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Sample records for zambia

  1. 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

  2. Novel Arenavirus, Zambia

    PubMed Central

    Thomas, Yuka; Moonga, Ladslav; Nakamura, Ichiro; Ohnuma, Aiko; Hang’ombe, Bernard; Takada, Ayato; Mweene, Aaron; Sawa, Hirofumi

    2011-01-01

    To investigate arenavirus in Zambia, we characterized virus from the kidneys of 5 arenavirus RNA–positive rodents (Mastomys natalensis) among 263 captured. Full-genome sequences of the viruses suggested that they were new strains similar to Lassa virus–related arenaviruses. Analyzing samples from additional rodents and other species can elucidate epizootiologic aspects of arenaviruses. PMID:22000372

  3. Wildlife rabies in Zambia.

    PubMed

    Röttcher, D; Sawchuk, A M

    1978-10-01

    Wildlife species made up 26 (2.0%) of 1,304 positive rabies cases received between 1969 and 1976. The jackal (Canis adustus) was the predominate wildlife species involved (69%) and played a role in the epidemiology of bovine rabies in remote farm areas. Rabies appears to be absent from the intact wildlife communities in Zambia, especially the National Parks; this is considered in the light of the epidemiology of the disease in wildlife.

  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. Quality assurance in Zambia.

    PubMed

    Reinke, J; Tembo, J; Limbambala, M F; Chikuta, S; Zaenger, D

    1996-01-01

    Primary health care reforms in Zambia have focused on the themes of effective leadership, community involvement, and improved service quality. To achieve these goals, the Ministry of Health's structure has been decentralized and a Health Reforms Implementation Team (including a Quality Assurance Unit) has been established. This unit collaborates with government and private sector organizations and professional groups in areas such as strategic planning, problem solving, facility assessment, standards setting, and indicator development. Each province has two linkage facilitators who provide district-level training and support to quality assurance coaches. As part of this process, staff at Nanga Rural Health Center in Mazabuka District selected patient privacy as a priority quality assurance issue and established an enclosed area for patient interviews. This measure facilitated increased patient disclosure about and comfort with discussing sensitive medical issues such as family planning and sexually transmitted diseases. Next, the health center staff examined the problem of pharmaceutical shortages, and user fees were identified as a means of purchasing commonly unavailable drugs. At the Magoye Rural Health Center, quality assurance assessment led to the consolidation of services such as infant weighing and immunization at the same location, thereby significantly increasing service utilization.

  6. Country watch. Zambia.

    PubMed

    Kapyepye, E

    1994-01-01

    In Mansa District, Zambia, people are unaware of the risk factors of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). To remedy this, the District HIV Prevention and Care Team invited a member of the Positive and Living Squad (PALS), John Luonde, to speak at educational sessions for various target audiences. Goals included providing information, dissipating misinformation, alleviating community fears, and mobilizing people through specific activities that addressed identified needs. The sessions began with the testimony of John Luonde and a simple question and answer period, which were followed by focus groups, often with a video, for more difficult or sensitive topics. Information materials were distributed and a condom demonstration was conducted. Although some institutions initially refused permission because of the holiday season or the possible impact on staff, Luonde returned to cover the missed groups. More than 105 people from 9 sectors of the community participated. Groups that were represented included the Mansa Sports Club, the Mutende Deaf Branch, a factory, the local army and police, and physicians from the Mansa Hospital Board. Questions from the different groups were similar. Participants saw that, although anyone could contract AIDS (the central theme of the project), they could still hope for productive years with proper treatment, self-care, and diet. Most participants wanted to change their sexual behavior and Luonde was asked to return. Women and people with physical disabilities need to be targeted. Although condoms were previously seen as promoting promiscuity, institutions are now requesting their distribution. The team is collaborating with a social marketing organization on condom use promotion. Distribution sites include bars, restaurants, filling stations, supermarkets, and hair dressers. At the request of the community, a meeting was held with the director of the Mansa Hospital Board to develop policy

  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

  8. 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)

  9. Observations on abortion in Zambia.

    PubMed

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

    1990-01-01

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

  10. Spontaneously settled refugees in Northwestern Province, Zambia.

    PubMed

    Freund, P J; Kalumba, K

    1986-01-01

    The UN High Commissioner for Refugees (UNHCR) commissioned researchers from the University of Zambia to conduct a socioeconomic survey and census of "spontaneously settled" Zairean and Angolan refugees in the Northwestern Province of Zambia in 1982. The sample consisted of 188 Angolans, 201 Zaireans, and 2 South Africans. The difficulties experienced by refugees in Northwestern Province in achieving integration were related to a combination of factors including the lack of a clear national policy on refugees and refugee status, a national concern for maintaining security, the popular belief that aliens are responsible for an increasing crime rate, the desire by immigration officials for stricter laws to control alien infiltration, conflict between traditional and modern leaders, and Zambia's deteriorating economic situation. In spite of the problems described, the integration of refugees into existing communities is a desirable goal and should be encouraged. One should not assume that self-settling refugees are able to live with ethnic kin, receive assistance and hospitality, and thus are better off than those in camps. The Zambian case provides ample evidence that integration is not easy even with kin support, shared ethnicity, language, and historical connections. Moreover, given the fact that Zambia will continue to receive refugees it is vital that there is a well defined refugee policy and an administrative mechanism for implementing that policy at all levels. This will be particularly important in Zambia as it will undoubtedly continue to receive large influxes of refugees, from countries such as Namibia, Uganda, Angola, Mozambique, and South Africa.

  11. Spontaneously settled refugees in Northwestern Province, Zambia.

    PubMed

    Freund, P J; Kalumba, K

    1986-01-01

    The UN High Commissioner for Refugees (UNHCR) commissioned researchers from the University of Zambia to conduct a socioeconomic survey and census of "spontaneously settled" Zairean and Angolan refugees in the Northwestern Province of Zambia in 1982. The sample consisted of 188 Angolans, 201 Zaireans, and 2 South Africans. The difficulties experienced by refugees in Northwestern Province in achieving integration were related to a combination of factors including the lack of a clear national policy on refugees and refugee status, a national concern for maintaining security, the popular belief that aliens are responsible for an increasing crime rate, the desire by immigration officials for stricter laws to control alien infiltration, conflict between traditional and modern leaders, and Zambia's deteriorating economic situation. In spite of the problems described, the integration of refugees into existing communities is a desirable goal and should be encouraged. One should not assume that self-settling refugees are able to live with ethnic kin, receive assistance and hospitality, and thus are better off than those in camps. The Zambian case provides ample evidence that integration is not easy even with kin support, shared ethnicity, language, and historical connections. Moreover, given the fact that Zambia will continue to receive refugees it is vital that there is a well defined refugee policy and an administrative mechanism for implementing that policy at all levels. This will be particularly important in Zambia as it will undoubtedly continue to receive large influxes of refugees, from countries such as Namibia, Uganda, Angola, Mozambique, and South Africa. PMID:12267853

  12. Improving abortion care in Zambia.

    PubMed

    Bradley, J; Sikazwe, N; Healy, J

    1991-01-01

    In this commentary, the impact of the introduction of manual vacuum aspiration (MVA) for incomplete abortion patients and for early uterine evacuation is discussed for the University Teaching Hospital in Lusaka, Zambia. This 3-year training and service delivery program was begun in 1988 after it was clear that 15% of maternal deaths were due to illegally induced abortion. The prior procedure of dilation and curettage (D and C) required use of the main operating room and general anesthesia, which resulted in severe congestion and treatment delays. As a result of the new MVA procedure, congestion has decreased substantially, treatment is safer and more timely, and the staff's ability to provide abortions has increased. Family planning counseling is provided to postabortion patients in a more thorough fashion, and the savings in time has improved the quality of patient-staff interactions. Specifically, the patient flow has improved from a 12-hour wait to a 4-6 hour wait and rarely requires overnight hospitalization. The demand for the main operating room had decreased which frees space, time, and commodities for other gynecological treatment. The shorter procedure and release time means a minimal loss of earnings and productivity, and allows for greater privacy in explaining absences to families, schools, or employers. The improved quality of are is reflected in the figures for number treated, i.e., in 1989, 74% were treated with MVA for incomplete abortion 12 weeks and pregnancy termination 8 weeks compared with 26% treated with D and C. In 1990, the figures were 86% with MVA and 14% with D and C. The likelihood of complications from hemorrhage and sepsis have also been reduced. The MVA procedure is also less traumatic for the patient. The increased access to safe legal abortion services is reflected in the ratio of induced to incomplete abortions between 1988-1990 (1:25 to 1:5). Family planning counseling is provided by a full-time counselor who counsels preabortion

  13. 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

  14. 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

  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. Men targeted for family planning in Zambia.

    PubMed

    Chirambo, K

    1992-08-01

    80% of women using contraception in Zambia use oral contraceptives (OCs), yet they often complain about side effects. 66% of people polled at family planning (FP) clinics prefer OCs and 30% chose condoms. Nevertheless only 10% of the 60% of married couples familiar with FP use contraception. This contributes to Zambia having 1 of the highest annual population growth rates in the world (3.4%). The Planned Parenthood Association of Zambia (PPAZ) thinks that if males become more knowledgeable about FP, the population growth would slow down. At least 60% of men in Zambia approve of their wives using FP, yet they are slow to use male contraception. They say condoms reduce sensation and wives often consider condoms a nuisance. The AIDS epidemic forces men to rethink their views toward condom use, however. Those 30% of men who do use condoms are more likely to use them with their girlfriends or women with whom they are unfamiliar. So they are not using them for FP purposes. Men fear vasectomy because they perceive it to cause impotence. Considerable education to counter this myth is needed to increase the number of vasectomies. Besides some men prefer their wives be sterilized rather than themselves because if the men lose all their children they can have other children with other wives. PPAZ aims programs at men in order to expand their participation and nurture their influence in FP matters. It has a male counseling program serving rural villages along the railroad lines which begin in the northern copper belt and end in urban areas in the south to promote birth spacing. It is working with companies to include FP services in their clinics so men can learn more about FP. FP specialists in Zambia foresee an increase in male support of FP as they realize the difficulty of supporting large families during the economic crises.

  17. 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.

  18. Structural adjustment and drought in Zambia.

    PubMed

    Mulwanda, M

    1995-06-01

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

  19. New Agricultural Settlement, Meheba River, Zambia, Africa

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This infra-red view of a new settlement along the Meheba River, Zambia, Africa (12.5S, 26.0E) resembles the resettlement clusters in the Amazon basin of Brazil. However, this settlement is on savanna land not a tropical forest region, so relatively little land clearing was required. The familiar pattern of small single family plots, no large commercial fields, along the branches of a herringbone road network is evident.

  20. 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…

  1. 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…

  2. Syphilis in pregnant women in Zambia.

    PubMed Central

    Ratnam, A V; Din, S N; Hira, S K; Bhat, G J; Wacha, D S; Rukmini, A; Mulenga, R C

    1982-01-01

    Because of the high incidence of congenital syphilis at the University Teaching Hospital, Lusaka, Zambia, the potential risks of congenital infection and fetal loss due to syphilis were assessed by screening 202 antenatal patients, 340 pregnant women admitted to the hospital whose pregnancies ended in either spontaneous abortion or stillbirth, and 469 consecutive babies delivered at the hospital. Primary serological screening was performed with the rapid plasma reagin test, and reactive sera were confirmed by the Treponema pallidum haemagglutination test. In all cases detailed histories were obtained and patients were examined for clinical signs of syphilis. The TPHA test result was reactive in 12.5% of antenatal patients and in 42% of women who aborted in the later half of pregnancy. Among 469 consecutive babies delivered at the hospital, 30 had reactive results to the TPHA test; of these two were stillborn and four had signs of congenital syphilis at birth. Thus, syphilis appears to affect adversely an appreciably high number of pregnant women in Zambia. For this reason a special campaign to screen adequately and treat pregnant women and neonates is needed. PMID:6756542

  3. 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

  4. The Mesoproterozoic Irumide belt of Zambia

    NASA Astrophysics Data System (ADS)

    De Waele, B.; Kampunzu, A. B.; Mapani, B. S. E.; Tembo, F.

    2006-09-01

    The Mesoproterozoic Irumide belt is a northeast-trending structural province stretching from central Zambia to the Zambia-Tanzania border and northern Malawi. Mesoproterozoic and Neoproterozoic transcurrent shear zones within reactivated parts of the Palaeoproterozoic Ubendian belt define its northeastern limit. The northwestern margin is defined by the largely undeformed basement lithologies of the Bangweulu block. An intensely folded and sheared zone at the southeastern margin of the Mporokoso Group sedimentary depocentre on the Bangweulu block, interpreted to have developed above a thrust at the basement-cover interface, indicates that far-field effects of the Irumide Orogen also affected the southeastern part of the Bangweulu block sedimentary cover. To the west and southwest, Irumide and basement lithologies were reworked by the Damara-Lufilian-Zambezi Orogen within the Neoproterozoic Zambezi and Lufilian belts. The Choma-Kalomo block, previously regarded as the southwesterly continuation of the Irumide belt, is a distinct Mesoproterozoic province, while a succession of structurally juxtaposed tectonic terranes in eastern Zambia record a deformation event related to the Irumide Orogen. The lithological units identified in the Irumide belt include: (1) limited Neoarchaean rocks emplaced between 2.73 and 2.61 Ga and representing the oldest rocks in the Bangweulu block; (2) ca. 2.05-1.85 Ga volcano-plutonic complexes and gneisses representing the most important components in the Bangweulu block; (3) an extensive quartzite-metapelite succession with minor carbonate forming the Muva Supergroup, and deposited at ca. 1.85 Ga; (4) granitoids emplaced between 1.65 and 1.55 Ga; (5) a minor suite of anorogenic plutons (nepheline syenite and biotite granite) restricted to the far northeastern Irumide belt and emplaced between 1.36 and 1.33 Ga; (6) voluminous syn- to post-kinematic Irumide granitoids emplaced between 1.05 and 0.95 Ga. Crustal shortening and thickening in

  5. 77 FR 66797 - Executive-Led Trade Mission to South Africa and Zambia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... International Trade Administration Executive-Led Trade Mission to South Africa and Zambia AGENCY: International... notice for the Executive-Led Trade Mission to South Africa and Zambia scheduled for November 26-30, 2012... Africa and Zambia scheduled for November 26-30, 2012, announced in the Notice published at 77 FR...

  6. Deschooling Language Study in East Africa: The Zambia Plan.

    ERIC Educational Resources Information Center

    Roberts, David Harrill

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

  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. Visit to Zambia offers humbling reminder of privileges Canadians enjoy.

    PubMed Central

    Needham, D

    1996-01-01

    McMaster University medical student Dale Needham is spending 6 months in Zambia, where he is focusing on HIV/AIDS research. He describes the home environment of two of his Zambian colleagues, who recently travelled to Vancouver to attend the XI International AIDS Conference. Images p580-a PMID:8804266

  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. 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…

  12. Sexual activity among junior secondary school girls in Zambia.

    PubMed

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

    1997-07-01

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

  13. 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…

  14. 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

  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. 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…

  17. 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

  18. 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.

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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..., which is a field, where the corn has been grown must have been inspected at least once during...

  4. 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..., which is a field, where the corn has been grown must have been inspected at least once during...

  5. 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..., which is a field, where the corn has been grown must have been inspected at least once during...

  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..., which is a field, where the corn has been grown must have been inspected at least once during...

  7. 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..., which is a field, where the corn has been grown must have been inspected at least once during...

  8. 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...

  9. 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...

  10. 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…

  11. Investigating Bilingual Literacy: Evidence from Malawi and Zambia. Education Research Paper.

    ERIC Educational Resources Information Center

    Williams, E.

    This monograph describes contrasting classroom methods and experiences teaching reading in Malawi (where reading is taught through the medium of a local language) and in Zambia (where the medium used is English). In describing research carried out in Malawi and Zambia, the monograph specifically discusses the importance of the research for those…

  12. 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,…

  13. The health status of rural primary schoolchildren in Central Zambia.

    PubMed

    Ng'andu, N H; Nkowane, B M; Watts, T E

    1991-06-01

    In a study of 528 rural primary schoolchildren in Central Zambia, it was found that the health status of the schoolchildren was not good as indicated by inadequate nutrition, a high prevalence of S. haematobium (18%), hookworm (33%), and malaria (43%) infections. There were no statistically significant differences in prevalence of undernutrition between girls and boys and there were no significant trends with age. The treatment and control of hookworm disease, urinary schistosomiasis and malaria deserve a high priority in this area. As for malaria, until an international programme on its control can be developed, the acquisition of protective immunity is of paramount importance. This study shows how the use of 'simple' screening procedures can provide information to direct health education and other disease control measures in school health programmes. As the economic situation in Zambia is not good, the best hope for improvement of the children's health lies with environmental improvement in sanitation, water supplies and provision of basic health education. PMID:1711129

  14. Measles infection in hospitalized children in Lusaka, Zambia.

    PubMed

    Oshitani, H; Mpabalwani, M; Kasolo, F; Mizuta, K; Luo, N P; Bhat, G J; Suzuki, H; Numazaki, Y

    1995-06-01

    A 2-year hospital-based survey of measles infections were carried out at the University Teaching Hospital (UTH) in Lusaka, Zambia from January 1992 to December 1993. During this period, a total of 1066 children with a clinical diagnosis of measles were admitted to the paediatric isolation ward at UTH. Measles cases were seen throughout both 1992 and 1993. However, there was a peak from September to December, 1992. The number of cases decreased with age, and 370 (34.7%) were under 1 year old. It is noteworthy that 203 (19.0%) were less than the 9 months of age which is the recommended time for measles vaccination in Zambia. The overall case fatality rate was 12.6%, and was higher in children aged 0-3 years (14.3%) than in those aged 4 years and above (6.7%). Measles vaccination status could be checked from the child's immunization card for 343 measles cases over 9 months of age, 118 (34.4%) of these having previously received measles vaccine. Vaccinated children had a significantly lower case fatality rate (6.4%) than the unvaccinated group (17.0%). This suggests that while measles vaccine cannot prevent infection, it can reduce the severity of infection.

  15. 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.

  16. 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.

  17. 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

  18. Two new species of Tricorythus Eaton 1868 (Ephemeroptera, Tricorythidae) from Zambia.

    PubMed

    Kluge, Nikita J

    2016-01-01

    Larvae, subimagoes, imagoes of both sexes and eggs of Tricorythus furcifer sp.n. and T. tener sp.n. are described based on reared material from Zambia. Larvae of both species closely resemble larvae of T. varicauda (Pictet 1843), while genitals of male imagoes are different, being especially unusual in T. furcifer. A new locality for Tricorythus tinctus Kimmins 1956 is recorded in Zambia. PMID:27394455

  19. 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

  20. A study of malnourished children in children's hospital Lusaka (Zambia).

    PubMed

    Khan, A A; Gupta, B M

    1979-01-01

    The parents of 200 malnourished childred referred and admitted over the July-December 1976 period to the nutrition wing of the Children's University Teaching Hospital, Zambia, were interviewed in an effort to understand the home environment of malnourished children in Lusaka, Zambia. The 1974 incidence of malnutrition in Zambia was about 23% with higher prevalences of marasmus and moderate malnutrition. There were 9.4% severly malnourished children admitted in 1976 as compared with less than 1% in 1971. Many of these children were admitted very late in a hypothermic shocked state which is directly responsible for the increasing incidence of mortality over these years. Plasma or blood transfusion is a standard procedure in all shocked cases of kwashiorkor, yet many of the children still die within 24 hours of admission. Malnutrition incidence was found to be closely linked to the rise in price index. The majority of the children were admitted from the rainy months November to March, the time associated with a higher incidence of gastroenteritis, respiratory infections, and measles. 88% of the children were between 1-3 years old. Marasmus (33.5%) and marasmic kwashiorkor (40.5%) were more frequent. 63% of the malnourished childred had attended the child health clinics in their infancy and were immunized but discontinued attendance one vaccination was completed. The problem of malnutrition was in the toddler age group. 86% of the childred came from urban slums and periurban areas; 83% were from unitary families, living in 1 or 2 bedroom houses with no separate provision for a kitchen. Rural families (14%) were living as joint families. 32% of the children were from large families. 52% of the parents were employed as casual laborers and earning under US $35 per month. There were only 10 families with earnings in excess of US $125 per month and only 8 had good sources of income from farms. As many as 68.5% children were experiencing 1 or more adverse factors which

  1. Filarial infections in domestic dogs in Lusaka, Zambia.

    PubMed

    Siwila, Joyce; Mwase, Enala T; Nejsum, Peter; Simonsen, Paul E

    2015-06-15

    Filariae are common parasites of dogs in many parts of the world, but little is known about the status of these infections in sub-Saharan Africa. A study was carried out to determine the occurrence and species of filariae among 272 dogs in Lusaka, Zambia. Giemsa stained blood smear and Knott's concentration methods revealed microfilariae in 16 (5.9%) of the dogs. PCR confirmed that most of these dogs had Acanthocheilonema reconditum infection. Ten (4.0%) of the examined dogs were positive for Dirofilaria immitis circulating antigen (by DiroCHEK(®) test), but D. immitis microfilariae were not identified in any of the dogs and the status of this infection remains unclear. Further studies are needed to explore the occurrence of filariae in Zambian dogs and the zoonotic potential for humans.

  2. 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

  3. Perinatal transmission of HIV-I in Zambia.

    PubMed Central

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

    1989-01-01

    OBJECTIVE--To determine the occurrence of vertical transmission of HIV-I from women positive for the virus and the prognosis for their babies. DESIGN--Women presenting in labour were tested for HIV-I. Their newborn babies were also tested. Women positive for the virus were followed up with their babies for two years. SETTING--Teaching hospital in Lusaka, Zambia. SUBJECTS--1954 Women, of whom 227 were seropositive. Of 205 babies, 192 were positive for HIV-I. After birth 109 seropositive mothers and their babies and 40 seronegative mothers and their babies were available for follow up. MAIN OUTCOME MEASURES--Serological examination of mothers and their babies by western blotting. Birth weight and subsequent survival of babies. Women and babies were tested over two years for signs of seroconversion and symptoms of infection with HIV, AIDS related complex, and AIDS. RESULTS--Of the 109 babies born to seropositive mothers and available for follow up, 18 died before 8 months, 14 with clinical AIDS. Of the 91 remaining, 23 were seropositive at 8 months. By 24 months 23 of 86 surviving babies were seropositive, and a further five infected babies had died, four were terminally ill, 17 had AIDS related complex, and two had no symptoms. The overall rate of perinatal transmission was 42 out of 109 (39%). The overall mortality of infected children at 2 years was 19 out of 42 (44%). Before the age of 1 year infected children had pneumonia and recurrent coughs, thereafter symptoms included failure to thrive, recurrent diarrhoea and fever, pneumonia, candidiasis, and lymphodenopathy. All babies had received live attenuated vaccines before 8 months with no adverse affects. CONCLUSIONS--Vertical transmission from infected mothers to their babies is high in Zambia and prognosis is poor for the babies. Perinatal transmission and paediatric AIDS must be reduced, possibly by screening young women and counselling those positive for HIV-I against future pregnancy. PMID:2513899

  4. Improved diagnostic testing and malaria treatment practices in Zambia

    PubMed Central

    Hamer, Davidson H; Ndhlovu, Micky; Zurovac, Dejan; Fox, Matthew; Yeboah-Antwi, Kojo; Chanda, Pascalina; Sipilinyambe, Naawa; Simon, Jonathon L; Snow, Robert W

    2009-01-01

    Context Improving the accuracy of malaria diagnosis using rapid diagnostic tests (RDT) has been proposed as an approach for reducing over-treatment of malaria in the current era of widespread implementation of artemisinin-based combination therapy in sub-Saharan Africa. Objective To assess the impact of microscopy and RDT use on prescription of antimalarials. Design, Setting, and Participants Cross-sectional, cluster sample survey of all sick outpatients seen at a health facility during one working day that included all public and mission health facilities in four sentinel districts in Zambia. Main Outcome Measures Proportions of patients undergoing malaria diagnostic procedures and receiving anti-malarial treatment. Results 17% of the 104 health facilities surveyed had functional microscopy, 63% had RDTs available, and 73% had at least one type of malaria diagnostics. 27.8% of subjects with fever (suspected malaria) seen in health facilities with malaria diagnostics were tested and 44.6% were positive. 58.4% of patients with negative blood smears were prescribed an antimalarial as were 35.5% of those with a negative RDT result. 65.9% of the subjects with fever who did not have diagnostic tests done were also prescribed antimalarials. In facilities with artemether-lumefantrine in stock, this antimalarial was prescribed to a larger proportion of febrile patients with a positive diagnostic test (blood smear 75.0%; RDT 70.4%) than those with a negative diagnostic test (blood smear 30.4%; RDT 26.7%). Conclusion Despite efforts to scale up the provision of malaria diagnostics in Zambia they continue to be under-utilized and patients with negative test results frequently receive antimalarials. The provision of new tools to reduce the inappropriate use of new expensive antimalarial treatments must be accompanied by a paradigm shift in clinical management of patients without evidence of malaria infection. PMID:17519412

  5. Intestinal Infestations in Under-Five Children in Zambia

    PubMed Central

    Mwale, Kamukwamba; Siziya, Seter

    2015-01-01

    Background: Intestinal infestations are of considerable public health importance in Zambia and elsewhere in Africa. Children aged less than 5 years are at the highest risk of infection. Interventions for prevention and control of these infestations require identification of their determinants. This study investigates the determinants of intestinal infestations in children below 5 years of age admitted to a children’s hospital and assesses the most prevalent of the helminthes. Methods: This was a hospital based cross-sectional study conducted at Arthur Davison Children’s Hospital, Ndola, Zambia. Socio-demographic data of study participants and possible determinants for occurrence of intestinal infestations were collected using structured questionnaires. Stool samples were collected and examined for presence of parasites using direct techniques. The Pearson’s Chi-square and Fisher’s exact tests were used to establish associations. Results: Present study had 148 participants out of the expected 165, making a respondent rate of 89.7%. Over half of the participants were male (50.6%), and 68.9% were above the age of 2 years. Prevalence of intestinal infestations was 19.6%, and the most prevalent parasite was Ascaris lumbricoides. Factors independently associated with worm infestation were father’s employment (AOR = 0.41; 95 % CI [0.19, 0.90]) and history of prior worm infestation (AOR = 6.54; 95 % CI [3.28, 13.03]). Conclusion: Intestinal infestations particularly Ascaris lumbricoides were more prevalent in this study. There should be policy towards countrywide deworming programs and enhanced hygiene.

  6. 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

  7. 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.

  8. Insecticide Resistance and the Future of Malaria Control in Zambia

    PubMed Central

    Chanda, Emmanuel; Hemingway, Janet; Kleinschmidt, Immo; Rehman, Andrea M.; Ramdeen, Varsha; Phiri, Faustina N.; Coetzer, Sarel; Mthembu, David; Shinondo, Cecilia J.; Chizema-Kawesha, Elizabeth; Kamuliwo, Mulakwa; Mukonka, Victor; Baboo, Kumar S.; Coleman, Michael

    2011-01-01

    Background In line with the Global trend to improve malaria control efforts a major campaign of insecticide treated net distribution was initiated in 1999 and indoor residual spraying with DDT or pyrethroids was reintroduced in 2000 in Zambia. In 2006, these efforts were strengthened by the President's Malaria Initiative. This manuscript reports on the monitoring and evaluation of these activities and the potential impact of emerging insecticide resistance on disease transmission. Methods Mosquitoes were captured daily through a series of 108 window exit traps located at 18 sentinel sites. Specimens were identified to species and analyzed for sporozoites. Adult Anopheles mosquitoes were collected resting indoors and larva collected in breeding sites were reared to F1 and F0 generations in the lab and tested for insecticide resistance following the standard WHO susceptibility assay protocol. Annual cross sectional household parasite surveys were carried out to monitor the impact of the control programme on prevalence of Plasmodium falciparum in children aged 1 to 14 years. Results A total of 619 Anopheles gambiae s.l. and 228 Anopheles funestus s.l. were captured from window exit traps throughout the period, of which 203 were An. gambiae malaria vectors and 14 An. funestus s.s.. In 2010 resistance to DDT and the pyrethroids deltamethrin, lambda-cyhalothrin and permethrin was detected in both An. gambiae s.s. and An. funestus s.s.. No sporozoites were detected in either species. Prevalence of P. falciparum in the sentinel sites remained below 10% throughout the study period. Conclusion Both An. gambiae s.s. and An. funestus s.s. were controlled effectively with the ITN and IRS programme in Zambia, maintaining a reduced disease transmission and burden. However, the discovery of DDT and pyrethroid resistance in the country threatens the sustainability of the vector control programme. PMID:21915314

  9. 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…

  10. 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…

  11. 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.

  12. Health Seeking Behaviour among Individuals with Presumptive Tuberculosis in Zambia

    PubMed Central

    Kapata, Nathan; Masiye, Felix; Maboshe, Mwendaweli; Klinkenberg, Eveline; Cobelens, Frank; Grobusch, Martin P.

    2016-01-01

    Background Tuberculosis (TB) prevalence surveys offer a unique opportunity to study health seeking behaviour at the population level because they identify individuals with symptoms that should ideally prompt a health consultation. Objective To assess the health-seeking behaviour among individuals who were presumptive TB cases in a national population based TB prevalence survey. Methods A cross sectional survey was conducted between 2013 and 2014 among 66 survey clusters in Zambia. Clusters were census supervisory areas (CSAs). Participants (presumptive TB cases) were individuals aged 15 years and above; having either cough, fever or chest pain for 2 weeks or more; and/or having an abnormal or inconclusive chest x-ray image. All survey participants were interviewed about symptoms and had a chest X-ray taken. An in-depth interview was conducted to collect information on health seeking behaviour and previous TB treatment. Results Of the 6,708 participants, the majority reported at least a history of chest pain (3,426; 51.1%) followed by cough (2,405; 35.9%), and fever (1,030; 15.4%) for two weeks or more. Only 34.9% (2,340) had sought care for their symptoms, mainly (92%) at government health facilities. Of those who sought care, 13.9% (326) and 12.1% (283) had chest x-ray and sputum examinations, respectively. Those ever treated for TB were 9.6% (644); while 1.7% (114) was currently on treatment. The average time (in weeks) from onset of symptoms to first care-seeking was 3 for the presumptive TB cases. Males, urban dwellers and individuals in the highest wealth quintile were less likely to seek care for their symptoms. The likelihood of having ever been treated for TB was highest among males, urban dwellers; respondents aged 35–64 years, individuals in the highest wealth quintile, or HIV positive. Conclusion Some presumptive TB patients delay care-seeking for their symptoms. The health system misses opportunities to diagnose TB among those who seek care. Improving

  13. 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.

  14. Seroprevalence of Canine Parvovirus in Dogs in Lusaka District, Zambia

    PubMed Central

    2016-01-01

    Canine parvovirus (CPV) enteritis is a highly contagious enteric disease of young dogs. Limited studies have been done in Zambia to investigate the prevalence of CPV in dogs. Blood was collected from dogs from three veterinary clinics (clinic samples, n = 174) and one township of Lusaka (field samples, n = 56). Each dog's age, sex, breed, and vaccination status were recorded. A haemagglutination assay using pig erythrocytes and modified live parvovirus vaccine as the antigen was used. Antibodies to CPV were detected in 100% of dogs (unvaccinated or vaccinated). The titres ranged from 160 to 10240 with a median of 1280. Vaccinated dogs had significantly higher antibody titres compared to unvaccinated (p < 0.001). There was a significant difference in titres of clinic samples compared to field samples (p < 0.0001) but not within breed (p = 0.098) or sex (p = 0.572). Multiple regression analysis showed that only age and vaccination status were significant predictors of antibody titres. The presence of antibody in all dogs suggests that the CPV infection is ubiquitous and the disease is endemic, hence the need for research to determine the protection conferred by vaccination and natural exposure to the virus under local conditions.

  15. The Socioeconomic status of children with epilepsy in Zambia

    PubMed Central

    Chomba, Elwyn; Haworth, Alan; Atadzhanov, Masharip; Mbewe, Edward; Birbeck, Gretchen L.

    2008-01-01

    Summary Epilepsy is a highly stigmatized disorder in Zambia. Adult studies indicated that adults with epilepsy in many regions have significantly lower socioeconomic status (SES) than their peers. We conducted a case-control study of Zambian children with epilepsy (CWE) to assess the SES of CWE. 98 child pairs were recruited (n=196), mean age 10.8 yrs, 59.7% male. The comparison group’s medical conditions included asthma (54.0%), rheumatic heart disease (26.6%), type 1 diabetes (14.2%), and hypertension (5.2%). Compared to children with non-stigmatized chronic medical conditions, CWE have fewer educational opportunities, more environmental hazards, and poorer food quality and security (all p’s<0.05). These deprivations may be related to lost maternal income from mothers who deferred employment so they could remain at home to care for the child. These early deprivations have long-term implications for health and well-being. Healthcare workers and child advocates need to be aware of the circumstances facing CWE in this region. PMID:18602496

  16. Urban women's informal savings and credit systems in Zambia.

    PubMed

    O'reilly, C

    1996-05-01

    This article is based on findings from semi-structured interviews and discussions among "chilimba" groups in Zambia. Chilimba groups are primarily women's groups that engage in credit and savings programs. Group membership ranges from 4 to 20 members. The women agree on a fixed, regular cash contribution that is given in turn to each member in a specified order. Market groups tend to be larger and contributions of about a dollar are made daily. Smaller groups tend to make larger, but less frequent contributions. Default is rare, as the commitment is taken very seriously. New members are added at the end of the rotation. Loans can be used for domestic or business use. Chilimba groups are evidence that very poor people desire savings. Chilimba brings together people with similar financial needs and resources. Chilimba does not require formal, written procedures or formal institutional frameworks. Chilimba is not a remedy for reducing overall poverty. It is appropriate only for people with some regular source of income. It does not serve as a safety net in emergencies. Long-term loans are not possible. A limitation is its openness and lack of structure that permit potential abuse. It is a livelihood strategy for women, but benefits could be gained from including men. It is urged that groups consider whether the position of the poor is being enhanced or undermined. Different models need to be tested. Members themselves must decide on the type and phasing of activities.

