zambian legislated limits for food crops were exceeded by up to 16 times for Pb and 58 times for Hg. The results of this study show that heavy metal contamination is present in irrigation water used and food crops grown in urban agriculture in Chunga, Lusaka, Zambia. Recommended maximum limits for heavy metals in irrigation water and food are exceeded in some samples indicating there may be a risk to health.

  8. Worlds apart 3: Botswana and Zambia. Zambian women's needs not being met.

    PubMed

    Hermans, T

    1994-01-01

    Zambia has not been as successful as neighboring Botswana in reducing fertility. Zambian fertility only declined from 7.1 to 6.5 between 1972 and 1992. Only 15% use modern contraception, even though 87% have knowledge of modern contraception and a source of supply. A major obstacle to fertility decline is the lack of government endorsement of family planning (FP), even though the Planned Parenthood Association of Zambia has promoted FP since 1972. Contraception was feared and perceived as the persecution of Black Africans by White colonists. State hospitals did not begin accepting FP until the late 1970s, and foreign aid was directed to maternal and child health services. In 1989, a national population policy was adopted, and goals were set to attain 30% contraceptive prevalence by the year 2000. Health services lacked trained personnel to provide FP services. Teenagers were particularly unaware of contraception in a country where, in 1992, 66% of women were either mothers or pregnant by the age of 19 years. Unmet need was estimated at 33% of women who desired a delay in childbearing or no more children. Service accessibility was an obstacle, since many remote areas were 20-25 km from a health center. Other obstacles to good health were contaminated water supplies, lack of hygienic practices, and air pollution. 71% of the population lived in absolute poverty in 1990. Overcrowding in urban areas and lack of educational facilities contributed to the lack of social development. The tropical climate and shortages of arable land coupled with high fertility resulted in a difficult existence. Cultural support for a large family was still strong. Donor and government support is currently directed to contraceptive logistics, communications, contraceptive social marketing, community- and employment-based distribution, operations research, and safe abortions, which are legal but cumbersome because of bureaucratic procedures and the lack of an informed population. PMID:12345837

  9. Assessing the Consequences of Stigma for Tuberculosis Patients in Urban Zambia

    PubMed Central

    Cremers, Anne Lia; de Laat, Myrthe Manon; Kapata, Nathan; Gerrets, Rene; Klipstein-Grobusch, Kerstin; Grobusch, Martin Peter

    2015-01-01

    Background Stigma is one of the many factors hindering tuberculosis (TB) control by negatively affecting hospital delay and treatment compliance. In Zambia, the morbidity and mortality due to TB remains high, despite extended public health attempts to control the epidemic and to diminish stigma. Study Aim To enhance understanding of TB-related stigmatizing perceptions and to describe TB patients’ experiences of stigma in order to point out recommendations to improve TB policy. Methods We conducted a mixed method study at Kanyama clinic and surrounding areas, in Lusaka, Zambia; structured interviews with 300 TB patients, multiple in-depth interviews with 30 TB patients and 10 biomedical health workers, 3 focus group discussions with TB patients and treatment supporters, complemented by participant observation and policy analysis of the TB control program. Predictors of stigma were identified by use of multivariate regression analyses; qualitative analysis of the in-depth interviews, focus group discussions and participant observation was used for triangulation of the study findings. Results We focused on the 138/300 patients that described TB-related perceptions and attitudes, of whom 113 (82%) reported stigma. Stigma provoking TB conceptions were associated with human immunodeficiency virus (HIV)-infection, alleged immoral behaviour, (perceived) incurability, and (traditional) myths about TB aetiology. Consequences of stigma prevailed both among children and adults and included low self-esteem, insults, ridicule, discrimination, social exclusion, and isolation leading to a decreased quality of life and social status, non-disclosure, and/or difficulties with treatment compliance and adherence. Women had significantly more stigma-related problems than men. Conclusions The findings illustrate that many TB patients faced stigma-related issues, often hindering effective TB control and suggesting that current efforts to reduce stigma are not yet optimal. The content and implementation of sensitization programs should be improved and more emphasis needs to be placed on women and children. PMID:25806955

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

    PubMed Central

    2012-01-01

    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. PMID:22985229

  11. The zoonotic potential of avian influenza viruses isolated from wild waterfowl in Zambia.

    PubMed

    Simulundu, Edgar; Nao, Naganori; Yabe, John; Muto, Nilton A; Sithebe, Thami; Sawa, Hirofumi; Manzoor, Rashid; Kajihara, Masahiro; Muramatsu, Mieko; Ishii, Akihiro; Ogawa, Hirohito; Mweene, Aaron S; Takada, Ayato

    2014-10-01

    Whilst remarkable progress in elucidating the mechanisms governing interspecies transmission and pathogenicity of highly pathogenic avian influenza viruses (AIVs) has been made, similar studies focusing on low-pathogenic AIVs isolated from the wild waterfowl reservoir are limited. We previously reported that two AIV strains (subtypes H6N2 and H3N8) isolated from wild waterfowl in Zambia harbored some amino acid residues preferentially associated with human influenza virus proteins (so-called human signatures) and replicated better in the lungs of infected mice and caused more morbidity than a strain lacking such residues. To further substantiate these observations, we infected chickens and mice intranasally with AIV strains of various subtypes (H3N6, H3N8, H4N6, H6N2, H9N1 and H11N9) isolated from wild waterfowl in Zambia. Although some strains induced seroconversion, all of the tested strains replicated poorly and were nonpathogenic for chickens. In contrast, most of the strains having human signatures replicated well in the lungs of mice, and one of these strains caused severe illness in mice and induced lung injury that was characterized by a severe accumulation of polymorphonuclear leukocytes. These results suggest that some strains tested in this study may have the potential to infect mammalian hosts directly without adaptation, which might possibly be associated with the possession of human signature residues. Close monitoring and evaluation of host-associated signatures may help to elucidate the prevalence and emergence of AIVs with potential for causing zoonotic infections. PMID:24862188

  12. Erectile function in circumcised and uncircumcised men in Lusaka, Zambia: A cross-sectional study

    PubMed Central

    Chinkoyo, Evans

    2015-01-01

    Background Evidence from three randomised control trials in South Africa, Uganda and Kenya showing that male circumcision can reduce heterosexual transmission of human immunodeficiency virus (HIV) infection from infected females to their male partners by up to 60% has led to an increase in circumcisions in most African countries. This has created anxieties around possible deleterious effects of circumcision on erectile function (EF). Aim To compare EF in circumcised and uncircumcised men aged 18 years and older. Setting Four primary healthcare facilities in Lusaka, Zambia. Methods Using a cross-sectional survey 478 participants (242 circumcised and 236 uncircumcised) from four primary healthcare facilities in Lusaka, Zambia were asked to complete the IIEF-5 questionnaire. EF scores were calculated for the two groups, where normal EF constituted an IIEF-5 score ≥ 22 (out of 25). Results Circumcised men had higher average EF scores compared to their uncircumcised counterparts, (p < 0.001). The prevalence of erectile dysfunction was lower in circumcised men (56%) compared to uncircumcised men (68%) (p < 0.05). EF scores were similar in those circumcised in childhood and those who had the procedure in adulthood, (p = 0.59). The groups did not differ significantly in terms of age, relationship status, smoking, alcohol and medication use. A statistically significant difference was observed in education levels, with the circumcision group having higher levels of education (p < 0.005). Conclusion The higher EF scores in circumcised men show that circumcision does not confer adverse EF effects in men. These results suggest that circumcision can be considered safe in terms of EF. A definitive prospective study is needed to confirm these findings. PMID:26245613

  13. Testing the Validity and Reliability of the Shame Questionnaire among Sexually Abused Girls in Zambia

    PubMed Central

    Michalopoulos, Lynn T. M.; Murray, Laura K.; Kane, Jeremy C.; Skavenski van Wyk, Stephanie; Chomba, Elwyn; Cohen, Judith; Imasiku, Mwiya; Semrau, Katherine; Unick, Jay; Bolton, Paul A.

    2015-01-01

    Purpose The aim of the current study is to test the validity and reliability of the Shame Questionnaire among traumatized girls in Lusaka, Zambia. Methods The Shame Questionnaire was validated through both classical test and item response theory methods. Internal reliability, criterion validity and construct validity were examined among a sample of 325 female children living in Zambia. Sub-analyses were conducted to examine differences in construct validity among girls who reported sexual abuse and girls who did not. Results All girls in the sample were sexually abused, but only 61.5% endorsed or reported that sexual abuse had occurred. Internal consistency was very good among the sample with alpha = .87. Criterion validity was demonstrated through a significant difference of mean Shame Questionnaire scores between girls who experienced 0–1 trauma events and more than one traumatic event, with higher mean Shame Questionnaire scores among girls who had more than one traumatic event (p = .004 for 0–1 compared to 2 and 3 events and p = .016 for 0–1 compared to 4+ events). Girls who reported a history of witnessing or experiencing physical abuse had a significantly higher mean Shame Questionnaire score than girls who did not report a history of witnessing or experiencing physical abuse (p<.0001). There was no significant difference in mean Shame Questionnaire score between girls who reported a sexual abuse history and girls who did not. Exploratory factor analysis indicated a two-factor model of the Shame Questionnaire, with an experience of shame dimension and an active outcomes of shame dimension. Item response theory analysis indicated adequate overall item fit. Results also indicate potential differences in construct validity between girls who did and did not endorse sexual abuse. Conclusions This study suggests the general utility of the Shame Questionnaire among Zambian girls and demonstrates the need for more psychometric studies in low and middle income countries. PMID:25879658

  14. School holidays: examining childhood, gender norms, and kinship in children's shorter-term residential mobility in urban Zambia

    PubMed Central

    Hunleth, Jean; Jacob, Rebekah R; Cole, Steven M; Bond, Virginia; James, Aimee S

    2015-01-01

    This article discusses a practice of child residential mobility in Zambia that is frequently overlooked in migration studies and difficult to capture through standard survey methods: the practice of ‘going on holiday’ to the homes of relatives during breaks in the school term. Drawing on child-centered and quantitative research, this article examines the multiple dimensions of ‘going on holiday’ for children living in a low-income urban settlement in Lusaka. Findings suggest that the practice was gendered and may map onto changing norms in schooling in Zambia. Within a context where resources are severely constrained, going on holiday may serve as one means for cultivating reciprocity, sharing the burden of care and household labor, and strengthening kin ties. This work further demonstrates the importance of using locally meaningful terms and practices in survey research where general questions about children's mobility may fail to capture the nature and extent of children's movements. PMID:26435699

  15. Factors influencing modes of transport and travel time for obstetric care: a mixed methods study in Zambia and Uganda.

    PubMed

    Sacks, Emma; Vail, Daniel; Austin-Evelyn, Katherine; Greeson, Dana; Atuyambe, Lynn M; Macwan'gi, Mubiana; Kruk, Margaret E; Grépin, Karen A

    2016-04-01

    Transportation is an important barrier to accessing obstetric care for many pregnant and postpartum women in low-resource settings, particularly in rural areas. However, little is known about how pregnant women travel to health facilities in these settings. We conducted 1633 exit surveys with women who had a recent facility delivery and 48 focus group discussions with women who had either a home or a facility birth in the past year in eight districts in Uganda and Zambia. Quantitative data were analysed using univariate statistics, and qualitative data were analysed using thematic content analysis techniques. On average, women spent 62-68 min travelling to a clinic for delivery. Very different patterns in modes of transport were observed in the two countries: 91% of Ugandan women employed motorized forms of transportation, while only 57% of women in Zambia did. Motorcycle taxis were the most commonly used in Uganda, while cars, trucks and taxis were the most commonly used mode of transportation in Zambia. Lower-income women were less likely to use motorized modes of transportation: in Zambia, women in the poorest quintile took 94 min to travel to a health facility, compared with 34 for the wealthiest quintile; this difference between quintiles was ∼50 min in Uganda. Focus group discussions confirmed that transport is a major challenge due to a number of factors we categorized as the 'three A's:' affordability, accessibility and adequacy of transport options. Women reported that all of these factors had influenced their decision not to deliver in a health facility. The two countries had markedly different patterns of transportation for obstetric care, and modes of transport and travel times varied dramatically by wealth quintile, which policymakers need to take into account when designing obstetric transport interventions. PMID:26135364

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

    PubMed

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

    2005-06-01

    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

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

    SciTech Connect

    Utting, J. ); Wielens, H. )

    1992-10-01

    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.

  18. Beliefs, Behaviors, and Perceptions of Community-Led Total Sanitation and Their Relation to Improved Sanitation in Rural Zambia.

    PubMed

    Lawrence, J Joseph; Yeboah-Antwi, Kojo; Biemba, Godfrey; Ram, Pavani K; Osbert, Nicolas; Sabin, Lora L; Hamer, Davidson H

    2016-03-01

    Inadequate hygiene and sanitation remain leading global contributors to morbidity and mortality in children and adults. One strategy for improving sanitation access is community-led total sanitation (CLTS), in which participants are guided into self-realization of the importance of sanitation through activities called "triggering." This qualitative study explored community members' and stakeholders' sanitation, knowledge, perceptions, and behaviors during early CLTS implementation in Zambia. We conducted 67 in-depth interviews and 24 focus group discussions in six districts in Zambia 12-18 months after CLTS implementation. Triggering activities elicited strong emotions, including shame, disgust, and peer pressure, which persuaded individuals and families to build and use latrines and handwashing stations. New sanitation behaviors were also encouraged by the hierarchical influences of traditional leaders and sanitation action groups and by children's opinions. Poor soil conditions were identified as barriers to latrine construction. Taboos, including prohibition of different generations of family members, in-laws, and opposite genders from using the same toilet, were barriers for using sanitation facilities. CLTS, through community empowerment and ownership, produced powerful responses that encouraged construction and use of latrines and handwashing practices. These qualitative data suggest that CLTS is effective for improving sanitation beliefs and behaviors in Zambia. PMID:26787149

  19. Zambia Wetland

    Atmospheric Science Data Center

    2013-04-16

    ... here) is the Izhi-tezhi, and downstream (middle right of the images) is the Kafue Gorge dam. Since the construction of these dams, the ... processed identically. Here, color changes indicate surface texture, and are influenced by terrain, vegetation structure, soil type and ...

  20. The human resource for health situation in Zambia: deficit and maldistribution

    PubMed Central

    2011-01-01

    Introduction Current health policy directions in Zambia are formulated in the National Health Strategic Plan. The Plan focuses on national health priorities, which include the human resources (HR) crisis. In this paper we describe the way the HRH establishment is distributed in the different provinces of Zambia, with a view to assess the dimension of shortages and of imbalances in the distribution of health workers by province and by level of care. Population and methods We used secondary data from the "March 2008 payroll data base", which lists all the public servants on the payroll of the Ministry of Health and of the National Health Service facilities. We computed rates and ratios and compared them. Results The highest relative concentration of all categories of workers was observed in Northern, Eastern, Lusaka, Western and Luapula provinces (in decreasing order of number of health workers). The ratio of clinical officers (mid-level clinical practitioners) to general medical officer (doctors with university training) varied from 3.77 in the Lusaka to 19.33 in the Northwestern provinces. For registered nurses (3 to 4 years of mid-level training), the ratio went from 3.54 in the Western to 15.00 in Eastern provinces and for enrolled nurses (two years of basic training) from 4.91 in the Luapula to 36.18 in the Southern provinces. This unequal distribution was reflected in the ratio of population per cadre. The provincial distribution of personnel showed a skewed staff distribution in favour of urbanized provinces, e.g. in Lusaka's doctor: population ratio was 1: 6,247 compared to Northern Province's ratio of 1: 65,763. In the whole country, the data set showed only 109 staff in health posts: 1 clinical officer, 3 environmental health technologists, 2 registered nurses, 12 enrolled midwives, 32 enrolled nurses, and 59 other. The vacancy rates for level 3 facilities(central hospitals, national level) varied from 5% in Lusaka to 38% in Copperbelt Province; for level 2 facilities (provincial level hospitals), from 30% for Western to 70% for Copperbelt Province; for level 1 facilities (district level hospitals), from 54% for the Southern to 80% for the Western provinces; for rural health centres, vacancies varied from 15% to 63% (for Lusaka and Luapula provinces respectively); for urban health centres the observed vacancy rates varied from 13% for the Lusaka to 96% for the Western provinces. We observed significant shortages in most staff categories, except for support staff, which had a significant surplus. Discussion and Conclusions This case study documents how a peaceful, politically stable African country with a longstanding tradition of strategic management of the health sector and with a track record of innovative approaches dealt with its HRH problems, but still remains with a major absolute and relative shortage of health workers. The case of Zambia reinforces the idea that training more staff is necessary to address the human resources crisis, but it is not sufficient and has to be completed with measures to mitigate attrition and to increase productivity. PMID:22182366

  1. Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia

    PubMed Central

    Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

    2015-01-01

    Introduction The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Methods Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. Results 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.201.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.241.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.297.86) and in both rural and urban settings. Conclusions QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation. PMID:26098555

  2. Developing the national community health assistant strategy in Zambia: a policy analysis

    PubMed Central

    2013-01-01

    Background In 2010, the Ministry of Health in Zambia developed the National Community Health Assistant strategy, aiming to integrate community health workers (CHWs) into national health plans by creating a new group of workers, called community health assistants (CHAs). The aim of the paper is to analyse the CHA policy development process and the factors that influenced its evolution and content. A policy analysis approach was used to analyse the policy reform process. Methodology Data were gathered through review of documents, participant observation and key informant interviews with CHA strategic team members in Lusaka district, and senior officials at the district level in Kapiri Mposhi district where some CHAs have been deployed. Results The strategy was developed in order to address the human resources for health shortage and the challenges facing the community-based health workforce in Zambia. However, some actors within the strategic team were more influential than others in informing the policy agenda, determining the process, and shaping the content. These actors negotiated with professional/statutory bodies and health unions on the need to develop the new cadre which resulted in compromises that enabled the policy process to move forward. International agencies also indirectly influenced the course as well as the content of the strategy. Some actors classified the process as both insufficiently consultative and rushed. Due to limited consultation, it was suggested that the policy content did not adequately address key policy content issues such as management of staff attrition, general professional development, and progression matters. Analysis of the process also showed that the strategy might create a new group of workers whose mandate is unclear to the existing group of health workers. Conclusions This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the fact that actors’ power or position in the political hierarchy may, more than their knowledge and understanding of the issue, play a disproportionate role in shaping the process as well as content of health policy reform. PMID:23870454

  3. Microbiome frequency and their association with trypanosome infection in male Glossina morsitans centralis of Western Zambia.

    PubMed

    Mbewe, Njelembo J; Mweempwa, Cornelius; Guya, Samuel; Wamwiri, Florence N

    2015-06-30

    Tsetse flies (Diptera: Glossinidae) are considered primary cyclical vectors that transmit pathogenic trypanosomes in Africa. They harbour a variety of microbes including Wolbachia, Sodalis and the salivary gland hypertrophy virus (SGHV) which are all vertically transmitted. Knowledge on tsetse microbiome and their interactions may identify novel strategies for tsetse fly and trypanosomiasis control. Area-wide application of such strategies requires an understanding of the natural microbiome frequency in the different species and subspecies of Glossina in their geographical populations. Consequently, this study determined the prevalence of Sodalis, Wolbachia, SGHV and trypanosome infections in Glossina morsitanscentralis from two sites of Western Zambia. We also explored possible associations of the microbes with trypanosome infections. Male G. morsitanscentralis samples were collected from two sites (Lyoni and Lusinina) in Western Zambia. The age structure of the flies at each site was determined using the wing fray method. DNA was extracted from the samples and analyzed for Wolbachia, Sodalis, SGHV and trypanosome presence using PCR. Associations and measures of associations between trypanosome infection and microbes in the fly were determined. The flies from the two locations (Lusinina, n=45 and Lyoni, n=24) had a similar age structure with their median fray category not being significantly different (p=0.698). The overall prevalence of Wolbachia was 72.5% (95% CI: 61.6-83.3%), Sodalis was 15.9% (95% CI: 7.1-24.8%), SGHV was 31.9% (95% CI: 20.6-43.2%) and Trypanosoma species was 23.2% (95% CI: 13-33.4%). The prevalence of Wolbachia was significantly higher in Lusinina than Lyoni (p=0.000). However this was not the case for Sodalis, SGHV and Trypanosoma species. Despite the low number of flies that were positive for both trypanosome and Sodalis (6; 8.7%), a statistically significant association (p=0.013; AOR 6.2; 95% CI: 1.5-25.8) was observed in G. morsitanscentralis. The study showed that the prevalence of microbiota may vary within the same species of the tsetse depending on the geographical location as was the case of Wolbachia. Further it showed that infection with Sodalis could affect vector competence. The study concludes that Sodalis could be an ideal candidate for symbiont-mediated trypanosomiasis control interventions in G. morsitanscentralis. PMID:25983231

  4. “All for some”: water inequity in Zambia and Zimbabwe

    NASA Astrophysics Data System (ADS)

    Robinson, Peter B.

    In southern Africa, gross disparities in access to water are symptomatic of the overall uneven pattern of development. Despite post-independence egalitarian rhetoric, in countries such as Zambia and Zimbabwe inappropriate models (piped house connections in the urban areas, high technology irrigation schemes in the agricultural sector), combined with weak macro-economies and poorly formulated sectoral policies have actually exacerbated the disparities. Zero or very low tariffs have played a major role in this. Although justified as being consistent with water’s special status, inadequate tariffs in fact serve to undermine any programme of making water accessible to all. This has led to a narrowing of development options, resulting in exclusivist rather than inclusivist development, and stagnation rather than dynamism. A major part of the explanation for perpetuation of such unsatisfactory outcomes is the existence of political interest groups who benefit from the status quo. The first case study in the paper involves urban water consumers in Zambia, where those with piped water connections seek to continue the culture of low tariffs which is by now deeply embedded. The result is that the water supply authorities (in this case the newly formed, but still politically constrained ‘commercialised utilities’) are unable even to maintain adequate supplies to the piped customers, let alone extend service to the peri-urban dwellers, 56% of whom do not have access to safe water. The paper outlines some modest, workable principles to achieve universal, affordable access to water in the urban areas, albeit through a mix of service delivery mechanisms. In a second case study of rural productive water in Zimbabwe, the reasons for only 2% of the rural subsistence farming households being involved in formal small-scale irrigation schemes 20 years after independence are explored. Again, a major part of the explanation lies in government pursuing a water delivery model which is not affordable or sustainable on a wide scale. Its provision, via substantial capital and recurrent subsidies, for a small group has a large opportunity cost for society as a whole. The small-scale irrigators have a vested interest in ensuring that the subsidies are maintained, but in the process continue to absorb a disproportionate amount of resources which could be used for development elsewhere. By choosing simpler, cheaper water technologies, and assisting farmers with growing and marketing high value crops, the resources could instead be used to benefit a much larger proportion of households. With well designed programmes aimed at achieving equity, large numbers of subsistence farmers could improve their incomes and start working their way out of poverty.

  5. Pilot-testing service-based planning for health care in rural Zambia

    PubMed Central

    2014-01-01

    Background Human resources for health (HRH) planning in Zambia, as in other countries, is often done by comparing current HRH numbers with established posts, without considering whether population health needs are being met. Service-based HRH planning compares the number and type of services required by populations, given their needs, with the capacity of existing HRH to perform those services. The objective of the study was to demonstrate the effectiveness of service-based HRH planning through its adaptation in two rural Zambian districts, Gwembe and Chibombo. Methods The health conditions causing the greatest mortality and morbidity in each district were identified using administrative data and consultations with community health committees and health workers. The number and type of health care services required to address these conditions were estimated based on their population sizes, incidence and prevalence of each condition, and desired levels of service. The capacity of each district’s health workers to provide these services was estimated using a survey of health workers (n=44) that assessed the availability of their specific competencies. Results The primary health conditions identified in the two districts were HIV/AIDS in Gwembe and malaria in Chibombo. Although the competencies of the existing health workforces in these two mostly aligned with these conditions, some substantial gaps were found between the services the workforce can provide and the services their populations need. The largest gaps identified in both districts were: performing laboratory testing and interpreting results, performing diagnostic imaging and interpreting results, taking and interpreting a patient’s medical history, performing a physical examination, identifying and diagnosing the illness in question, and assessing eligibility for antiretroviral treatment. Conclusions Although active, productive, and competent, health workers in these districts are too few to meet the leading health care needs of their populations. Given the specific competencies most lacking, on-site training of existing health workers to develop these competencies may be the best approach to addressing the identified gaps. Continued use of the service-based approach in Zambia will enhance the country’s ability to align the training, management, and deployment of its health workforce to meet the needs of its people. PMID:25080074

  6. Implementation of cervical cancer prevention services for HIV-infected women in Zambia: measuring program effectiveness

    PubMed Central

    Parham, Groesbeck P; Mwanahamuntu, Mulindi H; Sahasrabuddhe, Vikrant V; Westfall, Andrew O; King, Kristin E; Chibwesha, Carla; Pfaendler, Krista S; Mkumba, Gracilia; Mudenda, Victor; Kapambwe, Sharon; Vermund, Sten H; Hicks, Michael L; Stringer, Jeffrey SA; Chi, Benjamin H

    2014-01-01

    Background Cervical cancer kills more women in low-income nations than any other malignancy. A variety of research and demonstration efforts have proven the efficacy and effectiveness of low-cost cervical cancer prevention methods but none in routine program implementation settings of the developing world, particularly in HIV-infected women. Methods In our public sector cervical cancer prevention program in Zambia, nurses conduct screening using visual inspection with acetic acid aided by digital cervicography. Women with visible lesions are offered same-visit cryotherapy or referred for histologic evaluation and clinical management. We analyzed clinical outcomes and modeled program effectiveness among HIV-infected women by estimating the total number of cervical cancer deaths prevented through screening and treatment. Results Between 2006 and 2008, 6572 HIV-infected women were screened, 53.6% (3523) had visible lesions, 58.5% (2062) were eligible for cryotherapy and 41.5% (1461) were referred for histologic evaluation. A total of 75% (1095 out of 1462) of patients who were referred for evaluation complied. Pathology results from 65% (715 out of 1095) of women revealed benign abnormalities in 21% (151), cervical intraepithelial neoplasia (CIN) I in 30% (214), CIN 2/3 in 33% (235) and invasive cervical cancer in 16.1% (115, of which 69% were early stage). Using a conditional probability model, we estimated that our program prevented 142 cervical cancer deaths (high/low range: 23896) among the 6572 HIV-infected women screened, or one cervical cancer death prevented per 46 (corresponding range: 2868) HIV-infected women screened. Conclusion Our prevention efforts using setting-appropriate human resources and technology have reduced morbidity and mortality from cervical cancer among HIV-infected women in Zambia. Financial support for implementing cervical cancer prevention programs integrated within HIV/AIDS care programs is warranted. Our prevention model can serve as the implementation platform for future low-cost HPV-based screening methods, and our results may provide the basis for comparison of programmatic effectiveness of future prevention efforts. PMID:25419240

  7. Effects of Early, Abrupt Weaning on HIV-free Survival of Children in Zambia

    PubMed Central

    Kuhn, Louise; Aldrovandi, Grace M.; Sinkala, Moses; Kankasa, Chipepo; Semrau, Katherine; Mwiya, Mwiya; Kasonde, Prisca; Scott, Nancy; Vwalika, Cheswa; Walter, Jan; Bulterys, Marc; Tsai, Wei-Yann; Thea, Donald M.

    2008-01-01

    Background In low-resource settings, many programs recommend that women who are infected with the human immunodeficiency virus (HIV) stop breast-feeding early. We conducted a randomized trial to evaluate whether abrupt weaning at 4 months as compared with the standard practice has a net benefit for HIV-free survival of children. Methods We enrolled 958 HIV-infected women and their infants in Lusaka, Zambia. All the women planned to breast-feed exclusively to 4 months; 481 were randomly assigned to a counseling program that encouraged abrupt weaning at 4 months, and 477 to a program that encouraged continued breast-feeding for as long as the women chose. The primary outcome was either HIV infection or death of the child by 24 months. Results In the intervention group, 69.0% of the mothers stopped breast-feeding at 5 months or earlier; 68.8% of these women reported the completion of weaning in less than 2 days. In the control group, the median duration of breast-feeding was 16 months. In the overall cohort, there was no significant difference between the groups in the rate of HIV-free survival among the children; 68.4% and 64.0% survived to 24 months without HIV infection in the intervention and control groups, respectively (P = 0.13). Among infants who were still being breast-fed and were not infected with HIV at 4 months, there was no significant difference between the groups in HIV-free survival at 24 months (83.9% and 80.7% in the intervention and control groups, respectively; P = 0.27). Children who were infected with HIV by 4 months had a higher mortality by 24 months if they had been assigned to the intervention group than if they had been assigned to the control group (73.6% vs. 54.8%, P = 0.007). Conclusions Early, abrupt cessation of breast-feeding by HIV-infected women in a low-resource setting, such as Lusaka, Zambia, does not improve the rate of HIV-free survival among children born to HIV-infected mothers and is harmful to HIV-infected infants. (ClinicalTrials.gov number, NCT00310726.) PMID:18525036

  8. Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia.

    PubMed

    Handa, Sudhanshu; Peterman, Amber; Seidenfeld, David; Tembo, Gelson

    2016-02-01

    There is promising recent evidence that poverty-targeted social cash transfers have potential to improve maternal health outcomes; however, questions remain surrounding design features responsible for impacts. In addition, virtually no evidence exists from the African region. This study explores the impact of Zambia's Child Grant Program on a range of maternal health utilization outcomes using a randomized design and difference-in-differences multivariate regression from data collected over 24 months from 2010 to 2012. Results indicate that while there are no measurable program impacts among the main sample, there are heterogeneous impacts on skilled attendance at birth among a sample of women residing in households having better access to maternal health services. The latter result is particularly interesting because of the overall low level of health care availability in program areas suggesting that dedicated program design or matching supply-side interventions may be necessary to leverage unconditional cash transfers in similar settings to impact maternal health. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25581062

  9. Accumulation of metals in the liver and kidneys of cattle from agricultural areas in Lusaka, Zambia.

    PubMed

    Yabe, John; Nakayama, Shouta M M; Ikenaka, Yoshinori; Muzandu, Kaampwe; Ishizuka, Mayumi; Umemura, Takashi

    2012-10-01

    Intensive agricultural practices are recognized as significant sources of metal pollution in soils and pasture. This study investigated metal contamination in cattle offal from an agricultural area in Zambia, where inorganic fertilizers, agricultural lime, and pesticides are routinely applied. The highest median values (mg/kg, wet weight) of Cu (40.9), Zn (35.2), Cr (1.35) and Ni (0.594) were recorded in the liver, whereas the highest median values of Pb (0.061) and Cd (0.049) were found in kidneys. Maximum levels of Hg, As and Co were under 0.2 mg/kg in both organs. Pb and Cd did not exceed the benchmark values in cattle offal for human consumption and did not pose immediate health risks. Concentrations of Ni and Cr could present a public health concern. Monitoring of metal accumulations in offal of cattle, not only from well-known polluted environments but also agricultural areas, should be done regularly for the health of human consumers. PMID:22672843

  10. HIV Testing and Tolerance to Gender Based Violence: A Cross-Sectional Study in Zambia

    PubMed Central

    Gari, Sara; Malungo, Jacob R. S.; Martin-Hilber, Adriane; Musheke, Maurice; Schindler, Christian; Merten, Sonja

    2013-01-01

    This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR?=?2.48 95% CI?=?1.006.19); tolerance to gender-based violence (OR?=?2.10 95% CI?=?1.054.32) and fear of social rejection (OR?=?1.48 95% CI?=?1.231.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families. PMID:23991005

  11. Stigma and psychiatric morbidity among mothers of children with epilepsy in Zambia

    PubMed Central

    Elafros, Melissa A.; Sakubita-Simasiku, Claire; Atadzhanov, Masharip; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

    2013-01-01

    Background Epilepsy-associated stigma contributes substantially to the social, medical, and economic burden of disease for people with epilepsy (PWE), but little is known about its impact on caregivers of PWE. Methods To better understand stigma experienced by caregivers of PWE, factors that influence caregiver stigma, and the effect of stigma on a caregiver's psychologic well being, we interviewed 100 caregivers of children with epilepsy in Zambia. Questions assessed maternal knowledge, attitudes, and practices related to epilepsy, maternal stigma, mother's proxy report of child stigma, and maternal psychiatric morbidity. Results Of 100 mothers, 39 (39%) indicated that their child was stigmatized because of his or her epilepsy. Maternal proxy report of child stigma was highly correlated with maternal stigma (OR: 5.4, p=0.04), seizure frequency (p=0.03) and seizure severity (p=0.01). One in five of 100 mothers (20%) reported feeling stigmatized because of their child's epilepsy. Higher maternal stigma was associated with lower familial and community support (ORs: 65.2 and 34.7, respectively; both p<0.0001) as well as higher psychiatric morbidity (OR: 1.2; p=0.002). Formal education and epilepsy knowledge were associated with decreased maternal stigma (ORs: 0.8 and 0.7, respectively; both p<0.001). Conclusions One in five mothers of PWE feel stigmatized because of their child's epilepsy. As maternal stigma is associated with psychiatric morbidity, educating caregivers about epilepsy and screening for anxiety and depression are warranted. PMID:24214528

  12. Serological Survey of Foot-and-Mouth Disease Virus in Buffaloes (Syncerus caffer) in Zambia

    PubMed Central

    Sikombe, T. K. W.; Mweene, A. S.; Muma, John; Kasanga, C.; Sinkala, Y.; Banda, F.; Mulumba, M.; Fana, E. M.; Mundia, C.; Simuunza, M.

    2015-01-01

    A study was conducted to determine the serotypes of foot-and-mouth disease viruses (FMDV) circulating in African buffaloes (Syncerus caffer) from selected areas in Zambia. Sera and probang samples were collected between 2011 and 2012 and analysed for presence of antibodies against FMDV while probang samples were used to isolate the FMDV by observing cytopathic effect (CPE). Samples with CPE were further analysed using antigen ELISA. High FMD seroprevalence was observed and antibodies to all the three Southern African Territories (SAT) serotypes were detected in four study areas represented as follows: SAT2 was 72.7 percent; SAT1 was 62.6 percent; and SAT3 was 26.2 percent. Mixed infections accounted for 68.6 percent of those that were tested positive. For probang samples, CPE were observed in three of the samples, while the antigen ELISA results showed positivity and for SAT1 (n = 1) and SAT2 (n = 2). It is concluded that FMDV is highly prevalent in Zambian buffaloes which could play an important role in the epidemiology of the disease. Therefore livestock reared at interface with the game parks should be included in all routine FMDV vaccination programmes. PMID:26347208

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

    NASA Astrophysics Data System (ADS)

    Mumba, M.; Thompson, J. R.

    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 km 2. 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.

  14. Examining targets for HIV prevention: intravaginal practices in Urban Lusaka, Zambia.

    PubMed

    Alcaide, Maria L; Chisembele, Maureen; Mumbi, Miriam; Malupande, Emeria; Jones, Deborah

    2014-03-01

    Intravaginal practices (IVP) are the introduction of products inside the vagina for hygienic, health, or sexuality reasons. The influence of men and Alengizis, traditional marriage counselors for girls, in promoting IVP has not been explored. We conducted gender-concordant focus groups and key informant interviews with Alengizis. The responses were conducted grouped into three themes: (1) cultural norms, (2) types and reasons for IVP, and (3) health consequences. We found that IVP were used by all participants in our sample and were taught from generation to generation by friends, relatives, or Alengizis. The reasons for women to engage in IVP were hygienic, though men expect women to engage in IVP to enhance sexual pleasure. Approximately 40% of women are aware that IVP can facilitate genital infections, but felt they would not feel clean discontinuing IVP. All men were unaware of the vaginal damage caused by IVP, and were concerned about the loss of sexual pleasure if women discontinued IVP. Despite the health risks of IVP, IVP continue to be widespread in Zambia and an integral component of hygiene and sexuality. The frequency of IVP mandates exploration into methods to decrease or ameliorate their use as an essential component of HIV prevention. PMID:24568672

  15. Postpartum maternal morbidity requiring hospital admission in Lusaka, Zambia - a descriptive study.

    PubMed

    Vallely, Lisa; Ahmed, Yusuf; Murray, Susan F

    2005-02-01

    BACKGROUND: Information on the extent of postpartum maternal morbidity in developing countries is extremely limited. In many settings, data from hospital-based studies is hard to interpret because of the small proportion of women that have access to medical care. However, in those areas with good uptake of health care, the measurement of the type and incidence of complications severe enough to require hospitalisation may provide useful baseline information on the acute and severe morbidity that women experience in the early weeks following childbirth. An analysis of health services data from Lusaka, Zambia, is presented. METHODS: Six-month retrospective review of hospital registers and 4-week cross-sectional study with prospective identification of postpartum admissions. RESULTS: Both parts of the study identified puerperal sepsis and malaria as, respectively, the leading direct and indirect causes of postpartum morbidity requiring hospital admission. Puerperal sepsis accounted for 34.8% of 365 postpartum admissions in the 6-month period. Malaria and pneumonia together accounted for one-fifth of all postpartum admissions (14.5% & 6% respectively). At least 1.7% of the postpartum population in Lusaka will require hospital-level care for a maternal morbidity. CONCLUSIONS: In developing country urban settings with high public health care usage, meticulous review of hospital registers can provide baseline information on the burden of moderate-to-severe postpartum morbidity. PMID:15686592

  16. Health-seeking behaviour of patients with sexually transmitted diseases in Zambia.

    PubMed

    Faxelid, E; Ahlberg, B M; Ndulo, J; Krantz, I

    1998-04-01

    The aim of this paper is to describe health-seeking behaviour, time with symptoms and sexual activity during symptom period among patients attending the public health sector in urban and rural Zambia for treatment of an STD. The study was conducted at two urban health centres and at one rural mission hospital during four months in 1994 and 1995. Four hundred and seventy nine patients seeking health care for STD symptoms were interviewed. The patients had experienced STD symptoms for one to two weeks before they came to the clinic. During this period two thirds in the urban and one third in the rural setting had had sex. Sixty per cent of the patients in the urban and 50% in the rural setting had taken some kind of medicine before they came to the clinic. More people had used modern compared to traditional medicine, especially in the urban area. Market places, other clinics and doctors, friends, and relatives were common treatment sources. Ten per cent had received medicine from a traditional healer. Thus, a majority of the patients had received medication from other sources before they came to the clinic. Sex during periods with STD symptoms was common. This has serious implications for STD as well as HIV transmission. PMID:9745841

  17. Temporal Trends and Predictors of Modern Contraceptive Use in Lusaka, Zambia, 20042011

    PubMed Central

    Hancock, Nancy L.; Chibwesha, Carla J.; Stoner, Marie C. D.; Vwalika, Bellington; Rathod, Sujit D.; Kasaro, Margaret Phiri; Stringer, Elizabeth M.; Stringer, Jeffrey S. A.; Chi, Benjamin H.

    2015-01-01

    Introduction. Although increasing access to family planning has been an important part of the global development agenda, millions of women continue to face unmet need for contraception. Materials and Methods. We analyzed data from a repeated cross-sectional community survey conducted in Lusaka, Zambia, over an eight-year period. We described prevalence of modern contraceptive use, including long-acting reversible contraception (LARC), among female heads of household aged 1650 years. We also identified predictors of LARC versus short-term contraceptive use among women using modern methods. Results and Discussion. Twelve survey rounds were completed between November 2004 and September 2011. Among 29,476 eligible respondents, 17,605 (60%) reported using modern contraception. Oral contraceptive pills remained the most popular method over time, but use of LARC increased significantly, from less than 1% in 2004 to 9% by 2011 (p < 0.001). Younger women (OR: 0.46, 95% CI: 0.34, 0.61) and women with lower levels of education (OR: 0.70, 95% CI: 0.56, 0.89) were less likely to report LARC use compared to women using short-term modern methods. Conclusions. Population-based assessments of contraceptive use over time can guide programs and policies. To achieve reproductive health equity and reduce unmet contraceptive need, future efforts to increase LARC use should focus on young women and those with less education. PMID:26819951

  18. Risk reduction among HIV-seroconcordant and -discordant couples: the Zambia NOW2 intervention.

    PubMed

    Jones, Deborah; Kashy, Deborah; Chitalu, Ndashi; Kankasa, Chipepo; Mumbi, Mirriam; Cook, Ryan; Weiss, Stephen

    2014-08-01

    Heterosexual HIV transmission remains the leading cause of HIV incidence in adult men and women in sub-Saharan Africa. This study assessed whether an HIV risk-reduction intervention would be more likely to increase sexual barrier acceptability and decrease risk behavior when delivered to couples in gender concordant groups or in an individual format. This study also examined the mutual impact of couple members as a source of influence on acceptability, and assessed whether product acceptability, intimate partner violence (IPV), and/or partner communication predicted sexual barrier use. HIV seroconcordant and serodiscordant couples (n=216) were recruited in Lusaka, Zambia, and randomized to a four session gender-concordant intervention. Participants were assessed at baseline, 6, and 12 months. Willingness to use barriers (p=0.012), acceptability (p<0.001), and barrier use (p<0.001) increased over time in both conditions, and were influenced by gender preferences. IPV decreased (p=0.040) and positive communication increased (p<0.001) in both conditions. Individual and gender concordant group sessions achieved similar increases in sexual barrier use following the intervention. Results highlight the influence of partners as well as product acceptability as predictors of sexual barrier use among couples in sub-Saharan Africa. Future prevention studies should consider both product acceptability and partner influence to achieve optimal sexual risk behavior outcomes. PMID:24983201

  19. Life cycle assessment to evaluate the environmental impact of biochar implementation in conservation agriculture in Zambia.

    PubMed

    Sparrevik, Magnus; Field, John L; Martinsen, Vegard; Breedveld, Gijs D; Cornelissen, Gerard

    2013-02-01

    Biochar amendment to soil is a potential technology for carbon storage and climate change mitigation. It may, in addition, be a valuable soil fertility enhancer for agricultural purposes in sandy and/or weathered soils. A life cycle assessment including ecological, health and resource impacts has been conducted for field sites in Zambia to evaluate the overall impacts of biochar for agricultural use. The life cycle impacts from conservation farming using cultivation growth basins and precision fertilization with and without biochar addition were in the present study compared to conventional agricultural methods. Three different biochar production methods were evaluated: traditional earth-mound kilns, improved retort kilns, and micro top-lit updraft (TLUD) gasifier stoves. The results confirm that the use of biochar in conservation farming is beneficial for climate change mitigation purposes. However, when including health impacts from particle emissions originating from biochar production, conservation farming plus biochar from earth-mound kilns generally results in a larger negative effect over the whole life cycle than conservation farming without biochar addition. The use of cleaner technologies such as retort kilns or TLUDs can overcome this problem, mainly because fewer particles and less volatile organic compounds, methane and carbon monoxide are emitted. These results emphasize the need for a holistic view on biochar use in agricultural systems. Of special importance is the biochar production technique which has to be evaluated from both environmental/climate, health and social perspectives. PMID:23272937

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

    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.

  1. Pediatric HIV-HBV Coinfection in Lusaka, Zambia: Prevalence and Short-Term Treatment Outcomes.

    PubMed

    Peebles, Kathryn; Nchimba, Lweendo; Chilengi, Roma; Bolton Moore, Carolyn; Mubiana-Mbewe, Mwangelwa; Vinikoor, Michael J

    2015-12-01

    Hepatitis B virus (HBV) is endemic in Africa, where it may occur as an HIV coinfection. Data remain limited on HIV-HBV epidemiology in Africa, particularly in children. Using programmatic data from pediatric HIV clinics in Lusaka, Zambia during 2011-2014, we analyzed the prevalence of chronic HBV coinfection (defined as a single positive hepatitis B surface antigen [HBsAg] test) and its impact on immune recovery and liver enzyme elevation (LEE) during the first year of antiretroviral therapy. Among 411 children and adolescents, 10.4% (95% confidence interval, 7.6-14.1) had HIV-HBV. Coinfected patients were more likely to have World Health Organization stage 3/4, LEE and CD4 <14% at care entry (all p?

