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Sample records for zambia lusaka zambia

  1. Medical Journal of Zambia - Lusaka

    African Journals Online (AJOL)

    The Medical Journal of Zambia is a peer-reviewed quarterly journal intended for the publication of papers from all specialities of medicine (Internal Medicine, Surgery, Paediatrics and Obstetrics & Gynaecology) and their subspecialties, basic sciences, public health, social medicine and medical politics. The journal also ...

  2. Zambia.

    Science.gov (United States)

    1988-08-01

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

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

    OpenAIRE

    Saasa, Ngonda; Nalubamba, King Shimumbo; M’kandawire, Ethel; Siwila, Joyce

    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. Antibod...

  4. Cholera Epidemic - Lusaka, Zambia, October 2017-May 2018.

    Science.gov (United States)

    Sinyange, Nyambe; Brunkard, Joan M; Kapata, Nathan; Mazaba, Mazyanga Lucy; Musonda, Kunda G; Hamoonga, Raymond; Kapina, Muzala; Kapaya, Fred; Mutale, Lwito; Kateule, Ernest; Nanzaluka, Francis; Zulu, James; Musyani, Chileshe Lukwesa; Winstead, Alison V; Davis, William W; N'cho, Hammad S; Mulambya, Nelia L; Sakubita, Patrick; Chewe, Orbie; Nyimbili, Sulani; Onwuekwe, Ezinne V C; Adrien, Nedghie; Blackstock, Anna J; Brown, Travis W; Derado, Gordana; Garrett, Nancy; Kim, Sunkyung; Hubbard, Sydney; Kahler, Amy M; Malambo, Warren; Mintz, Eric; Murphy, Jennifer; Narra, Rupa; Rao, Gouthami G; Riggs, Margaret A; Weber, Nicole; Yard, Ellen; Zyambo, Khozya D; Bakyaita, Nathan; Monze, Namani; Malama, Kennedy; Mulwanda, Jabbin; Mukonka, Victor M

    2018-05-18

    On October 6, 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, from stool specimens from two patients with acute watery diarrhea. The two patients had gone to a clinic in Lusaka, the capital city, on October 4. Cholera cases increased rapidly, from several hundred cases in early December 2017 to approximately 2,000 by early January 2018 (Figure). In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples. In late December 2017, a number of water-related preventive actions were initiated, including increasing chlorine levels throughout the city's water distribution system and placing emergency tanks of chlorinated water in the most affected neighborhoods; cholera cases declined sharply in January 2018. During January 10-February 14, 2018, approximately 2 million doses of oral cholera vaccine were administered to Lusaka residents aged ≥1 year. However, in mid-March, heavy flooding and widespread water shortages occurred, leading to a resurgence of cholera. As of May 12, 2018, the outbreak had affected seven of the 10 provinces in Zambia, with 5,905 suspected cases and a case fatality rate (CFR) of 1.9%. Among the suspected cases, 5,414 (91.7%), including 98 deaths (CFR = 1.8%), occurred in Lusaka residents.

  5. Filarial infections in domestic dogs in Lusaka, Zambia

    DEFF Research Database (Denmark)

    Siwila, Joyce; Mwase, Enala T.; Nejsum, Peter

    2015-01-01

    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....

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

    Science.gov (United States)

    Saasa, Ngonda; Nalubamba, King Shimumbo; M'kandawire, Ethel; Siwila, Joyce

    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 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.

  7. Human impact on Karst: the example of Lusaka (Zambia.

    Directory of Open Access Journals (Sweden)

    De Waele Jo

    2003-01-01

    Full Text Available Lusaka, the capital of Zambia with over 2,000,000 inhabitants, is built on an extensive plateau composed mainly of schists and dolomitic marbles, constituting a very important aquifer that provides the city with almost half of its drinking water needs. Recent demographic growth, leading to uncontrolled urban expansion, and mismanagement of the water resource and of urban waste has lead, in the past 20 years, to an overexploitation of the aquifer and to a generalised water quality depletion, putting in serious danger the future social and economical development of the capital. This third world city has, for these reasons, become a terrifying example of human impact on a vulnerable karst environment, and if no measures will be taken in the very near future, quality of life in the city will be at serious risk.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Ngonda Saasa

    2016-01-01

    Full Text Available 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.

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

    Science.gov (United States)

    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.

  11. Creating "a place to feel at home" : Christian church life and social control in Lusaka, Zambia (1970s)

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.; Binsbergen, van W.M.J.; Konings, P.J.J.; Hesseling, G.S.C.M.

    2000-01-01

    In this chapter the author explores how the inhabitants of Lusaka, the capital of Zambia, have used their church organization to create a viable social texture for themselves, serving political, economic and kinship goals way beyond the letter of the gospel. In Zambia, towns only came into being

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

    Science.gov (United States)

    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 (pcaninum 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. © 2011 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    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.

  14. Evaluation of service quality in family planning clinics in Lusaka, Zambia.

    Science.gov (United States)

    Hancock, Nancy L; Vwalika, Bellington; Sitali, Elizabeth Siyama; Mbwili-Muleya, Clara; Chi, Benjamin H; Stuart, Gretchen S

    2015-10-01

    To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach. We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up. Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%). This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability. Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement. Copyright © 2015

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

    Science.gov (United States)

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

    2004-06-01

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

  16. Mental Health of HIV Positive Adolescents in Zambia ... - Lusaka

    African Journals Online (AJOL)

    Objectives: To assess the mental health of HIV positive Zambian adolescents by comparing with Zambian school sample and an age matched British normative sample. Design: This was a cross-sectional study of adolescents from school in the age range of 11-15 and HIV positive adolescents from clinics in Lusaka.

  17. Chlamydia and gonorrhea infections in HIV-positive women in urban Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Maria L Alcaide

    2012-01-01

    Full Text Available Background: Sexually transmitted infections (STIs remain an important public health issue in sub-Saharan Africa. STIs in HIV-positive women are associated not only with gynecological complications but with increased risk of HIV transmission to HIV-negative partners and newborns. Aims: The aims of this study are to determine the prevalence of chlamydia (CT and gonorrhea (GC and examine the demographic characteristics and risk behaviors associated with these STIs in a group of HIV-positive women in Lusaka, Zambia. Settings and Design: Cross-sectional study of a sample of HIV-infected women enrolled in two large studies conducted in urban Lusaka, Zambia. Materials and Methods: HIV-seropositive women (n = 292 were assessed for demographic and behavioral risk factors and tested for CT and GC. Univariate analysis was used to determine the demographic characteristics and risk behaviors associated with having CT or GC. Results: The identified prevalence of CT was 1% and of GC was 1.4%. There was an association of CT/GC with the use of alcohol before sex (OR = 9.I, CI = 0.59-0.15, P = 0.03. Conclusions: Rates of CT and GC are described in this sample of HIV-positive women. While being in HIV care may serve to increase medical care and condom use, alcohol use should be addressed in this population.

  18. Translation and sustainability of an HIV prevention intervention in Lusaka, Zambia.

    Science.gov (United States)

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

    2014-06-01

    The scale-up of HIV treatment programs in sub-Saharan Africa necessitates creative solutions that do not further burden the health system to meet global initiatives in prevention and care. This study assessed the work environment and impact of providing a behavioral risk reduction intervention in six community health centers (CHCs) in Lusaka, Zambia; opportunities and challenges to long-term program sustainability were identified. CHC staff participants (n = 82) were assessed on perceived clinic burden, job satisfaction, and burnout before and after implementation of the intervention. High levels of clinic burden were identified; however, no increase in perceived clinic burden or staff burnout was associated with providing the intervention. The intervention was sustained at the majority of CHCs and also adopted at additional clinics. Behavioral interventions can be successfully implemented and maintained in resource-poor settings. Creative strategies to overcome structural and economic challenges should be applied to enhance translation research.

  19. Etiologic pattern of genital ulcers in Lusaka, Zambia: has chancroid been eliminated?

    Science.gov (United States)

    Makasa, Mpundu; Buve, Anne; Sandøy, Ingvild Fossgard

    2012-10-01

    Genital ulcers are a public health problem in developing countries. The World Health Organization recommends the use of syndromic guidelines for sexually transmitted infection treatment in resource-constrained countries. Monitoring local etiologies provides information that may aid policy for sexually transmitted infection treatment. We investigated the etiology of genital ulcer disease among outpatients in Lusaka, Zambia. Swabs from genital ulcers of 200 patients were tested using polymerase chain reaction for Treponema pallidum, herpes simplex virus types 1 (HSV-1) and 2 (HSV-2), Haemophilus ducreyi, and Chlamydia trachomatis. The prevalence of the detected pathogens was as follows; HSV-2, 28%; T. pallidum, 11.5%; C. trachomatis, 3%; HSV-1, 0.5%; and H. ducreyi, 0%. Coinfection with HSV-2 and T. pallidum was 1.5%, and coinfection of HSV-2 and C. trachomatis was 1%. In 55% of the patients, no etiologic diagnosis could be established. H. ducreyi was not detected, whereas HSV-2 and T. pallidum were the commonest pathogens. Nondetection of H. ducreyi requires further studies. If the present findings are validated, treatment guidelines would require to be revised in Zambia.

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

    Science.gov (United States)

    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.

  1. Liver scanning using indium-113m at the University Teaching Hospital, Lusaka, Zambia

    Energy Technology Data Exchange (ETDEWEB)

    Mulaisho, C [Nuclear Medicine Unit, Department of Medicine, University of Zambia, Lusaka, Zambia; Mumba, K N [Radio-isotope Research Unit, National Council for Scientific Research, Lusaka, Zambia

    1981-11-21

    Liver scanning using the radio-isotope indium-113m, can now be routinely perfomed at the University Teaching Hospital, Lusaka, Zambia. The dose used is 1 - 4 mCi. Liver scans have been performed on 48 subjects, including 10 healthy individuals 16 patients with histologically proven hepatocellular carcinoma, 11 with clinical and laboratory evidence of portal hypertension and 11 with miscellaneous illnesses. Seven representative scans are illustrated. The procedure is easy, and gives a fairly accurate functional estimate of Kupffer cell mass. In hepatoma the scan may be either larger than or smaller than normal and reflects more accurately the residual function of the Kupffer cells. In cirrhosis of the liver with portal hypertention, residual Kupffer cell mass is small. Consequently, most of the indium-113m is taken up by the splenic reticulo-endothelial system, resulting in a large spleen scan. This technique, although fraught with major limitations, is a useful additional diagnostic tool in the management of chronic liver disease.

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

    Directory of Open Access Journals (Sweden)

    Nancy L. Hancock

    2015-01-01

    Full Text Available 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.

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

    Science.gov (United States)

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

    2013-10-01

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

  4. Theory-based formative research on oral rehydration salts and zinc use in Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Katie Greenland

    2016-04-01

    Full Text Available Abstract Background A theoretically grounded formative research study was carried out to investigate behaviour related to the use of Oral Rehydration Salts (ORS and zinc tablets. The purpose was to inform the design of the behaviour change component of the Programme for Awareness and Elimination of Diarrhoea in Lusaka Province, Zambia, which aims to reduce childhood morbidity and mortality from diarrhoeal disease. Methods Fourteen behaviour trials were conducted among caregivers of children under-five with diarrhoea. Caregivers were recruited from two clinics situated in rural and peri-urban Lusaka. Trials took ten days and data were captured using video, observation and repeated interviews. Additional data were collected through focus group discussions with mothers, observations in clinics and pharmacies and interviews with clinic and pharmacy staff. Findings were organised according to categories of behavioural determinants from Evo-Eco theory. Results Participants were all familiar with ORS and most knew its purpose. ORS use was motivated by symptoms of dehydration, rather than the start of a diarrhoea episode, and was stopped when the child had visibly recovered energy. Only four of 14 behaviour trial participants were observed to correctly prepare ORS. Errors were mainly associated with measurement, resulting in a solution that was too concentrated. ORS was not observed to be given to children at clinics. Although zinc was unknown in this population, it was positively received by mothers keen to learn whether zinc would work better than alternative treatments to stop diarrhoea. Conclusions ORS was sub-optimally prepared and used at home. It was not used while waiting to be seen at a clinic. In homes, the behaviour change intervention should promote early and continued use of correctly prepared ORS. In the longer-term, these behaviours may best be encouraged by changing the product design or sachet size. Despite its unfamiliarity, this

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

    Science.gov (United States)

    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.

  6. The epidemiology and small-scale spatial heterogeneity of urinary schistosomiasis in Lusaka province, Zambia

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    Christopher Simoonga

    2008-11-01

    Full Text Available In line with the aims of the “National Bilharzia Control Programme” and the “School Health and Nutrition Programme” in Zambia, a study on urinary schistosomiasis was conducted in 20 primary schools of Lusaka province to further our understanding of the epidemiology of the infection, and to enhance spatial targeting of control. We investigated risk factors associated with urinary schistosomiasis, and examined small-scale spatial heterogeneity in prevalence, using data collected from 1,912 schoolchildren, 6 to 15-year-old, recruited from 20 schools in Kafue and Luangwa districts. The risk factors identified included geographical location, altitude, normalized difference vegetation index (NDVI, maximum temperature, age, sex of the child and intermediate host snail abundance. Three logistic regression models were fitted assuming different random effects to allow for spatial structuring. The mean prevalence rate was 9.6%, with significance difference between young and older children (odds ratio (OR = 0.71; 95% confidence interval (CI = 0.51-0.96. The risk of infection was related to intermediate host snail abundance (OR = 1.03; 95% CI = 1.00-1.05 and vegetation cover (OR = 1.04; 95% CI = 1.00-1.07. Schools located either on the plateau and the valley also differed in prevalence and intensity of infection for moderate infection to none (OR = 1.64; 95% CI = 1.36- 1.96. The overall predictive performance of the spatial random effects model was higher than the ordinary logistic regression. In addition, evidence of heterogeneity of the infection risk was found at the micro-geographical level. A sound understanding of small-scale heterogeneity, caused by spatial aggregation of schoolchildren, is important to inform health planners for implementing control schistosomiasis interventions.

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

    Science.gov (United States)

    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.

  8. A retrospective study of HIV, antiretroviral therapy, and pregnancy-associated hypertension among women in Lusaka, Zambia.