  17. 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.

  18. Seroprevalence of Canine Parvovirus in Dogs in Lusaka District, Zambia

    PubMed Central

    2016-01-01

    Canine parvovirus (CPV) enteritis is a highly contagious enteric disease of young dogs. Limited studies have been done in Zambia to investigate the prevalence of CPV in dogs. Blood was collected from dogs from three veterinary clinics (clinic samples, n = 174) and one township of Lusaka (field samples, n = 56). Each dog's age, sex, breed, and vaccination status were recorded. A haemagglutination assay using pig erythrocytes and modified live parvovirus vaccine as the antigen was used. Antibodies to CPV were detected in 100% of dogs (unvaccinated or vaccinated). The titres ranged from 160 to 10240 with a median of 1280. Vaccinated dogs had significantly higher antibody titres compared to unvaccinated (p < 0.001). There was a significant difference in titres of clinic samples compared to field samples (p < 0.0001) but not within breed (p = 0.098) or sex (p = 0.572). Multiple regression analysis showed that only age and vaccination status were significant predictors of antibody titres. The presence of antibody in all dogs suggests that the CPV infection is ubiquitous and the disease is endemic, hence the need for research to determine the protection conferred by vaccination and natural exposure to the virus under local conditions. PMID:27699205

  19. Preventing HIV with young people: a case study from Zambia.

    PubMed

    Gordon, Gill; Mwale, Vincent

    2006-11-01

    The US President's Emergency Plan for AIDS Relief (PEPFAR) is funding thousands of community-based organisations, international NGOs and government services in high HIV prevalence countries to persuade young people to abstain from sex until marriage (Abstinence, Behaviour Change, Youth--ABY). This paper describes how this strategy is being implemented in Zambia, and community responses to it. It is derived from published information and observations and discussions in the Eastern Province in 2005-2006. A few NGOs have challenged the strategy, but many took the funds and are paying large numbers of peer educators to promote abstinence only. Messages are rife that condoms have holes or don't work sufficiently well to make them worth using. Condom promotion materials have been replaced. Service providers refuse to give condoms to young people. Young people who had attended sexuality and life skills programmes that gave them accurate information are rejecting inaccurate messages and demanding condoms. Without this education, however, inaccurate messages will spread quickly. It is not possible to promote condoms only for high risk people without stigmatising both the people and condoms, and it also jeopardises promoting condom use for contraception. Everything possible must be done to reduce negative messages about condoms. Everyone involved in HIV/AIDS needs to reflect on their own work in relation to this new climate and ensure that all prevention options are widely available, correct information is given and condoms are available for everyone who needs them.

  20. Flexible engineering designs for urban water management in Lusaka, Zambia.

    PubMed

    Tembo, Lucy; Pathirana, Assela; van der Steen, Peter; Zevenbergen, Chris

    2015-01-01

    Urban water systems are often designed using deterministic single values as design parameters. Subsequently the different design alternatives are compared using a discounted cash flow analysis that assumes that all parameters remain as-predicted for the entire project period. In reality the future is unknown and at best a possible range of values for design parameters can be estimated. A Monte Carlo simulation could then be used to calculate the expected Net Present Value of project alternatives, as well as so-called target curves (cumulative frequency distribution of possible Net Present Values). The same analysis could be done after flexibilities were incorporated in the design, either by using decision rules to decide about the moment of capacity increase, or by buying Real Options (in this case land) to cater for potential capacity increases in the future. This procedure was applied to a sanitation and wastewater treatment case in Lusaka, Zambia. It included various combinations of on-site anaerobic baffled reactors and off-site waste stabilisation ponds. For the case study, it was found that the expected net value of wastewater treatment systems can be increased by 35-60% by designing a small flexible system with Real Options, rather than a large inflexible system.

  1. 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 2003–2004 outbreak season and on 6045 cholera patients in the 2005–2006 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 2005–2006 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

  2. Piecework (ganyu) as an indicator of household vulnerability in rural Zambia.

    PubMed

    Cole, Steven M; Hoon, Parakh N

    2013-01-01

    Piecework (ganyu) is short-term, casual labor common in rural Zambia and neighboring countries. Reliance on piecework as a strategy to cope during food shortages in the rainy/cultivation season can restrict own-farm production, and thus, is regarded as an indicator of a household's vulnerability to food insecurity. Based on a household's level of participation in piecework, we explore this claim in rural Zambia using survey data collected during the rainy and dry seasons in 2009. We argue that seasonal assessments are essential if such dependence on piecework is used as a robust measure of a household's vulnerability to food insecurity.

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

    PubMed

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

    2012-04-01

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

  4. 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.

  5. 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…

  6. 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)

  7. The distribution of African swine fever virus isolated from Ornithodoros moubata in Zambia.

    PubMed

    Wilkinson, P J; Pegram, R G; Perry, B D; Lemche, J; Schels, H F

    1988-12-01

    African swine fever (ASF) has been reported in the Eastern Province of Zambia since 1912 and is now considered to be enzootic there. A survey of the distribution of ASF virus in Zambia was carried out by virus isolation from Ornithodoros moubata ticks collected from animal burrows in National Parks and Game Management Areas in northern, eastern, central and southern Zambia. ASF virus was isolated from ticks in all areas examined. The prevalence of infection in O. moubata was between 0.4% in South Luangwa National Park and 5.1% in Livingstone Game Park and mean infectious virus titres ranged from 10(3.4) HAD50/tick in Kakumbe Game Management Area to 10(5.9) HAD50/tick in Chunga and Nalusanga Game Management Areas. The prevalence of infection in adult ticks was between 4.7% and 5.3% in all areas examined except Sumbu National Park and Livingstone Game Park, where the prevalence was 15.1% and 13.2% respectively in adult ticks. The ratio of infected females to males for all the infected adult ticks in all areas of Zambia was 3.2:1.

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  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. Absence of Active Hepatitis C Virus Infection in Human Immunodeficiency Virus Clinics in Zambia and Mozambique

    PubMed Central

    Wandeler, Gilles; Mulenga, Lloyd; Hobbins, Michael; Joao, Candido; Sinkala, Edford; Hector, Jonas; Aly, Musa; Chi, Benjamin H.; Egger, Matthias; Vinikoor, Michael J.

    2016-01-01

    Few studies have evaluated the prevalence of replicating hepatitis C virus (HCV) infection in sub-Saharan Africa. Among 1812 individuals infected with human immunodeficiency virus, no patient in rural Mozambique and 4 patients in urban Zambia were positive for anti-HCV antibodies. Of these, none had confirmed HCV replication. PMID:27047986

  18. 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…

  19. 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

  20. 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

  1. The distribution of African swine fever virus isolated from Ornithodoros moubata in Zambia.

    PubMed Central

    Wilkinson, P. J.; Pegram, R. G.; Perry, B. D.; Lemche, J.; Schels, H. F.

    1988-01-01

    African swine fever (ASF) has been reported in the Eastern Province of Zambia since 1912 and is now considered to be enzootic there. A survey of the distribution of ASF virus in Zambia was carried out by virus isolation from Ornithodoros moubata ticks collected from animal burrows in National Parks and Game Management Areas in northern, eastern, central and southern Zambia. ASF virus was isolated from ticks in all areas examined. The prevalence of infection in O. moubata was between 0.4% in South Luangwa National Park and 5.1% in Livingstone Game Park and mean infectious virus titres ranged from 10(3.4) HAD50/tick in Kakumbe Game Management Area to 10(5.9) HAD50/tick in Chunga and Nalusanga Game Management Areas. The prevalence of infection in adult ticks was between 4.7% and 5.3% in all areas examined except Sumbu National Park and Livingstone Game Park, where the prevalence was 15.1% and 13.2% respectively in adult ticks. The ratio of infected females to males for all the infected adult ticks in all areas of Zambia was 3.2:1. PMID:3215286

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

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

    PubMed Central

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

    2013-01-01

    Two cases of extremely drug-resistant Salmonella enterica serovar Senftenberg isolated from patients in Zambia were investigated by utilizing MIC determinations and whole-genome sequencing. The isolates were resistant to, and harbored genes toward, nine drug classes, including fluoroquinolones and extended-spectrum cephalosporins, contained two plasmid replicons, and differed by 93 single-nucleotide polymorphisms. PMID:23077128

  8. 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…

  9. Two new planthopper species (Hemiptera, Fulgoroidea, Caliscelidae) collected in pitfall traps in Zambia.

    PubMed

    Chmurova, Lucia; Webb, Michael D

    2016-01-01

    Two new species of planthoppers in the family Caliscelidae (Hemiptera: Fulgoroidea) are described from Zambia, i.e., Afronaso spinosa sp. n. and Calampocus zambiaensis sp. n. All specimens are flightless males and nearly all were collected from baited pitfall traps (except for one specimen collected from a yellow pan trap), suggesting that they live near to or on the ground. PMID:27615842

  10. 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…

  11. 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,…

  12. Disappearance of some human African trypanosomiasis transmission foci in Zambia in the absence of a tsetse fly and trypanosomiasis control program over a period of forty years.

    PubMed

    Mwanakasale, Victor; Songolo, Peter

    2011-03-01

    We conducted a situation analysis of human African trypanosomiasis (HAT) in Zambia from January 2000 to April 2007. The aim of this survey was to identify districts in Zambia that were still recording cases of HAT. Three districts namely, Mpika, Chama, and Chipata were found to be still reporting cases of HAT and thus lay in HAT transmission foci in North Eastern Zambia. During the period under review, 24 cases of HAT were reported from these three districts. We thereafter reviewed literature on the occurrence of HAT in Zambia from the early 1960s to mid 1990s. This revealed that HAT transmission foci were widespread in Western, North Western, Lusaka, Eastern, Luapula, and Northern Provinces of Zambia during this period. In this article we have tried to give possible reasons as to why the distribution of HAT transmission foci is so different between before and after 2000 when there has been no active national tsetse fly and trypanosomiasis control program in Zambia.

  13. Nutrient and carbon cycling in the Kafue River (Zambia)

    NASA Astrophysics Data System (ADS)

    Zurbruegg, R.; Senn, D.; Lehmann, M.; Wamulume, J.; Nyambe, I.; Wehrli, B.

    2008-12-01

    The lower Kafue River in central Zambia flows through the Kafue Flats (830 sq. km), a sensitive floodplain ecosystem (Ramsar site), and serves as an important subsistence fishery. The lower Kafue River (Qavg ~ 300 m3/s) is heavily impacted by two dams that regulate flow and flooding, and in so doing have substantially degraded the habitats. While the hydrology and ecology of the system have been studied extensively in some sections, there have been no systematic studies of the dam impacts on floodplain biogeochemistry. In May 2008 we initiated a study of C, N, and P cycling in the lower Kafue River through sampling at 10-20 km resolution along 300 km of river. Low inorganic nitrogen levels (<1 uM nitrate, <1 uM ammonium) were found along the entire river, despite it being in hydraulic communication with an extremely productive floodplain. The low inorganic N levels coincided with relatively high total nitrogen (>40 uM), suggesting that the riverine N budget is dominated by organic N. Phosphate concentrations increased by a factor of 4 along the river (0.2 uM to 0.8 uM), and transitioned from representing only a small fraction of total P upstream to accounting for nearly 100% of total P at downstream stations. Along one short (35 km; travel time ~ 16 h), relatively pristine stretch of river with a substantial flow rate (400 m3/s) and no visible tributaries, dissolved oxygen levels decreased from >5 mg/l to 1 mg/l. A drop in pH from (7.9 to 7.2) accompanied the sharp oxygen decline, consistent with respiration occurring either within the river or in the adjacent floodplain. Low dissolved oxygen levels (<2 mg/l). persisted for another 150 km downstream despite reaeration. This presentation will explore in greater detail the factors contributing to this persistent low oxygen stretch in the Kafue River, along with an exploration of N, C, and P cycling in the system

  14. Adolescent HIV disclosure in Zambia: barriers, facilitators and outcomes

    PubMed Central

    Mburu, Gitau; Hodgson, Ian; Kalibala, Sam; Haamujompa, Choolwe; Cataldo, Fabian; Lowenthal, Elizabeth D; Ross, David

    2014-01-01

    Introduction As adolescents living with HIV gain autonomy over their self-care and begin to engage in sexual relationships, their experiences of being informed about their HIV status and of telling others about their HIV status may affect their ability to cope with having the disease. Methods In 2010, we conducted a qualitative study among adolescents aged 10–19 living with HIV in Zambia, and with their parents and health care providers. Through interviews and focus group discussions, we explored the disclosure of HIV status to adolescents living with HIV; adolescents’ disclosure of their status to others; and the impact of both forms of disclosure on adolescents. Results Our study identified three main barriers to disclosure of HIV status: local norms that deter parents from communicating with their children about sexuality; fear of HIV stigma; and an underlying presumption that adolescents would not understand the consequences of a HIV diagnosis on their lives and relationships. With regard to adolescents’ disclosure of their HIV status to their sexual partners, our study identified fear of rejection as a common barrier. In rare cases, open family conversations about HIV helped adolescents come to terms with a HIV diagnosis. Findings indicated that disclosure had various outcomes at the individual and interpersonal levels. At the individual level, some adolescents described being anxious, depressed and blaming themselves after being told they had HIV. At the interpersonal level, disclosure created opportunities for adolescents to access adherence support and other forms of psychosocial support from family members and peers. At the same time, it occasionally strained adolescents’ sexual relationships, although it did not always lead to rejection. Conclusions There is a need for public health interventions that guide adolescents living with HIV, their parents and families through the disclosure process. Such interventions should help parents to assess and

  15. Restructuring of labor markets in the Philippines and Zambia: the gender dimension.

    PubMed

    Floro, M S; Schaefer, K

    1998-01-01

    This paper critically examines labor market changes accompanying the process of structural adjustment in the Philippines and Zambia and, in particular, the resulting impact on women's economic participation. The changes in the labor market occurring during the process of economic restructuring in Zambia and the Philippines are similar in some respects but very different in others. Zambia's economic performance has not been sufficient to generate wide-based employment and has been characterized by rising unemployment. The Philippines has also unfortunately been characterized by a growth in joblessness, specifically with regard to skilled and semiskilled employment. Global integration of labor markets in the Philippines give some employment opportunity to workers who are willing to seek jobs overseas but not to those in Zambia. Both in the Philippines and Zambia, the informal sector has shifted its agricultural reforms to female labor toward agricultural wage work (which is seasonal and low paid). In the Philippines, specifically in urban areas, certain export-oriented industries have created some jobs, predominantly for young women, but only a small proportion of total females are employed. Much of the female job growth has occurred in sales and service sectors, including sex work, domestic service, and petty trade. International labor migration in the Philippines has become more feminized, because a majority of overseas contract workers are women, who are employed in the service sector as entertainers and domestic helpers. Access to paid work in some cases may empower women, yet in other cases their power may be diminished. Both the specific character of labor market development and the nature of the accompanying economic reform alter the ability of the women and men to take advantage of the opportunity. Reform shifts patterns of production organization and location of employment and can either reinforce the prevailing distribution of power or provide tension

  16. Satellite Estimates of Crop Area and Maize Yield in Zambia's Agricultural Districts

    NASA Astrophysics Data System (ADS)

    Azzari, G.; Lobell, D. B.

    2015-12-01

    Predicting crop yield and area from satellite is a valuable tool to monitor different aspects of productivity dynamics and food security. In Sub-Saharan Africa, where the agricultural landscape is complex and dominated by smallholder systems, such dynamics need to be investigated at the field scale. We leveraged the large data pool and computational power of Google Earth Engine to 1) generate 30 m resolution cover maps of selected provinces of Zambia, 2) estimate crop area, and 3) produce yearly maize yield maps using the recently developed SCYM (Scalable satellite-based Crop Yield Mapper) algorithm. We will present our results and their validation against a ground survey dataset collected yearly by the Zambia Ministry of Agriculture from about 12,500 households.

  17. Genomic research in Zambia: confronting the ethics, policy and regulatory frontiers in the 21st Century.

    PubMed

    Chanda-Kapata, Pascalina; Kapata, Nathan; Moraes, Albertina Ngomah; Chongwe, Gershom; Munthali, James

    2015-10-29

    Genomic research has the potential to increase knowledge in health sciences, but the process has to ensure the safety, integrity and well-being of research participants. A legal framework for the conduct of health research in Zambia is available. However, the ethical, policy and regulatory framework to operationalise genomic research requires a paradigm shift. This paper outlines the current legal and policy framework as well as the ethics environment, and suggests recommendations for Zambia to fully benefit from the opportunity that genomic research presents. This will entail creating national research interest, improving knowledge levels, and building community trust among researchers, policymakers, donors, regulators and, most importantly, patients and research participants. A real balancing act of the risk and benefits will need to be objectively undertaken.

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

    PubMed

    Ogawa, Hirohito; Ohnuma, Miyuki; Squarre, David; Mweene, Aaron Simanyengwe; Ezaki, Takayuki; Fujikura, Daisuke; Ohnishi, Naomi; Thomas, Yuka; Hang'ombe, Bernard Mudenda; Higashi, Hideaki

    2015-08-01

    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.

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

    PubMed Central

    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

  20. 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°-550°C. The

  1. 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

  2. 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

  3. Outbreak of Plague in a High Malaria Endemic Region - Nyimba District, Zambia, March-May 2015.

    PubMed

    Sinyange, Nyambe; Kumar, Ramya; Inambao, Akatama; Moonde, Loveness; Chama, Jonathan; Banda, Mapopa; Tembo, Elliot; Nsonga, Beron; Mwaba, John; Fwoloshi, Sombo; Musokotwane, Kebby; Chizema, Elizabeth; Kapin'a, Muzala; Hang'ombe, Benard Mudenda; Baggett, Henry C; Hachaambwa, Lottie

    2016-01-01

    Outbreaks of plague have been recognized in Zambia since 1917 (1). On April 10, 2015, Zambia's Ministry of Health was notified by the Eastern Provincial Medical Office of possible bubonic plague cases in Nyimba District. Eleven patients with acute fever and cervical lymphadenopathy had been evaluated at two rural health centers during March 28-April 9, 2015; three patients died. To confirm the outbreak and develop control measures, the Zambia Ministry of Health's Field Epidemiology Training Program (ZFETP) conducted epidemiologic and laboratory investigations in partnership with the University of Zambia's schools of Medicine and Veterinary Medicine and the provincial and district medical offices. Twenty-one patients with clinically compatible plague were identified, with symptom onset during March 26-May 5, 2015. The median age was 8 years, and all patients were from the same village. Blood specimens or lymph node aspirates from six (29%) patients tested positive for Yersinia pestis by polymerase chain reaction (PCR). There is an urgent need to improve early identification and treatment of plague cases. PCR is a potential complementary tool for identifying plague, especially in areas with limited microbiologic capacity. Twelve (57%) patients, including all six with PCR-positive plague and all three who died, also tested positive for malaria by rapid diagnostic test (RDT). Plague patients coinfected with malaria might be misdiagnosed as solely having malaria, and appropriate antibacterial treatment to combat plague might not be given, increasing risk for mortality. Because patients with malaria might be coinfected with other pathogens, broad spectrum antibiotic treatment to cover other pathogens is recommended for all children with severe malaria, until a bacterial infection is excluded. PMID:27513350

  4. Investment Incentives and the Implementation of the Framework Convention on Tobacco Control: Evidence from Zambia

    PubMed Central

    Drope, Jeffrey; Labonte, Ronald; Zulu, Richard; Goma, Fastone

    2016-01-01

    Purpose Policy misalignment across different sectors of government serves as one of the pivotal barriers to WHO Framework convention on Tobacco Control (FCTC) implementation. This paper examines the logic used by government officials to justify providing investment incentives to increase tobacco processing and manufacturing in the context of FCTC implementation in Zambia. Methods We conducted qualitative semi-structured interviews with key informants from government, civil society and intergovernmental economic organizations (n=23). We supplemented the interview data with an analysis of public documents pertaining to economic development policy in Zambia. Results We found gross misalignments between the policies of the economic sector and efforts to implement the provisions of the FCTC. Our interviews uncovered the rationale used by officials in the economic sector to justify providing economic incentives to bolster tobacco processing and manufacturing in Zambia: 1) tobacco is not consumed by Zambians/tobacco is an export commodity, 2) economic benefits outweigh health costs, and 3) tobacco consumption is a personal choice. Conclusions Much of the struggle Zambia has experienced implementing the FCTC can be attributed to misalignments between the economic and health sectors. Zambia’s development agenda seeks to bolster agricultural processing and manufacturing. Tobacco control proponents must understand and work within this context of economic development in order to foster productive strategies with those working on tobacco supply issues. These findings are broadly applicable to the global analysis on the barriers and facilitators of FCTC implementation. It is important that the Ministry of Health monitors the tobacco policy of other sectors and engages with these sectors to find ways of harmonizing FCTC implementation across sectors. PMID:26135987

  5. Women's knowledge and attitudes surrounding abortion in Zambia: a cross-sectional survey across three provinces

    PubMed Central

    Cresswell, Jenny A; Schroeder, Rosalyn; Dennis, Mardieh; Owolabi, Onikepe; Vwalika, Bellington; Musheke, Maurice; Campbell, Oona; Filippi, Veronique

    2016-01-01

    Objectives In Zambia, despite a relatively liberal legal framework, there remains a substantial burden of unsafe abortion. Many women do not use skilled providers in a well-equipped setting, even where these are available. The aim of this study was to describe women's knowledge of the law relating to abortion and attitudes towards abortion in Zambia. Setting Community-based survey in Central, Copperbelt and Lusaka provinces. Participants 1484 women of reproductive age (15–44 years). Primary and secondary outcome measures Correct knowledge of the legal grounds for abortion, attitudes towards abortion services and the previous abortions of friends, family or other confidants. Descriptive statistics and multivariable logistic regression were used to analyse how knowledge and attitudes varied according to sociodemographic characteristics. Results Overall, just 16% (95% CI 11% to 21%) of women of reproductive age correctly identified the grounds for which abortion is legal. Only 40% (95% CI 32% to 45% of women of reproductive age knew that abortion was legally permitted in the extreme situation where the pregnancy threatens the life of the mother. Even in urban areas of Lusaka province, only 55% (95% CI 41% to 67%) of women knew that an abortion could legally take place to save the mother's life. Attitudes remain conservative. Women with correct knowledge of abortion law in Zambia tended to have more liberal attitudes towards abortion and access to safe abortion services. Neither correct knowledge of the law nor attitudes towards abortion were associated with knowing someone who previously had an induced abortion. Conclusions Poor knowledge and conservative attitudes are important obstacles to accessing safe abortion services. Changing knowledge and attitudes can be challenging for policymakers and public health practitioners alike. Zambia could draw on its previous experience in dealing with its large HIV epidemic to learn cross-cutting lessons in effective mass

  6. 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

  7. Outbreak of Plague in a High Malaria Endemic Region - Nyimba District, Zambia, March-May 2015.

    PubMed

    Sinyange, Nyambe; Kumar, Ramya; Inambao, Akatama; Moonde, Loveness; Chama, Jonathan; Banda, Mapopa; Tembo, Elliot; Nsonga, Beron; Mwaba, John; Fwoloshi, Sombo; Musokotwane, Kebby; Chizema, Elizabeth; Kapin'a, Muzala; Hang'ombe, Benard Mudenda; Baggett, Henry C; Hachaambwa, Lottie

    2016-08-12

    Outbreaks of plague have been recognized in Zambia since 1917 (1). On April 10, 2015, Zambia's Ministry of Health was notified by the Eastern Provincial Medical Office of possible bubonic plague cases in Nyimba District. Eleven patients with acute fever and cervical lymphadenopathy had been evaluated at two rural health centers during March 28-April 9, 2015; three patients died. To confirm the outbreak and develop control measures, the Zambia Ministry of Health's Field Epidemiology Training Program (ZFETP) conducted epidemiologic and laboratory investigations in partnership with the University of Zambia's schools of Medicine and Veterinary Medicine and the provincial and district medical offices. Twenty-one patients with clinically compatible plague were identified, with symptom onset during March 26-May 5, 2015. The median age was 8 years, and all patients were from the same village. Blood specimens or lymph node aspirates from six (29%) patients tested positive for Yersinia pestis by polymerase chain reaction (PCR). There is an urgent need to improve early identification and treatment of plague cases. PCR is a potential complementary tool for identifying plague, especially in areas with limited microbiologic capacity. Twelve (57%) patients, including all six with PCR-positive plague and all three who died, also tested positive for malaria by rapid diagnostic test (RDT). Plague patients coinfected with malaria might be misdiagnosed as solely having malaria, and appropriate antibacterial treatment to combat plague might not be given, increasing risk for mortality. Because patients with malaria might be coinfected with other pathogens, broad spectrum antibiotic treatment to cover other pathogens is recommended for all children with severe malaria, until a bacterial infection is excluded.

  8. 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.

  9. 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

  10. 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

  11. Malaria prevention in Zambia: a practical application of the diffusion of innovations model.

    PubMed

    Steury, Elinda Enright

    2013-04-01

    Transcultural nursing educators can be change agents for health issues in other cultures. Yet unfamiliar disease processes and the foreign environment provide challenges that must be overcome to achieve a lasting, effective, and positive change. Rogers's Diffusion of Innovations Model can be used to plan and implement community-focused interventions into the cultures of developing nations, specifically malaria prevention in Zambia. Transcultural nurse educators could use concepts from the model to effect change in other cultures or communities.

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

    PubMed

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

    2006-05-01

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

  13. 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.

  14. Diagnosis and genotyping of African swine fever viruses from 2015 outbreaks in Zambia.

    PubMed

    Thoromo, Jonas; Simulundu, Edgar; Chambaro, Herman M; Mataa, Liywalii; Lubaba, Caesar H; Pandey, Girja S; Takada, Ayato; Misinzo, Gerald; Mweene, Aaron S

    2016-01-01

    In early 2015, a highly fatal haemorrhagic disease of domestic pigs resembling African swine fever (ASF) occurred in North Western, Copperbelt, and Lusaka provinces of Zambia. Molecular diagnosis by polymerase chain reaction targeting specific amplification of p72 (B646L) gene of ASF virus (ASFV) was conducted. Fourteen out of 16 domestic pigs from the affected provinces were found to be positive for ASFV. Phylogenetic analyses based on part of the p72 and the complete p54 (E183L) genes revealed that all the ASFVs detected belonged to genotypes I and Id, respectively. Additionally, epidemiological data suggest that the same ASFV spread from Lusaka to other provinces possibly through uncontrolled and/or illegal pig movements. Although the origin of the ASFV that caused outbreaks in domestic pigs in Zambia could not be ascertained, it appears likely that the virus may have emerged from within the country or region, probably from a sylvatic cycle. It is recommended that surveillance of ASF, strict biosecurity, and quarantine measures be imposed in order to prevent further spread and emergence of new ASF outbreaks in Zambia. PMID:27247062

  15. Geographical patterns and predictors of malaria risk in Zambia: Bayesian geostatistical modelling of the 2006 Zambia national malaria indicator survey (ZMIS)

    PubMed Central

    2010-01-01

    Background The Zambia Malaria Indicator Survey (ZMIS) of 2006 was the first nation-wide malaria survey, which combined parasitological data with other malaria indicators such as net use, indoor residual spraying and household related aspects. The survey was carried out by the Zambian Ministry of Health and partners with the objective of estimating the coverage of interventions and malaria related burden in children less than five years. In this study, the ZMIS data were analysed in order (i) to estimate an empirical high-resolution parasitological risk map in the country and (ii) to assess the relation between malaria interventions and parasitaemia risk after adjusting for environmental and socio-economic confounders. Methods The parasitological risk was predicted from Bayesian geostatistical and spatially independent models relating parasitaemia risk and environmental/climatic predictors of malaria. A number of models were fitted to capture the (potential) non-linearity in the malaria-environment relation and to identify the elapsing time between environmental effects and parasitaemia risk. These models included covariates (a) in categorical scales and (b) in penalized and basis splines terms. Different model validation methods were used to identify the best fitting model. Model-based risk predictions at unobserved locations were obtained via Bayesian predictive distributions for the best fitting model. Results Model validation indicated that linear environmental predictors were able to fit the data as well as or even better than more complex non-linear terms and that the data do not support spatial dependence. Overall the averaged population-adjusted parasitaemia risk was 20.0% in children less than five years with the highest risk predicted in the northern (38.3%) province. The odds of parasitaemia in children living in a household with at least one bed net decreases by 40% (CI: 12%, 61%) compared to those without bed nets. Conclusions The map of parasitaemia

  16. 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.

  17. 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

  18. "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

  19. The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion.

    PubMed

    Leone, Tiziana; Coast, Ernestina; Parmar, Divya; Vwalika, Bellington

    2016-09-01

    Zambia has one of the most liberal abortion laws in sub-Saharan Africa. However, rates of unsafe abortion remain high with negative health and economic consequences. Little is known about the economic burden on women of abortion care-seeking in low income countries. The majority of studies focus on direct costs (e.g. hospital fees). This article estimates the individual-level economic burden of safe and unsafe abortion care-seeking in Zambia, incorporating all indirect and direct costs. It uses data collected in 2013 from a tertiary hospital in Lusaka, (n = 112) with women who had an abortion. Three treatment routes are identified: (1) safe abortion at the hospital, (2) unsafe clandestine medical abortion initiated elsewhere with post-abortion care at the hospital and (3) unsafe abortion initiated elsewhere with post-abortion care at the hospital. Based on these three typologies, we use descriptive analysis and linear regression to estimate the costs for women of seeking safe and unsafe abortion and to establish whether the burden of abortion care-seeking costs is equally distributed across the sample. Around 39% of women had an unsafe abortion, incurring substantial economic costs before seeking post-abortion care. Adolescents and poorer women are more likely to use unsafe abortion. Unsafe abortion requiring post-abortion care costs women 27% more than a safe abortion. When accounting for uncertainty this figure increases dramatically. For safe and unsafe abortions, unofficial provider payments represent a major cost to women.This study demonstrates that despite a liberal legislation, Zambia still needs better dissemination of the law to women and providers and resources to ensure abortion service access. The policy implications of this study include: the role of pharmacists and mid-level providers in the provision of medical abortion services; increased access to contraception, especially for adolescents; and elimination of demands for unofficial provider

  20. "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

  1. 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

  2. Biochar effect on maize yield and soil characteristics in five conservation farming sites in Zambia

    USGS Publications Warehouse

    Cornelissen, Gerard; Martinsen, Vegard; Shitumbanuma, Victor; Alling, Vanja; Breedveld, Gijs D.; Rutherford, David W.; Sparrevik, Magnus; Hale, Sarah E.; Obia, Alfred; Mulder, Jan

    2013-01-01

    Biochar addition to agricultural soils can improve soil fertility, with the added bonus of climate change mitigation through carbon sequestration. Conservation farming (CF) is precision farming, often combining minimum tillage, crop rotation and residue retention. In the present farmer-led field trials carried out in Zambia, the use of a low dosage biochar combined with CF minimum tillage was tested as a way to increase crop yields. Using CF minimum tillage allows the biochar to be applied to the area where most of the plant roots are present and mirrors the fertilizer application in CF practices. The CF practice used comprised manually hoe-dug planting 10-L sized basins, where 10%–12% of the land was tilled. Pilot trials were performed with maize cob biochar and wood biochar on five soils with variable physical/chemical characteristics. At a dosage as low as 4 tons/ha, both biochars had a strong positive effect on maize yields in the coarse white aeolian sand of Kaoma, West-Zambia, with yields of 444% ± 114% (p = 0.06) and 352% ± 139% (p = 0.1) of the fertilized reference plots for maize and wood biochar, respectively. Thus for sandy acidic soils, CF and biochar amendment can be a promising combination for increasing harvest yield. Moderate but non-significant effects on yields were observed for maize and wood biochar in a red sandy clay loam ultisol east of Lusaka, central Zambia (University of Zambia, UNZA, site) with growth of 142% ± 42% (p > 0.2) and 131% ± 62% (p > 0.2) of fertilized reference plots, respectively. For three other soils (acidic and neutral clay loams and silty clay with variable cation exchange capacity, CEC), no significant effects on maize yields were observed (p > 0.2). In laboratory trials, 5% of the two biochars were added to the soil samples in order to study the effect of the biochar on physical and chemical soil characteristics. The large increase in crop yield in Kaoma soil was tentatively explained by a combination of an

  3. Is the Bangweulu Basin in Zambia the Eroded Remnant of a Large, Multiring Impact Crater?

    NASA Astrophysics Data System (ADS)

    Master, S.