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

    NASA Astrophysics Data System (ADS)

    Abel, Nick; Blaikie, Piers

    1986-11-01

    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 great deal about the origins of present-day ecological problems. Further-more, problems are commonly analyzed within narrow discilinary frameworks which predetermine the nature of conclusions and lead to professionally biased proposals. This case study of the Luangwa Valley, Zambia, is used to demonstrate a method which attempts to remedy these weaknesses, In the first part of the article we examine the role of the Luangwa National Parks in the context of the Zambian political economy, and identify social groups which compete for the resources of the national parks. Next we trace the historical origins of present-day ecological changes. These analyses lead toward a model of the Parks and some of their relationships with the national economy. We end with a proposal for communal use of wildlife which attempts to resolve some of the contradictions inherent in current policy.

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

    PubMed Central

    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

    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] 1926). 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 3540) at delivery; the median birth weight of newborns was 3000 g (IQR 27003300 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. PMID:21315347

  4. The verification of seasonal precipitation forecasts for early warning in Zambia and Malawi

    NASA Astrophysics Data System (ADS)

    Hyvrinen, O.; Mtilatila, L.; Pilli-Sihvola, K.; Venlinen, A.; Gregow, H.

    2015-04-01

    We assess the probabilistic seasonal precipitation forecasts issued by Regional Climate Outlook Forum (RCOF) for the area of two southern African countries, Malawi and Zambia from 2002 to 2013. The forecasts, issued in August, are of rainy season rainfall accumulations in three categories (above normal, normal, and below normal), for early season (October-December) and late season (January-March). As observations we used in-situ observations and interpolated precipitation products from Global Precipitation Climatology Project (GPCP), Global Precipitation Climatology Centre (GPCC), and Climate Prediction Centre (CPC) Merged Analysis of Precipitation (CMAP). Differences between results from different data products are smaller than confidence intervals calculated by bootstrap. We focus on below normal forecasts as they were deemed to be the most important for society. The well-known decomposition of Brier score into three terms (Reliability, Resolution, and Uncertainty) shows that the forecasts are rather reliable or well-calibrated, but have a very low resolution; that is, they are not able to discriminate different events. The forecasts also lack sharpness as forecasts for one category are rarely higher than 40 % or less than 25 %. However, these results might be unnecessarily pessimistic, because seasonal forecasts have gone through much development during the period when the forecasts verified in this paper were issued, and forecasts using current methodology might have performed better.

  5. Folklore as an instrument of education among the Chewa people of Zambia

    NASA Astrophysics Data System (ADS)

    Banda, Dennis; Morgan, W. John

    2013-07-01

    This article considers the folklore of the Chewa people of Zambia as an instrument of education. It suggests that there is only a fine distinction between Chewa culture [ mwambo wa a Chewa] and Chewa education [ maphunziro ya Uchewa]. The former comprises tribal "truths" to be imposed on the minds of the younger generation. The latter comprises stages in the development of the young through training and some formalised learning. However, by and large, the former dominates the latter. The strongest features of an African Indigenous Knowledge System (AIKS) such as that of the Chewa people are best expressed in terms of Jakayo Peter Ocitti's five philosophical principles of African indigenous education, namely preparationism, functionalism, communalism, perennialism and holisticism. They build on one another and are, therefore, related. The authors of this article demonstrate how Chewa culture and education use folklore to influence the minds of the young. They give examples of how various components of Chewa folklore are used to criticise, commend, dislike, admire, discard and adapt various traits in people. This paper does not present folklore as an educational panacea; there are weaknesses in Chewa traditional education which are also discussed. Rather, folklore is considered here as a valuable supplementary element in education. What the authors propose is to integrate folklore and informal learning as practised by the community in the formal curriculum to enhance the quality of the education provided for all and to maintain cultural identity.

  6. Accumulation and biological effects of metals in wild rats in mining areas of Zambia.

    PubMed

    Nakayama, Shouta M M; Ikenaka, Yoshinori; Hamada, Kyohei; Muzandu, Kaampwe; Choongo, Kennedy; Yabe, John; Umemura, Takashi; Ishizuka, Mayumi

    2013-06-01

    The lead-zinc (Pb-Zn) mine in Kabwe City and the copper-cobalt (Cu-Co) mine in the Copperbelt Province are major mining areas in Zambia. To examine the effects of metal pollution on wildlife, wild black rats (Rattus rattus and Rattus tanezumi) were captured in Kabwe and Chingola (in the Copperbelt Province), and in Lusaka (a noncontaminated site). Wild black rats in Kabwe accumulated significantly higher concentrations of Pb and Cd in various organs than rats from Lusaka. In Chingola, significantly higher concentrations of Cu, Co, Pb, and Cd were accumulated in wild black rats than in rats from Lusaka. These results were in accordance with metal accumulation patterns in soil. From toxicological aspects, concentrations of Pb and Cd in rats were generally low. However, metallothionein-1 (MT-1) and metallothionein-2 (MT-2) mRNA expression levels in wild black rats from Kabwe were significantly higher than those in rats from Lusaka. A generalized linear model (GLM) showed that concentrations of Zn and Cu had positive effects on the MT-1 and MT-2 mRNA expression. These results suggest that wild black rats in Zambian mining sites were exposed to metals that accumulated in their organs, causing biological responses such as MT mRNA induction. GLM indicated that heme oxygenase-1 (HO-1) mRNA expression could be a marker for Cr exposure. PMID:23054276

  7. Examining Targets for HIV Prevention: Intravaginal Practices in Urban Lusaka, Zambia

    PubMed Central

    Chisembele, Maureen; Mumbi, Miriam; Malupande, Emeria; Jones, Deborah

    2014-01-01

    Abstract Intravaginal practices (IVP) are the introduction of products inside the vagina for hygienic, health, or sexuality reasons. The influence of men and Alengizis, traditional marriage counselors for girls, in promoting IVP has not been explored. We conducted gender-concordant focus groups and key informant interviews with Alengizis. The responses were conducted grouped into three themes: (1) cultural norms, (2) types and reasons for IVP, and (3) health consequences. We found that IVP were used by all participants in our sample and were taught from generation to generation by friends, relatives, or Alengizis. The reasons for women to engage in IVP were hygienic, though men expect women to engage in IVP to enhance sexual pleasure. Approximately 40% of women are aware that IVP can facilitate genital infections, but felt they would not feel clean discontinuing IVP. All men were unaware of the vaginal damage caused by IVP, and were concerned about the loss of sexual pleasure if women discontinued IVP. Despite the health risks of IVP, IVP continue to be widespread in Zambia and an integral component of hygiene and sexuality. The frequency of IVP mandates exploration into methods to decrease or ameliorate their use as an essential component of HIV prevention. PMID:24568672

  8. eC3—A Modern Telecommunications Matrix for Cervical Cancer Prevention in Zambia

    PubMed Central

    Parham, Groesbeck P.; Mwanahamuntu, Mulindi H.; Pfaendler, Krista S.; Sahasrabuddhe, Vikrant V.; Myung, Daniel; Mkumba, Gracilia; Kapambwe, Sharon; Mwanza, Bianca; Chibwesha, Carla; Hicks, Michael L.; Stringer, Jeffrey S.A.

    2013-01-01

    Objectives Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. Materials and Methods We developed a system operated by nonphysician health providers that used widely available and affordable communication technology to create locally adaptable and sustainable public sector cervical cancer prevention program in Zambia, one of the world’s poorest countries. Results Nurses were trained to perform visual inspection with acetic acid aided by digital cervicography using predefined criteria. Electronic digital images (cervigrams) were reviewed with patients, and distance consultation was sought as necessary. Same-visit cryotherapy or referral for further evaluation by a gynecologist was offered. The Zambian system of “electronic cervical cancer control” bypasses many of the historic barriers to the delivery of preventive health care to women in low-resource environments while facilitating monitoring, evaluation, and continued education of primary health care providers, patient education, and medical records documentation. Conclusions The electronic cervical cancer control system uses appropriate technology to bridge the gap between screening and diagnosis, thereby facilitating the conduct of “screen-and-treat” programs. The inherent flexibility of the system lends itself to the integration with future infrastructures using rapid molecular human papillomavirus–based screening approaches and wireless telemedicine communications. PMID:20592550

  9. Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia

    PubMed Central

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

    2014-01-01

    Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

  10. The prevalence of bovine herpesvirus-1 in traditional cattle in Southern Province, Zambia.

    PubMed

    Mweene, A S; Fukushi, H; Pandey, G S; Syakalima, M; Simuunza, M; Malamo, M; Nambota, A; Samui, K L; Tsubota, T; Nakazato, Y; Onuma, M; Yasuda, J

    2003-12-01

    A study was conducted to determine the prevalence of bovine herpesvirus-1 (BHV-1), which causes infectious bovine rhinotracheitis, in cattle destined for market in Southern Province, Zambia. A total of 116 nasal secretion samples were tested using the direct fluorescent antibody test, while blood samples from the same cattle were examined by a commercial enzyme-linked immunosorbent assay kit. The prevalence of the BHV-1 antigens in cattle was 23.28% (27/116), while the mean prevalence of the BHV-1 antibodies was 48.28% (56/116). This study showed that cattle in transit to markets could easily spread the virus, which was reactivated by the stress of trekking for long distances under unfavourable conditions, to the other cattle with which they came into contact. Thus, these transit cattle posed a serious threat to other bovines. Systems of cattle trading where cattle must be transported a long wayto market should be reviewed by the authorities to minimise the conditions that may exacerbate the spread of infection. PMID:15005545

  11. Prevalence of Giardia in dairy cattle in Lusaka and Chilanga districts, Zambia.

    PubMed

    Kakandelwa, Cliff; Siwila, Joyce; Nalubamba, King S; Muma, John B; Phiri, Isaac G K

    2016-01-15

    Giardia is an intestinal protozoan parasite of mammals including humans. A cross-sectional study was conducted to estimate prevalence of Giardia infections in smallholder and commercial dairy herds in Chilanga and Lusaka districts of Zambia. A total of 377 calves aged from 1 to 365 days were sampled on 34 farms. All faecal samples were analyzed for Giardia antigen using a commercially available ELISA kit. Overall prevalence of Giardia was 34.5% (95% CI=29.7-39.3). Among smallholder farms, animal level prevalence ranged from 0 to 100% (mean=44.636.9 standard deviations) and 12.5 to 60.9% (mean=33.516.7 standard deviations) within commercial herds. Prevalence was highest in calves less than three months old (p=0.010), and there was no significant difference in the prevalence between smallholder and commercial farms (p=0.300). Giardia prevalence was not associated with occurrence of diarrhoea in the calves (p=0.205). The study demonstrates that Giardia infections are common in dairy herds in the study areas, especially in calves less than three months of age. PMID:26790746

  12. Associations between household responsibilities and academic competencies in the context of education accessibility in Zambia

    PubMed Central

    Reich, Jodi; Hein, Sascha; Krivulskaya, Suzanna; Hart, Lesley; Gumkowski, Nina; Grigorenko, Elena L.

    2013-01-01

    The relationship between education and socioeconomic status has been demonstrated in studies of the developed and the developing world, yet there are communities in which schooling is either not available to all children or not a preferred activity for all children. In this study, we investigated the differences between children in-school and out-of-school in rural and peri-urban communities of Zambia. As expected, we found that the children in-school performed higher in domains of adaptive behavior and on assessments of academic achievement (i.e., mathematics, reading). Somewhat unexpectedly, however, when controlling for socioeconomic status, home responsibilities (i.e., chores, work) were a positive predictor for the performance of the children out-of-school, but a negative predictor for the children in-school. The relationship between home responsibilities and academic performance may be bidirectional and differential; for example, our findings allow for the hypothesis that for in-school children chores take time away from the studies, but for out-of-school children they provide some limited mathematics exposure. PMID:24347996

  13. Serological Survey of Foot-and-Mouth Disease Virus in Buffaloes (Syncerus caffer) in Zambia.

    PubMed

    Sikombe, T K W; Mweene, A S; Muma, John; Kasanga, C; Sinkala, Y; Banda, F; Mulumba, M; Fana, E M; Mundia, C; Simuunza, M

    2015-01-01

    A study was conducted to determine the serotypes of foot-and-mouth disease viruses (FMDV) circulating in African buffaloes (Syncerus caffer) from selected areas in Zambia. Sera and probang samples were collected between 2011 and 2012 and analysed for presence of antibodies against FMDV while probang samples were used to isolate the FMDV by observing cytopathic effect (CPE). Samples with CPE were further analysed using antigen ELISA. High FMD seroprevalence was observed and antibodies to all the three Southern African Territories (SAT) serotypes were detected in four study areas represented as follows: SAT2 was 72.7 percent; SAT1 was 62.6 percent; and SAT3 was 26.2 percent. Mixed infections accounted for 68.6 percent of those that were tested positive. For probang samples, CPE were observed in three of the samples, while the antigen ELISA results showed positivity and for SAT1 (n = 1) and SAT2 (n = 2). It is concluded that FMDV is highly prevalent in Zambian buffaloes which could play an important role in the epidemiology of the disease. Therefore livestock reared at interface with the game parks should be included in all routine FMDV vaccination programmes. PMID:26347208

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

    PubMed

    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

    2012-07-01

    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

  15. High burden of malaria following scale-up of control interventions in Nchelenge District, Luapula Province, Zambia

    PubMed Central

    2014-01-01

    Background Malaria control interventions have been scaled-up in Zambia in conjunction with a malaria surveillance system. Although substantial progress has been achieved in reducing morbidity and mortality, national and local information demonstrated marked heterogeneity in the impact of malaria control across the country. This study reports the high burden of malaria in Nchelenge District, Luapula Province, Zambia from 2006 to 2012 after seven years of control measures. Methods Yearly aggregated information on cases of malaria, malaria deaths, use of malaria diagnostics, and malaria control interventions from 2006 to 2012 were obtained from the Nchelenge District Health Office. Trends in the number of malaria cases, methods of diagnosis, malaria positivity rate among pregnant women, and intervention coverage were analysed using descriptive statistics. Results Malaria prevalence remained high, increasing from 38% in 2006 to 53% in 2012. Increasing numbers of cases of severe malaria were reported until 2010. Intense seasonal malaria transmission was observed with seasonal declines in the number of cases between April and August, although malaria transmission continued throughout the year. Clinical diagnosis without accompanying confirmation declined from 95% in 2006 to 35% in 2012. Intervention coverage with long-lasting insecticide-treated nets and indoor residual spraying increased from 2006 to 2012. Conclusions Despite high coverage with vector control interventions, the burden of malaria in Nchelenge District, Zambia remained high. The high parasite prevalence could accurately reflect the true burden, perhaps in part as a consequence of population movement, or improved access to care and case reporting. Quality information at fine spatial scales will be critical for targeting effective interventions and measurement of progress. PMID:24755108

  16. Exploring SWAp's contribution to the efficient allocation and use of resources in the health sector in Zambia.

    PubMed

    Chansa, Collins; Sundewall, Jesper; McIntyre, Di; Tomson, Gran; Forsberg, Birger C

    2008-07-01

    Zambia introduced a sector-wide approach (SWAp) in the health sector in 1993. The goal was to improve efficiency in the use of domestic funds and externally sourced development assistance by integrating these into a joint sectoral framework. Over a decade into its existence, however, the SWAp remains largely unevaluated. This study explores whether the envisaged improvements have been achieved by studying developments in administrative, technical and allocative efficiency in the Zambian health sector from 1990-2006. A case study was conducted using interviews and analysis of secondary data. Respondents represented a cross-section of stakeholders in the Zambian health sector. Secondary data from 1990-2006 were collected for six indicators related to administrative, technical and allocative efficiency. The results showed small improvements in administrative efficiency. Transaction costs still appeared to be high despite the introduction of the SWAp. Indicators for technical efficiency showed a drop in hospital bed utilization rates and government share of funding for drugs. As for allocative efficiency, budget execution did not improve with the SWAp, although there were large variations between both donors and year. Funding levels had apparently improved at district level but declined for hospitals. Finally, the SWAp had not succeeded in bringing all external assistance together under a common framework. Despite strong commitment to implement the SWAp in Zambia, the envisaged efficiency improvements do not seem to have been attained. Possible explanations could be that the SWAp has not been fully developed or that not all parties have completely embraced it. SWAp is not ruled out as a coordination model, but the current setup in Zambia has not proved to be fully effective. PMID:18562459

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

    PubMed

    Hanjra, Munir A; Culas, Richard J

    2011-01-01

    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

  18. Impact of Pregnancy-Related Deaths on Female Life Expectancy in Zambia: Application of Life Table Techniques to Census Data

    PubMed Central

    Banda, Richard; Sandøy, Ingvild Fossgard; Fylkesnes, Knut; Janssen, Fanny

    2015-01-01

    Introduction Since 2000, the world has been coalesced around efforts to reduce maternal mortality. However, few studies have estimated the significance of eliminating maternal deaths on female life expectancy. We estimated, based on census data, the potential gains in female life expectancy assuming complete elimination of pregnancy-related mortality in Zambia. Methods We used data on all-cause and pregnancy-related deaths of females aged 15–49 reported in the Zambia 2010 census, and evaluated, adjusted and smoothed them using existing and verified techniques. We used associated single decrement life tables, assuming complete elimination of pregnancy-related deaths to estimate the potential gains in female life expectancy at birth, at age 15, and over the ages 15–49. We compared these gains with the gains from eliminating deaths from accidents, injury, violence and suicide. Results Complete elimination of pregnancy-related deaths would extend life expectancy at birth among Zambian women by 1.35 years and life expectancy at age 15 by 1.65 years. In rural areas, this would be 1.69 years and 2.19 years, respectively, and in urban areas, 0.78 years and 0.85 years. An additional 0.72 years would be spent in the reproductive age group 15–49; 1.00 years in rural areas and 0.35 years in urban areas. Eliminating deaths from accidents, injury, suicide and violence among women aged 15–49 would cumulatively contribute 0.55 years to female life expectancy at birth. Conclusion Eliminating pregnancy-related mortality would extend female life expectancy in Zambia substantially, with more gains among adolescents and females in rural areas. The application of life table techniques to census data proved very valuable, although rigorous evaluation and adjustment of reported deaths and age was necessary to attain plausible estimates. The collection of detailed high quality cause-specific mortality data in future censuses is indispensable. PMID:26513160

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

    PubMed

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

    2007-09-01

    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

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

    NASA Astrophysics Data System (ADS)

    Wendorff, Marek

    2005-07-01

    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.

  1. Remote Sensing of Aquatic Vegetation Coverage in the Kafue River, Zambia and Comparison to Climatic Variables

    NASA Astrophysics Data System (ADS)

    Mischler, J. A.; Abdalati, W.; Hussein, K.; Townsend, A. R.

    2013-12-01

    The Kafue River is the longest river in Zambia and is a major tributary of the Zambezi River. It is a vital source of fish, transportation, drinking water, and hydropower for much of Zambia's population, over half of whom live in the Kafue River basin. Like many important water bodies in developing countries the Kafue and its ecosystems face pollution from industrial, mining, agricultural, and domestic/sewage discharge. The Kafue River forms a wide and shallow wetland (the Kafue Flats) during the rainy season (Nov. - Apr.) which serves as habitat for diverse groups of birds and mammals. In recent years the unprecedented emergence of invasive aquatic vegetation such as the water hyacinth (Eichhornia crassipes) and Salvinia molesta have choked the river, degrading its ability to provide adequate habitat to promote biodiversity, ecosystem services, and hydropower. In addition, these plants provide additional habitat for mosquitoes (vectors for malaria) and aquatic snails (vectors of schistosomiasis). Nutrient-rich effluents are widely believed to contribute to the proliferation and explosive growth of this floating aquatic vegetation. The general methods for managing these aquatic weeds have included mechanical and physical removal, herbicides, and bio-control agents which have had very little impact. However, as in neighboring Lake Victoria, total weed coverage has fluctuated dramatically from year to year making evaluation of the efficacy of management programs difficult. The objectives of this study were to (1) generate the first record of aquatic plant coverage for a section of the Kafue River which is immediately downstream of a sugar plantation (a major source of nitrogen and phosphorus to the river) and (2) determine if plant coverage is correlated with any major climatic (ENSO, temperature, rainfall) or management (introduction of bio-control agents) indices. We utilized remote sensing techniques in conjunction with Landsat 4-5 TM and Landsat 7 ETM imagery for the time range 1990 to 2013 to identify the extent of aquatic vegetation in the dry season for all years available within the time range using spectral data. We derived rainfall for the time period from TRMM data and temperature from MODIS LST data. Overall weed coverage tended to increase from 1990 to 2013. There was no significant correlation between rainfall (as measured by TRMM) and water hyacinth coverage. However there was a significant positive correlation between minimum October temperatures (the warmest month of the year) and weed coverage (exponential fit, R2 = 0.81). There was no indication that the release of bio-control agents reduced weed coverage. Water hyacinth is known to be sensitive to temperature, with cooler temperatures retarding growth. In the Kafue River, aquatic plant coverage varies mainly with October low temperatures indicating an overall control of temperature on weed coverage. Increasing low temperatures in the region would be expected to exacerbate problems associated with aquatic weeds.

  2. A Bayesian geostatistical Moran Curve model for estimating net changes of tsetse populations in Zambia.

    PubMed

    Sedda, Luigi; Mweempwa, Cornelius; Ducheyne, Els; De Pus, Claudia; Hendrickx, Guy; Rogers, David J

    2014-01-01

    For the first time a Bayesian geostatistical version of the Moran Curve, a logarithmic form of the Ricker stock recruitment curve, is proposed that is able to give an estimate of net change in population demographic rates considering components such as fertility and density dependent and density independent mortalities. The method is applied to spatio-temporally referenced count data of tsetse flies obtained from fly-rounds. The model is a linear regression with three components: population rate of change estimated from the Moran curve, an explicit spatio-temporal covariance, and the observation error optimised within a Bayesian framework. The model was applied to the three main climate seasons of Zambia (rainy--January to April, cold-dry--May to August, and hot-dry--September to December) taking into account land surface temperature and (seasonally changing) cattle distribution. The model shows a maximum positive net change during the hot-dry season and a minimum between the rainy and cold-dry seasons. Density independent losses are correlated positively with day-time land surface temperature and negatively with night-time land surface temperature and cattle distribution. The inclusion of density dependent mortality increases considerably the goodness of fit of the model. Cross validation with an independent dataset taken from the same area resulted in a very accurate estimate of tsetse catches. In general, the overall framework provides an important tool for vector control and eradication by identifying vector population concentrations and local vector demographic rates. It can also be applied to the case of sustainable harvesting of natural populations. PMID:24755848

  3. Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia

    PubMed Central

    Masiye, Felix; Kaonga, Oliver; Kirigia, Joses M

    2016-01-01

    Background Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Methods Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households’ out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Results Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence. Conclusion Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of user fee removal on CHE among particularly poorest households. PMID:26795620

  4. New investigations at Kalambo Falls, Zambia: Luminescence chronology, site formation, and archaeological significance.

    PubMed

    Duller, Geoff A T; Tooth, Stephen; Barham, Lawrence; Tsukamoto, Sumiko

    2015-08-01

    Fluvial deposits can provide excellent archives of early hominin activity but may be complex to interpret, especially without extensive geochronology. The Stone Age site of Kalambo Falls, northern Zambia, has yielded a rich artefact record from dominantly fluvial deposits, but its significance has been restricted by uncertainties over site formation processes and a limited chronology. Our new investigations in the centre of the Kalambo Basin have used luminescence to provide a chronology and have provided key insights into the geomorphological and sedimentological processes involved in site formation. Excavations reveal a complex assemblage of channel and floodplain deposits. Single grain quartz optically stimulated luminescence (OSL) measurements provide the most accurate age estimates for the youngest sediments, but in older deposits the OSL signal from some grains is saturated. A different luminescence signal from quartz, thermally transferred OSL (TT-OSL), can date these older deposits. OSL and TT-OSL results are combined to provide a chronology for the site. Ages indicate four phases of punctuated deposition by the dominantly laterally migrating and vertically aggrading Kalambo River (?500-300 ka, ?300-50 ka, ?50-30 ka, ?1.5-0.49 ka), followed by deep incision and renewed lateral migration at a lower topographic level. A conceptual model for site formation provides the basis for improved interpretation of the generation, preservation, and visibility of the Kalambo archaeological record. This model highlights the important role of intrinsic meander dynamics in site formation and does not necessarily require complex interpretations that invoke periodic blocking of the Kalambo River, as has previously been suggested. The oldest luminescence ages place the Mode 2/3 transition between ?500 and 300 ka, consistent with other African and Asian sites where a similar transition can be found. The study approach adopted here can potentially be applied to other fluvial Stone Age sites throughout Africa and beyond. PMID:26073072

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

    PubMed

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

    2011-05-01

    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

  6. Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach

    PubMed Central

    Kim, Young Mi; Banda, Joseph; Kanjipite, Webby; Sarkar, Supriya; Bazant, Eva; Hiner, Cyndi; Tholandi, Maya; Reinhardt, Stephanie; Njobvu, Panganani Dalisani; Kols, Adrienne; Benavides, Bruno

    2013-01-01

    ABSTRACT Background: The Zambia Defence Force (ZDF) has applied the Standards-Based Management and Recognition (SBM-R) approach, which uses detailed performance standards, at some health facilities to improve HIV-related services offered to military personnel and surrounding civilian communities. This study examines the effectiveness of the SBM-R approach in improving facility readiness and provider performance at ZDF facilities. Methods: We collected data on facility readiness and provider performance before and after the 20102012 intervention at 4 intervention sites selected for their relatively poor performance and 4 comparison sites. Assessors observed whether each facility met 16 readiness standards and whether providers met 9 performance standards during consultations with 354 returning antiretroviral therapy (ART) clients. We then calculated the percentages of criteria achieved for each readiness and performance standard and conducted bivariate and multivariate analyses of provider performance data. Results: Facilities' ART readiness scores exceeded 80% before the intervention at both intervention and comparison sites. At endline, scores improved on 4 facility readiness standards in the intervention group but on only 1 standard in the comparison group. Multivariate analysis found that the overall provider performance score increased significantly in the intervention group (from 58% to 84%; P<.01) but not in the comparison group (from 62% to 70%). The before-and-after improvement in scores was significantly greater among intervention sites than among comparison sites for 2 standardsinitial assessment of the client's condition and nutrition counseling. Conclusion: The standards-based approach, which involved intensive and mutually reinforcing intervention activities, showed modest improvements in some aspects of providers' performance during ART consultations. Further research is needed to determine whether improvements in provider performance affect client outcomes such as adherence to ART. PMID:25276534

  7. Bucking social norms: Examining anomalous fertility aspirations in the face of HIV in Lusaka, Zambia

    PubMed Central

    Moore, Ann M.; Keogh, Sarah; Kavanaugh, Megan; Bankole, Akinrinola; Mulambia, Chishimba; Mutombo, Namuunda

    2014-01-01

    In settings of high fertility and high HIV prevalence, individuals are making fertility decisions while simultaneously trying to avoid or manage HIV. We sought to increase our understanding of how individuals dually manage HIV risk while attempting to achieve their fertility goals as part of the project entitled HIV Status and Achieving Fertility Desires conducted in Zambia in 2011. Using multivariate regression to predict fertility patterns based on socio-demographic characteristics for respondents from facility-based and community-based surveys, we employed Anomalous Case Analysis (ACA) whereby in-depth interview respondents were selected from the groups of outliers amongst the survey respondents who reported lower or higher fertility preferences than predicted as well as those who adhered to predicted patterns, and lived in Lusaka (n=45). All of the facility-based respondents were HIV-positive. We utilize the Theory of Conjunctural Action (TCA) to categorize domains of influence on individuals’ preferences and behavior. Both community-based and facility-based right-tail respondents (outliers whose fertility intentions indicated that they wanted a/nother child when we predicted that they did not) expressed comparatively less control over their fertility and gave more weight to pressures from others to continue childbearing. Partner communication about fertility desires was greater among left-tail respondents (outliers whose fertility intentions indicated that they did not want a/nother child when we predicted that they did). HIV-positive right-tail respondents were more likely to see anti-retroviral therapies (ARTs) which prevent mother to child transmission of HIV as highly effective, mitigating inhibitions to further childbearing. Drug interactions between ARTs and contraceptives were identified as a limitation to HIV-positive individuals’ contraceptive options on both sides of the distribution. Factors that should be taken into account in the future to understand fertility behavior in high HIV-prevalent settings include couples’ communication around fertility and perception of the efficacy of ARTs. PMID:25150655

  8. Failure to detect tuberculosis in Black lechwe antelopes (Kobus leche smithemani) in Zambia

    PubMed Central

    2011-01-01

    Background Two types of lechwe antelopes exclusively exist in their natural ecosystems in Zambia; the Black lechwe (Kobus leche smithemani) and the Kafue lechwe (Kobus leche kafuensis). Despite inhabiting similar ecosystems, tuberculosis has been reported in Kafue lechwe without its documentation in Black lechwe antelopes. However, the past few decades have seen a drastic decline in both lechwe populations. Whereas studies have postulated that infectious diseases such as tuberculosis are having a negative impact on the Kafue lechwe population, no information is available on Black lechwe antelopes. Thus this study was conducted to investigate tuberculosis in Black lechwe antelopes of the Bangweulu swamps in comparison with the Kafue lechwe antelopes of Lochinvar. Findings A total of 44 lechwe antelopes (Black (n = 30): Kafue (n = 14) were sampled from Bangweulu and Lochinvar respectively. A positive case was defined with findings of gross lesions with Ziehl Nielsen and culture confirmation. Out of the 14 animals examined in Lochinvar, 21.4% [95% CI: 15.4, 44.4%] had necropsy lesions consistent with tuberculosis. The corresponding samples from 30 Black lechwe of Bangweulu yielded negative results on all the three tests. Conclusions Current findings from this study intimate the possible absence of tuberculosis in Black lechwe antelopes whilst confirming the presence of tuberculosis in Kafue lechwe of the Kafue basin. The absence of tuberculosis in the Black lechwe suggests that the observed population decline may not be caused by tuberculosis. However, without detailed molecular epidemiological studies it is not possible to determine the association of M. bovis infection in sympatric animal populations. The possible role of transmission of tuberculosis between wildlife and cattle is discussed herein. Findings PMID:21729320

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

    PubMed

    Kasonde, Joseph M; Campbell, Sandy

    2012-01-01

    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. PMID:23034056

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

    PubMed Central

    2012-01-01

    The concept of the Knowledge Translation Platform (KTP) provides cohesion and leadership for nationallevel 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 ZAMFOHRs 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 policymakers. Ultimately, ZAMFOHRs 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. PMID:23034056

  11. Resistance status of ticks (Acari; Ixodidae) to amitraz and cypermethrin acaricides in Isoka District, Zambia.

    PubMed

    Muyobela, Jackson; Nkunika, Philip Obed Yobe; Mwase, Enala Tembo

    2015-12-01

    This study was designed to obtain data on the farmer's approach to tick control and to determine whether Rhipicephalus appendiculatus Neuman, Amblyomma variegatum (Fabricius), and Rhipicephalus (Boophilus) microplus (Canestrini) were resistant to amitraz and cypermethrin acaricides, in Isoka District, Zambia. Prevailing tick control practices were documented by administering a semi-structured questionnaire to 80 randomly selected smallholder livestock farmers from four agricultural camps (Longwe, Kantenshya, Kapililonga, and Ndeke) in Isoka District. Modified larval packet test (LPT) bioassay experiments were used to determine the resistance status of the common tick species against amitraz and cypermethrin acaricides. Fifty percent of respondents practiced chemical tick control with amitraz (27%) and cypermethrin (23%) being the acaricides in use, and were applied with knapsack sprayers. Less than 3l of spray wash per animal was used which was considerably lower than the recommended delivery rate of 10l of spray wash per animal. No significant susceptibility change to amitraz at 95% confidence level was observed in R. appendiculatus and A. variegatum against amitraz. However, a significant change in the susceptibility of R. (Bo.) microplus tested with amitraz was detected at 95% confidence. The test population had a lower susceptibility (LD50 0.014%; LD90 0.023%) than the reference population (LD50 0.013%; LD90 0.020%). The results indicated that resistance to amitraz was developing in R. (Bo.) microplus. For cypermethrin, no significant susceptibility change at 95% confidence was observed in any of the three species and thus resistance to this chemical was not observed. PMID:26310511

  12. A Bayesian Geostatistical Moran Curve Model for Estimating Net Changes of Tsetse Populations in Zambia

    PubMed Central

    Sedda, Luigi; Mweempwa, Cornelius; Ducheyne, Els; De Pus, Claudia; Hendrickx, Guy; Rogers, David J.

    2014-01-01

    For the first time a Bayesian geostatistical version of the Moran Curve, a logarithmic form of the Ricker stock recruitment curve, is proposed that is able to give an estimate of net change in population demographic rates considering components such as fertility and density dependent and density independent mortalities. The method is applied to spatio-temporally referenced count data of tsetse flies obtained from fly-rounds. The model is a linear regression with three components: population rate of change estimated from the Moran curve, an explicit spatio-temporal covariance, and the observation error optimised within a Bayesian framework. The model was applied to the three main climate seasons of Zambia (rainy January to April, cold-dry May to August, and hot-dry September to December) taking into account land surface temperature and (seasonally changing) cattle distribution. The model shows a maximum positive net change during the hot-dry season and a minimum between the rainy and cold-dry seasons. Density independent losses are correlated positively with day-time land surface temperature and negatively with night-time land surface temperature and cattle distribution. The inclusion of density dependent mortality increases considerably the goodness of fit of the model. Cross validation with an independent dataset taken from the same area resulted in a very accurate estimate of tsetse catches. In general, the overall framework provides an important tool for vector control and eradication by identifying vector population concentrations and local vector demographic rates. It can also be applied to the case of sustainable harvesting of natural populations. PMID:24755848

  13. Behavior Change Pathways to Voluntary Medical Male Circumcision: Narrative Interviews with Circumcision Clients in Zambia

    PubMed Central

    Price, Jessica E.; Phiri, Lyson; Mulenga, Drosin; Hewett, Paul C.; Topp, Stephanie M.; Shiliya, Nicholas; Hatzold, Karin

    2014-01-01

    As an HIV prevention strategy, the scale-up of voluntary medical male circumcision (VMMC) is underway in 14 countries in Africa. For prevention impact, these countries must perform millions of circumcisions in adolescent and adult men before 2015. Although acceptability of VMMC in the region is well documented and service delivery efforts have proven successful, countries remain behind in meeting circumcision targets. A better understanding of men's VMMC-seeking behaviors and experiences is needed to improve communication and interventions to accelerate uptake. To this end, we conducted semi-structured interviews with 40 clients waiting for surgical circumcision at clinics in Zambia. Based on Stages of Change behavioral theory, men were asked to recount how they learned about adult circumcision, why they decided it was right for them, what they feared most, how they overcame their fears, and the steps they took to make it to the clinic that day. Thematic analysis across all cases allowed us to identify key behavior change triggers while within-case analysis elucidated variants of one predominant behavior change pattern. Major stages included: awareness and critical belief adjustment, norming pressures and personalization of advantages, a period of fear management and finally VMMC-seeking. Qualitative comparative analysis of ever-married and never-married men revealed important similarities and differences between the two groups. Unprompted, 17 of the men described one to four failed prior attempts to become circumcised. Experienced more frequently by older men, failed VMMC attempts were often due to service-side barriers. Findings highlight intervention opportunities to increase VMMC uptake. Reaching uncircumcised men via close male friends and female sex partners and tailoring messages to stage-specific concerns and needs would help accelerate men's movement through the behavior change process. Expanding service access is also needed to meet current demand. Improving clinic efficiencies and introducing time-saving procedures and advance scheduling options should be considered. PMID:25375790

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

    PubMed Central

    2010-01-01

    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. PMID:20825646

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

    USGS Publications Warehouse

    Barham, L.; Phillips, W.M.; Maher, B.A.; Karloukovski, V.; Duller, G.A.T.; Jain, M.; Wintle, A.G.

    2011-01-01

    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 (10Be/26Al) 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. ?? 2010 Elsevier Ltd.

  16. Prevalence of Neurocysticercosis in People with Epilepsy in the Eastern Province of Zambia.

    PubMed

    Mwape, Kabemba E; Blocher, Joachim; Wiefek, Jasmin; Schmidt, Kathie; Dorny, Pierre; Praet, Nicolas; Chiluba, Clarance; Schmidt, Holger; Phiri, Isaac K; Winkler, Andrea S; Gabriël, Sarah

    2015-08-01

    Zambia is endemic for Taenia solium taeniosis and cysticercosis. In this single-centered, cross-sectional, community-based study, the role of neurocysticercosis (NCC) as a cause of epilepsy was examined. People with epilepsy (PWE, n = 56) were identified in an endemic area using a screening questionnaire followed by in-depth interviews and neurological examination. Computed tomography (CT) was performed on 49 people with active epilepsy (PWAE) and their sera (specific antibody and antigen detection, n = 56) and stools (copro-antigen detection, n = 54) were analyzed. The CT scan findings were compared to a group of 40 CT scan controls. Of the PWE, 39.3% and 23.2% were positive for cysticercal antibodies and antigens, respectively, and 14.8% for coproantigens (taeniosis). Lesions highly suggestive of NCC were detected in 24.5% and definite NCC lesions in 4.1% of CT scans of PWAE. This compares to 2.5% and 0%, respectively, in the control CT scans. Using the Del Brutto diagnostic criteria, 51.8% of the PWAE were diagnosed with probable or definitive NCC and this rose to 57.1% when the adapted criteria, as proposed by Gabriël et al. (adding the sero-antigen ELISA test as a major criterion), were used. There was no statistically significant relationship between NCC, current age, age at first seizure and gender. This study suggests that NCC is the single most important cause of epilepsy in the study area. Additional large-scale studies, combining a community based prevalence study for epilepsy with neuroimaging and serological analysis in different areas are needed to estimate the true impact of neurocysticercosis in endemic regions and efforts should be instituted to the control of T. solium. PMID:26285031

  17. Prevalence of Neurocysticercosis in People with Epilepsy in the Eastern Province of Zambia

    PubMed Central

    Wiefek, Jasmin; Schmidt, Kathie; Dorny, Pierre; Praet, Nicolas; Chiluba, Clarance; Schmidt, Holger; Phiri, Isaac K.; Winkler, Andrea S.; Gabriël, Sarah

    2015-01-01

    Zambia is endemic for Taenia solium taeniosis and cysticercosis. In this single-centered, cross-sectional, community-based study, the role of neurocysticercosis (NCC) as a cause of epilepsy was examined. People with epilepsy (PWE, n = 56) were identified in an endemic area using a screening questionnaire followed by in-depth interviews and neurological examination. Computed tomography (CT) was performed on 49 people with active epilepsy (PWAE) and their sera (specific antibody and antigen detection, n = 56) and stools (copro-antigen detection, n = 54) were analyzed. The CT scan findings were compared to a group of 40 CT scan controls. Of the PWE, 39.3% and 23.2% were positive for cysticercal antibodies and antigens, respectively, and 14.8% for coproantigens (taeniosis). Lesions highly suggestive of NCC were detected in 24.5% and definite NCC lesions in 4.1% of CT scans of PWAE. This compares to 2.5% and 0%, respectively, in the control CT scans. Using the Del Brutto diagnostic criteria, 51.8% of the PWAE were diagnosed with probable or definitive NCC and this rose to 57.1% when the adapted criteria, as proposed by Gabriël et al. (adding the sero-antigen ELISA test as a major criterion), were used. There was no statistically significant relationship between NCC, current age, age at first seizure and gender. This study suggests that NCC is the single most important cause of epilepsy in the study area. Additional large-scale studies, combining a community based prevalence study for epilepsy with neuroimaging and serological analysis in different areas are needed to estimate the true impact of neurocysticercosis in endemic regions and efforts should be instituted to the control of T. solium. PMID:26285031

  18. "If You Were the Researcher What Would You Research?": Understanding Children's Perspectives on Educational Research in Mongolia and Zambia

    ERIC Educational Resources Information Center

    Morgan, Julia; Sengedorj, Tumendelger

    2015-01-01

    This paper draws on data from a project undertaken with children (N?=?72) in Mongolia and Zambia. The research is distinctive in bringing together diverse children, ranging from those living on the street to those in mainstream education and involving them in discussions about educational research. Being conscious of critiques of adult-initiated

  19. "If You Were the Researcher What Would You Research?": Understanding Children's Perspectives on Educational Research in Mongolia and Zambia

    ERIC Educational Resources Information Center

    Morgan, Julia; Sengedorj, Tumendelger

    2015-01-01

    This paper draws on data from a project undertaken with children (N?=?72) in Mongolia and Zambia. The research is distinctive in bringing together diverse children, ranging from those living on the street to those in mainstream education and involving them in discussions about educational research. Being conscious of critiques of adult-initiated…

  20. "Distance Learning" or "Learning at a Distance"? Case Study of an Education Initiative to Deliver an In-Service Bachelors Degree in Zambia

    ERIC Educational Resources Information Center

    Smith, Christopher J.

    2010-01-01

    In 1998, as part of what was then Zambia's Department of Technical Education and Vocational Training's (DTEVT) human resources capacity building initiative, under the Ministry of Science, Technology and Vocational Training (MSTVT), donor funding was secured to provide degree-level training for key teachers and managers within the technical…

  1. Report to UNESCO on Eleven Weeks as Consultant to the Governments of Kenya, Tanzania, Zambia and Malawi on Aspects of Biology Teaching, February to April, 1971.

    ERIC Educational Resources Information Center

    Meyer, Rex

    This report describes the activities of a UNESCO consultant who visited Kenya, Tanzania, Zambia and Malawi for the purpose of assisting local education agencies in the Biology Teaching Pilot Project. The consultant's report briefly summarizes the status of the School Science Project (SSP) in these East African countries. Also listed are the…

  2. Situation Reports--Austria, Belgium, Bolivia, Botswana, Finland, German Federal Republic, Italy, Luxembourg, Mauritania, Netherlands, Norway, Portugal, Puerto Rico, Sweden, Tanzania, Yugoslavia, and Zambia.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data pertaining to population and family planning in seventeen foreign countries are presented in these situation reports. Countries included are Austria, Belgium, Bolivia, Botswana, Finland, German Federal Republic, Italy, Luxembourg, Mauritania, Netherlands, Norway, Portugal, Puerto Rico, Sweden, Tanzania, Yugoslavia, and Zambia. Information is…

  3. "Distance Learning" or "Learning at a Distance"? Case Study of an Education Initiative to Deliver an In-Service Bachelors Degree in Zambia

    ERIC Educational Resources Information Center

    Smith, Christopher J.

    2010-01-01

    In 1998, as part of what was then Zambia's Department of Technical Education and Vocational Training's (DTEVT) human resources capacity building initiative, under the Ministry of Science, Technology and Vocational Training (MSTVT), donor funding was secured to provide degree-level training for key teachers and managers within the technical

  4. Native and Second Language Interference in Learning a Second Foreign Language: The Case of Bemba-Speakers Learning French in Zambia

    ERIC Educational Resources Information Center

    Chishiba, G. M.; Mukuka, J.