    Science.gov (United States)

    Stoner, Marie C D; Vwalika, Bellington; Smid, Marcela C; George, Shalin; Chi, Benjamin H; Stringer, Elizabeth M; Stringer, Jeffrey S A

    2016-09-01

    To investigate the association between HIV, antiretroviral therapy (ART), and pregnancy-associated hypertension (PAH) in an HIV-endemic setting. A retrospective cohort study was undertaken of pregnant women for whom information was recorded between February 2006 and December 2012 in the Zambia Electronic Perinatal Record System, which captures data from 25 facilities in Lusaka, Zambia. PAH was defined as eclampsia, pre-eclampsia, hypertension, or elevated blood pressure (>140/80mm Hg) during delivery admission. Logistic regression estimated the odds of PAH among women by HIV serostatus, and by most recent CD4 T lymphocyte count and ART status among women with HIV infection. Among 249 771 women included in the analysis, 5354 (2.1%) had PAH. Compared with women without HIV infection, women with HIV infection not receiving ART had lower odds of PAH (adjusted odds ratio [AOR] 0.86, 95% confidence interval 0.78-0.95), whereas those with HIV infection who had initiated ART had higher odds of PAH (AOR 1.15, 95% CI 1.01-1.32). No association was found between PAH and timing of ART initiation or CD4 lymphocyte count. In a large African urban cohort, women with untreated HIV infection had the lowest odds of PAH. Treatment with ART could increase PAH risk beyond that of women without HIV infection and those with untreated infection. Published by Elsevier Ireland Ltd.

  9. Opportunities and challenges of E-learning in Zambia

    African Journals Online (AJOL)

    1University of Zambia (UNZA), Department of Medical Education, Lusaka, Zambia. 2 LinkNet ... are teacher centred and often limiting students input. .... challenge of measuring their ... developed locally through the College of Surgeons. 13.

  10. Evaluation of a task-shifting strategy involving peer educators in HIV care and treatment clinics in Lusaka, Zambia

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    Lonny J. Born

    2012-03-01

    Full Text Available Rapid expansion of antiretroviral therapy (ART and a shortage of health care workers (HCWs required the implementation of a peer educator (PE model as part of a task-shifting strategy in Lusaka District clinics. The purpose of this study was to evaluate patient and staff perceptions regarding whether the PE program: a relieved the workload on professional HCWs; and b delivered services of acceptable quality. Qualitative and quantitative data were gathered from five primary care clinics delivering ART in Lusaka, Zambia. Closed surveys were conducted with 148 patients receiving ART, 29 PEs, and 53 HCWs. Data was imported into Microsoft Excel to calculate descriptive statistics. Six focus group discussions and eight key informant (KI interviews were conducted, recorded, transcribed, and coded to extract relevant data. Survey results demonstrated that 50 of 53 (96.1% HCWs agreed PEs reduced the amount of counseling duties required of HCWs. HCWs felt that PEs performed as well as HCWs in counseling patients (48 of 53; 90.6% and that having PEs conduct counseling enabled clinical staff to see more patients (44 of 53; 83%. A majority of patients (141 of 148; 95.2% agreed or strongly agreed that PEs were knowledgeable about ART, and 89 of 144 (61.8% expressed a high level of confidence with PEs performing counseling and related tasks. Focus group and KI interviews supported these findings. PEs helped ease the work burden of HCWs and provided effective counseling, education talks, and adherence support to patients in HIV care. Consideration should be given to formalizing their role in the public health sector.

  11. Association between hepatitis B co-infection and elevated liver stiffness among HIV-infected adults in Lusaka, Zambia.

    Science.gov (United States)

    Vinikoor, Michael J; Mulenga, Lloyd; Siyunda, Alice; Musukuma, Kalo; Chilengi, Roma; Moore, Carolyn Bolton; Chi, Benjamin H; Davies, Mary-Ann; Egger, Matthias; Wandeler, Gilles

    2016-11-01

    To describe liver disease epidemiology among HIV-infected individuals in Zambia. We recruited HIV-infected adults (≥18 years) at antiretroviral therapy initiation at two facilities in Lusaka. Using vibration controlled transient elastography, we assessed liver stiffness, a surrogate for fibrosis/cirrhosis, and analysed liver stiffness measurements (LSM) according to established thresholds (>7.0 kPa for significant fibrosis and >11.0 kPa for cirrhosis). All participants underwent standardised screening for potential causes of liver disease including chronic hepatitis B (HBV) and C virus co-infection, herbal medicine, and alcohol use. We used multivariable logistic regression to identify factors associated with elevated liver stiffness. Among 798 HIV-infected patients, 651 had a valid LSM (median age, 34 years; 53% female). HBV co-infection (12%) and alcohol use disorders (41%) were common and hepatitis C virus co-infection (7.0 kPa (all P 11.0 kPa. Among HIV-HBV patients, those with elevated ALT and HBV viral load were more likely to have significant liver fibrosis than patients with normal markers of HBV activity. HBV co-infection was the most important risk factor for liver fibrosis and cirrhosis and should be diagnosed early in HIV care to optimise treatment outcomes. © 2016 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    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.

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

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    Emmanuel Mwila Musenge

    2016-01-01

    Full Text Available 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.

  14. Engaging with Community Advisory Boards (CABs) in Lusaka Zambia: perspectives from the research team and CAB members.

    Science.gov (United States)

    Mwinga, Alwyn; Moodley, Keymanthri

    2015-06-03

    The use of a Community Advisory Board (CAB) is one method of ensuring community engagement in community based research. To identify the process used to constitute CABs in Zambia, this paper draws on the perspectives of both research team members and CAB members from research groups who used CABs in Lusaka. Enabling and restricting factors impacting on the functioning of the CAB were identified. All studies approved by the University of Zambia Bioethics Research Committee (UBNZABREC) from 2008 - 2012 were reviewed to identify those studies that were likely to include a CAB. Eight teams with studies that included a CAB were identified. For each of these studies, consent was obtained to conduct an informal interview with a research team member and to obtain contact details for one CAB member. In total 14 interviews were conducted with 8 research team members and 6 CAB members from 12-30 August 2013. Identification of potential CAB members from the community and their participation in developing the terms of reference for CABs was perceived to have contributed to the success of the CAB. Due to the trust that the community had in members of their community the CABs were then in a stronger position to influence community participation in the research. Training of CAB members was identified as a factor that enhanced the functioning of a CAB. Lack of commitment and low literacy levels of CAB members posed a threat to the role of the CAB. Although compensation in the form of a stipend was not provided, CAB members were provided with transport reimbursements for attending meetings. Selection of CAB members from within the community contributed to community confidence in the CAB, enhancing its ability to act as an effective link between study team and community. This contributed positively to the conduct of the study and enhanced community awareness and acceptance of the research. However, establishment of study specific CABs has the potential to compromise CAB independence

  15. Biogas in Lusaka ? Feasibility study: Possibilities to extract and utilise biogas from municipal solid waste in Lusaka, Zambia

    Energy Technology Data Exchange (ETDEWEB)

    Hermansson, Emma; Nelson, Sara

    2000-07-01

    The objective of this study was to investigate possibilities to extract and utilise biogas from municipal solid waste in Lusaka, considering environmental, financial, technological and social aspects. The outcome provided three recommendations: 1 - a new landfill with biocells. The only legal tipping site in Lusaka has been condemned and there are plans for the construction of a new landfill. We recommend that the new site should be a sanitary landfill with full gas and leachate management. Thus, the costs for extracting biogas would be included in the investments for the landfill. It would be advisable to start with a simple end-use application during a running-in period when the technique and organisation is tested. Utilising the gas for internal heating or in a nearby industry will probably be the easiest and cheapest choice. 2 - a pilot project in a high-density area for co-dispersal of latrine and putrescibles. The sanitary conditions in high-density areas, where pit-latrines are the principal sanitary method, are insufficient. It is of great importance to master the situation in order to avoid further epidemics and water pollution. Compared to other solutions we consider a fermentation digester to be the best alternative. The main purpose for this pilot plant would, at least in the initial stage, be to investigate whether this method is a feasible solution for the problems with pit latrines. The aim of the end-use application could then merely be to demonstrate and inform the public about biogas. 3 - further investigations regarding the possibilities to extract and utilise biogas in industries and from manure, The estimated biogas potential from industries and manure and droppings from livestock and chickens is much bigger than from municipal solid waste and should be exploited. The end-use applications would probably be for internal use (heat and/or electricity). This was not investigated any further in our study.

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

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    Nsakashalo-Senkwe Mutale

    2011-01-01

    Full Text Available Abstract Background Developing countries are undergoing an epidemiological transition, from Communicable or Infectious to 'Non-Communicable' diseases (NCDs, such that cardiovascular disease, chronic respiratory diseases, cancer, and diabetes were responsible for 60% of all deaths globally in 2005, with more than 75% of these deaths occurring in developing countries. A survey was conducted to determine among other objectives the prevalence of diabetes and its association with physical fitness and biological factors. Methods A cross sectional study utilizing a modified World Health Organization's STEPwise approach to surveillance of NCDs was conducted in Lusaka district, Zambia. A multi-stage cluster sampling technique was used to select study participants of age 25 years or older. All eligible members of a household that was selected were invited to participate in the study. Unadjusted odds ratios (OR, and adjusted odds ratios (AOR together with their 95% Confidence Intervals (CI were obtained using Complex samples logistic regression Results A total of 1928 individuals participated in the survey, of which 33.0% were males. About half of the participants were of age 25-34 years (53.2%, and about a third of the respondents had attained secondary level of education (35.8%. The combined prevalence for impaired glucose level or diabetes was 4.0%. Age and mild hypertension were significantly associated with impaired levels of glucose or diabetes. Compared to participants in the age group 25-34 years, older participants were more likely to have impaired glucose level or diabetes (AOR = 2.49 (95%CI [1.35, 2.92] for 35-44 years age group, and AOR = 3.80 (95%CI [2.00, 7.23] for 45 + years age group. Mild hypertension was associated with impaired glucose level or diabetes (AOR = 2.57 (95%CI [1.44, 4.57]. Conclusions The prevalence of diabetes in Lusaka district has not reached an alarming level and it is now that interventions targeting the younger age

  17. Prevention of Congenital Syphilis Through Antenatal Screenings in Lusaka, Zambia: A Systematic Review

    Science.gov (United States)

    Rehman, Sabah

    2018-01-01

    Congenital syphilis is one of the preventable diseases caused by the gram-negative bacteria Treponema pallidum; yet, it imposes a serious global health and economic burden, with more than half of the cases resulting in serious adverse outcomes, including infant mortality. Mother-to-child transmission (MTCT) of syphilis is estimated at 3.6 million adjusted life years (DALYs) and around $309 million in medical costs. In 2006, an estimated 9.7 million children of age less than five years died in developing countries; almost four million were neonatal deaths. There were 3.2 million stillbirths globally, among whom 95% were in the developing countries. In sub-Saharan Africa, there is an estimated 2.7% (0.1%-10.3%) of pregnant women infected with syphilis, representing more than 900,000 pregnancies at risk each year. There were many non-specific and specific diagnostic tests used in the past, which required laboratory equipment and electricity, but there are many newer tests available now that provide rapid results with high sensitivity and specificity, e.g., the immunochromatographic strip (ICS) and rapid syphilis tests (RST). Early syphilis can be completely eliminated with a single injection of penicillin, which is readily available, cheap, and highly effective, and treating pregnant women with penicillin is 98% effective at preventing congenital syphilis. Targeting women at a high risk of having syphilis makes universal screening in antenatal programs the most efficacious way to prevent syphilis-associated morbidity and mortality. The potential for a program to prevent congenital syphilis in the perinatal, neonatal, and postnatal periods is evident. While considering resource allocation to child survival programs in areas where the prevalence of syphilis is high, officials need to include antenatal syphilis screening, using rapid tests and treatment at the first contact of the mother with the health care system. In countries like Zambia and other resource

  18. Use of task-shifting to rapidly scale-up HIV treatment services: experiences from Lusaka, Zambia

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    Chi Harmony F

    2009-01-01

    Full Text Available Abstract The World Health Organization advocates task-shifting, the process of delegating clinical care functions from more specialized to less specialized health workers, as a strategy to achieve the United Nations Millennium Development Goals. However, there is a dearth of literature describing task shifting in sub-Saharan Africa, where services for antiretroviral therapy (ART have scaled up rapidly in the face of generalized human resource crises. As part of ART services expansion in Lusaka, Zambia, we implemented a comprehensive task-shifting program among existing health providers and community-based workers. Training begins with didactic sessions targeting specialized skill sets. This is followed by an intensive period of practical mentorship, where providers are paired with trainers before working independently. We provide on-going quality assessment using key indicators of clinical care quality at each site. Program performance is reviewed with clinic-based staff quarterly. When problems are identified, clinic staff members design and implement specific interventions to address targeted areas. From 2005 to 2007, we trained 516 health providers in adult HIV treatment; 270 in pediatric HIV treatment; 341 in adherence counseling; 91 in a specialty nurse "triage" course, and 93 in an intensive clinical mentorship program. On-going quality assessment demonstrated improvement across clinical care quality indicators, despite rapidly growing patient volumes. Our task-shifting strategy was designed to address current health care worker needs and to sustain ART scale-up activities. While this approach has been successful, long-term solutions to the human resource crisis are also urgently needed to expand the number of providers and to slow staff migration out of the region.

  19. Serum phosphate predicts early mortality in adults starting antiretroviral therapy in Lusaka, Zambia: a prospective cohort study.

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    Douglas C Heimburger

    Full Text Available BACKGROUND: Patients starting antiretroviral therapy (ART for acquired immunodeficiency syndrome (AIDS in sub-Saharan Africa have high rates of mortality in the initial weeks of treatment. We assessed the association of serum phosphate with early mortality among HIV-infected adults with severe malnutrition and/or advanced immunosuppression. METHODOLOGY/PRINCIPAL FINDINGS: An observational cohort of 142 HIV-infected adults initiating ART in Lusaka, Zambia with body mass index (BMI <16 kg/m(2 or CD4(+ lymphocyte count <50 cells/microL, or both, was followed prospectively during the first 12 weeks of ART. Detailed health and dietary intake history, review of systems, physical examination, serum metabolic panel including phosphate, and serum ferritin and high-sensitivity C-reactive protein (hsCRP were monitored. The primary outcome was mortality. Baseline serum phosphate was a significant predictor of mortality; participants alive at 12 weeks had a median value of 1.30 mmol/L (interquartile range [IQR]: 1.04, 1.43, compared to 1.06 mmol/L (IQR: 0.89, 1.27 among those who died (p<0.01. Each 0.1 mmol/L increase in baseline phosphate was associated with an incremental decrease in mortality (AHR 0.83; 95% CI 0.72 to 0.95. The association was independent of other metabolic parameters and known risk factors for early ART-associated mortality in sub-Saharan Africa. While participant attrition represented a limitation, it was consistent with local program experience. CONCLUSIONS/SIGNIFICANCE: Low serum phosphate at ART initiation was an independent predictor of early mortality among HIV patients starting ART with severe malnutrition or advanced immunosuppression. This may represent a physiologic phenomenon similar to refeeding syndrome, and may lead to therapeutic interventions that could reduce mortality.

  20. Seroprevalence and determinants of toxoplasmosis in pregnant women attending antenatal clinic at the university teaching hospital, Lusaka, Zambia.