    1993-07-01

    The Bangweulu Basin (BB) (ca. 29 degrees-31 degrees E, 10 degrees-12 degrees S) is a roughly circular depression, ~150 km in diameter, on the Bangweulu Block of Zambia. The basin, about 1148 m ASL, is occupied by Lakes Bangweulu (~85 km long) and Kampolombo (~20 km long) and the Bangweulu Swamps [1,2]. The basement consists partly of granitoids (~1.8 Ga) together with ~1.1-Ga Katangan cover rocks. To the north, cover rocks of the Mporokoso Group (~1.8-1.3 Ga) form the arcuate Luongo Fold Belt [3], partly defining the perimeter of the outermost ring (R = 125 km) of the Bangweulu structure. Drainage into the BB is centripetal, with one outlet in the south, draining into a tributary of the Luapula River, which then curves in a broad arc toward the north, along the Zambia-Zaire border, before entering Lake Mweru. Rivers entering the BB include the Luansenshi, which rises in the north and flows in an arc to the southeast and south before joining the Chambeshi River, which flows southwest, west, and northwest before entering Lake Bangweulu. There is an arcuate watershed in the west (at R = 100 km), to the west of which rivers drain to the southwest and west into the Luapula River. Several elongate curved sliver-like islands, including Mbawala (~30 x 4 km) and Chisi, are present in Lake Bangweulu. The curvature of the islands follows the arcuate northwest boundary of the lake in a concentric manner. Unlike all the other major lakes in Zambia and surrounding areas (Mweru, Tanganyika, Rukwa, Malawi, and Kariba), which occupy seismically active rift structures [4,5], the Bangweulu Basin is generally aseismic, and is unrelated to rifting. There is a positive aeromagnetic intensity anomaly over the central Bangweulu depression, and there is also a magnetic anomaly density high over the central part of the BB, surrounded by a concentric low [6]. A roughly circular anomaly, outlined by the -140 mgal contour, of the regional Bouguer gravity field is centerd on Lake Bangweulu

  4. 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…

  5. Perceptions and Attitudes of Student Teachers and Their Cognitive-Metacognitive Awareness in Mathematics in Colleges of Education in Zambia

    ERIC Educational Resources Information Center

    Mulendema, Peter; Ndhlovu, Zanzini; Mulenga, H.

    2016-01-01

    The purpose of the study was to establish perceptions and attitudes of student teachers and their cognitive-metacognitive awareness in mathematics in colleges of education in Zambia. Although there has been abundant research into perceptions, attitudes and cognitive-metacognitive awareness in teacher education, relatively little research has…

  6. 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…

  7. 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…

  8. "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"…

  9. 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.

  10. 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

    ... vertebratus, Diaphania indica, Helicoverpa armigera, and Spodoptera littoralis. (a) Approved greenhouses. The baby squash and baby courgettes must be grown in Zambia in insect-proof, pest-free greenhouses approved jointly by the Zambian national plant protection organization (NPPO) and APHIS. (1) The greenhouses...

  11. A qualitative study of migrant-related stressors, psychosocial outcomes and HIV risk behaviour among truck drivers in Zambia.

    PubMed

    Michalopoulos, Lynn Murphy; Ncube, Nomagugu; Simona, Simona J; Kansankala, Brian; Sinkala, Emmanuel; Raidoo, Jasmin

    2016-09-01

    Truck drivers are part of mobile populations which have been noted as a key population at risk of HIV in Zambia. This study was aimed at: (1) determining potentially traumatic events (PTEs), labour migrant-related stressors, psychosocial problems and HIV risk behaviours among truck drivers in Zambia; and (2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behaviour among truck drivers in Zambia. We conducted 15 semi-structured interviews with purposively sampled male truck drivers at trucking companies in Lusaka, Zambia. Findings indicate that truck drivers experience multiple stressors and potentially traumatic incidences, including delays and long waiting hours at borders, exposure to crime and violence, poverty, stress related to resisting temptation of sexual interactions with sex workers or migrant women, and job-related safety concerns. Multiple psychosocial problems such as intimate partner violence, loneliness, anxiety and depression-like symptoms were noted. Transactional sex, coupled with inconsistent condom use, were identified as HIV sexual risk behaviours. Findings suggest the critical need to develop HIV-prevention interventions which account for mobility, potentially traumatic events, psychosocial problems, and the extreme fear of HIV testing among this key population. PMID:27681145

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. Effects of the Gama Cuulu radio serial drama on HIV-related behavior change in Zambia.

    PubMed

    Kraft, Joan Marie; Hill, Zelee; Membe, Ian; Zhang, Yujia; Meassick, Elizabeth Onjoro; Monsour, Michael; Maumbi, Mwendalubi; Ndubani, Phillimon; Manengu, Joy Masheke; Mwinga, Alwyn

    2012-01-01

    The Gama Cuulu radio serial drama is written and produced in Zambia's Southern Province. It promotes behavior change and service use to prevent HIV transmission. The authors evaluated the effects of Gama Cuulu on intermediate outcomes (e.g., perceived norms), as well as number of sexual partners, condom use, and HIV testing in the past year among adults between 18 and 49 years of age. The authors used a pretest/posttest assessment with a comparison group design, with Southern Province as the intervention area and Western Province as the comparison area. Approximately 1,500 in-person interviews were conducted in both provinces in 2006 (pretest), 2007, and 2008. Regression models included terms for province, time, and the interaction of the two. Outcomes improved in both provinces (e.g., by 2008, 37.6% of participants in Southern Province and 28.3% participants in Western Province tested for HIV in the past year). Pretest-to-posttest changes in condom use (from 20.2% to 29.4% in Southern Province) and 5 intermediate outcomes were significantly different in the 2 provinces. However, changes in condom use were not associated with listening to Gama Cuulu and changes in other outcomes were similar in both provinces. Weak intervention effects might be attributable to implementation challenges or the saturation of HIV programs in Zambia.

  17. 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

  18. 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

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

    PubMed Central

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

    2012-01-01

    Relationship quality and partner dynamics provide important insights into understanding sexual behavior within HIV sero-positive and -discordant couples. Individuals in long-term partnerships may be vulnerable to HIV/STI infection within their relationships due to misperceptions of their partners risk behaviors and potential concurrent (e.g., extramarital, non-primary) sexual partnerships. This study sought to examine relationship quality among HIV sero-positive and – discordant couples in Zambia, and its association with safer sex behavior. This study utilized data drawn from an ongoing translational study, The Partnership II Project – a couples based sexual risk reduction intervention in Lusaka, Zambia. Couples (n = 240) were assessed on demographics, relationship quality, and sexual risk behavior. Overall, couples perceiving their relationships more positively engaged in less risky sexual behavior (i.e., more condom use (b = .011, t = 3.14, p = .002) and fewer partners (χ2 = 11.4, p = .003). Within the dyad, condom use was “actor driven,” indicating that the association between relationship quality and condom use did not depend on the partner’s evaluation of the relationship. Safer sex behavior was positively influenced by communication about condoms. Results support the paradigm shift from prevention strategies with HIV positive and at-risk individuals to concentrated efforts addressing male-female dyads, and suggest that interventions to address the role of couples’ relationship quality, a modifiable target for decreasing sexual risk behavior, are needed. PMID:23336258

  20. 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.

  1. Strengthening faculty recruitment for health professions training in basic sciences in Zambia.

    PubMed

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

    2014-08-01

    Zambia is facing a crisis in its human resources for health, 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 schools--two 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 master's 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

  2. 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 schools—two 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 master’s 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

  3. Strengthening faculty recruitment for health professions training in basic sciences in Zambia.

    PubMed

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

    2014-08-01

    Zambia is facing a crisis in its human resources for health, 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 schools--two 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 master's 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.

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

    PubMed Central

    Moore, Ann M.; Akinyemi, Odunayo; Adewole, Isaac; Dzekedzeke, Kumbutso; Awolude, Olutosin; Arulogun, Oyedunni

    2012-01-01

    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 outcome 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

  6. 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.

  7. 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; Djønne, 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

  8. The effect of food insecurity on mental health: panel evidence from rural Zambia.

    PubMed

    Cole, Steven M; Tembo, Gelson

    2011-10-01

    A growing number of studies show support for a positive association between food insecurity and poor mental health in developing countries. Few of these studies, however, explore the relationship statistically employing longitudinal data. This study combines ethnography with randomly sampled household-level panel data (two waves) collected in 2009 to examine the association between food insecurity and mental health in rural Zambia. Mental health was measured using the Self-Reporting Questionnaire and food insecurity was assessed utilizing a modified 7-item scale based on local coping strategies used during food shortages. A multilevel linear regression model was employed with repeated measures nested within individuals (N = 280 observations) living in 81 households nested within 16 villages. Regression results confirm the postulated positive association between poor mental health and food insecurity. Food insecurity during the dry season, the time of year in rural Zambia when many households are typically food secure, had a subsequent greater effect on mental health than food insecurity during the rainy season. The difference in the effect was statistically significant at the five-percent level. In a country where mental health care resources are severely lacking, policy and applied efforts aimed at improving access to key agricultural resources, thereby increasing agricultural output, could potentially produce beneficial mental health outcomes.

  9. Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15-24 years in Zambia: an in-depth analysis of the 2001-2002 and 2007 Zambia Demographic and Health Surveys.

    PubMed

    Kembo, Joshua

    2013-01-01

    HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001-2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15-24 years in Zambia increased significantly by 15.2% (p=.000) and 5.9% (p=.001) respectively, between 2001-2002 and 2007. A statistically significant increase of 6.6% (p=.029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p=.000) and 1.4% (p=.000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15-24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (-4.5%), premarital sex (-2.6%), sex before age 18 (-2.4%) and proportion reporting multiple partnerships (-1.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the

  10. 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

  11. GC-MS determination of targeted pesticides in environmental samples from the Kafue Flats of Zambia.

    PubMed

    Sichilongo, Kwenga; Banda, Daniel

    2013-11-01

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

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

    PubMed

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

    2010-03-01

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

  13. 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.

  14. Preventing Malaria among Children in Zambia: The Role of Mother's Knowledge.

    PubMed

    Pylypchuk, Yuriy; Norton, Samuel W

    2015-11-01

    Malaria remains a devastating disease in Zambia, responsible for about 13% of deaths among children under age 5. Lack of malaria-specific knowledge has been commonly assumed to be an important barrier to engagement in behaviors that prevent malaria. To the best of our knowledge, this is the first study that accounts for the endogeneity of maternal knowledge in household's ownership of insecticide-treated nets (ITN), child's use of ITN, and household's protection against mosquitos (HSP). We account for the endogeneity of maternal knowledge through discrete factor and standard instrumental variable estimators. We find significant causal effects of maternal knowledge on the child's use of ITN and HSP but no significant effect on ownership of ITN. The causal effects of maternal knowledge on the use of ITN and HSP are strikingly larger in magnitude than the effects in the reduced form models.

  15. 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.

  16. Molecular epidemiology of paramyxoviruses in frugivorous Eidolon helvum bats in Zambia.

    PubMed

    Muleya, Walter; Sasaki, Michihito; Orba, Yasuko; Ishii, Akihiro; Thomas, Yuka; Nakagawa, Emiko; Ogawa, Hirohito; Hang'ombe, Bernard; Namangala, Boniface; Mweene, Aaron; Takada, Ayato; Kimura, Takashi; Sawa, Hirofumi

    2014-04-01

    In this study, we describe the detection of novel paramyxoviruses from the Eidolon helvum species of fruit bats. We extracted RNA from 312 spleen samples from bats captured in Zambia over a period of 4 years (2008-2011). Semi-nested RT-PCR detected a total of 25 (8%) positive samples for paramyxoviruses which were then directly sequenced and analyzed using phylogenetic analysis. Among the positive samples, seven novel paramyxoviruses were detected. Five viruses were closely related to the genus Henipavirus, while two viruses were related to the unclassified Bat paramyxoviruses from Ghana and Congo Brazzaville. Our study identified novel Henipavirus-related and unrelated viruses using RT-PCR in fruit bats from Kansaka National Park and indicated the presence of similar Bat paramyxoviruses originating from wide geographic areas, suggesting the ability of bats to harbor and transmit viruses. The presence of these viruses in fruit bats might pose a public health risk.

  17. 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.

  18. 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.

  19. 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. PMID:25581062

  20. 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

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

    PubMed

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

    2010-03-01

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

  2. 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

  3. 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

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

    PubMed Central

    2010-01-01

    Background Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services. Aims The aim of this paper was to explore health providers' views about mental health integration into primary health care. Methods A mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka) and one rural setting (Mumbwa). Results There is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems. Recommendations It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level. Conclusion Integrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia. PMID:20653981

  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.

  6. Living as an adolescent with HIV in Zambia -- lived experiences, sexual health and reproductive needs.

    PubMed

    Hodgson, Ian; Ross, Julia; Haamujompa, Choolwe; Gitau-Mburu, D

    2012-01-01

    HIV services in developing countries are often ill-equipped to address the specific needs of HIV-positive adolescents. Studies suggest a lack of consistent, age-appropriate support regarding sexuality, relationships and transitioning to adulthood. The aims of this study were to explore and document the informational, psychosocial, sexual and reproductive health (SRH) needs of adolescents (aged 10-19 years) living with HIV in Zambia, and identify gaps between these needs and existing services. This paper reports a qualitative explorative study. Semi-structured interviews and focus group discussions were conducted with 111 HIV-positive adolescents and 59 key informants, including health care workers (n=38) and parents/guardians (n=21). Participants were selected via a purposive sampling method. Three sites - Lusaka, Kitwe and Kalomo - were selected to ensure a broad representation of service-delivery settings in Zambia. Data were entered into NVIVO (QSR International) software, and analysed inductively to extract key themes, gather results and draw conclusions. Findings confirm that social networks have significant impact on treatment adherence and assist adolescents in coming to terms with an HIV diagnosis. The trauma of diagnosis, however, is exacerbated if poorly managed. Nevertheless, many adolescents are determined not to let HIV change their lives. They want to know SRH and HIV information, but service providers do not often adequately meet these informational needs. Where available, tailored and participatory events around HIV and SRH are greatly appreciated. Services that are welcoming, empowering and provide tailored information are highly valued. Adolescents living with HIV require effective, targeted and sustainable HIV services to navigate safely through adolescence.

  7. 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

  8. Natural and human induced factors influencing the abundance of Schistosoma host snails in Zambia.

    PubMed

    Monde, Concillia; Syampungani, Stephen; van den Brink, Paul J

    2016-06-01

    Schistosomiasis remains a global public health problem affecting about 240 million people. In Zambia, 2 million are infected while 3 million live with the risk of getting infected. Research and interventions relating to schistosomiasis are mainly linked to disease epidemiology. Malacological and ecological aspects of the disease are superficially understood. Developing effective control measures requires an understanding of interacting environmental and socioeconomic factors of host snails vis-a-vis schistosomiasis. Therefore, the present work involved collecting social and environmental data in a large field study in two zones in Zambia that are different in terms of temperature and rainfall amounts. Social data collected through questionnaires included demographic, educational and knowledge of schistosomiasis disease dynamics. Environmental data included physicochemical factors, aquatic plants and snails. Gender (P < 0.001) significantly influences livelihood strategies, while age (P = 0.069) and level of education (P = 0.086) have a moderate influence in zone I. In zone III, none of these factors (age, P = 0.378; gender, P = 0.311; education, P = 0.553) play a significant role. Environmental parameters explained 43 and 41 % variation in species composition for zones I and III, respectively. Most respondents' (52 %, 87 %) perception is that there are more cases of bilharzia in hot season than in other seasons (rainy season 23 %, 7 %; cold season 8 %, 0 % and year round 17 %, 6 %) for zone I and zone III, respectively. PMID:27230422

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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.

  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. Detection of Theileria parva antibodies in the African buffalo (Syncerus caffer) in the livestock-wildlife interface areas of Zambia.

    PubMed

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

    2009-12-01

    A serolocigical survey was conducted for the detection of Theileria parva antibodies in 176 African buffaloes (Syncerus caffer) sampled between 1996 and 2005 in livestock-wildlife interface areas of Zambia. Rhipicephalus appendiculatus, Rhipicephalus species, and Amblyomma variegatum were the most abundant tick species identified on buffaloes. T. parva sero-positives were reported in buffaloes sampled from game management areas at Mlanga and Nanzhila bordering the Kafue National Parks and in the Lochnivar National Park while buffaloes sampled from Lower Zambezi National Park were sero-negative. Given that Game Management Areas serve as interface areas that permit the co-existence of livestock and wildlife in similar ecological habitats our findings suggest that buffaloes could play a significant role in the epidemiology of theileriosis in livestock-wildlife interface areas. Thus far, the disease has only been reported in livestock and is herein being reported in the African buffalo for the first time in Zambia.

  16. Metal and metalloid contamination in roadside soil and wild rats around a Pb-Zn mine in Kabwe, Zambia.

    PubMed

    Nakayama, Shouta M M; Ikenaka, Yoshinori; Hamada, Kyohei; Muzandu, Kaampwe; Choongo, Kennedy; Teraoka, Hiroki; Mizuno, Naoharu; Ishizuka, Mayumi

    2011-01-01

    Metal (Cr, Co, Cu, Zn, Cd, Pb, Ni) and metalloid (As) accumulation was studied in roadside soil and wild rat (Rattus sp.) samples from near a Pb-Zn mine (Kabwe, Zambia) and the capital city of Zambia (Lusaka). The concentrations of the seven metals and As in the soil samples and Pb in the rat tissue samples were quantified using atomic absorption spectroscopy. The concentrations of Pb, Zn, Cu, Cd, and As in Kabwe soil were much higher than benchmark values. Geographic Information System analysis indicated the source of metal pollution was mining and smelting activity. Interestingly, the area south of the mine was more highly contaminated even though the prevailing wind flow was westward. Wild rats from Kabwe had much higher tissue concentrations of Pb than those from Lusaka. Their body weight and renal Pb levels were negatively correlated, which suggests that mining activity might affect terrestrial animals in Kabwe. PMID:20971538

  17. Redescription of the genus Cheleocloeon Wuillot & Gillies 1993 (Ephemeroptera: Baetidae) with descriptions of three new species from Zambia and Uganda.

    PubMed

    Kluge, Nikita J

    2016-01-01

    Revised characteristics of Cheleocloeon Wuillot & Gillies 1993 are given. This taxon occupies a separate position within Anteropatellata. The species described as Cheleocloeon mirandei Lugo-Ortiz & McCafferty 1997 and Cheleocloeon sigiense Gillies 2001, as well as the species originally described as Centroptilum falcatum Crass 1947, do not belong to Cheleocloeon. Three new species, Ch. clavifolium sp. n., Ch. lancetofolium sp. n. and C. truncifolium sp. n. from Zambia and Uganda are described based on larvae, subimagoes, imagoes of both sexes and eggs associated by rearing. Additional characteristics of Ch. yolandae Wuillot 1993, Ch. carinatum Wuillot 1993 and Ch. soldani Gattolliat & Sartori 2008 are given based on new material. Some species of Cheleocloeon without formal names are reported from Zambia and Uganda. PMID:27395868

  18. Metal and metalloid contamination in roadside soil and wild rats around a Pb-Zn mine in Kabwe, Zambia.

    PubMed

    Nakayama, Shouta M M; Ikenaka, Yoshinori; Hamada, Kyohei; Muzandu, Kaampwe; Choongo, Kennedy; Teraoka, Hiroki; Mizuno, Naoharu; Ishizuka, Mayumi

    2011-01-01

    Metal (Cr, Co, Cu, Zn, Cd, Pb, Ni) and metalloid (As) accumulation was studied in roadside soil and wild rat (Rattus sp.) samples from near a Pb-Zn mine (Kabwe, Zambia) and the capital city of Zambia (Lusaka). The concentrations of the seven metals and As in the soil samples and Pb in the rat tissue samples were quantified using atomic absorption spectroscopy. The concentrations of Pb, Zn, Cu, Cd, and As in Kabwe soil were much higher than benchmark values. Geographic Information System analysis indicated the source of metal pollution was mining and smelting activity. Interestingly, the area south of the mine was more highly contaminated even though the prevailing wind flow was westward. Wild rats from Kabwe had much higher tissue concentrations of Pb than those from Lusaka. Their body weight and renal Pb levels were negatively correlated, which suggests that mining activity might affect terrestrial animals in Kabwe.

  19. Metal distribution in tissues of free-range chickens near a lead-zinc mine in Kabwe, Zambia.

    PubMed

    Yabe, John; Nakayama, Shouta M M; Ikenaka, Yoshinori; Muzandu, Kaampwe; Choongo, Kennedy; Mainda, Geoffrey; Kabeta, Matthew; Ishizuka, Mayumi; Umemura, Takashi

    2013-01-01

    Concentrations of Pb, Cd, and other metals in tissues of 17 free-range and 32 commercial broiler chickens from the Kabwe mining town in Zambia were determined. Mean concentrations of Pb and Cd exceeded maximum levels for human consumption in some organs including muscle (Pb only) in free-range chickens, in contrast to low levels in broiler chickens. Human consumers in Kabwe could be exposed to Pb and Cd in free-range chickens.

  20. 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

  1. 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

  2. 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.

  3. Detection of Babesia spp. in free-ranging Pukus, Kobus vardonii, on a game ranch in Zambia.

    PubMed

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

    2011-12-01

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

  4. Human resource challenges facing Zambia's mental health care system and possible solutions: results from a combined quantitative and qualitative study.

    PubMed

    Sikwese, Alice; Mwape, Lonia; Mwanza, Jason; Kapungwe, Augustus; Kakuma, Ritsuko; Imasiku, Mwiya; Lund, Crick; Cooper, Sara; The Mhapp Research Programme Consortium

    2010-01-01

    Human resources for mental health care in low- and middle-income countries are inadequate to meet the growing public health burden of neuropsychiatric disorders. Information on actual numbers is scarce, however. The aim of this study was to analyse the key human resource constraints and challenges facing Zambia's mental health care system, and the possible solutions. This study used both qualitative and quantitative methodologies. The WHO-AIMS Version 2.2 was utilized to ascertain actual figures on human resource availability. Semi-structured interviews and focus group discussions were conducted to assess key stakeholders' perceptions regarding the human resource constraints and challenges. The results revealed an extreme scarcity of human resources dedicated to mental health in Zambia. Respondents highlighted many human resource constraints, including shortages, lack of post-graduate and in-service training, and staff mismanagement. A number of reasons for and consequences of these problems were highlighted. Dedicating more resources to mental health, increasing the output of qualified mental health care professionals, stepping up in-service training, and increasing political will from government were amongst the key solutions highlighted by the respondents. There is an urgent need to scale up human and financial resources for mental health in Zambia. PMID:21226643

  5. 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

  6. Zambia Wetland

    Atmospheric Science Data Center

    2013-04-16

    ... these images is the prominent roundish shape of the Lukanga Swamp, another important wetland. The images along the left are natural ... plateau of the Kafue National Park, to the west of Lukanga Swamp, appears brighter in 2004 compared with 2003, which indicates weaker ...

  7. 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

  8. Taenia solium Infections in a Rural Area of Eastern Zambia-A Community Based Study

    PubMed Central

    Mwape, Kabemba E.; Phiri, Isaac K.; Praet, Nicolas; Muma, John B.; Zulu, Gideon; de Deken, Reginald; Speybroeck, Niko; Dorny, Pierre; Gabriël, Sarah

    2012-01-01

    Background Taenia solium taeniosis/cysticercosis is a parasitic infection occurring in many developing countries. Data on the status of human infections in Zambia is largely lacking. We conducted a community-based study in Eastern Zambia to determine the prevalence of human taeniosis and cysticercosis in a rural community. Methods and Findings Stool and serum samples were collected from willing participants. Geographical references of the participants' households were determined and household questionnaires administered. Taeniosis was diagnosed in stool samples by coprology and by the polyclonal antibody-based copro-antigen enzyme-linked immunosorbent assay (copro-Ag ELISA), while cysticercosis was diagnosed in serum by the B158/B60 monoclonal antibody-based antigen ELISA (sero-Ag ELISA). Identification of the collected tapeworm after niclosamide treatment and purgation was done using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). A total of 255 households from 20 villages participated in the study, 718 stool and 708 serum samples were collected and examined. Forty-five faecal samples (6.3%) were found positive for taeniosis on copro-Ag ELISA while circulating cysticercus antigen was detected in 5.8% (41/708) individuals. The tapeworm recovered from one of the cases was confirmed to be T. solium on PCR-RFLP. Seropositivity (cysticercosis) was significantly positively related to age (p = 0.00) and to copro-Ag positivity (taeniosis) (p = 0.03) but not to gender. Change point analysis revealed that the frequency of cysticercus antigens increased significantly in individuals above the age of 30. Copro-Ag positivity was not related to age or gender. The following risk factors were noted to be present in the study community: free-range pig husbandry system and poor sanitation with 47.8% of the households visited lacking latrines. Conclusions This study has recorded high taeniosis and cysticercosis prevalences and identified the

  9. Hepatitis B Infection, Viral Load and Resistance in HIV-Infected Patients in Mozambique and Zambia

    PubMed Central

    Wandeler, Gilles; Musukuma, Kalo; Zürcher, Samuel; Vinikoor, Michael J.; Llenas-García, Jara; Aly, Mussa M.; Mulenga, Lloyd; Chi, Benjamin H.; Ehmer, Jochen; Hobbins, Michael A.; Bolton-Moore, Carolyn; Hoffmann, Christopher J.; Egger, Matthias

    2016-01-01

    Background Few data on the virological determinants of hepatitis B virus (HBV) infection are available from southern Africa. Methods We enrolled consecutive HIV-infected adult patients initiating antiretroviral therapy (ART) at two urban clinics in Zambia and four rural clinics in Northern Mozambique between May 2013 and August 2014. HBsAg screening was performed using the Determine® rapid test. Quantitative real-time PCR and HBV sequencing were performed in HBsAg-positive patients. Risk factors for HBV infection were evaluated using Chi-square and Mann-Whitney tests and associations between baseline characteristics and high level HBV replication explored in multivariable logistic regression. Results Seventy-eight of 1,032 participants in Mozambique (7.6%, 95% confidence interval [CI]: 6.1–9.3) and 90 of 797 in Zambia (11.3%, 95% CI: 9.3–13.4) were HBsAg-positive. HBsAg-positive individuals were less likely to be female compared to HBsAg-negative ones (52.3% vs. 66.1%, p<0.001). Among 156 (92.9%) HBsAg-positive patients with an available measurement, median HBV viral load was 13,645 IU/mL (interquartile range: 192–8,617,488 IU/mL) and 77 (49.4%) had high values (>20,000 UI/mL). HBsAg-positive individuals had higher levels of ALT and AST compared to HBsAg-negative ones (both p<0.001). In multivariable analyses, male sex (adjusted odds ratio: 2.59, 95% CI: 1.22–5.53) and CD4 cell count below 200/μl (2.58, 1.20–5.54) were associated with high HBV DNA. HBV genotypes A1 (58.8%) and E (38.2%) were most prevalent. Four patients had probable resistance to lamivudine and/or entecavir. Conclusion One half of HBsAg-positive patients demonstrated high HBV viremia, supporting the early initiation of tenofovir-containing ART in HIV/HBV-coinfected adults. PMID:27032097

  10. 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:1.20–1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24–1.65). 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: 4.29–7.86) and in both rural and urban settings. Conclusions QA/QI tools can be used to assess performance at

  11. 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

  12. “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

  13. 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

  14. 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.

  15. 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 < 0.05). During treatment, CD4 increases and LEE incidence were similar by HBsAg status. HBsAg positivity decreased (11.8% vs. 6.6%; p = 0.24) following HBV vaccine introduction. These findings support screening pediatric HIV patients in Africa for HBV coinfection. Dedicated cohorts are needed to assess long-term outcomes of coinfection.

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

    NASA Astrophysics Data System (ADS)

    Hyvärinen, O.; Mtilatila, L.; Pilli-Sihvola, K.; Venäläinen, 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.

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

    PubMed

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

    2014-01-01

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

  18. Desire for fertility among HIV-seroconcordant and -discordant couples in Lusaka, Zambia.

    PubMed

    Cook, Ryan; Hayden, Robert; Weiss, Stephen M; Jones, Deborah L

    2014-01-01

    Pregnancy rates and the desire to conceive are increasing among women living with HIV in Africa. However, attempts to conceive may increase the risk of HIV transmission or reinfection. A better understanding of factors influencing fertility desires would significantly contribute to programmes to meet the reproductive needs of women living with HIV. Using a couples-based approach, this paper explored fertility desires among HIV-seroconcordant and -discordant couples in Lusaka, Zambia. Participants were 208 heterosexual couples recruited from community health clinics and their respective catchment areas. Couples completed assessments on demographics, condom use, relationship quality and communication. Desire for children was often shared among couple members, and the strongest predictor of participants' desire for children was having a partner who wanted children. Additionally, the number of children participants had, their own reports of positive communication, and their partner's HIV serostatus influenced reproductive desires. Results support the involvement of both couple members in pre-conception counselling and pregnancy planning interventions. The inclusion of both partners may be a more effective strategy to respond to the reproductive needs of couples affected by HIV, enabling them to safeguard the health of both partners and infants.

  19. Determinants of intravaginal practices among HIV-infected women in Zambia using conjoint analysis.

    PubMed

    Alcaide, Maria L; Cook, Ryan; Chisembele, Maureen; Malupande, Emeria; Jones, Deborah L

    2016-05-01

    Intravaginal practices (IVPs) are associated with an increased risk of bacterial vaginosis and may play a role in HIV transmission. The objective of this study was to identify the importance of factors underlying the decision to engage in IVP using conjoint analysis; a novel statistical technique used to quantify health-related decisions. This study was a cross-sectional study. HIV-infected women in Zambia completed audio computer-administered self-interview questionnaires assessing demographic, risk factors and IVPs. Reasons for engaging in IVPs were explored using conjoint questionnaires. Conjoint analysis was used to identify the relative importance of factors for engaging in IVPs. Results of the conjoint analysis demonstrated that hygiene was the most important reason for engaging in IVPs (mean importance score = 61, SD = 24.3) followed by partner's preference (mean importance score = 20, SD = 14.4) and health (mean importance score = 17, SD = 13.5). When making the decision to engage in IVPs, women rank the importance of hygiene, partner preference and health differently, according to their personal characteristics. The use of conjoint analysis to define the characteristics of women more likely to engage in specific practices should be used to develop tailored rather than standardised IVP interventions, and such interventions should be incorporated into clinical practice and women's health programmes.

  20. Modelling the economic benefits of tuberculosis preventive therapy for people with HIV: the example of Zambia.

    PubMed

    Foster, S; Godfrey-Faussett, P; Porter, J

    1997-06-01

    The authors used available data from selected published literature to assess the economic costs and benefits of providing daily isoniazid preventive therapy for tuberculosis (TB) for 6 months in HIV-infected persons in Zambia. The base case scenario assumes recruitment at a voluntary testing and counseling site where HIV seroprevalence is 30%, HIV-infected individuals have a 25% probability of developing active TB during their lifetime, two additional cases of TB would be prevented per person completing a course of preventive therapy, compliance would be 63%, and an efficacy of isoniazid in preventing active TB of 60%. The costs under that scenario would exceed benefits by a factor of 1.16, or a benefit/cost ratio (BCR) of 0.86. However, if preventing one case of TB prevented an additional five cases, the benefits would exceed the costs by a BCR of 1.71. Other scenarios indicate likely significant net benefits from the targeted preventive therapy of HIV-infected persons whose occupation or living situation brings them into contact with a large number of other people.

  1. The role of electronic media in the health services of Zambia.

    PubMed

    Chirwa, B U

    1989-01-01

    The Zambian government has shifted its emphasis from a hospital-oriented approach to healthcare to a primary health care, community approach. This new approach demands that health education be promoted through mass media and/or interpersonally. The Health Education Unit in Zambia has used television and radio to sensitize individuals and communities to health and health-related problems, as well as to motivate them to initiate activities to solve those problems. 57% of the target population, however, lives in rural areas where they do not have access to television and only poor radio reception, if that. An improved state of television and radio reception in remote areas will go far in disseminating health education to these people in need. For now, the Ministry of Health, together with UNICEF, is undertaking a pilot project on group radio listenership in rural areas to determine the feasibility of small communities coming together and listening to health programs for the purpose of initiating health action in the community. Reception could be improved be either improving transmission facilities at the center or by establishing booster services at each of the six rural provincial headquarters. The latter approach seems the most likely of the two options to provide the desired results.

  2. Risk factors for foot-and-mouth disease in Zambia, 1981-2012.

    PubMed

    Hamoonga, R; Stevenson, M A; Allepuz, A; Carpenter, T E; Sinkala, Y

    2014-04-01

    The aim of this study was to describe the spatial distribution of foot-and-mouth disease (FMD) outbreaks in Zambia for the period January 1981-December 2012 and to quantify the association between geographical features (proximity to roads, national parks, wetland areas) and the spatial distribution of FMD using a Poisson point process model. Details of FMD outbreaks retrieved from the Zambian Department of Veterinary and Livestock Development included the date of onset of clinical signs and the name of the ward in which the index case enterprise was located. A total of 62 FMD outbreaks occurred throughout the study period. Outbreaks occurred in the south of the Southern province along the border with Namibia and Botswana (n=5), in the Western province (n=2), in the Southern and Central provinces on the Kafue flood plains (n=44), and in the north east of the country close to the border with Tanzania (n=11). Increases in distance to the nearest major international border crossing, distance to the nearest major road, distance to the wetland area of the Kafue flood plain, wetness index and elevation were all associated with a decrease in FMD-outbreak ward intensity. Our analyses support the hypothesis that in drier areas of the country cattle are more likely to aggregate around communal drinking pools. Aggregation of cattle provides conditions suitable for FMD spread and detection.