    2012-01-01

    Language interference is one of the factors that affect language learning by many learners of second and third languages. In Zambia, the impact of language interference on the learners of French requires closer attention. Our literature review shows that few studies have looked at the impact of interference from Zambian languages on the learners

  5. Native and Second Language Interference in Learning a Second Foreign Language: The Case of Bemba-Speakers Learning French in Zambia

    ERIC Educational Resources Information Center

    Chishiba, G. M.; Mukuka, J.

    2012-01-01

    Language interference is one of the factors that affect language learning by many learners of second and third languages. In Zambia, the impact of language interference on the learners of French requires closer attention. Our literature review shows that few studies have looked at the impact of interference from Zambian languages on the learners…

  6. Prevalence and diversity of Babesia, Hepatozoon, Ehrlichia, and Bartonella in wild and domestic carnivores from Zambia, Africa.

    PubMed

    Williams, Brianna M; Berentsen, Are; Shock, Barbara C; Teixiera, Maria; Dunbar, Michael R; Becker, Matthew S; Yabsley, Michael J

    2014-03-01

    A molecular survey was conducted for several hemoparasites of domestic dogs and three species of wild carnivores from two sites in Zambia. Three Babesia spp. were detected including Babesia felis and Babesia leo in lions (Panthera leo) and a Babesia sp. (similar to Babesia lengau) in spotted hyenas (Crocuta crocuta) and a single lion. All wild dogs (Lycaon pictus) and domestic dogs were negative for Babesia. High prevalences for Hepatozoon were noted in all three wild carnivores (38-61%) and in domestic dogs (13%). Significantly higher prevalences were noted in hyenas and wild dogs compared with domestic dogs and lions. All carnivores were PCR negative for Ehrlichia canis, Ehrlichia ewingii, and Bartonella spp. Overall, high prevalences and diversity of Babesia and Hepatozoon were noted in wild carnivores from Zambia. This study is the first molecular characterization of Babesia from any hyena species and is the first report of a Babesia sp. closely related to B. lengau, a parasite previously only reported from cheetahs (Acinonyx jubatus), in lions and hyenas. Although usually benign in wild carnivores, these hemoparasites can be pathogenic under certain circumstances. Importantly, data on vectors for these parasites are lacking, so studies are needed to identify vectors as well as determine transmission routes, infection dynamics, and host specificity of these hemoparasites in wildlife in Africa and also the risk of transmission between domestic animals and wildlife. PMID:24363181

  7. Evaluation of a Density-Based Rapid Diagnostic Test for Sickle Cell Disease in a Clinical Setting in Zambia

    PubMed Central

    Hennek, Jonathan W.; Mantina, Hamakwa; Lee, S. Y. Ryan; Patton, Matthew R.; Sambo, Pauline; Sinyangwe, Silvester; Kankasa, Chipepo; Chintu, Chifumbe; Brugnara, Carlo; Stossel, Thomas P.; Whitesides, George M.

    2014-01-01

    Although simple and low-cost interventions for sickle cell disease (SCD) exist in many developing countries, child mortality associated with SCD remains high, in part, because of the lack of access to diagnostic tests for SCD. A density-based test using aqueous multiphase systems (SCD-AMPS) is a candidate for a low-cost, point-of-care diagnostic for SCD. In this paper, the field evaluation of SCD-AMPS in a large (n?=?505) case-control study in Zambia is described. Of the two variations of the SCD-AMPS used, the best system (SCD-AMPS-2) demonstrated a sensitivity of 86% (8290%) and a specificity of 60% (5367%). Subsequent analysis identified potential sources of false positives that include clotting, variation between batches of SCD-AMPS, and shipping conditions. Importantly, SCD-AMPS-2 was 84% (6294%) sensitive in detecting SCD in children between 6 months and 1 year old. In addition to an evaluation of performance, an assessment of end-user operability was done with health workers in rural clinics in Zambia. These health workers rated the SCD-AMPS tests to be as simple to use as lateral flow tests for malaria and HIV. PMID:25490722

  8. Feeding and indoor resting behaviour of the mosquito Anopheles longipalpis in an area of hyperendemic malaria transmission in southern Zambia.

    PubMed

    Kent, R J; Coetzee, M; Mharakurwa, S; Norris, D E

    2006-12-01

    Anopheles longipalpis (Theobald) (Diptera: Culicidae) is a predominantly zoophilic mosquito that has not been implicated in malaria transmission. However, this species was collected indoors with An. funestus s.l. in southern Zambia, where transmission of Plasmodium falciparum is hyperendemic, and we initially misidentified it morphologically and molecularly as An. funestus s.l. The indoor resting density and blood-feeding behaviour of An. longipalpis were investigated during the 2004-05 and 2005-06 transmission seasons in Mufwafwi village in southern Zambia. Numbers of endophilic An. longipalpis increased towards the end of the rainy season. Although specimens were collected during human landing catches, the feeding behaviour of An. longipalpis was significantly biased towards cattle (88.7%), with other bloodmeals originating from dogs, goats and chickens. None of the 177 specimens of An. longipalpis were infected with P. falciparum. These data are consistent with existing reports that An. longipalpis is not involved in malaria transmission. However, more extensive sampling is necessary. Importantly, the correct identification of An. longipalpis is crucial for malaria control programmes in areas where An. funestus s.l and An. longipalpis exist sympatrically so that scarce resources are not wasted on the control of a non-vector. PMID:17199758

  9. Evaluation Of A Maternal Health Program In Uganda And Zambia Finds Mixed Results On Quality Of Care And Satisfaction.

    PubMed

    Kruk, Margaret E; Vail, Daniel; Austin-Evelyn, Katherine; Atuyambe, Lynn; Greeson, Dana; Grépin, Karen Ann; Kibira, Simon P S; Macwan'gi, Mubiana; Masvawure, Tsitsi B; Rabkin, Miriam; Sacks, Emma; Simbaya, Joseph; Galea, Sandro

    2016-03-01

    Saving Mothers, Giving Life is a multidonor program designed to reduce maternal mortality in Uganda and Zambia. We used a quasi-random research design to evaluate its effects on provider obstetric knowledge, clinical confidence, and job satisfaction, and on patients' receipt of services, perceived quality, and satisfaction. Study participants were 1,267 health workers and 2,488 female patients. Providers' knowledge was significantly higher in Ugandan and Zambian intervention districts than in comparison districts, and in Uganda there were similar positive differences for providers' clinical confidence and job satisfaction. Patients in Ugandan intervention facilities were more likely to give high ratings for equipment availability, providers' knowledge and communication skills, and care quality, among other factors, than patients in comparison facilities. There were fewer differences between Zambian intervention and comparison facilities. Country differences likely reflect differing intensity of program implementation and the more favorable geography of intervention districts in Uganda than in Zambia. National investments in the health system and provider training and the identification of intervention components most associated with improved performance will be required for scaling up and sustaining the program. PMID:26953307

  10. Property grabbing and will writing in Lusaka, Zambia: an examination of wills of HIV-infected cohabiting couples.

    PubMed

    Mendenhall, E; Muzizi, L; Stephenson, R; Chomba, E; Ahmed, Y; Haworth, A; Allen, S

    2007-03-01

    High rates of HIV and poverty place women in a precarious economic situation in Lusaka, Zambia. Mortality from HIV infection is high, leaving many households single headed and creating almost a half a million orphans. One of the most prevalent forms of gender violence that creates poverty in women is when the male's family claims the property of the deceased from the widow and the children. The Zambia-Emory HIV Research Project collected 184 wills from individuals in monogamous unions where one or both of the individuals were HIV-positive. Despite the fact that many wills specifically stated that their extended family was not allowed to tamper with their possessions in the event of death, property grabbing proved to be a prevalent and difficult issue in Lusaka. In order to improve the lives of widowed women in Lusaka, the government and other civic and non-governmental organisations must inform women of their rights to own and protect their land and other assets in the event of their husbands' death, an issue of increasing importance in the area of HIV/AIDS. PMID:17453571

  11. Lithostratigraphical correlation of the Neoproterozoic Roan Supergroup from Shaba (Zaire) and Zambia, in the central African copper-cobalt metallogenic province

    NASA Astrophysics Data System (ADS)

    Cailteux, J.; Binda, P. L.; Katekesha, W. M.; Kampunzu, A. B.; Intiomale, M. M.; Kapenda, D.; Kaunda, C.; Ngongo, K.; Tshiauka, T.; Wendorff, M.

    1994-11-01

    New data on the lower Katangan sequences in Shaba (Zaire) and Zambia, collected during the 1989 and 1990 UNESCO-sponsored Geotraverses, reveal an important development on friction breccias throughout the Zambian Copperbelt, which still remains poorly documented, and shows that the Zairean and Zambian facies of the Roan Supergroup can be correlated in detail. As in Zaire, the deformation of Katangan terranes during the Lufilian orogeny produced important friction breccias in Zambia. Such breccias occur mostly between the upper part of the Lower Roan Supergroup and the Mwashya Group (R-4): above the shale with grit (RL3) at Konkola and Mindola, or within the Upper Roan Dolomite at Chambishi South, Muliashi and Nchanga. At Mufulira, a typical fragment of Shaba Mines Group was observed within a major heterogeneous tectonic breccia. This situation is similar to that reported at Kipapila (Kimpe) and Lubembe in Zaire, both located on the same tectonic trend as Mufulira. However, a continuous stratigraphical succession can be observed in Zambia from the basal unconformity to the Mwashya Group. Strong lithological similarities were found, formation by formation, between the Roan sequences of Zambia and Zaire. In particular, the complete Mines Group of Zaire (R-2) and the units from the RL6 to the RL4 in Zambia were deposited under comparable conditions of sedimentation and show a similar and correlatable evolution of lithologies. Furthermore, the overlying Dipeta Group (R-3) of Zaire and the RL3, RU2/RU1 of Zambia, are equally comparable. Above the Upper Roan Dolomite, Lower Mwashya dolomitic rocks, identical with the ones of Shaba, have been noted to occur in Zambia in stratigraphical continuity with the typical black shales of the Upper Mwashya. The correlation between the coarse clastics of the Zambian footwall (RL7) and the red dolomitic argillites and sandstones of the Zairean R.A.T. (Roches Argillo Talqueuses: R-1) remains uncertain. However these two sequences show some similarities suggesting a lateral facies change from high-energy siliciclastic sedimentation in Zambia, to quieter, less clastic and more carbonate rich sedimentation in Zaire. In agreement with the proposed lithostratigraphical correlation, volcanic and pyroclastic rocks, occurring both in Zaire and Zambia in the Lower Mwashya, testify to a major period of igneous activity in the region. Intrusive rocks found in the Zambian Roan Group and in the Zairean Dipeta Group can probably be attributed to the same episode of magmatism. Finally it can be shown that several copper-cobalt orebodies are found at the same lithostratigraphical position in Zambia and Zaire: the Zambian ore shale corresponds to the classical Shaba orebodies at the base of the Mines Group (R-2), the Nchanga upper orebody to the lower R-2.3 mineralization and the Zambian RL3 anomalous copper occurrences to those of the R-3.1.2 Dipeta unit.

  12. Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia

    PubMed Central

    2011-01-01

    Background Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI) in Zambia. Methods The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves. Results Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition. Conclusions This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services. PMID:21943178

  13. Barriers to care for patients with neurologic disease in rural Zambia.

    PubMed

    Birbeck, G L

    2000-03-01

    The awesome burden of treatable yet untreated neurologic disease in the developing world presents a humanitarian crisis to those of us with neurologic expertise from more privileged situations. Although increased economic resources are critically needed, a shortage of personnel to care for these patients is as great a problem. It is neither feasible nor desirable to propose training neurologists to work in these regions. However, COs could be selected to receive additional training and return to their home regions to serve as resources for referrals and as community educators. Such a training program would not require massive financial commitments. A handful of dedicated neurologists could conceivably accomplish this in 6- to 8-week training sessions. Ideally, educational materials, such as posters and pamphlets in both English and the native language of the various regions, would be provided at no cost. Existing textbooks in neurology are written for physicians and often focus on diagnostic evaluations and therapies far beyond the services available in developing countries. A text for practical use by COs and community health workers that discusses the application of available medicines and therapies for common neurologic problems would be invaluable. Similar books exist that address general medical and obstetrical problems (for example, Where There Is No Doctor: A Village Health Care Handbook). Where There Is No Neurologist could be developed as a primary teaching tool and a valuable reference for COs with neurologic expertise. Neuroscience researchers, clinical neurologists, and neurology residents from industrialized countries have much to offer and to gain by working in the Third World. Research to monitor the incidence and resource utilization of emerging problems such as stroke is needed to influence public policy. The economic burden and lost productivity caused by neurologic disease in this part of the world has not been appreciated or explored. Disease beyond the scope of Western experience manifests daily in places like Chikankata. Entities such as tabes neurosyphilis, which previous generations of neurologists used as the basis for their training, still abound in Zambia. Much personal satisfaction can be gained in providing care to this vulnerable and underserved population. PMID:10714673

  14. Hope and despair: community health assistants experiences of working in a rural district in Zambia

    PubMed Central

    2014-01-01

    Background In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. Methods A phenomenological approach was used to examine CHAs experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Results Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHAs self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs ability to deliver services. Conclusions Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare. PMID:24886146

  15. Characterisation of the Wildlife Reservoir Community for Human and Animal Trypanosomiasis in the Luangwa Valley, Zambia

    PubMed Central

    Anderson, Neil E.; Mubanga, Joseph; Fevre, Eric M.; Picozzi, Kim; Eisler, Mark C.; Thomas, Robert; Welburn, Susan C.

    2011-01-01

    Background Animal and human trypanosomiasis are constraints to both animal and human health in Sub-Saharan Africa, but there is little recent evidence as to how these parasites circulate in wild hosts in natural ecosystems. The Luangwa Valley in Zambia supports high densities of tsetse flies (Glossina species) and is recognised as an historical sleeping sickness focus. The objective of this study was to characterise the nature of the reservoir community for trypanosomiasis in the absence of influence from domesticated hosts. Methodology/Principal Findings A cross-sectional survey of trypanosome prevalence in wildlife hosts was conducted in the Luangwa Valley from 2005 to 2007. Samples were collected from 418 animals and were examined for the presence of Trypanosoma brucei s.l., T. b. rhodesiense, Trypanosoma congolense and Trypanosoma vivax using molecular diagnostic techniques. The overall prevalence of infection in all species was 13.9% (95% confidence interval [CI]: 10.71–17.57%). Infection was significantly more likely to be detected in waterbuck (Kobus ellipsiprymnus) (Odds ratio [OR] = 10.5, 95% CI: 2.36–46.71), lion (Panthera leo) (OR = 5.3, 95% CI: 1.40–19.69), greater kudu (Tragelaphus strepsiceros) (OR = 4.7, 95% CI: 1.41–15.41) and bushbuck (Tragelaphus scriptus) (OR = 4.5, 95% CI: 1.51–13.56). Bushbucks are important hosts for T. brucei s.l. while the Bovidae appear the most important for T. congolense. The epidemiology of T. vivax was less clear, but parasites were detected most frequently in waterbuck. Human infective T. b. rhodesiense were identified for the first time in African buffalo (Syncerus caffer) and T. brucei s.l. in leopard (Panthera pardus). Variation in infection rates was demonstrated at species level rather than at family or sub-family level. A number of significant risk factors interact to influence infection rates in wildlife including taxonomy, habitat and blood meal preference. Conclusion and Significance Trypanosoma parasites circulate within a wide and diverse host community in this bio-diverse ecosystem. Consistent land use patterns over the last century have resulted in epidemiological stability, but this may be threatened by the recent influx of people and domesticated livestock into the mid-Luangwa Valley. PMID:21713019

  16. Investigating Voluntary Medical Male Circumcision Program Efficiency Gains through Subpopulation Prioritization: Insights from Application to Zambia

    PubMed Central

    Awad, Susanne F.; Sgaier, Sema K.; Tambatamba, Bushimbwa C.; Mohamoud, Yousra A.; Lau, Fiona K.; Reed, Jason B.; Njeuhmeli, Emmanuel; Abu-Raddad, Laith J.

    2015-01-01

    Background Countries in sub-Saharan Africa are scaling-up voluntary male medical circumcision (VMMC) as an HIV intervention. Emerging challenges in these programs call for increased focus on program efficiency (optimizing program impact while minimizing cost). A novel analytic approach was developed to determine how subpopulation prioritization can increase program efficiency using an illustrative application for Zambia. Methods and Findings A population-level mathematical model was constructed describing the heterosexual HIV epidemic and impact of VMMC programs (age-structured mathematical (ASM) model). The model stratified the population according to sex, circumcision status, age group, sexual-risk behavior, HIV status, and stage of infection. A three-level conceptual framework was also developed to determine maximum epidemic impact and program efficiency through subpopulation prioritization, based on age, geography, and risk profile. In the baseline scenario, achieving 80% VMMC coverage by 2017 among males 15–49 year old, 12 VMMCs were needed per HIV infection averted (effectiveness). The cost per infection averted (cost-effectiveness) was USD $1,089 and 306,000 infections were averted. Through age-group prioritization, effectiveness ranged from 11 (20–24 age-group) to 36 (45–49 age-group); cost-effectiveness ranged from $888 (20–24 age-group) to $3,300 (45–49 age-group). Circumcising 10–14, 15–19, or 20–24 year old achieved the largest incidence rate reduction; prioritizing 15–24, 15–29, or 15–34 year old achieved the greatest program efficiency. Through geographic prioritization, effectiveness ranged from 9–12. Prioritizing Lusaka achieved the highest effectiveness. Through risk-group prioritization, prioritizing the highest risk group achieved the highest effectiveness, with only one VMMC needed per infection averted; the lowest risk group required 80 times more VMMCs. Conclusion Epidemic impact and efficiency of VMMC programs can be improved by prioritizing young males (sexually active or just before sexual debut), geographic areas with higher HIV prevalence than the national, and high sexual-risk groups. PMID:26716442

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

    PubMed Central

    2013-01-01

    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 < 0.001 for both). ITT-C was the only other alternative which had comparable sensitivity (RR = 0.821 [0.765, 0.881], P < 0.001), relative to HLC indoor other than CDC-LT for sampling An. funestus. Conclusions While the two most sensitive exposure-free techniques primarily capture host-seeking mosquitoes, both have substantial disadvantages for routine community-based surveillance applications: the CDC-LT requires regular recharging of batteries while the bulkiness of ITT-C makes it difficult to move between sampling locations. RB placed indoors or outdoors and WET had consistently poor sensitivity so it may be useful to evaluate additional alternative methods, such as pyrethrum spray catches and back packer aspirators, for catching resting mosquitoes. PMID:23570257

  18. 'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa

    PubMed Central

    2010-01-01

    Background Many public health researchers conducting studies in resource-constrained settings have experienced negative 'rumours' about their work; in some cases they have been reported to create serious challenges and derail studies. However, what may appear superficially as 'gossip' or 'rumours' can also be regarded and understood as metaphors which represent local concerns. For researchers unaccustomed to having concerns expressed from participants in this manner, possible reactions can be to be unduly perturbed or conversely dismissive. This paper represents a retrospective examination of a malnutrition study conducted by an international team of researchers in Zambia, Southern Africa. The fears of mothers whose children were involved in the study and some of the concerns which were expressed as rumours are also presented. This paper argues that there is an underlying logic to these anxieties and to dismiss them simply as 'rumours' or 'gossip' would be to overlook the historic and socio-economic factors which have contributed to their production. Methods Qualitative interviews were conducted with the mothers whose children were involved in the study and with the research nurses. Twenty five face-to-face interviews and 2 focus group discussions (FGDs) were conducted with mothers. In addition, face-to-face interviews were conducted with research nurses participating in the trial. Results A prominent anxiety expressed as rumours by the mothers whose children were involved in the study was that recruitment into the trial was an indicator that the child was HIV-infected. Other anxieties included that the trial was a disguise for witchcraft or Satanism and that the children's body parts would be removed and sold. In addition, the liquid, milk-based food given to the children to improve their nutrition was suspected of being insufficiently nutritious, thus worsening their condition. The form which these anxieties took, such as rumours related to the stealing of body parts and other anxieties about a stigmatised condition, provide an insight into the historical, socio-economic and cultural influences in such settings. Conclusions Employing strategies to understand local concerns should accompany research aims to achieve optimal success. The concerns raised by the participants we interviewed are not unique to this study. They are produced in countries where the historic, socio-economic and cultural settings communicate anxieties in this format. By examining this study we have shown that by contextualizing these 'rumours', the concerns they express can be constructively addressed and in turn result in the successful conduct of research aims. PMID:20849580

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

    NASA Astrophysics Data System (ADS)

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

    2013-02-01

    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.

  20. Geochemistry and mineralogy of Cu and Co in mine tailings at the Copperbelt, Zambia

    NASA Astrophysics Data System (ADS)

    Sracek, O.; Mihaljevič, M.; Kříbek, B.; Majer, V.; Veselovský, F.

    2010-04-01

    Two sulfidic mine tailings within the Zambian Copperbelt in the north of Zambia have been studied: Chambishi, representing an old site (age about 40 y) and Mindolo, which represents a relatively recent site (age less than 10 y). The neutralization capacity based on solid phase carbonates at both sites remains high, thus neutral to alkaline conditions (paste pH up to 8.5 at Chambishi and up to 6.9 at Mindolo) predominate. Pore water at Chambishi has 568 mg/l of Ca and 1820 mg/l of sulfate, but concentrations of Fe and Mn are below 0.1 mg/l and concentrations of Cu and Co are below 0.05 mg/l. The principal secondary minerals at both sites are gypsum, poorly crystalline Fe(III) phases and hematite. Secondary Fe(III) phases are found as mineral coatings or completely replaced primary sulfides like pyrite and chalcopyrite and include large quantities of copper and cobalt in surface rims (up to 7.0 wt.% of Cu and up to 2.0 wt.% of Co). The presence of Fe(III) phases is marked by red color of mine tailings material, which is observed even below the expected penetration of the sulfide oxidation front. This may be explained by reductive dissolution of Fe(III) phases caused by flooding of tailings and temporarily reducing conditions during rainy period, when dissolved iron is transported by infiltrating water to the deeper zone of mine tailings, where it re-precipitates later. At the Chambishi site, precipitation of secondary minerals resulted in an early stage of hardpan formation at 0.6-0.9 m depth, composed mostly of gypsum and hematite. This zone also corresponds to maximum solid phase contents of Cu and Co. No such hardpans were found at the relatively young Mindolo site, where red tailings material, which includes poorly crystalline Fe(III) phases and hematite, is present only in discrete banded zones at several depth levels. Based on geochemical modeling results at the Mindolo site, precipitation of secondary Cu phases such as brochantite and malachite is likely in the zone of evaporation enrichment close to the mine tailings surface. At both the Chambishi and Mindolo sites, there does not seem to be a threat of acid mine drainage formation even over the long-term. Furthermore, the Cu and Co incorporated in hematite seem to be immobilized within the mine tailings.

  1. Measuring health workers motivation in rural health facilities: baseline results from three study districts in Zambia

    PubMed Central

    2013-01-01

    Introduction Health worker motivation can potentially affect the provision of health services. Low morale among the workforce can undermine the quality of service provision and drive workers away from the profession. While the presence of high-quality, motivated staff is a key aspect of health system performance, it is also one of the most difficult factors to measure. Methods We assessed health worker motivation as part of the baseline assessment for a health system strengthening intervention in three rural districts in Zambia. The intervention (Better Health Outcomes Through Mentoring and Assessment (BHOMA)) aims to increase health worker motivation through training, mentoring and support. We assessed motivation by examining underlying issues grouped around relevant outcome constructs such as job satisfaction, general motivation, burnout, organization commitment, conscientiousness and timeliness that collectively measure overall levels of motivation. The tools and the concepts have been used in high-income countries and they were recently applied in African settings to measure health worker motivation. Results Female participants had the highest motivation scores (female: mean 78.5 (SD 7.8) vs male: mean (SD 7.0)). By type of worker, nurses had the highest scores while environmental health technicians had the lowest score (77.4 (SD 7.8 vs 73.2 (SD 9.3)). Health workers who had been in post longer also had higher scores (>7months). Health workers who had received some form of training in the preceding 12months were more likely to have a higher score; this was also true for those older than 40years when compared to those less than 40years of age. The highest score values were noted in conscientiousness and timeliness, with all districts scoring above 80. Conclusions This study evaluated motivation among rural health workers using a simple adapted tool to measure the concept of motivation. Results showed variation in motivation score by sex, type of health worker, training and time in post. Further research is needed to establish why these health worker attributes were associated with motivation and whether health system interventions targeting health workers, such as the current intervention, could influence health worker motivation. PMID:23433226

  2. Underperformance of African Protected Area Networks and the Case for New Conservation Models: Insights from Zambia

    PubMed Central

    Lindsey, Peter A.; Nyirenda, Vincent R.; Barnes, Jonathan I.; Becker, Matthew S.; McRobb, Rachel; Tambling, Craig J.; Taylor, W. Andrew; Watson, Frederick G.; t’Sas-Rolfes, Michael

    2014-01-01

    Many African protected areas (PAs) are not functioning effectively. We reviewed the performance of Zambia’s PA network and provide insights into how their effectiveness might be improved. Zambia’s PAs are under-performing in ecological, economic and social terms. Reasons include: a) rapidly expanding human populations, poverty and open-access systems in Game Management Areas (GMAs) resulting in widespread bushmeat poaching and habitat encroachment; b) underfunding of the Zambia Wildlife Authority (ZAWA) resulting in inadequate law enforcement; c) reliance of ZAWA on extracting revenues from GMAs to cover operational costs which has prevented proper devolution of user-rights over wildlife to communities; d) on-going marginalization of communities from legal benefits from wildlife; e) under-development of the photo-tourism industry with the effect that earnings are limited to a fraction of the PA network; f) unfavourable terms and corruption which discourage good practice and adequate investment by hunting operators in GMAs; g) blurred responsibilities regarding anti-poaching in GMAs resulting in under-investment by all stakeholders. The combined effect of these challenges has been a major reduction in wildlife densities in most PAs and the loss of habitat in GMAs. Wildlife fares better in areas with investment from the private and/or NGO sector and where human settlement is absent. There is a need for: elevated government funding for ZAWA; greater international donor investment in protected area management; a shift in the role of ZAWA such that they focus primarily on national parks while facilitating the development of wildlife-based land uses by other stakeholders elsewhere; and new models for the functioning of GMAs based on joint-ventures between communities and the private and/or NGO sector. Such joint-ventures should provide defined communities with ownership of land, user-rights over wildlife and aim to attract long-term private/donor investment. These recommendations are relevant for many of the under-funded PAs occurring in other African countries. PMID:24847712

  3. The Prevalence of Tuberculosis in Zambia: Results from the First National TB Prevalence Survey, 2013–2014

    PubMed Central

    Kapata, Nathan; Chanda-Kapata, Pascalina; Ngosa, William; Metitiri, Mine; Klinkenberg, Eveline; Kalisvaart, Nico; Sunkutu, Veronica; Shibemba, Aaron; Chabala, Chishala; Chongwe, Gershom; Tembo, Mathias; Mulenga, Lutinala; Mbulo, Grace; Katemangwe, Patrick; Sakala, Sandra; Chizema-Kawesha, Elizabeth; Masiye, Felix; Sinyangwe, George; Onozaki, Ikushi; Mwaba, Peter; Chikamata, Davy; Zumla, Alimuddin; Grobusch, Martin P.

    2016-01-01

    Background Tuberculosis in Zambia is a major public health problem, however the country does not have reliable baseline data on the TB prevalence for impact measurement; therefore it was among the priority countries identified by the World Health Organization to conduct a national TB prevalence survey Objective To estimate the prevalence of tuberculosis among the adult Zambian population aged 15 years and above, in 2013–2014. Methods A cross-sectional population-based survey was conducted in 66 clusters across all the 10 provinces of Zambia. Eligible participants aged 15 years and above were screened for TB symptoms, had a chest x-ray (CXR) performed and were offered an HIV test. Participants with TB symptoms and/or CXR abnormality underwent an in-depth interview and submitted one spot- and one morning sputum sample for smear microscopy and liquid culture. Digital data collection methods were used throughout the process. Results Of the 98,458 individuals who were enumerated, 54,830 (55.7%) were eligible to participate, and 46,099 (84.1%) participated. Of those who participated, 45,633/46,099 (99%) were screened by both symptom assessment and chest x-ray, while 466/46,099 (1.01%) were screened by interview only. 6,708 (14.6%) were eligible to submit sputum and 6,154/6,708 (91.7%) of them submitted at least one specimen for examination. MTB cases identified were 265/6,123 (4.3%). The estimated national adult prevalence of smear, culture and bacteriologically confirmed TB was 319/100,000 (232-406/100,000); 568/100,000 (440-697/100,000); and 638/100,000 (502-774/100,000) population, respectively. The risk of having TB was five times higher in the HIV positive than HIV negative individuals. The TB prevalence for all forms was estimated to be 455 /100,000 population for all age groups. Conclusion The prevalence of tuberculosis in Zambia was higher than previously estimated. Innovative approaches are required to accelerate the control of TB. PMID:26771588

  4. Remotely-sensed, nocturnal, dew point correlates with malaria transmission in Southern Province, Zambia: a time-series study

    PubMed Central

    2014-01-01

    Background Plasmodium falciparum transmission has decreased significantly in Zambia in the last decade. The malaria transmission is influenced by environmental variables. Incorporation of environmental variables in models of malaria transmission likely improves model fit and predicts probable trends in malaria disease. This work is based on the hypothesis that remotely-sensed environmental factors, including nocturnal dew point, are associated with malaria transmission and sustain foci of transmission during the low transmission season in the Southern Province of Zambia. Methods Thirty-eight rural health centres in Southern Province, Zambia were divided into three zones based on transmission patterns. Correlations between weekly malaria cases and remotely-sensed nocturnal dew point, nocturnal land surface temperature as well as vegetation indices and rainfall were evaluated in time-series analyses from 2012week 19 to 2013week 36. Zonal as well as clinic-based, multivariate, autoregressive, integrated, moving average (ARIMAX) models implementing environmental variables were developed to model transmission in 2011week 19 to 2012week 18 and forecast transmission in 2013week 37 to week 41. Results During the dry, low transmission season significantly higher vegetation indices, nocturnal land surface temperature and nocturnal dew point were associated with the areas of higher transmission. Environmental variables improved ARIMAX models. Dew point and normalized differentiated vegetation index were significant predictors and improved all zonal transmission models. In the high-transmission zone, this was also seen for land surface temperature. Clinic models were improved by adding dew point and land surface temperature as well as normalized differentiated vegetation index. The mean average error of prediction for ARIMAX models ranged from 0.7 to 33.5%. Forecasts of malaria incidence were valid for three out of five rural health centres; however, with poor results at the zonal level. Conclusions In this study, the fit of ARIMAX models improves when environmental variables are included. There is a significant association of remotely-sensed nocturnal dew point with malaria transmission. Interestingly, dew point might be one of the factors sustaining malaria transmission in areas of general aridity during the dry season. PMID:24927747

  5. The Impact of Key HIV Intervention Components as Predictors of Sexual Barrier Use: The Zambia Partner Project.

    PubMed

    Chitalu, Ndashi; Mumbi, Mirriam; Cook, Ryan; Weiss, Stephen M; Jones, Deborah

    2016-01-01

    Behavioral interventions have utilized a variety of strategies and components to reduce HIV risk. This article describes the partner intervention, a couple-based group HIV risk reduction intervention implemented in 6 urban community health clinics in Lusaka, Zambia, and examines the components of the intervention and their relationship with condom use. Couple members completed assessments on condom use, acceptability, willingness to use condoms, communication, intimate partner violence (IPV), self-efficacy, and HIV information at baseline and 6 months' follow-up. This study examined the relative impact of elements of the intervention as predictors of condom use. Changes in acceptability had the greatest overall influence on condom use, followed by social support, relationship consensus, and willingness to use condoms. Changes in self-efficacy, IPV, negotiation, and information had no influence. Results support the use of multidimensional approaches in behavioral interventions and highlight the importance of identifying critical elements of interventions to maximize risk reduction outcomes. PMID:24482105

  6. The Impact of Key HIV Intervention Components as Predictors of Sexual Barrier Use: The Zambia Partner Project

    PubMed Central

    Chitalu, Ndashi; Mumbi, Mirriam; Cook, Ryan; Weiss, Stephen M.; Jones, Deborah

    2016-01-01

    Behavioral interventions have utilized a variety of strategies and components to reduce HIV risk. This article describes the partner intervention, a couple-based group HIV risk reduction intervention implemented in 6 urban community health clinics in Lusaka, Zambia, and examines the components of the intervention and their relationship with condom use. Couple members completed assessments on condom use, acceptability, willingness to use condoms, communication, intimate partner violence (IPV), self-efficacy, and HIV information at baseline and 6 months' follow-up. This study examined the relative impact of elements of the intervention as predictors of condom use. Changes in acceptability had the greatest overall influence on condom use, followed by social support, relationship consensus, and willingness to use condoms. Changes in self-efficacy, IPV, negotiation, and information had no influence. Results support the use of multidimensional approaches in behavioral interventions and highlight the importance of identifying critical elements of interventions to maximize risk reduction outcomes. PMID:24482105

  7. Migration as an adaptive strategy to climate variability: a study of the Tonga-speaking people of Southern Zambia.

    PubMed

    Simatele, Danny; Simatele, Munacinga

    2015-10-01

    There is increasing consensus that the effects of extreme weather conditions in the form of drought, flooding and extreme temperature will have increasingly devastating impacts on those who depend on climate-sensitive resources and ecosystems for their livelihoods. The most affected will be the poor in developing countries who have a low adaptive capacity to climate change due to high poverty levels. Despite these projections, there are, to date, insufficient empirical studies linking the relationship between climate change and migration, particularly in the context of southern Africa. Using field-based data collected from two study locations in Zambia, this paper examines the complex relationship between extreme weather events and population movement. It is envisaged that the findings presented in this paper will contribute to current discussions on the complex relationship between extreme weather conditions and population movement specifically in the context of sub-Saharan Africa and other developing countries. PMID:25754466

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

    PubMed Central

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

    2011-01-01

    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. PMID:22391811

  9. A survey to assess the extent of public-private mix DOTS in the management of tuberculosis in Zambia

    PubMed Central

    Kapata, Nathan; Maboshe, Mwendaweli; Michelo, Charles; Babaniyi, Olusegun

    2015-01-01

    Background Involving all relevant healthcare providers in tuberculosis (TB) management through public-private mix (PPM) approaches is a vital element in the World Health Organization's (WHO) Stop TB Strategy. The control of TB in Zambia is mainly done in the public health sector, despite the high overall incidence rates. Aim We conducted a survey to determine the extent of private-sector capacity, participation, practices and adherence to national guidelines in the control of TB. Setting This survey was done in the year 2012 in 157 facilities in three provinces of Zambia where approximately 85% of the country's private health facilities are found. Methods We used a structured questionnaire to interview the heads of private health facilities to assess the participation of the private health sector in TB diagnosis, management and prevention activities. Results Out of 157 facilities surveyed, 40.5% were from the Copperbelt, 4.4% from Central province and 55.1% from Lusaka province. Only 23.8% of the facilities were able to provide full diagnosis and management of TB patients. Although 47.4% of the facilities reported that they do notify their cases to the National TB control programme, the majority (62.7%) of these facilities did not show evidence of notifications. Conclusion Our results show that the majority of the facilities that diagnose and manage TB in the private sector do not report their TB activities to the National TB Control Programme (NTP). There is a need for the NTP to improve collaboration with the private sector with respect to TB control activities and PPM for Directly Observed Treatment, Short Course (DOTS). PMID:26245591

  10. Human growth in southern Zambia: a first study of Tonga children predating the Kariba Dam (1957-1958).

    PubMed

    Gillet, Rhonda M; Tobias, Phillip V

    2002-01-01

    During the late 1950s the Kariba hydro-electric dam was constructed on the border of Zambia and Zimbabwe forcing the relocation of 57,000 people, mainly Tonga. As part of a larger study to assess the effects of the relocation, research into the human biology of the Tonga people was conducted. The research reported here provides a basis for comparison with long-term follow-up data on growth and physical status of Gwembe Tonga to determine the effects of resettlement. The sample consists of 303 schoolchildren, 7 to 13 years, from two schools that were not relocated and three schools that were to be relocated. Homogeneity of the two groups led us to combine them as a single baseline sample before relocation. Comparisons with NCHS (National Center for Health Statistics) reference data and with contemporary urban data from southern Zambia indicate sub-optimal nutritional status. After ages 6 and 7, height-for-age and weight-for-age Z-scores of boys decline steadily towards -2.0 SD throughout the 12th year, whereas mean Z-scores of girls decline markedly from 8 years on. Mean HAZ (Height-for-age-Z-score) of girls falls below -2.0 SD by 11 years and approaches -3.0 SD by 13 years. Thirty-nine percent of males and 47% of females in the baseline sample showed effects of moderate or severe protein energy malnutrition at the time of relocation. Because these children were from a school sample, gender differences in opportunity to attend school may be a factor in what appears to be gender bias, favoring the status of boys. This sample provides a baseline for assessing the long-term impact of forced relocation on the Gwembe Tonga. PMID:11911454

  11. Effect of Seasonal Variation on Adult Clinical Laboratory Parameters in Rwanda, Zambia, and Uganda: Implications for HIV Biomedical Prevention Trials

    PubMed Central

    Ruzagira, Eugene; Abaasa, Andrew; Karita, Etienne; Mulenga, Joseph; Kilembe, William; Allen, Susan; Bahemuka, Ubaldo; Bwanika, Agnes N.; Levin, Jonathan; Price, Matthew A.; Kamali, Anatoli

    2014-01-01

    Objectives To investigate the effect of seasonal variation on adult clinical laboratory parameters in Rwanda, Zambia, and Uganda and determine its implications for HIV prevention and other clinical trials. Methods Volunteers in a cross-sectional study to establish laboratory reference intervals were asked to return for a seasonal visit after the local season had changed from dry to rainy or vice versa. Volunteers had to be clinically healthy, not pregnant and negative for HIV, Hepatitis B and C, and syphilis infection at both visits. At each visit, blood was taken for measurement of hemoglobin, haematocrit, mean corpuscular volume, red blood cells, platelets, total white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils, basophils, CD4/CD8 T cells, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, direct bilirubin, total bilirubin, total immunoglobulin gamma, total protein, creatinine, total amylase, creatine phosphokinase and lactate dehydrogenase (LDH). Consensus dry season reference intervals were applied to rainy season values (and vice versa) and the proportion of out-of-range values determined. Percentage differences between dry and rainy season parameter mean values were estimated. Results In this cohort of 903 volunteers, less than 10.0% of consensus parameter (except LDH) values in one season were out-of-range in the other. Twenty-two (22) percent of rainy season LDH values fell outside of the consensus dry season interval with the higher values observed in the rainy season. Variability between consensus seasonal means ranged from 0.0% (total WBC, neutrophils, monocytes, basophils, and direct bilirubin) to 40.0% (eosinophils). Within sites, the largest seasonal variations were observed for monocytes (Masaka, 11.5%), LDH (Lusaka, 21.7%), and basophils (Kigali, 22.2%). Conclusions Seasonality had minimal impact on adult clinical laboratory parameter values in Rwanda, Zambia, and Uganda. Seasonal variation may not be an important factor in the evaluation of adult clinical laboratory parameters in HIV prevention and other clinical trials in these countries. PMID:25118593

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

    PubMed Central

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

    2011-01-01

    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

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

    PubMed

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

    2011-10-01

    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

  14. Progress made towards enhancement of rheumatology education and practice in Zambia: review of an ILAR-supported project.

    PubMed

    Chipeta, James; Njobvu, Panganani; McGill, Paul E; Bucala, Richard

    2014-01-01

    The burden of non-communicable diseases such as musculoskeletal diseases in the developing world is often overshadowed by the more prevalent infectious diseases. Generally, there is gross underestimation of the burden of rheumatologic disease in the backdrop of scanty or indeed non-existent rheumatology services in these countries. Local studies conducted in the last two decades in Zambia have documented the increasing burden of rheumatologic conditions in the country. There are unfortunately negligible rheumatology services in the country both at tertiary or primary health-care facility levels. There is thus an urgent need to build capacity for these services so as to improve the care and management of rheumatic conditions. Here, we review progress made by an International League of Associations for Rheumatology (ILAR)-supported project that has run for the past 2 years (2012-2013) with the objective of enhancing paediatric and adult rheumatology education and practice so as to stimulate positive change in practice and related care services in Zambia. During this short time of the project, substantial progress has been made in the areas of paediatric and adult rheumatology services enhancement at the University Teaching Hospital, Lusaka: streamlining of referrals and follow-ups of rheumatology patients, laying foundations for short- and long-term medical education in rheumatology and raising public awareness of rheumatic diseases. The progress made by this grant underscores the suitability of the ILAR mission statement "think global, act local" demonstrating that even with minimum resources and networking, improvement of rheumatology care in developing countries is attainable. PMID:24752350

  15. A survey of pre-harvest ear rot diseases of maize and associated mycotoxins in south and central Zambia.

    PubMed

    Mukanga, Mweshi; Derera, John; Tongoona, Pangirayi; Laing, Mark D

    2010-07-15

    Maize ear rots reduce grain yield and quality with implication on food security and health. Some of the pathogenic fungi produce mycotoxins in maize grain posing a health risk to humans and livestock. Unfortunately, the levels of ear rot and mycotoxin infection in grain produced by subsistence farmers in sub-Saharan countries are not known. A survey was thus conducted to determine the prevalence of the ear rot problem and levels of mycotoxins in maize grain. A total of 114 farmsteads were randomly sampled from 11 districts in Lusaka and southern provinces in Zambia during 2006. Ten randomly picked cobs were examined per farmstead and the ear rot disease incidence and severity were estimated on site. This was followed by the standard seed health testing procedures for fungal isolation in the laboratory. Results indicated that the dominant ear rots were caused by Fusarium and Stenocarpella. Incidence of Fusarium verticillioides ranged from 2 to 21%, whereas that of Stenocarpella maydis reached 37% on ear rot diseased maize grain. In addition, 2-7% F. verticillioides, and 3-18% Aspergillus flavus, respectively, were recovered from seemingly healthy maize grain. The mean rank of fungal species, from highest to lowest, was F. verticillioides, S. maydis, A. flavus, Fusarium graminearum, Aspergillus niger, Penicillium spp., Botrydiplodia spp., and Cladosporium spp. The direct competitive ELISA-test indicated higher levels of fumonisins than aflatoxins in pre-harvest maize grain samples. The concentration of fumonisins from six districts, and aflatoxin from two districts, was 10-fold higher than 2 ppm and far higher than 2 ppb maximum daily intake recommended by the FAO/WHO. The study therefore suggested that subsistence farmers and consumers in this part of Zambia, and maybe also in similar environments in sub-Saharan Africa, might be exposed to dangerous levels of mycotoxins due to the high levels of ear rot infections in maize grain. PMID:20626099

  16. Defining the malaria burden in Nchelenge District, northern Zambia using the World Health Organization malaria indicators survey

    PubMed Central

    2014-01-01

    Background Malaria is considered as one of the major public health problems and among the diseases of poverty. In areas of stable and relatively high transmission, pregnant women and their newborn babies are among the higher risk groups. A multicentre trial on the safety and efficacy of several formulations of artemisinin-based combination therapy (ACT) during pregnancy is currently on-going in four African countries, including Zambia, whose study site is in Nchelenge district. As the study outcomes may be influenced by the local malaria endemicity, this needs to be characterized. A cross-sectional survey to determine the prevalence and intensity of infection among <10years old was carried out in March-April 2012 in Nchelenge district. Methods The sampling unit was the household where all children?Zambia, despite the reported decline in malaria burden, pockets of high malaria endemicity, such as Nchelenge district, still remain. This is a border area and significant progress can be achieved only by concerted efforts aimed at increasing coverage of current control interventions across the border. PMID:24902708

  17. Local Perceptions, Cultural Beliefs and Practices That Shape Umbilical Cord Care: A Qualitative Study in Southern Province, Zambia

    PubMed Central

    Herlihy, Julie M.; Shaikh, Affan; Mazimba, Arthur; Gagne, Natalie; Grogan, Caroline; Mpamba, Chipo; Sooli, Bernadine; Simamvwa, Grace; Mabeta, Catherine; Shankoti, Peggy; Messersmith, Lisa; Semrau, Katherine; Hamer, Davidson H.