    Science.gov (United States)

    Frimpong, Christiana; Makasa, Mpundu; Sitali, Lungowe; Michelo, Charles

    2017-01-05

    Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending antenatal clinic at the University Teaching Hospital (UTH). A cross-sectional study was employed where 411 pregnant women attending antenatal clinic at UTH were interviewed using closed ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid test cassettes by CTK Biotech, Inc, USA. The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of association between contact with cats, employment type as well as socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

  1. Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia

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    Maurice Musheke

    2016-08-01

    Full Text Available Abstract Background Knowledge of HIV status is crucial for HIV prevention and management in marital relationships. Yet some marital partners of people living with HIV decline HIV testing despite knowing the HIV-positive status of their partners. To date, little research has explored the reasons for this. Methods An exploratory qualitative study was undertaken in Lusaka, Zambia, between March 2010 and September 2011, nested within a larger ethnographic study. In-depth interviews were held with individuals who knew the HIV-positive status of their marital partners but never sought HIV testing (n = 30 and HIV service providers of a public sector clinic (n = 10. A focus group discussion was also conducted with eight (8 lay HIV counsellors. Data was transcribed, coded and managed using ATLAS.ti and analysed using latent content analysis. Results The overarching barrier to uptake of HIV testing was study participants’ perception of their physical health, reinforced by uptake of herbal remedies and conventional non-HIV medication to mitigate perceived HIV-related symptoms. They indicated willingness to test for HIV if they noticed a decline in physical health and other alternative forms of care became ineffective. Also, some study participants viewed themselves as already infected with HIV on account of the HIV-positive status of their marital partners, with some opting for faith healing to get ‘cured’. Other barriers were the perceived psychological burden of living with HIV, modulated by lay belief that knowledge of HIV-positive status led to rapid physical deterioration of health. Perceived inability to sustain uptake of life-long treatment – influenced by a negative attitude towards treatment – further undermined uptake of HIV testing. Self-stigma, which manifested itself through fear of blame and a need to maintain moral credibility in marital relationships, also undermined uptake of HIV testing. Conclusions Improving uptake of HIV

  2. Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia.

    Science.gov (United States)

    Musheke, Maurice; Merten, Sonja; Bond, Virginia

    2016-08-25

    Knowledge of HIV status is crucial for HIV prevention and management in marital relationships. Yet some marital partners of people living with HIV decline HIV testing despite knowing the HIV-positive status of their partners. To date, little research has explored the reasons for this. An exploratory qualitative study was undertaken in Lusaka, Zambia, between March 2010 and September 2011, nested within a larger ethnographic study. In-depth interviews were held with individuals who knew the HIV-positive status of their marital partners but never sought HIV testing (n = 30) and HIV service providers of a public sector clinic (n = 10). A focus group discussion was also conducted with eight (8) lay HIV counsellors. Data was transcribed, coded and managed using ATLAS.ti and analysed using latent content analysis. The overarching barrier to uptake of HIV testing was study participants' perception of their physical health, reinforced by uptake of herbal remedies and conventional non-HIV medication to mitigate perceived HIV-related symptoms. They indicated willingness to test for HIV if they noticed a decline in physical health and other alternative forms of care became ineffective. Also, some study participants viewed themselves as already infected with HIV on account of the HIV-positive status of their marital partners, with some opting for faith healing to get 'cured'. Other barriers were the perceived psychological burden of living with HIV, modulated by lay belief that knowledge of HIV-positive status led to rapid physical deterioration of health. Perceived inability to sustain uptake of life-long treatment - influenced by a negative attitude towards treatment - further undermined uptake of HIV testing. Self-stigma, which manifested itself through fear of blame and a need to maintain moral credibility in marital relationships, also undermined uptake of HIV testing. Improving uptake of HIV testing requires a multi-pronged approach that addresses self-stigma, lay risk

  3. Findings from a comprehensive diarrhoea prevention and treatment programme in Lusaka, Zambia

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    Samuel Bosomprah

    2016-06-01

    Full Text Available Abstract Background The Programme for the Awareness and Elimination of Diarrhoea (PAED was a pilot comprehensive diarrhoea prevention and control programme aimed to reduce post-neonatal, all-cause under-five mortality by 15 % in Lusaka Province. Interventions included introduction of the rotavirus vaccine, improved clinical case management of diarrhoea, and a comprehensive community prevention and advocacy campaign on hand washing with soap, exclusive breastfeeding up to 6 months of age, and the use of ORS and Zinc. This study aimed to assess the impact of PAED on under-5 mortality. Methods The study was a pre-post evaluation design. The Demographic and Health Survey style population-based two-stage approach was used to collect data at the beginning of the intervention and 3 years following the start of intervention implementation in Lusaka province. The primary outcome of interest was an all-cause, post-neonatal under-five mortality rate defined as the probability of dying after the 28th day and before the fifth birthday among children aged 1–59 months. The Kaplan-Meier time to event analysis was used to estimate the probability of death; multiplying this probability by 1000 to yield the post-neonatal mortality rate. Survival-time inverse probability weighting model was used to estimate Average Treatment Effect (ATE. Results The percentage of children under age 5 who had diarrhoea in the last 2 weeks preceding the survey declined from 15.8 % (95 % CI: 15.2 %, 16.4 % in 2012 to 12.7 % (95 % CI: 12.3 %, 13.2 % in 2015. Over the same period, mortality in post-neonatal children under 5 years of age declined by 34 %, from an estimated rate of 29 deaths per 1000 live births (95 % CI: (26, 32 death per 1000 live births to 19 deaths per 1000 live births (95 % CI: (16, 21 death per 1000 live births. When every child in the population of children aged 1–59 months is exposed to the intervention, the average time-to-death was estimated to

  4. Hepatitis B vaccination coverage and the determinants of vaccination among health care workers in selected health facilities in Lusaka district, Zambia: an exploratory study.

    Science.gov (United States)

    Mungandi, Namwaka; Makasa, Mpundu; Musonda, Patrick

    2017-01-01

    Hepatitis B is a viral infection of the liver and causes both acute and chronic disease. It is transmitted through contact with an infected person's bodily fluids. It is an occupational hazard for healthcare workers and can be prevented by the administration of a vaccine. It is recommended that healthcare workers be vaccinated against vaccine preventable diseases including hepatitis B. The study objective was to determine the prevalence and determinants of hepatitis B vaccination among healthcare workers in selected health facilities in Lusaka. The study took place in seven health facilities across Lusaka district in Zambia. A total sample size of 331 healthcare workers was selected of which; 90 were nurses, 88 were doctors, 86 were laboratory personnel and 67 were general workers. A self-administered structured questionnaire was given to a total of 331 healthcare workers. Investigator led stepwise approach was used to select the best predictor variables in a multiple logistic regression model and all analyses were performed using STATA software, version 12.1 SE (Stata Corporation, College Station, TX, USA). Only 64(19.3%) of the healthcare workers were vaccinated against hepatitis B, with 35 (54.7%) of these being fully vaccinated and 29 (45.3%) partially vaccinated. Analysis showed that; age of the healthcare worker, sharp injuries per year and training in infection control were the variables that were statistically significant in predicting a healthcare worker's vaccination status. It is reassuring to learn that healthcare workers have knowledge regarding hepatitis B and the vaccine and are willing to be vaccinated against it. Health institutions should bear the cost for vaccinating staff and efforts should be made for appropriate health education regarding hepatitis B infection and its prevention. Establishment of policies on compulsory hepatitis B vaccination for healthcare workers in Zambia is recommended.

  5. Signal functions for emergency obstetric care as an intervention for reducing maternal mortality: a survey of public and private health facilities in Lusaka District, Zambia.

    Science.gov (United States)

    Tembo, Tannia; Chongwe, Gershom; Vwalika, Bellington; Sitali, Lungowe

    2017-09-06

    Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia. A descriptive cross sectional study was conducted between November 2014 and February 2015 at 35 public and private health facilities. The Service Availability and Readiness Assessment tool was adapted and administered to overall in-charges, hospital administrators or maternity ward supervisors at health facilities providing maternal and newborn health services. The survey quantified infrastructure, human resources, equipment, essential drugs and supplies and used the UN process indicators to determine availability, accessibility and quality of signal functions. Data on deliveries and complications were collected from registers for periods between June 2013 and May 2014. Of the 35 (25.7% private and 74.2% public) health facilities assessed, only 22 (62.8%) were staffed 24 h a day, 7 days a week and had provided obstetric care 3 months prior to the survey. Pre-eclampsia/ eclampsia and obstructed labor accounted for most direct complications while postpartum hemorrhage was the leading cause of maternal deaths. Overall, 3 (8.6%) and 5 (14.3%) of the health facilities had provided Basic and Comprehensive EmONC services, respectively. All facilities obtained blood products from the only blood bank at a government referral hospital. The UN process indicators can be adequately used to monitor progress towards maternal mortality reduction. Lusaka district had an unmet need for BEmONC as health facilities fell below the minimum UN standard

  6. Medical Journal of Zambia - Vol 42, No 1 (2015)

    African Journals Online (AJOL)

    Haptoglobin Phenotypes and Hypertension in Indigenous Zambians at the University Teaching Hospital, Lusaka, Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. MM Phiri, T Kaile, FM Goma, 1- 6 ...

  7. Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia.

    Science.gov (United States)

    Hampanda, Karen M

    2016-03-01

    Prevention of mother-to-child transmission (PMTCT) depends critically on HIV-positive women's adherence to antiretroviral drugs during and after pregnancy. Adherence among pregnant and breastfeeding women remains a challenge across sub-Saharan Africa. Power dynamics within couples, such as intimate partner violence, has largely been neglected in research regarding PMTCT adherence. This study aims to determine if there is a relationship between intimate partner violence and non-adherence to PMTCT. In 2014, using a verbally administered cross-sectional survey at a large public health clinic in Lusaka, Zambia, 320 HIV-positive postpartum women, who were currently married or living with a man, provided information on their drug adherence during and after pregnancy, as well as relationship dynamics. Adherence was defined as the woman reporting she took or gave to the infant at least 80% of prescribed medication doses. Experiencing intimate partner violence was associated with decreased odds of adherence to PMTCT during and after pregnancy. Different forms of violence affected PMTCT adherence differentially. Physical violence had a less pronounced effect on non-adherence than emotional and sexual violence. A dose-response relationship between intimate partner violence and non-adherence was also observed. Intimate partner violence is associated with non-adherence to PMTCT during and after pregnancy, which deserves increased attention in the effort to eliminate mother-to-child transmission of HIV. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Zambia mental health country profile.

    Science.gov (United States)

    Mayeya, John; Chazulwa, Roy; Mayeya, Petronella Ntambo; Mbewe, Edward; Magolo, Lonia Mwape; Kasisi, Friday; Bowa, Annel Chishimba

    2004-01-01

    This country profile for Zambia was compiled between 1998 and 2002. The objectives of the exercise were to first of all avail policymakers, other key decision makers and leaders in Zambia, information about mental health in Zambia in order to assist policy and services development. Secondly, to facilitate comparative analyses of mental health services between countries. The work involved formation of a core group of experts who coordinated the collection of information from the various organizations in Zambia. The information was later shared to a broad spectrum of stakeholders for consensus. A series of focus group discussions (FGDs) supplemented the information collected. There are various factors that contribute to mental health in Zambia. It is clear from the Zambian perspective that social, demographic, economic, political, environmental, cultural and religious influences affect the mental health of the people. With a population of 10.3 million and annual growth rate of 2.9%, Zambia is one of the most urbanized countries in sub-Saharan Africa. Poverty levels stood at 72.9% in 1998. In terms of unemployment, the most urbanized provinces, Lusaka (the capital city), and the copper-belt are the most affected. The gross domestic product (GDP) is US$3.09 billion dollars while per capita income is US$300. The total budget allocation for health in the year 2002 was 15% while the proportion of the GDP per capita expenditure for health was 5.6%. The HIV/AIDS prevalence rates stand at 20% among the reproductive age group 15-49 years. Political instability and wars in neighbouring states has resulted in an influx of refugees. Environmental factors affecting the country include natural and man-made disasters such as floods and drought, mine accidents, and deforestation. To a large extent in Zambia, people who are mentally ill are stigmatized, feared, scorned at, humiliated and condemned. However, caring for mental ill health in old age is positively perceived. It is

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

    Directory of Open Access Journals (Sweden)

    Deo Sarang

    2012-05-01

    Full Text Available Abstract Background Previous operational research studies have demonstrated the feasibility of large-scale public sector ART programs in resource-limited settings. However, organizational and structural determinants of quality of care have not been studied. Methods We estimate multivariate regression models using data from 13 urban HIV treatment facilities in Zambia to assess the impact of structural determinants on health workers’ adherence to national guidelines for conducting laboratory tests such as CD4, hemoglobin and liver function and WHO staging during initial and follow-up visits as part of Zambian HIV care and treatment program. Results CD4 tests were more routinely ordered during initial history and physical (IHP than follow-up (FUP visits (93.0 % vs. 85.5 %; p  Conclusion Physical space plays an important role in ensuring high quality care in resource-limited setting. In the context of protocolized care, new staff members are likely to be more diligent in following the protocol verbatim rather than relying on memory and experience thereby improving adherence. Future studies should use prospective data to confirm the findings reported here.

  10. Zambia Country Background Report

    DEFF Research Database (Denmark)

    Hampwaye, Godfrey; Jeppesen, Søren; Kragelund, Peter

    This paper provides background data and general information for the Zambia studies focusing on local food processing sub­‐sector; and the local suppliers to the mines as part of the SAFIC project (Successful African Firms and Institutional Change).......This paper provides background data and general information for the Zambia studies focusing on local food processing sub­‐sector; and the local suppliers to the mines as part of the SAFIC project (Successful African Firms and Institutional Change)....

  11. Zambia country study

    Energy Technology Data Exchange (ETDEWEB)

    1999-09-01

    The Zambia Country Study, which was part of the Danida-funded project Climate Change Mitigation in Southern Africa: Phase 2, aimed at methodological development, national mitigation analysis and institutional capacity building in Zambia. The study comprised the following five elements: Comprehensive evaluation of national social and economic development framework for climate change; Baseline scenario(s) projection(s); Mitigation scenario(s) projection(s); Macro-economic assessment; Implementation Issues. (au) 17 refs.

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

    Directory of Open Access Journals (Sweden)

    Mwambazi Mwate

    2011-10-01

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

  13. The Republic of Zambia.

    Science.gov (United States)

    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

  14. Population immunity to measles virus and the effect of HIV-1 infection after a mass measles vaccination campaign in Lusaka, Zambia: a cross-sectional survey.