  3. Temporal Trends and Predictors of Modern Contraceptive Use in Lusaka, Zambia, 2004–2011

    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 16–50 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

  4. Pharmacovigilance and new essential drugs in Africa: Zambia draws lessons from its own experiences and beyond.

    PubMed

    Huff-Rousselle, M; Simooya, O; Kabwe, V; Hollander, I; Handema, R; Mwango, A; Mwape, E

    2007-01-01

    Jolted into action by the thalidomide tragedy, developed Western countries began to establish national systems for identifying and responding to adverse drug reactions and events (or pharmacovigilance systems) about 40 years ago. These systems focus on side effects, adverse reactions, and drug interactions. In developing countries, especially in Africa, the scope for pharmacovigilance needs to be broader (despite the additional challenges this brings) because of growing problems with substandard and counterfeit drugs and the need to have an early warning signal system for the development of antimicrobial resistance to the 'new essential drugs' that are barely beyond the clinical trial stage in Africa, e.g. artemisinin-combination therapy (ACT) for malaria and antiretrovirals (ARV) for HIV/AIDS. Zambia learned important lessons from its own initial experiences in attempting to use ACT as a pathfinder for pharmacovigilance, as well as its experience with other drug information systems. In preparing its own renewed plans, it also drew lessons from international experience, including the weaknesses of the Food and Drug Administration's approach to pharmacovigilance in the USA, the UK's 'yellow card scheme', Brazil's fledgling pharmacovigilance systems for AIDS treatment, and the guidance provided by the World Health Organization and the Uppsala Monitoring Centre. These lessons are relevant for other African countries and even for developed countries seeking to improve pharmacovigilance systems. PMID:19280399

  5. 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] 19–26). Syphilis screening was documented in 95 663 (83%) pregnancies: 2449 (2.6%) women tested positive, of whom 1589 (64.9%) were treated appropriately. 111 108 (96%) women agreed to HIV testing, of whom 22% were diagnosed with HIV. Overall, 112 813 (98%) of recorded pregnancies resulted in a live birth, and 2739 (2%) in a stillbirth. The median gestational age was 38 weeks (IQR 35–40) at delivery; the median birth weight of newborns was 3000 g (IQR 2700–3300 g). Conclusion The results demonstrate the feasibility of using a comprehensive electronic medical record in an urban African setting, and highlight its important role in ongoing efforts to improve clinical care. PMID:21315347

  6. 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

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

    PubMed

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

    2013-10-01

    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.

  8. Distinct Clinical and Immunologic Profiles in Severe Malarial Anemia and Cerebral Malaria in Zambia

    PubMed Central

    Thuma, Philip E.; van Dijk, Janneke; Bucala, Rick; Debebe, Zufan; Nekhai, Sergei; Kuddo, Thea; Nouraie, Mehdi; Weiss, Günter

    2011-01-01

    Background. The mechanisms of severe malarial anemia and cerebral malaria, which are extreme manifestations of Plasmodium falciparum malaria, are not fully understood. Methods. Children aged <6 years from southern Zambia presenting to the hospital with severe malarial anemia (n = 72), cerebral malaria (n = 28), or uncomplicated malaria (n = 66) were studied prospectively. Children with overlapping severe anemia and cerebral malaria were excluded. Results. Low interleukin 10 concentrations had the strongest association with severe anemia (standard β = .61; P < .001) followed by high tumor necrosis factor α and sFas concentrations, low weight-for-age z scores, presence of stool parasites, and splenomegaly (standard β = .15–.25; P ≤ .031); most of these factors were also associated with lower reticulocytes. Greater parasitemia was associated with higher interleukin 10 and tumor necrosis factor α concentrations, whereas sulfadoxizole/pyrimethamine therapy and lower weight-for-age z scores were associated with lower interleukin 10 levels. Thrombocytopenia and elevated tissue plasminogen activator inhibitor 1 levels had the strongest associations with cerebral malaria (standard β = .37 or .36; P < .0001), followed by exposure to traditional herbal medicine and hemoglobinuria (standard β = .21–.31; P ≤ .006). Conclusions. Predictors of severe malarial anemia (altered immune responses, poor nutrition, intestinal parasites, and impaired erythropoiesis) differed from those of cerebral malaria (thrombocytopenia, herbal medicine, and intravascular hemolysis). Improved preventive and therapeutic measures may need to consider these differences. PMID:21288821

  9. 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.

  10. 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.

  11. Determination of dichlorvos residue levels in vegetables sold in Lusaka, Zambia

    PubMed Central

    Sinyangwe, Davies Mwazi; Mbewe, Boniface; Sijumbila, Gibson

    2016-01-01

    Introduction Small scale and large scale farmers around Lusaka, the capital city of Zambia grow vegetables using intensive agriculture methods to satisfy the ever increasing demand. To ensure maximum yield they apply various types of pesticides to control pests and diseases that attack these vegetables. Organophosphate pesticides are widely used in agriculture for the control of various insect pests mainly in developing countries. The purpose of the study was to determine the residual levels of the most commonly used organophosphate, 2, 2-Dichlorovinyl dimethyl phosphate, in three commonestvegetables supplied at various markets around Lusaka. Methods Samples of 9 bunches of rape, 14 bunches lettuce and 15 rolls cabbage were randomly picked from several study sites around Lusaka. The vegetables were chopped into small pieces which were chemically treated to get methanol extracts. The extracts were then dissolved in an appropriate solvent and using Shimadzu High Performance Liquid Chromatography-Ultra-violet detector (HPLC-UV) levels of 2, 2-Dichlorovinyl dimethyl phosphate were determined. Results The analysis showed that the average levels of dichlorvos were significantly above the maximum accepted limit as set by Zambian Food and Drugs Act on vegetables. Conclusion Locally grown vegetables from around Lusaka have higher than maximum acceptable limits. This may have implications on human health as the cumulative effect of organophosphates in human body has potential to cause long term health problems. PMID:27279940

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

    PubMed

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

    2007-09-01

    Providing safe water to >1 billion people in need is a major challenge. To address this need, the Safe Water System (SWS) - household water treatment with dilute bleach, safe water storage, and behavior change - has been implemented in >20 countries. To assess the potential sustainability of the SWS, we analyzed costs in Zambia of "Clorin" brand product sold in bottles sufficient for a month of water treatment at a price of $0.09. We analyzed production, marketing, distribution, and overhead costs of Clorin before and after sales reached nationwide scale, and analyzed Clorin sales revenue. The average cost per bottle of Clorin production, marketing and distribution at start-up in 1999 was $1.88 but decreased by 82% to $0.33 in 2003, when >1.7 million bottles were sold. The financial loss per bottle decreased from $1.72 in 1999 to $0.24 in 2003. Net program costs in 2003 were $428,984, or only $0.04 per person-month of protection. A sensitivity analysis showed that if the bottle price increased to $0.18, the project would be self-sustaining at maximum capacity. This analysis demonstrated that efficiencies in the SWS supply chain can be achieved through social marketing. Even with a subsidy, overall program costs per beneficiary are low.

  13. 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

  14. 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 = 1.00–6.19); tolerance to gender-based violence (OR = 2.10 95% CI = 1.05–4.32) and fear of social rejection (OR = 1.48 95% CI = 1.23–1.80). 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

  15. Determinants of intravaginal practices among HIV-infected women in Zambia using conjoint analysis.

    PubMed

    Alcaide, Maria L; Cook, Ryan; Chisembele, Maureen; Malupande, Emeria; Jones, Deborah L

    2016-05-01

    Intravaginal practices (IVPs) are associated with an increased risk of bacterial vaginosis and may play a role in HIV transmission. The objective of this study was to identify the importance of factors underlying the decision to engage in IVP using conjoint analysis; a novel statistical technique used to quantify health-related decisions. This study was a cross-sectional study. HIV-infected women in Zambia completed audio computer-administered self-interview questionnaires assessing demographic, risk factors and IVPs. Reasons for engaging in IVPs were explored using conjoint questionnaires. Conjoint analysis was used to identify the relative importance of factors for engaging in IVPs. Results of the conjoint analysis demonstrated that hygiene was the most important reason for engaging in IVPs (mean importance score = 61, SD = 24.3) followed by partner's preference (mean importance score = 20, SD = 14.4) and health (mean importance score = 17, SD = 13.5). When making the decision to engage in IVPs, women rank the importance of hygiene, partner preference and health differently, according to their personal characteristics. The use of conjoint analysis to define the characteristics of women more likely to engage in specific practices should be used to develop tailored rather than standardised IVP interventions, and such interventions should be incorporated into clinical practice and women's health programmes. PMID:25957322

  16. 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.

  17. 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

  18. Barriers and facilitators to patients' adherence to antiretroviral treatment in Zambia: a qualitative study.

    PubMed

    Sanjobo, Nawa; Frich, Jan C; Fretheim, Atle

    2008-09-01

    Patients' adherence to antiretroviral therapy (ART) is important for effective medical treatment of HIV/AIDS. We conducted a qualitative interview study in the Copperbelt Province of Zambia in 2006. The aim of the study was to explore patients' and health care professionals' perceived barriers and facilitators to patients' adherence to ART. Based on data from individual interviews and focus group interviews with a total of 60 patients and 12 health care professionals, we identified barriers and facilitators related to patients' beliefs and behaviours, the health service, and socio-economic and cultural factors. Among the barriers we identified were lack of communication and information about ART, inadequate time during consultations, lack of follow-up and counselling, forgetfulness, stigma, discrimination and disclosure of HIV status, lack of confidentiality in the treatment centres, and lack of nutritional support. Feeling better, prospects of living longer, family support, information about ART, support for income-generating activities, disclosure of HIV status, prayers and transport support were among the facilitators. Our study suggests that several issues need to be considered when providing ART. Further research is needed to study interactions between patients and their health care providers. Our findings can inform interventions to improve adherence to ART.

  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.

  20. 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

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

    PubMed

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

    2010-07-01

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

  2. 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.

  3. Intersectoral debate on social research strengthens alliances, advocacy and action for maternal survival in Zambia.

    PubMed

    Manandhar, Mary; Maimbolwa, Margaret; Muulu, Elson; Mulenga, Mary Mwange; O'Donovan, Diarmuid

    2009-03-01

    The Health Promotion Research Centre of the National University of Ireland, Galway and the University of Zambia's School of Medicine conducted operational research to understand and address the socio-cultural and gender contexts of maternal survival. Together with an analytical policy and programming review and qualitative research, the project process also involved the convening of 'Interest Group' meetings involving intersectoral stakeholders at Central (Lusaka) and Provincial (Kasama) levels. These meetings aimed to catalyse debate and stimulate advocacy on the project theme by using discussion of qualitative research as entry point. Participants came from government departments, civil society groups, the indigenous health system, academia, technical provider associations, and media, advocacy and human rights organisations. We found that engagement in Interest Groups was successful at Provincial level with lively participation from civil society, media and advocacy stakeholders and strong engagement by the health system. The process was welcomed as an opportunity to fill gaps in understanding about underlying social determinants of health and jointly explore intervention approaches. Overburdened government staff at central level faced with disease-focused interventions rather than underlying contextual determinants, and a weak culture of health sector engagement with civil society, academics and activists, contributed to less successful functioning in Lusaka. Final Dissemination and Discussion Events incorporated material from Interest Group Meetings to stimulate wider discussion and make recommendations. This project highlights the potential value of intersectoral stakeholder discussions from the inception stage of research to stimulate intersectoral exchange and alliance building, inform advocacy, and catalyse the process of research into action.

  4. 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

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

    PubMed

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

    2007-09-01

    Providing safe water to >1 billion people in need is a major challenge. To address this need, the Safe Water System (SWS) - household water treatment with dilute bleach, safe water storage, and behavior change - has been implemented in >20 countries. To assess the potential sustainability of the SWS, we analyzed costs in Zambia of "Clorin" brand product sold in bottles sufficient for a month of water treatment at a price of $0.09. We analyzed production, marketing, distribution, and overhead costs of Clorin before and after sales reached nationwide scale, and analyzed Clorin sales revenue. The average cost per bottle of Clorin production, marketing and distribution at start-up in 1999 was $1.88 but decreased by 82% to $0.33 in 2003, when >1.7 million bottles were sold. The financial loss per bottle decreased from $1.72 in 1999 to $0.24 in 2003. Net program costs in 2003 were $428,984, or only $0.04 per person-month of protection. A sensitivity analysis showed that if the bottle price increased to $0.18, the project would be self-sustaining at maximum capacity. This analysis demonstrated that efficiencies in the SWS supply chain can be achieved through social marketing. Even with a subsidy, overall program costs per beneficiary are low. PMID:17878553

  6. 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

  7. Developing a scale to measure stigmatizing attitudes and beliefs about women who have abortions: results from Ghana and Zambia.

    PubMed

    Shellenberg, Kristen M; Hessini, Leila; Levandowski, Brooke A

    2014-01-01

    The objective of this research was to explore the context of abortion stigma in Ghana and Zambia through qualitative research, and develop a quantitative instrument to measure stigmatizing attitudes and beliefs about abortion. Ultimately, we aimed to develop a scale to measure abortion stigma at the individual and community level that can also be used in the evaluation of stigma reduction interventions. Focus group discussions were conducted in both countries to provide information around attitudes and beliefs about abortion. A 57-item instrument was created from these data, pre-tested, and then administered to 531 individuals (n = 250 in Ghana and n = 281 in Zambia). Exploratory factor analyses were conducted on 33 of the original 57 items to identify a statistically and conceptually relevant scale. Items with factor loadings > 0.39 were retained. All analyses were completed using Stata IC/11.2. Exploratory factor analysis resulted in a three-factor solution that explained 53% of the variance in an 18-item instrument. The three identified subscales are: (i) negative stereotypes (eight items), (ii) discrimination and exclusion (seven items), and (iii) potential contagion (three items). Coefficient alphas of 0.85, 0.80, and 0.80 for the three subscales, and 0.90 for the full 18-item instrument provide evidence of internal consistency reliability. Our Stigmatizing Attitudes, Beliefs, and Actions scale captures three important dimensions of abortion stigma: negative stereotypes about men and women who are associated with abortion, discrimination/exclusion of women who have abortions, and fear of contagion as a result of coming in contact with a woman who has had an abortion. The development of this scale provides a validated tool for measuring stigmatizing attitudes and beliefs about abortion in Ghana and Zambia. Additionally, the scale has the potential to be applicable in other country settings. It represents an important contribution to the fields of reproductive

  8. 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

  9. Acute hypophosphataemia and hypokalaemia in a patient starting antiretroviral therapy in Zambia-a new context for refeeding syndrome?

    PubMed

    Nyirenda, Christopher; Zulu, Isaac; Kabagambe, Edmond K; Bagchi, Shashwatee; Potter, Dara; Bosire, Claire; Krishnasami, Zipporah; Heimburger, Douglas C

    2009-01-01

    High mortality rates have been reported in the first 90 days of antiretroviral therapy in Zambia and other low-income countries. We report a case of acute hypophosphataemia and hypokalaemia in the first week of antiretroviral therapy in a patient with extreme AIDS wasting. Given its occurrence in an extremely wasted patient, it may be physiologically similar to refeeding syndrome but other causes could be relevant as well. Acute hypophosphataemia may contribute to early antiretroviral therapy associated mortality in low-income countries.

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

    PubMed Central

    2010-01-01

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

  11. 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

  12. 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

  13. 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 3 l of spray wash per animal was used which was considerably lower than the recommended delivery rate of 10 l 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.

  14. 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 3 l of spray wash per animal was used which was considerably lower than the recommended delivery rate of 10 l 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

  15. 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

  16. Taenia spp. infections in wildlife in the Bangweulu and Kafue flood plains ecosystems of Zambia.

    PubMed

    Muma, J B; Gabriël, S; Munyeme, M; Munang'andu, H M; Victor, B; Dorny, P; Nalubamba, K S; Siamudaala, V; Mwape, K E

    2014-09-15

    Taenia spp. have an indirect life cycle, cycling between a definitive and an intermediate host with zoonotic species causing public health problems in many developing countries. During the course of 2 separate surveys in Zambia (2004 and 2009), the presence of Taenia larval stages (cysticerci) was examined in Kafue lechwe (Kobus leche kafuensis), Black lechwe (Kobus leche smithermani) and other wildlife species from the Kafue and Bangweulu flood plains. Examinations involved post-mortem inspection and serum specific antigen detection. The recovered cysts from seven carcasses were characterised using PCR and DNA sequence analysis. The overall proportion of infection in wildlife on post-mortem examination was 19.0% (95% CI: 9.1-29.0%). The proportion of infected wildlife based on post-mortem examinations in the Kafue flood plains was estimated at 28.6% (95% CI: 13.3-43.9%), while the seroprevalence was estimated at 25.0% (95% CI: 2.9-47.1%). The seroprevalence for cattle in the Kafue flood plains was estimated at 61.5% (95% CI: 42.0-81.0%) while that of Kafue lechwe in the same ecosystem was estimated at 66.6% (95% CI: 45.6-85.7%). Infection rates were higher in Kafue lechwe than in Black lechwe suggesting differences in the exposure patterns. The sequencing results indicated that none of the recovered cysts were either Taenia solium or Taenia saginata. We therefore conclude they most likely belong to a less studied (wildlife) Taenia species that requires further characterisation. PMID:25090953

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

    PubMed

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

    2013-01-01

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

  18. The Incidence of Human Cysticercosis in a Rural Community of Eastern Zambia

    PubMed Central

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

    2013-01-01

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

  19. 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

    2015-01-01

    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

  20. Prevalence of schistosome antibodies with hepatosplenic signs and symptoms among patients from Kaoma, Western Province, Zambia

    PubMed Central

    2013-01-01

    Background Schistosomiasis is a major cause of morbidity and mortality, with over 200 million people infected worldwide. Eighty-five percent of cases are in Africa. The hepatosplenic form develops over time by an immune reaction to trapped Schistosoma mansoni eggs in the portal system leading to liver fibrosis, portal hypertension and oesophageal varices. Most patients presenting to the University Teaching Hospital in Lusaka with oesophageal varices, come from Western province, but no formal studies have been carried out in this area assessing the burden of hepatosplenic pathology. We aimed to define the extent of the problem in Kaoma district, western Zambia, and to correlate signs and symptoms with serology. Findings A symptom questionnaire, demographic survey and physical examination was conducted amongst patients presenting to Kaoma district outpatient clinics. To assess the prevalence of Schistosoma mansoni infections, blood was collected and screened for the presence of Schistosoma antibodies using Enzyme linked immunosorbent assay (ELISA). Of the 110 patients screened, 97 (88%) were ELISA positive. Forty-six percent (51/110) reported haematochezia and 7% experienced haematemesis (8/110). On physical examination 27% (30/110) hepatomegaly and 17% (30/110) splenomegaly was observed amongst participants but there were few correlations between serology and signs/symptoms. On questioning 68% (75/110) of participants knew nothing about schistosomiasis transmission. Conclusions Our serological and clinical data indicate a very heavy burden of schistosomiasis-related portal hypertension. Our evidence highlights a need for mass treatment in Kaoma to address and prevent extensive pathology of hepatosplenic schistosomiasis. Safe water and health education throughout Western Province are clearly also important. PMID:23987918

  1. Local adaptations to a global health initiative: penalties for home births in Zambia.

    PubMed

    Greeson, Dana; Sacks, Emma; Masvawure, Tsitsi B; Austin-Evelyn, Katherine; Kruk, Margaret E; Macwan'gi, Mubiana; Grépin, Karen A

    2016-11-01

    Global health initiatives (GHIs) are implemented across a variety of geographies and cultures. Those targeting maternal health often prioritise increasing facility delivery rates. Pressure on local implementers to meet GHI goals may lead to unintended programme features that could negatively impact women. This study investigates penalties for home births imposed by traditional leaders on women during the implementation of Saving Mothers, Giving Life (SMGL) in Zambia. Forty focus group discussions (FGDs) were conducted across four rural districts to assess community experiences of SMGL at the conclusion of its first year. Participants included women who recently delivered at home (3 FGDs/district), women who recently delivered in a health facility (3 FGDs/district), community health workers (2 FGDs/district) and local leaders (2 FGDs/district). Findings indicate that community leaders in some districts-independently of formal programme directive-used fines to penalise women who delivered at home rather than in a facility. Participants in nearly all focus groups reported hearing about the imposition of penalties following programme implementation. Some women reported experiencing penalties firsthand, including cash and livestock fines, or fees for child health cards that are typically free. Many women who delivered at home reported their intention to deliver in a facility in the future to avoid penalties. While communities largely supported the use of penalties to promote facility delivery, the penalties effectively introduced a new tax on poor rural women and may have deterred their utilization of postnatal and child health care services. The imposition of penalties is thus a punitive adaptation that can impose new financial burdens on vulnerable women and contribute to widening health, economic and gender inequities in communities. Health initiatives that aim to increase demand for health services should monitor local efforts to achieve programme targets in order

  2. 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

  3. Deterrents to HIV-patient initiation of antiretroviral therapy in urban Lusaka, Zambia: a qualitative study.

    PubMed

    Musheke, Maurice; Bond, Virginia; Merten, Sonja

    2013-04-01

    Some people living with HIV (PLHIV) refuse to initiate antiretroviral therapy (ART) despite availability. Between March 2010 and September 2011, using a social ecological framework, we investigated barriers to ART initiation in Lusaka, Zambia. In-depth interviews were conducted with PLHIV who were offered treatment but declined (n=37), ART staff (n=5), faith healers (n=5), herbal medicine providers (n=5), and home-based care providers (n=5). One focus group discussion with lay HIV counselors and observations in the community and at an ART clinic were conducted. Interviews were audio-recorded, transcribed, and translated, coded using Atlas ti, and analyzed using latent content analysis. Lack of self-efficacy, negative perceptions of medication, desire for normalcy, and fear of treatment-induced physical body changes, all modulated by feeling healthy, undermined treatment initiation. Social relationships generated and perpetuated these health and treatment beliefs. Long waiting times at ART clinics, concerns about long-term availability of treatment, and taking strong medication amidst livelihood insecurity also dissuaded PLHIV from initiating treatment. PLHIV opted for herbal remedies and faith healing as alternatives to ART, with the former being regarded as effective as ART, while the latter contributed to restoring normalcy through the promise of being healed. Barriers to treatment initiation were not mutually exclusive. Some coalesced to undermine treatment initiation. Ensuring patients initiate ART requires interventions at different levels, addressing, in particular, people's health and treatment beliefs, changing perceptions about effectiveness of herbal remedies and faith healing, improving ART delivery to attenuate social and economic costs and allaying concerns about future non-availability of treatment. PMID:23530573

  4. Assessing the microbiological performance and potential cost of boiling drinking water in urban Zambia.

    PubMed

    Psutka, Rebecca; Peletz, Rachel; Michelo, Sandford; Kelly, Paul; Clasen, Thomas

    2011-07-15

    Boiling is the most common method of disinfecting water in the home and the benchmark against which other point-of-use water treatment is measured. In a six-week study in peri-urban Zambia, we assessed the microbiological effectiveness and potential cost of boiling among 49 households without a water connection who reported "always" or "almost always" boiling their water before drinking it. Source and household drinking water samples were compared weekly for thermotolerant coliforms (TTC), an indicator of fecal contamination. Demographics, costs, and other information were collected through surveys and structured observations. Drinking water samples taken at the household (geometric mean 7.2 TTC/100 mL, 95% CI, 5.4-9.7) were actually worse in microbiological quality than source water (geometric mean 4.0 TTC/100 mL, 95% CI, 3.1-5.1) (p < 0.001), although both are relatively low levels of contamination. Only 60% of drinking water samples were reported to have actually been boiled at the time of collection from the home, suggesting over-reporting and inconsistent compliance. However, these samples were of no higher microbiological quality. Evidence suggests that water quality deteriorated after boiling due to lack of residual protection and unsafe storage and handling. The potential cost of fuel or electricity for boiling was estimated at 5% and 7% of income, respectively. In this setting where microbiological water quality was relatively good at the source, safe-storage practices that minimize recontamination may be more effective in managing the risk of disease from drinking water at a fraction of the cost of boiling.

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

    PubMed Central

    2010-01-01

    Background Much of the debate as to whether or not the scaling up of HIV service delivery in Africa benefits non-HIV priority services has focused on the use of nationally aggregated data. This paper analyses and presents routine health facility record data to show trend correlations across priority services. Methods Review of district office and health facility client records for 39 health facilities in three districts of Zambia, covering four consecutive years (2004-07). Intra-facility analyses were conducted, service and coverage trends assessed and rank correlations between services measured to compare service trends within facilities. Results VCT, ART and PMTCT client numbers and coverage levels increased rapidly. There were some strong positive correlations in trends within facilities between reproductive health services (family planning and antenatal care) and ART and PMTCT, with Spearman rank correlations ranging from 0.33 to 0.83. Childhood immunisation coverage also increased. Stock-outs of important drugs for non-HIV priority services were significantly more frequent than were stock-outs of antiretroviral drugs. Conclusions The analysis shows scale-up in reproductive health service numbers in the same facilities where HIV services were scaling up. While district childhood immunisations increased overall, this did not necessarily occur in facility catchment areas where HIV service scale-up occurred. The paper demonstrates an approach for comparing correlation trends across different services, using routine health facility information. Larger samples and explanatory studies are needed to understand the client, facility and health systems factors that contribute to positive and negative synergies between priority services. PMID:20825666

  6. 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

  7. 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

  8. Assessment of Disaster Risk Reduction and Climate Change Adaptation policy integration in Zambia

    NASA Astrophysics Data System (ADS)

    Pilli-Sihvola, K.; Väätäinen-Chimpuku, S.

    2015-12-01

    Integration of Disaster Risk Management (DRM) and Climate Change Adaptation (CCA) policies, their implementation measures and the contribution of these to development has been gaining attention recently. Due to the shared objectives of CCA and particularly Disaster Risk Reduction (DRR), a component of DRM, their integration provides many benefits. At the implementation level, DRR and CCA are usually integrated. Policy integration, however, is often lacking. This study presents a novel analysis of the policy integration of DRR and CCA by 1) suggesting a definition for their integration at a general and further at horizontal and vertical levels, 2) using an analysis framework for policy integration cycle, which separates the policy formulation and implementation processes, and 3) applying these to a case study in Zambia. Moreover, the study identifies the key gaps in the integration process, obtains an understanding of identified key factors for creating an enabling environment for the integration, and provides recommendations for further progress. The study is based on a document analysis of the relevant DRM, climate change (CC), agriculture, forestry, water management and meteorology policy documents and Acts, and 21 semi-structured interviews with key stakeholders. Horizontal integration has occurred both ways, as the revised DRM policy draft has incorporated CCA, and the new CC policy draft has incorporated DRR. This is not necessarily an optimal strategy and unless carefully implemented, it may create pressure on institutional structures and duplication of efforts in the implementation. Much less vertical integration takes place, and where it does, no guidance on how potential goal conflicts with sectorial and development objectives ought to be handled. The objectives of the instruments show convergence. At the programme stage, the measures are fully integrated as they can be classified as robust CCA measures, providing benefits in the current and future

  9. 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

  10. 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

  11. Child Health Week in Zambia: costs, efficiency, coverage and a reassessment of need.

    PubMed

    Fiedler, John L; Mubanga, Freddie; Siamusantu, Ward; Musonda, Mofu; Kabwe, Kabaso F; Zulu, Charles

    2014-01-01

    Child Health Weeks (CHWs) are semi-annual, campaign-style, facility- and outreach-based events that provide a package of high-impact nutrition and health services to under-five children. Since 1999, 30% of the 85 countries that regularly implement campaign-style vitamin A supplementation programmes have transformed their programmes into CHW. Using data drawn from districts' budget, expenditures and salary documents, UNICEF's CHW planning and budgeting tool and a special purposive survey, an economic analysis of the June 2010 CHW's provision of measles, vitamin A and deworming was conducted using activity-based costing combined with an ingredients approach. Total CHW costs were estimated to be US$5.7 million per round. Measles accounted for 57%, deworming 22% and vitamin A 21% of total costs. The cost per child was US$0.46. The additional supplies and personnel required to include measles increased total costs by 42%, but reduced the average costs of providing vitamin A and deworming alone, manifesting economies of scope. The average costs of covering larger, more urban populations was less than the cost of covering smaller, more dispersed populations. Provincial-level costs per child served were determined primarily by the number of service sites, not the number of children treated. Reliance on volunteers to provide 60% of CHW manpower enables expanding coverage, shortening the duration of CHWs and reduces costs by one-third. With costs of $1093 per life saved and $45 per disability-adjusted life-year saved, WHO criteria classify Zambia's CHWs as 'very cost-effective'. The continued need for CHWs is discussed.

  12. Behavior change pathways to voluntary medical male circumcision: narrative interviews with circumcision clients in Zambia.

    PubMed

    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

  13. Child Health Week in Zambia: costs, efficiency, coverage and a reassessment of need.

    PubMed

    Fiedler, John L; Mubanga, Freddie; Siamusantu, Ward; Musonda, Mofu; Kabwe, Kabaso F; Zulu, Charles

    2014-01-01

    Child Health Weeks (CHWs) are semi-annual, campaign-style, facility- and outreach-based events that provide a package of high-impact nutrition and health services to under-five children. Since 1999, 30% of the 85 countries that regularly implement campaign-style vitamin A supplementation programmes have transformed their programmes into CHW. Using data drawn from districts' budget, expenditures and salary documents, UNICEF's CHW planning and budgeting tool and a special purposive survey, an economic analysis of the June 2010 CHW's provision of measles, vitamin A and deworming was conducted using activity-based costing combined with an ingredients approach. Total CHW costs were estimated to be US$5.7 million per round. Measles accounted for 57%, deworming 22% and vitamin A 21% of total costs. The cost per child was US$0.46. The additional supplies and personnel required to include measles increased total costs by 42%, but reduced the average costs of providing vitamin A and deworming alone, manifesting economies of scope. The average costs of covering larger, more urban populations was less than the cost of covering smaller, more dispersed populations. Provincial-level costs per child served were determined primarily by the number of service sites, not the number of children treated. Reliance on volunteers to provide 60% of CHW manpower enables expanding coverage, shortening the duration of CHWs and reduces costs by one-third. With costs of $1093 per life saved and $45 per disability-adjusted life-year saved, WHO criteria classify Zambia's CHWs as 'very cost-effective'. The continued need for CHWs is discussed. PMID:23242696

  14. 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

    2015-01-01

    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.

  15. Taenia spp. infections in wildlife in the Bangweulu and Kafue flood plains ecosystems of Zambia.

    PubMed

    Muma, J B; Gabriël, S; Munyeme, M; Munang'andu, H M; Victor, B; Dorny, P; Nalubamba, K S; Siamudaala, V; Mwape, K E

    2014-09-15

    Taenia spp. have an indirect life cycle, cycling between a definitive and an intermediate host with zoonotic species causing public health problems in many developing countries. During the course of 2 separate surveys in Zambia (2004 and 2009), the presence of Taenia larval stages (cysticerci) was examined in Kafue lechwe (Kobus leche kafuensis), Black lechwe (Kobus leche smithermani) and other wildlife species from the Kafue and Bangweulu flood plains. Examinations involved post-mortem inspection and serum specific antigen detection. The recovered cysts from seven carcasses were characterised using PCR and DNA sequence analysis. The overall proportion of infection in wildlife on post-mortem examination was 19.0% (95% CI: 9.1-29.0%). The proportion of infected wildlife based on post-mortem examinations in the Kafue flood plains was estimated at 28.6% (95% CI: 13.3-43.9%), while the seroprevalence was estimated at 25.0% (95% CI: 2.9-47.1%). The seroprevalence for cattle in the Kafue flood plains was estimated at 61.5% (95% CI: 42.0-81.0%) while that of Kafue lechwe in the same ecosystem was estimated at 66.6% (95% CI: 45.6-85.7%). Infection rates were higher in Kafue lechwe than in Black lechwe suggesting differences in the exposure patterns. The sequencing results indicated that none of the recovered cysts were either Taenia solium or Taenia saginata. We therefore conclude they most likely belong to a less studied (wildlife) Taenia species that requires further characterisation.

  16. 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

  17. Dental fluorosis associated with drinking water from hot springs in Choma district in southern province, Zambia.

    PubMed

    Shitumbanuma, V; Tembo, F; Tembo, J M; Chilala, S; Van Ranst, E

    2007-02-01

    This study was conducted to investigate the high incidence of mottled teeth among residents of an area with hot springs in the Choma District of the Southern Province of Zambia. A survey involving 128 pupils was conducted at a Basic School to collect data on pupil's backgrounds and their main sources of drinking water between birth and age 7. A dental specialist examined the pupils' teeth and samples of drinking water were collected from locations where the majority of the pupils lived. It was analysed for fluorides and other drinking water quality parameters. Results of the survey showed a highly significant (P < 0.001) association between pupils' main sources of drinking water between birth and age 7 and the incidence of discoloured teeth. All (100%) pupils who drank water from hot springs before age 7 had moderate to severe fluorosis, while the majority (96.7%) of the pupils who drank water from other sources had no dental fluorosis. Fluoride concentrations ranged from 5.95 to 10.09 mg/l in water from hot springs, and from 0.03 to 0.6 mg/l in water from other sources. Fluoride levels in water from hot spring water samples exceeded the 1.5 mg/l WHO guideline value for drinking water, while those in water from other sources were significantly (P < 0.05) lower than this. We conclude that the high prevalence of mottled teeth among residents of the study area is a case of endemic dental fluorosis associated with drinking water from hot springs containing high concentrations of fluoride.

  18. An Investigation into Challenges Faced by Secondary School Teachers and Pupils in Algebraic Linear Equations: A Case of Mufulira District, Zambia

    ERIC Educational Resources Information Center

    Samuel, Koji; Mulenga, H. M.; Angel, Mukuka

    2016-01-01

    This paper investigates the challenges faced by secondary school teachers and pupils in the teaching and learning of algebraic linear equations. The study involved 80 grade 11 pupils and 15 teachers of mathematics, drawn from 4 selected secondary schools in Mufulira district, Zambia in Central Africa. A descriptive survey method was employed to…

  19. 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…

  20. 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…

  1. "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…

  2. "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…

  3. 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.