    2013-01-01

    Background Global policy regarding optimal umbilical cord care to prevent neonatal illness is an active discussion among researchers and policy makers. In preparation for a large cluster-randomized control trial to measure the impact of 4% chlorhexidine as an umbilical wash versus dry cord care on neonatal mortality in Southern Province, Zambia, we performed a qualitative study to determine local perceptions of cord health and illness and the cultural belief system that shapes umbilical cord care knowledge, attitudes, and practices. Methods and Findings This study consisted of 36 focus group discussions with breastfeeding mothers, grandmothers, and traditional birth attendants, and 42 in-depth interviews with key community informants. Semi-structured field guides were used to lead discussions and interviews at urban and rural sites. A wide variation in knowledge, beliefs, and practices surrounding cord care was discovered. For home deliveries, cords were cut with non-sterile razor blades or local grass. Cord applications included drying agents (e.g., charcoal, baby powder, dust), lubricating agents (e.g., Vaseline, cooking oil, used motor oil) and agents intended for medicinal/protective purposes (e.g., breast milk, cow dung, chicken feces). Concerns regarding the length of time until cord detachment were universally expressed. Blood clots in the umbilical cord, bulongo-longo, were perceived to foreshadow neonatal illness. Management of bulongo-longo or infected umbilical cords included multiple traditional remedies and treatment at government health centers. Conclusion Umbilical cord care practices and beliefs were diverse. Dry cord care, as recommended by the World Health Organization at the time of the study, is not widely practiced in Southern Province, Zambia. A cultural health systems model that depicts all stakeholders is proposed as an approach for policy makers and program implementers to work synergistically with existing cultural beliefs and practices in order to maximize effectiveness of evidence-based interventions. PMID:24244447

  18. `WORSE THAN HIV' OR `NOT AS SERIOUS AS OTHER DISEASES'? CONCEPTUALIZATION OF CERVICAL CANCER AMONG NEWLY SCREENED WOMEN IN ZAMBIA

    PubMed Central

    White, Heather L.; Mulambia, Chishimba; Sinkala, Moses; Mwanahamuntu, Mulindi H.; Parham, Groesbeck P.; Moneyham, Linda; Grimley, Diane M.; Chamot, Eric

    2012-01-01

    Invasive cervical cancer is the second most common cancer among women worldwide, with approximately 85% of the disease burden occurring in developing countries. To date, there have been few systematic efforts to document African women's conceptualization of cervical cancer after participation in a visual inspection with acetic acid (VIA)-based see and treat cervical cancer prevention program. In this study, conducted between September, 2009-July, 2010, focus groups and in-depth interviews were conducted with 60 women who had recently undergone cervical cancer screening at a government-operated primary health care clinic in Lusaka, Zambia. Interviewers elicited participants' causal representations of cervical cancer, associated physical signs and symptoms, perceived physical and psychological effects, and social norms regarding the disease. The lay model of illness causation portrayed by participants after recent exposure to program promotion messages departed in several ways from causal models described in other parts of the world. However, causal conceptualizations included both lay and biomedical elements, suggesting a possible shift from a purely traditional causal model to one that incorporates both traditional concepts and recently promoted biomedical concepts. Most, but not all, women still equated cervical cancer with death, and perceived it to be a highly stigmatized disease in Zambia because of its anatomic location, dire natural course, connections to socially-condemned behaviors, and association with HIV/AIDS. No substantive differences of disease conceptualization existed according to HIV serostatus, though HIV positive women acknowledged that their immune status makes them more aware of their health and more likely to seek medical attention. Further attention should be dedicated to the processes by which women incorporate new knowledge into their representations of cervical cancer. PMID:22459188

  19. Movement Behaviour of Traditionally Managed Cattle in the Eastern Province of Zambia Captured Using Two-Dimensional Motion Sensors

    PubMed Central

    Lubaba, Caesar H.; Hidano, Arata; Welburn, Susan C.; Revie, Crawford W.; Eisler, Mark C.

    2015-01-01

    Two-dimensional motion sensors use electronic accelerometers to record the lying, standing and walking activity of cattle. Movement behaviour data collected automatically using these sensors over prolonged periods of time could be of use to stakeholders making management and disease control decisions in rural sub-Saharan Africa leading to potential improvements in animal health and production. Motion sensors were used in this study with the aim of monitoring and quantifying the movement behaviour of traditionally managed Angoni cattle in Petauke District in the Eastern Province of Zambia. This study was designed to assess whether motion sensors were suitable for use on traditionally managed cattle in two veterinary camps in Petauke District in the Eastern Province of Zambia. In each veterinary camp, twenty cattle were selected for study. Each animal had a motion sensor placed on its hind leg to continuously measure and record its movement behaviour over a two week period. Analysing the sensor data using principal components analysis (PCA) revealed that the majority of variability in behaviour among studied cattle could be attributed to their behaviour at night and in the morning. The behaviour at night was markedly different between veterinary camps; while differences in the morning appeared to reflect varying behaviour across all animals. The study results validate the use of such motion sensors in the chosen setting and highlight the importance of appropriate data summarisation techniques to adequately describe and compare animal movement behaviours if association to other factors, such as location, breed or health status are to be assessed. PMID:26366728

  20. Topotaxial reactions during the genesis of oriented rutile/hematite intergrowths from Mwinilunga (Zambia)

    NASA Astrophysics Data System (ADS)

    Re?nik, Aleksander; Stankovi?, Nadeda; Daneu, Nina

    2015-02-01

    Oriented rutile/hematite intergrowths from Mwinilunga in Zambia were investigated by electron microscopy methods in order to resolve the complex sequence of topotaxial reactions. The specimens are composed of up to several-centimeter-large euhedral hematite crystals covered by epitaxially grown reticulated rutile networks. Following a top-down analytical approach, the samples were studied from their macroscopic crystallographic features down to subnanometer-scale analysis of phase compositions and occurring interfaces. Already, a simple morphological analysis indicates that rutile and hematite are met near the orientation relationship. However, a more detailed structural analysis of rutile/hematite interfaces using electron diffraction and high-resolution transmission electron microscopy (HRTEM) has shown that the actual relationship between the rutile and hosting hematite is in fact . The intergrowth is dictated by the formation of equilibrium interfaces leading to 12 possible directions of rutile exsolution within a hematite matrix and 144 different incidences between the intergrown rutile crystals. Analyzing the potential rutile-rutile interfaces, these could be classified into four classes: (1) non-crystallographic contacts at 60 and 120, (2) {101} twins with incidence angles of 114.44 and their complementaries at 65.56, (3) {301} twins at 54.44 with complementaries at 125.56 and (4) low-angle tilt boundaries at 174.44 and 5.56. Except for non-crystallographic contacts, all other rutile-rutile interfaces were confirmed in Mwinilunga samples. Using a HRTEM and high-angle annular dark-field scanning TEM methods combined with energy-dispersive X-ray spectroscopy, we identified remnants of ilmenite lamellae in the vicinity of rutile exsolutions, which were an important indication of the high-T formation of the primary ferrian-ilmenite crystals. Another type of exsolution process was observed in rutile crystals, where hematite precipitates topotaxially exsolved from Fe-rich parts of rutile through intermediate Guinier-Preston zones, characterized by tripling the {101} rutile reflections. Unlike rutile exsolutions in hematite, hematite exsolutions in rutile form equilibrium interfaces. The overall composition of our samples indicates that the ratio between ilmenite and hematite in parent ferrian-ilmenite crystals was close to Ilm67Hem33, typical for Fe-Ti-rich differentiates of mafic magma. The presence of ilmenite lamellae indicates that the primary solid solution passed the miscibility gap at 900 C. Subsequent exsolution processes were triggered by surface oxidation of ferrous iron and remobilization of cations within the common oxygen sublattice. Based on nanostructural analysis of the samples, we identified three successive exsolution processes: (1) exsolution of ilmenite lamellae from the primary ferrian-ilmenite crystals, (2) exsolution of rutile lamellae from ilmenite and (3) exsolution of hematite precipitates from Fe-rich rutile lamellae. All observed topotaxial reactions appear to be a combined function of temperature and oxygen fugacity, fO2.

  1. The carbonate-hosted willemite prospects of the Zambezi Metamorphic Belt (Zambia)

    NASA Astrophysics Data System (ADS)

    Boni, Maria; Terracciano, Rosario; Balassone, Giuseppina; Gleeson, Sarah A.; Matthews, Alexander

    2011-10-01

    Zambian willemite (Zn2SiO4) deposits occur in the metasedimentary carbonate rocks of the Proterozoic Katangan Supergroup. The most important orebodies are located around Kabwe and contain both sulphides and willemite in dolomites of low metamorphic grade. The Star Zinc and Excelsior prospects (Lusaka area), discovered in the early 1920s, occur in the metamorphic lithotypes of the late Proterozoic Zambezi Supracrustal sequence, which were deposited in a transtensional basin formed during the oblique collision of the Kalahari and Congo cratons. The deposits are hosted by the limestone and dolomitic marbles of the Cheta and Lusaka Formations. Structural analysis indicates that several fracture sets host the deposits, which may be genetically related to the Pan-African Mwembeshi dislocation zone (a major geotectonic boundary between the Lufilian Arc and the Zambezi Belt). In both prospects, willemite replaces the marbles and is found along joints and fissures with open-space filling textures and locally may develop colloform and vuggy fabrics as well. Silver as well as traces of germanium and cadmium have been detected within the willemite ore, and lead or zinc sulphides are scarce or absent. Calcite locally replaces willemite. Willemite is associated with specular hematite and franklinite and post-dates the Zn-spinel gahnite in the paragenesis. Genthelvite [Zn4Be3(SiO4)3S] occurs as a minor phase in irregular aggregates. The willemites from the Lusaka area, though Mn-poor, show green cathodoluminescence colours and bright green fluorescence in short-wave UV (as the high-temperature willemites in USA). Thermometric analyses of primary fluid inclusions in willemite yield homogenization temperatures that range from 160C to 240C and salinities of 8-16 wt.% equiv. NaCl. The homogenization temperatures suggest a hypogene-hydrothermal origin for the willemite concentrations. The geochemistry of fluid inclusion leachates suggests that the hydrothermal fluids were brines derived from highly evaporated seawater. Precise age constraints are currently lacking for the Lusaka area deposits, though the deposits are not deformed, indicating that they post-date the Lufilian orogeny (~520 Ma). The possibility of precursor ores exists; the gahnite-franklinite-willemite deposits could have been derived from a metamorphosed primary sulphide (or even nonsulphide) concentration that has subsequently been completely destroyed. However, there is no real evidence of such a primary source for the willemite mineral association. The Lusaka zinc ores may have been produced by an extensive hydrothermal system, with fluids discharging along basinal fracture zones controlled by the pre-Pan-African rifting stage. A paragenesis similar to that of the Lusaka prospects has been proposed to be a vector towards massive sulphide ores in several parts of the world; therefore, it is possible that these small willemite showings in Zambia may be part of a much bigger, and still unexplored, zinc province.

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

    PubMed

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

    2013-07-01

    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

  3. Prevalence and characterization of Staphylococcus aureus and Staphylococcus pseudintermedius isolated from companion animals and environment in the veterinary teaching hospital in Zambia, Africa.

    PubMed

    Youn, Jung-Ho; Park, Yong Ho; Hang'ombe, Bernard; Sugimoto, Chihiro

    2014-03-01

    The Republic of Zambia consists of only one veterinary teaching school at the University of Zambia (UNZA) where students and veterinarians are exposed to many bacterial pathogens including Staphylococcus aureus (SA) and Staphylococcus pseudintermedius (SP). The aim of this study was the characterization and antimicrobial susceptibility profile of eleven SA and 48 SP isolates from the veterinary hospitals' in- and outpatients and the environment. No isolate was resistant to cefoxitin by disk diffusion test and the corresponding resistance gene mecA was not found. In contrast, the resistance rates of SA to penicillin (63.6%) and trimethoprim-sulfamethoxazole (36.4%) and SP to penicillin (52.1%) and tetracycline (25.0%) were the highest. A variety of sequence types (STs) without a predominant type including numerous novel types were determined, especially for SP (39.6%). The spa typing provided a clonal assignment for all SAs (100%) and 24 SPs (50%) with three and two novel types, respectively. This study has provided an overview of SA and SP in the veterinary teaching hospital at UNZA. However, for a better understanding of these species regarding pathogenesis and transmission, further studies on the prevalence and characterization of SA and SP from veterinary staff, pet owners, and farm animals in Zambia is needed. PMID:24480623

  4. Increased fairness in priority setting processes within the health sector: the case of Kapiri-Mposhi District, Zambia

    PubMed Central

    2014-01-01

    Background The challenge of priority setting (PS) in health care within contexts of severe resource limitations has continued to receive attention. Accountability for Reasonableness (AFR) has emerged as a useful framework to guide the implementation of PS processes. In 2006, the AFR approach to enhance legitimate and fair PS was introduced by researchers and decision makers within the health sector in the EU funded research project entitled Response to Accountable priority setting for Trust in health systems (REACT). The project aimed to strengthen fairness and accountability in the PS processes of health systems at district level in Zambia, Tanzania and Kenya. This paper focuses on local perceptions and practices of fair PS (baseline study) as well as at the evolution of such perceptions and practices in PS following an AFR based intervention (evaluation study), carried out at district level in Kapiri-Mposhi District in Zambia. Methods Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district administration, in non-governmental organizations (NGO) and in health facilities. Results During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing in the study district, which was partly attributed to the AFR based intervention. Conclusions The study findings suggest that increased attention was given to fairness in PS processes at district level. The changes were linked to a number of simultaneous factors among them the concepts introduced by the present project with its emphasis on fairness and enhanced participation. A responsive leadership that was increasingly accountable to its operational staff and communities emerged as one of the key elements in driving the processes forward. PMID:24548767

  5. Simplified Severe Sepsis Protocol: A Randomized Controlled Trial of Modified Early Goal-Directed Therapy in Zambia

    PubMed Central

    Andrews, Ben; Muchemwa, Levy; Kelly, Paul; Lakhi, Shabir; Heimburger, Douglas C; Bernard, Gordon R.

    2014-01-01

    Objective To assess the efficacy of a simple, goal-directed sepsis treatment protocol for reducing mortality in patients with severe sepsis in Zambia. Design Single center non-blinded randomized controlled trial Setting Emergency room, ICU, and medical wards of the national referral hospital in Lusaka, Zambia Patients 112 patients enrolled within 24 hours of admission with severe sepsis, defined as systemic inflammatory response syndrome with suspected infection and organ dysfunction Interventions Simplified Severe Sepsis Protocol (SSSP) consisting of up to 4 liters of intravenous fluids within 6 hours, guided by jugular venous pressure assessment, and dopamine and/or blood transfusion in selected patients. Control group was managed as usual care. Blood cultures were collected and early antibiotics administered for both arms. Measurements and Main Results Primary outcome was in-hospital all-cause mortality. 109 patients were included in the final analysis. 88 (80.7%) were HIV positive. Pulmonary infections were the most common source of sepsis. In-hospital mortality rate was 64.2% in the intervention group and 60.7% in the control group (RR 1.05, 95%CI:0.79-1.41). Mycobacterium tuberculosis complex was isolated from 31 of 82 (37.8%) HIV positive patients with available mycobacterial blood culture results. SSSP patients received significantly more IV fluids in the first 6 hours (2.7 liters vs. 1.7 liters, p=0.002). The study was stopped early because of high mortality rate among patients with hypoxemic respiratory failure in the intervention arm (8/8, 100%) compared with the control arm [7/10, 70%, RR 1.43 (95%CI:0.95-2.14)]. Conclusion Factors other than tissue hypoperfusion probably account for much of the end organ dysfunction in African patients with severe sepsis. Studies of fluid-based interventions should utilize inclusion criteria to accurately capture patients with hypovolemia and tissue hypoperfusion who are most likely to benefit from fluids. Exclusion of patients with severe respiratory distress should be considered when ventilator support is not readily available. PMID:25072757

  6. Adherence to the Food and Agricultural Organization guidelines on trypanocide usage among cattle farmers in Itezhi tezhi, Central Zambia.

    PubMed

    Mbewe, Njelembo J; Sitali, Lungowe; Namangala, Boniface; Michelo, Charles

    2015-04-15

    Trypanocides will continue to play an important role in the control of tsetse fly transmitted trypanosomosis now and in the near future. The drugs are mostly administered by farmers without any veterinary supervision leading to misuse and under dosing of medication, and these could be factors that promote trypanocidal drug resistance (TDR) development. In order to delay or prevent TDR, the Food and Agriculture Organization (FAO) recommended guidelines on trypanocide use. It is not known if these recommended guidelines are adhered to in Itezhi tezhi district of Zambia. A survey was undertaken to examine how socio-economic and environmental factors were associated with adherence to the recommended guidelines on trypanocide use in Itezhi tezhi, Central Zambia. Ninety farmers who use trypanocides were interviewed using a questionnaire to collect their socio-economic characteristics (age, education in years, cattle herd size, competence on trypanocide use and their access to extension on trypanocide use) and trypanocide usage practices while crush pens which they use were stratified according to location, whether in the Game Management Area (GMA) (Mutenda, Itumbi, Kapulwe and Banachoongo) or non-GMA (Iyanda, New Ngoma and Shinampamba) as an environmental factor. Associations and measures of associations to adherence of FAO guidelines were determined. The results showed that 25.6% of the farmers adhered to guidelines by FAO on trypanocide use and that none of the socio-economic factors under investigation were significantly associated with it. Further the farmers that used crush pens that were in the GMA had an 80% reduction in the likelihood of adhering to the FAO guidelines on trypanocide use than those that used crush pens in the non-GMA (AOR 0.20, 95% CI: 0.05-0.81, P=0.02). There was low adherence to the recommended FAO guidelines on trypanocide use and it was associated with the location of the crush pen whether in the GMA or not, as an environmental factor. With farmers in the GMA less likely to adhere to FAO guidelines than those in the non-GMA, we recommend an integrated approach of measures to control trypanosomosis in the GMA of Itezhi tezhi to lessen overuse of trypanocides by the farmers. PMID:25740569

  7. The impact of consumer awareness of water sector issues on willingness to pay and cost recovery in Zambia

    NASA Astrophysics Data System (ADS)

    Ntengwe, F. W.

    The recovery of costs in water utilities is a key element in sustainability of both the provider and of the water resource itself. This paper examines the role played by consumer awareness in their willingness to pay for water supply in two cities in Zambia. Research conducted in Kitwe and Lusaka reveals that level of awareness, willingness to pay and cost recovery all vary directly. Whereas awareness may increase consumers willingness to pay, therefore assisting service providers cost recovery, the research presented here also reveals that factors such as ability to pay, affordability of bills, quality of water and of the service provided, as well as good business-consumer relations are important factors affecting a utilitys ability to recover its costs. If water utilities are to attain sustainability over the long-term, they will have to embark on and maintain consumer awareness programmes, raise the quality of service (e.g., through improved operation and maintenance), and develop and apply the right water tariff.

  8. 'Big push' to reduce maternal mortality in Uganda and Zambia enhanced health systems but lacked a sustainability plan.

    PubMed

    Kruk, Margaret E; Rabkin, Miriam; Grépin, Karen Ann; Austin-Evelyn, Katherine; Greeson, Dana; Masvawure, Tsitsi Beatrice; Sacks, Emma Rose; Vail, Daniel; Galea, Sandro

    2014-06-01

    In the past decade, "big push" global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts in Uganda and Zambia. We evaluated the first six to twelve months of the program's implementation, its ownership by national ministries of health, and its effects on health systems. The project's impact on maternal mortality is not reported here. We found that the Saving Mothers, Giving Life initiative delivered a large "dose" of intervention quickly by capitalizing on existing US international health assistance platforms, such as the President's Emergency Plan for AIDS Relief. Early benefits to the broader health system included greater policy attention to maternal and child health, new health care infrastructure, and new models for collaborating with the private sector and communities. However, the rapid pace, external design, and lack of a long-term financing plan hindered integration into the health system and local ownership. Sustaining and scaling up early gains of similar big push initiatives requires longer-term commitments and a clear plan for transition to national control. PMID:24889956

  9. Analysis of the study skills of undergraduate pharmacy students of the University of Zambia School of Medicine

    PubMed Central

    Ezeala, Christian Chinyere; Siyanga, Nalucha

    2015-01-01

    It aimed to compare the study skills of two groups of undergraduate pharmacy students in the School of Medicine, University of Zambia using the Study Skills Assessment Questionnaire (SSAQ), with the goal of analysing students study skills and identifying factors that affect study skills. A questionnaire was distributed to 67 participants from both programs using stratified random sampling. Completed questionnaires were rated according to participants study skill. The total scores and scores within subscales were analysed and compared quantitatively. Questionnaires were distributed to 37 students in the regular program, and to 30 students in the parallel program. The response rate was 100%. Students had moderate to good study skills: 22 respondents (32.8%) showed good study skills, while 45 respondents (67.2%) were found to have moderate study skills. Students in the parallel program demonstrated significantly better study skills (mean SSAQ score, 185.414.5), particularly in time management and writing, than the students in the regular program (mean SSAQ score 17525.4; P<0.05). No significant differences were found according to age, gender, residential or marital status, or level of study. The students in the parallel program had better time management and writing skills, probably due to their prior work experience. The more intensive training to students in regular program is needed in improving time management and writing skills. PMID:26442716

  10. The impact of the global economic crisis on HIV and AIDS programmes directed at women and children in Zambia.

    PubMed

    Serieux, John; Njelesani, Mwansa; Chompolola, Abson; Sepehri, Ardeshir; Guliani, Harminder

    2015-01-01

    This investigation sought to ascertain the extent to which the global economic crisis of 2008-2009 affected the delivery of HIV/AIDS-related services directed at pregnant and lactating mothers, children living with HIV and children orphaned through HIV in Zambia. Using a combined macroeconomic analysis and a multiple case study approach, the authors found that from mid-2008 to mid-2009 the Zambian economy was indeed buffeted by the global economic crisis. During that period the case study subjects experienced challenges with respect to the funding, delivery and effectiveness of services that were clearly attributable, directly or indirectly, to the global economic crisis. The source of funding most often compromised was external private flows. The services most often compromised were non-medical services (such as the delivery of assistance to orphans and counselling to HIV-positive mothers) while the more strictly medical services (such as antiretroviral therapy) were protected from funding cuts and service interruptions. Impairments to service effectiveness were experienced relatively equally by (HIV-positive) pregnant women and lactating mothers and children orphaned through HIV. Children living with AIDS were least affected because of the primacy of ARV therapy in their care. PMID:26223326

  11. The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

    PubMed Central

    Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D.; Garcia, Patricia J.; Bronzan, Rachel; Gill, Michelle M.; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W.; Newman, Lori

    2015-01-01

    Objective Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Methods Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Results Although this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. Conclusion This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. PMID:25963907

  12. To What did They Consent? Understanding Consent Among Low Literacy Participants in a Microbicide Feasibility Study in Mazabuka, Zambia.

    PubMed

    Munalula-Nkandu, Esther; Ndebele, Paul; Siziya, Seter; Munthali, J C

    2015-12-01

    We conducted a study to review the consenting process in a vaginal Microbicide feasibility study conducted in Mazabuka, Zambia. Participants were drawn from those participating in the microbicide study. A questionnaire and focus group discussion were used to collect information on participants understanding of study aims, risks and benefits. Altogether, 200 participants took part in this study. The results of the study showed that while all participants signed or endorsed their thumbprints to the consent forms, full informed consent was not attained from most of the participants since 77% (n?=?154) of the participants had numerous questions about the study and 34% (n?=?68) did not know who to get in touch with concerning the study. Study objectives were not fully understood by over 61% of the participants. Sixty four percent of the participants were not sure of the risks of taking part in the microbicide study. A significant number thought the study was all about determining their HIV status. Some participants were concerned that their partners were not on the trial as they were convinced that being on the study meant that that they had a lifetime protection from HIV infection. The process of obtaining consent was inadequate as various phases of the study were not fully understood. We recommend the need for researchers to reinforce the consenting process in all studies and more so when studies are conducted in low literacy populations. PMID:25132499

  13. Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia

    PubMed Central

    Michelo, Charles; Mudenda, Boyd; Manankov, Alexey

    2016-01-01

    Background. The control of diabetes mellitus depends on several factors that also include individual lifestyles. We assessed glycaemic control status and self-management behaviours that may influence glycaemic control among diabetic outpatients. Methods. This cross-sectional study among 198 consenting randomly selected patients was conducted at the University Teaching Hospital diabetic clinic between September and December 2013 in Lusaka, Zambia. A structured interview schedule was used to collect data on demographic characteristics, self-management behaviours, and laboratory measurements. Binary logistic regression analysis using IBM SPSS for Windows version 20.0 was carried out to predict behaviours that were associated with glycaemic control status. Results. The proportion of patients that had good glycaemic control status (HbA1c≤ 48 mmol/mol) was 38.7% compared to 61.3% that had poor glycaemic control status (HbA1c≥ 49 mmol/mol). Adherence to antidiabetic treatment and fasting plasma glucose predicted glycaemic control status of the patients. However, self-blood glucose monitoring, self-blood glucose monitoring means and exercise did not predict glycaemic control status of the patients.  Conclusion. We find evidence of poor glycaemic control status among most diabetic patients suggesting that health promotion messages need to take into account both individual and community factors to promote behaviours likely to reduce nonadherence. PMID:26798654

  14. Urban and Rural Ozone Pollution Over Lusaka (Zambia, 15.5S, 25E) During SAFARI-2000 (September 2000)

    NASA Technical Reports Server (NTRS)

    Thompson, Anne M.; Herman, J. R.; Witte, J. C.; Phahlane, A.; Coetzee, G. J. R.; Mukula, C.; Hudson, R. D.; Frolov, A. D.; Bhartia, P. K. (Technical Monitor)

    2001-01-01

    In early September, throughout south central Africa, seasonal clearing of dry vegetation and the production of charcoal for cooking leads to intense smoke haze and ozone formation. Ozone soundings made over Lusaka during a six-day period in early September 2000 recorded layers of high ozone (greater than 125 ppbv at 5 km) during two stagnant periods, interspersed by a frontal passage that reduced boundary layer ozone by 30 percent. Smoke aerosol column variations aloft and total ozone were monitored by a sun photometer. During the 6-day measurement period, surface ozone concentrations ranged from 50-95 ppbv and integrated tropospheric ozone from the soundings was 39- 54 Dobson Units (note 1.3 km elevation at the launch site). High ozone concentrations above the mixed and inversion layers were advected from rural burning regions in western Zambia where SAFARI aircraft and ground-based instruments observed intense biomass fires and elevated aerosol and trace gas amounts. TOMS tropospheric ozone and smoke aerosols products show the distribution of biomass burning and associated pollution throughout southern Africa in September 2000. Animations of satellite images and trajectories confirm pollutant recirculation over south central African fires, exit of ozone from Mozambique and Tanzania to the Indian Ocean and the characteristic buildup of tropospheric ozone over the Atlantic from western African outflow.

  15. The impact of a short depression and anxiety screening tool in epilepsy care in primary health care settings in Zambia.

    PubMed

    Mbewe, Edward K; Uys, Leana R; Birbeck, Gretchen L

    2013-11-01

    Up to 60% of the 50 million persons with epilepsy (PWE) worldwide have depression and anxiety and 80% of PWE live in low-income regions. Common psychiatric comorbidities are often unrecognized and undertreated. We developed and validated a 10-item screening tool for the detection of depression and anxiety at primary healthcare clinics in Zambia in which the baseline detection rate among PWE was 1%. We trained primary care clinic workers in selected clinics to use this screening tool. A retrospective chart review was conducted for 120 consecutive PWE who received care one month after training. Detection improved from 1% to 49%, and treatment was frequently initiated. Of the 120 screened, 59 (49.2%) scored above cutoff point of 18. Of these persons, 43 (73.0%) were positive for depression, 16 (23.0%) were positive for anxiety, 38 (64.4%) received counseling, 18 (30.5%) received antidepressants, and 3 (5.1%) were referred to a psychiatrist. Use of this screening tool resulted in improved mental health care for PWE. PMID:24062482

  16. Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia: A Novel Context for Refeeding Syndrome?

    PubMed Central

    Koethe, John R.; Blevins, Meridith; Nyirenda, Christopher K.; Kabagambe, Edmond K.; Chiasera, Janelle M.; Shepherd, Bryan E.; Zulu, Isaac; Heimburger, Douglas C.

    2013-01-01

    Background. Low body mass index (BMI) at antiretroviral therapy (ART) initiation is associated with early mortality, but the etiology is not well understood. We hypothesized that low pretreatment serum phosphate, a critical cellular metabolism intermediate primarily stored in skeletal muscle, may predict mortality within the first 12 weeks of ART. Methods. We prospectively studied 352 HIV-infected adults initiating ART in Lusaka, Zambia to estimate the odds of death for each 0.1?mmol/L decrease in baseline phosphate after adjusting for established predictors of mortality. Results. The distribution of phosphate values was similar across BMI categories (median value 1.2?mmol/L). Among the 145 participants with BMI <18.5?kg/m2, 28 (19%) died within 12 weeks. Lower pretreatment serum phosphate was associated with increased mortality (odds ratio (OR) 1.24 per 0.1?mmol/L decrement, 95% CI: 1.05 to 1.47; P = 0.01) after adjusting for sex, age, and CD4+ lymphocyte count. A similar relationship was not observed among participants with BMI ?18.5?kg/m2 (OR 0.96, 95% CI: 0.76 to 1.21; P = 0.74). Conclusions. The association of low pretreatment serum phosphate level and early ART mortality among undernourished individuals may represent a variant of the refeeding syndrome. Further studies of cellular metabolism in this population are needed. PMID:23691292

  17. Comparison of Surface and Satellite Derived Aerosol Optical Depth (AOD) Measurements in Finland, Estonia, Zambia and Brazil

    NASA Astrophysics Data System (ADS)

    Mielonen, T.; Aaltonen, V.; Arola, A.; Komppula, M.; Lihavainen, H.; Kolmonen, P.; Kaurila, T.; Lehtinen, K. E.

    2008-12-01

    Aerosol Optical Depth (AOD) values derived with the new MODIS retrieval algorithm over land (Collection 5) were compared with ground-based sun photometer measurements in northern Europe, Africa and South America. Sites in northern Europe were chosen to represent clean atmosphere, whereas locations in the southern hemisphere were heavily affected by biomass burning aerosols. In Finland (Jokioinen and Sodankyl) measurements were done with Precision Filter Radiometer (PFR), while in Estonia (Toravere), Zambia (Mongu) and Brazil (Alta Floresta) level 2 AERONET data were used. Comparison results were generally good although in the aerosol model selection, particularly how dust is taken into account, there seems to be room for improvement. At all studied sites the MODIS algorithm selects occasionally dust aerosol model even though dust does not seem to be present and the air masses are not coming from arid regions. This happens especially when AOD values are small (<0.3) or during apparent cloud contamination. Moreover, the ngstrm exponent in Collection 5 data is no longer an independent parameter, thus caution is required when using it. However, it is an important parameter if one tries to estimate the anthropogenic component of aerosols. Collocated measurements from the AERONET sites with the largest absolute and relative differences were studied in more detail. Based on these case studies, it seems that cloud screening algorithms are the main reason for the largest differences between satellite and ground-based instruments.

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

    PubMed

    Lyons, Andrew

    2013-02-01

    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

  19. Effects of Water Provision and Hydration on Cognitive Function among Primary-School Pupils in Zambia: A Randomized Trial

    PubMed Central

    Trinies, Victoria; Chard, Anna N.; Mateo, Tommy; Freeman, Matthew C.

    2016-01-01

    There is a well-established link between hydration and improved cognitive performance among adults, with evidence of similar findings among children. No trials have investigated the impact of water provision on cognitive performance among schoolchildren in hot and arid low-resource settings. We conducted a randomized-controlled trial in five schools with limited water access in Chipata district in Eastern province, Zambia, to assess the efficacy of water provision on cognition. Pupils in grades 3–6 were randomly assigned to either receive a bottle of drinking water that they could refill throughout the day (water group, n = 149) or only have access to drinking water that was normally available at the school (control group, n = 143). Hydration was assessed in the morning before provision of water and in the afternoon through urine specific gravity (Usg) measured with a portable refractometer. In the afternoon we administered six cognitive tests to assess short-term memory, concentration, visual attention, and visual motor skills. Morning prevalence of dehydration, defined as Usg≥1.020, was 42%. Afternoon dehydration increased to 67% among the control arm and dropped to 10% among the intervention arm. We did not find that provision of water or hydration impacted cognitive test scores, although there were suggestive relationships between both water provision and hydration and increased scores on tests measuring visual attention. We identified key improvements to the study design that are warranted to further investigate this relationship. Trial Registration: ClinicalTrials.gov NCT01924546 PMID:26950696

  20. Autonomy dimensions and care seeking for delivery in Zambia; the prevailing importance of cluster-level measurement.

    PubMed

    Gabrysch, Sabine; McMahon, Shannon A; Siling, Katja; Kenward, Michael G; Campbell, Oona M R

    2016-01-01

    It is widely held that decisions whether or when to attend health facilities for childbirth are not only influenced by risk awareness and household wealth, but also by factors such as autonomy or a woman's ability to act upon her own preferences. How autonomy should be constructed and measured - namely, as an individual or cluster-level variable - has been less examined. We drew on household survey data from Zambia to study the effect of several autonomy dimensions (financial, relationship, freedom of movement, health care seeking and violence) on place of delivery for 3200 births across 203 rural clusters (villages). In multilevel logistic regression, two autonomy dimensions (relationship and health care seeking) were strongly associated with facility delivery when measured at the cluster level (OR 1.27 and 1.57, respectively), though not at the individual level. This suggests that power relations and gender norms at the community level may override an individual woman's autonomy, and cluster-level measurement may prove critical to understanding the interplay between autonomy and care seeking in this and similar contexts. PMID:26931301

  1. Urban and Rural Ozone Collect over Lusaka (Zambia, 15.5 S, 28 E) during SAFARI-2000 (September 2000)

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

    In early September, throughout south central Africa, seasonal clearing of dry vegetation and the production of charcoal for cooking leads to intense smoke haze and ozone formation. Ozone soundings made over Lusaka in early September 2000 recorded layers of high ozone (greater than 125 ppbv at 5 km) during two stagnant periods, broken by a frontal passage that reduced boundary layer ozone by 30%. During the 6-day measurement period, surface ozone concentrations ranged from 50-95 ppbv and integrated tropospheric ozone from the soundings was 39-54 Dobson Units (note 1.3 km elevation at the launch site). A stable layer of high ozone at 2-5 km was advected from rural burning regions in western Zambia and neighboring countries, making Lusaka a collection point for transboundary pollution. This is confirmed by trajectories that show ozone leaving Angola, Namibia, Botswana and South Africa before heading toward the Indian Ocean and returning to Lusaka via Mozambique and Zimbabwe. Ozone in the mixed layer at Lusaka is heavily influenced by local sources.

  2. Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia.

    PubMed

    Musenge, Emmanuel Mwila; Michelo, Charles; Mudenda, Boyd; Manankov, Alexey

    2016-01-01

    Background. The control of diabetes mellitus depends on several factors that also include individual lifestyles. We assessed glycaemic control status and self-management behaviours that may influence glycaemic control among diabetic outpatients. Methods. This cross-sectional study among 198 consenting randomly selected patients was conducted at the University Teaching Hospital diabetic clinic between September and December 2013 in Lusaka, Zambia. A structured interview schedule was used to collect data on demographic characteristics, self-management behaviours, and laboratory measurements. Binary logistic regression analysis using IBM SPSS for Windows version 20.0 was carried out to predict behaviours that were associated with glycaemic control status. Results. The proportion of patients that had good glycaemic control status (HbA1c? 48?mmol/mol) was 38.7% compared to 61.3% that had poor glycaemic control status (HbA1c? 49?mmol/mol). Adherence to antidiabetic treatment and fasting plasma glucose predicted glycaemic control status of the patients. However, self-blood glucose monitoring, self-blood glucose monitoring means and exercise did not predict glycaemic control status of the patients.??Conclusion. We find evidence of poor glycaemic control status among most diabetic patients suggesting that health promotion messages need to take into account both individual and community factors to promote behaviours likely to reduce nonadherence. PMID:26798654

  3. The Rise and Fall of a Second-Generation CBNRM Project in Zambia: Insights from a Project Perspective

    NASA Astrophysics Data System (ADS)

    Lyons, Andrew

    2013-02-01

    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.

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

    PubMed Central

    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

    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. PMID:23153896

  5. Inquiry into the Indigenous, Cultural and Traditional Astronomical Knowledge: A case of the Lamba land of Zambia

    NASA Astrophysics Data System (ADS)

    Simpemba, Prospery C.

    2015-08-01

    Indigenous astronomy in the context of Zambia is the oral astronomy knowledge, culture and beliefs which relate to celestial bodies, astronomy events and related behaviour that are held by the elderly persons and passed on to younger generations. Much is not written down and with the passing away of the custodians, this knowledge is threatened to be extinct. A mini study of the astronomical beliefs and culture of the ancient Zambian community during the International Year of Astronomy (IYA) 2009 revealed that such knowledge existed. A comprehensive study assesses cultural and traditional knowledge on astronomy and to ascertain how much of this knowledge has been passed on to the younger generations. Open-ended interviews were conducted using questionnaires and focus group discussions. Respondents were identified by snowball sampling of the elderly people and random sampling of the middle aged and young. Nine randomly sampled districts of the Copperbelt Province were considered. The collected data has been analysed using MAXQDA software. Knowledge of traditional astronomy is high among the elderly people and declining with age hence the need for documenting and introducing it in the school curriculum and regular public discourse.

  6. Predictive Malaria Risk and Uncertainty Mapping in Nchelenge District, Zambia: Evidence of Widespread, Persistent Risk and Implications for Targeted Interventions.

    PubMed

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy; Lupiya, James; Kobayashi, Tamaki; Mulenga, Modest; Moss, William J; Curriero, Frank C

    2015-12-01

    Malaria risk maps may be used to guide policy decisions on whether vector control interventions should be targeted and, if so, where. Active surveillance for malaria was conducted through household surveys in Nchelenge District, Zambia from April 2012 through December 2014. Households were enumerated based on satellite imagery and randomly selected for study enrollment. At each visit, participants were administered a questionnaire and a malaria rapid diagnostic test (RDT). Logistic regression models were used to construct spatial prediction risk maps and maps of risk uncertainty. A total of 461 households were visited, comprising 1,725 participants, of whom 48% were RDT positive. Several environmental features were associated with increased household malaria risk in a multivariable logistic regression model adjusting for seasonal variation. The model was validated using both internal and external evaluation measures to generate and assess root mean square error, as well as sensitivity and specificity for predicted risk. The final, validated model was used to predict and map malaria risk including a measure of risk uncertainty. Malaria risk in a high, perennial transmission setting is widespread but heterogeneous at a local scale, with seasonal variation. Targeting malaria control interventions may not be appropriate in this epidemiological setting. PMID:26416106

  7. Autonomy dimensions and care seeking for delivery in Zambia; the prevailing importance of cluster-level measurement

    PubMed Central

    Gabrysch, Sabine; McMahon, Shannon A.; Siling, Katja; Kenward, Michael G.; Campbell, Oona M. R.

    2016-01-01

    It is widely held that decisions whether or when to attend health facilities for childbirth are not only influenced by risk awareness and household wealth, but also by factors such as autonomy or a woman’s ability to act upon her own preferences. How autonomy should be constructed and measured – namely, as an individual or cluster-level variable – has been less examined. We drew on household survey data from Zambia to study the effect of several autonomy dimensions (financial, relationship, freedom of movement, health care seeking and violence) on place of delivery for 3200 births across 203 rural clusters (villages). In multilevel logistic regression, two autonomy dimensions (relationship and health care seeking) were strongly associated with facility delivery when measured at the cluster level (OR 1.27 and 1.57, respectively), though not at the individual level. This suggests that power relations and gender norms at the community level may override an individual woman’s autonomy, and cluster-level measurement may prove critical to understanding the interplay between autonomy and care seeking in this and similar contexts. PMID:26931301

  8. Female Sex Workers, Male Circumcision and HIV: A Qualitative Study of Their Understanding, Experience, and HIV Risk in Zambia

    PubMed Central

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

    2013-01-01

    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

  9. Implementation of the Community Health Assistant (CHA) Cadre in Zambia: A Process Evaluation to Guide Future Scale-Up Decisions.

    PubMed

    Shelley, Katharine D; Belete, Yekoyesew W; Phiri, Sydney Chauwa; Musonda, Mutinta; Kawesha, Elizabeth Chizema; Muleya, Evelyn Mutinta; Chibawe, Caroline Phiri; van den Broek, Jan Willem; Vosburg, Kathryn Bradford

    2016-04-01

    Universal health coverage requires an adequate health workforce, including community health workers (CHWs) to reach rural communities. To improve healthcare access in rural areas, in 2010 the Government of Zambia implemented a national CHW strategy that introduced a new cadre of healthcare workers called community health assistants (CHAs). After 1 year of training the pilot class of 307 CHAs deployed in September 2012. This paper presents findings from a process evaluation of the barriers and facilitators of implementation of the CHA pilot, along with how evidence was used to guide ongoing implementation and scale-up decisions. Qualitative inquiry was used to assess implementation during the first 6 months of the program rollout, with 43 in-depth individual and 32 small group interviews across five respondent types: CHAs, supervisors, volunteer CHWs, community members, and district leadership. Potential 'implementation moderators' were explored using deductive coding and thematic analysis of participant perspectives on community acceptance of CHAs, supervision support mechanisms, and coordination with volunteer CHWs, and health system integration of a new cadre. Community acceptance of CHAs was generally high, but coordination between CHAs and existing volunteer CHWs presented some challenges. The supervision support system was found to be inconsistent, limiting assurance of consistent quality care delivered by CHAs. Underlying health system weaknesses regarding drug supply and salary payments furthermore hindered incorporation of a new cadre within the national health system. Recommendations for implementation and future scale based on the process evaluation findings are discussed. PMID:26547550

  10. Rights-based services for adolescents living with HIV: adolescent self-efficacy and implications for health systems in Zambia.