    Science.gov (United States)

    Lowther, Sara A; Curriero, Frank C; Kalish, Brian T; Shields, Timothy M; Monze, Mwaka; Moss, William J

    2009-03-21

    Measles control efforts are hindered by challenges in sustaining high vaccination coverage, waning immunity in HIV-1-infected children, and clustering of susceptible individuals. Our aim was to assess population immunity to measles virus after a mass vaccination campaign in a region with high HIV prevalence. 3 years after a measles supplemental immunisation activity (SIA), we undertook a cross-sectional survey in Lusaka, Zambia. Households were randomly selected from a satellite image. Children aged 9 months to 5 years from selected households were eligible for enrolment. A questionnaire was administered to the children's caregivers to obtain information about measles vaccination history and history of measles. Oral fluid samples were obtained from children and tested for antibodies to measles virus and HIV-1 by EIA. 1015 children from 668 residences provided adequate specimens. 853 (84%) children had a history of measles vaccination according to either caregiver report or immunisation card. 679 children (67%) had antibodies to measles virus, and 64 (6%) children had antibodies to HIV-1. Children with antibodies to HIV-1 were as likely to have no history of measles vaccination as those without antibodies to HIV-1 (odds ratio [OR] 1.17, 95% CI 0.57-2.41). Children without measles antibodies were more likely to have never received measles vaccine than those with antibodies (adjusted OR 2.50, 1.69-3.71). In vaccinated children, 33 (61%) of 54 children with antibodies to HIV-1 also had antibodies to measles virus, compared with 568 (71%) of 796 children without antibodies to HIV-1 (p=0.1). 3 years after an SIA, population immunity to measles was insufficient to interrupt measles virus transmission. The use of oral fluid and satellite images for sampling are potential methods to assess population immunity and the timing of SIAs.

  15. African Journals Online: Zambia

    African Journals Online (AJOL)

    The Medical Journal of Zambia is a peer-reviewed quarterly journal intended for the publication of papers from all specialities of medicine (Internal Medicine, Surgery, Paediatrics and Obstetrics & Gynaecology) and their subspecialties, basic sciences, public health, social medicine and medical politics. The journal also ...

  16. Illegal deforestation in Zambia

    OpenAIRE

    Travis, A.J.

    2005-01-01

    Dr. Dale Lewis, a co-PI on the grant and the originator of the COMACO model, points out recent illegal deforestation in one of Zambia's National Forests to Dr. Alfonso Torres, another co-PI on the grant (from Cornell). LTRA-2 (An Agricultural Markets Model for Biodiversity Conservation)

  17. Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Quiterio Nicole

    2009-07-01

    Full Text Available Abstract Background Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results Some 483 active clinical staff completed the questionnaire (84% response rate, 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2–1.6 and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3–2.2. Reasons for co-worker attrition included: better pay (40%, feeling overworked or stressed (21%, moving away (16%, death (8% and illness (5%. When asked about HIV testing, 370 of 456 (81% reported having tested; 240 (50% tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability.

  18. Kina i Zambia: Indsigt i kinesiske investeringer i Zambias kobberminer

    OpenAIRE

    Tewolde, Eden; Boateng, Amanda

    2016-01-01

    Projektet tager udgangspunkt i Kinas investeringer i Zambias Kobberminer og fokusere på de to landes relationer med hinanden, samt de konsekvenser der forekommer af Kinas privatiseringer af Zambias kobbersektor. Projektet har en økonomisk og social tilgang, hvor Kinas FDI i Zambia, bliver analyseret for at se på hvor stor en økonomisk vækst der skabes i Zambia på vejne af udlandske investeringer. Derudover er der også blevet gjort brug af ressourceforbandelsens teori, til at se på de sociale,...

  19. Impact of communication strategies to increase knowledge, acceptability, and uptake of a new Woman's Condom in urban Lusaka, Zambia: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Pinchoff, Jessie; Chowdhuri, Rachna Nag; Taruberekera, Noah; Ngo, Thoai D

    2016-12-13

    Globally, 220 million women experience an unmet need for family planning. A newly designed female condom, the Woman's Condom (WC), has been developed featuring an improved design. It is the first dual-protection, female-initiated contraceptive that is a premium, higher price point product. However, market availability alone will not increase uptake. In February 2016 the WC will be distributed with a strong media campaign and interpersonal communication (IPC) outreach intervention. The impact of these on knowledge, acceptability, and use of the WC will be measured. A baseline survey of 2314 randomly selected 18- to 24-year-old sexually active men and women has been conducted. The WC and mass media will be introduced throughout 40 urban wards in and surrounding Lusaka, Zambia. The baseline survey will serve as a quasi-control arm to determine the impact of introducing the WC with mass media. Half of the wards will be randomly allocated to additionally receive the IPC intervention. A single-blind randomized controlled trial will determine the impact of the IPC intervention on knowledge, uptake, and use of the WC. After one year, another 2314 individuals will be randomly selected to participate in the endline survey. We hypothesize that (1) the distribution and media campaign of the WC will increase overall condom use in selected urban wards, and specifically use of the WC; (2) the IPC intervention will significantly impact knowledge, acceptability, and use of the WC. The primary outcome measures are use of the WC, use of any condom, and willingness to use the WC. Secondary outcomes include measures of knowledge, acceptability, and choice of contraception. Odds ratios will be estimated to measure the effect of the intervention on the outcomes with 95% confidence intervals. All analyses will be based on the intention-to-treat principle. Increasing uptake of dual prevention measures (such as the WC) may reduce incidence of sexually transmitted infections/HIV and

  20. Status of cassava mosaic disease and whitefly population in Zambia ...

    African Journals Online (AJOL)

    Cassava mosaic disease is the most important disease affecting cassava in Zambia. A study was conducted through a survey to determine the status of cassava mosaic disease incidence, severity and whitefly abundance in farmers' fields in six provinces: Lusaka, Northern, North-Western, Luapula, Eastern and Western ...

  1. Medical Journal of Zambia - Vol 36, No 2 (2009)

    African Journals Online (AJOL)

    Status of the artemisinin resistance-associated PfATPase6 S769N Mutation in Plasmodium falciparum infections of Lusaka Urban District, Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. EB Chaponda, CJ Shinondo, S Mharakurwa.

  2. Medical Journal of Zambia - Vol 39, No 1 (2012)

    African Journals Online (AJOL)

    Factors Associated with Mortality in Adults Admitted with Heart Failure at the University Teaching Hospital in Lusaka, Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. P Chansa, S Lakhi, B Andrews, S Kalinchenko, R Sakr, 1-10 ...

  3. Medical Journal of Zambia - Vol 39, No 2 (2012)

    African Journals Online (AJOL)

    A Comparative Study of Septic Complications in HIVInfected and HIV-Uninfected Women Undergoing Caesarean Section at the University Teaching Hospital, Lusaka, Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A Musonda, M Chisembele, Y Ahmed, 44- ...

  4. Medical Journal of Zambia - Vol 43, No 3 (2016)

    African Journals Online (AJOL)

    Indigenous knowledge systems for the treatment of hypertension in Lusaka, Zambia: perceptions, knowledge and practice · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. F Goma, L Prasha, C.A. Kalungia, A Bwalya, A Hamachil, R.K. Mutati, E Zingani, C Mwila, ...

  5. Medical Journal of Zambia - Vol 41, No 2 (2014)

    African Journals Online (AJOL)

    Ambient Air Pollution by Second Hand Tobacco Smoke in Public Entertainment Places In Selected Areas of Lusaka, Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. FM Goma, MM Phiri, 59-64 ...

  6. Kapitalflugt fra Zambia

    OpenAIRE

    Absalonsen, Kristian Matras; Svennevig, Cilia U.; Vangstrup, Caroline; Winther, Christian

    2014-01-01

    Capital flight is a worldwide problem and an Achilles heel for most tax authorities around the world. A place where capital flight represents a major problem is in developing countries where weak states and ineffective public institutions creates a perfect arena in which multinational corporations earn large sums caused by tax evasion. The problem appears rather clearly in Zambia, where the multinational corporation Glencore and its subsidiary, Mopani, has deceived the Zambian government for ...

  7. Archives: Medical Journal of Zambia

    African Journals Online (AJOL)

    Items 1 - 39 of 39 ... Archives: Medical Journal of Zambia. Journal Home > Archives: Medical Journal of Zambia. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 39 of 39 Items ...

  8. HIV-Positive Women Taking Lifelong Antiretroviral Therapy Report Better Adherence Than Women Taking Short-Course Prophylaxis During and After Pregnancy Under PMTCT Program Option A in Lusaka, Zambia.

    Science.gov (United States)

    Hampanda, Karen M; Abuogi, Lisa L; Ahmed, Yusuf

    2017-01-01

    HIV-positive women's adherence to antiretrovirals is critical for prevention of mother-to-child transmission. We aimed to establish if mothers taking triple lifelong antiretroviral therapy report higher adherence compared to mothers taking short-course prophylaxis under Option A in Lusaka, Zambia. In this clinic-based cross-sectional study, we interviewed 320 HIV-positive mothers at a large public health facility in Lusaka in 2014. Participants reported adherence using a visual analog scale. Multiple logistic regression models were used to determine the adjusted odds of adherence by mother's prescribed regimen. Women taking lifelong triple antiretroviral therapy report higher adjusted odds of adherence during pregnancy, postpartum, and to giving the infant prophylaxis compared to women to women taking short-course prophylaxis. Women on lifelong therapy may have better adherence compared to women on short course prophylaxis because they knew their positive status for longer or were symptomatic with HIV-related disease. The lifelong therapy regimen may be easier for women to follow, particularly because they are required to give the infant prophylaxis for a shorter duration of time. Our results indicate that lifelong triple antiretroviral therapy has the potential to promote better drug adherence during and after pregnancy among women living with HIV in sub-Saharan Africa, compared to short-course antiretroviral regimens.

  9. Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004–2014)

    OpenAIRE

    Mwiinde, Allan Mayaba; Simuunza, Martin; Namangala, Boniface; Chama-Chiliba, Chitalu Miriam; Machila, Noreen; Anderson, Neil; Shaw, Alexandra; Welburn, Susan C.

    2017-01-01

    Background Acute human African trypanosomiasis (rHAT) caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated. Only a few studies have examined the psychological, social and economic impacts of rHAT. In this study, mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe, Rufunsa, Mpika and Chama Districts of Zambia. Methods Individuals diagnosed with rHAT from 2004 to 2014 were tra...

  10. Mental illness--stigma and discrimination in Zambia.

    Science.gov (United States)

    Kapungwe, A; Cooper, S; Mwanza, J; Mwape, L; Sikwese, A; Kakuma, R; Lund, C; Flisher, A J

    2010-07-01

    The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. In Zambia, as in many other low-income African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue.

  11. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

    Science.gov (United States)

    2013-01-01

    Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create

  12. Estimating the economic and social consequences for patients diagnosed with human African trypanosomiasis in Muchinga, Lusaka and Eastern Provinces of Zambia (2004-2014).

    Science.gov (United States)

    Mwiinde, Allan Mayaba; Simuunza, Martin; Namangala, Boniface; Chama-Chiliba, Chitalu Miriam; Machila, Noreen; Anderson, Neil; Shaw, Alexandra; Welburn, Susan C

    2017-10-10

    Acute human African trypanosomiasis (rHAT) caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated. Only a few studies have examined the psychological, social and economic impacts of rHAT. In this study, mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe, Rufunsa, Mpika and Chama Districts of Zambia. Individuals diagnosed with rHAT from 2004 to 2014 were traced using hospital records and discussions with communities. Either they, or their families, were interviewed using a structured questionnaire and focus group discussions were conducted with affected communities. The burden of the disease was investigated using disability adjusted life years (DALYs), with and without discounting and age-weighting. The impact of long-term disabilities on the rHAT burden was also investigated. Sixty four cases were identified in the study. The majority were identified in second stage, and the mortality rate was high (12.5%). The total number of DALYs was 285 without discounting or age-weighting. When long-term disabilities were included this estimate increased by 50% to 462. The proportion of years lived with disability (YLD) increased from 6.4% to 37% of the undiscounted and un-age-weighted DALY total. When a more active surveillance method was applied in 2013-2014 the cases identified increased dramatically, suggesting a high level of under-reporting. Similarly, the proportion of females increased substantially, indicating that passive surveillance may be especially failing this group. An average of 4.9 months of productive time was lost per patient as a consequence of infection. The health consequences included pain, amnesia and physical disability. The social consequences included stigma, dropping out of education, loss of friends and self-esteem. Results obtained from focus group discussions revealed misconceptions among community members which could be

  13. Air-cooling mathematical analysis as inferred from the air-temperature observation during the 1st total occultation of the Sun of the 21st century at Lusaka, Zambia

    Science.gov (United States)

    Peñaloza-Murillo, Marcos A.; Pasachoff, Jay M.

    2015-04-01

    We analyze mathematically air temperature measurements made near the ground by the Williams College expedition to observe the first total occultation of the Sun [TOS (commonly known as a total solar eclipse)] of the 21st century in Lusaka, Zambia, in the afternoon of June 21, 2001. To do so, we have revisited some earlier and contemporary methods to test their usefulness for this analysis. Two of these methods, based on a radiative scheme for solar radiation modeling and that has been originally applied to a morning occultation, have successfully been combined to obtain the delay function for an afternoon occultation, via derivation of the so-called instantaneous temperature profiles. For this purpose, we have followed the suggestion given by the third of these previously applied methods to calculate this function, although by itself it failed to do so at least for this occultation. The analysis has taken into account the limb-darkening, occultation and obscuration functions. The delay function obtained describes quite fairly the lag between the solar radiation variation and the delayed air temperature measured. Also, in this investigation, a statistical study has been carried out to get information on the convection activity produced during this event. For that purpose, the fluctuations generated by turbulence has been studied by analyzing variance and residuals. The results, indicating an irreversible steady decrease of this activity, are consistent with those published by other studies. Finally, the air temperature drop due to this event is well estimated by applying the empirical scheme given by the fourth of the previously applied methods, based on the daily temperature amplitude and the standardized middle time of the occultation. It is demonstrated then that by using a simple set of air temperature measurements obtained during solar occultations, along with some supplementary data, a simple mathematical analysis can be achieved by applying of the four

  14. Attitudes toward abortion in Zambia.

    Science.gov (United States)

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

    2012-09-01

    Despite Zambia's relatively progressive abortion law, women continue to seek unsafe, illegal abortions. Four domains of abortion attitudes - support for legalization, immorality, rights, and access to services - were measured in 4 communities. A total of 668 people were interviewed. Associations among the 4 domains were inconsistent with expectations. The belief that abortion is immoral was widespread, but was not associated with lack of support for legalization. Instead, it was associated with belief that women need access to safe services. These findings suggest that increasing awareness about abortion law in Zambia may be important for encouraging more favorable attitudes. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Leprosy trends in Zambia 1991-2009

    NARCIS (Netherlands)

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

    2012-01-01

    To document leprosy trends in Zambia over the past two decades to ascertain the importance of leprosy as a health problem in Zambia. Retrospective study covering the period 1991-2009 of routine national leprosy surveillance data, published national programme review reports and desk reviews of

  16. Zambia Economic Brief, October 2013 : Zambia's Jobs Challenge--Realities on the Ground

    OpenAIRE

    World Bank

    2013-01-01

    Zambia shares its robust economic growth and capital inflows in the past few years with other Sub-Saharan countries, growth supported by high commodity prices that while declining are still at historical high levels. High commodity prices have induced large foreign direct investment (FDI) flows, mainly in extractive industries but also in services sector, supporting growth. Zambia's mining...