  4. 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% (82–90%) and a specificity of 60% (53–67%). 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% (62–94%) 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

  5. Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space.

    PubMed

    Bossert, Thomas J; Beauvais, Joel C

    2002-03-01

    This study reviews the experience of decentralization in four developing countries: Ghana, Uganda, Zambia and the Philippines. It uses two analytical frameworks to describe and compare the types and degrees of decentralization in each country. The first framework specifies three types of decentralization: deconcentration, delegation and devolution. The second framework uses a principal agent approach and innovative maps of 'decision space' to define the range of choice for different functions that is transferred from the centre to the periphery of the system. The analysis finds a variety of different types and degrees of decentralization, with the Philippines demonstrating the widest range of choice over many functions that were devolved to local government units. The least choice was transferred through delegation to an autonomous health service in Ghana. Uganda and Zambia display variations between these extremes. There was insufficient evidence of the impact of decentralization to assess how these differences in 'decision space' influenced the performance of each health system. The authors suggest that this is a major area for future research.

  6. Detection of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Market-Ready Chickens in Zambia.

    PubMed

    Chishimba, K; Hang'ombe, B M; Muzandu, K; Mshana, S E; Matee, M I; Nakajima, C; Suzuki, Y

    2016-01-01

    The frequent administering of antibiotics in the treatment of poultry diseases may contribute to emergence of antimicrobial-resistant strains. The objective of this study was to detect the presence of extended-spectrum β-lactamase- (ESBL-) producing Escherichia coli in poultry in Zambia. A total of 384 poultry samples were collected and analyzed for ESBL-producing Escherichia coli. The cultured E. coli isolates were subjected to antimicrobial susceptibility tests and the polymerase chain reaction for detection of bla CTX-M, bla SHV, and bla TEM genes. Overall 20.1%, 77/384, (95% CI; 43.2-65.5%) of total samples analyzed contained ESBL-producing Escherichia coli. The antimicrobial sensitivity test revealed that 85.7% (66/77; CI: 75.7-92) of ESBL-producing E. coli isolates conferred resistance to beta-lactam and other antimicrobial agents. These results indicate that poultry is a potential reservoir for ESBL-producing Escherichia coli. The presence of ESBL-producing Escherichia coli in poultry destined for human consumption requires strengthening of the antibiotic administering policy. This is important as antibiotic administration in food animals is gaining momentum for improved animal productivity in developing countries such as Zambia. PMID:27190518

  7. Health communication in multilingual contexts: a study of reading preferences, practices, and proficiencies among literate adults in Zambia.

    PubMed

    Underwood, Carol; Serlemitsos, Elizabeth; Macwangi, Mubiana

    2007-06-01

    Comprehension of health materials and messages is a necessary, though not sufficient, condition for the development of health literacy; in the case of print materials, reading comprehension is elemental. Assessments of the population's ability to read and comprehend written materials are complex and highly salient in multilingual countries, such as Zambia, particularly when an excolonial language is but one of multiple official languages. Yet no study has contrasted adult Zambians' reading comprehension of health materials in the major Zambian languages with comparable English-language materials. This article reports the results of a survey of 2,009 literate Zambian adults who were tested for reading comprehension of health materials written at fourth- and eighth-grade levels. The analysis found that respondents who had not gone beyond primary school scored significantly higher on Zambian- than on English-language reading comprehension tests. Respondents with at least an eighth-grade education scored equally well or better on English-language compared with Zambian-language tests. Overall, respondents were more likely to pass the grade-four than the grade-eight reading comprehension tests. In the multilingual context of Zambia it is vital to produce health communication print materials written at or near a grade-four readability level in English and, when warranted, in appropriate Zambian languages.

  8. 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

  9. Detection of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Market-Ready Chickens in Zambia

    PubMed Central

    Chishimba, K.; Hang'ombe, B. M.; Muzandu, K.; Mshana, S. E.; Matee, M. I.; Nakajima, C.; Suzuki, Y.

    2016-01-01

    The frequent administering of antibiotics in the treatment of poultry diseases may contribute to emergence of antimicrobial-resistant strains. The objective of this study was to detect the presence of extended-spectrum β-lactamase- (ESBL-) producing Escherichia coli in poultry in Zambia. A total of 384 poultry samples were collected and analyzed for ESBL-producing Escherichia coli. The cultured E. coli isolates were subjected to antimicrobial susceptibility tests and the polymerase chain reaction for detection of blaCTX-M, blaSHV, and blaTEM genes. Overall 20.1%, 77/384, (95% CI; 43.2–65.5%) of total samples analyzed contained ESBL-producing Escherichia coli. The antimicrobial sensitivity test revealed that 85.7% (66/77; CI: 75.7–92) of ESBL-producing E. coli isolates conferred resistance to beta-lactam and other antimicrobial agents. These results indicate that poultry is a potential reservoir for ESBL-producing Escherichia coli. The presence of ESBL-producing Escherichia coli in poultry destined for human consumption requires strengthening of the antibiotic administering policy. This is important as antibiotic administration in food animals is gaining momentum for improved animal productivity in developing countries such as Zambia. PMID:27190518

  10. 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

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

    PubMed

    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.

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

    PubMed

    Hunleth, Jean

    2013-01-01

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

  13. 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.

  14. Employing Demand-Based Volumetric Forecasting to Identify Potential for and Roles of Devices in Scale-Up of Medical Male Circumcision in Zambia and Zimbabwe

    PubMed Central

    Fram, Francine; Church, Fred; Sundaram, Maaya; Sgaier, Sema K.; Ridzon, Renee; Eletskaya, Maria; Nanga, Alice; Gumede-Moyo, Sehlulekile; Tambatamba, Bushimbwa; Mugurungi, Owen; Ncube, Getrude; Xabayu, Sinokuthemba; Odawo, Patrick

    2016-01-01

    Introduction: Devices for male circumcision (MC) are becoming available in 14 priority countries where MC is being implemented for HIV prevention. Understanding potential impact on demand for services is one important programmatic consideration because countries determine whether to scale up devices within MC programs. Methods: A population-based survey measuring willingness to undergo MC, assuming availability of surgical MC and 3 devices, was conducted among 1250 uncircumcised men, ages 10–49 years in Zambia and 1000 uncircumcised men, ages 13–49 years in Zimbabwe. Simulated Test Market methodology was used to estimate incremental MC demand and the extent to which devices might be preferred over surgery, assuming availability of: surgical MC in both countries; the devices PrePex, ShangRing, and Unicirc in Zambia; and PrePex in Zimbabwe. Results: Modeled estimates indicate PrePex has the potential to provide an overall increase in MC demand ranging from an estimated 13%–50%, depending on country and WHO prequalification ages, replacing 11%–41% of surgical procedures. In Zambia, ShangRing could provide 8% overall increase, replacing 45% of surgical procedures, and Unicirc could provide 30% overall increase, replacing 85% of surgical procedures. Conclusions: In both countries, devices have potential to increase overall demand for MC, assuming wide scale awareness and availability of circumcision by the devices. With consideration for age and country, PrePex may provide the greatest potential increase in demand, followed by Unicirc (measured in Zambia only) and ShangRing (also Zambia only). These results inform one program dimension for decision making on potential device introduction strategies; however, they must be considered within the broader programmatic context. PMID:27331597

  15. 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

  16. Microbial Contamination and Hygiene of Fresh Cow's Milk Produced by Smallholders in Western Zambia.

    PubMed

    Knight-Jones, Theodore J D; Hang'ombe, M Bernard; Songe, Mwansa M; Sinkala, Yona; Grace, Delia

    2016-01-01

    A field study was performed to assess safety of smallholder fresh cow's milk around Mongu, Western Province, Zambia. This involved observation and sampling of milk along the value chain from milking to point-of-sale and storage. Samples were collected from 86 cows, from 9 farmers, selling through two dairy cooperatives, with additional samples from informal markets. Production was very low; around one litre/day/cow and 10 L/day/herd. The milk was typically transported by bicycle in high ambient temperatures without refrigeration until reaching the point-of-sale (journey times of 30-120 min), where it was sold without pasteurisation despite milk-borne zoonoses being endemic (bovine tuberculosis (bTB) and Brucellosis). Although microbiological contamination was initially low, with geometric mean total bacterial count (TBC) of 425 cfu/mL (cfu = colony forming units) upon arrival at point-of-sale, poor hygiene led to high bacterial loads later on (geometric mean TBC > 600,000 cfu/mL after two days refrigeration), with almost all samples culture positive for Staphylococcus aureus and Escherichia coli. After milking, milk was kept for 100-223 min at temperatures favouring microbial growth (median 34 °C) and sold without a microbial kill step. In this situation limited variation in observed standards of milk hygiene had no significant effect on milk end-product bacterial counts. Options for refrigerated transport are limited. Pasteurisation at the cooperative should be investigated, as this would largely remove pathogenic microbes present in the milk whether resulting from cattle infection or poor hygiene during milking and transportation. As milk is also purchased directly from producers, on-farm milk heating options should also be assessed. Smallholders may benefit from access to national markets by providing milk to large dairies, which have systems for ensuring safety. However, this requires significant investment and an increased and more consistent supply of milk

  17. Risk factors for brucellosis in indigenous cattle reared in livestock-wildlife interface areas of Zambia.

    PubMed

    Muma, J B; Samui, K L; Oloya, J; Munyeme, M; Skjerve, E

    2007-08-16

    We conducted this cross-sectional study to investigate risk factors of Brucella seropositivity in cattle herds reared in livestock-wildlife interface areas of Blue Lagoon and Lochinvar National Parks in Zambia between August 2003 and September 2004. Sera were collected from cattle aged > or =2 years from 124 herds. Data on husbandry practices, grazing strategies, and herd structure (sex and age composition) were also collected. Sera were screened for anti-Brucella antibodies using the Rose Bengal test (RBT) as a presumptive test and a competitive-ELISA (c-ELISA) as a confirmatory test. A herd was classified as Brucella seropositive if at least one animal tested positive on both RBT and c-ELISA in series testing. Risk factors for herd-level brucellosis seropositivity were tested using multivariable logistic regression; risk factors for increases in the within-herd counts of seropositive cattle were analyzed using the negative binomial regression model with the number of seropositive animals as outcome and total number of cattle tested in a herd as the population at risk (exposure). Of the 110 herds tested, 68 (62; 95% CI: 53, 71% after adjusting for clustering by area) tested seropositive for exposure to Brucella spp. The final logistic-regression model identified geographical area, with Lochinvar (OR=3.4; CI: 0.97, 12) and Kazungula (OR=4.3; CI: 0.91, 20) recording higher odds of Brucella infections compared to Blue Lagoon. Herds coming in contact with wildlife had higher odds compared to those without contact (OR=3.4; CI: 1, 11). Similarly, the odds of Brucella infection were progressively higher in the larger herd categories (26-40 cattle, OR=2.6; CI: 0.70, 10; 41-82 cattle, OR=4.9; CI: 0.93, 26; >82 cattle, OR=9.4; CI: 1.7-51) compared to the smallest herd category (10-25). The negative binomial regression model identified geographical area, contact with wildlife, and herd size as having significant effect on counts of seropositive cattle in a herd.

  18. 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. δ34S for copper sulphides range from +2.3 ‰ to +18.5 ‰, with pyrite typically restricted to values between +3.9 ‰ and +6.2

  19. Microbial Contamination and Hygiene of Fresh Cow’s Milk Produced by Smallholders in Western Zambia

    PubMed Central

    Knight-Jones, Theodore J.D.; Hang’ombe, M. Bernard; Songe, Mwansa M.; Sinkala, Yona; Grace, Delia

    2016-01-01

    A field study was performed to assess safety of smallholder fresh cow’s milk around Mongu, Western Province, Zambia. This involved observation and sampling of milk along the value chain from milking to point-of-sale and storage. Samples were collected from 86 cows, from 9 farmers, selling through two dairy cooperatives, with additional samples from informal markets. Production was very low; around one litre/day/cow and 10 L/day/herd. The milk was typically transported by bicycle in high ambient temperatures without refrigeration until reaching the point-of-sale (journey times of 30–120 min), where it was sold without pasteurisation despite milk-borne zoonoses being endemic (bovine tuberculosis (bTB) and Brucellosis). Although microbiological contamination was initially low, with geometric mean total bacterial count (TBC) of 425 cfu/mL (cfu = colony forming units) upon arrival at point-of-sale, poor hygiene led to high bacterial loads later on (geometric mean TBC > 600,000 cfu/mL after two days refrigeration), with almost all samples culture positive for Staphylococcus aureus and Escherichia coli. After milking, milk was kept for 100–223 min at temperatures favouring microbial growth (median 34 °C) and sold without a microbial kill step. In this situation limited variation in observed standards of milk hygiene had no significant effect on milk end-product bacterial counts. Options for refrigerated transport are limited. Pasteurisation at the cooperative should be investigated, as this would largely remove pathogenic microbes present in the milk whether resulting from cattle infection or poor hygiene during milking and transportation. As milk is also purchased directly from producers, on-farm milk heating options should also be assessed. Smallholders may benefit from access to national markets by providing milk to large dairies, which have systems for ensuring safety. However, this requires significant investment and an increased and more consistent supply of

  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

  1. The impact of habitat fragmentation on tsetse abundance on the plateau of eastern Zambia.

    PubMed

    Ducheyne, E; Mweempwa, C; De Pus, C; Vernieuwe, H; De Deken, R; Hendrickx, G; Van den Bossche, P

    2009-09-01

    Tsetse-transmitted human or livestock trypanosomiasis is one of the major constraints to rural development in sub-Saharan Africa. The epidemiology of the disease is determined largely by tsetse fly density. A major factor, contributing to tsetse population density is the availability of suitable habitat. In large parts of Africa, encroachment of people and their livestock resulted in a destruction and fragmentation of such suitable habitat. To determine the effect of habitat change on tsetse density a study was initiated in a tsetse-infested zone of eastern Zambia. The study area represents a gradient of habitat change, starting from a zone with high levels of habitat destruction and ending in an area where livestock and people are almost absent. To determine the distribution and density of the fly, tsetse surveys were conducted throughout the study area in the dry and in the rainy season. Landsat ETM+ imagery covering the study area were classified into four land cover classes (munga, miombo, agriculture and settlements) and two auxiliary spectral classes (clouds and shadow) using a Gaussian Maximum Likelihood Classifier. The classes were regrouped into natural vegetation and agricultural zone. The binary images were overlaid with hexagons to obtain the spatial spectrum of spatial pattern. Hexagonal coverage was selected because of its compact and regular form. To identify scale-specific spatial patterns and associated entomological phenomena, the size of the hexagonal coverage was varied (250 and 500 m). Per coverage, total class area, mean patch size, number of patches and patch size standard deviation were used as fragmentation indices. Based on the fragmentation index values, the study zone was classified using a Partitioning Around Mediods (PAM) method. The number of classes was determined using the Wilks' lambda coefficient. To determine the impact of habitat fragmentation on tsetse abundance, the correlation between the fragmentation indices and the index

  2. Feasibility and Effectiveness of a Peer Referral Incentive Intervention to Promote Male Circumcision Uptake in Zambia

    PubMed Central

    Bolton, Carolyn; Lyabola, Lane-Lee; Phiri, Gabriel; Samona, Alick; Kaonga, Albert; Thirumurthy, Harsha

    2016-01-01

    Background: Medical male circumcision is a promising HIV prevention tool in countries with generalized HIV epidemics, but demand creation interventions are needed to support scale-up. We piloted a peer referral intervention in which circumcision clients were offered incentives for referring their peers for circumcision. Methods: The intervention was implemented between June 2014 and February 2015 in 6 randomly selected health facilities in Southern Province, Zambia. For the first 5 months, circumcision clients ≥18 years of age were given referral vouchers that allowed them to refer up to 5 peers for circumcision within a 3-month period. An incentive of US$2 was offered for each referral. The primary outcome was the number of circumcisions performed per month in each facility. To assess the effect of the intervention, a difference-in-difference analysis was performed using longitudinal data from the intervention facilities and 22 nonintervention facilities. A questionnaire was also implemented to understand men's perceptions of the intervention. Results: During the 8-month intervention period, 1222 men over 18 years of age were circumcised in intervention facilities. In the first 5 months, 699 circumcision clients were enrolled and 385 clients brought a referral voucher given to them by an enrolled client. Difference-in-difference analyses did not show a significant increase in circumcisions performed in intervention facilities. However, circumcision clients reported that the referral incentive motivated them to encourage their friends to seek male circumcision. Peer referrals were also reported to be an important factor in men's decisions because 78% of clients who were referred reported that talking with a circumcised friend was important for their decision to get circumcised. Conclusions: The peer referral incentive intervention for male circumcision was feasible and acceptable. However, the intervention did not have a significant effect on demand for male

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

    PubMed

    Birbeck, G L

    2000-03-01

    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

  4. 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

  5. '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

  6. Women as food producers and suppliers in the twentieth century. The case of Zambia.

    PubMed

    Muntemba, S

    1982-01-01

    marketable crop, to the disadvantage of sufficient food supplies for the producers themselves. The case of Zambia is presented, and it is concluded that the situation of women producers and of food production worsened at a pace responding to the nature of capitalist appropriation of land and labor and the intensification of cash crop production. Thus the phenomenon became more marked after 1945 when colonial states intensified cash crop production. The situation persisted after formal independence. Another Development must tackle the problem areas of land, labor, the sexual division of labor, the state, and men.

  7. Crustal Structure Beneath the Luangwa Rift, Zambia: Constraints from Potential Field Data

    NASA Astrophysics Data System (ADS)

    Atekwana, E. A.; Matende, K.; Abdelsalam, M. G.; Mickus, K. L.; Atekwana, E. A.; Gao, S. S.; Sikazwe, O.; Liu, K. H.; Evans, R. L.

    2015-12-01

    We used gravity and magnetic data to examine the thermal and crustal structure beneath the Luangwa Rift Valley (LRV) in Zambia in order to examine the geodynamic controls of its formation.. The LRV lies at the boundary between the Mesoproterozoic-Neoproterozoic Irumide and Southern Irumide orogenic belts between the Zimbabwe craton and the Bangwelu Block. We computed the Curie Point Depth (CPD) using two-dimensional (2D) power spectrum analysis of the aeromagnetic data, and these results were used to estimate heat flow beneath the LRV. We also inverted the aeromagnetic data for three-dimensional (3D) magnetic susceptibility distribution. We further determined the depths to the Moho using 2D power spectrum analysis of the satellite gravity data and 2D forward modeling of the terrestrial gravity data. We found that: (1) there is no consistent pattern of elevated CPD beneath the LRV, and as such no consistent pattern of elevated heat flow anomaly, (2) there are numerous 5-15 km wide magnetic bodies at shallow depth (5-20 km) beneath the LRV and the 2D forward gravity modeling suggests these to be dense intrusive bodies, (3) a thick crust (49-52 km) underlies the northwestern margin of the rift centered beneath the ~ 1 km high Muchinga escarpment which represents the main border fault of the LRV. This thick crust contrasts with the thinner crust (35-45 km) outside the rift, and (4) the thickened crust coincides with a NE-SE elongated belt of 1.05-1.0 Ga granitoids previously interpreted as manifestations of the metacratonization of the southeastern edge of the Bangweulu Block. Our 2D forward gravity model suggests that the thickened crust is due to the presence of possibly Karoo-aged magmatic under-plated mafic body (UPMB) whose thermal anomaly has since decayed. We suggest that the initiation of the LRV was associated with this deep magmatic activity that introduced rheological weaknesses that facilitated strain localization although it never breached the surface. It

  8. 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 (>7 months). Health workers who had received some form of training in the preceding 12 months were more likely to have a higher score; this was also true for those older than 40 years when compared to those less than 40 years 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

  9. Paediatric malaria case-management with artemether-lumefantrine in Zambia: a repeat cross-sectional study

    PubMed Central

    Zurovac, Dejan; Ndhlovu, Mickey; Sipilanyambe, Nawa; Chanda, Pascalina; Hamer, Davidson H; Simon, Jon L; Snow, Robert W

    2007-01-01

    Background Zambia was the first African country to change national antimalarial treatment policy to artemisinin-based combination therapy – artemether-lumefantrine. An evaluation during the early implementation phase revealed low readiness of health facilities and health workers to deliver artemether-lumefantrine, and worryingly suboptimal treatment practices. Improvements in the case-management of uncomplicated malaria two years after the initial evaluation and three years after the change of policy in Zambia are reported. Methods Data collected during the health facility surveys undertaken in 2004 and 2006 at all outpatient departments of government and mission facilities in four Zambian districts were analysed. The surveys were cross-sectional, using a range of quality of care assessment methods. The main outcome measures were changes in health facility and health worker readiness to deliver artemether-lumefantrine, and changes in case-management practices for children below five years of age presenting with uncomplicated malaria as defined by national guidelines. Results In 2004, 94 health facilities, 103 health workers and 944 consultations for children with uncomplicated malaria were evaluated. In 2006, 104 facilities, 135 health workers and 1125 consultations were evaluated using the same criteria of selection. Health facility and health worker readiness improved from 2004 to 2006: availability of artemether-lumefantrine from 51% (48/94) to 60% (62/104), presence of artemether-lumefantrine dosage wall charts from 20% (19/94) to 75% (78/104), possession of guidelines from 58% (60/103) to 92% (124/135), and provision of in-service training from 25% (26/103) to 41% (55/135). The proportions of children with uncomplicated malaria treated with artemether-lumefantrine also increased from 2004 to 2006: from 1% (6/527) to 27% (149/552) in children weighing 5 to 9 kg, and from 11% (42/394) to 42% (231/547) in children weighing 10 kg or more. In both weight groups

  10. 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.

  11. Rotavirus landscape in Africa-Towards prevention and control: A report of the 8th African rotavirus symposium, Livingstone, Zambia.

    PubMed

    Rudd, Cheryl; Mwenda, Jason; Chilengi, Roma

    2015-06-26

    The 8th African Rotavirus Symposium was held in Livingstone, Zambia from the 12-13 June 2014. Over 130 delegates from 35 countries - 28 from African nations - participated in this symposium, which included scientists, clinicians, immunisation managers, public health officials, policymakers and vaccine manufacturers. The theme for the symposium was Rotavirus Landscape in Africa-Towards Prevention and Control. At the time of the symposium, a total of 21 African countries had introduced the rotavirus vaccine into their national immunisation schedules. This meeting was particularly timely and relevant to review early data on vaccine adoption and impact from these countries. The concluding panel discussion proposed several recommendations for areas of focus moving forward in rotavirus advocacy and research.

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

    PubMed

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

    2005-01-01

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

  13. 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

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

    PubMed

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

    1992-01-01

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

  15. Survival of people on antiretroviral treatment in Zambia: a retrospective cohort analysis of HIV clients on ART

    PubMed Central

    Amanzi, Patrick; Michelo, Charles; Simoonga, Christopher; Dambe, Rosalia; Chongwe, Gershom

    2016-01-01

    Introduction Provision of free anti-retroviral therapy in Zambia started in June 2004. There were only 15,000 people on treatment as at December that year, mainly due to lack of access. This number rose to 580,000 people as at December 2013. The general objective of this study was to determine survival of people on ART and to examine associated predictors for survival. Methods The study included ART patients enrolled between the year 2002 and 2013 (n=10,395) in 285 health facilities in Zambia. Patient files were analyzed retrospectively. The study used Kaplan Meier and Cox-proportional hazard models to describe the relationship between lost to follow up and age, sex, baseline CD4 cell count and weight. Results Results showed that lost to follow up accounted for 90% of the clients that had dropped out, while 10% was to deaths. Low baseline CD4 count (p-value 0.001, HR 0.9994, (95% CI 0.9993, 0.9996) at initiation was associated with lost to follow up together with weight at initiation (p-value 0.031, HR 0.9987 at 95% CI (0.9975, 0.9998)) of ART. Conclusion This study has demonstrated that lost to follow up is a substantial contributing factor to drop outs among HIV patients on treatment. Strengthening of community treatment supporters especially immediate family members in emphasizing to the client the need to continue treatment is necessary. The health facility could do more in emphasizing the importance of treatment especially in the initial stages. Further, in order to reduce opportunistic infections and probable deaths during treatment, cotrimoxazole prophylaxis should be maintained so as to raise the CD4 levels. Improved nutritional assessment and counseling to boost the nutritional status of the clients throughout should be encouraged. PMID:27642482

  16. Postnatal care utilization and local understandings of contagion among HIV-infected and uninfected women in rural, southern Zambia.

    PubMed

    Sacks, Emma; Moss, William J; Winch, Peter J; Thuma, Philip; van Dijk, Janneke H; Mullany, Luke C

    2016-08-01

    Postnatal care is essential for ensuring the optimal health of newborns and necessary for the prevention of maternal-to-child human immunodeficiency virus (HIV) transmission as well as the early diagnosis and treatment of HIV-infected infants. However, coverage of postnatal care is low in many rural areas of sub-Saharan Africa. We examined women's experiences of accessing formal postnatal care for their HIV-exposed newborns, comparing reports of HIV-infected and uninfected women in an HIV-endemic area of rural southern Zambia. We conducted 24 qualitative in-depth interviews with recently delivered women in a rural region of southern Zambia, including 8 with women who were willing to disclose their HIV infection status and answer additional questions. Data were transcribed, coded and analyzed using thematic analysis techniques. HIV-infected women identified more disincentives and reported more negative experiences accessing postnatal care than HIV-uninfected women. A local notion of contagion holds that healthy infants may become sick with chibele, a fatal, febrile illness, if exposed to another infant who is taking "strong medicine", such as antiretroviral drugs. Thus, HIV-uninfected women expressed objections to sharing clinics with women and infants who were presumed to be under treatment. Additionally, women reported receiving better treatment from staff at HIV clinics compared to general pediatric clinics. Due to these tensions, HIV-infected women were less likely to visit a clinic for newborn care if the clinic or waiting area was a common space used by HIV-uninfected women and their children. When integrating programs for HIV with maternal and child health care, these nuanced tensions between groups of patients must be recognized and resolved.

  17. The Impact of SMS-Based Interventions on VMMC Uptake in Lusaka Province, Zambia: A Randomized Controlled Trial

    PubMed Central

    Leiby, Kevin; Tsague, Landry; Sapele, Crispin; Kaonga, Albert; Kakaire, Joshua; Wang, Paul

    2016-01-01

    Introduction: Zambia has high HIV prevalence and low voluntary medical male circumcision (VMMC) rates, heightening the need for effective VMMC demand generation strategies for HIV prevention. Methods: A 3-arm randomized controlled trial measured the impact of 2 short message service (SMS) campaigns on self-reported and verified VMMC uptake over 6 months in Lusaka Province. The study enrolled 2312 uncircumcised males aged 15–30 previously subscribed on Zambia U-Report, an existing SMS platform providing confidential, free counseling services relevant to HIV and other sexually transmitted infections. Participants in the “Conventional” campaign group received a standard package of messages promoting VMMC. Messages sent to the “Tailored” campaign group were targeted at participants' intention level to get circumcised. The control group had routine counselor access through SMS. Data were collected using SMS surveys, and verification of self-reported VMMC uptake used health facility client data. Results: Six-month self-reported VMMC uptake was 11.6%, 12.6%, and 10.4% in the Conventional, Tailored, and control arms, respectively; verified uptake was 1.8%, 1.1%, and 1.5%. Using multivariate logistic regression, the adjusted odds ratio of self-reported VMMC uptake was 1.17 (95% CI: 0.80 to 1.72) in the Conventional campaign arm compared with the control arm and 1.24 (95% CI: 0.84 to 1.81) in the Tailored campaign arm. The adjusted odds ratios of verified VMMC uptake in the Conventional and Tailored campaign arms were 1.34 (95% CI: 0.45 to 4.02) and 0.67 (95% CI: 0.20 to 2.23), respectively. Conclusions: Neither SMS campaign had statistically significant impact on VMMC uptake compared with routine SMS counseling. Future research is necessary to fully understand the potential of SMS-based tools for VMMC demand creation. PMID:27404007

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

    PubMed Central

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

    2013-01-01

    Background There are few published estimates of the cost of pediatric antiretroviral therapy (ART) in Africa. Our objective was to estimate the outpatient cost of providing ART to children remaining in care at six public sector clinics in Zambia during the first three years after ART initiation, stratified by service delivery site and time on treatment. Methods Data on resource utilization (drugs, diagnostics, outpatient visits, fixed costs) and treatment outcomes (in care, died, lost to follow up) were extracted from medical records for 1,334 children at six sites who initiated ART at <15 years of age between 2006 and 2011. Fixed and variable unit costs (reported in 2011 USD) were estimated from the provider’s perspective using site level data. Results Median age at ART initiation was 4.0 years; median CD4 percentage was 14%. One year after ART initiation, 73% of patients remained in care, ranging from 60% to 91% depending on site. The average annual outpatient cost per patient remaining in care was $209 (95% CI, $199–$219), ranging from $116 (95% CI, $107–$126) to $516 (95% CI, $499–$533) depending on site. Average annual costs decreased as time on treatment increased. Antiretroviral drugs were the largest component of all outpatient costs (>50%) at four sites. At the two remaining sites, outpatient visits and fixed costs together accounted for >50% of outpatient costs. The distribution of costs is slightly skewed, with median costs 3% to 13% lower than average costs during the first year after ART initiation depending on site. Conclusions Outpatient costs for children initiating ART in Zambia are low and comparable to reported outpatient costs for adults. Outpatient costs and retention in care vary widely by site, suggesting opportunities for efficiency gains. Taking advantage of such opportunities will help ensure that targets for pediatric treatment coverage can be met. PMID:23840788

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

    PubMed Central

    Sundewall, Jesper; Forsberg, Birger C; Jönsson, Kristina; Chansa, Collins; Tomson, Göran

    2009-01-01

    Background The increasing resources available for and number of partners providing health sector aid have stimulated innovations, notably, the Paris Declaration on Aid Effectiveness, which aim to improve aid coordination. In this, one of the first studies to analyse implementation of aid coordination below national level, the aim was to investigate the effect of the Paris Declaration on coordination of health sector aid at the district level in Zambia. Methods The study was carried out in three districts of Zambia. Data were collected via interviews with health centre staff, district managers and officials from the Ministry of Health, and from district action plans, financial reports and accounts, and health centre ledger cards. Four indicators of coordination related to external-partner activity, common arrangements used by external partners and predictability of funding were analysed and assessed in relation to the 2010 targets set by the Paris Declaration. Findings While the activity of external partners at the district level has increased, funding and activities provided by these partners are often not included in local plans. HIV/AIDS support show better integration in planning and implementation at the district level than other support. Regarding common arrangements used for fund disbursement, the share of resources provided as programme-based support is not increasing. The predictability of funds coming from outside the government financing mechanism is low. Conclusion Greater efforts to integrate partners in district level planning and implementation are needed. External partners must improve the predictability of their support and be more proactive in informing the districts about their intended contributions. With the deadline for achieving the targets set by the Paris Declaration fast approaching, it is time for the signatories to accelerate its implementation. PMID:19505300

  20. Monitoring the endangered population of the antelope Kobus leche smithemani (Artiodactyla: Bovidae), in the Bangweulu Ecosystem, Zambia.

    PubMed

    Siamudaala, Victor M; Munyeme, Musso; Matandiko, Wigganson; Muma, John B; Munang'andu, Hetron M

    2012-12-01

    Black lechwe (Kobus leche smithemani) is a semi-aquatic medium sized antelope currently enlisted on the IUCN red list of endangered species and is only endemic to the Bangweulu basin of Zambia. Its population has significantly decreased due to floods that took place during the period 1930-1940 from over 250 000-15000 leading the Zambian government to gazette all habitats of Black lechwe into state protected areas, and to establish urgent management strategies needed to save the remaining population from extinction. Using retrospective data, our findings show that the population has increased from 15000 animals in 1954 to 55 632 in 2009. The current population is estimated at 34.77% (55 632/160 000) of the carrying capacity of the Bangweulu basin. Although the Black lechwe is one of the 42 species offered for consumptive utilization by the Zambia Wildlife Authority (ZAWA), only 0.12% and 0.08% of the current stock was offered for safari and resident hunting annually for the period 2005-2009, respectively. Annual quota utilization were estimated at 67% (n=37) and 81% (n=37) for safari and resident hunting, respectively. Hence, overall income obtained from utilization of Black lechwe is very low accounting for only 2.1% of the total revenue earned from wildlife utilization. Although the current population trend is showing a unit increase of 639 animals per year, it is still far below levels ideal for the lucrative utilization. In this study, we demonstrate that adverse ecological changes on wildlife species, can lead to their vulnerability and danger of extinction, and that their recovery to full carrying capacity may demand a considerable amount of time. PMID:23342517

  1. 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.

  2. 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

  3. Monitoring the endangered population of the antelope Kobus leche smithemani (Artiodactyla: Bovidae), in the Bangweulu Ecosystem, Zambia.