    PubMed

    Mburu, Gitau; Hodgson, Ian; Teltschik, Anja; Ram, Mala; Haamujompa, Choolwe; Bajpai, Divya; Mutali, Beatrice

    2013-05-01

    A rights-based approach in HIV service delivery for adults is increasingly taking root in sub-Saharan Africa in the context of greater availability of antiretroviral therapy. Yet there has been comparatively little progress in strengthening a rights-based approach to adolescent HIV services, which we learned during a qualitative study in 2010 among 111 adolescents living with HIV, 21 parents and 38 health providers in three districts in Zambia. Adolescents in the study expressed a range of information and support needs and wanted locally relevant interventions to meet those needs. They wanted greater access to HIV, sexual and reproductive health information, information on how to protect themselves, privacy and confidentiality in service sites, skills training so as to be able to earn money, and better control over disclosure of their HIV status to others. Both health workers and parents acknowledged that information and services needed to be improved to meet those needs far better. This paper provides examples of successful programmes in Zimbabwe, Uganda, Tanzania, Botswana and South Africa and calls for adolescent services to be linked to both paediatric and adult services, peer networks to be established to increase adolescents' ability to collectively voice their concerns and support each other, interventions supporting adolescents' control over self-disclosure, and lastly that adolescent health should become a training specialty in sub-Saharan Africa. PMID:23684200

  11. Prevalence and Determinants of Mucous Membrane Irritations in a Community Near a Cement Factory in Zambia: A Cross Sectional Study

    PubMed Central

    Nkhama, Emmy; Ndhlovu, Micky; Dvonch, J. Timothy; Siziya, Seter; Voyi, Kuku

    2015-01-01

    Exposure to cement dust has been associated with deleterious health effects in humans. This study investigated whether residing near a cement factory increases the risk of irritations to the mucous membranes of the eyes and respiratory system. A cross sectional study was conducted in Freedom Compound, a community bordering a cement factory in Chilanga, Zambia and a control community, Bauleni, located 18 km from the cement plant. A modified American Thoracic Society questionnaire was administered to 225 and 198 respondents aged 1559 years from Freedom and Bauleni, respectively, to capture symptoms of the irritations. Respondents from Freedom Compound, were more likely to experience the irritations; adjusted ORs 2.50 (95% CI: 1.65, 3.79), 4.36 (95% CI (2.96, 6.55)) and 1.94 (95% CI (1.19, 3.18)) for eye, nose and sinus membrane irritations respectively. Cohort panel studies to determine associations of cement emissions to mucous membrane irritations and respiratory symptoms, coupled with field characterization of the exposure are needed to assess whether the excess prevalence of symptoms of mucous membrane irritations observed in Freedom compound are due to emissions from the cement factory. PMID:25602972

  12. Unexpected diversity of Anopheles species in Eastern Zambia: implications for evaluating vector behavior and interventions using molecular tools

    PubMed Central

    Lobo, Neil F.; Laurent, Brandyce St.; Sikaala, Chadwick H.; Hamainza, Busiku; Chanda, Javan; Chinula, Dingani; Krishnankutty, Sindhu M.; Mueller, Jonathan D.; Deason, Nicholas A.; Hoang, Quynh T.; Boldt, Heather L.; Thumloup, Julie; Stevenson, Jennifer; Seyoum, Aklilu; Collins, Frank H.

    2015-01-01

    The understanding of malaria vector species in association with their bionomic traits is vital for targeting malaria interventions and measuring effectiveness. Many entomological studies rely on morphological identification of mosquitoes, limiting recognition to visually distinct species/species groups. Anopheles species assignments based on ribosomal DNA ITS2 and mitochondrial DNA COI were compared to morphological identifications from Luangwa and Nyimba districts in Zambia. The comparison of morphological and molecular identifications determined that interpretations of species compositions, insecticide resistance assays, host preference studies, trap efficacy, and Plasmodium infections were incorrect when using morphological identification alone. Morphological identifications recognized eight Anopheles species while 18 distinct sequence groups or species were identified from molecular analyses. Of these 18, seven could not be identified through comparison to published sequences. Twelve of 18 molecularly identified species (including unidentifiable species and species not thought to be vectors) were found by PCR to carry Plasmodium sporozoites - compared to four of eight morphological species. Up to 15% of morphologically identified Anopheles funestus mosquitoes in insecticide resistance tests were found to be other species molecularly. The comprehension of primary and secondary malaria vectors and bionomic characteristics that impact malaria transmission and intervention effectiveness are fundamental in achieving malaria elimination. PMID:26648001

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

    PubMed Central

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

    2013-01-01

    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. PMID:23555590

  14. Knowledge and attitudes to HIV and AIDS and sexual practices among university students in Lusaka, Zambia and London, England: are they so different?

    PubMed

    Baggaley, R; Drobniewski, F; Pozniak, A; Chipanta, D; Tembo, M; Godfrey-Faussett, P

    1997-04-01

    Surveys conducted among university students in Lusaka, Zambia, and London, England, in 1993-94 revealed comparable AIDS-related knowledge, attitudes, and sexual practices, despite vast differences between the two countries in AIDS prevalence. Questionnaires were completed by 946 seniors and 294 new students from the University of Zambia in 1993 and 1994 and by 100 seniors and 117 new students from London University in 1994. Both groups of students were quite knowledgeable about transmission of HIV through semen, blood, and vaginal fluid; however, 50% in both settings believed saliva transmits HIV. Although more than two-thirds of Lusaka students, compared with one-fourth of London students, knew or had known someone with HIV, British students had more compassionate, less judgmental attitudes toward AIDS patients. 90% of Lusakan but under 50% of London students worried about catching HIV. By their senior year, 61% of female and 85% of male students in Zambia had had one or more sexual partner compared with 73% and 76%, respectively, in London. 66% of Lusakan and 75% of London students used condoms most of the time with casual partners; with regular partners, these rates were only 23% and 35%, respectively. Lusakan students were less likely than their London counterparts to discuss HIV with their partners. 75% of students in both countries had received some type of AIDS education, but the majority expressed an interest in additional counseling. Recommended, in both settings, are university-based AIDS education programs, with particular emphasis on the importance of condom use with all sexual partners. PMID:9223847

  15. “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

    2012-01-01

    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. PMID:23192013

  16. Knowledge base and caretaker-child communication about HIV in peri-urban schoolchildren of Lusaka, Zambia.

    PubMed

    Carnevale, Julia; Gropper, Adrienne B; Agnew-Blais, Jessica; Mimiaga, Matthew J; Mhango, Anna; Bail, Richard; Ngoma, Mary

    2011-05-01

    Peri-urban communities, which face health risks of both urban and rural environments, have grown extensively with recent global urbanization. These communities' combination of multiple HIV risk factors with the lack of a formalized sexual education system sets the stage for high-risk behavior in peri-urban youth. We conducted a cross-sectional survey of children (ages 5-17, N=331) and accompanying caretakers in peri-urban Lusaka, Zambia, using both closed- and open-ended questions to investigate HIV knowledge and communication. We found that while 67% of children had heard of HIV, only 26% and 23% could accurately name a major mode of transmission and prevention, respectively. In a multivariate model, increasing age was the only significant demographic correlate of a child's ability to offer accurate responses to either question. Though HIV/AIDS knowledge levels were high in the eldest (14-17-year old) age group, in the 10-13-year-old age group accurate modes of transmission and prevention were provided by only 41% and 33% of study participants, respectively. Sharp instruments, particularly razor blades, were mentioned nearly as frequently as sexual intercourse with respect to both transmission and prevention, a response trend that predominated in the youngest age group but persisted into the oldest. Seventy percent of caretakers had not spoken with their child about HIV. A history of caretaker-child communication about HIV was associated with an increased likelihood of a child offering an accurate mode of transmission (OR 2.70, 95% confidence interval (CI) 1.41-5.18, p=0.0029) or prevention (OR 3.43, 95% CI 1.78-6.60, p=0.0002), in multivariate analyses. Our results demonstrate a lack of knowledge and dialog about HIV in the pre-adolescent subset of high-risk peri-urban youth, and uncover undue emphasis on razor blades as a major mode of disease transmission. PMID:21293994

  17. Oligosaccharide Composition of Breast Milk Influences Survival of Uninfected Children Born to HIV-Infected Mothers in Lusaka, Zambia12

    PubMed Central

    Kuhn, Louise; Kim, Hae-Young; Hsiao, Lauren; Nissan, Caroline; Kankasa, Chipepo; Mwiya, Mwiya; Thea, Donald M; Aldrovandi, Grace M; Bode, Lars

    2015-01-01

    Background: Human milk oligosaccharides (HMOs) have multiple immunomodulatory functions that influence child health. Objective: In this study we investigated whether HMO composition influences survival to 2 y of age in HIV-infected and HIV-exposed, uninfected (HEU) children during and after breastfeeding. Methods: In the context of an early weaning trial in 958 HIV-infected women in Lusaka, Zambia, we conducted a nested case-cohort analysis of mortality to 2 y of age among 103 HIV-infected and 143 HEU children. Breast-milk samples collected at 1 mo postpartum were analyzed for HMO content. Samples were selected to include mothers of all HIV-infected children detected by 6 wk of age, of whom 63 died at <2 y of age; mothers of all HEU children who died at <2 y of age (n = 66); and a random sample of 77 HEU survivors. Associations before and after weaning in HIV-infected and HEU infants separately were investigated by using Cox models. Results: Among HEU children, higher maternal breast-milk concentrations of 2-linked fucosylated HMOs [2′-fucosyllactose and lacto-N-fucopentaose (LNFP) I] (HR: 0.33; 95% CI: 0.14, 0.74) as well as non–2-linked fucosylated HMOs (3-fucosyllactose and LNFP II/III; HR: 0.28; 95% CI: 0.13, 0.67) were significantly associated with reduced mortality during, but not after, breastfeeding after adjustment for confounders. Breastfeeding was protective against mortality only in HEU children with high concentrations of fucosylated HMOs. Among HIV-infected children, no consistent associations between HMOs and mortality were observed, but breastfeeding was protective against mortality. Conclusions: The oligosaccharide composition of breast milk may explain some of the benefits of breastfeeding in HEU children. HIV infection may modulate some of the consequences of HMOs on child survival. PMID:25527660

  18. Cost effectiveness of community-based therapeutic care for children with severe acute malnutrition in Zambia: decision tree model

    PubMed Central

    Bachmann, Max O

    2009-01-01

    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 care centres in Lusaka, Zambia, compared to no care. A decision tree model compared the costs (in year 2008 international dollars) and outcomes of CTC to a hypothetical 'do-nothing' alternative. The primary outcomes were mortality within one year, and disability adjusted life years (DALYs) after surviving one year. Outcomes and health service costs of CTC were obtained from the CTC programme, local health services and World Health Organization (WHO) estimates of unit costs. Outcomes of doing nothing were estimated from published African cohort studies. Probabilistic and deterministic sensitivity analyses were done. Results The mean cost of CTC per child was $203 (95% confidence interval (CI) $139$274), of which ready to use therapeutic food (RUTF) cost 36%, health centre visits cost 13%, hospital admissions cost 17% and technical support while establishing the programme cost 34%. Expected death rates within one year of presentation were 9.2% with CTC and 20.8% with no treatment (risk difference 11.5% (95% CI 0.423.0%). CTC cost $1760 (95% CI $592$10142) per life saved and $ 53 (95% CI $18$306) per DALY gained. CTC was at least 80% likely to be cost effective if society was willing to pay at least $88 per DALY gained. Analyses were most sensitive to assumptions about mortality rates with no treatment, weeks of CTC per child and costs of purchasing RUTF. Conclusion CTC is relatively cost effective compared to other priority health care interventions in developing countries, for a wide range of assumptions. PMID:19146668

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

    PubMed

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

    1996-07-01

    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

  20. Field effectiveness of combination antiretroviral prophylaxis for the prevention of mother-to-child HIV transmission in rural Zambia

    PubMed Central

    GARTLAND, Matthew G; CHINTU, Namwinga T; LI, Michelle S; LEMBALEMBA, Mwila K; MULENGA, Saziso N; BWEUPE, Maximillian; MUSONDA, Patrick; STRINGER, Elizabeth M; STRINGER, Jeffrey SA; CHI, Benjamin H

    2013-01-01

    Objective To evaluate the effectiveness of maternal combination antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV (PMTCT) in a program setting Design Prospective cohort study Setting Nine primary care clinics in rural Zambia Participants 284 HIV-infected pregnant women at ?28 weeks gestation initiating PMTCT services between April 2009 and January 2011 and their newborn infants Intervention In four intervention sites, PMTCT comprised universal combination antiretroviral prophylaxis (i.e., irrespective of CD4 count) from pregnancy until the cessation of breastfeeding. In five control sites, women received antenatal zidovudine and peripartum nevirapine, the standard of care at the time. Prophylaxis during breastfeeding was not available in control sites. Main outcome measure Cumulative infant HIV infection and death at 12 months postpartum Results At 12 month postpartum, 1 of 104 (1.0%) infants born to mothers at the intervention sites were HIV-infected, compared to 14 of 116 (12.1%) receiving care in the control sites (relative risk [RR]: 12.6, 95%CI: 2.2-73.1; P=0.005). When we considered the composite outcome of HIV infection or death, similar trends were observed in the overall study population (RR: 3.4, 95%CI: 1.6-7.6; P=0.002) and in a sub-analysis of women with CD4 >350 cells/?L (RR: 3.2; 95%CI: 1.1-9.6; P=0.04). Conclusions When compared to PMTCT services based on antenatal zidovudine and peripartum nevirapine, the provision of maternal combination prophylaxis imparted measurable health benefits to HIV-exposed infants. Implementation research is needed to further tailor and optimize these strategies for similar field settings. PMID:23324656

  1. Reasons for Missing Antiretroviral Therapy: Results from a Multi-Country Study in Tanzania, Uganda, and Zambia

    PubMed Central

    Koole, Olivier; Denison, Julie A; Menten, Joris; Tsui, Sharon; Wabwire-Mangen, Fred; Kwesigabo, Gideon; Mulenga, Modest; Auld, Andrew; Agolory, Simon; Mukadi, Ya Diul; van Praag, Eric; Torpey, Kwasi; Williams, Seymour; Kaplan, Jonathan; Zee, Aaron; Bangsberg, David R; Colebunders, Robert

    2016-01-01

    Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence. Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as having missed ART for at least 48 consecutive hours during the past 3 months. Results Twenty-nine percent of participants reported at least one reason for having ever missed ART (1278/4425). The most frequent reason was simply forgetting (681/1278 or 53%), followed by ART-related hunger or not having enough food (30%), and symptoms (12%). The median number of symptoms reported by participants was 4 (IQR: 2–7). Every additional symptom increased the odds of incomplete adherence by 12% (OR: 1.1, 95% CI: 1.1–1.2). Female participants and participants initiated on a regimen containing stavudine were more likely to report greater numbers of symptoms. Conclusions Symptoms were a common reason for missing ART, together with simply forgetting and food insecurity. A combination of ART regimens with fewer side effects, use of mobile phone text message reminders, and integration of food supplementation and livelihood programmes into HIV programmes, have the potential to decrease missed ART and hence to improve adherence and the outcomes of ART programmes. PMID:26788919

  2. Task-Shifting and Quality of HIV Testing Services: Experiences from a National Reference Hospital in Zambia

    PubMed Central

    Mwangala, Sheila; Moland, Karen M.; Nkamba, Hope C.; Musonda, Kunda G.; Monze, Mwaka; Musukwa, Katoba K.; Fylkesnes, Knut

    2015-01-01

    Background With new testing technologies, task-shifting and rapid scale-up of HIV testing services in high HIV prevalence countries, assuring quality of HIV testing is paramount. This study aimed to explore various cadres of providers’ experiences in providing HIV testing services and their understanding of elements that impact on quality of service in Zambia. Methods Sixteen in-depth interviews and two focus group discussions were conducted with HIV testing service providers including lay counselors, nurses and laboratory personnel at purposively selected HIV testing sites at a national reference hospital in Lusaka. Qualitative content analysis was adopted for data analysis. Results Lay counselors and nurses reported confidentiality and privacy to be greatly compromised due to limited space in both in- and out-patient settings. Difficulties in upholding consent were reported in provider-initiated testing in in-patient settings. The providers identified non-adherence to testing procedures, high workload and inadequate training and supervision as key elements impacting on quality of testing. Difficulties related to testing varied by sub-groups of providers: lay counselors, in finger pricking and obtaining adequate volumes of specimen; non-laboratory providers in general, in interpreting invalid, false-negative and false-positive results. The providers had been participating in a recently established national HIV quality assurance program, i.e. proficiency testing, but rarely received site supervisory visits. Conclusion Task-shifting coupled with policy shifts in service provision has seriously challenged HIV testing quality, protection of confidentiality and the process of informed consent. Ways to better protect confidentiality and informed consent need careful attention. Training, supervision and quality assurance need strengthening tailored to the needs of the different cadres of providers. PMID:26605800

  3. Counselor and Participant Perspectives of Trauma-Focused Cognitive Behavioral Therapy for Children in Zambia: A Qualitative Study

    PubMed Central

    Murray, Laura K.; Skavenski, Stephanie; Michalopoulos, Lynn M.; Bolton, Paul A.; Bass, Judith K.; Familiar, Itziar; Imasiku, Mwiya; Cohen, Judy

    2014-01-01

    Objective This study examined Zambian counselors, children, and caregivers' perceptions of an evidence-based treatment (EBT) for trauma (Trauma-Focused Cognitive Behavioral Therapy, TF-CBT) utilized in Zambia to address mental health problems in children. Method Semi-structured interviews were conducted with local counselors trained in TF-CBT (N=19; 90% of those trained; 12 Female) and children/caregivers who had received TF-CBT in a small feasibility study (N=18; 86% of the children and N=16; 76% of the caregivers) who completed TF-CBT (Total completed; N=21). Each client was asked six open-ended questions, and domain analysis was used to explore the data. Results Counselors were positive about the program, liked the structure and flexibility, reported positive changes in their clients, and discussed the cultural adaptation around activities and language. Counselors stated the training was too short, and the supervision was necessary. Challenges included client engagement and attendance, availability of location, funding, and a lack of community understanding of “therapy.” Children and caregivers stated multiple positive changes they attributed to TF-CBT, such as better family communication, reduction of problem behaviors, and ability to speak about the trauma. They recommended continuing the program. Conclusion This study brings a critical examination of providers' and clients' perspectives of the implementation of an EBT for children in a low-resource setting. Clinical implications include changing implementation methods based on responses. Research implications include future study directions such as an effectiveness trial of TF-CBT and an examination of implementation factors. PMID:24400677

  4. Geology of the Fishtie deposit, Central Province, Zambia: iron oxide and copper mineralization in Nguba Group metasedimentary rocks

    NASA Astrophysics Data System (ADS)

    Hendrickson, Michael D.; Hitzman, Murray W.; Wood, David; Humphrey, John D.; Wendlandt, Richard F.

    2015-08-01

    The Fishtie copper deposit, located in the Central Province of Zambia, contains approximately 55 Mt of 1.04 % Cu at a 0.5 % Cu cut-off in oxide, sulfide, and mixed oxide-sulfide ores. The deposit is hosted in Neoproterozoic diamictites and siltstones of the Grand Conglomrat Formation and overlying Kakontwe Limestone Formation of the lower Nguba Group. The Grand Conglomrat Formation at Fishtie directly overlies basement schists and quartzites. Mineralized zones are located adjacent to high-angle normal faults that appear to control thickness variations in the Grand Conglomrat Formation suggesting synsedimentary fault movement. Iron-rich rocks consisting of nearly monomineralic bands of magnetite and ankerite occur within the Grand Conglomrat Formation. The absence of magnetite-rich clasts in overlying diamictites and the presence of disseminated magnetite, ankerite, and apatite in adjacent diamictites suggest this iron-rich rock formed by replacement of siltstone beds. These magnetite-rich rocks thicken towards normal faults suggesting the faults formed conduits for oxidized hydrothermal solutions. The magnetite-ankerite-quartz rock was overprinted by later hydrothermal alteration and sulfide mineralization. Copper sulfide precipitation was associated with growth of both muscovite and chlorite, together with weak silicification. Sulfides are zoned relative to normal faults with bornite more common in proximity to faults and ore stage pyrite most common in an outer zone with chalcopyrite. Copper sulfides display generally heavy sulfur isotopic values, suggesting sulfide derivation from thermochemical reduction of Neoproterozoic seawater sulfate. Copper mineralized zones in the Grand Conglomrat at Fishtie are megascopically similar to those observed in the newly discovered Kamoa deposit in the southern Democratic Republic of Congo. Alteration and mineralization at Fishtie display lateral zoning relative to normal faults unlike the broad vertical zonation observed at the giant Kamoa deposit. The small size of the known mineralized zones at the Fishtie deposit relative to Kamoa is probably due to the absence of a thick siliciclastic palaeoaquifer beneath the Grand Conglomrat Formation as is present at Kamoa.

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

    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.

  6. Counselor and client perspectives of Trauma-focused Cognitive Behavioral Therapy for children in Zambia: a qualitative study.

    PubMed

    Murray, Laura K; Skavenski, Stephanie; Michalopoulos, Lynn M; Bolton, Paul A; Bass, Judith K; Familiar, Itziar; Imasiku, Mwiya; Cohen, Judith

    2014-01-01

    This study examined Zambian counselors, children, and caregivers' perceptions of an evidence-based treatment (EBT) for trauma (Trauma-Focused Cognitive Behavioral Therapy [TF-CBT]) utilized in Zambia to address mental health problems in children. Semistructured interviews were conducted with local counselors trained in TF-CBT (N=19; 90% of those trained; 12 female) and children/caregivers who had received TF-CBT in a small feasibility study (N=18; 86% of the children and N=16; 76% of the caregivers) who completed TF-CBT (total completed; N=21). Each client was asked six open-ended questions, and domain analysis was used to explore the data. Counselors were positive about the program, liked the structure and flexibility, reported positive changes in their clients, and discussed the cultural adaptation around activities and language. Counselors stated the training was too short, and the supervision was necessary. Challenges included client engagement and attendance, availability of location, funding, and a lack of community understanding of "therapy." Children and caregivers stated multiple positive changes they attributed to TF-CBT, such as better family communication, reduction of problem behaviors, and ability to speak about the trauma. They recommended continuing the program. This study brings a critical examination of providers' and clients' perspectives of the implementation of an EBT for children in a low-resource setting. Clinical implications include changing implementation methods based on responses. Research implications include future study directions such as an effectiveness trial of TF-CBT and an examination of implementation factors. PMID:24400677

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

    PubMed Central

    2012-01-01

    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. PMID:22978604

  8. Preliminary evaluation of Community-Led Total Sanitation for the control of Taenia solium cysticercosis in Katete District of Zambia.

    PubMed

    Bulaya, Carol; Mwape, Kabemba E; Michelo, Charles; Sikasunge, Chummy S; Makungu, Chitwambi; Gabriel, Sarah; Dorny, Pierre; Phiri, Isaac K

    2015-01-30

    Taenia solium taeniasis/cysticercosis is a zoonotic disease endemic in sub-Saharan Africa. It is associated with poor sanitary practices, free-range pig husbandry and lack of disease awareness in endemic communities. A comparative research was conducted with pre and post-intervention assessments in nine villages to evaluate Community-Led Total Sanitation (CLTS) as an intervention measure for the control of porcine cysticercosis in Katete District in the Eastern Province of Zambia. Blood samples were collected from pigs for circulating antigen detection and a questionnaire focused on the household was administered to a total of 153 respondents whose pigs were examined (64 pre-intervention, 89 post-intervention), in order to obtain information on general demographic characteristics, pig husbandry practices, sanitation practices and associated knowledge and awareness of T. solium infections. The first sampling was conducted prior to the implementation of the CLTS and second sampling eight months after triggering of CLTS in the selected villages. A total of 379 pig serum samples were examined using the B158/B60 Ag-ELISA to detect T. solium cysticercosis, 104 pre-intervention and 275 post-intervention, of which 14 (13.5%) and 45 (16.4%) were positive, respectively. Wald test p-values were computed to assess significant differences in the variables of interest mentioned above for the pre and post CLTS. The research revealed that CLTS as a control measure did not significantly improve T. solium infections in pigs. The research also revealed that the sanitation practices and awareness of cysticercosis did not change. It is recommended that a longer term evaluation be undertaken when the villages have been declared open defaecation free. In addition, the research recommends that health education, mass drug treatment and pig vaccination be incorporated, as an essential component of prevention and control programmes for T. solium infections. PMID:25591408

  9. Sector-Wide Approaches in Education: Issues for Donor Agencies Arising from Case Studies of Zambia and Mozambique. A Report from the Meeting of the International Working Group on Education (IWGE) (Lisbon, Portugal, November 19-21, 2001).

    ERIC Educational Resources Information Center

    Riddell, Abby

    This book contains two case studies--one from Zambia, one from Mozambique--of the implications for donors of pursuing sector-wide approaches (SWAps) in education. (A sector-wide approach is characterized as a sustained partnership led by national authorities involving different arms of government and, where relevant, donor agencies, with the goals

  10. Molecular epidemiology of pathogenic Leptospira spp. in the straw-colored fruit bat (Eidolon helvum) migrating to Zambia from the Democratic Republic of Congo.

    PubMed

    Ogawa, Hirohito; Koizumi, Nobuo; Ohnuma, Aiko; Mutemwa, Alisheke; Hang'ombe, Bernard M; Mweene, Aaron S; Takada, Ayato; Sugimoto, Chihiro; Suzuki, Yasuhiko; Kida, Hiroshi; Sawa, Hirofumi

    2015-06-01

    The role played by bats as a potential source of transmission of Leptospira spp. to humans is poorly understood, despite various pathogenic Leptospira spp. being identified in these mammals. Here, we investigated the prevalence and diversity of pathogenic Leptospira spp. that infect the straw-colored fruit bat (Eidolon helvum). We captured this bat species, which is widely distributed in Africa, in Zambia during 2008-2013. We detected the flagellin B gene (flaB) from pathogenic Leptospira spp. in kidney samples from 79 of 529 E. helvum (14.9%) bats. Phylogenetic analysis of 70 flaB fragments amplified from E. helvum samples and previously reported sequences, revealed that 12 of the fragments grouped with Leptospira borgpetersenii and Leptospira kirschneri; however, the remaining 58 flaB fragments appeared not to be associated with any reported species. Additionally, the 16S ribosomal RNA gene (rrs) amplified from 27 randomly chosen flaB-positive samples was compared with previously reported sequences, including bat-derived Leptospira spp. All 27 rrs fragments clustered into a pathogenic group. Eight fragments were located in unique branches, the other 19 fragments were closely related to Leptospira spp. detected in bats. These results show that rrs sequences in bats are genetically related to each other without regional variation, suggesting that Leptospira are evolutionarily well-adapted to bats and have uniquely evolved in the bat population. Our study indicates that pathogenic Leptospira spp. in E. helvum in Zambia have unique genotypes. PMID:25791930

  11. 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

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

    2011-01-01

    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

  12. Detection of Parasites and Parasitic Infections of Free-Ranging Wildlife on a Game Ranch in Zambia: A Challenge for Disease Control

    PubMed Central

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

    2012-01-01

    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

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

    PubMed

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

    2011-01-01

    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

  14. A Study of Naturally Acquired Canine Babesiosis Caused by Single and Mixed Babesia Species in Zambia: Clinicopathological Findings and Case Management

    PubMed Central

    Nalubamba, King Shimumbo; Mudenda, Ntombi Basimbi; Namwila, Mwaka Mwangala; Mulenga, Chilufya Susan; Bwalya, Eugene Chisela; M'kandawire, Ethel; Saasa, Ngonda; Hankanga, Careen; Oparaocha, Elizabeth; Simuunza, Martin

    2015-01-01

    A retrospective and prospective analysis of clinical records of dogs diagnosed with Babesia infections was carried out for the years 2000 to 2013 from practices in Lusaka, Zambia. Records of 363 dogs with confirmed Babesia infections were analysed using demographic factors including sex, breed, age, and clinical signs in relation to haematological findings and Babesia species. The clinical and laboratory findings observed are described as well as Babesia species identification. The study included 18 breeds and the highest proportion were mongrels (32.2%), males representing 64.5% of the population. The most common presenting problems were anorexia (65.3%) and lethargy/weakness (65.3%). The most common clinical signs were fever (87.3%), pallor (52.3%), lymphadenopathy (47.4%), and presence of ticks (44.9%). Anaemia (96.4%) and nucleated erythrocytes (42.2%) were the most common laboratory findings. A mixed infection of Babesia rossi and Babesia gibsoni was present in 59.7% of dogs, whilst 8% and 32.2% had B. rossi and B. gibsoni as a single infection, respectively. Case management mainly involved therapy with tetracyclines and imidocarb and was usually accompanied by clinical improvement. This study highlights, for the first time, the presence of B. gibsoni in natural dog populations in Zambia, where previously only B. rossi was reported. PMID:26682062

  15. Towards a new understanding of the Neoproterozoic-early palozoic Lufilian and northern Zambezi belts in Zambia and the Democratic Republic of Congo

    NASA Astrophysics Data System (ADS)

    Porada, Hubertus; Berhorst, Volker

    2000-04-01

    The Lufilian Belt is of geological significance and economic importance due to rich Cu?Co mineralisation in the Katanga Province of the Democratic Republic of Congo and the Copperbelt of Zambia. Though thorough exploration has yielded much information on the mines districts, the understanding of the belt as a whole appears, to some extent, historically charged and confused. In the first part of this article, basic knowledge and assumptions are reviewed and existing models critically assessed. Results include recognition of standard lithostratigraphies of the Katanga Supergroup comprising the Roan, Mwashia, Lower and Upper Kudelungu Groups in the Copperbelt and Katanga, a lower limit for the onset of deposition at about 880 Ma, and a major orogenetic event involving northeast directed thrusting (Lufilian Orogeny) at 560-550 Ma. The depositional history of the Lufilian Belt was controlled by continental rifting leading to formation of a passive continental margin. Continental rifting related to the dispersal of Rodinia began ca 880 Ma ago and was accompanied by magmatism (Kafue rhyolites: 879 Ma; Nchanga Granite: 877 Ma; Lusaka Granite: 865 Ma). Differential subsidence of the northwestward propagating rift soon allowed invasion by the sea advancing from the southeast, and subsequent development of marine rift-basin and platform domains. The standard stratigraphies for the Roan Group are restricted to the platform domain that bordered the rift-basin on its northeastern side. This domain included the Domes region of the Lufilian Belt and extended southeastwards into the northern Zambezi Belt. The platform was differentiated into a carbonate platform (barrier) represented by the Bancroft Subgroup (previously 'Upper Roan') in Zambia and Kambove Dolomite Formation in Katanga and a lagoon-basin (lower Kitwe Subgroup/Zambia; Dolomitic Shale Formation/Katanga) with mudflats (R.A.T. Subgroup/Katanga) and a siliciclastic margin towards the hinterland. The mineralised horizons of the 'Ore Formation' in Zambia and 'Series des Mines' in Katanga are related to temporarily anoxic conditions prevailing in the Roan Lagoon-Basin which had a southwest-northeast extent of ca 400 km. The lagoon-basin was subsequently filled by clastics derived from mainly northeastern sources (upper Kitwe Subgroup/Zambia; Dipeta Subgroup/Katanga). Possibly due to continental rupture in the southeastern, more advanced, segment of the rift and concomitant differential movement in the rupturing plate, the Kundelungu Basin started to open during deposition of the Mwashia Group. Opening of the extensional basin was accompanied by rifting, rapid subsidence of the affected platform segment and widespread mafic magmatism, which lasted until deposition of the Lower Kundelungu Group. The elevated margins of the rapidly subsiding Kundelungu Basin offered favourable conditions for inland glaciation during the Sturtian-Rapitan global glaciation epoch. The diamictites of the Grand Conglomt are thus dated at ca 750 Ma. Tectonogenesis in the Lufilian and Zambezi Belts is related to ca 560-550 Ma collision of the 'Angola-Kalahari Plate' (comprising the Kalahari Craton and southwestern part of the Congo Craton) and the 'Congo-Tanzania Plate' (comprising the remaining part of the Congo Craton) along a southeast-northwest trending suture linking up the southern Mozambique Belt with the West Congo Belt. Collision was accompanied by northeast directed thrusting involving deep crustal detachments and forward-propagating thrust faults that developed in platform and slope deposits below a high level thrust. In the Domes region, the platform sequence was detached from its basement and displaced for ca 150 km into the External Fold-Thrust Belt of Katanga. The large displacement was enhanced by fluids liberated from evaporite-rich mudflat deposits of the R.A.T. Subgroup. In the Zambezi Belt, northeast directed thrusting was succeeded by southwest directed backfolding and backthrusting, due to greater shortening or thickening of the thrust wedge. The Mwembeshi Shear Zone accommod

  16. A retrospective evaluation of the quality of malaria case management at twelve health facilities in four districts in Zambia

    PubMed Central

    Chanda-Kapata, Pascalina; Chanda, Emmanuel; Masaninga, Freddie; Habluetzel, Annette; Masiye, Felix; Fall, Ibrahima Soce

    2014-01-01

    Objective To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management. Results Out of 4?891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI95 21.3.1-23.7) were not subjected to any malaria test. Of the 2?247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI95 6.9-9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria, years of residence in the district and length of service of the health worker at the facility were not associated with diagnostic and treatment choices. Conclusions Malaria case management was characterised by poor adherence to treatment guidelines. The non-adherence was mainly in terms of: inconsistent use of confirmatory tests (rapid diagnostic test or microscopy) for malaria; prescribing anti-malarials which are not recommended (e.g. sulphadoxine-pyrimethamine) and prescribing anti-malarials to cases testing negative. Innovative approaches are required to improve health worker adherence to diagnosis and treatment guidelines. PMID:25182953

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

    PubMed

    Jrgensen, Marte; Sandy, Ingvild F; Michelo, Charles; Fylkesnes, Knut; Mwangala, Sheila; Blystad, Astrid

    2013-11-01

    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

  18. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia: a population based survey

    PubMed Central

    2014-01-01

    Background Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban areas of three districts in Kenya, Tanzania and Zambia. Methods A population-based survey was conducted in 2007 as part of the ‘REsponse to ACcountable priority setting for Trust in health systems’ (REACT) project. Stratified random cluster sampling was used and the data included information on place of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban–rural residence. Results There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth was 15, 70 and 37% in the rural areas of Malindi, Mbarali and Kapiri Mposhi respectively, and 57, 75 and 77% in the urban areas of the districts respectively. However, striking socio-economic inequities were revealed regardless of district. Furthermore, there were indications that repeated exposure to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. Conclusion Strong socio-economic inequities in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to strengthen services targeting disadvantaged and remote populations. The finding of a positive association between HIV counselling/testing and odds in favor of giving birth at a health facility suggests potential positive effects can be achieved by strengthening integrated approaches in maternal health service delivery. PMID:24996456

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

    PubMed Central

    Musheke, Maurice; Bond, Virginia; Merten, Sonja

    2012-01-01

    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. PMID:22713354

  20. Retention and risk factors for attrition among adults in antiretroviral treatment programmes in Tanzania, Uganda and Zambia

    PubMed Central

    Koole, Olivier; Tsui, Sharon; Wabwire-Mangen, Fred; Kwesigabo, Gideon; Menten, Joris; Mulenga, Modest; Auld, Andrew; Agolory, Simon; Mukadi, Ya Diul; Colebunders, Robert; Bangsberg, David R.; van Praag, Eric; Torpey, Kwasi; Williams, Seymour; Kaplan, Jonathan; Zee, Aaron; Denison, Julie

    2016-01-01

    OBJECTIVES We assessed retention and predictors of attrition (recorded death or loss to follow-up) in antiretroviral treatment (ART) clinics in Tanzania, Uganda and Zambia. METHODS We conducted a retrospective cohort study among adults (?18 years) starting ART during 20032010. We purposefully selected six health facilities per country and randomly selected 250 patients from each facility. Patients who visited clinics at least once during the 90 days before data abstraction were defined as retained. Data on individual and programme level risk factors for attrition were obtained through chart review and clinic manager interviews. KaplanMeier curves for retention across sites were created. Predictors of attrition were assessed using a multivariable Cox-proportional hazards model, adjusted for site-level clustering. RESULTS From 17 facilities, 4147 patients were included. Retention ranged from 52.0% to 96.2% at 1 year to 25.8%90.4% at 4 years. Multivariable analysis of ART initiation characteristics found the following independent risk factors for attrition: younger age [adjusted hazard ratio (aHR) and 95% confidence interval (95%CI) = 1.30 (1.141.47)], WHO stage 4 ([aHR (95% CI): 1.56 (1.291.88)], >10% bodyweight loss [aHR (95%CI) = 1.17 (1.001.38)], poor functional status [ambulatory aHR (95%CI) = 1.29 (1.091.54); bedridden aHR1.54 (1.152.07)], and increasing years of clinic operation prior to ART initiation in government facilities [aHR (95%CI) = 1.17 (1.101.23)]. Patients with higher CD4 cell count were less likely to experience attrition [aHR (95%CI) = 0.88 (0.781.00)] for every log (tenfold) increase. Sites offering community ART dispensing [aHR (95% CI) = 0.55 (0.301.01) for women; 0.40 (0.210.75) for men] had significantly less attrition. CONCLUSIONS Patient retention to an individual programme worsened over time especially among males, younger persons and those with poor clinical indicators. Community ART drug dispensing programmes could improve retention. PMID:25227621

  1. Perinatal Outcomes of Multiple Gestation Pregnancies in Kenya, Zambia, Pakistan, India, Guatemala and Argentina: A Global Network Study

    PubMed Central

    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; Belizan, Jose; Derman, Richard J.; Hibberd, Patricia L.; Hambidge, K. Michael; Buekens, Pierre; Goldenberg, Robert L.; Carlo, Waldemar A.; Wallace, Dennis; Moore, Janet; Koso-Thomas, Marion; Wright, Linda L.; Liechty, Edward A.

    2014-01-01

    Objective The aims of the study were to determine the rates of multiple gestation, the stillbirth, perinatal, and neonatal mortality rates, and to determine health care characteristics associated with outcomes of these pregnancies in low- and mid-income countries. Design/Methods All pregnant women residing in defined geographic clusters located in 7 sites in 6 countries, Kenya, Zambia, Argentina, Guatemala, Pakistan, India (Belgaum and Nagpur) were enrolled and followed to 42 days postpartum, with staff collecting pregnancy characteristics and maternal and perinatal outcomes. Results A total of 69,706 women were enrolled. Multiple gestations accounted for 0.9% of all births (twins 0.9%, triplets 0.01%). Kenya and Pakistan had the highest rates of multiple gestation deliveries with 14.6/1000 and 10.7/1000 live births respectively. The mothers with a multiple gestation were more likely to deliver in a health care facility compared to singleton pregnancy mothers (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 section (18% vs. 9%, p<0.001). Multiple gestation fetuses had a relative risk (RR) for stillbirth of 2.65 (2.06, 3.41) and for perinatal mortality rate (PMR) a RR of 3.98 (3.40, 4.65) relative to singletons (both p<0.0001). Neither delivery in a health facility nor the Cesarean section 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. Physician delivery may be associated with improved outcomes; however, neither delivery in a health facility nor the Cesarean section rate is associated with improved PMR. These results suggest that merely encouraging women to deliver in health facilities will not be sufficient to decrease these risks associated with multiple gestation. PMID:23512321

  2. Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study

    PubMed Central

    2013-01-01

    Background The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambias MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. Methods A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. Results The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity to hold health workers accountable for the drugs and services. Conclusion The study has shown that building block specific weaknesses had cross cutting effect in other health system building blocks. These linkages emphasised the need to use system wide approaches in assessing the performance of health system strengthening interventions. PMID:23902601

  3. First sero-prevalence of dengue fever specific immunoglobulin G antibodies in Western and North-Western provinces of Zambia: a population based cross sectional study

    PubMed Central

    2014-01-01

    Background Dengue fever is a tropical infectious disease caused by dengue virus (DENV), a single positive-stranded RNA Flavivirus. There is no published evidence of dengue in Zambia. The objective of the study was to determine the sero-prevalence and correlates for dengue fever specific IgG antibodies in Western and North-Western provinces in Zambia. Methods A randomized cluster design was used to sample participants for yellow fever risk assessment. In order to rule out cross reactivity with other flaviviruses including dengue, differential antibody tests were done by ELISA. Data was processed using Epi Data version 3.1 and transferred to SPSS version 16.0 for analysis. Bivariate and multivariate analyses were performed to determine the association of dengue fever with various factors. Unadjusted odds ratios (OR), adjusted odds ratios (AOR) and their 95% confidence intervals (CI) are reported. Results A total of 3,624 persons were sampled for dengue virus infection of whom 53.3% were female and 23.9% were in the 514 years age group. Most persons in the survey attained at least primary education (47.6%). No significant association was observed between sex and dengue virus infection (p?=?1.000). Overall, 4.1% of the participants tested positive for Dengue IgG. In multivariate analysis, the association of age with Dengue infection showed that those below 5years of age were 63% (AOR?=?0.37; 95% CI [0.16, 0.86]) less likely to be infected with Dengue virus compared to those aged 45years or older. A significant association was observed between grass thatched roofing and Dengue infection (AOR?=?2.28; 95% CI [1.15, 4.53]) Respondents who used Insecticide Treated Nets (ITN) were 21% (AOR?=?1.21; 95% CI [1.01, 1.44]) more likely to be infected with dengue infection than those who did not use ITNs. Meanwhile, participants who visited Angola were 73% (AOR?=?1.73; 95% CI [1.27, 2.35]) more likely to be infected with Dengue virus than those who did not visit Angola. Conclusion This study provides the first evidence of dengue infection circulation in both North-Western and Western provinces of Zambia. It is important that surveillance activities for Dengue and diagnostic systems are expanded and strengthened, nationwide in order to capture information related to dengue virus and other flaviviruses. PMID:25078113

  4. Analysis of Anopheles arabiensis blood feeding behavior in southern Zambia during the two years after introduction of insecticide-treated bed nets.

    PubMed

    Fornadel, Christen M; Norris, Laura C; Glass, Gregory E; Norris, Douglas E

    2010-10-01

    Anopheles arabiensis mosquitoes are the primary vector responsible for Plasmodium falciparum transmission in Macha, Zambia. Because insecticide-treated bed nets (ITNs) have the potential to alter host feeding behavior, the extent of the zoophilic and exophagic tendencies of the vector was evaluated during the two rainy seasons after ITN introduction. Centers for Disease Control light traps, paired indoor/outdoor human landing catches, and outdoor cattle-baited collections were used to assess potential changes in host preference. Results support the hypothesis that An. arabiensis mosquitoes in Macha remain highly anthropophilic despite high ITN use. Anopheles arabiensis mosquitoes in Macha appear to be relatively exophagic and have been caught biting outdoors immediately after sunset and before sunrise, potentially circumventing some of the protective effects of ITNs. PMID:20889878

  5. 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

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

    2002-09-01

    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

  6. Control of aquatic weeds through pollutant reduction and weed utilization: a weed management approach in the lower Kafue River of Zambia

    NASA Astrophysics Data System (ADS)

    Sinkala, Thomson; Mwase, Enala T.; Mwala, Mick

    The aquatic weed situation in the Kafue River in Zambia continues to be a major challenge to the sustainable utilization of the water resources of the river. The general methods for managing the weeds, especially the water hyacinth, include use of bio-agents, chemicals, mechanical and physical approaches. These have had very little impact. This paper reports on a project that is investigating weed management strategies which involve use of cleaner production (CP) approach and the utilization of the weed for economic purposes. In addition, the ecological implications of these methods are being assessed. Effluent assessments indicated that apart from nitrates and phosphates, other effluent parameters met the Environmental Council of Zambia standards. Results further show that all the 24 areas surveyed for CP have uncontrolled socio-economic activities which generate both point and non-point sources of pollution that enter the water bodies. To minimize pollution, efforts include devising policy and technical strategies with the involvement of the affected riparian community. Production of mushroom by the communities using the water hyacinth substrate has been demonstrated. Up to 2.1 kg of mushroom was harvested from a single flush over a period of 4-5 weeks. Vegetables grown on soils treated with water hyacinth manure performed better than those grown using commercial fertiliser. The economics of the production are however, yet to be confirmed. If weed usage is proven economically and ecologically viable, the riverine community is envisaged to play a big role in aquatic weed management. High numbers of invertebrates known to be sensitive to pollution have been recorded in the weed-infested Kafue River implying that the water is of good quality for these aquatic invertebrates. This observed quality of water may be due to water hyacinth playing a role by sieving pollutants from the river.