  17. Ecology of rodents at an old quarry in Zambia

    African Journals Online (AJOL)

    Ecology of rodents at an old quarry in Zambia. E.N. Chidumayo. Livingstone Museum, Zambia. An old quarry, 2,5 hain size near Livingstone in southern. Zambia was kill- and live-trapped between September 1974 and December 1976 to determine ecological relations among. rodent species inhabiting it. Seven species ...

  18. The University of Zambia School Teaching Experience: Is It Effective?

    Directory of Open Access Journals (Sweden)

    Peter Chomba Manchishi

    2014-05-01

    Full Text Available Teaching practice exercises serve the purpose of orienting the teacher into real classroom situations where the novice puts his or her skills into practice. Education students at the University of Zambia (UNZA go through the school teaching experience after their third year of study. This comes after they have arguably completed enough content and methodology courses to teach. The purpose of this study was to establish the effectiveness of the UNZA school teaching experience. The research instruments used were interview guides, observation checklists, and focus group discussions. The respondents included 80 serving teachers, 80 student teachers, and 10 head teachers drawn from 10 high schools in the Lusaka District. In addition, 10 lecturers from UNZA were also sampled. The findings revealed that the design and delivery of the UNZA student teaching experience was not effective.

  19. Infant-mother and infant-sibling attachment in Zambia.

    Science.gov (United States)

    Mooya, Haatembo; Sichimba, Francis; Bakermans-Kranenburg, Marian

    2016-12-01

    This study, the first in Zambia using the Strange Situation Procedure (SSP) to observe attachment relationships and the "very first" observational study of infant-sibling attachment, examined patterns of infant-mother and infant-sibling attachment, and tested their association. We included siblings who were substantially involved in caregiving activities with their younger siblings. We hypothesized that infants would develop attachment relationships to both mothers and siblings; the majority of infants would be classified as securely attached to both caregivers, and infant-mother and infant-sibling attachment would be unrelated. The sample included 88 low-income families in Lusaka, Zambia (average of 3.5 children; SD = 1.5). The SSP distributions (infant-mother) were 59% secure, 24% avoidant and 17% resistant, and 46% secure, 20% avoidant, 5% resistant and 29% disorganized for three- and four-way classifications, respectively. The infant-sibling classifications were 42% secure, 23% avoidant and 35% resistant, and 35% secure, 23% avoidant, 9% resistant and 33% disorganized for three- and four-way classifications, respectively. Infant-mother and infant-sibling attachment relationships were not associated.

  20. to Middle-Income Population, Zambia

    African Journals Online (AJOL)

    user

    database. Methods: This was a retrospective study of patients diagnosed with pancreatic cancer at the CDH in. Zambia, Southern Africa between 2007 and 2014. We entered the term “pancreatic cancer” into the. CDH database, extracted patient medical records numbers, and manually located the records for review.

  1. Livestock sector in Zambia: Opportunities and limitations

    International Nuclear Information System (INIS)

    Daka, D.E.

    2002-01-01

    Zambia is endowed with a vast feed resource base for animal production purposes. However, the feed resource base is not fully utilised and this is manifested by low livestock productivity. The quality and production levels of animal products depend largely on the quality and quantity of feed, which is fed to the livestock. Among the constraints limiting livestock productivity in Zambia, insufficient and low quality of veld grass, particularly during the long dry season (March-November) is responsible for low production levels and poor reproductive performance in ruminants. The problem of inadequate veld grass can be overcome by feeding crop residues which are in abundance during the dry season. Zambia produces large quantities of sugarcane tops, bagasse and straws from maize, sorghum, wheat, millet and rice. These could sustain livestock productivity if supplemented with protein sources or treated with urea. Despite the production of large quantities of crop residues, these are wasted by burning or get destroyed by termites. There is a need, therefore, to develop feeding systems based on crop residues which are compatible with the farming systems in Zambia and to promote such feeding systems. (author)

  2. Power instability in rural Zambia, case Macha

    CSIR Research Space (South Africa)

    Mudenda, C

    2013-11-01

    Full Text Available This paper provides insights on the nature of electricity supply in the rural village Macha, Zambia. It reports on case study research. Use of Information and Communication Technologies and access to e-services are constrained by the availability...

  3. Implications for Child Survival Interventions in Zambia

    African Journals Online (AJOL)

    Musumali

    Methods: This report is a product of data that was collected using verbal autopsy for a study on Factors. Associated with high Under Five Mortality in the. Luapula province of Zambia. Verbal autopsies were used to collect information from three hundred and sixty (360) caretakers about illnesses that led to the death of their ...

  4. Zambia: Multi-Faith Religious Education?

    Science.gov (United States)

    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…

  5. Journal of Science and Technology (Zambia)

    African Journals Online (AJOL)

    The University of Zambia Journal of Science and Technology provides an outlet for research findings and reviews in areas of science and technology found to be relevant for national and international development. The bi-annual journal is intended, in its publications, to stimulate new research and foster practical ...

  6. Producing biodiesel from soybeans in Zambia

    NARCIS (Netherlands)

    Drabik, Dusan; Gorter, de Harry; Timilsina, Govinda R.

    2016-01-01

    Facing a huge fiscal burden due to imports of its entire petroleum demand in the face of ample supply of agricultural land to produce biofuels, Zambia has recently introduced a biofuel mandate. However, a number of questions, particularly those related to the economics of biofuels, have not been

  7. Medical Journal of Zambia: Submissions

    African Journals Online (AJOL)

    Authors from the University Teaching Hospital in Lusaka may find it quicker to submit their articles through the e-mail: MedJZambia@yahoo.com. Manuscripts Papers should be clear, precise and logical. The Journal welcomes submissions in any of the following categories: original articles, review articles, short reports, case ...

  8. Role of partnership in enhancing the performance of radiation regulatory authority in Zambia

    International Nuclear Information System (INIS)

    Banda, S.C.

    2003-01-01

    The National Radiation Infrastructure includes legislation, human resource, technical capacity to execute responsibilities of the regulatory (1). In cases of developing countries like Zambia, special challenges arise in view of the constraints both in terms of human resource and funding. This paper will highlight same measures that may be undertaken to improve the operations of nation radiation protection infrastructure. The measures include collaboration with Science and Technology organisations that have technical capacity, delegation of responsible to key institutions that may have competence and generation of funds through training and provision of reliable quality service. (2). In Zambia, some achievements in this line have been registered by Radiation Protection Board working with the University of Zambia and National Institute for Scientific and Industrial Research (3). Some measures of generation of funds have been done though utilization of the generated remains to be the limiting factor to exploit fully benefits that may arise from the use of the monies generated from services. Partnerships with private sector may be used as regulatory authorities for support to its programme in particular the public awareness campaign. Sponsorship by a Private Cellar Phone Company (Telecel Zambia) and Rotary Club of Lusaka for Radiation Week to Radiation Protection Service under Theme 'Safe Radiation Use' is one such an example. The other opportunity is the technical cooperation with regional and international organisations such as SADC, IAEA, WHO, Interpol, EU and WCO for technical capacity building, human resource development and information access. (author)

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

    Directory of Open Access Journals (Sweden)

    Mwape Lonia

    2012-09-01

    Full Text Available Abstract 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.

  10. Improved HIV testing coverage after scale-up of ... - Lusaka

    African Journals Online (AJOL)

    Improved HIV testing coverage after scale-up of antiretroviral therapy programs in urban Zambia: Evidence from serial hospital surveillance. ... Background: We evaluated changing HIV testing coverage and prevalence rates before and after expanding city-wide antiretroviral therapy (ART) programs in Lusaka, Zambia.

  11. Structural adjustment and drought in Zambia.

    Science.gov (United States)

    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.

  12. Economic Justification Of Robust Or Adaptive Planning And Design Of Resilient Water Resources Systems Under Deep Uncertainty: A Case Study In The Iolanda Water Treatment Plant Of Lusaka, Zambia

    Science.gov (United States)

    Mendoza, G.; Tkach, M.; Kucharski, J.; Chaudhry, R.

    2017-12-01

    This discussion is focused around the application of a bottom-up vulnerability assessment procedure for planning of climate resilience to a water treament plant for teh city of Iolanda, Zambia. This project is a Millennium Challenge Corporation (MCC) innitiaive with technical support by the UNESCO category II, International Center for Integrated Water Resources Management (ICIWaRM) with secretariat at the US Army Corps of Engineers Institute for Water Resources. The MCC is an innovative and independent U.S. foreign aid agency that is helping lead the fight against global poverty. The bottom-up vulnerability assessmentt framework examines critical performance thresholds, examines the external drivers that would lead to failure, establishes plausibility and analytical uncertainty that would lead to failure, and provides the economic justification for robustness or adaptability. This presentation will showcase the experiences in the application of the bottom-up framework to a region that is very vulnerable to climate variability, has poor instituional capacities, and has very limited data. It will illustrate the technical analysis and a decision process that led to a non-obvious climate robust solution. Most importantly it will highlight the challenges of utilizing discounted cash flow analysis (DCFA), such as net present value, in justifying robust or adaptive solutions, i.e. comparing solution under different future risks. We highlight a solution to manage the potential biases these DCFA procedures can incur.

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

    Science.gov (United States)

    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

  14. Read full report, Youth employment challenges in Zambia

    International Development Research Centre (IDRC) Digital Library (Canada)

    Analysis at the Zambia Institute of Policy Analysis and Research. ...... The use of TEVET is specific to Zambia and there is no material difference between it and TVET. ..... to continue to upgrade their skills, in line with the job require- ments.

  15. Mental illness - stigma and discrimination in Zambia | Kapungwe ...

    African Journals Online (AJOL)

    Objective: The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other ...

  16. Perceptions of and Attitudes towards Ageing in Zambia

    Science.gov (United States)

    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…

  17. A Review of Outcome of Postgraduate Medical Training in Zambia ...

    African Journals Online (AJOL)

    A Review of Outcome of Postgraduate Medical Training in Zambia. K Bowa, F Goma, JINM Yikona, YF Mulla, SS Banda. Abstract. The University of Zambia School of Medicine was opened in 1966. Since inception, over 1200 undergraduate students have graduated with Bachelor of Medicine and Bachelor of Surgery.

  18. Conservation narratives and contested protected areas in Zambia: a ...

    African Journals Online (AJOL)

    Conservation narratives and contested protected areas in Zambia: a political ecological analysis. ... Mgbakoigba: Journal of African Studies ... This paper uses a political ecological perspective to examine the link between environmental conservation narratives and resource conflicts and degradation in Zambia's protected ...

  19. Promotion of couples? voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia

    OpenAIRE

    Kelley, April L.; Hagaman, Ashley K.; Wall, Kristin M.; Karita, Etienne; Kilembe, William; Bayingana, Roger; Tichacek, Amanda; Kautzman, Michele; Allen, Susan A.

    2016-01-01

    Abstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the f...

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

    Science.gov (United States)

    Serpell, Robert; Jere-Folotiya, Jacqueline

    2008-04-01

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

  1. Filoviral haemorrhagic fevers: A threat to Zambia?

    Directory of Open Access Journals (Sweden)

    Katendi Changula

    2012-06-01

    Full Text Available Filoviral haemorrhagic fevers (FVHF are caused by agents belonging to Filoviridae family, Ebola and Marburg viruses. They are amongst the most lethal pathogens known to infect humans. Incidence of FVHF outbreaks are increasing, with affected number of patients on the rise. Whilst there has been no report yet of FVHF in Zambia, its proximity to Angola and Democratic Republic of Congo, which have recorded major outbreaks, as well as the open borders, increased trade and annual migration of bats between these countries, puts Zambia at present and increased risk. Previous studies have indicated bats as potential reservoir hosts for filoviruses. An increasing population with an increasing demand for resources has forced incursion into previously uninhabited land, potentially bringing them into contact with unknown pathogens, reservoir hosts and/or amplifying hosts. The recent discovery of a novel arenavirus, Lujo, highlights the potential that every region, including Zambia, has for being the epicentre or primary focus for emerging and re-emerging infections. It is therefore imperative that surveillance for potential emerging infections, such as viral haemorrhagic fevers be instituted. In order to accomplish this surveillance, rapid detection, identification and monitoring of agents in patients and potential reservoirs is needed. International co-operation is the strategy of choice for the surveillance and fight against emerging infections. Due to the extensive area in which filoviral infections can occur, a regional approach to surveillance activities is required, with regional referral centres. There is a need to adopt shared policies for the prevention and control of infectious diseases. There is also need for optimisation of currently available tests and development of new diagnostic tests, in order to have robust, highly sensitive and specific diagnostic tests that can be used even where there are inadequate laboratories and diagnostic services.

  2. HIV, hepatitis B, and hepatitis C in Zambia

    Directory of Open Access Journals (Sweden)

    Kenneth C Kapembwa

    2011-01-01

    Full Text Available Objectives : Epidemiologic data of HIV and viral hepatitis coinfection are needed in sub-Saharan Africa to guide health policy for hepatitis screening and optimized antiretroviral therapy (ART. Materials and Methods: We screened 323 HIV-infected, ART-eligible adults for hepatitis B surface antigen (HBsAg and hepatitis C antibody (HCV Ab at a tertiary hospital in Lusaka, Zambia. We collected basic demographic, medical, and laboratory data to determine predictors for coinfection. Results: Of 323 enrolled patients, 32 (9.9%; 95% CI=6.7-13.2% were HBsAg positive, while 4 (1.2%; 95% CI=0.03-2.4% were HCV Ab positive. Patients with hepatitis B coinfection were more likely to be 200 IU/L was uncommon and did not differ between the two groups (3.4% vs. 2.3%; P=0.5. We were unable to determine predictors of hepatitis C infection due to the low prevalence of disease. Conclusions: HIV and hepatitis B coinfection was common among patients initiating ART at this tertiary care facility. Routine screening for hepatitis B should be considered for HIV-infected persons in southern Africa.

  3. Male and female sterility in Zambia

    Directory of Open Access Journals (Sweden)

    Athena Pantazis

    2014-02-01

    Full Text Available Background: Population measures of sterility are traditionally constructed for women, despite fertility and sterility being conditions of the couple. Estimates of male sterility provide insight into population-level sterility, and complement estimates based solely on women. Objective: This study seeks to estimate male sterility for the Gwembe Tonga of Zambia using male birth histories collected by the Gwembe Tonga Research Project from 1957 to 1995, while providing context by estimating female sterility for the Gwembe Tonga, as well as female sterility in all of Zambia, from Zambian DHS data (1992, 1997, 2001-02, and 2007. Methods: Sterility is measured using the Larson-Menken subsequently infertile indicator. Estimates are produced using discrete time event history analysis. Results: The odds of sterility were higher for women than men, though women's odds of sterility were only 1.5 times that of men's in the middle reproductive years. The odds of sterility increased steadily with age for both men and women, and across all datasets. However, women's sterility increased much more sharply with age than men's did, and women's odds of sterility were higher than men's at all reproductive ages.