    PubMed

    Siamudaala, Victor M; Munyeme, Musso; Matandiko, Wigganson; Muma, John B; Munang'andu, Hetron M

    2012-12-01

    Black lechwe (Kobus leche smithemani) is a semi-aquatic medium sized antelope currently enlisted on the IUCN red list of endangered species and is only endemic to the Bangweulu basin of Zambia. Its population has significantly decreased due to floods that took place during the period 1930-1940 from over 250 000-15000 leading the Zambian government to gazette all habitats of Black lechwe into state protected areas, and to establish urgent management strategies needed to save the remaining population from extinction. Using retrospective data, our findings show that the population has increased from 15000 animals in 1954 to 55 632 in 2009. The current population is estimated at 34.77% (55 632/160 000) of the carrying capacity of the Bangweulu basin. Although the Black lechwe is one of the 42 species offered for consumptive utilization by the Zambia Wildlife Authority (ZAWA), only 0.12% and 0.08% of the current stock was offered for safari and resident hunting annually for the period 2005-2009, respectively. Annual quota utilization were estimated at 67% (n=37) and 81% (n=37) for safari and resident hunting, respectively. Hence, overall income obtained from utilization of Black lechwe is very low accounting for only 2.1% of the total revenue earned from wildlife utilization. Although the current population trend is showing a unit increase of 639 animals per year, it is still far below levels ideal for the lucrative utilization. In this study, we demonstrate that adverse ecological changes on wildlife species, can lead to their vulnerability and danger of extinction, and that their recovery to full carrying capacity may demand a considerable amount of time.

  4. 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

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

    NASA Astrophysics Data System (ADS)

    Rečnik, Aleksander; Stanković, Nadežda; 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

  6. 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

    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.

  7. Health inequities, environmental insecurity and the attainment of the millennium development goals in sub-Saharan Africa: the case study of Zambia.

    PubMed

    Anyangwe, Stella C E; Mtonga, Chipayeni; Chirwa, Ben

    2006-09-01

    The United Nations Millennium Development Goals (MDGs) are a series of 8 goals and 18 targets aimed at ending extreme poverty by 2015, and there are 48 quantifiable indicators for monitoring the process. Most of the MDGs are health or health-related goals. Though the MDGs might sound ambitious, it is imperative that the world, and sub-Saharan Africa in particular, wake up to the persistent and unacceptably high rates of extreme poverty that populations live in, and find lasting solutions to age-old problems. Extreme poverty is a cause and consequence of low income, food insecurity and hunger, education and gender inequities, high disease burden, environmental degradation, insecure shelter, and lack of access to safe drinking water and basic sanitation. It is also directly linked to unsound governance and inequitable distribution of public wealth. While many regions in the world will strive to attain the MDGs by 2015, most of the countries in sub-Saharan Africa, with major human development challenges associated with socio-economic disparities, will not. Zambia's MDG progress reports of 2003 and 2005 show that despite laudable political commitment and some advances made towards achieving universal primary education, gender equality, improvement of child health and management of the HIV/AIDS epidemic, it is not likely that Zambia will achieve even half of the goals. Zambia's systems have been weakened by high disease burden and excess mortality, natural and man-made environmental threats and some negative effects of globalization such as huge external debt, low world prices for commodities and the human resource "brain drain", among others. Urgent action must follow political will, and some tried and tested strategies or "quick wins" that have been proven to produce high positive impact in the short term, need to be rapidly embarked upon by Zambia and other countries in sub-Saharan Africa if they are to achieve the Millennium Development Goals.

  8. 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.

  9. 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

  10. 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

  11. Retention in care, resource utilization, and costs for adults receiving antiretroviral therapy in Zambia: a retrospective cohort study

    PubMed Central

    2014-01-01

    Background Of the estimated 800,000 adults living with HIV in Zambia in 2011, roughly half were receiving antiretroviral therapy (ART). As treatment scale up continues, information on the care provided to patients after initiating ART can help guide decision-making. We estimated retention in care, the quantity of resources utilized, and costs for a retrospective cohort of adults initiating ART under routine clinical conditions in Zambia. Methods Data on resource utilization (antiretroviral [ARV] and non-ARV drugs, laboratory tests, outpatient clinic visits, and fixed resources) and retention in care were extracted from medical records for 846 patients who initiated ART at ≥15 years of age at six treatment sites between July 2007 and October 2008. Unit costs were estimated from the provider’s perspective using site- and country-level data and are reported in 2011 USD. Results Patients initiated ART at a median CD4 cell count of 145 cells/μL. Fifty-nine percent of patients initiated on a tenofovir-containing regimen, ranging from 15% to 86% depending on site. One year after ART initiation, 75% of patients were retained in care. The average cost per patient retained in care one year after ART initiation was $243 (95% CI, $194-$293), ranging from $184 (95% CI, $172-$195) to $304 (95% CI, $290-$319) depending on site. Patients retained in care one year after ART initiation received, on average, 11.4 months’ worth of ARV drugs, 1.5 CD4 tests, 1.3 blood chemistry tests, 1.4 full blood count tests, and 6.5 clinic visits with a doctor or clinical officer. At all sites, ARV drugs were the largest cost component, ranging from 38% to 84% of total costs, depending on site. Conclusions Patients initiate ART late in the course of disease progression and a large proportion drop out of care after initiation. The quantity of resources utilized and costs vary widely by site, and patients utilize a different mix of resources under routine clinical conditions than if they were

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

    PubMed

    Singh, Kavita; Luseno, Winnie; Haney, Erica

    2013-01-01

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

  13. Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia

    PubMed Central

    Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

    2016-01-01

    Introduction Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. Methods We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Results Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the

  14. Gains in awareness, ownership and use of insecticide-treated nets in Nigeria, Senegal, Uganda and Zambia

    PubMed Central

    Baume, Carol A; Marin, M Celeste

    2008-01-01

    Background In April 2000, the Roll Back Malaria (RBM) "Abuja Summit" set a target of having at least 60% of pregnant women and children under five use insecticide-treated nets (ITNs). Thereafter, programmes were implemented to create demand, reduce taxes and tariffs, spur the commercial market, and reach vulnerable populations with subsidized ITNs. Using national ITN monitoring data from the USAID-sponsored AED/NetMark project, this article examines the extent to which these activities were successful in increasing awareness, ownership, and use of nets and ITNs. Methods A series of surveys with standardized sampling and measurement methods was used to compare four countries at two points in time. Surveys were conducted in 2000 and again in 2004 (Nigeria, Senegal, Zambia) or 2006 (Uganda). They contained questions permitting classification of each net as untreated, ever-treated or currently-treated (an ITN). Household members as well as nets owned were enumerated so that households, household members, and nets could be used as units of analysis. Several measures of net/ITN ownership, plus RBM ITN use indicators, were calculated. The results show the impact of ITN activities before the launch of massive free net distribution programmes. Results In 2000, treated nets were just being introduced to the public, but four to six years later the awareness of ITNs was nearly universal in all countries but Nigeria, where awareness increased from 7% to 60%. By any measure, there were large increases in ownership of nets, especially treated nets, in all countries. All countries but Nigeria made commensurate gains in the proportion of under-fives sleeping under a net/ITN, and in all countries the proportion of pregnant women sleeping under a net/ITN increased greatly. Conclusion A mix of demand creation, a strengthened commercial sector, reduced taxes and tariffs, and programmes making ITNs available at reduced prices resulted in impressive gains in awareness, ownership, and use

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

    PubMed

    Lobo, Neil F; St Laurent, Brandyce; 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

    2015-12-09

    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.

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

    PubMed

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

    2012-07-15

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

  17. 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

  18. 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

  19. Prevalence and distribution of gastrointestinal helminths and their effects on weight gain in free-range chickens in Central Zambia.

    PubMed

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

    2007-05-01

    Examination of helminths from gastrointestinal tracts of 125 free-range chickens in Zambia revealed a 95.2% prevalence rate. The species and their prevalences were: Allodapa suctoria (85.6%), Tetrameres americana (80.8%), Ascaridia galli (28.8%), Gonglonema ingluvicola (50.4%), Raillietina spp. (81.6%) and Heterakis gallinarum (32.8%). No trematodes or Syngamus trachea were found. Mixed infections accounted for 88.2% as compared to 7.2% of single infections. Effects of helminthoses on weight gain were investigated in 100 growing chickens randomly assigned to treatment (levamisole) and untreated control groups. There was a significant mean (+/- SEM) weight gain (grams) of 812.8 +/- 51.4 in the treatment group and 623 +/- 57.4 in the control group (p < 0.01). The mean (+/- SEM) worm burdens from the control group and the treatment group were 96.3 +/- 5.61 and 22.05 +/- 2.61, respectively. These results confirm the higher risk of helminth infections in free-range systems and may explain the deleterious effects in chickens.

  20. 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.

  1. Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia

    PubMed Central

    Chinsembu, Kazhila C.

    2016-01-01

    Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots) are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond.) Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach.) Milne-Redh., Dichrostachys cinerea (L.) Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd.) Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants. PMID:27069489

  2. 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.

  3. Lead poisoning in children from townships in the vicinity of a lead-zinc mine in Kabwe, Zambia.

    PubMed

    Yabe, John; Nakayama, Shouta M M; Ikenaka, Yoshinori; Yohannes, Yared B; Bortey-Sam, Nesta; Oroszlany, Balazs; Muzandu, Kaampwe; Choongo, Kennedy; Kabalo, Abel Nketani; Ntapisha, John; Mweene, Aaron; Umemura, Takashi; Ishizuka, Mayumi

    2015-01-01

    Childhood lead poisoning is a serious public health concern worldwide. Blood lead levels exceeding 5 μg dL(-1) are considered elevated. In Kabwe, the capital of Zambia's Central Province, extensive Pb contamination of township soils in the vicinity of a Pb-Zn mine and posing serious health risk to children has been reported. We investigated BLLs in children under the age of 7 years in townships around the mine; where blood samples were collected and analyzed using an ICP-MS. All of the sampled children had BLLs exceeding 5 μg dL(-1). Children in these areas could be at serious risk of Pb toxicity as 18% of the sampled children in Chowa, 57% (Kasanda) and 25% (Makululu) had BLLs exceeding 65 μg dL(-1). Eight children had BLLs exceeding 150 μg dL(-1) with the maximum being 427.8 μg dL(-1). We recommend that medical intervention be commenced in the children with BLL exceeding 45 μg dL(-1).

  4. 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.

  5. Engaging therapeutic citizenship and clientship: Untangling the reasons for therapeutic pacifism among people living with HIV in urban Zambia.

    PubMed

    Patterson, Amy S

    2016-10-01

    This article explores the reasons for therapeutic pacifism among people living with HIV (PLHIVs) in urban Zambia. It contributes to a growing ethnography on global health, biosociality, and patient-provider dynamics. Therapeutic citizenship is a biopolitical citizenship that includes claims and ethical projects that emerge from techniques to control and manage bodies. In some contexts, therapeutic citizenship has included activism and claims-making against local, national, and international power brokers. This article investigates therapeutic citizenship in the specific context of impoverished urban Zambian compounds, sites of food insecurity, unemployment, and political exclusion, as well as targets for donor, NGO, and faith-based organisation projects and PLHIV support group proliferation. The article utilises data from participant observations at two Lusaka AIDS clinics, interviews, and focused discussions with support groups of PLHIVs. It argues that PLHIVs continuously negotiate subjectivities related to kinship, clientship, religious belief, and political citizenship in processes that complicate therapeutic citizenship. Rather than fostering participation in PLHIV support groups or challenging 'politics as usual' through activist claims-making to institutions of biopower, these processes lead to therapeutic pacifism.

  6. 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

  7. 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.

  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.

  9. Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia.

    PubMed

    Chinsembu, Kazhila C

    2016-01-01

    Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots) are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond.) Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach.) Milne-Redh., Dichrostachys cinerea (L.) Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd.) Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants.

  10. 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

  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. 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, 185.4±14.5), particularly in time management and writing, than the students in the regular program (mean SSAQ score 175±25.4; 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

  13. 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 15–59 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

  14. 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

  15. Conundrum of Sexual Decision Making in Marital Relationships: Safer-Sex Knowledge, Behavior, and Attitudes of Married Women in Zambia.

    PubMed

    Amoyaw, Jonathan Anim; Kuuire, Vincent Zubedaar; Boateng, Godfred Odei; Asare-Bediako, Yvonne; Ung, Mengieng

    2015-01-01

    Recent research suggests that Zambian women face an increasing risk of contracting human immunodeficiency virus (HIV) within marital relationships. Married women's perceived ability to negotiate safer sex or adopt self-efficacy practices is recognized as critical in preventing new infections within marriage. Yet women's self-efficacy practices, such as requesting condom use or refusing sex within marriage, are influenced by individual and context-specific factors. Using the 2007 Zambia Demographic and Health Survey data from 4,306 married women, this article examines the association between married women's perceived ability to negotiate safer sex and a range of attitudinal, knowledge, and sociodemographic variables. Results from complementary log-log regression models reveal that married women who have factual knowledge about HIV transmission and prevention, as well as those who have been tested for their HIV serostatus, were more likely to report they can request that their husbands use a condom. Rural married women were more likely to report they can refuse their husbands sex compared to woman in urban areas. Likewise, married women who agree that a wife is justified in refusing her husband sex if he sleeps with other women were more likely to report they can negotiate safer sex compared to women who disagree. These findings suggest that married women are able to negotiate safer sex if they have correct factual knowledge about HIV transmission and are aware of their rights within marital relations. PMID:26132804

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

    PubMed

    Sichilongo, Kwenga; Torto, Nelson

    2006-08-01

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

  17. 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

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

    PubMed

    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/m(2), 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/m(2) (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.

  19. 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

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

    PubMed

    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, 185.4±14.5), particularly in time management and writing, than the students in the regular program (mean SSAQ score 175±25.4; 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.

  1. 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.

  2. '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

  3. Ethnobotanical Study of Plants Used in the Management of HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia.

    PubMed

    Chinsembu, Kazhila C

    2016-01-01

    Faced with critical shortages of staff, long queues, and stigma at public health facilities in Livingstone, Zambia, persons who suffer from HIV/AIDS-related diseases use medicinal plants to manage skin infections, diarrhoea, sexually transmitted infections, tuberculosis, cough, malaria, and oral infections. In all, 94 medicinal plant species were used to manage HIV/AIDS-related diseases. Most remedies are prepared from plants of various families such as Combretaceae, Euphorbiaceae, Fabaceae, and Lamiaceae. More than two-thirds of the plants (mostly leaves and roots) are utilized to treat two or more diseases related to HIV infection. Eighteen plants, namely, Achyranthes aspera L., Lannea discolor (Sond.) Engl., Hyphaene petersiana Klotzsch ex Mart., Asparagus racemosus Willd., Capparis tomentosa Lam., Cleome hirta Oliv., Garcinia livingstonei T. Anderson, Euclea divinorum Hiern, Bridelia cathartica G. Bertol., Acacia nilotica Delile, Piliostigma thonningii (Schumach.) Milne-Redh., Dichrostachys cinerea (L.) Wight and Arn., Abrus precatorius L., Hoslundia opposita Vahl., Clerodendrum capitatum (Willd.) Schumach., Ficus sycomorus L., Ximenia americana L., and Ziziphus mucronata Willd., were used to treat four or more disease conditions. About 31% of the plants in this study were administered as monotherapies. Multiuse medicinal plants may contain broad-spectrum antimicrobial agents. However, since widely used plants easily succumb to the threats of overharvesting, they need special protocols and guidelines for their genetic conservation. There is still need to confirm the antimicrobial efficacies, pharmacological parameters, cytotoxicity, and active chemical ingredients of the discovered plants. PMID:27069489

  4. Conundrum of Sexual Decision Making in Marital Relationships: Safer-Sex Knowledge, Behavior, and Attitudes of Married Women in Zambia.

    PubMed

    Amoyaw, Jonathan Anim; Kuuire, Vincent Zubedaar; Boateng, Godfred Odei; Asare-Bediako, Yvonne; Ung, Mengieng

    2015-01-01

    Recent research suggests that Zambian women face an increasing risk of contracting human immunodeficiency virus (HIV) within marital relationships. Married women's perceived ability to negotiate safer sex or adopt self-efficacy practices is recognized as critical in preventing new infections within marriage. Yet women's self-efficacy practices, such as requesting condom use or refusing sex within marriage, are influenced by individual and context-specific factors. Using the 2007 Zambia Demographic and Health Survey data from 4,306 married women, this article examines the association between married women's perceived ability to negotiate safer sex and a range of attitudinal, knowledge, and sociodemographic variables. Results from complementary log-log regression models reveal that married women who have factual knowledge about HIV transmission and prevention, as well as those who have been tested for their HIV serostatus, were more likely to report they can request that their husbands use a condom. Rural married women were more likely to report they can refuse their husbands sex compared to woman in urban areas. Likewise, married women who agree that a wife is justified in refusing her husband sex if he sleeps with other women were more likely to report they can negotiate safer sex compared to women who disagree. These findings suggest that married women are able to negotiate safer sex if they have correct factual knowledge about HIV transmission and are aware of their rights within marital relations.

  5. 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

  6. A quantitative risk assessment of bovine theileriosis entering Luapula Province from Central Province in Zambia via live cattle imports from traditional and commercial production sectors.

    PubMed

    Makungu, C; Mwacalimba, K K

    2014-09-01

    Theileriosis or East Coast Fever (ECF) is an important livestock disease widespread in Zambia except for some provinces such as Luapula. This freedom status has been achieved due to strict livestock movement regulations that only authorise cattle imports from commercial farms implementing strict ECF control regimens. Recent increases in both the demand and price of beef in Zambia are stimulating a policy change towards a more inclusive inter-provincial trade in live cattle. This may also encourage the introduction of breeding cattle from high production pastoral sectors such as Central Province to stimulate the beef industry in disease free low production areas such as the Luapula Province. To estimate and compare the risks linked with those potential introductions of cattle from the traditional or commercial production sectors of the Central Province, a quantitative risk assessment model was developed. This risk comparison was necessary because the traditional livestock production sector accounts for over 79% of breeding cattle trade in Central Province but is characterised by minimalistic tick-borne disease control and a higher prevalence of ECF. We estimate that should the importation of breeding cattle from Central into Luapula Province be permitted, we could expect to import ECF by the introduction of infected animals at a median rate (5th and 95th percentiles) of every 0.44 years (0.12, 2.60), from the traditional sector compared to every 3.57 years (0.37, 103.6) from the commercial sector. Infected ticks would be expected to enter every 3.46 (0.66, 43.8) years via traditional cattle imports. These risks are strongly influenced by the prevalence of infection, performance of pre-transport screening tests, and the effectiveness of pre-transport tick cleansing. This assessment is expected to provide a model for tick borne disease risk assessments in similar settings, as well as inform ECF control, cattle trade, and stock movement policies in Zambia.

  7. A quantitative risk assessment of bovine theileriosis entering Luapula Province from Central Province in Zambia via live cattle imports from traditional and commercial production sectors.

    PubMed

    Makungu, C; Mwacalimba, K K

    2014-09-01

    Theileriosis or East Coast Fever (ECF) is an important livestock disease widespread in Zambia except for some provinces such as Luapula. This freedom status has been achieved due to strict livestock movement regulations that only authorise cattle imports from commercial farms implementing strict ECF control regimens. Recent increases in both the demand and price of beef in Zambia are stimulating a policy change towards a more inclusive inter-provincial trade in live cattle. This may also encourage the introduction of breeding cattle from high production pastoral sectors such as Central Province to stimulate the beef industry in disease free low production areas such as the Luapula Province. To estimate and compare the risks linked with those potential introductions of cattle from the traditional or commercial production sectors of the Central Province, a quantitative risk assessment model was developed. This risk comparison was necessary because the traditional livestock production sector accounts for over 79% of breeding cattle trade in Central Province but is characterised by minimalistic tick-borne disease control and a higher prevalence of ECF. We estimate that should the importation of breeding cattle from Central into Luapula Province be permitted, we could expect to import ECF by the introduction of infected animals at a median rate (5th and 95th percentiles) of every 0.44 years (0.12, 2.60), from the traditional sector compared to every 3.57 years (0.37, 103.6) from the commercial sector. Infected ticks would be expected to enter every 3.46 (0.66, 43.8) years via traditional cattle imports. These risks are strongly influenced by the prevalence of infection, performance of pre-transport screening tests, and the effectiveness of pre-transport tick cleansing. This assessment is expected to provide a model for tick borne disease risk assessments in similar settings, as well as inform ECF control, cattle trade, and stock movement policies in Zambia. PMID

  8. “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

  9. Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia

    PubMed Central

    Chola, Lumbwe; Robberstad, Bjarne

    2009-01-01

    Background Millions of children die every year in developing countries, from preventable diseases such as pneumonia and diarrhoea, owing to low levels of investment in child health. Investment efforts are hampered by a general lack of adequate information that is necessary for priority setting in this sector. This paper measures the health system costs of providing inpatient and outpatient services, and also the costs associated with treating pneumonia and diarrhoea in under-five children at a health centre in Zambia. Methods Annual economic and financial cost data were collected in 2005-2006. Data were summarized in a Microsoft excel spreadsheet to obtain total department costs and average disease treatment costs. Results The total annual cost of operating the health centre was US$1,731,661 of which US$1 284 306 and US$447,355 were patient care and overhead departments costs, respectively. The average cost of providing out-patient services was US$3 per visit, while the cost of in-patient treatment was US$18 per bed day. The cost of providing dental services was highest at US$20 per visit, and the cost of VCT services was lowest, with US$1 per visit. The cost per out-patient visit for under-five pneumonia was US$48, while the cost per bed day was US$215. The cost per outpatient visit attributed to under-five diarrhoea was US$26, and the cost per bed day was US$78. Conclusion In the face of insufficient data, a cost analysis exercise is a difficult but feasible undertaking. The study findings are useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions. PMID:19845966

  10. 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

  11. Impacts of intra-seasonal agricultural decision-making and forecast information on maize production in Zambia

    NASA Astrophysics Data System (ADS)

    Tian, D.; Estes, L. D.; Evans, T. P.; Caylor, K. K.; Sheffield, J.; Wood, E. F.

    2015-12-01

    Maize is the most important food staple in sub-Saharan Africa. Climate change and rainfall variability pose great risks on maize production in this region. Intra-seasonal adaptive management combined with more skillful weather forecasts has the potential to improve the resilience of agricultural systems. Our aim is to understand the extent to which within-season agricultural management decisions can mitigate weather risks to maize production, and the degree to which this mitigation varies as a function of when the decision is made and the trajectory of weather. Using Zambia as a test case, we conducted crop-modeling experiments to determine which crop and water management decisions (typical of smallholder farmers) are most effective in mitigating rainfall-driven yield reductions under three precipitation scenarios (below normal, normal, and above normal). Yields were simulated using the DSSAT CERES-Maize model driven by an ensemble of historical weather data. Potential maize yields under different management options were simulated from different forecast points during the growing season, starting at planting and then in successive two-week intervals through the grain-filling period. The yield distributions were constructed as a function of the weather conditions and the management options, with results indicating which decision options provide the most mitigation in relation to a) the particular point in the growing season at which they are made, and b) the potential rainfall scenario. This study will help to understand how smallholder farmers in semi-arid systems may increase their resilience to highly variable weather by using typical within-season management options, and which decisions are most robust to forecast uncertainty.

  12. Hormonal Contraceptive Use Among HIV-Positive Women and HIV Transmission Risk to Male Partners, Zambia, 1994–2012

    PubMed Central

    Wall, Kristin M.; Kilembe, William; Vwalika, Bellington; Ravindhran, Preeti; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Johnson, Brent A.; Haddad, Lisa B.; Tichacek, Amanda; Allen, Susan

    2016-01-01

    Background. Evidence on the association between female-to-male human immunodeficiency virus (HIV) transmission risk and hormonal contraception is sparse and conflicting. Methods. Heterosexual HIV-discordant couples from Lusaka, Zambia, were followed longitudinally at 3 month-intervals from 1994 to 2012. The impact of hormonal contraception on time to HIV transmission from HIV-positive women to their HIV-negative male partners (M−F+) was evaluated. Results. Among 1601 M−F+ couples, 171 genetically linked HIV transmissions occurred in men over 3216 couple-years (5.3 transmissions/100 couple-years; 95% confidence interval [CI], 4.5–6.2). In multivariable Cox models, neither injectable (adjusted hazard ratio [aHR], 0.6; 95% CI, .4–1.2), oral contraceptive pill (aHR, 0.8; 95% CI, .3–2.1), nor implant (aHR, 0.8; 95% CI, .5–1.4) use was associated with HIV transmission, relative to nonhormonal methods, after controlling for the man's age at baseline and time-varying measures of pregnancy, self-reported unprotected sex with the study partner, sperm present on a vaginal swab wet mount, genital inflammation of either partner, genital ulceration of the man, and first follow-up interval. Sensitivity analyses, including marginal structural modeling and controlling for viral load and fertility intentions available in a subset of couples, led to similar conclusions. Conclusions. Our findings suggest null associations between hormonal contraception and risk of female-to-male HIV transmission. We support efforts to increase the contraceptive method mix for all women, regardless of HIV serostatus, along with reinforced condom counseling for HIV-serodiscordant couples. PMID:27462093

  13. Re-assessment of tick control after immunization against East Coast fever in the Eastern Province of Zambia.

    PubMed

    Berkvens, D L

    1991-01-01

    East Coast Fever, caused by the protozoon Theileria parva and transmitted by the ixodid tick Rhipicephalus appendiculatus is one of the most important cattle diseases in east and central Africa, responsible for considerable direct losses and necessitating expensive control measures. Traditionally, the disease was controlled by means of intensive tick control. The Belgian Animal Disease Control Project was requested to study the disease epizootiology and vector ecology in order to formulate and implement a control program adapted to the requirements and capabilities of the cattle owners in the Eastern Province of Zambia. The weaknesses of a rigorous tick control program were demonstrated. It was decided to initiate an immunization program in the enzootic areas. The overall calf mortality rate was lowered by 90% and it was shown that none of the other tick-borne diseases caused significant problems in the absence of tick control. The tick ecology studies had indicated that the climatic conditions in the area were so unfavourable that the important vector species (Amblyomma variegatum, Boophilus microplus and R. appendiculatus) would not attain problem levels. It was therefore recommended to suspend all tick control in the area. Control of East Coast Fever in the epizootic and disease-free areas is still a more complex issue. It appears unlikely that the latter will remain disease-free, because of the proximity of the enzootic areas and because of considerable cattle movement in the province. Given the advantages of control by immunization, it can be argued that a longterm solution should be based on this approach.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. 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

  15. Structure, age, and regional significance of syntectonic augen gneisses in the Pan-African Zambezi belt, south-central Zambia

    SciTech Connect

    Hanson, R.E.; Wilson, T.J.; Wardlaw, M.S.

    1985-01-01

    The Pan-African Zambezi belt in Zambia contains two major augen gneiss units that are elongated parallel to regional strike. These were previously regarded as slices of sialic basement structurally interleaved with Katangan metasedimentary rocks. New field and geochronologic evidence suggests that the gneisses are syntectonic granites intruded as large concordant sheets during main-phase (D/sub 1/) Pan-African deformation. A pervasive, horizontal or shallowly plunging mineral lineation on S/sub 1/ in the gneisses indicates that the parent granites were injected along major zones of transcurrent shear. The northern gneiss unit shows local discordant contacts against, and contains xenoliths of, adjacent Katangan rocks. Large, partly polygonized K-spar augen in the gneiss are wrapped around by S/sub 1/ and offset by microfractures antithetic to S/sub 1/. Finer grained granites intruding the gneiss are penetratively foliated to nondeformed, indicating that they were injected at various times relative to D/sub 1/. In the more intensely deformed southern gneiss unit, local pods of protomylonitic flaser gneiss grade into mylonites containing asymmetric K-spar augen set in a dynamically recrystallized matrix. U-Pb analyses of four fractions plus an air-abraded split of one fraction form a normal linear discordance pattern with an upper intercept of 820 +/- 7 Ma, taken as the age of igneous crystallization. Comparison with other available geochronologic data indicates that this age dates main-phase deformation in the Zambezi belt, and that deformation in the supposedly continuous Damaran belt to the SW was significantly younger.

  16. Long-term use of the female condom among couples at high risk of human immunodeficiency virus infection in Zambia.

    PubMed

    Musaba, E; Morrison, C S; Sunkutu, M R; Wong, E L

    1998-05-01

    A study conducted in Lusaka, Zambia, sought to determine whether couples at high risk of HIV infection would use the female condom over a 1-year period and if such use would lead to a reduction in unprotected coital acts. A total of 99 couples in which at least one partner had a sexually transmitted disease were enrolled. At baseline, 73% of men were HIV-positive and 8% had gonorrhea, while 47% of the women were HIV-positive and 10% had gonorrhea. The couples were given female condoms, male condoms, and spermicides and counseled to use either condom and spermicide for each coital act. 51, 38, and 30 couples were available for follow up at 3, 6, and 12 months, respectively. A total of 3426 coital acts were recorded during the study period. 45%, 46%, and 57% of coital acts were protected by the male condom at 3, 6, and 12 months, respectively. Female condoms were used in 24%, 27%, and 23% of coital acts and by 86%, 79%, and 67% of the returning couples during each time interval. Less than 15% of sex acts during any time period were unprotected by a barrier method. Male condom use was higher when only the female was HIV-infected, while female condom and spermicide use were higher when the male was infected. Higher levels of use of the female condom at 12 months were correlated with high self-efficacy and low perceived barriers to method use. Although male condoms were used more often than the female condom, these findings suggest that the addition of female condoms to the barrier method mix may reduce unprotected sex among couples at high risk of HIV infection.

  17. 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

  18. Comatose and noncomatose adult diabetic ketoacidosis patients at the University Teaching Hospital, Zambia: Clinical profiles, risk factors, and mortality outcomes

    PubMed Central

    Kakusa, Mwanja; Kamanga, Brown; Ngalamika, Owen; Nyirenda, Soka

    2016-01-01

    Background: Diabetic ketoacidosis (DKA) is one of the commonly encountered diabetes mellitus emergencies. Aim: This study aimed at describing the clinical profiles and hospitalization outcomes of DKA patients at the University Teaching Hospital (UTH) in Lusaka, Zambia and to investigate the role of coma on mortality outcome. Materials and Methods: This was a cross-sectional analytical study of hospitalized DKA patients at UTH. The data collected included clinical presentation, precipitating factors, laboratory profiles, complications, and hospitalization outcomes. Primary outcome measured was all-cause in-hospital mortality. Results: The median age was 40 years. Treatment noncompliance was the single highest identified risk factor for development of DKA, followed by new detection of diabetes, then infections. Comatose patients were significantly younger, had lower baseline blood pressure readings, and higher baseline respiratory rates compared to noncomatose patients. In addition, comatose patients had higher baseline admission random blood glucose readings. Their baseline sodium and chloride levels were also higher. The prevalences of hypokalemia, hypernatremia, and hyperchloremia were also higher among comatose patients compared to noncomatose patients. Development of aspiration during admission with DKA, pneumonia at baseline, development of renal failure, and altered mental status were associated with an increased risk of mortality. Development of renal failure was independently predictive of mortality. Conclusion: The mortality rate from DKA hospitalizations is high at UTH. Treatment noncompliance is the single highest identifiable precipitant of DKA. Aspiration, development of renal failure, altered sensorium, and pneumonia at baseline are associated with an increased risk of mortality. Development of renal failure during admission is predictive of mortality. PMID:27042416

  19. 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

  20. 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.

  1. 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.

  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. Assessment of Heavy-Metal Pollution in Sediments and Tilapia Fish Species in Kafue River of Zambia.

    PubMed

    Mbewe, Gezile; Mutondo, Moola; Maseka, Kenneth; Sichilongo, Kwenga

    2016-10-01

    We report results from an evaluation of the levels of heavy metals, i.e., copper (Cu), cadmium (Cd), lead (Pb), nickel (Ni), manganese (Mn), chromium (Cr), and iron (Fe) in sediment and tilapia fish samples from a wide stretch of the Kafue river of Zambia. In sediment samples, the highest Pb and Fe concentrations were recorded at Hippo Dam, i.e., 36.2 ± 0.1 mg/kg dw and 733 ± 37 mg/kg dw at Kafue Town, respectively. Other notably high metal concentrations in sediment were Cr at Kafue Bridge (42.5 ± 0.1 mg/kg dw [dw]), Cu at Mpongwe (233 ± 5 mg/kg dw), and Mn at Kafue Town (133 ± 1 mg/kg dw); it was highest at Ithezi Tezhi Dam at 166 ± 1 mg/kg d. Three fish species, i.e., three-spot bream Tilapia andersonii, red-breasted bream T. rendalli, and nile tilapia Oreochromis niloticus were evaluated for levels of the seven metals. The concentrations of the metals in these fish species afforded estimation of the biota sediment-accumulation factor, which is the ratio of the concentration of the metal in liver to that in the sediment. The coefficients of condition (K) values, which give an indication of the health of the fish, were also estimated. The K values ranged from 2.5 ± 0.5 to 5.1 ± 0.6 in all of the three fish species. Partial least squares analysis showed that heavy metals are generally sequestered evenly in all of the parts of all of the three fish species except for elevated levels of Mn, Cd, and Pb in the liver samples. PMID:27401599

  4. HIV- and AIDS-associated neurocognitive functioning in Zambia – a perspective based on differences between the genders

    PubMed Central

    Kabuba, Norma; Menon, J Anitha; Franklin, Donald R; Heaton, Robert K; Hestad, Knut A

    2016-01-01

    Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are frequently associated with neurocognitive impairment (NCI). However, few studies have examined the interrelationship between gender and NCI in the HIV and AIDS population. This cross-sectional study examined the neurocognitive (NC) functioning of HIV-infected male and female adults from urban Zambia. The participants included 266 HIV seropositive (HIV+) adults (males [n=107] and females [n=159]). Participants completed NC assessment by means of a comprehensive test battery using normative data from 324 HIV-seronegative (HIV−) controls. The norms corrected for effects of age, education, and gender in the general population, and the test battery measures domains of attention/working memory (learning and delayed recall), executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. An overall comparison of the HIV+ male and female participants yielded no statistically significant differences. Analysis of covariance results controlling for disease characteristics showed that HIV+ female participants had worse delayed recall scores than males, F(1,117) =9.70, P=0.002, partial η2=0.077. The females also evidenced a trend toward greater impairment on learning efficiency (P=0.015). The findings suggest that there are gender-related differences in NCI after controlling for disease characteristics. It was observed that although the HIV+ females enjoyed better health compared to their HIV+ male counterparts, they still had worse performance on the neuropsychological tests. This implies that HIV may have more NC consequences for Zambian females than males. PMID:27570456

  5. Serosurvey of Brucella spp. infection in the Kafue lechwe (Kobus leche kafuensis) of the Kafue flats in Zambia.

    PubMed

    Muma, John Bwalya; Lund, Arve; Siamudaala, Victor M; Munang'andu, Hetron Mweemba; Munyeme, Musso; Matope, Gift; Nielsen, Klaus; DJønne, Berit; Godfroid, Jacques; Tryland, Morten; Skjerve, Eystein

    2010-10-01

    One of the diseases of veterinary and public health importance affecting the Kafue lechwe (Kobus leche kafuensis) on the Kafue flats is brucellosis, for which only scant information is available. During the 2003 (October), 2004 (December), and 2008 (July-December) hunting seasons in the Kafue flats, we conducted a study to determine the seroprevalence of Brucella spp. in the Kafue lechwe and to evaluate serologic tests for detection of Brucella spp. antibodies in lechwe. The Rose Bengal Test (RBT), competitive enzyme-linked immunosorbent assay (cELISA), and fluorescence polarization assay (FPA) were used. A total of 121 Kafue lechwe were hunted for disease investigations in 2003, 2004, and 2008 in the Kafue Flat Game Management Area. Of these, 21.6%, (95% confidence interval [CI]: 14.2-29.1%) had detectable antibodies to Brucella spp. The Kafue lechwe in Lochnivar National Park had higher antibody results than those in Blue Lagoon National Park (odds ratio=3.0; 95% CI: 0.94-9.4). Infection levels were similar in females (21.6%) and males (21.7%). Results were similar among RBT, FPA, cELISA tests, suggesting that these could effectively be used in diagnosing brucellosis in the Kafue lechwe. Our study demonstrates the presence of Brucella infections in the Kafue lechwe in two national parks located in the Kafue flats and further highlights the suitability of serologic assays for testing the Kafue lechwe. Because the Kafue lechwe is the most hunted wildlife species in Zambia, hunters need to be informed of the public health risk of Brucella spp. infection.