  7. Attitudes of women and men living with HIV and their healthcare providers towards pregnancy and abortion by HIV-positive women in Nigeria and Zambia.

    PubMed

    Moore, Ann M; Bankole, Akinrinola; Awolude, Olutoin; Audam, Suzette; Oladokun, Adesina; Adewole, Isaac

    2015-01-01

    Fertility decisions among people living with HIV/AIDS (PLWHA) are complicated by disease progression, the health of their existing children and possible antiretroviral therapy (ART) use, among other factors. Using a sample of HIV-positive women (n = 353) and men (n = 299) from Nigeria and Zambia and their healthcare providers (n = 179), we examined attitudes towards childbearing and abortion by HIV-positive women. To measure childbearing and abortion attitudes, we used individual indicators and a composite measure (an index). Support for an HIV-positive woman to have a child was greatest if she was nulliparous or if her desire to have a child was not conditioned on parity and lowest if she already had an HIV-positive child. Such support was found to be lower among HIV-positive women than among HIV-positive men, both of which were lower than reported support from their healthcare providers. There was wider variation in support for abortion depending on the measure than there was for support for childbearing. Half of all respondents indicated no or low support for abortion on the index measure while between 2 and 4 in 10 respondents were supportive of HIV-positive women being able to terminate a pregnancy. The overall low levels of support for abortion indicate that most respondents did not see HIV as a medical condition which justifies abortion. Respondents in Nigeria and those who live in urban areas were more likely to support HIV-positive women's childbearing. About a fifth of HIV-positive respondents reported being counselled to end childbearing after their diagnosis. In summary, respondents from both Nigeria and Zambia demonstrate tempered support of (continued) childbearing among HIV-positive women while anti-abortion attitudes remain strong. Access to ART did not impart a strong effect on these attitudes. Therefore, pronatalist attitudes remain in place in the face of HIV infection. PMID:25920981

  8. New constraints on the Pan-African Orogeny in Central Zambia: A structural and geochronological study of the Hook Batholith and the Mwembeshi Zone

    NASA Astrophysics Data System (ADS)

    Naydenov, Kalin V.; Lehmann, Jeremie; Saalmann, Kerstin; Milani, Lorenzo; Kinnaird, Judith A.; Charlesworth, Guy; Frei, Dirk; Rankin, William

    2014-12-01

    In Central Zambia, the Mwembeshi Zone (MwZ) separates two branches of the Pan-African Orogen: the Lufilian Arc and the Zambezi Belt. To the north of the MwZ, the Hook Batholith was emplaced within Neoproterozoic Katangan metasedimentary rocks. Field mapping and structural studies, microstructural observations, interpretation of airborne geophysical images and U-Pb zircon geochronology constrain a new model for the tectonic evolution of this poorly studied part of the orogen. Two temporarily separated and highly oblique orogenic contraction events are defined. D1 is characterised by a regional low-metamorphic grade E-W shortening that produced strain partitioning between N-S trending pure-shear-dominated and NW trending sinistral simple-shear dominated domains. The emplacement of the batholith between ca. 550 and 533 Ma (U-Pb zircon ages) is syn-tectonic to D1. The D2 N-S shortening event was active after ca. 530, which is indicated by the age of the newly dated, deformed molasse of the Hook Batholith. During D2, the MwZ developed as an E- to ENE-striking zone of pure-shear dominated deformation that localised to the south and within the already exhumed Hook Batholith. At the scale of the Pan-African Orogen in Southern Africa, the D1 is considered to be a far field expression of the E-W collision event in the Mozambique Belt. The following Early Cambrian D2 event corresponds to the high angle collision between the Congo and Kalahari Cratons and the stitching of the Lufilian and Zambezi belts along the MwZ. Therefore, in the Hook area, the MwZ cannot be regarded as a continental-scale wrench structure as widely discussed in the literature. The tectonic events in Central Zambia suggest that the amalgamation of Gondwana was accompanied by suturing along highly oblique orogenic belts during plate reorganization at around 530 Ma.

  9. Factors associated with neonatal mortality in the general population: evidence from the 2007 Zambia Demographic and Health Survey (ZDHS); a cross sectional study

    PubMed Central

    Lukonga, Etambuyu; Michelo, Charles

    2015-01-01

    Introduction Neonatal mortality accounts for almost 40 percent of under-five child mortality globally and this could be associated with a complex chain of factors including but not limited to socio-economic, biological and healthcare-related factors. We examined factors that may be associated with neonatal mortality in Zambia. Methods Using across-sectional design, data were extracted from the 2007 Zambia Demographic and Health Survey for women using a “Women's Questionnaire” for respondents aged 15-49 years in the selected households. Records of women who reported having given birth to live infants within the five years preceding the survey defined the study population. However only records on those infants who could have lived through the first month (28 days) were assessed (de facto population). Results Overall (n=6 435), there were 3204(49.8%) males and 3231(50.2%)females. There were 219 (3.4%) neonatal deaths recorded. Low birth weight and overweight were reported as the prominent factors. The odds of dying were significantly higher for infants with low birth weight compared to infants born with normal weight, (aOR=2.58, 95%CI 1.02-6.49). The pattern was the same in both rural though insignificant. Over weight born babies showed increased odds of dying (aOR 3.21, 95%CI 1.36-7.59). Compared to infants born from Mothers with no education, infants born from mothers with higher education were associated with increased odds of dying (aOR 3.55, CI 95%, 1.26-9.94). Conclusion Neonatal survival is still a challenge in this population and determinants show varying socio-demographic contrasts. This may suggest limitations in past efforts to improve neonatal health. Future strategies need to continue but should account for varying setting specific epidemiological contrasts. PMID:26090022

  10. HIV infection and domestic smoke exposure, but not human papillomavirus, are risk factors for esophageal squamous cell carcinoma in Zambia: a casecontrol study

    PubMed Central

    Kayamba, Violet; Bateman, Allen C; Asombang, Akwi W; Shibemba, Aaron; Zyambo, Kanekwa; Banda, Themba; Soko, Rose; Kelly, Paul

    2015-01-01

    There is emerging evidence that esophageal cancer occurs in younger adults in sub-Saharan Africa than in Europe or North America. The burden of human immunodeficiency virus (HIV) is also high in this region. We postulated that HIV and human papillomavirus (HPV) infections might contribute to esophageal squamous cell carcinoma (OSCC) risk. This was a casecontrol study based at the University Teaching Hospital in Lusaka, Zambia. Cases were patients with confirmed OSCC and controls had completely normal upper endoscopic evaluations. A total of 222 patients were included to analyze the influence of HIV infection; of these, 100 patients were used to analyze the influence of HPV infection, alcohol, smoking, and exposure to wood smoke. The presence of HIV infection was determined using antibody kits, and HPV infection was detected by polymerase chain reaction. HIV infection on its own conferred increased risk of developing OSCC (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.05.1; P=0.03). The OR was stronger when only people under 60years were included (OR 4.3; 95% CI 1.513.2; P=0.003). Cooking with charcoal or firewood, and cigarette smoking, both increased the odds of developing OSCC ([OR 3.5; 95% CI 1.49.3; P=0.004] and [OR 9.1; 95% CI 3.030.4; P<0.001], respectively). There was no significant difference in HPV detection or alcohol intake between cases and controls. We conclude that HIV infection and exposure to domestic and cigarette smoke are risk factors for OSCC, and HPV immunization unlikely to reduce OSCC incidence in Zambia. PMID:25641622

  11. Measuring teamwork and taskwork of community-based teams delivering life-saving health interventions in rural Zambia: a qualitative study

    PubMed Central

    2013-01-01

    Background The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 059months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Methods Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. Results We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Conclusion Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries. PMID:23802766

  12. A Mobile Phone-Based, Community Health Worker Program for Referral, Follow-Up, and Service Outreach in Rural Zambia: Outcomes and Overview

    PubMed Central

    Sindano, Ntazana; Theis, Mathew; Zue, Cory; Joseph, Jessica; Chilengi, Roma; Chi, Benjamin H.; Stringer, Jeffrey S.A.; Chintu, Namwinga

    2014-01-01

    Abstract Background: Mobile health (m-health) utilizes widespread access to mobile phone technologies to expand health services. Community health workers (CHWs) provide first-level contact with health facilities; combining CHW efforts with m-health may be an avenue for improving primary care services. As part of a primary care improvement project, a pilot CHW program was developed using a mobile phone-based application for outreach, referral, and follow-up between the clinic and community in rural Zambia. Materials and Methods: The program was implemented at six primary care sites. Computers were installed at clinics for data entry, and data were transmitted to central servers. In the field, using a mobile phone to send data and receive follow-up requests, CHWs conducted household health surveillance visits, referred individuals to clinic, and followed up clinic patients. Results: From January to April 2011, 24 CHWs surveyed 6,197 households with 33,304 inhabitants. Of 15,539 clinic visits, 1,173 (8%) had a follow-up visit indicated and transmitted via a mobile phone to designated CHWs. CHWs performed one or more follow-ups on 74% (n=871) of active requests and obtained outcomes on 63% (n=741). From all community visits combined, CHWs referred 840 individuals to a clinic. Conclusions: CHWs completed all planned aspects of surveillance and outreach, demonstrating feasibility. Components of this pilot project may aid clinical care in rural settings and have potential for epidemiologic and health system applications. Thus, m-health has the potential to improve service outreach, guide activities, and facilitate data collection in Zambia. PMID:24926815

  13. Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

    PubMed Central

    Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

    2014-01-01

    Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 20102011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (28% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (7795% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

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

    NASA Astrophysics Data System (ADS)

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

    2004-12-01

    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.

  15. Zambia and Botswana

    Atmospheric Science Data Center

    2013-04-16

    ... that the images acquired through MISR's red, green, and blue filters, respectively, are displayed as red, green, and blue when creating the ... shades of blue and purple in the multi-angle composite as a result of the manner in which the smoke particles scatter sunlight. Other ...

  16. Partnerships in Zambia.

    PubMed

    Kapopo, R

    1996-03-01

    Zambian communities in 21 settlements have developed partnerships with District Councils and nongovernmental organizations (NGOs) with the aid of the Community Development Programme. A Training Programme for Community Participation in Settlements Improvement was implemented by the government from 1984 to 1994 with the support of the UN Centre for Human Settlements (UNCHS) (Habitat). Although seed money for physical settlement improvements was not included, integrating training with the actual process of upgrading enabled the participating communities to make the improvements. The selected communities, with the support of District Council staff, produced project documents to solicit the support of NGOs. The partnerships consisted of three groups; 1) Resident Development Committees, which represented the communities; 2) NGOs; and 3) District Councils. The first group mobilized the communities in the identification of priority needs and in action planning. The second group supplied equipment and funds. The third group provided technical services and created a legal framework in the form of a memorandum of understanding, which was signed by all partners. Sustainability, maintenance, and management of services after the phasing out of NGO support were defined in the memorandum. Schools, clinics, storm-water drainage, and road improvements were some of the benefits obtained from this tripartite partnership. PMID:12293486

  17. ‘Are We Not Human?’ Stories of Stigma, Disability and HIV from Lusaka, Zambia and Their Implications for Access to Health Services

    PubMed Central

    Parsons, Janet A.; Bond, Virginia A.; Nixon, Stephanie A.

    2015-01-01

    Background The advent of anti-retroviral therapy (ART) in Southern Africa holds the promise of shifting the experience of HIV toward that of a manageable chronic condition. However, this potential can only be realized when persons living with HIV are able to access services without barriers, which can include stigma. Our qualitative study explored experiences of persons living with disabilities (PWD) in Lusaka, Zambia who became HIV-positive (PWD/HIV+). Methods and Findings We conducted interviews with 32 participants (21 PWD/HIV+ and 11 key informants working in the fields of HIV and/or disability). Inductive thematic analysis of interview transcripts was informed by narrative theory. Participants’ accounts highlighted the central role of stigma experienced by PWD/HIV+, with stigmatizing attitudes closely linked to prevailing societal assumptions that PWD are asexual. Seeking diagnostic and treatment services for HIV was perceived as evidence of PWD being sexually active. Participants recounted that for PWD/HIV+, stigma was enacted in a variety of settings, including the queue for health services, their interactions with healthcare providers, and within their communities. Stigmatizing accounts told about PWD/HIV+ were described as having important consequences. Not only did participants recount stories of internalized stigma (with its damaging effects on self-perception), but also that negative experiences resulted in some PWD preferring to “die quietly at home” rather than being subjected to the stigmatizing gaze of others when attempting to access life-preserving ART. Participants recounted how experiences of stigma also affected their willingness to continue ART, their willingness to disclose their HIV status to others, as well as their social relations. However, participants also offered counter-stories, actively resisting stigmatizing accounts and portraying themselves as resilient and resourceful social actors. Conclusions The study highlights a significant barrier to healthcare experienced by PWD/HIV+, with important implications for the future design and equitable delivery of HIV services in Zambia. Stigma importantly affects the abilities of PWD/HIV+ to manage their health conditions. PMID:26039666

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

    PubMed Central

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

    2012-01-01

    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. PMID:23284843

  19. Genomic Signature of Multidrug-Resistant Salmonella enterica Serovar Typhi Isolates Related to a Massive Outbreak in Zambia between 2010 and 2012

    PubMed Central

    Leekitcharoenphon, Pimlapas; Lukjancenko, Oksana; Lukwesa-Musyani, Chileshe; Tambatamba, Bushimbwa; Mwaba, John; Kalonda, Annie; Nakazwe, Ruth; Kwenda, Geoffrey; Jensen, Jacob Dyring; Svendsen, Christina A.; Dittmann, Karen K.; Kaas, Rolf S.; Cavaco, Lina M.; Aarestrup, Frank M.; Hasman, Henrik; Mwansa, James C. L.

    2014-01-01

    Retrospectively, we investigated the epidemiology of a massive Salmonella enterica serovar Typhi outbreak in Zambia during 2010 to 2012. Ninety-four isolates were susceptibility tested by MIC determinations. Whole-genome sequence typing (WGST) of 33 isolates and bioinformatic analysis identified the multilocus sequence type (MLST), haplotype, plasmid replicon, antimicrobial resistance genes, and genetic relatedness by single nucleotide polymorphism (SNP) analysis and genomic deletions. The outbreak affected 2,040 patients, with a fatality rate of 0.5%. Most (83.0%) isolates were multidrug resistant (MDR). The isolates belonged to MLST ST1 and a new variant of the haplotype, H58B. Most isolates contained a chromosomally translocated region containing seven antimicrobial resistance genes, catA1, blaTEM-1, dfrA7, sul1, sul2, strA, and strB, and fragments of the incompatibility group Q1 (IncQ1) plasmid replicon, the class 1 integron, and the mer operon. The genomic analysis revealed 415 SNP differences overall and 35 deletions among 33 of the isolates subjected to whole-genome sequencing. In comparison with other genomes of H58, the Zambian isolates separated from genomes from Central Africa and India by 34 and 52 SNPs, respectively. The phylogenetic analysis indicates that 32 of the 33 isolates sequenced belonged to a tight clonal group distinct from other H58 genomes included in the study. The small numbers of SNPs identified within this group are consistent with the short-term transmission that can be expected over a period of 2 years. The phylogenetic analysis and deletions suggest that a single MDR clone was responsible for the outbreak, during which occasional other S. Typhi lineages, including sensitive ones, continued to cocirculate. The common view is that the emerging global S. Typhi haplotype, H58B, containing the MDR IncHI1 plasmid is responsible for the majority of typhoid infections in Asia and sub-Saharan Africa; we found that a new variant of the haplotype harboring a chromosomally translocated region containing the MDR islands of IncHI1 plasmid has emerged in Zambia. This could change the perception of the term classical MDR typhoid currently being solely associated with the IncHI1 plasmid. It might be more common than presently thought that S. Typhi haplotype H58B harbors the IncHI1 plasmid or a chromosomally translocated MDR region or both. PMID:25392358

  20. Impact of the large-scale deployment of artemether/lumefantrine on the malaria disease burden in Africa: case studies of South Africa, Zambia and Ethiopia.

    PubMed

    Barnes, Karen I; Chanda, Pascalina; Ab Barnabas, Gebre

    2009-01-01

    Malaria is one of the most significant causes of morbidity and mortality worldwide. Every year, nearly one million deaths result from malaria infection. Malaria can be controlled in endemic countries by using artemisinin-based combination therapy (ACT) in combination with indoor residual spraying (IRS) and insecticide-treated nets (ITNs). At least 40 malaria-endemic countries in sub-Saharan Africa now recommend the use of ACT as first-line treatment for uncomplicated falciparum malaria as a cornerstone of their malaria case management. The scaling up of malaria control strategies in Zambia has dramatically reduced the burden of malaria. Zambia was the first African country to adopt artemether/lumefantrine (AL; Coartem) as first-line therapy in national malaria treatment guidelines in 2002. Further, the vector control with IRS and ITNs was also scaled up. By 2008, the rates of in-patient malaria cases and deaths decreased by 61% and 66%, respectively, compared with the 2001-2002 reference period. Treatment with AL as first-line therapy against a malaria epidemic in the KwaZulu-Natal province of South Africa, in combination with strengthening of vector control, caused the number of malaria-related outpatient cases and hospital admissions to each fall by 99% from 2001 to 2003, and malaria-related deaths decreased by 97% over the same period. A prospective study also showed that gametocyte development was prevented in all patients receiving AL. This reduction in malaria morbidity has been sustained over the past seven years. AL was introduced as first-line anti-malarial treatment in 2004 in the Tigray region of Ethiopia. During a major malaria epidemic from May-October 2005, the district in which local community health workers were operating had half the rate of malaria-related deaths compared with the district in which AL was only available in state health facilities. Over the two-year study period, the community-based deployment of AL significantly lowered the risk of malaria-specific mortality by 37%. Additionally, the malaria parasite reservoir was three-fold lower in the intervention district than in the control district during the 2005 high-transmission season. Artemisinin-based combination therapy has made a substantial contribution to reducing the burden of malaria in sub-Saharan Africa. PMID:19818175

  1. Patient satisfaction and perceived quality of care: evidence from a cross-sectional national exit survey of HIV and non-HIV service users in Zambia

    PubMed Central

    Dansereau, Emily; Masiye, Felix; Gakidou, Emmanuela; Masters, Samuel H; Burstein, Roy; Kumar, Santosh

    2015-01-01

    Objective To examine the associations between perceived quality of care and patient satisfaction among HIV and non-HIV patients in Zambia. Setting Patient exit survey conducted at 104 primary, secondary and tertiary health clinics across 16 Zambian districts. Participants 2789 exiting patients. Primary independent variables Five dimensions of perceived quality of care (health personnel practice and conduct, adequacy of resources and services, healthcare delivery, accessibility of care, and cost of care). Secondary independent variables Respondent, visit-related, and facility characteristics. Primary outcome measure Patient satisfaction measured on a 1–10 scale. Methods Indices of perceived quality of care were modelled using principal component analysis. Statistical associations between perceived quality of care and patient satisfaction were examined using random-effect ordered logistic regression models, adjusting for demographic, socioeconomic, visit and facility characteristics. Results Average satisfaction was 6.9 on a 10-point scale for non-HIV services and 7.3 for HIV services. Favourable perceptions of health personnel conduct were associated with higher odds of overall satisfaction for non-HIV (OR=3.53, 95% CI 2.34 to 5.33) and HIV (OR=11.00, 95% CI 3.97 to 30.51) visits. Better perceptions of resources and services were also associated with higher odds of satisfaction for both non-HIV (OR=1.66, 95% CI 1.08 to 2.55) and HIV (OR=4.68, 95% CI 1.81 to 12.10) visits. Two additional dimensions of perceived quality of care—healthcare delivery and accessibility of care—were positively associated with higher satisfaction for non-HIV patients. The odds of overall satisfaction were lower in rural facilities for non-HIV patients (OR 0.69; 95% CI 0.48 to 0.99) and HIV patients (OR=0.26, 95% CI 0.16 to 0.41). For non-HIV patients, the odds of satisfaction were greater in hospitals compared with health centres/posts (OR 1.78; 95% CI 1.27 to 2.48) and lower at publicly-managed facilities (OR=0.41, 95% CI=0.27 to 0.64). Conclusions Perceived quality of care is an important driver of patient satisfaction with health service delivery in Zambia. PMID:26719321

  2. Genomic signature of multidrug-resistant Salmonella enterica serovar typhi isolates related to a massive outbreak in Zambia between 2010 and 2012.

    PubMed

    Hendriksen, Rene S; Leekitcharoenphon, Pimlapas; Lukjancenko, Oksana; Lukwesa-Musyani, Chileshe; Tambatamba, Bushimbwa; Mwaba, John; Kalonda, Annie; Nakazwe, Ruth; Kwenda, Geoffrey; Jensen, Jacob Dyring; Svendsen, Christina A; Dittmann, Karen K; Kaas, Rolf S; Cavaco, Lina M; Aarestrup, Frank M; Hasman, Henrik; Mwansa, James C L

    2015-01-01

    Retrospectively, we investigated the epidemiology of a massive Salmonella enterica serovar Typhi outbreak in Zambia during 2010 to 2012. Ninety-four isolates were susceptibility tested by MIC determinations. Whole-genome sequence typing (WGST) of 33 isolates and bioinformatic analysis identified the multilocus sequence type (MLST), haplotype, plasmid replicon, antimicrobial resistance genes, and genetic relatedness by single nucleotide polymorphism (SNP) analysis and genomic deletions. The outbreak affected 2,040 patients, with a fatality rate of 0.5%. Most (83.0%) isolates were multidrug resistant (MDR). The isolates belonged to MLST ST1 and a new variant of the haplotype, H58B. Most isolates contained a chromosomally translocated region containing seven antimicrobial resistance genes, catA1, blaTEM-1, dfrA7, sul1, sul2, strA, and strB, and fragments of the incompatibility group Q1 (IncQ1) plasmid replicon, the class 1 integron, and the mer operon. The genomic analysis revealed 415 SNP differences overall and 35 deletions among 33 of the isolates subjected to whole-genome sequencing. In comparison with other genomes of H58, the Zambian isolates separated from genomes from Central Africa and India by 34 and 52 SNPs, respectively. The phylogenetic analysis indicates that 32 of the 33 isolates sequenced belonged to a tight clonal group distinct from other H58 genomes included in the study. The small numbers of SNPs identified within this group are consistent with the short-term transmission that can be expected over a period of 2 years. The phylogenetic analysis and deletions suggest that a single MDR clone was responsible for the outbreak, during which occasional other S. Typhi lineages, including sensitive ones, continued to cocirculate. The common view is that the emerging global S. Typhi haplotype, H58B, containing the MDR IncHI1 plasmid is responsible for the majority of typhoid infections in Asia and sub-Saharan Africa; we found that a new variant of the haplotype harboring a chromosomally translocated region containing the MDR islands of IncHI1 plasmid has emerged in Zambia. This could change the perception of the term "classical MDR typhoid" currently being solely associated with the IncHI1 plasmid. It might be more common than presently thought that S. Typhi haplotype H58B harbors the IncHI1 plasmid or a chromosomally translocated MDR region or both. PMID:25392358

  3. Geochronology and nature of the Palaeoproterozoic basement in the Central African Copperbelt (Zambia and the Democratic Republic of Congo), with regional implications

    NASA Astrophysics Data System (ADS)

    Rainaud, C.; Master, S.; Armstrong, R. A.; Robb, L. J.

    2005-07-01

    U-Pb SHRIMP zircon age data, together with geochemical analyses, from the basement to the Katanga Supergroup in the Central African Copperbelt reveal the existence of a widespread Palaeoproterozoic magmatic arc terrane. The Lufubu schists represent a long-lived calc-alkaline volcanic arc sequence and, where dated in both Zambia and the Democratic Republic of Congo (DRC), yield ages of 1980 7, 1968 9, 1964 12 and 1874 8 Ma. The oldest dated unit from the region, the Mkushi granitic gneiss from south-east of the Zambian Copperbelt, has an age of 2049 6 Ma. The copper-mineralized Mtuga aplites, which crosscut the foliation in the Mkushi gneisses, have mainly xenocrystic, zoned zircons with cores dated at ca. 2.07-2.00 Ga. Overgrowths on these cores are dated at 1059 26 Ma, which is interpreted as the intrusive age of the aplites. An augen gneiss from the Mulungushi Bridge locality yielded an emplacement age of 1976 5 Ma. The Mufulira Pink Granite has an age of 1994 7 Ma, while the Chambishi granite has been dated at 1983 5 Ma, an age within error of Lufubu schist metavolcanics from elsewhere in the Chambishi basin. The gneisses, granitoids and acid-intermediate calc-alkaline metavolcanics are considered to represent stages in the evolution of one or more magmatic arcs that formed episodically over a 200 million year period between 2050 and 1850 Ma. We suggest naming this assemblage of rocks the "Lufubu Metamorphic Complex". The rocks of the Lufubu Metamorphic Complex are interpreted to be part of a regionally extensive Palaeoproterozoic magmatic arc terrane stretching from northern Namibia to northern Zambia and the DRC. This terrane is termed the Kamanjab-Bangweulu arc and is inferred to have collided with the Archaean Tanzanian craton during the ca. 2.0-1.9 Ga Ubendian orogeny, to produce a new composite minicontinental entity that we term the "Kambantan" terrane. The Kambantan terrane was accreted onto the southern margin of the Congo craton during the ca. 1.4-1.0 Kibaran orogeny.

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

    PubMed

    Heslop, Jo; Banda, Rabecca

    2013-05-01

    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

  5. Population-Wide Malaria Testing and Treatment with Rapid Diagnostic Tests and Artemether-Lumefantrine in Southern Zambia: A community Randomized Step-Wedge Control Trial Design

    PubMed Central

    Larsen, David A.; Bennett, Adam; Silumbe, Kafula; Hamainza, Busiku; Yukich, Joshua O.; Keating, Joseph; Littrell, Megan; Miller, John M.; Steketee, Richard W.; Eisele, Thomas P.

    2015-01-01

    Reducing the human reservoir of malaria parasites is critical for elimination. We conducted a community randomized controlled trial in Southern Province, Zambia to assess the impact of three rounds of a mass test and treatment (MTAT) intervention on malaria prevalence and health facility outpatient case incidence using random effects logistic regression and negative binomial regression, respectively. Following the intervention, children in the intervention group had lower odds of a malaria infection than individuals in the control group (adjusted odds ratio = 0.47, 95% confidence interval [CI] = 0.24–0.90). Malaria outpatient case incidence decreased 17% in the intervention group relative to the control group (incidence rate ratio = 0.83, 95% CI = 0.68–1.01). Although a single year of MTAT reduced malaria prevalence and incidence, the impact of the intervention was insufficient to reduce transmission to a level approaching elimination where a strategy of aggressive case investigations could be used. Mass drug administration, more sensitive diagnostics, and gametocidal drugs may potentially improve interventions targeting the human reservoir of malaria parasites. PMID:25802434

  6. Consistency of Use and Effectiveness of Household Water Treatment Practices Among Urban and Rural Populations Claiming to Treat Their Drinking Water at Home: A Case Study in Zambia.

    PubMed

    Rosa, Ghislaine; Kelly, Paul; Clasen, Thomas

    2016-02-01

    Household water treatment (HWT) can improve drinking water quality and prevent disease, if used correctly and consistently. While international monitoring suggests that 1.8 billion people practice HWT, these estimates are based on household surveys that may overstate the level of consistent use and do not address microbiological effectiveness. We sought to examine how HWT is practiced among households identified as HWT users according to international monitoring standards. Case studies were conducted in urban and rural Zambia. After a baseline survey (urban: 203 households, rural: 276 households) to identify HWT users, 95 urban and 82 rural households were followed up for 6 weeks. Consistency of HWT reporting was low; only 72.6% of urban and 50.0% of rural households reported to be HWT users in the subsequent visit. Similarly, availability of treated water was low, only 23.3% and 4.2% of urban and rural households, respectively, had treated water on all visits. Drinking water was significantly worse than source water in both settings. Only 19.6% of urban and 2.4% of rural households had drinking water free of thermotolerant coliforms on all visits. Our findings raise questions about the value of the data gathered through the international monitoring of HWT practices as predictors of water quality in the home. PMID:26572868

  7. A Review of Ecological Factors Associated with the Epidemiology of Wildlife Trypanosomiasis in the Luangwa and Zambezi Valley Ecosystems of Zambia

    PubMed Central

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

    2012-01-01

    Trypanosomiasis has been endemic in wildlife in Zambia for more than a century. The disease has been associated with neurological disorders in humans. Current conservation strategies by the Zambian government of turning all game reserves into state-protected National Parks (NPs) and game management areas (GMAs) have led to the expansion of the wildlife and tsetse population in the Luangwa and Zambezi valley ecosystem. This ecological niche lies in the common tsetse fly belt that harbors the highest tsetse population density in Southern Africa. Ecological factors such as climate, vegetation and rainfall found in this niche allow for a favorable interplay between wild reservoir hosts and vector tsetse flies. These ecological factors that influence the survival of a wide range of wildlife species provide adequate habitat for tsetse flies thereby supporting the coexistence of disease reservoir hosts and vector tsetse flies leading to prolonged persistence of trypanosomiasis in the area. On the other hand, increase in anthropogenic activities poses a significant threat of reducing the tsetse and wildlife habitat in the area. Herein, we demonstrate that while conservation of wildlife and biodiversity is an important preservation strategy of natural resources, it could serve as a long-term reservoir of wildlife trypanosomiasis. PMID:22693499

  8. Factors associated with HIV-testing and acceptance of an offer of home-based testing by men in rural Zambia.

    PubMed

    Hensen, B; Lewis, J J; Schaap, A; Tembo, M; Mutale, W; Weiss, H A; Hargreaves, J; Ayles, H

    2015-03-01

    The objective of this study is to describe HIV-testing among men in rural Lusaka Province, Zambia, using a population-based survey for a cluster-randomized trial. Households (N = 120) were randomly selected from each of the 42 clusters, defined as a health facility catchment area. Individuals aged 15-60 years were invited to complete questionnaires regarding demographics and HIV-testing history. Men testing in the last year were defined as recent-testers. After questionnaire completion adults were offered home-based rapid HIV-testing. Of the 2,828 men, 53 % reported ever-testing and 25 % recently-testing. Factors independently associated with ever- and recent-testing included age 20+ years, secondary/higher education, being married or widowed, a history of TB-treatment and higher socioeconomic position. 53 % of never-testers and 57 % of men who did not report a recent-test accepted home-based HIV-testing. Current HIV-testing approaches are inadequate in this high prevalence setting. Alternative strategies, including self-testing, mobile- or workplace-testing, may be required to complement facility-based services. PMID:25096893

  9. Nutritional status of breastfed infants in rural Zambia: comparison of the National Center for Health Statistics growth reference versus the WHO 12-month breastfed pooled data set.

    PubMed Central

    Hautvast, J. L.; Pandor, A.; Burema, J.; Tolboom, J. J.; Chishimba, N.; Monnens, L. A.; van Staveren, W. A.

    2000-01-01

    Cross-sectional data for breastfed infants in rural Zambia were used to evaluate the effect of applying two different data sets as a reference, i.e. the WHO 12-month breastfed pooled data set and the National Center for Health Statistics (NCHS) growth reference in terms of prevalence of malnutrition (stunting, underweight, and wasting). A total of 518 infants who were attending mother-and-child health clinics were included. Age, weight and length were recorded. Anthropometric Z-scores were calculated in two ways: by applying the NCHS growth reference and by using the WHO breastfed data set. Anthropometric Z-scores calculated using the breastfed data set were lower during the first 6-7 months of life compared with those calculated by applying the NCHS growth reference. This resulted in a higher proportion of children aged 0-6 months being classified as stunted and underweight using the breastfed data set versus the NCHS growth reference. After the age of 7 months, similar prevalences of stunting or underweight were observed. Relatively few infants were classified as wasted. In order to adequately assess the prevalence of stunting and underweight in breastfed infants, it is recommended that a new growth reference be developed, as has been initiated by WHO. PMID:10885182

  10. Factors Associated with Sustained Use of Long-Lasting Insecticide-Treated Nets Following a Reduction in Malaria Transmission in Southern Zambia.

    PubMed

    Pinchoff, Jessie; Hamapumbu, Harry; Kobayashi, Tamaki; Simubali, Limonty; Stevenson, Jennifer C; Norris, Douglas E; Colantuoni, Elizabeth; Thuma, Philip E; Moss, William J

    2015-11-01

    Understanding factors influencing sustained use of long-lasting insecticide-treated nets (LLIN) in areas of declining malaria transmission is critical to sustaining control and may facilitate elimination. From 2008 to 2013, 655 households in Choma District, Zambia, were randomly selected and residents were administered a questionnaire and malaria rapid diagnostic test. Mosquitoes were collected concurrently by light trap. In a multilevel model, children and adolescents of 5-17 years of age were 55% less likely to sleep under LLIN than adults (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.35, 0.58). LLIN use was 80% higher during the rainy season (OR = 1.8; CI = 1.5, 2.2) and residents of households with three or more nets were over twice as likely to use a LLIN (OR = 2.1; CI = 1.4, 3.1). For every increase in 0.5 km from the nearest health center, the odds of LLIN use decreased 9% (OR = 0.9; CI = 0.88, 0.98). In a second multilevel model, the odds of LLIN use were more than twice high if more than five mosquitoes (anopheline and culicine) were captured in the house compared with households with no mosquitoes captured (OR = 2.1; CI = 1.1, 3.9). LLIN use can be sustained in low-transmission settings with continued education and distributions, and may be partially driven by the presence of nuisance mosquitoes. PMID:26324729

  11. 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)

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

    2012-09-01

    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.

  12. Antimicrobial resistance in human and animal pathogens in Zambia, Democratic Republic of Congo, Mozambique and Tanzania: an urgent need of a sustainable surveillance system.

    PubMed

    Mshana, Stephen E; Matee, Mecky; Rweyemamu, Mark

    2013-01-01

    A review of the published and unpublished literature on bacterial resistance in human and animals was performed. Sixty-eight articles/reports from the Democratic Republic of Congo (DRC), Mozambique, Tanzania and Zambia were reviewed. The majority of these articles were from Tanzania. There is an increasing trend in the incidence of antibiotic resistance; of major concern is the increase in multidrug- resistant Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Vibrio cholera, non-typhoid Salmonella and other pathogens responsible for nosocomial infections. The increase in methicillin- resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) producers in the countries under review confirms the spread of these clones worldwide. Clinical microbiology services in these countries need to be strengthened in order to allow a coordinated surveillance for antimicrobial resistance and provide data for local treatment guidelines and for national policies to control antimicrobial resistance. While the present study does not provide conclusive evidence to associate the increasing trend in antibiotic resistance in humans with the use of antibiotics in animals, either as feed additives or veterinary prescription, we strongly recommend a one-health approach of systematic surveillance across the public and animal health sectors, as well as the adherence to the FAO (Food and Agriculture Organization)-OIE (World Organization of animal Health) -WHO(World Health Organization) recommendations for non-human antimicrobial usage. PMID:24119299

  13. Private sector involvement in the control of contagious bovine pleuropneumonia (CBPP) in the Kazungula district of Zambia benefitted the community and the control strategy.

    PubMed

    Muuka, Geoffrey Munkombwe; Songolo, Nadi; Kabilika, Swithine; Fandamu, Paul; Buonavoglia, Domenico; Scacchia, Massimo

    2013-03-01

    Contagious bovine pleuropneumonia (CBPP) is a disease of economic importance that is widely distributed in sub-Saharan African and contributes significantly to cattle morbidity and mortality. Lack of resources to implement eradication measures has led to the disease becoming endemic in most areas in sub-Saharan Africa where governments have little resources and the majority of the people are poor. Usually, control and eradication of such diseases as CBPP is treated as a public good by governments and to achieve this, governments are usually assisted by nongovernment organisations, bilateral government programmes and international donors. The private sector, which usually is companies that run businesses to make profit, although not very well established in sub-Saharan Africa could play a big role in the eradication of CBPP in the region. This could play a dual role of promoting investment and also eradicate livestock diseases which have proved a menace in the livestock sector. This paper highlights the role played by the private sector in the control of CBPP in Zambia. PMID:23334379

  14. A review of ecological factors associated with the epidemiology of wildlife trypanosomiasis in the luangwa and zambezi valley ecosystems of zambia.

    PubMed

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

    2012-01-01

    Trypanosomiasis has been endemic in wildlife in Zambia for more than a century. The disease has been associated with neurological disorders in humans. Current conservation strategies by the Zambian government of turning all game reserves into state-protected National Parks (NPs) and game management areas (GMAs) have led to the expansion of the wildlife and tsetse population in the Luangwa and Zambezi valley ecosystem. This ecological niche lies in the common tsetse fly belt that harbors the highest tsetse population density in Southern Africa. Ecological factors such as climate, vegetation and rainfall found in this niche allow for a favorable interplay between wild reservoir hosts and vector tsetse flies. These ecological factors that influence the survival of a wide range of wildlife species provide adequate habitat for tsetse flies thereby supporting the coexistence of disease reservoir hosts and vector tsetse flies leading to prolonged persistence of trypanosomiasis in the area. On the other hand, increase in anthropogenic activities poses a significant threat of reducing the tsetse and wildlife habitat in the area. Herein, we demonstrate that while conservation of wildlife and biodiversity is an important preservation strategy of natural resources, it could serve as a long-term reservoir of wildlife trypanosomiasis. PMID:22693499

  15. Assessing scale-up of mHealth innovations based on intervention complexity: two case studies of child health programs in Malawi and Zambia.

    PubMed

    Noordam, A Camielle; George, Asha; Sharkey, Alyssa B; Jafarli, Arzu; Bakshi, Salina S; Kim, Julia C

    2015-01-01

    As interest in mHealth (including Short Message Services or SMS) increases, it is important to assess potential benefits and limitations of this technology in improving interventions in resource-poor settings. The authors analyzed two case studies (early infant diagnosis of HIV and nutrition surveillance) of three projects in Malawi and Zambia using a conceptual framework that assesses the technical complexity of the programs, with and without the use of SMS technology. The authors based their findings on literature and discussions with key informants involved in the programs. For both interventions, introducing SMS reduced barriers to effective and timely delivery of services by simplifying the tracking and analysis of data and improving communication between healthcare providers. However, the primary implementation challenges for both interventions were related to broader program delivery characteristics (e.g., human resource needs and transportation requirements) that are not easily addressed by the addition of SMS. The addition of SMS technology itself introduced new layers of complexity. PMID:25581520

  16. 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

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

    2012-06-01

    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

  17. The effect of joint contraceptive decisions on the use of Injectables, Long-Acting and Permanent Methods (ILAPMs) among married female (15–49) contraceptive users in Zambia: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Zambia’s fertility rate and unmet need for family planning are still high. This is in spite of the progress reported from 1992 to 2007 of the increase in contraceptive prevalence rate from 15% to 41% and use of modern methods of family planning from 9% to 33%. However, partner disapproval of family planning has been cited by many women in many countries including Zambia. Given the effectiveness of long-acting and permanent methods of family planning (ILAPMs) in fertility regulation, this paper sought to examine the relationship between contraceptive decision-making and use of ILAPMs among married women in Zambia. Methods This paper uses data from the 2007 Zambia Demographic and Health Survey. The analysis is based on married women (15–49) who reported using a method of family planning at the time of the survey. Out of the 7,146 women interviewed, only 1,630 women were valid for this analysis. Cross-tabulations and binary logistic regressions with Chi-square were used to analyse associations and the predictors of use of ILAPMs of contraception, respectively. A confidence interval of .95 was used in determining relationships between independent and dependent variables. Results Two thirds of women made joint decisions regarding contraception and 29% of the women were using ILAPMs. Women who made joint contraceptive decisions are significantly more likely to use ILAPMs than women who did not involve their husband in contraceptive decisions. However, the most significant predictor is the wealth index. Women from rich households are more likely to use ILAPMs than women from medium rich and poor households. Results also show that women of North Western ethnicities and those from Region 3 had higher odds of using ILAPMs than Tonga women and women from Region 2, respectively. Conclusion Joint contraceptive decision-making between spouses is key to use of ILAPMs in Zambia. Our findings have also shown that the wealth index is actually the strongest factor determining use of these methods. As such, family planning programmes directed at increasing use of LAPMs ought to not only encourage spousal communication but should also consider rolling out interventions that incorporate economic empowerment. PMID:24993034

  18. Tectono-metamorphic evolution of the internal zone of the Pan-African Lufilian orogenic belt (Zambia): Implications for crustal reworking and syn-orogenic uranium mineralizations

    NASA Astrophysics Data System (ADS)

    Eglinger, Aurélien; Vanderhaeghe, Olivier; André-Mayer, Anne-Sylvie; Goncalves, Philippe; Zeh, Armin; Durand, Cyril; Deloule, Etienne

    2016-01-01

    The internal zone of the Pan-African Lufilian orogenic belt (Zambia) hosts a dozen uranium occurrences mostly located within kyanite micaschists in a shear zone marking the contact between metasedimentary rocks attributed to the Katanga Neoproterozoic sedimentary sequence and migmatites coring domes developed dominantly at the expense of the pre-Neoproterozoic basement. The P-T-t-d paths reconstructed for these rocks combining field observations, microstructural analysis, metamorphic petrology and thermobarometry and geochronology indicate that they have recorded burial and exhumation during the Pan-African orogeny. Both units of the Katanga metasedimentary sequence and pre-Katanga migmatitic basement have underwent minimum peak P-T conditions of ~ 9-11 kbar and ~ 640-660 °C, dated at ca. 530 Ma by garnet-whole rock Lu-Hf isochrons. This suggests that this entire continental segment has been buried up to a depth of 40-50 km with geothermal gradients of 15-20 °C.km- 1 during the Pan-African orogeny and the formation of the West Gondwana supercontinent. Syn-orogenic exhumation of the partially molten root of the Lufilian belt is attested by isothermal decompression under P-T conditions of ~ 6-8 kbar at ca. 530-500 Ma, witnessing an increase of the geothermal gradients to 25-30 °C·km- 1. Uranium mineralizations that consist of uraninite and brannerite took place at temperatures ranging from ~ 600 to 700 °C, and have been dated at ca. 540-530 Ma by U-Pb ages on uraninite. The main uranium deposition thus occurred at the transition from the syn-orogenic burial to the syn-orogenic exhumation stages and has been then partially transposed and locally remobilized during the post-orogenic exhumation accommodated by activation of low-angle extensional detachment.

  19. Exploiting Human Resource Requirements to Infer Human Movement Patterns for Use in Modelling Disease Transmission Systems: An Example from Eastern Province, Zambia.