  4. SAFARI 2000 Atmospheric Aerosol Measurements, Hand-held Hazemeters, Zambia

    Data.gov (United States)

    National Aeronautics and Space Administration — In conjunction with the AERONET (AErosol RObotic NETwork) participation in SAFARI 2000, the USDA Forest Service deployed handheld hazemeters in western Zambia from...

  5. Mental Health of HIV Positive Adolescents in Zambia

    African Journals Online (AJOL)

    Administrator

    2 School of Community Health Sciences, University of Nottingham, ... Keywords: HIV, adolescents, mental health, SDQ, Zambia. 1. 2 ... can only reduce the viral load but cannot eradicate it ... disclosure, stigma, fear of death and family conflict.

  6. A Review of Outcome of Postgraduate Medical Training in Zambia

    African Journals Online (AJOL)

    USER

    1University of Zambia, School of Medicine, 2Consultant Physician, UK. ABSTRACT ... average graduation rate is 5 students per annum. The largest specialist ... The secondary objective was .... of the examinations for Fellowship of the Nigerian.

  7. Medical Journal of Zambia - Vol 40, No 2 (2013)

    African Journals Online (AJOL)

    literacy adults: implications for neuropsychological test development in Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. L Ndhlovu, R Serpell, J Mwanza, 69-80 ...

  8. Orange maize in Zambia: crop development and delivery experience

    African Journals Online (AJOL)

    Orange maize in Zambia: crop development and delivery experience. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE ... African Journal of Food, Agriculture, Nutrition and Development. Journal Home ...

  9. Acute Flaccid Paralysis Surveillance in Zambia: Progress towards ...

    African Journals Online (AJOL)

    Acute Flaccid Paralysis Surveillance in Zambia: Progress towards the Polio End Game. ... to ensure that the affected children are adequately supported as a contribution to the polio eradication end game. ... AJOL African Journals Online.

  10. Distribution and phenology of ixodid ticks in southern Zambia.

    Science.gov (United States)

    Speybroeck, N; Madder, M; Van Den Bossche, P; Mtambo, J; Berkvens, N; Chaka, G; Mulumba, M; Brandt, J; Tirry, L; Berkvens, D

    2002-12-01

    Distribution data for epidemiologically important ticks (Acari: Ixodidae) in the Southern Province of Zambia, one of the main cattle areas of the country, are presented. Boophilus microplus (Canestrini) was not recorded in southern Zambia, whereas Boophilus decoloratus (Koch) is present throughout the area. New distribution patterns for less economically important ixodid ticks are also discussed. Southern Zambia is a transition zone because it is the most northern area in Africa where mixed Rhipicephalus appendiculatus Neumann and Rhipicephalus zambeziensis Walker, Norval & Corwin populations were reported. Although a second generation of adult R. appendiculatus/R. zamnbeziensis was encountered, simulations indicated that this phenomenon is very rare in southern Zambia, mainly because of the colder temperatures during the early dry season and lower rainfall. These simulations were supported by a development trial under experimental conditions. Tick body size measurements showed that southern Zambian ticks are larger than eastern Zambian R. appendiculatus. It is hypothesized that body size is related to diapausing intensity in this species. The epidemiological consequences are that a different approach to control Theileria parva (Theiler) (Piroplasmida: Theileriidae) and other tick-borne diseases is needed in southern Zambia, compared to the one adopted in eastern Zambia.

  11. Contraception and family planning among HIV-seroconcordant and -serodiscordant couples in the US and Zambia

    Directory of Open Access Journals (Sweden)

    Deborah L Jones

    2010-05-01

    Full Text Available Deborah L Jones1, Olga Villar-Loubet1, Chipepo Kankasa2, Ndashi Chitalu2, Miriam Mumbi2, Stephen M Weiss11Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Paediatrics, University of Zambia School of Medicine, Lusaka, ZambiaAbstract: With the advent of antiretroviral therapy, remarkable progress has been made in the reduction of morbidity and mortality associated with the human immunodeficiency virus (HIV. As a result, in both the developed and developing world, reproductive decision-making and family planning has re-emerged as an important health issue among HIV-seroconcordant and -serodiscordant couples. This study sought to explore contraceptive attitudes and practices among HIV-seropositive and -serodiscordant couples in the US and Zambia and to compare contraceptive decision-making between seroconcordant and discordant couples. Study results suggest that while most participants expressed a willingness to use protection to prevent pregnancy, the majority were not using protection consistently. Similarly, among seropositive younger men in both the US and Zambia, more men expressed a desire to have children than women of either serostatus group. Study outcomes also suggest that male and female condom use to reduce HIV transmission within couples is limited. Thus, as males are largely the sexual decision makers regarding condom use, women’s attitudes or plans regarding child bearing may be eclipsed by those of their male partners, and recent reductions in provision of female condoms in the developing world may further reduce women’s options to protect themselves and prevent pregnancy. Education and counseling on vertical and horizontal transmission of HIV among both seropositive and serodiscordant couples should be an element of family planning efforts. Conversely, family planning should be a critical element of HIV counseling and testing strategies to

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

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Shouta M.M.; Ikenaka, Yoshinori; Hamada, Kyohei [Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Kita 18, Nishi 9, Kita-ku, Sapporo 060-0818 (Japan); Muzandu, Kaampwe; Choongo, Kennedy [Department of Biomedical Studies, School of Veterinary Medicine, University of Zambia, P.O. Box 32379, Lusaka (Zambia); Teraoka, Hiroki; Mizuno, Naoharu [Department of Toxicology, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu 069-8501 (Japan); Ishizuka, Mayumi, E-mail: ishizum@vetmed.hokudai.ac.j [Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Kita 18, Nishi 9, Kita-ku, Sapporo 060-0818 (Japan)

    2011-01-15

    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. - The area around Kabwe, Zambia is highly polluted with metals and As. Wild rats from this area had high tissue concentrations of Pb and decreased body weight.

  13. A Qualitative Study of Migrant-related Stressors, Psychosocial Outcomes and HIV Risk Behavior among Truck Drivers in Zambia

    Science.gov (United States)

    Ncube, Nomagugu; Simona, Simona J.; Kansankala, Brian; Sinkala, Emmanuel; Raidoo, Jasmin

    2017-01-01

    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), labor migrant-related stressors, psychosocial problems and HIV risk behaviors among truck drivers in Zambia and 2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behavior among truck drivers in Zambia. We conducted fifteen 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 behaviors. 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

  14. Rift Valley fever: Real or perceived threat for Zambia?

    Directory of Open Access Journals (Sweden)

    George Dautu

    2012-06-01

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

  15. Socio-economic, gender and health services factors affecting diagnostic delay for tuberculosis patients in urban Zambia.

    Science.gov (United States)

    Needham, D M; Foster, S D; Tomlinson, G; Godfrey-Faussett, P

    2001-04-01

    In-depth interviews regarding health seeking behaviour were conducted with 202 adults registered with pulmonary tuberculosis at the centralized Chest Clinic in Lusaka, Zambia. The median (mean) diagnostic delay was 8.6 (9) weeks, and was significantly associated with the following factors: female sex, lower education, more than six instances of health-seeking encounters, outpatient diagnosis of tuberculosis, and visiting a private doctor or traditional healer. More effective tuberculosis control interventions require novel methods of accessing women and less educated people. Decentralization of public tuberculosis care and improved integration with private sector health providers may also reduce diagnostic delay.

  16. Mapping the geographical distribution of lymphatic filariasis in Zambia

    DEFF Research Database (Denmark)

    Mwase, Enala T; Stensgaard, Anna-Sofie; Nsakashalo-Senkwe, Mutale

    2014-01-01

    to be an important determinant of medium-high prevalence levels. CONCLUSIONS/SIGNIFICANCE: LF was found to be surprisingly widespread in Zambia, although in most places with low prevalence. The produced maps and the identified environmental correlates of LF infection will provide useful guidance for planning...... volunteers from 108 geo-referenced survey sites across Zambia were examined for circulating filarial antigens (CFA) with rapid format ICT cards, and a map indicating the distribution of CFA prevalences in Zambia was prepared. 78% of survey sites had CFA positive cases, with prevalences ranging between 1......% and 54%. Most positive survey sites had low prevalence, but six foci with more than 15% prevalence were identified. The observed geographical variation in prevalence pattern was examined in more detail using a species distribution modeling approach to explore environmental requirements for parasite...

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

    Directory of Open Access Journals (Sweden)

    Ferrinho Paulo

    2011-12-01

    Full Text Available Abstract 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

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

    Science.gov (United States)

    Ferrinho, Paulo; Siziya, Seter; Goma, Fastone; Dussault, Gilles

    2011-12-19

    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. 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. The highest relative concentration of all categories of workers was observed in Northern, Eastern, Lusaka, Western and Luapula provinces (in decreasing order of number of health workers).The ratio of clinical officers (mid-level clinical practitioners) to general medical officer (doctors with university training) varied from 3.77 in the Lusaka to 19.33 in the Northwestern provinces. For registered nurses (3 to 4 years of mid-level training), the ratio went from 3.54 in the Western to 15.00 in Eastern provinces and for enrolled nurses (two years of basic training) from 4.91 in the Luapula to 36.18 in the Southern provinces.This unequal distribution was reflected in the ratio of population per cadre. The provincial distribution of personnel showed a skewed staff distribution in favour of urbanized provinces, e.g. in Lusaka's doctor: population ratio was 1: 6,247 compared to Northern Province's ratio of 1: 65,763.In the whole country, the data set showed only 109 staff in health posts: 1 clinical officer, 3 environmental health technologists, 2 registered nurses, 12 enrolled midwives, 32 enrolled nurses, and 59 other.The vacancy rates for level 3 facilities(central hospitals, national level) varied from 5% in Lusaka to 38% in Copperbelt Province; for level 2 facilities (provincial level hospitals), from

  19. The institutional context of tobacco production in Zambia.

    Science.gov (United States)

    Labonté, Ronald; Lencucha, Raphael; Drope, Jeffrey; Packer, Corinne; Goma, Fastone M; Zulu, Richard

    2018-01-16

    Tobacco production is said to be an important contributor to Zambia's economy in terms of labour and revenue generation. In light of Zambia's obligations under the WHO Framework Convention of Tobacco Control (FCTC) we examined the institutional actors in Zambia's tobacco sector to better understand their roles and determine the institutional context that supports tobacco production in Zambia. Findings from 26 qualitative, semi-structured individual or small-group interviews with key informants from governmental, intergovernmental and non-governmental organisations were analysed, along with data and information from published literature. Although Zambia is obligated under the FCTC to take steps to reduce tobacco production, the country's weak economy and strong tobacco interests make it difficult to achieve this goal. Respondents uniformly acknowledged that growing the country's economy and ensuring employment for its citizens are the government's top priorities. Lacklustre coordination and collaboration between the institutional actors, both within and outside government, contributes to an environment that helps sustain tobacco production in the country. A Tobacco Products Control Bill has been under review for a number of years, but with no supply measures included, and with no indication of when or whether it will be passed. As with other low-income countries involved in tobacco production, there is inconsistency between Zambia's economic policy to strengthen the country's economy and its FCTC commitment to regulate and control tobacco production. The absence of a whole-of-government approach towards tobacco control has created an institutional context of duelling objectives, with some government ministries working at cross-purposes and tobacco interests left unchecked. With no ultimate coordinating authority, this industry risks being run according to the desire and demands of multinational tobacco companies, with few, if any, checks against them.

  20. Diabetes mellitus, hypertension and albuminuria in rural Zambia

    DEFF Research Database (Denmark)

    Rasmussen, Jon B; Thomsen, Jakúp A; Rossing, Peter

    2013-01-01

    OBJECTIVE: To assess albuminuria in rural Zambia among patients with diabetes mellitus only (DM group), hypertension only (HTN group) and patients with combined DM and HTN (DM/HTN group). METHODS: A cross-sectional survey was conducted at St. Francis Hospital in the Eastern province of Zambia...... of DM or HTN. RESULTS: A total of 193 participants were included (DM group: n = 33; HTN group: n = 92; DM/HTN group: n = 68). The participants in the DM group used insulin more frequently as diabetes medication than the DM/HTN group (P

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

    Science.gov (United States)

    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

  2. Video-Voice Project (Zambia) | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Video-Voice Project (Zambia). The Zambian health care system has been negatively affected by globalization and faces severe resource constraints. The government has adopted a health reform that emphasizes public participation. This approach requires an informed citizenry, however, at a time when the country is facing ...

  3. Equity Gauge Zambia : Enhancing Governance, Equity and Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... identifying strategies for and indicators of equitable community participation; refining a ... Human resources for health in Zambia : equity and health system strengthening; some local perspectives (IDRC lunch hour discussion, Ottawa, 22 Mar. ... and adaptive water management: Innovative solutions from the Global South”.

  4. Medical Journal of Zambia - Vol 44, No 4 (2017)

    African Journals Online (AJOL)

    Pancreatic cancer: Patterns in a low- to middle- income Ppopulation, Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A.W. Asombang, R. Madsen, M. Simuyandi, G. Phiri, M. Bechtold, J.A. Ibdah, K. Lishimpi, L. Banda, 212-217 ...

  5. Medical Journal of Zambia - Vol 42, No 4 (2015)

    African Journals Online (AJOL)

    DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. W Mweemba, 144-149. Effect of Indoor Residual Spraying on the Incidence of Malaria in Kaoma District of Western Zambia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. E Phiri, KS Baboo, J Miller, 150-158 ...

  6. Cigarette smoking among school-going adolescents in Kafue, Zambia

    African Journals Online (AJOL)

    Introduction: Cigarette smoking is a leading cause of global morbidity and mortality. Interest in developing countries smoking prevalence has been growing since 1999. Objectives: To estimate the prevalence of current cigarette smoking and associated factors among school-age adolescents in Kafue, Zambia. Methods: A ...

  7. Postpartum care attendance at a rural district hospital in Zambia

    NARCIS (Netherlands)

    J. Lagro (Joep); A. Liche (Agnes); J. Mumba (John); R. Ntebeka (Ruth); J. van Roosmalen (Jos)

    2006-01-01

    textabstractPostpartum care is an important tool in both preventive and promotive maternal health care. We studied the postpartum care attendance rate in 540 women who delivered at a district hospital in Zambia. Forty-two percent of the women attended postpartum care within six weeks of delivery.

  8. Self-inflicted serious injuries among adolescents in Zambia | Muula ...

    African Journals Online (AJOL)

    The following variables were associated with history of self inflicted injury: worry; sadness; suicidal behavior; history of ever having been drunk and marijuana use. Reported history of injury and self-inflicted injury among in-school adolescents in Zambia are common. History of self-inflicted injury was associated with other ...