  6. HIV- and AIDS-associated neurocognitive functioning in Zambia - a perspective based on differences between the genders.

    PubMed

    Kabuba, Norma; Menon, J Anitha; Franklin, Donald R; Heaton, Robert K; Hestad, Knut A

    2016-01-01

    Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) are frequently associated with neurocognitive impairment (NCI). However, few studies have examined the interrelationship between gender and NCI in the HIV and AIDS population. This cross-sectional study examined the neurocognitive (NC) functioning of HIV-infected male and female adults from urban Zambia. The participants included 266 HIV seropositive (HIV+) adults (males [n=107] and females [n=159]). Participants completed NC assessment by means of a comprehensive test battery using normative data from 324 HIV-seronegative (HIV-) controls. The norms corrected for effects of age, education, and gender in the general population, and the test battery measures domains of attention/working memory (learning and delayed recall), executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. An overall comparison of the HIV+ male and female participants yielded no statistically significant differences. Analysis of covariance results controlling for disease characteristics showed that HIV+ female participants had worse delayed recall scores than males, F(1,117) =9.70, P=0.002, partial η(2)=0.077. The females also evidenced a trend toward greater impairment on learning efficiency (P=0.015). The findings suggest that there are gender-related differences in NCI after controlling for disease characteristics. It was observed that although the HIV+ females enjoyed better health compared to their HIV+ male counterparts, they still had worse performance on the neuropsychological tests. This implies that HIV may have more NC consequences for Zambian females than males. PMID:27570456

  7. 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…

  8. 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.

  9. Single genome amplification of proviral HIV-1 DNA from dried blood spot specimens collected during early infant screening programs in Lusaka, Zambia.

    PubMed

    Seu, Lillian; Mwape, Innocent; Guffey, M Bradford

    2014-07-01

    The ability to evaluate individual HIV-1 virions from the quasispecies of vertically infected infants was evaluated in a field setting at the Centre for Infectious Disease Research in Zambia. Infant heel-prick blood specimens were spotted onto dried blood spot (DBS) filter paper cards at government health clinics. Nucleic acid was extracted and used as a template for HIV-1 proviral DNA detection by a commercial Amplicor HIV-1 PCR test (Roche, version 1.5). On samples that tested positive by commercial diagnostic assay, amplification of DNA was performed using an in-house assay of the 5' and 3' region of the HIV-1 genome. Additionally, fragments covering 1200 nucleotides within pol (full length protease and partial reverse transcriptase) and 1400 nucleotides within env (variable 1-variable 5 region) were further analyzed by single genome amplification (SGA). In summary, we have demonstrated an in-house assay for amplifying the 5' and 3' proviral HIV-1 DNA as well as pol and env proviral DNA fragments from DBS cards collected and analyzed entirely in Zambia. In conclusion, this study shows the feasibility of utilizing DBS cards to amplify the whole proviral HIV-1 genome as well as perform SGA on key HIV-1 genes.

  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.

  11. Single genome amplification of proviral HIV-1 DNA from dried blood spot specimens collected during early infant screening programs in Lusaka, Zambia.

    PubMed

    Seu, Lillian; Mwape, Innocent; Guffey, M Bradford

    2014-07-01

    The ability to evaluate individual HIV-1 virions from the quasispecies of vertically infected infants was evaluated in a field setting at the Centre for Infectious Disease Research in Zambia. Infant heel-prick blood specimens were spotted onto dried blood spot (DBS) filter paper cards at government health clinics. Nucleic acid was extracted and used as a template for HIV-1 proviral DNA detection by a commercial Amplicor HIV-1 PCR test (Roche, version 1.5). On samples that tested positive by commercial diagnostic assay, amplification of DNA was performed using an in-house assay of the 5' and 3' region of the HIV-1 genome. Additionally, fragments covering 1200 nucleotides within pol (full length protease and partial reverse transcriptase) and 1400 nucleotides within env (variable 1-variable 5 region) were further analyzed by single genome amplification (SGA). In summary, we have demonstrated an in-house assay for amplifying the 5' and 3' proviral HIV-1 DNA as well as pol and env proviral DNA fragments from DBS cards collected and analyzed entirely in Zambia. In conclusion, this study shows the feasibility of utilizing DBS cards to amplify the whole proviral HIV-1 genome as well as perform SGA on key HIV-1 genes. PMID:24667303

  12. Single genome amplification of proviral HIV-1 DNA from dried blood spot specimens collected during early infant screening programs in Lusaka, Zambia

    PubMed Central

    Seu, Lillian; Mwape, Innocent; Guffey, M. Bradford

    2014-01-01

    The ability to evaluate individual HIV-1 virions from the quasispecies of vertically infected infants was evaluated in a field setting at the Centre for Infectious Disease Research in Zambia. Infant heel-prick blood specimens were spotted onto dried blood spot (DBS) filter paper cards at government health clinics. Nucleic acid was extracted and used as a template for HIV-1 proviral DNA detection by a commercial Amplicor HIV-1 PCR test (Roche, version 1.5). On samples that tested positive by commercial diagnostic assay, amplification of DNA was performed using an in-house assay of the 5′ and 3′ region of the HIV-1 genome. Additionally, fragments covering 1200 nucleotides within pol (full length protease and partial reverse transcriptase) and 1400 nucleotides within env (variable 1-variable 5 region) were further analyzed by single genome amplification (SGA). In summary, we have demonstrated an in-house assay for amplifying the 5′ and 3′ proviral HIV-1 DNA as well as pol and env proviral DNA fragments from DBS cards collected and analyzed entirely in Zambia. In conclusion, this study shows the feasibility of utilizing DBS cards to amplify the whole proviral HIV-1 genome as well as perform SGA on key HIV-1 genes. PMID:24667303

  13. 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

  14. 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 δ34S 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 δ34S 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

  15. 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 Conglomérat Formation and overlying Kakontwe Limestone Formation of the lower Nguba Group. The Grand Conglomérat 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 Conglomérat Formation suggesting synsedimentary fault movement. Iron-rich rocks consisting of nearly monomineralic bands of magnetite and ankerite occur within the Grand Conglomérat 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 Conglomérat 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

  16. Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia

    PubMed Central

    2012-01-01

    Background The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. Methods The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Results Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68

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

    PubMed

    Jürgensen, Marte; Sandøy, 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

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

    PubMed

    Jürgensen, Marte; Sandøy, 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

  19. Use of a Nutrition Behavior Change Counseling Tool: Lessons from a Rapid Qualitative Assessment in Eastern Zambia.

    PubMed

    Weiss, Ingrid; Stepanovic, Serena; Chinyemba, Ulembe; Bateman, Jessica; Hemminger, Carolyn; Burrows, Emily

    2016-01-01

    The U.S. Agency for International Development Feed the Future Mawa Project - led by Catholic Relief Services - aims to improve food and economic security for farming households in Zambia's Eastern Province. Mawa employs social and behavior change (SBC) strategies with households and communities to improve nutrition and reduce stunting among children under two (CU2). To support these strategies, sub-partner University Research Co., LLC employed a participatory process to develop a series of 35 action cards, each illustrating one project-promoted behavior, that are used at household and community group levels. Caregivers of CU2 are given a full set of action cards to promote household dialogue and support for the promoted behaviors. As a final step in the action card tool development process, a qualitative rapid assessment was conducted 1 month after implementation to investigate preliminary ways action cards were being used, and if the methods of using the cards had the potential to impact behavior change. The research team conducted nine key informant interviews and four focus group discussions with Mawa staff and administered 41 qualitative interview questionnaires with project participants in the Chipata and Lundazi districts. Although not based on a representative sampling frame, the assessment produced valuable results for program improvement purposes. It also provided a feedback mechanism for community-based staff and project participants, a crucial step in the participatory tool development process. The assessment found that Mawa staff at every level use action cards combined with at least one other social behavior change tool for each nutrition intervention. Our results suggest that Mawa staff and project participants share a common understanding of the cards' purpose. Each group noted that the cards provide a visual cue for action and reinforce previous Mawa nutrition messages. Intended uses confirmed by the assessment include encouraging household

  20. An evaluation of the performance and acceptability of three LED fluorescent microscopes in Zambia: lessons learnt for scale-up.

    PubMed

    Turnbull, Eleanor R; Kaunda, Kaunda; Harris, Jennifer B; Kapata, Nathan; Muvwimi, Mweemba W; Kruuner, Annika; Henostroza, German; Reid, Stewart E

    2011-01-01

    The World Health Organization recommends the roll-out of light-emitting diode (LED) fluorescent microscopes (FM) as an alternative to light microscopes in resource-limited settings. We evaluated the acceptability and performance of three LED FMs after a short orientation among laboratory technicians from government health centers in Zambia. Sixteen technicians with varied light microscopy experience were oriented to FMs and divided into groups; each group read a different set of 40 slides on each LED FM (Primo Star iLED™, Lumin™, FluoLED™) and on a reference mercury-vapor FM (Olympus BX41TF). Slide reading times were recorded. An experienced FM technician examined each slide on the Olympus BX41TF. Sensitivity and specificity compared to TB culture were calculated. Misclassification compared to the experienced technician and inter-rater reliability between trainees was assessed. Trainees rated microscopes on technical aspects. Primo Star iLED™, FluoLED™ and Olympus BX41TF had comparable sensitivities (67%, 65% and 65% respectively), with the Lumin™ significantly worse (56%; p<0.05). Specificity was low for trainees on all microscopes (75.9%) compared to the experienced technician on Olympus BX41TF (100%). Primo Star iLED™ had significantly less misclassification (21.1% p<0.05) than FluoLED™ (26.5%) and Lumin™ (26.8%) and significantly higher inter-rater reliability (0.611; p<0.05), compared to FluoLED™ (0.523) and Lumin™ (0.492). Slide reading times for LED FMs were slower than the reference, but not significantly different from each other. Primo Star iLED™ rated highest in acceptability measures, followed by FluoLED™ then Lumin™. Primo Star iLED™ was consistently better than FluoLED™ and Lumin™, and performed comparably to the Olympus BX41TF in all analyses, except reading times. The Lumin™ compared least favorably and was thought unacceptable for use. Specificity and inter-rater reliability were low for all microscopes

  1. Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia

    PubMed Central

    2012-01-01

    Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Methods Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. Results At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. Conclusion As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom

  2. The Application of Climate Risk Informed Decision Analysis to the Ioland Water Treatment Plant in Lusaka, Zambia

    NASA Astrophysics Data System (ADS)

    Kucharski, John; Tkach, Mark; Olszewski, Jennifer; Chaudhry, Rabia; Mendoza, Guillermo

    2016-04-01

    This presentation demonstrates the application of Climate Risk Informed Decision Analysis (CRIDA) at Zambia's principal water treatment facility, The Iolanda Water Treatment Plant. The water treatment plant is prone to unacceptable failures during periods of low hydropower production at the Kafue Gorge Dam Hydroelectric Power Plant. The case study explores approaches of increasing the water treatment plant's ability to deliver acceptable levels of service under the range of current and potential future climate states. The objective of the study is to investigate alternative investments to build system resilience that might have been informed by the CRIDA process, and to evaluate the extra resource requirements by a bilateral donor agency to implement the CRIDA process. The case study begins with an assessment of the water treatment plant's vulnerability to climate change. It does so by following general principals described in "Confronting Climate Uncertainty in Water Resource Planning and Project Design: the Decision Tree Framework". By utilizing relatively simple bootstrapping methods a range of possible future climate states is generated while avoiding the use of more complex and costly downscaling methodologies; that are beyond the budget and technical capacity of many teams. The resulting climate vulnerabilities and uncertainty in the climate states that produce them are analyzed as part of a "Level of Concern" analysis. CRIDA principals are then applied to this Level of Concern analysis in order to arrive at a set of actionable water management decisions. The principal goals of water resource management is to transform variable, uncertain hydrology into dependable services (e.g. water supply, flood risk reduction, ecosystem benefits, hydropower production, etc…). Traditional approaches to climate adaptation require the generation of predicted future climate states but do little guide decision makers how this information should impact decision making. In

  3. Why pigs are free-roaming: Communities' perceptions, knowledge and practices regarding pig management and taeniosis/cysticercosis in a Taenia solium endemic rural area in Eastern Zambia.

    PubMed

    Thys, Séverine; Mwape, Kabemba E; Lefèvre, Pierre; Dorny, Pierre; Phiri, Andrew M; Marcotty, Tanguy; Phiri, Isaac K; Gabriël, Sarah

    2016-07-30

    Taenia solium cysticercosis is a neglected parasitic zoonosis in many developing countries including Zambia. 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. Socio-cultural determinants related to free range pig management and their implications for control of T. solium remain unclear. The study objective was to assess the communities' perceptions, reported practices and knowledge regarding management of pigs and taeniosis/cysticercosis (including neurocysticercosis) in an endemic rural area in Eastern Zambia, and to identify possible barriers to pig related control measures such as pig confinement. A total of 21 focus group discussions on pig husbandry practices were organized separately with men, women and children, in seven villages from Petauke district. The findings reveal that the perception of pigs and their role in society (financial, agricultural and traditional), the distribution of the management tasks among the family members owning pigs (feeding, building kraal, seeking care) and environmental aspects (feed supply, presence of bush, wood use priorities, rainy season) prevailing in the study area affect pig confinement. People have a fragmented knowledge of the pork tapeworm and its transmission. Even if negative aspects/health risks of free-range pigs keeping are perceived, people are ready to take the risk for socio-economic reasons. Finally, gender plays an important role because women, and also children, seem to have a higher perception of the risks but lack power in terms of economic decision-making compared to men. Currently pig confinement is not seen as an acceptable method to control porcine cysticercosis by many farmers in Eastern Zambia, vaccination and treatment seemed to be more appropriate. Embedded in a One Health approach, disease control programs should therefore ensure a complementary appropriate set of control

  4. What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

    PubMed Central

    Sheikh, Kabir; Uplekar, Mukund

    2016-01-01

    Background: The unregulated availability and irrational use of tuberculosis (TB) medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs) have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs – India, Tanzania, and Zambia – and to understand the factors that constrain and enable these processes. Methods: We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO), on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators’ authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. Results: In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for regulation, technical

  5. What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

    PubMed Central

    Sheikh, Kabir; Uplekar, Mukund

    2016-01-01

    Background: The unregulated availability and irrational use of tuberculosis (TB) medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs) have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs – India, Tanzania, and Zambia – and to understand the factors that constrain and enable these processes. Methods: We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO), on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators’ authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. Results: In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for regulation, technical

  6. Why pigs are free-roaming: Communities' perceptions, knowledge and practices regarding pig management and taeniosis/cysticercosis in a Taenia solium endemic rural area in Eastern Zambia.

    PubMed

    Thys, Séverine; Mwape, Kabemba E; Lefèvre, Pierre; Dorny, Pierre; Phiri, Andrew M; Marcotty, Tanguy; Phiri, Isaac K; Gabriël, Sarah

    2016-07-30

    Taenia solium cysticercosis is a neglected parasitic zoonosis in many developing countries including Zambia. 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. Socio-cultural determinants related to free range pig management and their implications for control of T. solium remain unclear. The study objective was to assess the communities' perceptions, reported practices and knowledge regarding management of pigs and taeniosis/cysticercosis (including neurocysticercosis) in an endemic rural area in Eastern Zambia, and to identify possible barriers to pig related control measures such as pig confinement. A total of 21 focus group discussions on pig husbandry practices were organized separately with men, women and children, in seven villages from Petauke district. The findings reveal that the perception of pigs and their role in society (financial, agricultural and traditional), the distribution of the management tasks among the family members owning pigs (feeding, building kraal, seeking care) and environmental aspects (feed supply, presence of bush, wood use priorities, rainy season) prevailing in the study area affect pig confinement. People have a fragmented knowledge of the pork tapeworm and its transmission. Even if negative aspects/health risks of free-range pigs keeping are perceived, people are ready to take the risk for socio-economic reasons. Finally, gender plays an important role because women, and also children, seem to have a higher perception of the risks but lack power in terms of economic decision-making compared to men. Currently pig confinement is not seen as an acceptable method to control porcine cysticercosis by many farmers in Eastern Zambia, vaccination and treatment seemed to be more appropriate. Embedded in a One Health approach, disease control programs should therefore ensure a complementary appropriate set of control

  7. 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.

  8. Female Partner Acceptance as a Predictor of Men's Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project

    PubMed Central

    Cook, Ryan; Jones, Deborah; Redding, Colleen A.; Zulu, Robert; Chitalu, Ndashi; Weiss, Stephen M.

    2015-01-01

    The World Health Organization has recommended the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in sub-Saharan Africa; however, men are often uninterested in undergoing VMMC. The Spear & Shield project enrolled 668 men and female partners from ten Zambian community health centers into parallel interventions promoting VMMC for HIV prevention or time-matched control conditions. A mediation model was utilized to examine the relationships between changes in women's acceptance of VMMC and men's readiness to undergo the procedure. Results demonstrated that, at 12 months post-intervention, a 5.9 % increase in the likelihood of undergoing VMMC among men in the experimental condition could be attributed to increased women's acceptance. From a public health perspective, involving women in VMMC promotion interventions such as the Spear & Shield project could significantly impact the demand for VMMC in Zambia. PMID:25931242

  9. Comparative health systems research in a context of HIV/AIDS: lessons from a multi-country study in South Africa, Tanzania and Zambia.

    PubMed

    Dawad, Suraya; Veenstra, Nina

    2007-10-30

    Comparative, multi-country research has been underutilised as a means to inform health system development. South-south collaboration has been particularly poor, even though there have been clearly identified benefits of such endeavours. This commentary argues that in a context of HIV/AIDS, the need for regional learning has become even greater. This is because of the regional nature of the problem and the unique challenges that it creates for health systems. We draw on the experience of doing comparative research in South Africa, Tanzania and Zambia, to demonstrate that it can be useful for determining preconditions for the success of health care reforms, for affirming common issues faced by countries in the region, and for developing research capacity. Furthermore, these benefits can be derived by all countries participating in such research, irrespective of differences in capacity or socio-economic development.

  10. 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.

  11. Using a discrete choice experiment to elicit the demand for a nutritious food: willingness-to-pay for orange maize in rural Zambia.

    PubMed

    Meenakshi, J V; Banerji, A; Manyong, Victor; Tomlins, Keith; Mittal, Nitya; Hamukwala, Priscilla

    2012-01-01

    Using a discrete choice experiment, this paper estimates the willingness to pay for biofortified orange maize in rural Zambia. The study design has five treatment arms, which enable an analysis of the impact of nutrition information, comparing the use of simulated radio versus community leaders in transmitting the nutrition message, on willingness to pay, and to account for possible novelty effects in the magnitude of premiums or discounts. The estimation strategy also takes into account lexicographic preferences of a subset of our respondents. The results suggest that (a) orange maize is not confused with yellow maize, and has the potential to compete with white maize in the absence of a nutrition campaign, (b) there is a premium for orange maize with nutrition information, and (c) different modes of nutritional message dissemination have the same impact on consumer acceptance.

  12. HIV infection and domestic smoke exposure, but not human papillomavirus, are risk factors for esophageal squamous cell carcinoma in Zambia: a case-control study.

    PubMed

    Kayamba, Violet; Bateman, Allen C; Asombang, Akwi W; Shibemba, Aaron; Zyambo, Kanekwa; Banda, Themba; Soko, Rose; Kelly, Paul

    2015-04-01

    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 case-control 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] 1.0-5.1; P = 0.03). The OR was stronger when only people under 60 years were included (OR 4.3; 95% CI 1.5-13.2; P = 0.003). Cooking with charcoal or firewood, and cigarette smoking, both increased the odds of developing OSCC ([OR 3.5; 95% CI 1.4-9.3; P = 0.004] and [OR 9.1; 95% CI 3.0-30.4; 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.

  13. A Case for Regular Aflatoxin Monitoring in Peanut Butter in Sub-Saharan Africa: Lessons from a 3-Year Survey in Zambia.

    PubMed

    Njoroge, Samuel M C; Matumba, Limbikani; Kanenga, Kennedy; Siambi, Moses; Waliyar, Farid; Maruwo, Joseph; Monyo, Emmanuel S

    2016-05-01

    A 3-year comprehensive analysis of aflatoxin contamination in peanut butter was conducted in Zambia, sub-Saharan Africa. The study analyzed 954 containers of 24 local and imported peanut butter brands collected from shops in Chipata, Mambwe, Petauke, Katete, and Nyimba districts and also in Lusaka from 2012 to 2014. For analysis, a sample included six containers of a single brand, from the same processing batch number and the same shop. Each container was quantitatively analyzed for aflatoxin B1 (AFB1) in six replicates by using competitive enzyme-linked immunosorbent assay; thus, aflatoxin contamination level of a given sample was derived from an average of 36 test values. Results showed that 73% of the brands tested in 2012 were contaminated with AFB1 levels >20 μg/kg and ranged up to 130 μg/kg. In 2013, 80% of the brands were contaminated with AFB1 levels >20 μg/kg and ranged up to 10,740 μg/kg. Compared with brand data from 2012 and 2013, fewer brands in 2014, i.e., 53%, had aflatoxin B1 levels >20 μg/kg and ranged up to 1,000 μg/kg. Of the eight brands tested repeatedly across the 3-year period, none consistently averaged ≤20 μg/kg. Our survey clearly demonstrates the regular occurrence of high levels of AF B1 in peanut butter in Zambia. Considering that some of the brands tested originated from neighboring countries such as Malawi, Zimbabwe, and South Africa, the current findings provide a sub-Saharan regional perspective regarding the safety of peanut butter.

  14. 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.

  15. Safety and Efficacy of the PrePex Male Circumcision Device: Results From Pilot Implementation Studies in Mozambique, South Africa, and Zambia

    PubMed Central

    Feldblum, Paul; Martinson, Neil; Bvulani, Bruce; Taruberekera, Noah; Mahomed, Mehebub; Chintu, Namwinga; Milovanovic, Minja; Hart, Catherine; Billy, Scott; Necochea, Edgar; Samona, Alick; Mhazo, Miriam; Bossemeyer, Debora; Lai, Jaim Jou; Lebinai, Limakatso; Ashengo, Tigistu A.; Macaringue, Lucinda; Veena, Valentine

    2016-01-01

    Background: Fourteen countries in East and Southern Africa have engaged in national programs to accelerate the provision of voluntary medical male circumcision (VMMC) since 2007. Devices have the potential to accelerate VMMC programs by making the procedure easier, quicker, more efficient, and widely accessible. Methods: Pilot Implementation studies were conducted in Mozambique, South Africa, and Zambia. The primary objective of the studies was to assess the safety of PrePex device procedures when conducted by nurses and clinical officers in adults and adolescent males (13–17 years, South Africa only) with the following end points: number and grade of adverse events (AEs); pain-related AEs measured using visual analog score; device displacements/self-removals; time to complete wound healing; and procedure times for device placement and removal. Results: A total of 1401 participants (1318 adult and 83 adolescent males) were circumcised using the PrePex device across the 3 studies. Rates of moderate/severe AEs were low (1.0%; 2.0%; and 2.8%) in the studies in Mozambique, Zambia, and South Africa, respectively. Eight early self-removals of 1401 (0.6%) were observed, all required corrective surgery. High rates of moderate/severe pain-related AEs were recorded especially at device removal in South Africa (34.9%) and Mozambique (59.5%). Ninety percent of participants were healed at day 56 postplacement. Discussion: The study results from the 3 countries suggest that the implementation of the PrePex device using nonphysician health care workers is both safe and feasible, but better pain control at device removal needs to be put in place to increase the comfort of VMMC clients using the PrePex device. PMID:27331589

  16. 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 2010–2011, 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 (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% 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

  17. 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.

  18. Age Distribution and Determinants of Invasive Cervical Cancer in a “Screen-and-Treat” Program Integrated With HIV/AIDS Care in Zambia

    PubMed Central

    Kapambwe, Sharon; Sahasrabuddhe, Vikrant V.; Blevins, Meridith; Mwanahamuntu, Mulindi H.; Mudenda, Victor; Shepherd, Bryan E.; Chibwesha, Carla J.; Pfaendler, Krista S.; Hicks, Michael L.; Vermund, Sten H.; Stringer, Jeffrey S. A.; Parham, Groesbeck P.

    2016-01-01

    Background Cervical cancer screening efforts linked to HIV/ AIDS care programs are being expanded across sub-Saharan Africa. Evidence on the age distribution and determinants of invasive cervical cancer (ICC) cases detected in such programs is limited. Methods We analyzed program operations data from the Cervical Cancer Prevention Program in Zambia, the largest public sector programs of its kind in sub-Saharan Africa. We examined age distribution patterns by HIV serostatus of histologically confirmed ICC cases and used multivariable logistic regression to evaluate independent risk factors for ICC among younger (≤35 years) and older (>35 years) women. Results Between January 2006 and April 2010, of 48,626 women undergoing screening, 571 (1.2%) were diagnosed with ICC, including 262 (46%) HIV seropositive (median age: 35 years), 131 (23%) HIV seronegative (median age: 40 years), and 178 (31%) of unknown HIV serostatus (median age: 38 years). Among younger (≤35 years) women, being HIV seropositive was associated with a 4-fold higher risk of ICC [adjusted odds ratio = 4.1 (95% confidence interval: 2.8, 5.9)] than being HIV seronegative. The risk of ICC increased with increasing age among HIV-seronegative women and women with unknown HIV serostatus, but among HIV-seropositive women, the risk peaked around age 35 and non-significantly declined with increasing ages. Other factors related to ICC included being married (vs. being unmarried/widowed) in both younger and older women, and with having 2+ (vs. ≤1) lifetime sexual partners among younger women. Conclusions HIV infection seems to have increased the risk of cervical cancer among younger women in Zambia, pointing to the urgent need for expanding targeted screening interventions. PMID:26322673

  19. 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

  20. A Case for Regular Aflatoxin Monitoring in Peanut Butter in Sub-Saharan Africa: Lessons from a 3-Year Survey in Zambia.

    PubMed

    Njoroge, Samuel M C; Matumba, Limbikani; Kanenga, Kennedy; Siambi, Moses; Waliyar, Farid; Maruwo, Joseph; Monyo, Emmanuel S

    2016-05-01

    A 3-year comprehensive analysis of aflatoxin contamination in peanut butter was conducted in Zambia, sub-Saharan Africa. The study analyzed 954 containers of 24 local and imported peanut butter brands collected from shops in Chipata, Mambwe, Petauke, Katete, and Nyimba districts and also in Lusaka from 2012 to 2014. For analysis, a sample included six containers of a single brand, from the same processing batch number and the same shop. Each container was quantitatively analyzed for aflatoxin B1 (AFB1) in six replicates by using competitive enzyme-linked immunosorbent assay; thus, aflatoxin contamination level of a given sample was derived from an average of 36 test values. Results showed that 73% of the brands tested in 2012 were contaminated with AFB1 levels >20 μg/kg and ranged up to 130 μg/kg. In 2013, 80% of the brands were contaminated with AFB1 levels >20 μg/kg and ranged up to 10,740 μg/kg. Compared with brand data from 2012 and 2013, fewer brands in 2014, i.e., 53%, had aflatoxin B1 levels >20 μg/kg and ranged up to 1,000 μg/kg. Of the eight brands tested repeatedly across the 3-year period, none consistently averaged ≤20 μg/kg. Our survey clearly demonstrates the regular occurrence of high levels of AF B1 in peanut butter in Zambia. Considering that some of the brands tested originated from neighboring countries such as Malawi, Zimbabwe, and South Africa, the current findings provide a sub-Saharan regional perspective regarding the safety of peanut butter. PMID:27296427

  1. 'We are also dying like any other people, we are also people': perceptions of the impact of HIV/AIDS on health workers in two districts in Zambia.

    PubMed

    Dieleman, Marjolein; Biemba, Godfrey; Mphuka, Simon; Sichinga-Sichali, Karen; Sissolak, Dagmar; van der Kwaak, Anke; van der Wilt, Gert-Jan

    2007-05-01

    In countries with a high AIDS prevalence, the health workforce is affected by AIDS in several ways. In Zambia, which has a prevalence rate of 16.5%, a study was carried out in 2004 with the aim to: explore the impact of HIV/AIDS on health workers, describe their coping mechanisms and recommend supportive measures. The qualitative study was complemented by a survey using self-administered questionnaires in four selected health facilities in two rural districts in Zambia, Mpika and Mazabuka. It is one of the few studies to have explored the impact of HIV/AIDS from the perspective of health workers and managers in the region. Thirty-four in-depth interviews and five group discussions were conducted with health workers, managers and volunteers, and 82 self-administered questionnaires were filled out by health workers. In addition, burnout among 42 health workers was measured using the Maslach Burnout Inventory (MBI). The MBI measures three components that contribute to burnout: emotional exhaustion, depersonalization and personal accomplishment. The results show that in both districts, HIV/AIDS has had a negative impact on workload and has considerably changed or added tasks to already overburdened health workers. In Mpika, 76% of respondents (29/38), and in Mazabuka, 79% (34/44) of respondents, expressed fear of infection at the workplace. HIV-positive health workers remained 'in hiding', did not talk about their illness and suffered in silence. Despite the fact that health workers were still relatively motivated, emotional exhaustion occurred among 62% of the respondents (26/42). The interviews revealed that counsellors and nurses were especially at risk for emotional exhaustion. In each of the selected facilities, organizational support for health workers to deal with HIV/AIDS was either haphazardly in place or not in place at all. AIDS complicates the already difficult work environment. In addition to health workers, management also needs support in dealing with

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

    PubMed Central

    2011-01-01

    Background Several frameworks have been constructed to analyse the factors which influence and shape the uptake of evidence into policy processes in resource poor settings, yet empirical analyses of health policy making in these settings are relatively rare. National policy making for cotrimoxazole (trimethoprim-sulfamethoxazole) preventive therapy in developing countries offers a pertinent case for the application of a policy analysis lens. The provision of cotrimoxazole as a prophylaxis is an inexpensive and highly efficacious preventative intervention in HIV infected individuals, reducing both morbidity and mortality among adults and children with HIV/AIDS, yet evidence suggests that it has not been quickly or evenly scaled-up in resource poor settings. Methods Comparative analysis was conducted in Malawi, Uganda and Zambia, using the case study approach. We applied the ‘RAPID’ framework developed by the Overseas Development Institute (ODI), and conducted a total of 47 in-depth interviews across the three countries to examine the influence of context (including the influence of donor agencies), evidence (both local and international), and the links between researcher, policy makers and those seeking to influence the policy process. Results Each area of analysis was found to have an influence on the creation of national policy on cotrimoxazole preventive therapy (CPT) in all three countries. In relation to context, the following were found to be influential: government structures and their focus, donor interest and involvement, healthcare infrastructure and other uses of cotrimoxazole and related drugs in the country. In terms of the nature of the evidence, we found that how policy makers perceived the strength of evidence behind international recommendations was crucial (if evidence was considered weak then the recommendations were rejected). Further, local operational research results seem to have been taken up more quickly, while randomised controlled

  3. Geology and potential hydrocarbon play system of Lower Karoo Group in the Maamba Coalfield Basin, southern Zambia

    NASA Astrophysics Data System (ADS)

    Phiri, Cryton; Wang, Pujun; Nyambe, Imasiku Anayawa

    2016-06-01

    This study attempts to augment geology and potential hydrocarbon play system database not only in the Maamba Coalfield basin of southern Zambia but in other similar continental non-marine Karoo rift basins in the region as well. Geological analyses were conducted through extensive outcrops and exposures and subsurface boreholes. Six (6) major lithofacies (diamictites, conglomerates, sandstones, siltstones, coal and mudstones) represents Lower Karoo Group sequence. Four (4) mudstone core samples were prepared for thin section petrography. In addition, six (6) samples of sandstones obtained from outcrops, exposures and cores were impregnated with blue epoxy before thin sectioning in order to facilitate easy recognition of porosity. Quantification of framework grain composition and porosity was achieved by point counting a total of 300 points per thin section. The identification of diagenetic constituents and pore types was made possible by the use of scanning electron microscopy (SEM). Rock-Eval pyrolysis analyses utilised 35 core samples of mudstones and coal. According to results of the analyses, three (3) deposition settings which include; alluvial, fluvial-lacustrine and lacustrine setting are envisaged. . Fluvial-lacustrine deposits are host to mudstones and coal source rocks and sandstone reservoir rocks. Mudstones and coal source rocks gave the total organic carbon (TOC) that is well above the recommended thresholds of 0.5 wt % and 2.5 wt % of gas and oil generation respectively. The hydrogen index (HI) values are mostly below 200 mg HC/g TOC, indicating fair quantities of type III kerogen. The thermal maturity readings measured by temperature Tmax range from 440 to 485 °C in agreement with calculated vitrinite reflectance (Rocalc) range of 0.76-1.57% indicating mature to post mature stages. This maturation is attributed to the burial temperatures and near-surface heat flows by faults. Production Index (PI) values are less than 0.1 suggesting some hydrocarbon

  4. Does knowledge about antiretroviral therapy and mother-to-child transmission affect the relationships between HIV status and fertility preferences and contraceptive use? New evidence from Nigeria and Zambia.