    PubMed

    Alderton, Simon; Noble, Jason; Schaten, Kathrin; Welburn, Susan C; Atkinson, Peter M

    2015-01-01

    In this research, an agent-based model (ABM) was developed to generate human movement routes between homes and water resources in a rural setting, given commonly available geospatial datasets on population distribution, land cover and landscape resources. ABMs are an object-oriented computational approach to modelling a system, focusing on the interactions of autonomous agents, and aiming to assess the impact of these agents and their interactions on the system as a whole. An A* pathfinding algorithm was implemented to produce walking routes, given data on the terrain in the area. A* is an extension of Dijkstra's algorithm with an enhanced time performance through the use of heuristics. In this example, it was possible to impute daily activity movement patterns to the water resource for all villages in a 75 km long study transect across the Luangwa Valley, Zambia, and the simulated human movements were statistically similar to empirical observations on travel times to the water resource (Chi-squared, 95% confidence interval). This indicates that it is possible to produce realistic data regarding human movements without costly measurement as is commonly achieved, for example, through GPS, or retrospective or real-time diaries. The approach is transferable between different geographical locations, and the product can be useful in providing an insight into human movement patterns, and therefore has use in many human exposure-related applications, specifically epidemiological research in rural areas, where spatial heterogeneity in the disease landscape, and space-time proximity of individuals, can play a crucial role in disease spread. PMID:26421926

  20. Can combination prevention strategies reduce HIV transmission in generalized epidemic settings in Africa? The HPTN 071 (PopART) study plan in South Africa and Zambia

    PubMed Central

    Vermund, Sten H.; Fidler, Sarah J.; Ayles, Helen; Beyers, Nulda; Hayes, Richard J.

    2013-01-01

    The HIV Prevention Trials Network (HPTN) is conducting the HPTN 071(PopART) study in 21 communities in Zambia and South Africa with support from a consortium of funders. HPTN 071(PopART) is a community-randomized trial of a combination prevention strategy to reduce HIV incidence in the context of the generalized epidemic of southern Africa. The full PopART intervention strategy is anchored in home-based HIV testing and facilitated linkage of HIV-infected persons to care through community health workers, and universal antiretroviral therapy for seropositive persons regardless of CD4+ cell count or HIV viral load. In order to further reduce risk of HIV acquisition among uninfected individuals, the study aims to expand voluntary medical male circumcision, diagnosis and treatment of sexually transmitted infections, behavioral counseling, and condom distribution. The full PopART intervention strategy also incorporates promotion of other interventions designed to reduce HIV and tuberculosis transmission, including optimization of the prevention of mother to child HIV transmission and enhanced individual and public health tuberculosis services. Success for the PopART strategy depends upon the ability to increase coverage for the study interventions whose uptake is a necessary antecedent to a prevention effect. Processes will be measured to assess the degree of penetration of the interventions into the communities. A randomly sampled population cohort from each community will be used to measure the impact of the PopART strategy on HIV incidence over three years. We describe the strategy being tested and progress to date in the HPTN 071(PopART) study. PMID:23764639

  1. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation.

    PubMed

    Shelley, Katharine D; Ansbro, imhn M; Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Tembo Mumba, Grace; Gill, Michelle M; Strasser, Susan; Peeling, Rosanna W; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider's perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in pilot and national rollout settings, and highlighted important differences in costs that may be observed when moving from pilot to scale-up. PMID:25970443

  2. Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

    PubMed Central

    Mwangala, Sheila; Musonda, Kunda G.; Monze, Mwaka; Musukwa, Katoba K.; Fylkesnes, Knut

    2016-01-01

    Background Despite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia. Methods Accuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT) exercises conducted in 2009 (n = 282 sites) and 2010 (n = 488 sites). Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS) were issued to testing sites by the national reference laboratory (NRL). Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively. Results Overall accuracy level was 93.1% (95% CI: 91.2–94.9) in 2009 and 96.9% (95% CI: 96.1–97.8) in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy. Conclusion The study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently strengthened. PMID:26745508

  3. Intimacy versus isolation: a qualitative study of sexual practices among sexually active HIV-infected patients in HIV care in Brazil, Thailand, and Zambia.

    PubMed

    Closson, Elizabeth F; Mimiaga, Matthew J; Sherman, Susan G; Tangmunkongvorakul, Arunrat; Friedman, Ruth K; Limbada, Mohammed; Moore, Ayana T; Srithanaviboonchai, Kriengkrai; Alves, Carla A; Roberts, Sarah; Oldenburg, Catherine E; Elharrar, Vanessa; Mayer, Kenneth H; Safren, Steven A

    2015-01-01

    The success of global treatment as prevention (TasP) efforts for individuals living with HIV/AIDS (PLWHA) is dependent on successful implementation, and therefore the appropriate contribution of social and behavioral science to these efforts. Understanding the psychosocial context of condomless sex among PLWHA could shed light on effective points of intervention. HPTN 063 was an observational mixed-methods study of sexually active, in-care PLWHA in Thailand, Zambia, and Brazil as a foundation for integrating secondary HIV prevention into HIV treatment. From 2010-2012, 80 qualitative interviews were conducted with PLWHA receiving HIV care and reported recent sexual risk. Thirty men who have sex with women (MSW) and 30 women who have sex with men (WSM) participated in equal numbers across the sites. Thailand and Brazil also enrolled 20 biologically-born men who have sex with men (MSM). Part of the interview focused on the impact of HIV on sexual practices and relationships. Interviews were recorded, transcribed, translated into English and examined using qualitative descriptive analysis. The mean age was 25 (SD = 3.2). There were numerous similarities in experiences and attitudes between MSM, MSW and WSM across the three settings. Participants had a high degree of HIV transmission risk awareness and practiced some protective sexual behaviors such as reduced sexual activity, increased use of condoms, and external ejaculation. Themes related to risk behavior can be categorized according to struggles for intimacy and fears of isolation, including: fear of infecting a sex partner, guilt about sex, sexual communication difficulty, HIV-stigma, and worry about sexual partnerships. Emphasizing sexual health, intimacy and protective practices as components of nonjudgmental sex-positive secondary HIV prevention interventions is recommended. For in-care PLWHA, this approach has the potential to support TasP. The overlap of themes across groups and countries indicates that similar intervention content may be effective for a range of settings. PMID:25793283

  4. Age at Antiretroviral Therapy Initiation Predicts Immune Recovery, Death, and Loss to Follow-Up Among HIV-Infected Adults in Urban Zambia

    PubMed Central

    Joseph, Jessica; Mwale, Jonas; Marx, Melissa A.; Goma, Fastone M.; Mulenga, Lloyd B.; Stringer, Jeffrey S.A.; Eron, Joseph J.; Chi, Benjamin H.

    2014-01-01

    Abstract We analyzed the association of age at antiretroviral therapy (ART) initiation with CD4+ T cell count recovery, death, and loss to follow-up (LTFU) among HIV-infected adults in Zambia. We compared baseline characteristics of patients by sex and age at ART initiation [categorized as 1629 years, 3039 years, 4049 years, 5059 years, and 60 years and older]. We used the medication possession ratio to assess adherence and analysis of covariance to measure the adjusted change in CD4+ T cell count during ART. Using Cox proportional hazard regression, we examined the association of age with death and LTFU. In a secondary analysis, we repeated models with age as a continuous variable. Among 92,130 HIV-infected adults who initiated ART, the median age was 34 years and 6,281 (6.8%) were aged ?50 years. Compared with 1629 year olds, 4049 year olds (46 cells/mm3), 5059 year olds (53 cells/mm3), and 60+ year olds (60 cells/mm3) had reduced CD4+ T cell gains during ART. The adjusted hazard ratio (AHR) for death was increased for individuals aged ?40 years (AHR 1.25 for 4049 year olds, 1.56 for 5059 year olds, and 2.97 for 60+ year olds). Adherence and retention in care were poorest among 1629 year olds but similar in other groups. As a continuous variable, a 5-year increase in age predicted reduced CD4+ T cell count recovery and increased risk of death. Increased age at ART initiation was associated with poorer clinical outcomes, while age <30 years was associated with a higher likelihood of being lost to follow-up. HIV treatment guidelines should consider age-specific recommendations. PMID:24998881

  5. Exploiting Human Resource Requirements to Infer Human Movement Patterns for Use in Modelling Disease Transmission Systems: An Example from Eastern Province, Zambia

    PubMed Central

    Alderton, Simon; Noble, Jason; Schaten, Kathrin; Welburn, Susan C.; Atkinson, Peter M.

    2015-01-01

    In this research, an agent-based model (ABM) was developed to generate human movement routes between homes and water resources in a rural setting, given commonly available geospatial datasets on population distribution, land cover and landscape resources. ABMs are an object-oriented computational approach to modelling a system, focusing on the interactions of autonomous agents, and aiming to assess the impact of these agents and their interactions on the system as a whole. An A* pathfinding algorithm was implemented to produce walking routes, given data on the terrain in the area. A* is an extension of Dijkstra’s algorithm with an enhanced time performance through the use of heuristics. In this example, it was possible to impute daily activity movement patterns to the water resource for all villages in a 75 km long study transect across the Luangwa Valley, Zambia, and the simulated human movements were statistically similar to empirical observations on travel times to the water resource (Chi-squared, 95% confidence interval). This indicates that it is possible to produce realistic data regarding human movements without costly measurement as is commonly achieved, for example, through GPS, or retrospective or real-time diaries. The approach is transferable between different geographical locations, and the product can be useful in providing an insight into human movement patterns, and therefore has use in many human exposure-related applications, specifically epidemiological research in rural areas, where spatial heterogeneity in the disease landscape, and space-time proximity of individuals, can play a crucial role in disease spread. PMID:26421926

  6. Community-based follow-up for late patients enrolled in a district-wide programme for antiretroviral therapy in Lusaka, Zambia.

    PubMed

    Krebs, D W; Chi, B H; Mulenga, Y; Morris, M; Cantrell, R A; Mulenga, L; Levy, J; Sinkala, M; Stringer, J S A

    2008-03-01

    Timely adherence to clinical and pharmacy appointments is well correlated with favourable patient outcomes among HIV-infected individuals on antiretroviral therapy. To date, however, there is little work exploring reasons behind missed visits or evaluating programmatic strategies to recall patients. For this study we implemented community-based follow-up of late patients as part of a large-scale programme for HIV care and treatment in Lusaka, Zambia. Through a network of local home-based care organizations, we attempted home visits to recall patients using locator information provided at time of enrolment. Between May and September 2005, home-based caregivers were dispatched to trace 1,343 patients with missed appointments. Of these, 554 (41%) were untraceable because the provided address was invalid, the patient had moved or no one was at the home. Of the remaining 789, 359 (46%) were reported to have died. Only 430 (54% of those traced, 32% overall) were contacted directly and encouraged to return for care. The likelihood of patient return was higher among traced patients in crude analysis (relative risk [RR] = 2.5; 95%CI = 1.9-3.2) and in multivariable analysis controlling for baseline body mass index, sex and CD4 + count < or = 50/microL (adjusted RR = 2.3; 95%CI = 1.7-3.2). However, the process was inefficient: one late patient returned for every 18 home visits that were made. Reasons for missed visits were provided in 271 of 430 (63%) of the patients who were successfully traced. Common reasons included feeling too sick to come to the clinic, travelling away from home and being too busy. Despite the availability of free ART in Lusaka, patients face significant barriers to attending scheduled clinical visits. Cost-effective and feasible strategies are urgently needed to improve timely patient follow-up. PMID:18351478

  7. Characterization of HIV Drug Resistance Mutations Among Patients Failing First-Line Antiretroviral Therapy From a Tertiary Referral Center in Lusaka, Zambia

    PubMed Central

    Seu, Lillian; Mulenga, Lloyd B.; Siwingwa, Mpanji; Sikazwe, Izukanji; Lambwe, Nason; Guffey, M. Bradford; Chi, Benjamin H.

    2015-01-01

    In settings of resource constraint, an understanding of HIV drug resistance can guide antiretroviral therapy (ART) at switch to second-line therapy. To determine the prevalence of such HIV drug resistance mutations (HIV DRM), we used an in-house sequencing assay in the pol gene (protease and partial reverse transcriptase) in a cohort of patients suspected of failing a first-line regimen, which in Zambia comprises two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Our analysis cohort (n=68) was referred to the University Teaching Hospital in Lusaka from November 2009 to October 2012. Median duration on first-line ART to suspected treatment failure was 3.2 years (IQR 1.74.7 years). The majority of patients (95%) harbored HIV-1 subtype C virus. Analysis of reverse transcriptase revealed M184V (88%), K103N/S (32%), and Y181C/I/V (41%) DRMs, with the latter conferring reduced susceptibility to the salvage therapy candidates etravirine and rilpivirine. Three patients (5%) had major protease inhibitor (PI) resistance mutations: all three had the V82A mutation, and one patient (Clade J virus) had a concurrent M46I, Q58E, and L76V DRM. HIV-1 genotyping revealed major and minor DRMs as well as high levels of polymorphisms in subtype C isolates from patients failing first-line antiretroviral therapy. Closer monitoring of DRM mutations at first-line failure can inform clinicians about future options for salvage therapy. PMID:25754408

  8. Characterization of HIV drug resistance mutations among patients failing first-line antiretroviral therapy from a tertiary referral center in Lusaka, Zambia.

    PubMed

    Seu, Lillian; Mulenga, Lloyd B; Siwingwa, Mpanji; Sikazwe, Izukanji; Lambwe, Nason; Guffey, M Bradford; Chi, Benjamin H

    2015-07-01

    In settings of resource constraint, an understanding of HIV drug resistance can guide antiretroviral therapy (ART) at switch to second-line therapy. To determine the prevalence of such HIV drug resistance mutations (HIV DRM), we used an in-house sequencing assay in the pol gene (protease and partial reverse transcriptase) in a cohort of patients suspected of failing a first-line regimen, which in Zambia comprises two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI). Our analysis cohort (n?=?68) was referred to the University Teaching Hospital in Lusaka from November 2009 to October 2012. Median duration on first-line ART to suspected treatment failure was 3.2 years (IQR 1.7-4.7 years). The majority of patients (95%) harbored HIV-1 subtype C virus. Analysis of reverse transcriptase revealed M184V (88%), K103N/S (32%), and Y181C/I/V (41%) DRMs, with the latter conferring reduced susceptibility to the salvage therapy candidates etravirine and rilpivirine. Three patients (5%) had major protease inhibitor (PI) resistance mutations: all three had the V82A mutation, and one patient (Clade J virus) had a concurrent M46I, Q58E, and L76V DRM. HIV-1 genotyping revealed major and minor DRMs as well as high levels of polymorphisms in subtype C isolates from patients failing first-line antiretroviral therapy. Closer monitoring of DRM mutations at first-line failure can inform clinicians about future options for salvage therapy. PMID:25754408

  9. Scaling Down to Scale Up: A Health Economic Analysis of Integrating Point-of-Care Syphilis Testing into Antenatal Care in Zambia during Pilot and National Rollout Implementation

    PubMed Central

    Ncube, Alexander Tshaka; Sweeney, Sedona; Fleischer, Colette; Mumba, Grace Tembo; Gill, Michelle M.; Strasser, Susan; Peeling, Rosanna W.; Terris-Prestholt, Fern

    2015-01-01

    Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, antenatal registers, clinic staff interviews, and facility observations, with the aim of assessing the cost and quality implications of scaling up a successful pilot into a national rollout. Start-up, capital, and recurrent cost inputs were collected, including costs of extensive supervision and quality monitoring during the pilot. Costs were analysed from a provider’s perspective, incremental to existing antenatal services. Total and unit costs were calculated and a multivariate sensitivity analysis was performed. Our accompanying qualitative study by Ansbro et al. (2015) elucidated quality assurance and supervisory system challenges experienced during rollout, which helped explain key cost drivers. The average unit cost per woman screened during rollout ($11.16) was more than triple the pilot unit cost ($3.19). While quality assurance costs were much lower during rollout, the increased unit costs can be attributed to several factors, including higher RST prices and lower RST coverage during rollout, which reduced economies of scale. Pilot and rollout cost drivers differed due to implementation decisions related to training, supervision, and quality assurance. This study explored the cost of integrating RST into antenatal care in pilot and national rollout settings, and highlighted important differences in costs that may be observed when moving from pilot to scale-up. PMID:25970443

  10. Finding a Needle in the Haystack: The Costs and Cost-Effectiveness of Syphilis Diagnosis and Treatment during Pregnancy to Prevent Congenital Syphilis in Kalomo District of Zambia

    PubMed Central

    Larson, Bruce A.; Lembela-Bwalya, Deophine; Bonawitz, Rachael; Hammond, Emily E.; Thea, Donald M.; Herlihy, Julie

    2014-01-01

    Background In March 2012, The Elizabeth Glaser Pediatric AIDS Foundation trained maternal and child health workers in Southern Province of Zambia to use a new rapid syphilis test (RST) during routine antenatal care. A recent study by Bonawitz et al. (2014) evaluated the impact of this roll out in Kalomo District. This paper estimates the costs and cost-effectiveness from the provider's perspective under the actual conditions observed during the first year of the RST roll out. Methods Information on materials used and costs were extracted from program records. A decision-analytic model was used to evaluate the costs (2012 USD) and cost-effectiveness. Basic parameters needed for the model were based on the results from the evaluation study. Results During the evaluation study, 62% of patients received a RST, and 2.8% of patients tested were positive (and 10.4% of these were treated). Even with very high RST sensitivity and specificity (98%), true prevalence of active syphilis would be substantially less (estimated at <0.7%). For 1,000 new ANC patients, costs of screening and treatment were estimated at $2,136, and the cost per avoided disability-adjusted-life year lost (DALY) was estimated at $628. Costs change little if all positives are treated (because prevalence is low and treatment costs are small), but the cost-per-DALY avoided falls to just $66. With full adherence to guidelines, costs increase to $3,174 per 1,000 patients and the cost-per-DALY avoided falls to $60. Conclusions Screening for syphilis is only useful for reducing adverse birth outcomes if patients testing positive are actually treated. Even with very low prevalence of syphilis (a needle in the haystack), cost effectiveness improves dramatically if those found positive are treated; additional treatment costs little but DALYs avoided are substantial. Without treatment, the needle is essentially found and thrown back into the haystack. PMID:25478877

  11. Why Latrines Are Not Used: Communities’ Perceptions and Practices Regarding Latrines in a Taenia solium Endemic Rural Area in Eastern Zambia

    PubMed Central

    Thys, Séverine; Mwape, Kabemba E.; Lefèvre, Pierre; Dorny, Pierre; Marcotty, Tanguy; Phiri, Andrew M.; Phiri, Isaak K.; Gabriël, Sarah

    2015-01-01

    Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints).The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people’s approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective. PMID:25739017

  12. "It is not an easy decision on HIV, especially in Zambia": opting for silence, limited disclosure and implicit understanding to retain a wider identity.

    PubMed

    Bond, Virginia Anne

    2010-01-01

    As universal testing moves onto the HIV agenda, there is a need for more understanding of the relatively low uptake of HIV testing and the dynamics of disclosure in Sub-Saharan Africa. Despite the expanding provision of anti-retroviral therapy in Zambia since 2004, disclosure of HIV status - beyond a closed network - remains limited. Drawing on 20 years of living and working in a high HIV prevalence country, research on HIV-related stigma and existing literature on disclosure, this paper explores the reasons that lie behind limited disclosure. Unravelling why HIV disclosure remains "a navigation in a moral field", the pattern of silence around HIV and the routine and often subtle presence of HIV in daily life reveals two key dynamics. The first dynamic is shifting public/private boundaries and retaining a wider identity. People living with HIV juggle the pragmatic advantages of disclosing to a limited circle with the importance of maintaining not only their moral integrity, status and (for some) professional and group identity but also of maintaining their privacy. A more public disclosure ("speaking it" more widely) shifts private-public boundaries and can be threatening, dangerous and can fix identity. Furthermore, disclosure carries obligations which, given high levels of poverty, can be hard to meet. The second dynamic is a pattern of implicit understanding. It can be easier in a context of high HIV prevalence to opt for silence, in its various forms, with the presence of HIV implicitly understood but not often explicitly spoken about. Although this gives more room for manoeuvre and for respect, silence too can be dangerous and certain situations dictate that it is better to breach the silence. More aggressive promotion of HIV testing needs to both respect and consider how to work within these existing dynamics to facilitate safe disclosure. PMID:20680855

  13. Cattle owners' awareness of bovine tuberculosis in high and low prevalence settings of the wildlife-livestock interface areas in Zambia

    PubMed Central

    2010-01-01

    Background Awareness of bovine tuberculosis (BTB) by cattle owners is of extreme importance to policy makers when considering mitigation. However, to our knowledge, little is known on cattle owners' awareness of BTB in Zambia. Similarly, such knowledge is uncommon within and outside Africa. The current study investigates the epidemiological characteristics of BTB in Zambian cattle in relation to awareness by cattle owners in high and low cattle BTB prevalence settings. A cross sectional study was designed and data was gathered based on 106 cattle owners and cattle herds; subjected to an interviewer-administered questionnaire and comparative intradermal tuberculin test using a cut-off for positivity of 4 mm, respectively. Results Reported levels of cattle and wildlife contact by respondents was at 40%, 58.2% and 1.8%, were relatively proportional to herd level prevalence of cattle BTB at 64.8%, 58.1% and 5.9% in Blue lagoon, Lochinvar and Kazungula respectively. Although 42/106 (39.6%) of cattle owners had heard of BTB, only 3 (7%) had an idea on how the disease was spread. Cattle contact with wildlife was associated with high levels of awareness by cattle owners (?2 = 43.5, df = 2, P < 0.001). Awareness of BTB in low prevalence settings was lower compared to high prevalence settings. Conclusions Our study has revealed low levels of awareness among cattle owners on BTB. These results could be useful for policy makers when planning mitigation measures to consider awareness levels by cattle owners for effective implementation. Such information is useful for determining sensitisation programs for cattle owners before mitigation. These results further provide useful insights that disease control is a multi-factorial process with cattle owners as an integral part that can support policy implementation. PMID:20406464

  14. Why latrines are not used: communities' perceptions and practices regarding latrines in a Taenia solium endemic rural area in Eastern Zambia.

    PubMed

    Thys, Séverine; Mwape, Kabemba E; Lefèvre, Pierre; Dorny, Pierre; Marcotty, Tanguy; Phiri, Andrew M; Phiri, Isaak K; Gabriël, Sarah

    2015-03-01

    Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities' perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints).The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people's approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective. PMID:25739017

  15. Intimacy versus Isolation: A Qualitative Study of Sexual Practices among Sexually Active HIV-Infected Patients in HIV Care in Brazil, Thailand, and Zambia

    PubMed Central

    Closson, Elizabeth F.; Mimiaga, Matthew J.; Sherman, Susan G.; Tangmunkongvorakul, Arunrat; Friedman, Ruth K.; Limbada, Mohammed; Moore, Ayana T.; Srithanaviboonchai, Kriengkrai; Alves, Carla A.; Roberts, Sarah; Oldenburg, Catherine E.; Elharrar, Vanessa; Mayer, Kenneth H.; Safren, Steven A.

    2015-01-01

    The success of global treatment as prevention (TasP) efforts for individuals living with HIV/AIDS (PLWHA) is dependent on successful implementation, and therefore the appropriate contribution of social and behavioral science to these efforts. Understanding the psychosocial context of condomless sex among PLWHA could shed light on effective points of intervention. HPTN 063 was an observational mixed-methods study of sexually active, in-care PLWHA in Thailand, Zambia, and Brazil as a foundation for integrating secondary HIV prevention into HIV treatment. From 2010–2012, 80 qualitative interviews were conducted with PLWHA receiving HIV care and reported recent sexual risk. Thirty men who have sex with women (MSW) and 30 women who have sex with men (WSM) participated in equal numbers across the sites. Thailand and Brazil also enrolled 20 biologically-born men who have sex with men (MSM). Part of the interview focused on the impact of HIV on sexual practices and relationships. Interviews were recorded, transcribed, translated into English and examined using qualitative descriptive analysis. The mean age was 25 (SD = 3.2). There were numerous similarities in experiences and attitudes between MSM, MSW and WSM across the three settings. Participants had a high degree of HIV transmission risk awareness and practiced some protective sexual behaviors such as reduced sexual activity, increased use of condoms, and external ejaculation. Themes related to risk behavior can be categorized according to struggles for intimacy and fears of isolation, including: fear of infecting a sex partner, guilt about sex, sexual communication difficulty, HIV-stigma, and worry about sexual partnerships. Emphasizing sexual health, intimacy and protective practices as components of nonjudgmental sex-positive secondary HIV prevention interventions is recommended. For in-care PLWHA, this approach has the potential to support TasP. The overlap of themes across groups and countries indicates that similar intervention content may be effective for a range of settings. PMID:25793283

  16. Application of Balanced Scorecard in the Evaluation of a Complex Health System Intervention: 12 Months Post Intervention Findings from the BHOMA Intervention: A Cluster Randomised Trial in Zambia

    PubMed Central

    Mutale, Wilbroad; Stringer, Jeffrey; Chintu, Namwinga; Chilengi, Roma; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Balabanova, Dina; Spicer, Neil; Lewis, James; Ayles, Helen

    2014-01-01

    Introduction In many low income countries, the delivery of quality health services is hampered by health system-wide barriers which are often interlinked, however empirical evidence on how to assess the level and scope of these barriers is scarce. A balanced scorecard is a tool that allows for wider analysis of domains that are deemed important in achieving the overall vision of the health system. We present the quantitative results of the 12 months follow-up study applying the balanced scorecard approach in the BHOMA intervention with the aim of demonstrating the utility of the balanced scorecard in evaluating multiple building blocks in a trial setting. Methods The BHOMA is a cluster randomised trial that aims to strengthen the health system in three rural districts in Zambia. The intervention aims to improve clinical care quality by implementing practical tools that establish clear clinical care standards through intensive clinic implementations. This paper reports the findings of the follow-up health facility survey that was conducted after 12 months of intervention implementation. Comparisons were made between those facilities in the intervention and control sites. STATA version 12 was used for analysis. Results The study found significant mean differences between intervention(I) and control (C) sites in the following domains: Training domain (Mean I:C; 87.5.vs 61.1, mean difference 23.3, p?=?0.031), adult clinical observation domain (mean I:C; 73.3 vs.58.0, mean difference 10.9, p?=?0.02 ) and health information domain (mean I:C; 63.6 vs.56.1, mean difference 6.8, p?=?0.01. There was no gender differences in adult service satisfaction. Governance and motivation scores did not differ between control and intervention sites. Conclusion This study demonstrates the utility of the balanced scorecard in assessing multiple elements of the health system. Using system wide approaches and triangulating data collection methods seems to be key to successful evaluation of such complex health intervention. Trial number ClinicalTrials.gov NCT01942278 PMID:24751780

  17. A cost-effective, community-based, mosquito-trapping scheme that captures spatial and temporal heterogeneities of malaria transmission in rural Zambia

    PubMed Central

    2014-01-01

    Background Monitoring mosquito population dynamics is essential to guide selection and evaluation of malaria vector control interventions but is typically implemented by mobile, centrally-managed teams who can only visit a limited number of locations frequently enough to capture longitudinal trends. Community-based (CB) mosquito trapping schemes for parallel, continuous monitoring of multiple locations are therefore required that are practical, affordable, effective, and reliable. Methods A CB surveillance scheme, with a monthly sampling and reporting cycle for capturing malaria vectors, using Centers for Disease Control and Prevention light traps (LT) and Ifakara Tent Traps (ITT), were conducted by trained community health workers (CHW) in 14 clusters of households immediately surrounding health facilities in rural south-east Zambia. At the end of the study, a controlled quality assurance (QA) survey was conducted by a centrally supervised expert team using human landing catch (HLC), LT and ITT to evaluate accuracy of the CB trapping data. Active surveillance of malaria parasite infection rates amongst humans was conducted by CHWs in the same clusters to determine the epidemiological relevance of these CB entomological surveys. Results CB-LT and CB-ITT exhibited relative sampling efficiencies of 50 and 7%, respectively, compared with QA surveys using the same traps. However, cost per sampling night was lowest for CB-LT ($13.6), followed closely by CB-ITT ($18.0), both of which were far less expensive than any QA survey (HLC: $138, LT: $289, ITT: $269). Cost per specimen of Anopheles funestus captured was lowest for CB-LT ($5.3), followed by potentially hazardous QA-HLC ($10.5) and then CB-ITT ($28.0), all of which were far more cost-effective than QA-LT ($141) and QA-ITT ($168). Time-trends of malaria diagnostic positivity (DP) followed those of An. funestus density with a one-month lag and the wide range of mean DP across clusters was closely associated with mean densities of An. funestus caught by CB-LT (P?

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

    PubMed

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

    2013-03-01

    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 (β = -0.22, p = 0.423). Being tested for HIV was associated with a reduction in stigma (β = -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 (β = -0.78, p = 0.080 vs. β = -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

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

    PubMed Central

    2013-01-01

    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 womens 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 mens health needs, as well as being attentive and responsive to gender inequality during couselling sessions. PMID:23496926

  20. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

    PubMed Central

    2013-01-01

    Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create fatalism and resignation with death while the reported self-prescription of antibiotics to treat HIV-related infections raises concerns about future development of microbial drug resistance amongst PLHIV. Collectively, these self-care practices undermine efforts to effectively abate the spread and burden of HIV and reduce AIDS-related mortality. Therefore, there is need for sensitization campaigns on the benefits of ART and the risks associated with widespread self-prescription of antibiotics and use of scientifically unproven herbal remedies. PMID:23675734

  1. Trace gas emissions from the production and use of domestic biofuels in Zambia measured by open-path Fourier transform infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Bertschi, Isaac T.; Yokelson, Robert J.; Ward, Darold E.; Christian, Ted J.; Hao, Wei Min

    2003-07-01

    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 fires and an earthen charcoal-making kiln in Zambia. These are the first in situ measurements of an extensive suite of trace gases emitted by tropical biofuel burning. We report emission ratios (ER) and emission factors (EF) for (in order of abundance) carbon dioxide (CO2), carbon monoxide (CO), methane (CH4), acetic acid (CH3COOH), methanol (CH3OH), formaldehyde (HCHO), ethene (C2H4), ammonia (NH3), acetylene (C2H2), nitric oxide (NO), ethane (C2H6), phenol (C6H5OH), propene (C3H6), formic acid (HCOOH), nitrogen dioxide (NO2), hydroxyacetaldehyde (HOCH2CHO), and furan (C4H4O). Compared to previous work, our emissions of organic acids and NH3 are 3-6.5 times larger. Another significant finding is that reactive oxygenated organic compounds account for 70-80% of the total nonmethane organic compounds (NMOC). For most compounds, the combined emissions from charcoal production and charcoal burning are larger than the emissions from wood fires by factors of 3-10 per unit mass of fuel burned and 2 per unit energy released. We estimate that Zambian savanna fires produce more annual CO2, HCOOH, and NOx than Zambian biofuel use by factors of 2.5, 1.7, and 5, respectively. However, biofuels contribute larger annual emissions of CH4, CH3OH, C2H2, CH3COOH, HCHO, and NH3 by factors of 5.1, 3.9, 2.7, 2.4, 2.2, and 2.0, respectively. Annual CO and C2H4 emissions are approximately equal from both sources. Coupling our data with recent estimates of global biofuel consumption implies that global biomass burning emissions for several compounds are significantly larger than previously reported. Biofuel emissions are produced year-round, disperse differently than savanna fire emissions, and could strongly impact the tropical troposphere.

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

    PubMed Central

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

    2012-01-01

    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: 0.300.73, p?=?0.001) and 54% among all household members (LPR?=?0.46, 95% CI: 0.300.70, 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 PMID:23082124

  3. Spatio-temporal robustness of fractional cover upscaling: a case study in semi-arid Savannah's of Namibia and Western Zambia

    NASA Astrophysics Data System (ADS)

    Zeidler, Julian; Wegmann, Martin; Dech, Stefan

    2012-10-01

    Vegetation cover is a key parameter in analyzing the state and dynamics of ecosystems. Africa's semi-arid savanna's are particularly prone to degradation, due to increasing population pressure as well as ongoing climatic changes. In most global land cover classifications inhomogeneous areas are aggregated into few discrete classes, delivering unsatisfying results in highly variable biomes, especially savanna's with their small scale patches of woody and herbaceous vegetation and bare soil. Fractional cover(FC) classifications, which provide an estimate of sub-pixel continuous cover percentages of underlying land cover classes, and are therefore an improved thematic representation, can deliver additional information for monitoring and decision making. Prior research demonstrated that multi-scale approaches are suitable for transferring en-detail information from a small subset to a larger study area via statistical up-scaling (e.g. Random Forest). In this case study the robustness of this up-scaling approach and the limits of the spatial and temporal transferability at the very high and intermediate resolution were analysed in the Caprivi Strip in Namibia and the adjacent Western Province of Zambia. The key research questions were to quantify i) the robustness of the upscaling, ii) the loss of accuracy depending on the lag in image acquisitions, iii) the loss of accuracy dependent on the time of image acquisition in the phenological cycle. To this end 12 Worldview(WV) and all usable Landsat TM and ETM+ images, covering all phases of the vegetation cycle were obtained. The analysis showed that continuous FC mapping is a highly suitable concept for semi-arid ecosystems with gradual transitions. The optimal time for WV acquisition was at the beginning of the dry season. The RMSE was unusable for LS images recorded in the rainy season between November and March, but otherwise it was usable even for larger lags up to a month, with deviations below 15%. As long as the spatial training subset(s) cover the whole occurring range of vegetation densities, comparably small WV scenes are sufficient to reliably scale to regional results.

  4. The accountability for reasonableness approach to guide priority setting in health systems within limited resources – findings from action research at district level in Kenya, Tanzania, and Zambia

    PubMed Central

    2014-01-01

    Background Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This paper focuses on the assessment of AFR within the project REsponse to ACcountable priority setting for Trust in health systems (REACT). Methods This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. An implementing action research team of core health team members and supporting researchers was formed to implement, and continually assess and improve the application of the four conditions. Researchers evaluated the intervention using qualitative and quantitative data collection and analysis methods. Results The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. Conclusions District stakeholders were able to take greater charge of closing the gap between nationally set planning and the local realities and demands of the served communities within the limited resources at hand. This study thus indicates that the operationalization of the four broadly defined and linked conditions is both possible and seems to be responding to an actual demand. This provides arguments for the continued application and further assessment of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications. PMID:25142148

  5. 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

    2011-01-01

    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. PMID:21219644

  6. A prospective observational description of frequency and timing of antenatal care attendance and coverage of selected interventions from sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia

    PubMed Central

    2015-01-01

    Background The Global Network for Womens and Childrens Health Research is one of the largest international networks for testing and generating evidence-based recommendations for improvement of maternal-child health in resource-limited settings. Since 2009, Global Network sites in six low and middle-income countries have collected information on antenatal care practices, which are important as indicators of care and have implications for programs to improve maternal and child health. We sought to: (1) describe the quantity of antenatal care attendance over a four-year period; and (2) explore the quality of coverage for selected preventative, screening, and birth preparedness components. Methods The Maternal Newborn Health Registry (MNHR) is a prospective, population-based birth and pregnancy outcomes registry in Global Network sites, including: Argentina, Guatemala, India (Belgaum and Nagpur), Kenya, Pakistan, and Zambia. MNHR data from these sites were prospectively collected from January 1, 2010 December 31, 2013 and analyzed for indicators related to quantity and patterns of ANC and coverage of key elements of recommended focused antenatal care. Descriptive statistics were generated overall by global region (Africa, Asia, and Latin America), and for each individual site. Results Overall, 96% of women reported at least one antenatal care visit. Indian sites demonstrated the highest percentage of women who initiated antenatal care during the first trimester. Women from the Latin American and Indian sites reported the highest number of at least 4 visits. Overall, 88% of women received tetanus toxoid. Only about half of all women reported having been screened for syphilis (49%) or anemia (50%). Rates of HIV testing were above 95% in the Argentina, African, and Indian sites. The Pakistan site demonstrated relatively high rates for birth preparation, but for most other preventative and screening interventions, posted lower coverage rates as compared to other Global Network sites. Conclusions Results from our large, prospective, population-based observational study contribute important insight into regional and site-specific patterns for antenatal care access and coverage. Our findings indicate a quality and coverage gap in antenatal care services, particularly in regards to syphilis and hemoglobin screening. We have identified site-specific gaps in access to, and delivery of, antenatal care services that can be targeted for improvement in future research and implementation efforts. Trial registration Registration at Clinicaltrials.gov (ID# NCT01073475) PMID:26063483

  7. Population-Level Scale-Up of Cervical Cancer Prevention Services in a Low-Resource Setting: Development, Implementation, and Evaluation of the Cervical Cancer Prevention Program in Zambia

    PubMed Central

    Parham, Groesbeck P.; Mwanahamuntu, Mulindi H.; Kapambwe, Sharon; Muwonge, Richard; Bateman, Allen C.; Blevins, Meridith; Chibwesha, Carla J.; Pfaendler, Krista S.; Mudenda, Victor; Shibemba, Aaron L.; Chisele, Samson; Mkumba, Gracilia; Vwalika, Bellington; Hicks, Michael L.; Vermund, Sten H.; Chi, Benjamin H.; Stringer, Jeffrey S. A.; Sankaranarayanan, Rengaswamy; Sahasrabuddhe, Vikrant V.

    2015-01-01

    Background Very few efforts have been undertaken to scale-up low-cost approaches to cervical cancer prevention in low-resource countries. Methods In a public sector cervical cancer prevention program in Zambia, nurses provided visual-inspection with acetic acid (VIA) and cryotherapy in clinics co-housed with HIV/AIDS programs, and referred women with complex lesions for histopathologic evaluation. Low-cost technological adaptations were deployed for improving VIA detection, facilitating expert physician opinion, and ensuring quality assurance. Key process and outcome indicators were derived by analyzing electronic medical records to evaluate program expansion efforts. Findings Between 2006-2013, screening services were expanded from 2 to 12 clinics in Lusaka, the most-populous province in Zambia, through which 102,942 women were screened. The majority (71.7%) were in the target age-range of 25–49 years; 28% were HIV-positive. Out of 101,867 with evaluable data, 20,419 (20%) were VIA positive, of whom 11,508 (56.4%) were treated with cryotherapy, and 8,911 (43.6%) were referred for histopathologic evaluation. Most women (87%, 86,301 of 98,961 evaluable) received same-day services (including 5% undergoing same-visit cryotherapy and 82% screening VIA-negative). The proportion of women with cervical intraepithelial neoplasia grade 2 and worse (CIN2+) among those referred for histopathologic evaluation was 44.1% (1,735/3,938 with histopathology results). Detection rates for CIN2+ and invasive cervical cancer were 17 and 7 per 1,000 women screened, respectively. Women with HIV were more likely to screen positive, to be referred for histopathologic evaluation, and to have cervical precancer and cancer than HIV-negative women. Interpretation We creatively disrupted the 'no screening' status quo prevailing in Zambia and addressed the heavy burden of cervical disease among previously unscreened women by establishing and scaling-up public-sector screening and treatment services at a population level. Key determinants for successful expansion included leveraging HIV/AIDS program investments, and context-specific information technology applications for quality assurance and filling human resource gaps. PMID:25885821

  8. New constraints on the Pan-African tectonics and the role of the Mwembeshi Zone in Central Zambia: Deformation style and timing of two orthogonal shortening events

    NASA Astrophysics Data System (ADS)

    Naydenov, Kalin; Lehmann, Jeremie; Saalmann, Kerstin; Milani, Lorenzo; Kinnaird, Judith; Charlesworth, Guy; Rankin, William; Frei, Dirk

    2014-05-01

    In Central Zambia the Mwembeshi Zone (MwZ) separates two branches of the Late Neoproterozoic - Cambrian Pan-African Orogen: the NE-convex Lufilian Arc and the E-W trending Zambezi Belt whose distinct features emphasize the role of the zone as a regional structural and metamorphic boundary. North of the MwZ, the Hook Batholith was emplaced within the low metamorphic grade Neoproterozoic metasedimentary rocks, and represents the largest Pan-African intrusion in Southern Africa. The granitoids and their host-rocks were affected by two deformation events. During the D1 deformation of E-W shortening, two high-strained zones developed in the batholith. To the NE, the Nalusanga Zone (NZ) is a ~3 km wide NW-striking subvertical sinistral strike-slip shear zone. To the SW, a ~2.5 km wide N-S trending subvertical pure-shear Itezhi-Tezhi Zone (ITZ) formed. In both structures, the granitoids show a smooth transition from weakly deformed rocks to porphyroclastic mylonites. Microstructural analysis defined them as medium metamorphic grade zones, deforming the granitoids at temperatures between 500 and 550C. The lower greenschist facies metamorphism in the country rocks indicates that the deformation occurred during the cooling of the granitoids. D1 in the metasedimentary rocks east of the Hook batholith formed tight, upright folds with subvertical axial-planar cleavage and NNW-SSE trending axis consistent with the E-W shortening. U-Pb zircon geochronology and cross-cutting relationships between granites bracket D1 deformation between 549 2 Ma and 541 3 Ma in the NZ and in the SE part of the batholith. In the ITZ, the 533 3 Ma age on a deformed granite indicates prolonged E-W shortening during granite emplacement and cooling history. D2 represents a stage of N-S shortening. Airborne geophysical data revealed bending of the N-S trending ITZ and rotation to the east. The D1 structures in the granitoids are cut by D2 north-vergent thrusts and subvertical NW trending dextral strike-slip zones. East of the granite, D2 resulted in E-W trending open folds that refolded the D1 structures. This folding becomes more intense and the folds are tighter when approaching the MwZ to the south. Along the MwZ, the molasse rocks, deposited after D1 (post ~528 Ma, based on new detrital-zircon ages), recorded high-strain greenschist facies coaxial deformation and the formation of E-W trending isoclinal folds with a steep south-dipping axial planar cleavage. This study shows that the area north of the MwZ is characterised by two orthogonal contraction events. The newly described D1 event of E-W shortening in the Hook area cannot be correlated with any of the published Pan-African tectonic models for the Lufilian Arc and Zambezi Belt. The D2 event of N-S shortening affected the region in response to the final docking between the Lufilian Arc and the Zambezi Belt. The strongest effect of this event was observed along the MwZ, which, during this stage, was a zone of intense coaxial deformation.

  9. North-South Corridor Demonstration Project: Ethical and Logistical Challenges in the Design of a Demonstration Study of Early Antiretroviral Treatment for Long Distance Truck Drivers along a Transport Corridor through South Africa, Zimbabwe, and Zambia

    PubMed Central

    Gomez, G. B.; Venter, W. D. F.; Lange, J. M. A.; Rees, H.; Hankins, C.

    2013-01-01

    Background. Long-distance truck drivers are at risk of acquiring and transmitting HIV and have suboptimal access to care. New HIV prevention strategies using antiretroviral drugs to reduce transmission risk (early antiretroviral therapy (ART) at CD4 count >350?cells/?L) have shown efficacy in clinical trials. Demonstration projects are needed to evaluate real world programme effectiveness. We present the protocol for a demonstration study to evaluate the feasibility, acceptability, and cost of an early ART intervention for HIV-positive truck drivers along a transport corridor across South Africa, Zimbabwe, and Zambia, as part of an enhanced strategy to improve treatment adherence and retention in care. Methods and Analysis. This demonstration study would follow an observational cohort of truck drivers receiving early treatment. Our mixed methods approach includes quantitative, qualitative, and economic analyses. Key ethical and logistical issues are discussed (i.e., choice of drug regimen, recruitment of participants, and monitoring of adherence, behavioural changes, and adverse events). Conclusion. Questions specific to the design of tailored early ART programmes are amenable to operational research approaches but present substantial ethical and logistical challenges. Addressing these in demonstration projects can inform policy decisions regarding strategies to reduce health inequalities in access to HIV prevention and treatment programmes. PMID:23606977

  10. Engagement of the Community, Traditional Leaders, and Public Health System in the Design and Implementation of a Large Community-Based, Cluster-Randomized Trial of Umbilical Cord Care in Zambia

    PubMed Central

    Hamer, Davidson H.; Herlihy, Julie M.; Musokotwane, Kebby; Banda, Bowen; Mpamba, Chipo; Mwangelwa, Boyd; Pilingana, Portipher; Thea, Donald M.; Simon, Jonathon L.; Yeboah-Antwi, Kojo; Grogan, Caroline; Semrau, Katherine E. A.