  9. Gastric Malignancy Survival in Zambia, Southern Africa: A Two Year ...

    African Journals Online (AJOL)

    Esem

    numbers provided at time of enrollment. Corresponding author: ... duration of symptoms, treatment (surgery, chemotherapy, ... Zambia and no studies about management survival out comes. ... evaluated risk factors associated with gastric cancer survival in ... patients because patient financial limitations precluded testing for ...

  10. Heart Failure in Zambia: Evidence for Improving Clinical Practice.

    African Journals Online (AJOL)

    Esem

    reducing mortality, but also on improving quality of life. ... Heart Failure in Zambia: Evidence for Improving ... likely to be a result of “informed guess work” with ... balance. The study reported that a high serum urea and high creatinine were ...

  11. Social Isolation and Aging in Zambia: Examining the Possible Predictors

    Directory of Open Access Journals (Sweden)

    Christopher Chabila Mapoma

    2012-01-01

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

  12. adherence to antiretroviral treatment in Zambia: a qualitative study

    African Journals Online (AJOL)

    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\\' ...

  13. Rabies trends and surveillance capabilities in Zambia | Kabaso ...

    African Journals Online (AJOL)

    The main objective of this study was to assess the trends, distribution and positivity rate of rabies cases in Zambia. A retrospective study for the period of 10 years between 2004 and 2014, was conducted by using rabies case reports. The data were analyzed with descriptive statistics and geo-coded in Quantum ...

  14. Mapping Postgraduate Research at the University of Zambia: A ...

    African Journals Online (AJOL)

    Mapping Postgraduate Research at the University of Zambia: A review of dissertations for the Master of Medicine Programme. ... Over half of the dissertations (76, 57.6%) addressed the determinants of the cause, risk and development of diseases; and a third dealt with management and evaluation of diseases (26 and 18, ...

  15. The Luangwa Valley, Zambia: flyway and stopover site for White ...

    African Journals Online (AJOL)

    Analyses of satellite telemetry data of White Storks Ciconia ciconia from the eastern populations at their stopover sites and staging areas document the importance of the Luangwa Valley, eastern Zambia, as a migration corridor bridging eastern and southern Africa. Twice each year from November to April, up to 100 000 ...

  16. Tuberculosis in the mines of Zambia: A case for intervention

    Directory of Open Access Journals (Sweden)

    Pascalina Chanda-Kapata

    2016-09-01

    Full Text Available Zambia is among the sub-Saharan countries highly burdened with tuberculosis (TB and has an estimated prevalence rate of 638 per 100000 population in those aged 15 years and above. The mining industry is the main contributor to the country's gross national product, although it is associated with public health challenges, with TB in the mines being among the occupational health diseases having a negative economic impact and threatening to delay the control of TB in the country. We reviewed available evidence on the extent of the burden of TB in the mines so as to inform the development of targeted interventions for the post-2015 End TB Strategy. This was a review of published data from Medline/Pubmed, Cochrane Library and Embase, including unpublished “grey” literature on the burden of TB and the risk factors of TB in the mines of Zambia. There is limited research in Zambia to fully understand the burden of TB and risk factors associated with TB in the mines. However, the few studies and data available have shown that TB is a significant health problem requiring interventions to improve the quality of life of miners, ex-miners and surrounding communities. TB is a potential problem in the mines of Zambia and the actual burden needs to be determined. Exposure to silica as a risk factor needs further investigation.

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

    Science.gov (United States)

    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

  18. Biochar Effect on Maize Yield and Soil Characteristics in Five Conservation Farming Sites in Zambia

    Directory of Open Access Journals (Sweden)

    Alfred Obia

    2013-04-01

    Full Text Available 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

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

    Science.gov (United States)

    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

  20. Molecular characterisation of methicillin-resistant Staphylococcus aureus (MRSA) isolated at a large referral hospital in Zambia.

    Science.gov (United States)

    Samutela, Mulemba Tillika; Kalonda, Annie; Mwansa, James; Lukwesa-Musyani, Chileshe; Mwaba, John; Mumbula, Enoch Mulowa; Mwenya, Darlington; Simulundu, Edgar; Kwenda, Geoffrey

    2017-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is globally recognized as an important public health problem. Whereas comprehensive molecular typing data of MRSA strains is available, particularly in Europe, North America and Australia, similar information is very limited in sub-Saharan Africa including Zambia. In this study, thirty two clinical isolates of Staphylococcus aureus , collected at a large referral hospital in Lusaka, Zambia between June 2009 and December 2012 were analysed by Staphylococcal cassette chromosome mec (SCCmec), Staphylococcus protein A gene typing (spa) and detection of the Panton-Valentine Leukocidin genes (pvl) . Three SCC mec types were identified namely SCC mec type IV (65.6%), SCCmec type III (21.9%), SCC mec type I (3.1%). Nine point four percent (9.4%) of the isolates were untypable. Five spa types, which included a novel type, were detected and the most prevalent spa type was t064 (40.6%). Other spa types included spa types t2104 (31.3%), t355 (3.1%) and t1257 (21.9%). The pvl genes were detected in 3 out of 32 isolates. These molecular typing data indicated that the MRSA strains collected in Lusaka were diverse. Although the source of these MRSA was not established, these results stress the need for assessing infection prevention and control procedures at this health-care facility in order to curtail possible nosocomial infections. Furthermore, country-wide surveillance of MRSA in both the community and health-care facilities is recommended for infection prevention and control. To our knowledge, this represents the first study to characterise MRSA using molecular tools in Zambia.

  1. Experiences of work among people with disabilities who are HIV-positive in Zambia.

    Science.gov (United States)

    Njelesani, Janet; Nixon, Stephanie; Cameron, Deb; Parsons, Janet; Menon, Anitha

    2015-01-01

    This paper focuses on accounts of how having a disability and being HIV-positive influences experiences of work among 21 people (12 women, 9 men) in Lusaka, Zambia. In-depth semi-structured interviews were conducted in English, Bemba, Nyanja, or Zambian sign language. Descriptive and thematic analyses were conducted. Three major themes were generated. The first, a triple burden, describes the burden of having a disability, being HIV-positive, and being unemployed. The second theme, disability and HIV is not inability, describes participants' desire for work and their resistance to being regarded as objects of charity. Finally, how work influences HIV management, describes the practicalities of working and living with HIV. Together these themes highlight the limited options available to persons with disabilities with HIV in Lusaka, not only secondary to the effects of HIV influencing their physical capacity to work, but also because of the attendant social stigma of being a person with a disability and HIV-positive.

  2. Cigarette price and other factors associated with brand choice and brand loyalty in Zambia: findings from the ITC Zambia Survey.

    Science.gov (United States)

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

    2015-07-01

    Little is known about cigarette pricing and brand loyalty in sub-Saharan Africa. This study examines these issues in Zambia, analysing data from the International Tobacco Control (ITC) Zambia Survey. Data from Wave 1 of the ITC Zambia Survey (2012) were analysed for current smokers of factory-made (FM) cigarettes compared with 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. 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% brands was ZMW0.50 (US$0.08) 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. "Health regains but livelihoods lag": findings from a study with people on ART in Zambia and Kenya.

    Science.gov (United States)

    Samuels, Fiona A; Rutenberg, Naomi

    2011-06-01

    Although ART is increasingly accessible and eases some stresses, it creates other challenges including the importance of food security to enhance ART-effectiveness. This paper explores the role livelihood strategies play in achieving food security and maintaining nutritional status among ART patients in Kenya and Zambia. Ongoing quantitative studies exploring adherence to ART in Mombasa, Kenya (n=118) and in Lusaka, Zambia (n=375) were used to identify the relationship between BMI and adherence; an additional set of in-depth interviews with people on ART (n=32) and members of their livelihood networks (n=64) were undertaken. Existing frameworks and scales for measuring food security and a positive deviance approach was used to analyse data. Findings show the majority of people on ART in Zambia are food insecure; similarly most respondents in both countries report missing meals. Snacking is important for dietary intake, especially in Kenya. Most food is purchased in both countries. Having assets is key for achieving livelihood security in both Kenya and Zambia. Food supplementation is critical to survival and for developing social capital since most is shared amongst family members and others. Whilst family and friends are key to an individual's livelihood network, often more significant for daily survival is proximity to people and the ability to act immediately, characteristics most often found amongst neighbours and tenants. In both countries findings show that with ART health has rebounded but livelihoods lag. Similarly, in both countries respondents with high adherence and high BMI are more self-reliant, have multiple income sources and assets; those with low adherence and low BMI have more tenuous livelihoods and were less likely to have farms/gardens. Food supplementation is, therefore, not a long-term solution. Building on existing livelihood strategies represents an alternative for programme managers and policy-makers as do other strategies including

  4. Antimicrobial Resistant Enteropathogenic Escherichia coli and Salmonella spp. in Houseflies Infesting Fish in Food Markets in Zambia

    Directory of Open Access Journals (Sweden)

    Mwansa M. Songe

    2016-12-01

    Full Text Available Diarrhea is one of the most common diseases and is a leading cause of death in developing countries. This is often caused by contaminated food. Poor food hygiene standards are exacerbated by the presence of flies which can transmit a variety of infectious microorganisms, particularly through animal source foods. This fact becomes especially important in developing countries like Zambia, where fish is a highly valued source of protein. Our interest in this study was to identify if the flies that beset food markets in Zambia carry important pathogenic bacteria on their bodies, and subsequently if these bacteria carry resistance genes to commonly used antibiotics, which would indicate problems in eradicating these pathogens. The present study took into account fish vendors’ and consumers’ perception of flies and interest in interventions to reduce their numbers. We conducted semi-structured interviews with (1 traders (comprised of randomly selected males and females and (2 consumers (including randomly selected males and females. Thereafter, we collected flies found on fish in markets in Mongu and Lusaka districts of Zambia. For the entire study, a total of 418 fly samples were analyzed in the laboratory and Salmonella spp. and enteropathogenic Escherichia coli were isolated from the flies. Further laboratory screening revealed that overall, 17.2% (72/418 (95% CI; 43.2%–65.5% of total samples analyzed contained Extended-Spectrum Beta-Lactamase (ESBL-producing E. coli. These significant findings call for a strengthening of the antibiotic administering policy in Zambia and the development of sustainable interventions to reduce fly numbers in food markets and improve food safety and hygiene.

  5. Rural-urban migration in Zambia and migrant ties to home villages.

    Science.gov (United States)

    Ogura, M

    1991-06-01

    Rural to urban migration patterns in Zambia and migrant ties to home villages are discussed 1st in terms of a statistical overview of migration and urbanization, and followed by an examination of lengthening stays in towns and ties to the home village based on other studies and the author's field research and random sampling in 6 urban areas of Zambia. The primary population centers are the copperbelt which comprises 45% of the total urban population, and Lusaka which is 24% of the total urban population. 31% of the total population reside in Lusaka, 7 mining towns, Kabwe, and Livingstone. Migration and a high rate of natural population growth are responsible for the urban growth. Recent economic difficulties have reduced the flow of migration to urban areas and lead to the out migration in copper towns. independence also has had an effect on migration, such that female migration increased along with male migration. Female migration reflects female educational advances and the changing practice of housewives accompanying husbands. The informal sector absorbs a great number of the migrant labor force. Income gaps between urban and rural areas also contribute to migration flows. Other magnets in urban areas are better educational opportunities, a water supply, and the lure of city lights. Since independence, migrants have increased their length of stay in towns but continue to maintain links with their home villages. 87.5% of mine workers are estimated as intending to go back to their villages. Before the mid-1970s it is estimated in a Ngombe squatter camp that 65% of employed male household heads had sent money home the prior year, 58% had visited home within the past 5 years, but 25% had never visited in 10 years. 58% intended to return home and 36% intended to stay permanently. The author's research between 1987-89 found 3 types of squatter villages: those retired and not returning to home villages such as Kansusuwa, those workers living in compounds where farm

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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.

  8. A Brief History of Kafue National Park, Zambia.

    Directory of Open Access Journals (Sweden)

    H.K. Mwima

    2001-07-01

    Full Text Available This paper presents the first documentation of the history of Zambia's oldest and largest national park: Kafue National Park. The movement of people out of the park is systematically presented. Furthermore, access and resource use and exploitation rights granted to people who lived inside the park are summarised. The paper looks at park administration, wildlife management, tourism and briefly presents areas for future studies.

  9. Assessing income redistributive effect of health financing in Zambia.

    Science.gov (United States)

    Mulenga, Arnold; Ataguba, John Ele-Ojo

    2017-09-01

    Ensuring an equitable health financing system is a major concern particularly in many developing countries. Internationally, there is a strong debate to move away from excessive reliance on direct out-of-pocket (OOP) spending towards a system that incorporates a greater element of risk pooling and thus affords greater protection for the poor. This is a major focus of the move towards universal health coverage (UHC). Currently, Zambia with high levels of poverty and income inequality is implementing health sector reforms for UHC through a social health insurance scheme. However, the way to identify the health financing mechanisms that are best suited to achieving this goal is to conduct empirical analysis and consider international evidence on funding universal health systems. This study assesses, for the first time, the progressivity of health financing and how it impacts on income inequality in Zambia. Three broad health financing mechanisms (general tax, a health levy and OOP spending) were considered. Data come from the 2010 nationally representative Zambian Living Conditions and Monitoring Survey with a sample size of 19,397 households. Applying standard methodologies, the findings show that total health financing in Zambia is progressive. It also leads to a statistically significant reduction in income inequality (i.e. a pro-poor redistributive effect estimated at 0.0110 (p taxes (0.0101 (p taxes. This points to areas where government policy may focus in attempting to reduce the high level of income inequality and to improve equity in health financing towards UHC in Zambia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Telemedicine and primary health: The virtual doctor project Zambia

    OpenAIRE

    Mupela, Evans; Mustarde, Paul; Jones, Huw

    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 d...

  11. Economics and subjectivities of wellbeing in rural Zambia

    OpenAIRE

    White, Sarah; Ramirez, Viviana

    2015-01-01

    Mixed method research in Chiawa rural Zambia explores the importance of the economic within subjective dimensions of wellbeing. Statistical analysis shows a close relationship between subjective economic confidence and overall happiness, and that objective economic status predicts some subjective dimensions of wellbeing. Qualitative analysis explores the role of economic capacity in forging (male) gender identities; the emphasis on reciprocity and a moral economy; and the use of economics as ...