    PubMed

    Bankole, Akinrinola; Biddlecom, Ann E; Dzekedzeke, Kumbutso; Akinyemi, Joshua O; Awolude, Olutosin; Adewole, Isaac F

    2014-09-01

    The increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009-2010 community-based surveys in Nigeria and Zambia, this study explores whether women's knowledge about ART and PMTCT influences the relationship between HIV status and fertility preferences and contraceptive behaviour. The findings show that women living with HIV are more likely to want more children in Nigeria and to want to limit childbearing in Zambia compared with HIV-negative women. While there is no significant difference in contraceptive use by women's HIV status in the two countries, women who did not know their HIV status are less likely to use contraceptives relative to women who are HIV-negative. Knowledge about ART reduces the childbearing desires of HIV-positive women in Nigeria and knowledge about PMTCT increases desire for more children among HIV-positive women in Zambia, as well as contraceptive use among women who do not know their HIV status. The findings indicate that knowledge about HIV prevention and treatment services changes how living with HIV affects childbearing desires and, at least in Zambia, pregnancy prevention, and highlight the importance of access to accurate knowledge about ART and PMTCT services to assist women and men to make informed childbearing decisions. Knowledge about ART and PMTCT should be promoted not only through HIV treatment and maternal and newborn care facilities but also through family planning centres and the mass media.

  5. Zambia and Botswana

    Atmospheric Science Data Center

    2013-04-16

    ... town of Maun is at its southeastern edge. Note how the plant life, which is highly reflective in the near-infrared, shows up as bright red ... D.C. The Terra spacecraft is managed by NASA's Goddard Space Flight Center, Greenbelt, MD. The MISR data were obtained from the NASA ...

  6. 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

  7. 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

  8. ‘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

  9. 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.

  10. 'A child is also a teacher': exploring the potential for children as change agents in the context of a school-based WASH intervention in rural Eastern Zambia.

    PubMed

    Bresee, S; Caruso, B A; Sales, J; Lupele, J; Freeman, M C

    2016-08-01

    As part of water, sanitation and hygiene interventions in low-income settings, it is frequently assumed that pupils can disseminate information and catalyze change at home, yet this assumption has not been rigorously assessed. We employed qualitative research methods in two phases to assess the potential for children to be change agents in five schools in rural Zambia. Phase 1 included role-play and focus group discussions among pupils on their percieved ability to serve as change agents. Children were then given 'homework' that included information on health messages and on how to build a handwashing station, and were encouraged to engage their family. In Phase 2, we conducted separate focus group discussions with pupils and mothers on their experiences with the 'homework'. We found that, in general, pupils were enthusiastic about engaging with parents-typically male heads of household-and were successful at constructing handwashing stations. Mothers reported high levels of trust in children to relay health information learned at school. Pupils were able to enact small changes to behavior, but not larger infrastructure changes, such as construction of latrines. Pupils are capable of communicating knowledge and behaviors to family members; however, discrete activities and guidance is required. PMID:27206442

  11. 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 Central

    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

  12. 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.

  13. Spatial and temporal changes in household structure locations using high-resolution satellite imagery for population assessment: an analysis in southern Zambia, 2006-2011.

    PubMed

    Shields, Timothy; Pinchoff, Jessie; Lubinda, Jailos; Hamapumbu, Harry; Searle, Kelly; Kobayashi, Tamaki; Thuma, Philip E; Moss, William J; Curriero, Frank C

    2016-05-31

    Satellite imagery is increasingly available at high spatial resolution and can be used for various purposes in public health research and programme implementation. Comparing a census generated from two satellite images of the same region in rural southern Zambia obtained four and a half years apart identified patterns of household locations and change over time. The length of time that a satellite image-based census is accurate determines its utility. Households were enumerated manually from satellite images obtained in 2006 and 2011 of the same area. Spatial statistics were used to describe clustering, cluster detection, and spatial variation in the location of households. A total of 3821 household locations were enumerated in 2006 and 4256 in 2011, a net change of 435 houses (11.4% increase). Comparison of the images indicated that 971 (25.4%) structures were added and 536 (14.0%) removed. Further analysis suggested similar household clustering in the two images and no substantial difference in concentration of households across the study area. Cluster detection analysis identified a small area where significantly more household structures were removed than expected; however, the amount of change was of limited practical significance. These findings suggest that random sampling of households for study participation would not induce geographic bias if based on a 4.5-year-old image in this region. Application of spatial statistical methods provides insights into the population distribution changes between two time periods and can be helpful in assessing the accuracy of satellite imagery.

  14. 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

  15. 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.

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

    PubMed Central

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

    2011-01-01

    In low-income settings, human immunodeficiency virus (HIV)-positive mothers must choose between breastfeeding their infants and risking transmission of HIV or replacement feeding their infants and risking diarrheal disease from contaminated water. We conducted a cross-sectional study of children < 2 years of age of 254 HIV-positive mothers in peri-urban Zambia to assess their exposure to waterborne fecal contamination. Fecal indicators were found in 70% of household drinking water samples. In a multivariable analysis, factors associated with diarrhea prevalence in children < 2 years were mother having diarrhea (adjusted odds ratio [aOR] = 5.18, 95% confidence interval [CI] = 1.65–16.28), child given water in the past 2 days (aOR = 4.08, 95% CI = 1.07–15.52), child never being breastfed (aOR = 2.67, 95% CI = 1.06–6.72), and rainy (versus dry) season (aOR = 4.60, 95% CI = 1.29–16.42). Children born to HIV-positive mothers were exposed to contaminated water through direct intake of drinking water, indicating the need for interventions to ensure microbiological water quality. PMID:21813854

  17. 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.

  18. 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

  19. 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.

  20. 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

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

    PubMed

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

    1998-09-01

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

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

    PubMed

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

    2011-03-01

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

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. A study on usefulness of a set of known risk factors in predicting maternal syphilis infections in three districts of Western Province, Zambia

    PubMed Central

    Sakala, Jacob; Chizuni, Nellisiwe; Nzala, Selestine

    2016-01-01

    Introduction Despite roll-out of cost-effective point-of-care tests, less than half antenatal attendees in rural western Zambia are screened for syphilis. This study formulated a clinical, risk-based assessment criteria and evaluated its usefulness as a non-biomedical alternative for identifying high-risk prenatal cases. Methods We conducted a cross-sectional survey of antenatal clinic attendees in Kaoma, Luampa and Nkeyema districts to collect data on exposure to nine pre-selected syphilis risk factors. These factors were classified into major and minor factors based on their observed pre-study association strengths to maternal syphilis. Clinical disease was defined as exposure to either two major factors, one major with two minor factors or three minor factors. Sensitivity, specificity and predictive values of the clinical protocol were then calculated in comparison to rapid plasmin reagin results. Results The observed syphilis prevalence was 9.3% (95% CI: 7.4 - 11.6%) and the overall sensitivity of the study criteria was 62.3% with positive predictive value of 72.9%. Sensitivities of individual case-defining categories were even lower; from 17.4% to 33.3%. Results confirmed that abortion history, still birth, multiple sexual partners, previous maternal syphilis infection, partner history of sexually transmitted infection and maternal co-morbid conditions of HIV and genital ulcer disease were significantly associated to maternal syphilis in study population as well. Conclusion The criteria was not as effective as biomedical tests in identifying maternal syphilis. However, it could be a useful adjunct/alternative in antenatal clinics when biomedical tests are either inadequate or unavailable.

  8. The Pratt Pouch Provides a Three-Fold Access Increase to Antiretroviral Medication for Births outside Health Facilities in Southern Zambia

    PubMed Central

    Dahinten, Alexander P.; Malkin, Robert A.

    2016-01-01

    Introduction: Modern day antiretroviral therapy allows HIV+ pregnant women to lower the likelihood of viral transmission to their infants before, during, and after birth from 20-45% to less than 5%. In developing countries, where non-facility births may outnumber facility births, infant access to safe antiretroviral medication during the critical first three days after birth is often limited. A single-dose, polyethylene pouch (“Pratt Pouch”) addresses this challenge by allowing the medication to be distributed to mothers during antenatal care. Methods: The Pratt Pouch was introduced as part of a one year clinical feasibility study in two districts in Southern Province, Zambia. Participating nurses, community health workers, and pharmacists were trained before implementation. Success in achieving improved antiretroviral medication access was assessed via pre intervention and post intervention survey responses by HIV+ mothers. Results: Access to medication for HIV-exposed infants born outside of a health facility increased from 35% (17/51) before the introduction of the pouch to 94% (15/16) after (p<0.05). A non-significant increase in homebirth rates from 33% (pre intervention cohort) to 50% (post intervention cohort) was observed (p>0.05). Results remained below the national average homebirth rate of 52%. Users reported minimal spillage and a high level of satisfaction with the Pratt Pouch. Conclusion: The Pratt Pouch enhances access to infant antiretroviral medication in a rural, non-facility birth setting. Wide scale implementation could have a substantial global impact on HIV transmission rates from mother to child. PMID:27073584

  9. Good Health and Moral Responsibility: Key Concepts Underlying the Interpretation of Treatment as Prevention in South Africa and Zambia Before Rolling Out Universal HIV Testing and Treatment

    PubMed Central

    Hoddinott, Graeme; Viljoen, Lario; Simuyaba, Melvin; Musheke, Maurice; Seeley, Janet

    2016-01-01

    Abstract Gauging community responses to the WHO 2015 recommendation to provide antiretroviral treatment (ART) to all people living with HIV (PLHIV) is critical. There is limited qualitative evidence on the acceptability of this Universal Test and Treat (UTT) strategy or community understanding of the impact of ART on reducing HIV transmission, promoted as Treatment as Prevention (TasP). This article explores early understanding of UTT and TasP in 21 urban communities in South Africa and Zambia in 2013 before a community randomized trial of combination prevention—HPTN 071 (PopART). It draws on participatory research conducted in each community, which carried out group discussions and interviews with 1202 respondents and 203 structured observations. Participants were largely unfamiliar with the concepts of UTT and TasP. They were concerned about an accompanying de-emphasis on sexual behavior change. Treatment and prevention seemed, at first glance, to be experienced separately. With the exception of the prevention of mother-to-child transmission, prevention seldom came into discussions about ART. This was partly because this science had not yet been explained to many and also because it was not an easy fit. Contemplating the link between treatment and prevention, participants emphasized both PLHIV taking care of themselves through good health and preventing disease progression and the moral responsibility of PLHIV to prevent HIV transmission. To avoid igniting moralizing and blaming when introducing UTT and TasP, we should capitalize on the “taking care of yourself” legacy while boosting public responsibility through broad antistigma education and patient empowerment efforts. PMID:27610464

  10. The contribution of counselling in hospital and home-based care in a small town and surrounding rural area in Zambia.

    PubMed

    Jordan, I B; Haworth, A

    1995-01-01

    In early 1991 in Zambia, Mansa General Hospital hosted Luapula Province's first training course for counselors of patients with AIDS and their families. Physicians and nurses soon saw that counseling made their work easier. Counseling helped the clients and their families and affected the behavior of the providers. The counselors have made it easier for hospital providers to discuss AIDS. Several months passed after counseling was implemented before a specific room for counseling was established to preserve privacy. The counselors provide pre- and post-test counseling. They meet weekly to share problems and concerns and to review counseling content so they can learn from each other. Since some patients live too far from the hospital, four counselors have joined the home-based care team (nurse, clinical officer, laboratory assistant, and physician). Home-based teams help HIV-positive spouses, widows about to lose all their property to the late husband's relatives, and family members providing for orphaned children. Community counseling or community education for transformation eventually replaced the hospital-centered home-based care model that ignored the community and its resources. The local health educator facilitated this transition. This model provided information to chiefs and headmen and helped them to learn how HIV/AIDS affects individuals. Teachers, social workers, and church workers were later also targeted as community leaders. The second training course in Mansa was established to train counselors who would then be resource persons to local institutions or within their own communities. Training of social workers and teachers relieves the home-based care team of the counseling burden. Thus, the counseling program evolved into a multi-nodal network made of resources from the hospital, health center, and community.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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, Éimhín 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

  16. 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

  17. 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, Éimhín 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

  18. Men's Understanding of and Experiences During the Postcircumcision Abstinence Period: Results From a Field Study of ShangRing Circumcision During Routine Clinical Services in Kenya and Zambia

    PubMed Central

    Li, Philip S.; Zulu, Robert; Awori, Quentin D.; Agot, Kawango; Combes, Stephanie; Simba, Raymond O.; Lee, Richard K.; Hart, Catherine; Lai, Jaim Jou; Zyambo, Zude; Goldstein, Marc; Feldblum, Paul J.; Sokal, David C.

    2016-01-01

    Background: Men's understanding of counseling messages after voluntary medical male circumcision (VMMC) plays an important role in whether they follow them. Data on triggers for early resumption of sex may be useful as scale-up of VMMC for HIV prevention continues in sub-Saharan Africa. Methods: Data on understanding of post-VMMC abstinence recommendations, resumption of sex, condom use, and triggers for resuming sex were collected from participants during a follow-up interview 35–42 days after ShangRing circumcision in Kenya and Zambia. Results: Of 1149 men who had ShangRing circumcision, 1096 (95.4%) completed follow-up. Nearly all (99.2%) reported being counseled to abstain from sex post-VMMC; among those, most (92.2%) recalled the recommended abstinence period was 6 weeks. Most men (94.1%) reported that the counselor gave reasons for post-VMMC abstinence and recalled appropriate reasons. Few (13.4%) men reported resuming sex at 35–42 days' follow-up. Among those, 54.8% reported never using a condom post-VMMC. Younger participants (odds ratio 0.3, 95% confidence interval: 0.2 to 0.5, P < 0.0001) and those reporting at least some condom use at baseline (odds ratio 0.5, 95% confidence interval: 0.3 to 0.7, P = 0.0003) were less likely to report resuming sex. Among men who reported some condom use, most (71.5%) said condoms were much easier or easier to use after circumcision. Men reported various reasons for early resumption of sex, primarily strong sexual desire (76.4%). Conclusions: Most men reported awareness of and adherence to the counseling recommendations for post-VMMC abstinence. A minority reported early resumption of sex, and, among those, condom use was low. Results could be used to improve post-VMMC counseling. PMID:27331585

  19. Elevated AST-to-platelet ratio index is associated with increased all-cause mortality among HIV-infected adults in Zambia

    PubMed Central

    Vinikoor, Michael J.; Sinkala, Edford; Mweemba, Aggrey; Zanolini, Arianna; Mulenga, Lloyd; Sikazwe, Izukanji; Fried, Michael W.; Eron, Joseph J.; Wandeler, Gilles; Chi, Benjamin H.

    2015-01-01

    Background and Aims We investigated the association between significant liver fibrosis, determined by AST-to-platelet ratio index (APRI), and all-cause mortality among HIV-infected patients prescribed antiretroviral therapy (ART) in Zambia Methods Among HIV-infected adults who initiated ART, we categorized baseline APRI scores according to established thresholds for significant hepatic fibrosis (APRI ≥1.5) and cirrhosis (APRI ≥2.0). Using multivariable logistic regression we identified risk factors for elevated APRI including demographic characteristics, body mass index (BMI), HIV clinical and immunologic status, and tuberculosis. In the subset tested for hepatitis B surface antigen (HBsAg), we investigated the association of hepatitis B virus co-infection with APRI score. Using Kaplan-Meier analysis and Cox proportional hazards regression we determined the association of elevated APRI with death during ART. Results Among 20,308 adults in the analysis cohort, 1,027 (5.1%) had significant liver fibrosis at ART initiation including 616 (3.0%) with cirrhosis. Risk factors for significant fibrosis or cirrhosis included male sex, BMI <18, WHO clinical stage 3 or 4, CD4+ count <200 cells/mm3, and tuberculosis. Among the 237 (1.2%) who were tested, HBsAg-positive patients had four times the odds (adjusted odds ratio, 4.15; 95% CI, 1.71–10.04) of significant fibrosis compared HBsAg-negatives. Both significant fibrosis (adjusted hazard ratio 1.41, 95% CI, 1.21–1.64) and cirrhosis (adjusted hazard ratio 1.57, 95% CI, 1.31–1.89) were associated with increased all-cause mortality. Conclusion Liver fibrosis may be a risk factor for mortality during ART among HIV-infected individuals in Africa. APRI is an inexpensive and potentially useful test for liver fibrosis in resource-constrained settings. PMID:25581487

  20. 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 16–29 years, 30–39 years, 40–49 years, 50–59 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 16–29 year olds, 40–49 year olds (–46 cells/mm3), 50–59 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 40–49 year olds, 1.56 for 50–59 year olds, and 2.97 for 60+ year olds). Adherence and retention in care were poorest among 16–29 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

  1. Availability of Volunteer-Led Home-Based Care System and Baseline Factors as Predictors of Clinical Outcomes in HIV-Infected Patients in Rural Zambia

    PubMed Central

    Estopinal, Christopher B.; van Dijk, Janneke H.; Sitali, Stanley; Stewart, Hannah; Davidson, Mario A.; Spurrier, John; Vermund, Sten H.

    2012-01-01

    Background We assessed the impact of home-based care (HBC) for HIV+ patients, comparing outcomes between two groups of Zambians receiving antiretroviral therapy (ART) who lived in villages with and without HBC teams. Methods We conducted a retrospective cohort study using medical charts from Macha Mission Hospital, a hospital providing HIV care in Zambia's rural Southern Province. Date of birth, date of ART initiation, place of residence, sex, body mass index (BMI), CD4+ cell count, and hemoglobin (Hgb) were abstracted. Logistic regression was used to test our hypothesis that HBC was associated with treatment outcomes. Results Of 655 patients, 523 (80%) were eligible and included in the study. There were 428 patients (82%) with favorable outcomes (alive and on ART) and 95 patients (18%) with unfavorable outcomes (died, lost to follow-up, or stopped treatment). A minority of the 523 eligible patients (n = 84, 16%) lived in villages with HBC available. Living in a village with HBC was not significantly associated with treatment outcomes; 80% of patients in a village with HBC had favorable outcomes, compared to 82% of patients in a village without HBC (P = 0.6 by χ2). In bivariable analysis, lower BMI (P<0.001), low CD4+ cell count (P = 0.02), low Hgb concentration (P = 0.02), and older age at ART initiation (P = 0.047) were associated with unfavorable outcomes. In multivariable analysis, low BMI remained associated with unfavorable outcomes (P<0.001). Conclusions We did not find that living in a village with HBC available was associated with improved treatment outcomes. We speculate that the ART clinic's rigorous treatment preparation before ART initiation and continuous adherence counseling during ART create a motivated group of patients whose outcomes did not improve with additional HBC support. An alternative explanation is that the quality of the HBC program is suboptimal. PMID:23236351

  2. U-Pb sensitive high-resolution ion microprobe (SHRIMP) zircon geochronology of granitoid rocks in eastern Zambia: Terrane subdivision of the Mesoproterozoic Southern Irumide Belt

    NASA Astrophysics Data System (ADS)

    Johnson, S. P.; de Waele, B.; Liyungu, K. A.

    2006-12-01

    The Southern Irumide Belt (SIB) is a structurally and metamorphically complex region of mainly Mesoproterozoic igneous rocks in southern and eastern Zambia, northern Mozambique and northern Malawi that was strongly overprinted in the Neoproterozoic to Cambrian Damara-Lufilian-Zambezi (DLZ) orogeny. Because of the scarcity of geological data from this region, little is known about the timing of tectonomagmatic events; however, this belt has traditionally been considered to be a southerly continuation of the adjacent Irumide Belt (IB). Here we provide 27 new U-Pb sensitive high-resolution ion microprobe (SHRIMP) zircon ages that constrain the Paleoproterozoic to Cambrian tectonomagmatic history of this belt and which, for the first time, allow for direct comparison with the adjoining IB. The SIB is floored by a predominantly late Paleoproterozoic basement, which was intruded by voluminous continental margin arc-related magmas between 1.09 and 1.04 Ga and accompanied by high-temperature/low-pressure metamorphism. In contrast, the IB is floored by a late Paleoproterozoic basement that is generally older than 2.0 Ga, contains significant mid-Mesoproterozoic plutonic rocks that are not present within the SIB, and underwent moderate-pressure/moderate-temperature compressional metamorphism and S-type granitoid magmatism at circa 1.02 Ga. These data indicate that the crust underlying the SIB is not a continuation of that underlying the IB but represents an allocthonous continental margin arc terrane juxtaposed against the Congo-Tanzania-Bangweulu Craton during the late Mesoproterozoic Irumide orogeny. Reworking and shearing of the SIB occurred during the DLZ orogen, resulting in the present-day architecture as a series of stacked terranes which have been exploited by voluminous posttectonic granitoid batholiths.

  3. 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

  4. 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

  5. Non-Uptake of HIV Testing in Children at Risk in Two Urban and Rural Settings in Zambia: A Mixed-Methods Study

    PubMed Central

    Ntalasha, Harriet; Musheke, Maurice

    2016-01-01

    This article investigates reasons why children who were considered at risk of HIV were not taken for HIV testing by their caregivers. Qualitative and quantitative data collected in Zambia from 2010–11 revealed that twelve percent of caregivers who stated that they had been suspecting an HIV infection in a child in their custody had not had the child tested. Fears of negative reactions from the family were the most often stated reason for not testing a child. Experience of pre-existing conflicts between the couple or within the family (aOR 1.35, 95% CI 1.00–1.82) and observed stigmatisation of seropositive children in one’s own neighbourhood (aOR 1.69, 95% CI1.20–2.39) showed significant associations for not testing a child perceived at risk of HIV. Although services for HIV testing and treatment of children have been made available through national policies and programmes, some women and children were denied access leading to delayed diagnosis and treatment–not on the side of the health system, but on the household level. Social norms, such as assigning the male household head the power to decide over the use of healthcare services by his wife and children, jeopardize women’s bargaining power to claim their rights to healthcare, especially in a conflict-affected relationship. Social norms and customary and statutory regulations that disadvantage women and their children must be addressed at every level–including the community and household–in order to effectively decrease barriers to HIV related care. PMID:27280282

  6. 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

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

    PubMed Central

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

    2009-01-01

    Objectives Single-dose nevirapine (SDNVP) for prevention of mother-to-child HIV transmission selects mutations conferring resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy. We investigated mortality and virologic and clinical outcomes following introduction of antiretroviral treatment (ART) among a cohort of women given SDNVP. Methods When ART programs were introduced in 2004 in Lusaka, Zambia, we were completing a trial of infant feeding which involved following HIV-infected women who received SDNVP between 2001 and 2005. Women still in follow-up or who could be contacted were evaluated for eligibility for ART (CD4 count <200 or <350 and WHO stage ≥ 3) and started on NNRTI-based therapy if eligible. We compared mortality in the cohort of women before and after ART access, and examined, among women initiating ART, whether virologic response was better allowing a longer time to elapse between SDNVP and treatment initiation. Results In the cohort of 872 women, mortality more than halved after ART became available (relative hazard [RH] = 0.46 95% CI: 0.23–0.91 p=0.03). Of 161 SDNVP-exposed women followed on NNRTI-based ART, 70.8% suppressed (viral load <400 copies/ml). Only 3/8 (37.5%) women SDNVP-exposed <6 months of starting therapy suppressed compared to 13/22 (59.1%) who started 6–12 months, 44/61 (72.1 %) 12–24 months, and 54/70 (77.1%) >24 months post-exposure (chi-square trend p=0.01). Conclusions Most SDNVP-exposed women respond well to NNRTI-based therapy but there was an attenuation of therapy efficacy that persisted to 12 months after exposure. Women should be screened for ART eligibility during pregnancy and started on effective regimens before delivery. PMID:19506483

  8. Evaluating Opportunities for Achieving Cost Efficiencies Through the Introduction of PrePex Device Male Circumcision in Adult VMMC Programs in Zambia and Zimbabwe

    PubMed Central

    Chintu, Naminga; Yano, Nanako; Mugurungi, Owen; Tambatamba, Bushimbwa; Ncube, Gertrude; Xaba, Sinokuthemba; Mpasela, Felton; Muguza, Edward; Mangono, Tichakunda; Madidi, Ngonidzashe; Samona, Alick; Tagar, Elva; Hatzold, Karin

    2016-01-01

    Background: Results from recent costing studies have put into question potential Voluntary Medical Male Circumcision (VMMC) cost savings with the introduction of the PrePex device. Methods: We evaluated the cost drivers and the overall unit cost of VMMC for a variety of service delivery models providing either surgical VMMC or both PrePex and surgery using current program data in Zimbabwe and Zambia. In Zimbabwe, 3 hypothetical PrePex only models were also included. For all models, clients aged 18 years and older were assumed to be medically eligible for PrePex and uptake was based on current program data from sites providing both methods. Direct costs included costs for consumables, including surgical VMMC kits for the forceps-guided method, device (US $12), human resources, demand creation, supply chain, waste management, training, and transport. Results: Results for both countries suggest limited potential for PrePex to generate cost savings when adding the device to current surgical service delivery models. However, results for the hypothetical rural Integrated PrePex model in Zimbabwe suggest the potential for material unit cost savings (US $35 per VMMC vs. US $65–69 for existing surgical models). Conclusions: This analysis illustrates that models designed to leverage PrePex's advantages, namely the potential for integrating services in rural clinics and less stringent infrastructure requirements, may present opportunities for improved cost efficiency and service integration. Countries seeking to scale up VMMC in rural settings might consider integrating PrePex only MC services at the primary health care level to reduce costs while also increasing VMMC access and coverage. PMID:27331598

  9. 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)

    Zurbrügg, 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,δ18O-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 <50μM 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.

  10. Good Health and Moral Responsibility: Key Concepts Underlying the Interpretation of Treatment as Prevention in South Africa and Zambia Before Rolling Out Universal HIV Testing and Treatment.

    PubMed

    Bond, Virginia; Hoddinott, Graeme; Viljoen, Lario; Simuyaba, Melvin; Musheke, Maurice; Seeley, Janet

    2016-09-01

    Gauging community responses to the WHO 2015 recommendation to provide antiretroviral treatment (ART) to all people living with HIV (PLHIV) is critical. There is limited qualitative evidence on the acceptability of this Universal Test and Treat (UTT) strategy or community understanding of the impact of ART on reducing HIV transmission, promoted as Treatment as Prevention (TasP). This article explores early understanding of UTT and TasP in 21 urban communities in South Africa and Zambia in 2013 before a community randomized trial of combination prevention-HPTN 071 (PopART). It draws on participatory research conducted in each community, which carried out group discussions and interviews with 1202 respondents and 203 structured observations. Participants were largely unfamiliar with the concepts of UTT and TasP. They were concerned about an accompanying de-emphasis on sexual behavior change. Treatment and prevention seemed, at first glance, to be experienced separately. With the exception of the prevention of mother-to-child transmission, prevention seldom came into discussions about ART. This was partly because this science had not yet been explained to many and also because it was not an easy fit. Contemplating the link between treatment and prevention, participants emphasized both PLHIV taking care of themselves through good health and preventing disease progression and the moral responsibility of PLHIV to prevent HIV transmission. To avoid igniting moralizing and blaming when introducing UTT and TasP, we should capitalize on the "taking care of yourself" legacy while boosting public responsibility through broad antistigma education and patient empowerment efforts.

  11. Good Health and Moral Responsibility: Key Concepts Underlying the Interpretation of Treatment as Prevention in South Africa and Zambia Before Rolling Out Universal HIV Testing and Treatment.

    PubMed

    Bond, Virginia; Hoddinott, Graeme; Viljoen, Lario; Simuyaba, Melvin; Musheke, Maurice; Seeley, Janet

    2016-09-01

    Gauging community responses to the WHO 2015 recommendation to provide antiretroviral treatment (ART) to all people living with HIV (PLHIV) is critical. There is limited qualitative evidence on the acceptability of this Universal Test and Treat (UTT) strategy or community understanding of the impact of ART on reducing HIV transmission, promoted as Treatment as Prevention (TasP). This article explores early understanding of UTT and TasP in 21 urban communities in South Africa and Zambia in 2013 before a community randomized trial of combination prevention-HPTN 071 (PopART). It draws on participatory research conducted in each community, which carried out group discussions and interviews with 1202 respondents and 203 structured observations. Participants were largely unfamiliar with the concepts of UTT and TasP. They were concerned about an accompanying de-emphasis on sexual behavior change. Treatment and prevention seemed, at first glance, to be experienced separately. With the exception of the prevention of mother-to-child transmission, prevention seldom came into discussions about ART. This was partly because this science had not yet been explained to many and also because it was not an easy fit. Contemplating the link between treatment and prevention, participants emphasized both PLHIV taking care of themselves through good health and preventing disease progression and the moral responsibility of PLHIV to prevent HIV transmission. To avoid igniting moralizing and blaming when introducing UTT and TasP, we should capitalize on the "taking care of yourself" legacy while boosting public responsibility through broad antistigma education and patient empowerment efforts. PMID:27610464

  12. The use of Time Domain Electromagnetic method and Continuous Vertical Electrical Sounding to map groundwater salinity in the Barotse sub-basin, Zambia

    NASA Astrophysics Data System (ADS)

    Chongo, M.; Wibroe, J.; Staal-Thomsen, K.; Moses, M.; Nyambe, I. A.; Larsen, F.; Bauer-Gottwein, P.

    This paper describes the results from the application of two geophysical exploration techniques, Time Domain Electromagnetic (TDEM) and Continuous Vertical Electrical Sounding (CVES) that have proved effective in mapping groundwater salinity variations within the sedimentary formations of the Barotse sub basin in the Western Province of Zambia. TDEM was used to map groundwater salinity variations on a regional scale, whereas CVES was used at the local scale to investigate freshwater-saltwater distribution in an ephemeral river valley. On a regional scale, salt water occurrence was shown to be present mainly on the south-eastern portions of the basin, which are situated in a rift that forms a tripe junction with the East African Rift Valley. The general geophysical model indicates an aquifer with saline water with a thickness of about 40 m with resistivity variations less than 35 Ωm (more than 500 mg/l of Cl - based on a formation factor of 5), overlain by an unconfined freshwater aquifer of about 10 m thickness with resistivities in excess of 70 Ωm (i.e. less than 250 mg/l of Cl - based on a formation factor of 5). The origin of the saline water is hypothesized to be related to the evapo-concentration of salts in interdune deposits, which were subsequently buried due to dune migration about 32 to 4 thousands of years ago or kilo annums (ka). The occurrence of saline groundwater could also possibly be linked to evaporation of a former Lake Paleo Makgadikgadi, an extensive endorheic lake system that once covered large parts of Southern Africa. Locally, a thin freshwater aquifer was observed in an ephemeral river valley, indicating recent recharge of river water into a pre-existing saline environment.

  13. "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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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 Women’s and Children’s 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

  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 women’s spouses for couple HIV testing resulting in some men feeling ‘trapped’ or ‘forced’ to test as part of their paternal responsibility. Couple testing had some positive outcomes, notably disclosure of HIV status to marital partner, renewed commitment to marital relationship, uptake of and adherence to treatment and formation of new social networks. However, there were also negative repercussions including abandonment, verbal abuse and cessation of sexual relations. Its promotion also did not always lead to safe sex as this was undermined by gendered power relationships and the desires for procreation and sexual intimacy. Conclusions Couple HIV testing provides enormous bio-medical and social benefits and should be encouraged

  20. 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: 0.30–0.73, p = 0.001) and 54% among all household members (LPR = 0.46, 95% CI: 0.30–0.70, p<0.001). While reduced WAZ was associated with reported diarrhea (−0.26; 95% CI: −0.37 to −0.14, p<0.001), there was no difference in WAZ between intervention and control groups. Conclusion In this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was

  1. 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 Zambia’s 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

  2. 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

  3. Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-he