    2015-01-01

    Conducting research in areas with diverse cultures requires attention to community sensitization and involvement. The process of community engagement is described for a large community-based, cluster-randomized, controlled trial comparing daily 4% chlorhexidine umbilical cord wash to dry cord care for neonatal mortality prevention in Southern Province, Zambia. Study preparations required baseline formative ethnographic research, substantial community sensitization, and engagement with three levels of stakeholders, each necessitating different strategies. Cluster-specific birth notification systems developed with traditional leadership and community members using community-selected data collectors resulted in a post-natal home visit within 48 hours of birth in 96% of births. Of 39,679 pregnant women enrolled (93% of the target of 42,570), only 3.7% were lost to follow-up or withdrew antenatally; 0.2% live-born neonates were lost by day 28 of follow-up. Conducting this trial in close collaboration with traditional, administrative, political, and community stakeholders facilitated excellent study participation, despite structural and sociocultural challenges. PMID:25646254

  11. Air-cooling mathematical analysis as inferred from the air-temperature observation during the 1st total occultation of the Sun of the 21st century at Lusaka, Zambia

    NASA Astrophysics Data System (ADS)

    Pealoza-Murillo, Marcos A.; Pasachoff, Jay M.

    2015-04-01

    We analyze mathematically air temperature measurements made near the ground by the Williams College expedition to observe the first total occultation of the Sun [TOS (commonly known as a total solar eclipse)] of the 21st century in Lusaka, Zambia, in the afternoon of June 21, 2001. To do so, we have revisited some earlier and contemporary methods to test their usefulness for this analysis. Two of these methods, based on a radiative scheme for solar radiation modeling and that has been originally applied to a morning occultation, have successfully been combined to obtain the delay function for an afternoon occultation, via derivation of the so-called instantaneous temperature profiles. For this purpose, we have followed the suggestion given by the third of these previously applied methods to calculate this function, although by itself it failed to do so at least for this occultation. The analysis has taken into account the limb-darkening, occultation and obscuration functions. The delay function obtained describes quite fairly the lag between the solar radiation variation and the delayed air temperature measured. Also, in this investigation, a statistical study has been carried out to get information on the convection activity produced during this event. For that purpose, the fluctuations generated by turbulence has been studied by analyzing variance and residuals. The results, indicating an irreversible steady decrease of this activity, are consistent with those published by other studies. Finally, the air temperature drop due to this event is well estimated by applying the empirical scheme given by the fourth of the previously applied methods, based on the daily temperature amplitude and the standardized middle time of the occultation. It is demonstrated then that by using a simple set of air temperature measurements obtained during solar occultations, along with some supplementary data, a simple mathematical analysis can be achieved by applying of the four methods reviewed here.

  12. Sediment-hosted stratabound copper assessment of the Neoproterozoic Roan Group, central African copperbelt, Katanga Basin, Democratic Republic of the Congo and Zambia: Chapter T in Global mineral resource assessment

    USGS Publications Warehouse

    Zientek, Michael L.; Bliss, James D.; Broughton, David W.; Christie, Michael; Denning, Paul D.; Hayes, Timothy S.; Hitzman, Murray W.; Horton, John D.; Frost-Killian, Susan; Jack, Douglas J.; Master, Sharad; Parks, Heather L.; Taylor, Cliff D.; Wilson, Anna B.; Wintzer, Niki E.; Woodhead, Jon

    2014-01-01

    This study estimates the location, quality, and quantity of undiscovered copper in stratabound deposits within the Neoproterozoic Roan Group of the Katanga Basin in the Democratic Republic of the Congo and Zambia. The study area encompasses the Central African Copperbelt, the greatest sediment-hosted copper-cobalt province in the world, containing 152 million metric tons of copper in greater than 80 deposits. This study (1) delineates permissive areas (tracts) where undiscovered sediment-hosted stratabound copper deposits may occur within 2 kilometers of the surface, (2) provides a database of known sediment-hosted stratabound copper deposits and prospects, (3) estimates numbers of undiscovered deposits within these permissive tracts at several levels of confidence, and (4) provides probabilistic estimates of amounts of copper and mineralized rock that could be contained in undiscovered deposits within each tract. The assessment, conducted in January 2010 using a three-part form of mineral resource assessment, indicates that a substantial amount of undiscovered copper resources might occur in sediment-hosted stratabound copper deposits within the Roan Group in the Katanga Basin. Monte Carlo simulation results that combine grade and tonnage models with estimates of undiscovered deposits indicate that the mean estimate of undiscovered copper in the study area is 168 million metric tons, which is slightly greater than the known resources at 152 million metric tons. Furthermore, significant value can be expected from associated metals, particularly cobalt. Tracts in the Democratic Republic of the Congo (DRC) have potential to contain near-surface, undiscovered deposits. Monte Carlo simulation results indicate a mean value of 37 million metric tons of undiscovered copper may be present in significant prospects.

  13. New U-Pb zircon geochronology of the Choma-Kalomo Block (Zambia) and the Dete-Kamativi Inlier (Zimbabwe), with implications for the extent of the Zimbabwe Craton.

    NASA Astrophysics Data System (ADS)

    Glynn, Sarah; Wiedenbeck, Michael; Master, Sharad; Frei, Dirk

    2015-04-01

    The Choma-Kalomo Block is a north-east trending, Mesoproterozoic terrane located in southern Zambia. It is composed of as yet undated gneissic basement with a high-grade metamorphosed supracrustal metasedimentary sequence, which is intruded by hornblende granites and gneisses of the Choma-Kalomo Batholith, that is dated between ca. 1.37 and 1.18 Ga. Our new zircon U-Pb age data on metasedimentary rocks of the Choma-Kalomo Block identifies samples of different ages, with slightly different provenances. The oldest metasedimentary rock is a muscovite-biotite schist, which has only Palaeoproterozoic detrital zircons, the two age clusters around 2.03-2.02 Ga and 1.8-1.9 Ga, correspond to the ages of granitic intrusion, and metamorphism, in the Magondi Mobile Belt on the western side of the Archaean Zimbabwe Craton. The second sample is a garnetiferous paragneiss, which contains both Palaeoproterozoic (2.04 Ga), and Mesoproterozoic zircons, ca. 1.36 Ga, derived from the granites of the Choma-Kalomo Batholith. The third sample is a biotite-muscovite schist, in which the detrital zircon ages fall into four separate clusters: ca. 3.39 Ga, ca. 2.7-2.6 Ga, ca. 2.1-1.7 Ga (with a peak at ca. 1.18 Ga), and 1.55 - 1.28 Ga. The Archaean zircons in this sample are derived from the Zimbabwe Craton, while the Palaeoproterozoic samples come from the Magondi belt, and the youngest zircons come from both phases of the Choma-Kalomo Batholith. A possible connection between the Choma-Kalomo Block and the Dete-Kamativi Inlier - some 150 km to the south-east in western Zimbabwe - has been proposed on the basis of similarities in the nature of their Sn-Ta-muscovite pegmatite mineralisation. The Dete-Kamativi Inlier, which is part of the Magondi Mobile Belt, is a window into Palaeoproterozoic north-east trending belts of deformed and metamorphosed supracrustal rocks. By dating localities which we suspect form the basement to the surrounding younger sediments, along with selected pegmatites from within the inlier itself; we have concluded that the Choma-Kalomo Block and Dete-Kamativi Inlier are, in fact, coeval. Preliminary results for a number of these granites and gneisses give ages between 2.05 and 2.02 Ga; correlating well with the 2.03-2.02 Ga ages of detrital zircons from the Choma-Kalomo Block. While these basement rocks are not Archaean in age, we have identified Archaean aged zircons in both the Choma-Kalomo Block and the Dete-Kamativi Inlier, making them the Western most occurrences of Archaean granitoids, implying that the Zimbabwe Craton extends much further west under the Magondi Belt than previously thought.

  14. A case of hartmannellid amebic meningoencephalitis in Zambia.

    PubMed

    Bhagwandeen, S B; Carter, R F; Naik, K G; Levitt, D

    1975-04-01

    A case of amebic meningoencephalitis recognized in an adult Zambian is described. This is the first authenticated case from Africa. The morphologic features of the organism, its ability to form cysts in tissue, and the granulomatous tissue response denote that the ameba is an hartmannellid rather than a Naegleria. Free-living amebas of the family Hartmannellidae have not been incriminated before as a cause of primary amebic meningoencephalitis in man. To our knowledge this is the only case where such an ameba was responsible for fulminating meningoencephalitis. The presence of the amebas in a cellulocutaneous abdominal lesion suggests hematogenous dissemination. PMID:1119442

  15. Burn prevention in Zambia: a work in progress.

    PubMed

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

    2013-01-01

    The aim of this study was to assess both burn prevention knowledge and the effectiveness of educational intervention in alleviating the current knowledge deficit in Zambian youth. In one rural Zambian district, a burn prevention program was implemented in June 2011. Children at two elementary schools completed a 10-question survey that aimed to assess knowledge regarding burn injuries. After completing the survey, children received a burn and fire safety presentation and a burn prevention coloring book. Children were reassessed in May 2012 using the same survey to determine program efficacy and knowledge retention. Burn knowledge assessments were also completed for children at other schools who did not receive the burn prevention program in 2011. Logistic regression analysis was used for statistical adjustment for confounding variables. Between June 2011 and May 2012, 2747 children from six schools were assessed for their burn knowledge, with 312 of them resurveyed after educational intervention since initial survey. Reassessed children performed significantly better on three questions after controlling for confounders. They did better on five questions but their performance on these failed to achieve statistical significance. Children performed significantly worse on one concept about first aid treatment of a burn. A majority of the children demonstrated knowledge deficit in three concepts, even after educational intervention. There is a large variation in first burn knowledge survey performance of children from different schools, with inconsistency between concepts. With half the questions, knowledge deficit did not improve with advancement in school grade. Low- and moderate-income countries (LMICs) face the largest burns burden. With the lack of adequate burn care facing LMICs, burn injury prevention is of particular importance in those countries. This study shows that burn educational intervention could be effective in reducing burn knowledge deficit; however, the residual deficit posteducation could still be large and potentially contributing to heightened burn injury incidence. Customized and integrated educational programs may be proposed regarding the epidemiological profile of burn knowledge deficit from various schools. This study represents one of the few reports on the effectiveness of a burn prevention program in an LMIC. Future epidemiological data will be needed from nearby healthcare facilities to determine whether this program decreased burn morbidity and mortality at the hospital level. PMID:24043246

  16. Burn prevention in Zambia: a targeted epidemiological approach.

    PubMed

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

    2013-01-01

    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

  17. Womens Experiences Living with Epilepsy in Zambia

    PubMed Central

    Birbeck, Gretchen L.; Chomba, Elwyn; Atadzhanov, Masharip; Mbewe, Edward; Haworth, Alan

    2008-01-01

    Epilepsy-associated stigma is a well-recognized phenomenon that adversely impacts the lives of people with epilepsy (PWE). The burden of stigma follows power differentials, with socially and economically disenfranchised groups being particularly susceptible. To guide instrument development for quantitative studies, we conducted a series of focus group discussions among PWE and found that women with epilepsy experienced especially adverse social and economic problems because of epilepsy-associated stigma. The social burden of the disease largely outweighed the medical burden. Women revealed seizure worries related to accidental and intentional injury and the risk of breaking taboos as well as limitations in role fulfillment and extremes of social rejection by family and community. Our findings have implications for access to care and care delivery for vulnerable populations with epilepsy. PMID:18689619

  18. Evaluation of malaria prevention strategies during pregnancy in Ndola, Zambia

    PubMed Central

    Mulamba, Mwamba

    2010-01-01

    ABSTRACT Background Malaria in pregnancy is associated with many negative outcomes for the woman, foetus and neonate. Intermittent preventive treatment during pregnancy (IPTp) using three doses of sulfadoxine/pyrimethamine (SP), insecticide-treated mosquito nets (ITNs) and indoor residual spray (IRS), constitute the main strategies used to prevent malaria. The aim of this study is to evaluate the effectiveness of these strategies for the reduction of malaria prevalence in pregnant women. Methods A questionnaire on socio-demographic information, history of malaria during current pregnancy and prevention strategies used was administered to 450 consecutive patients admitted into labour wards at three local clinics. From the antenatal cards, information was collected on the last menstrual period, date of each dose of SP taken, gravidity, and HIV status. A blood slide to detect Plasmodium was then collected from each woman after consent. Results Of the participants in the study, 2.4% had a positive blood slide at term and 15.8% reported malaria during pregnancy. All the participants took at least one dose of SP with 87.6% completing the stipulated three doses. The mean gestational ages for each dose were 22.1 (SD 4.6), 29.1 (SD 4.4) and 34.4 (SD 3.9) weeks for the first, second and third dose respectively. With regard to ITNs, 79.5% had one, but only 74.1% used it regularly. IRS was completed in all three of the clinics catchment areas. Only 23.4% used commercial insecticide. Conclusion The measured prevalence of malaria at term in Ndola was remarkably low, although the self-reported rate during pregnancy was still high. The national targets for accessing IPTp were exceeded, although the timing of each dose needs to be improved. Access to ITNs was high, but usage needs to increase.

  19. ICT and Literacy: Who Benefits? Experience from Zambia and India

    ERIC Educational Resources Information Center

    Farrell, Glen, Ed.

    2004-01-01

    This is the final report of a three-and-a-half-year project that pilot tested the usefulness of various information and communication technology (ICT) applications in the provision of literacy programmes. The report is based on data collected by in-country evaluators during the term of the project as well as from a follow-up study a year later.

  20. Assessing Farmer Innovations in Agroforestry in Eastern Zambia

    ERIC Educational Resources Information Center

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

    2007-01-01

    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

  1. Peace Corps/Zambia PST 1995 Special Lessons: Bemba.

    ERIC Educational Resources Information Center

    Peace Corps (Zambia).

    This manual is designed for the Bemba language training of Peace Corps volunteers and focuses on daily communication needs in that context. They consist of: a list of useful "survival" phrases and vocabulary; a noun and affix chart; the national anthem; a section on verb tenses and negation, with extensive grammar and usage notes; notes on…

  2. Hypercarotenodermia in Zambia: which children turned orange during mango season?

    PubMed

    Tanumihardjo, S A; Gannon, B M; Kaliwile, C; Chileshe, J

    2015-12-01

    Vitamin A (VA) deficiency is a public health problem in many countries. The World Health Organization recommends high-dose VA supplements to children aged 6-59 months based on unequivocal evidence that supplements decreased mortality risk. VA supplements were meant as a temporary intervention until more sustainable approaches could be implemented. Fortification of processed foods with preformed VA is a means to improve VA status. The most recent addition of retinyl palmitate to cooking oil in countries that may also fortify margarine and milk will undoubtedly have a positive impact on VA status. However, quantitative measures have not been used to assess the underlying VA status of the groups who have adopted widespread fortification. The addition of preformed VA to otherwise adequate diets in VA may cause excessive total body stores. Monitoring population status will require accurate VA assessment to ensure that hypervitaminosis does not prevail. This perspective describes a cohort of rural Zambian children who have adequate diets in VA, mostly as provitamin A carotenoids; who were given high-dose VA supplements till the age of 5 years; who have access to VA-fortified sugar; and whose mothers had access to VA-fortified sugar throughout pregnancy and lactation. Many of these children turned orange during mango season, and this phenomenon occurred at estimated liver reserve concentrations >1 μmol retinol equivalents/g liver. It will be necessary to continue to monitor VA status, including all sectors of the population that have access to successful interventions, to optimize health with the intent to lower retinol content of fortified foods or better target VA supplementation to areas of most need. PMID:26330146

  3. Health and human rights of women imprisoned in Zambia

    PubMed Central

    2011-01-01

    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. PMID:21696625

  4. Use of Space Technology in Flood Mitigation (Western Province, Zambia)

    NASA Astrophysics Data System (ADS)

    Mulando, A.

    2001-05-01

    Disasters, by definition are events that appear suddenly and with little warning. They are usually short lived, with extreme events bringing death, injury and destruction of buildings and communications. Their aftermath can be as damaging as their physical effects through destruction of sanitation and water supplies, destruction of housing and breakdown of transport for food, temporary shelter and emergency services. Since floods are one of the natural disasters which endanger both life and property, it becomes vital to know its extents and where the hazards exists. Flood disasters manifest natural processes on a larger scale and information provided by Remote Sensing is a most appropriate input to analysis of actual events and investigations of potential risks. An analytical and qualitative image processing and interpretation of Remotely Sensed data as well as other data such as rainfall, population, settlements not to mention but a few should be used to derive good mitigation strategies. Since mitigation is the cornerstone of emergency management, it therefore becomes a sustained action that will reduce or eliminate long term risks to people and property from natural hazards such as floods and their effects. This will definitely involve keeping of homes and other sensitive structures away from flood plains. Promotion of sound land use planning based on this known hazard, "FLOODS" is one such form of mitigation that can be applied in flood affected areas within flood plain. Therefore future mitigation technologies and procedures should increasingly be based on the use of flood extent information provided by Remote Sensing Satellites like the NOAA AVHRR as well as information on the designated flood hazard and risk areas.

  5. 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

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

    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…

  6. 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

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

    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

  7. Erratum to: Studies of trypanosomiasis in the Luangwa valley, north-eastern Zambia.

    PubMed

    Laohasinnarong, Dusit; Goto, Yasuyuki; Asada, Masahito; Nakao, Ryo; Hayashida, Kyoko; Kajino, Kiichi; Kawazu, Shin-ichiro; Sugimoto, Chihiro; Inoue, Noboru; Namangala, Boniface

    2015-01-01

    Unfortunately, the original version of this article [1] contained a mistake. The spelling of Yasuyuki Gotos name was incorrectly given as Yasuhuki Goto. The correct spelling is Yasuyuki Goto and is included correctly in the author list of this article. In addition, some author affiliations were assigned incorrectly. Yasuyuki Goto additionally belongs to affiliation 3, which should be listed as Laboratory of Molecular Immunology and not Department of Molecular Immunology. Masahito Asada was incorrectly assigned to affiliation number 3, but belongs to affiliation 1. This has been corrected in the affiliation list of this article. PMID:26493091

  8. Poverty, Physical Stature, and Cognitive Skills: Mechanisms Underlying Children's School Enrollment in Zambia

    ERIC Educational Resources Information Center

    McCoy, Dana Charles; Zuilkowski, Stephanie Simmons; Fink, Gnther

    2015-01-01

    Past research suggests robust positive associations between household socioeconomic status and children's early cognitive development in Western countries. Relatively little is known about these relations in low-income country settings characterized by economic adversity, high prevalence of malnutrition and infectious disease, and relatively lower

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

    ERIC Educational Resources Information Center

    Birbeck, Gretchen L.

    2012-01-01

    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…

  10. Incomplete adherence among treatment-experienced adults on antiretroviral therapy in Tanzania, Uganda and Zambia

    PubMed Central

    Denison, Julie A.; Koole, Olivier; Tsui, Sharon; Menten, Joris; Torpey, Kwasi; van Praag, Eric; Mukadi, Ya Diul; Colebunders, Robert; Auld, Andrew F.; Agolory, Simon; Kaplan, Jonathan E.; Mulenga, Modest; Kwesigabo, Gideon P.; Wabwire-Mangen, Fred; Bangsberg, David R.

    2016-01-01

    Objectives To characterize antiretroviral therapy (ART) adherence across different programmes and examine the relationship between individual and programme characteristics and incomplete adherence among ART clients in sub-Saharan Africa. Design A cross-sectional study. Methods Systematically selected ART clients (≥18 years; on ART ≥6 months) attending 18 facilities in three countries (250 clients/facility) were interviewed. Client self-reports (3-day, 30-day, Case Index ≥48 consecutive hours of missed ART), healthcare provider estimates and the pharmacy medication possession ratio (MPR) were used to estimate ART adherence. Participants from two facilities per country underwent HIV RNA testing. Optimal adherence measures were selected on the basis of degree of association with concurrent HIV RNA dichotomized at less than or greater/equal to 1000 copies/ml. Multivariate regression analysis, adjusted for site-level clustering, assessed associations between incomplete adherence and individual and programme factors. Results A total of 4489 participants were included, of whom 1498 underwent HIV RNA testing. Nonadherence ranged from 3.2% missing at least 48 consecutive hours to 40.1% having an MPR of less than 90%. The percentage with HIV RNA at least 1000 copies/ml ranged from 7.2 to 17.2% across study sites (mean = 9.9%). Having at least 48 consecutive hours of missed ART was the adherence measure most strongly related to virologic failure. Factors significantly related to incomplete adherence included visiting a traditional healer, screening positive for alcohol abuse, experiencing more HIV symptoms, having an ART regimen without nevirapine and greater levels of internalized stigma. Conclusion Results support more in-depth investigations of the role of traditional healers, and the development of interventions to address alcohol abuse and internalized stigma among treatment-experienced adult ART patients. PMID:25686684

  11. The Effectiveness of Using Virtual Laboratories to Teach Computer Networking Skills in Zambia

    ERIC Educational Resources Information Center

    Lampi, Evans

    2013-01-01

    The effectiveness of using virtual labs to train students in computer networking skills, when real equipment is limited or unavailable, is uncertain. The purpose of this study was to determine the effectiveness of using virtual labs to train students in the acquisition of computer network configuration and troubleshooting skills. The study was…

  12. Picturing Global Educational Inclusion? Looking and Thinking across Students' Photographs from the UK, Zambia and Indonesia

    ERIC Educational Resources Information Center

    Kaplan, Ian; Lewis, Ingrid; Mumba, Paul

    2007-01-01

    Over the last few years we have engaged children and young people in participatory photography projects in a diverse range of international contexts. The projects, diverse as they are, have been school-based and primarily focused on students' experiences of educational inclusion/exclusion. Photographs taken by students can stimulate conversations…

  13. 77 FR 29369 - Notice of Entering Into a Compact With the Republic of Zambia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions, to pay for the performance of involuntary sterilizations as a method of family planning..., abortions or involuntary sterilization as a means of family planning. Section 2.8 Taxes (a) Unless...

  14. Improving Validity of Informed Consent for Biomedical Research in Zambia Using a Laboratory Exposure Intervention

    PubMed Central

    Zulu, Joseph Mumba; Lisulo, Mpala Mwanza; Besa, Ellen; Kaonga, Patrick; Chisenga, Caroline C.; Chomba, Mumba; Simuyandi, Michelo; Banda, Rosemary; Kelly, Paul

    2014-01-01

    Background Complex biomedical research can lead to disquiet in communities with limited exposure to scientific discussions, leading to rumours or to high drop-out rates. We set out to test an intervention designed to address apprehensions commonly encountered in a community where literacy is uncommon, and where complex biomedical research has been conducted for over a decade. We aimed to determine if it could improve the validity of consent. Methods Data were collected using focus group discussions, key informant interviews and observations. We designed an intervention that exposed participants to a detailed demonstration of laboratory processes. Each group was interviewed twice in a day, before and after exposure to the intervention in order to assess changes in their views. Results Factors that motivated people to participate in invasive biomedical research included a desire to stay healthy because of the screening during the recruitment process, regular advice from doctors, free medical services, and trust in the researchers. Inhibiting factors were limited knowledge about samples taken from their bodies during endoscopic procedures, the impact of endoscopy on the function of internal organs, and concerns about the use of biomedical samples. The belief that blood can be used for Satanic practices also created insecurities about drawing of blood samples. Further inhibiting factors included a fear of being labelled as HIV positive if known to consult heath workers repeatedly, and gender inequality. Concerns about the use and storage of blood and tissue samples were overcome by a laboratory exposure intervention. Conclusion Selecting a group of members from target community and engaging them in a laboratory exposure intervention could be a useful tool for enhancing specific aspects of consent for biomedical research. Further work is needed to determine the extent to which improved understanding permeates beyond the immediate group participating in the intervention. PMID:25254378

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

    ERIC Educational Resources Information Center

    Commonwealth Secretariat, London (England).

    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

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

    ERIC Educational Resources Information Center

    Kanyengo, Christine Wamunyima

    2009-01-01

    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…

  17. Information Resource Management for Rural Communities in Zambia: Implications for National Information Policy Formulation.

    ERIC Educational Resources Information Center

    Lundu, Maurice C.

    Arguing that the information needs of the rural community are largely ignored in the establishment of information systems and services, this paper: (1) identifies the unique characteristics of information users in rural areas; (2) identifies and analyzes the types of communication channels most likely to deliver the information related to

  18. Representative Nature of Scientific Literacy Themes in a High School Chemistry Course: The Case of Zambia

    ERIC Educational Resources Information Center

    Mumba, Frackson; Hunter, William J. F.

    2009-01-01

    The purpose of this study was to find out how the scientific literacy themes are represented in the current Zambian high school chemistry syllabus, textbooks and grade twelve chemistry examination papers in an attempt to find out whether or not the chemistry course has adequate potential to contribute to the preparation of scientifically literate

  19. Sleeping sickness and its relationship with development and biodiversity conservation in the Luangwa Valley, Zambia.

    PubMed

    Anderson, Neil E; Mubanga, Joseph; Machila, Noreen; Atkinson, Peter M; Dzingirai, Vupenyu; Welburn, Susan C

    2015-01-01

    The Luangwa Valley has a long historical association with Human African Trypanosomiasis (HAT) and is a recognised geographical focus of this disease. It is also internationally acclaimed for its high biodiversity and contains many valuable habitats. Local inhabitants of the valley have developed sustainable land use systems in co-existence with wildlife over centuries, based on non-livestock keeping practices largely due to the threat from African Animal Trypanosomiasis. Historical epidemics of human sleeping sickness have influenced how and where communities have settled and have had a profound impact on development in the Valley. Historical attempts to control trypanosomiasis have also had a negative impact on conservation of biodiversity.Centralised control over wildlife utilisation has marginalised local communities from managing the wildlife resource. To some extent this has been reversed by the implementation of community based natural resource management programmes in the latter half of the 20(th) century and the Luangwa Valley provides some of the earliest examples of such programmes. More recently, there has been significant uncontrolled migration of people into the mid-Luangwa Valley driven by pressure on resources in the eastern plateau region, encouragement from local chiefs and economic development in the tourist centre of Mfuwe. This has brought changing land-use patterns, most notably agricultural development through livestock keeping and cotton production. These changes threaten to alter the endemically stable patterns of HAT transmission and could have significant impacts on ecosystem health and ecosystem services.In this paper we review the history of HAT in the context of conservation and development and consider the impacts current changes may have on this complex social-ecological system. We conclude that improved understanding is required to identify specific circumstances where win-win trade-offs can be achieved between the conservation of biodiversity and the reduction of disease in the human population. PMID:25879414

  20. Representative Nature of Scientific Literacy Themes in a High School Chemistry Course: The Case of Zambia

    ERIC Educational Resources Information Center

    Mumba, Frackson; Hunter, William J. F.

    2009-01-01

    The purpose of this study was to find out how the scientific literacy themes are represented in the current Zambian high school chemistry syllabus, textbooks and grade twelve chemistry examination papers in an attempt to find out whether or not the chemistry course has adequate potential to contribute to the preparation of scientifically literate…

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

    ERIC Educational Resources Information Center

    Mwape, Gertrude; Serpell, Robert

    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

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

    ERIC Educational Resources Information Center

    Katsui, Hisayo; Koistinen, Mari

    2008-01-01

    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

  3. Design and Validation of Assessment Tests for Young Children in Zambia

    ERIC Educational Resources Information Center

    Matafwali, Beatrice; Serpell, Robert

    2014-01-01

    Early childhood education has received unprecedented attention among African policymakers in recent years, recognizing that the early years form an important foundation upon which later development is anchored and noting evidence that various Early Childhood Development (ECD) indicators are predictive of future academic success. Central to the

  4. Picturing Global Educational Inclusion? Looking and Thinking across Students' Photographs from the UK, Zambia and Indonesia

    ERIC Educational Resources Information Center

    Kaplan, Ian; Lewis, Ingrid; Mumba, Paul

    2007-01-01

    Over the last few years we have engaged children and young people in participatory photography projects in a diverse range of international contexts. The projects, diverse as they are, have been school-based and primarily focused on students' experiences of educational inclusion/exclusion. Photographs taken by students can stimulate conversations

  5. The Effectiveness of Using Virtual Laboratories to Teach Computer Networking Skills in Zambia

    ERIC Educational Resources Information Center

    Lampi, Evans

    2013-01-01

    The effectiveness of using virtual labs to train students in computer networking skills, when real equipment is limited or unavailable, is uncertain. The purpose of this study was to determine the effectiveness of using virtual labs to train students in the acquisition of computer network configuration and troubleshooting skills. The study was

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

    ERIC Educational Resources Information Center

    Imboela, Bruce Lubinda

    2005-01-01

    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

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

    ERIC Educational Resources Information Center

    Kanyengo, Christine Wamunyima

    2009-01-01

    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

  8. Poverty, physical stature, and cognitive skills: Mechanisms underlying children's school enrollment in Zambia.

    PubMed

    McCoy, Dana Charles; Zuilkowski, Stephanie Simmons; Fink, Günther

    2015-05-01

    Past research suggests robust positive associations between household socioeconomic status and children's early cognitive development in Western countries. Relatively little is known about these relations in low-income country settings characterized by economic adversity, high prevalence of malnutrition and infectious disease, and relatively lower school enrollment. The present study develops and empirically evaluates an adapted model of early childhood development using a sample of 2,711 Zambian 6-year-olds. Early learning in and out of the home was found to explain much of the relation between socioeconomic status and children's cognitive skills, including language, nonverbal reasoning, and executive function. Child height-for-age (a proxy for overall nutritional status and health) was also predictive of children's cognitive skills and both early and on-time school enrollment. Implications for global child development, intervention, and future work are discussed. PMID:25844851

  9. Ecology and productivity of an African wetland system: The Kafue, Zambia

    SciTech Connect

    Ellenbroek, G.A.

    1987-01-01

    This book discusses the main ecological processes in African floodplain grasslands. It researches the structure of the various types of grasslands, and their correlation with the environmental factors operating in the floodplain ecosystem. From detailed measurements of structure and biomass it estimates primary production in various habitats. It also surveys the impact of disturbing factors like grazing and fires and discusses the year to year variation in the ecosystems.

  10. Women’s Perceptions and Misperceptions of Male Circumcision: A Mixed Methods Study in Zambia

    PubMed Central

    Haberland, Nicole A.; Kelly, Christine A.; Mulenga, Drosin M.; Mensch, Barbara S.; Hewett, Paul C.

    2016-01-01

    Women’s perceptions of male circumcision (MC) have implications for behavioral risk compensation, demand, and the impact of MC programs on women’s health. This mixed methods study combines data from the first two rounds of a longitudinal study (n = 934) and in-depth interviews with a subsample of respondents (n = 45) between rounds. Most women correctly reported that MC reduces men’s risk of HIV (64% R1, 82% R2). However, 30% of women at R1, and significantly more (41%) at R2, incorrectly believed MC is fully protective for men against HIV. Women also greatly overestimated the protection MC offers against STIs. The proportion of women who believed MC reduces a woman’s HIV risk if she has sex with a man who is circumcised increased significantly (50% to 70%). Qualitative data elaborate women’s misperception regarding MC. Programs should address women’s informational needs and continue to emphasize that condoms remain critical, regardless of male partner’s circumcision status. PMID:26937971

  11. Poverty, Physical Stature, and Cognitive Skills: Mechanisms Underlying Children's School Enrollment in Zambia

    ERIC Educational Resources Information Center

    McCoy, Dana Charles; Zuilkowski, Stephanie Simmons; Fink, Günther

    2015-01-01

    Past research suggests robust positive associations between household socioeconomic status and children's early cognitive development in Western countries. Relatively little is known about these relations in low-income country settings characterized by economic adversity, high prevalence of malnutrition and infectious disease, and relatively lower…

  12. Practicalities and challenges in re-orienting the health system in Zambia for treating chronic conditions

    PubMed Central

    2014-01-01

    Background The rapid evolution in disease burdens in low- and middle income countries is forcing policy makers to re-orient their health system towards a system which has the capability to simultaneously address infectious and non-communicable diseases. This paper draws on two different but overlapping studies which examined how actors in the Zambian health system are re-directing their policies, strategies and service structures to include the provision of health care for people with chronic conditions. Methods Study methods in both studies included semi-structured interviews with government health officials at national level, and governmental and non-governmental health practitioners operating from community-, primary health care to hospital facility level. Focus group discussions were conducted with staff, stakeholders and caregivers of programmes providing care and support at community- and household levels. Study settings included urban and rural sites. Results A series of adaptations transformed the HIV programme from an emergency response into the first large chronic care programme in the country. There are clear indications that the Zambian government is intending to expand this reach to patients with non-communicable diseases. Challenges to do this effectively include a lack of proper NCD prevalence data for planning, a concentration of technology and skills to detect and treat NCDs at secondary and tertiary levels in the health system and limited interest by donor agencies to support this transition. Conclusion The reorientation of Zambia’s health system is in full swing and uses the foundation of a decentralised health system and presence of local models for HIV chronic care which actively involve community partners, patients and their families. There are early warning signs which could cause this transition to stall, one of which is the financial capability to resource this process. PMID:25005125

  13. Transdisciplinary Project Communication and Knowledge Sharing Experiences in Tanzania and Zambia through a One Health Lens

    PubMed Central

    Bagnol, Brigitte; Clarke, Elizabeth; Li, Mu; Maulaga, Wende; Lumbwe, Hilda; McConchie, Robyn; de Bruyn, Julia; Alders, Robyn Gwen

    2016-01-01

    The project “Strengthening food and nutrition security through family poultry and crop integration in Tanzania and Zambia” brings together animal, crop, and human health specialists, economists, ecologists, social scientists, and practitioners to work with participating communities. It aims to increase poultry value chain, crop farming systems efficiency, and household food and nutrition security and thus requires understanding of, and ability to work effectively within, complex systems. In this context, communication knowledge sharing and synthesis between stakeholders from diverse backgrounds and a range of experiences, perspectives, agendas, and knowledge is a challenge. To address this situation, communication is conceived as a dialog and a participatory process bringing together all stakeholders. This process results in unanticipated and unexpected results that require a high degree of flexibility and adaptability from team members. The paper analyses the approach and aim of the communication strategy developed for the project and the challenges faced. PMID:26904532

  14. 75 FR 11976 - Bureau of Educational and Cultural Affairs (ECA) Request for Grant Proposals: Global Connections...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ..., Zambia, Ethiopia). Public and private non-profit organizations meeting the provisions described in..., Zambia, Ethiopia (at least three countries) Please note: Applicants may not include countries not...

  15. Increasing access to legal termination of pregnancy and postabortion contraception at the University Teaching Hospital, Lusaka, Zambia.

    PubMed

    Macha, Swebby; Muyuni, Mutinta; Nkonde, Scholastica; Faúndes, Anibal

    2014-07-01

    The Zambian Association of Gynecology and Obstetrics is one of the International Federation of Gynecology and Obstetrics (FIGO) member societies participating in the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences from the East, Central, and Southern Africa region. The activities included in this country's plan of action were to provide access to safe abortion within the full extent of the law to women receiving care at the University Teaching Hospital in Lusaka, and to increase the proportion of women leaving the hospital with a contraceptive method. Zambian law regarding abortion is liberal, but in general it was not applied until very recently. The proportion of legal terminations of pregnancy among patients receiving abortion care at the hospital increased from 3.2% in 2009 to 7.7% in 2011, while the percentage of women leaving the hospital with a contraceptive method increased from 25.3% to 69.4% over the same period. PMID:24786142

  16. 'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa. | accrualnet.cancer.gov

    Cancer.gov

    Rumors as to the purpose and outcome of research are a common feature of medical research conducted in developing countries. This paper presents a case study of how deep-seated suspicions among trial participants and family members can challenge medical research and public health interventions. The rumors are commentaries on social relations, involving and extending beyond scientific medical research. Consequently, rumors are best understood as metaphors representing local concerns and should be considered within this context.

  17. Clinical Performance of Digital Cervicography and Cytology for Cervical Cancer Screening in HIV-infected Women in Lusaka, Zambia

    PubMed Central

    Bateman, Allen C.; Parham, Groesbeck P.; Sahasrabuddhe, Vikrant V.; Mwanahamuntu, Mulindi H.; Kapambwe, Sharon; Katundu, Katundu; Nkole, Theresa; Mulundika, Jacqueline; Pfaendler, Krista S.; Hicks, Michael L.; Shibemba, Aaron; Vermund, Sten H.; Stringer, Jeffrey S.A.; Chibwesha, Carla J.

    2014-01-01

    While there is a growing literature on the clinical performance of VIA in HIV-infected women, to our knowledge none have studied VIA enhanced by digital cervicography. We estimated clinical performance of cervicography and cytology to detect cervical intraepithelial neoplasia grade 2 or worse. Sensitivity and specificity of cervicography were 84% (95% confidence interval [CI]: 72%91%) and 58% (95%CI: 52%64%). At the high-grade squamous intraepithelial lesion or worse cutoff for cytology, sensitivity and specificity were 61% (95%CI: 48%72%) and 58% (95%CI: 52%64%). In our study, cervicography appears to be as good as cytology in HIV-infected women. PMID:24977474

  18. School-Based Professional Development in a Developing Context: Lessons Learnt from a Case Study in Zambia

    ERIC Educational Resources Information Center

    Haßler, Björn; Hennessy, Sara; Cross, Andrew; Chileshe, Eness; Machiko, Brian

    2015-01-01

    This paper reports on the development and outcomes of the second phase of OER4Schools, a school-based professional development programme supporting interactive forms of subject teaching in conjunction with Open Educational Resources (OER) and technology in Zambian primary schools. We worked with partners to identify the needs of school-based…

  19. Men, women and the trouble with condoms: problems associated with condom use by migrant workers in rural Zambia.

    PubMed

    Bond, V; Dover, P

    1997-01-01

    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 and pervasive ideal is that sex is essentially a procreative act, since an emphasis on male potency and male and female fertility often overrides anxieties about contracting HIV and other sexually transmitted diseases. Hence condom use is usually only negotiated within some short-term relationships and then not consistently. Whilst both men and women have negative attitudes to condoms, women because of their economic and ideological dependence on men are in a much weaker position to negotiate condom use. PMID:10169656

  20. 7 CFR 319.56-48 - Conditions governing the entry of baby squash and baby courgettes from Zambia.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... accordance with 7 CFR 319.56-48.” (Approved by the Office of Management and Budget under control number 0579... 7 Agriculture 5 2010-01-01 2010-01-01 false Conditions governing the entry of baby squash and baby... Fruits and Vegetables § 319.56-48 Conditions governing the entry of baby squash and baby courgettes...

  1. A case-control study of stillbirths at a teaching hospital in Zambia, 1979-80: antenatal factors.

    PubMed

    Watts, T; Harris, R R

    1982-01-01

    A total of 266 mothers of stillborn babies (cases) and 266 mothers of live-born babies (controls), matched for parity, were studied in an attempt to define the causes of the stillbirths. Altogether, 16% of mothers in the former group were over 35 years old, compared with 9% in the latter; in addition, 16% of cases had a history of past perinatal death, compared with only 2.4% among the controls.Mothers of stillborn babies had fewer attendances at the antenatal clinic and a longer interval between the last visit and delivery, compared with the control group; 8% of the former group had no antenatal care. Only 47% of mothers had a Venereal Disease Research Laboratory (VDRL) test reported before delivery. The VDRL test was positive in 34% of the cases tested and in 7% of controls.Of the 266 stillborn infants, 56% were of low birth weight; 12% of the 170 macerated stillbirths were associated with intrapartum problems that may have contributed to death, compared with 46% of the 96 fresh stillbirths. Prolonged labour and prolapsed cord were the commonest intrapartum factors associated with death. The most common antepartum factors were a positive VDRL test, abruptio placentae, and a history of illness. A total of 5% of the stillborn infants had some congenital abnormality. No cause of death could be identified in 13.5% of these infants, the majority of whom were of low birth weight. PMID:6984373

  2. Factors affecting the duration of exclusive breastfeeding among HIV-infected and -uninfected women in Lusaka, Zambia.

    PubMed

    Chisenga, Molly; Kasonka, Lackson; Makasa, Mpundu; Sinkala, Moses; Chintu, Chifumbe; Kaseba, Christine; Kasolo, Francis; Tomkins, Andrew; Murray, Susan; Filteau, Suzanne

    2005-08-01

    Exclusive breastfeeding (EBF) is optimal for infant health and is associated with decreased risk of mother-to-child HIV transmission compared with mixed feeding of breast milk and other foods. To investigate why many women stop EBF before the recommended 6 months, maternal and infant health and infant-feeding data were collected from 177 HIV-infected and 177-uninfected Zambian women regularly from 34 weeks gestation to 16 weeks postpartum. Despite strong support for good breastfeeding practice, only 37% of women were still EBF at week 16. Factors significantly associated with shorter duration of EBF were primiparity, maternal systemic illness, and infant length at 6 weeks. The results suggest that the association of EBF with lower rates of mother-to-child HIV transmission may not be causal but may be secondary to the reduced duration of EBF associated with poor maternal or infant health. Programs supporting EBF should include support for maternal health. PMID:16113015

  3. School-Based Professional Development in a Developing Context: Lessons Learnt from a Case Study in Zambia

    ERIC Educational Resources Information Center

    Haler, Bjrn; Hennessy, Sara; Cross, Andrew; Chileshe, Eness; Machiko, Brian

    2015-01-01

    This paper reports on the development and outcomes of the second phase of OER4Schools, a school-based professional development programme supporting interactive forms of subject teaching in conjunction with Open Educational Resources (OER) and technology in Zambian primary schools. We worked with partners to identify the needs of school-based

  4. The giant Pan-African Hook Batholith, Central Zambia: A-type magmatism in a syn-collisional setting

    NASA Astrophysics Data System (ADS)

    Milani, Lorenzo; Lehmann, Jrmie; Naydenov, Kalin V.; Saalmann, Kerstin; Kinnaird, Judith A.; Daly, J. Stephen; Frei, Dirk; Lobo-Guerrero Sanz, Alberto

    2015-04-01

    The Pan-African Hook Batholith formed during the assembly of the Gondwana supercontinent between 570 and 520 Ma (U-Pb on zircon) as a result of syn-collisional stage interaction between the Congo and Kalahari Cratons1. The extension of the batholith, exposed and undercover, is estimated to be between 25,000 and 30,000 km2. The bimodal magmatism (mafic to predominantly felsic) is characterized by both an alkali-calcic and an alkalic suite, with the felsic rocks featuring a typical A-type, metaluminous, high Fe/Mg and K/Na geochemical signature. The scattered outcrops of gabbroic rocks, both tholeiitic and alkaline, suggest periodic input of mantle material, which, in some cases, interacted with metasomatizing fluids. Fractional crystallization is invoked for the most differentiated products, while Sr-Nd isotopes rule out any significant contribution from crustal assimilation. Exceptionally highly radiogenic Pb isotopes have been measured on both unaltered and hydrothermally altered rocks, and attest to the radiogenic character of the batholith. The Pb isotopes indicate that the anomalous signature was acquired during, or soon after, magma emplacement, and was likely enhanced by metasomatizing fluids. An enrichment in Th and U, affecting large portions of the crust along the southern margin of the Congo Craton, is suggested b