  12. Resuscitating voter interest in Zambia: the Adult Education Association of Zambia's role in national elections.

    Science.gov (United States)

    Chakanika, W W; Chuma, P C

    1999-08-01

    This paper examines the role of the Adult Education Association of Zambia (AEAZ) in the Zambian national elections. Outlined in this paper are workshop topics, challenges encountered, and outcomes of the education campaign by the AEAZ in its crusade to inform voters of their rights and obligations. The six interrelated topics presented at various civic awareness campaigns were leadership qualities; community participation in national development; responsible citizenship; electoral process and the management of elections; the role of a member parliament; and human rights. The primary problem of the AEAZ campaign was language. Although English is preferred in urban areas, most of the residents in the rural areas are illiterate, and the campaign had to be conducted in several local languages, where most of the people were unfamiliar to campaigners. Other challenges affecting the AEAZ outreach efforts were lack of reliable transportation and lack of funds. Despite these challenges, the campaign was successful in encouraging citizens to vote, lobbying, advocacy, and holding political representatives accountable for their actions. This was evident in the 1996 presidential and general elections, in which there was a significant increase in the number of voters who took part in the electoral process. This paper concludes that nongovernmental organizations involved in the sensitization campaigns should coordinate and collaborate in order to enhance their capacity.

  13. Molecular epidemiology of infectious bursal disease virus in Zambia

    Directory of Open Access Journals (Sweden)

    Christopher J. Kasanga

    2013-10-01

    Full Text Available Nucleotide sequences of the VP2 hypervariable region (VP2-HVR of 10 infectious bursal disease viruses detected in indigenous and exotic chickens in Zambia from 2004 to 2005 were determined. Phylogenetic analysis showed that the viruses diverged into two genotypes and belonged to the African very virulent types (VV1 and VV2. In the phylogenetic tree, strains in one genotype clustered in a distinct group and were closely related to some strains isolated in western Africa (VV1, with nucleotide similarities of 95.7%– 96.5%. Strains in the other genotype were clustered within the eastern African VV type (VV2, with nucleotide similarities of 97.3%– 98.5%. Both genotypes were distributed in the southern parts of Zambia and had a unique conserved amino acid substitution at 300 (E→A in addition to the putative virulence marker at positions 222(A, 242(I, 256(I, 294(I and 299(S. These findings represent the first documentation of the existence of the African VV-IBDV variants in both indigenous and exotic chickens in Zambia.

  14. "Lazy men", time-use, and rural development in Zambia.

    Science.gov (United States)

    Whitehead, A

    1999-11-01

    This paper examines how work and the labor in agriculture in rural sub-Saharan Africa is measured. Section 1 presents a historical example of colonial discourses of the "lazy" African (the Lamba in Zambia). Section 2 analyzes a study carried out in rural Zambia to illustrate the relationship between stereotypes held by many Europeans, particular aspects of the colonial project, and the social relations brought about by colonialism. Section 3 examines the ways in which present work and labor approaches in sub-Saharan Africa embody value judgements which leads to distorted documentation of the division of labor between opposite genders. Sections 4 through 7 look at a time-use study conducted in Zambia and argue that studies of such nature create value judgement on what comprises work, and about how researchers and planners classify this. Overall, this article has demonstrated that time-use surveys may provide inadequate understanding of women and men's work in the absence of an understanding of the local context in which the work is undertaken, and of labor markets.

  15. 5. Anaemia in Pregnancy among Pregnant Women in Lusaka ...

    African Journals Online (AJOL)

    user

    University Teaching Hospitals, Women and Newborn Hospital, Private Bag, RW1X, Lusaka, Zambia. Medical .... (21.8%) were single, one hundred and sixty nine. (78.2%) were .... were employed could have had long working hours with a very ...

  16. Explorations in the history and sociology of territorial cults in Zambia (1500-1950 CE)

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.; Binsbergen, van W.M.J.

    1981-01-01

    Aim of this volume, which brings together seven studies of religious change in Zambia, is to describe the processes of religious change in this country during the last few centuries. These studies are: 1) Towards a theory of religious change in Central Africa. 2) Possession and mediumship in Zambia:

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

    Science.gov (United States)

    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…

  18. Urbanization in Zambia. An International Urbanization Survey Report to the Ford Foundation.

    Science.gov (United States)

    Simmance, Alan J. F.

    This report reviews the "Seers Report," which contained policy guidelines for modern development planning in Zambia, and compares its findings to recent findings during the period 1963-1970. The Seers Report found that Zambia was the most urbanized country in Africa south of the Sahara (excluding South Africa). This report finds that…

  19. 77 FR 60966 - Executive-Led Trade Mission to South Africa and Zambia

    Science.gov (United States)

    2012-10-05

    ... Africa and Zambia AGENCY: International Trade Administration, Department of Commerce. ACTION: Notice...- Led Trade Mission to South Africa and Zambia scheduled for November 26- 30, 2012, to revise the dates... and scheduling constraints permit), interested U.S. agriculture, mining, transportation, water, energy...

  20. Speaking of Satan in Zambia : The persuasiveness of contemporary narratives about Satanism

    NARCIS (Netherlands)

    Kamps, J.

    2018-01-01

    According to an old English proverb, ‘Speak of the devil, and he appears.’ In contemporary Zambia, many people are speaking about Satan and Satanists. Satanism refers in Zambia to a supposed organization, headed by Satan, dedicated to bring evil and harm, especially to Christians. Ex-Satanists claim

  1. Access to health care for children with neural tube defects: Experiences of mothers in Zambia

    Directory of Open Access Journals (Sweden)

    Micah M. Simpamba

    2016-12-01

    Full Text Available Introduction: In Zambia, all children born with neural tube defects requiring surgery need to be referred to a tertiary level hospital in Lusaka, the capital city, where the specialists are based. The aim of this study was to explore the experiences of mothers accessing health care who had recently given birth to a child with a neural tube defect. Methods and analysis: In-depth interviews were conducted with a purposively selected sample of 20 mothers at the tertiary level hospital. The interviews were audiotaped, transcribed verbatim and translated. Content analysis was used to identify codes, which were later collapsed into categories and themes. Findings: Five themes emerged: access to health care, access to transport, access to information, concerns about family and support needs. Discussion: Barriers to access to health care included geographical barriers and barriers linked to availability. Geographical barriers were related to distance between home and the health centre, and referral between health facilities. Barriers to availability included the lack of specialist health workers at various levels, and insufficient hospital vehicles to transport mothers and children to the tertiary level hospital. The main barrier to affordability was the cost of transport, which was alleviated by either family or government support. Acceptability of the health services was affected by a lack of information, incorrect advice, the attitude of health workers and the beliefs of the family. Conclusion: Access to health care by mothers of children with neural tube defects in Zambia is affected by geographical accessibility, availability, affordability and acceptability. The supply-side barriers and demand-side barriers require different interventions to address them. This suggests that health policy is needed which ensures access to surgery and follow-up care.

  2. Secular trends in pediatric antiretroviral treatment programs in rural and urban Zambia: a retrospective cohort study.

    Science.gov (United States)

    Sutcliffe, Catherine G; Bolton-Moore, Carolyn; van Dijk, Janneke H; Cotham, Matt; Tambatamba, Bushimbwa; Moss, William J

    2010-07-30

    Since 2003 pediatric antiretroviral treatment (ART) programs have scaled-up in sub-Saharan Africa and should be evaluated to assess progress and identify areas for improvement. We evaluated secular trends in the characteristics and treatment outcomes of children in three pediatric ART clinics in urban and rural areas in Zambia. Routinely collected data were analyzed from three ART programs in rural (Macha and Mukinge) and urban (Lusaka) Zambia between program implementation and July 2008. Data were obtained from electronic medical record systems and medical record abstraction, and were categorized by year of program implementation. Characteristics of all HIV-infected and exposed children enrolled in the programs and all children initiating treatment were compared by year of implementation. Age decreased and immunologic characteristics improved in all groups over time in both urban and rural clinics, with greater improvement observed in the rural clinics. Among children both eligible and ineligible for ART at clinic enrollment, the majority started treatment within a year. A high proportion of children, particularly those ineligible for ART at clinic enrollment, were lost to follow-up prior to initiating ART. Among children initiating ART, clinical and immunologic outcomes after six months of treatment improved in both urban and rural clinics. In the urban clinics, mortality after six months of treatment declined with program duration, and in the rural clinics, the proportion of children defaulting by six months increased with program duration. Treatment programs are showing signs of progress in the care of HIV-infected children, particularly in the rural clinics where scale-up increased rapidly over the first three years of program implementation. However, continued efforts to optimize care are needed as many children continue to enroll in ART programs at a late stage of disease and thus are not receiving the full benefits of treatment.

  3. Assessing the consequences of stigma for tuberculosis patients in urban Zambia.

    Directory of Open Access Journals (Sweden)

    Anne Lia Cremers

    Full Text Available 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.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.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.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.The findings illustrate that many TB patients faced stigma-related issues, often hindering effective TB control and suggesting that current efforts to reduce stigma are not yet optimal. The content and implementation of sensitization

  4. Perceptions of HIV-related health services in Zambia for people with disabilities who are HIV-positive

    Science.gov (United States)

    Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse

    2014-01-01

    Introduction Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. Methods This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Results Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants’ profound concerns about poverty and unmet basic needs. Discussion This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Conclusions Despite the growing body of literature on increased

  5. Perceptions of HIV-related health services in Zambia for people with disabilities who are HIV-positive.

    Science.gov (United States)

    Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse

    2014-01-01

    Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants' profound concerns about poverty and unmet basic needs. This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Despite the growing body of literature on increased risk of exposure to HIV among HIV-negative PWDs, this is

  6. Promotion of couples' voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia.

    Science.gov (United States)

    Kelley, April L; Hagaman, Ashley K; Wall, Kristin M; Karita, Etienne; Kilembe, William; Bayingana, Roger; Tichacek, Amanda; Kautzman, Michele; Allen, Susan A

    2016-08-08

    Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples' voluntary counseling and testing (CVCT), fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs) and influential network agents (INAs) in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %-90 %) INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %-97 %) and speaking to a community leader about CVCT (79 %-88 %) in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %). In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %). CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can successfully promote evidence-based HIV prevention in Africa. Support from

  7. Promotion of couples’ voluntary HIV counseling and testing: a comparison of influence networks in Rwanda and Zambia

    Directory of Open Access Journals (Sweden)

    April L. Kelley

    2016-08-01

    Full Text Available Abstract Background Many African adults do not know that partners in steady or cohabiting relationships can have different HIV test results. Despite WHO recommendations for couples’ voluntary counseling and testing (CVCT, fewer than 10 % of couples have been jointly tested and counseled. We examine the roles and interactions of influential network leaders (INLs and influential network agents (INAs in promoting CVCT in Kigali, Rwanda and Lusaka, Zambia. Methods INLs were identified in the faith-based, non-governmental, private, and health sectors. Each INL recruited and mentored several INAs who promoted CVCT. INLs and INAs were interviewed about demographic characteristics, promotional efforts, and working relationships. We also surveyed CVCT clients about sources of CVCT information. Results In Zambia, 53 INAs and 31 INLs were surveyed. In Rwanda, 33 INAs and 27 INLs were surveyed. Most (75 %–90 % INAs believed that INL support was necessary for their promotional work. Zambian INLs reported being more engaged with their INAs than Rwandan INLs, with 58 % of Zambian INLs reporting that they gave a lot of support to their INAs versus 39 % in Rwanda. INAs in both Rwanda and Zambia reported promoting CVCT via group forums (77 %–97 % and speaking to a community leader about CVCT (79 %–88 % in the past month. More Rwandan INAs and INLs reported previous joint or individual HIV testing compared with their Zambian counterparts, of which more than half had not been tested. In Zambia and Rwanda, 1271 and 3895 CVCT clients were surveyed, respectively. Hearing about CVCT from INAs during one-on-one promotions was the most frequent source of information reported by clients in Zambia (71 %. In contrast, Rwandan couples who tested were more likely to have heard about CVCT from a previously tested couple (59 %. Conclusions CVCT has long been endorsed for HIV prevention but few couples have been reached. Influential social networks can

  8. Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia

    Directory of Open Access Journals (Sweden)

    Butts SA

    2017-09-01

    Full Text Available Stefani A Butts,1 Lauren E Parmley,1 Maria L Alcaide,1 Violeta J Rodriguez,1 Annette Kayukwa,2 Ndashi Chitalu,2 Stephen M Weiss,1 Deborah L Jones1 1Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Pediatrics, University of Zambia, Lusaka, Zambia Abstract: In Zambia, adolescent girls and young women (AGYW are disproportionately affected by human immunodeficiency virus (HIV, social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW. Keywords: HIV, sub-Saharan Africa, prevention, adolescent girls, women, Zambia

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

    Science.gov (United States)

    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 refeeding syndrome. Further studies of cellular metabolism in this population are needed. PMID:23691292

  10. Quality of antenatal care in Zambia: a national assessment

    Science.gov (United States)

    2012-01-01

    Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601

  11. Price, tax and tobacco product substitution in Zambia.

    Science.gov (United States)

    Stoklosa, Michal; Goma, Fastone; Nargis, Nigar; Drope, Jeffrey; Chelwa, Grieve; Chisha, Zunda; Fong, Geoffrey T

    2018-03-24

    In Zambia, the number of cigarette users is growing, and the lack of strong tax policies is likely an important cause. When adjusted for inflation, levels of tobacco tax have not changed since 2007. Moreover, roll-your-own (RYO) tobacco, a less-costly alternative to factory-made (FM) cigarettes, is highly prevalent. We modelled the probability of FM and RYO cigarette smoking using individual-level data obtained from the 2012 and 2014 waves of the International Tobacco Control (ITC) Zambia Survey. We used two estimation methods: the standard estimation method involving separate random effects probit models and a method involving a system of equations (incorporating bivariate seemingly unrelated random effects probit) to estimate price elasticities of FM and RYO cigarettes and their cross-price elasticities. The estimated price elasticities of smoking prevalence are -0.20 and -0.03 for FM and RYO cigarettes, respectively. FM and RYO are substitutes; that is, when the price of one of the products goes up, some smokers switch to the other product. The effects are stronger for substitution from FM to RYO than vice versa. This study affirms that increasing cigarette tax with corresponding price increases could significantly reduce cigarette use in Zambia. Furthermore, reducing between-product price differences would reduce substitution from FM to RYO. Since RYO use is associated with lower socioeconomic status, efforts to decrease RYO use, including through tax/price approaches and cessation assistance, would decrease health inequalities in Zambian society and reduce the negative economic consequences of tobacco use experienced by the poor. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. A rapid assessment of avoidable blindness in Southern Zambia.

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    Robert Lindfield

    Full Text Available INTRODUCTION: A rapid assessment of avoidable blindness (RAAB was conducted in Southern Zambia to establish the prevalence and causes of blindness in order to plan effective services and advocate for support for eye care to achieve the goals of VISION 2020: the right to sight. METHODS: Cluster randomisation was used to select villages in the survey area. These were further subdivided into segments. One segment was selected randomly and a survey team moved from house to house examining everyone over the age of 50 years. Each individual received a visual acuity assessment and simple ocular examination. Data was recorded on a standard proforma and entered into an established software programme for analysis. RESULTS: 2.29% of people over the age of 50 were found to be blind (VA <3/60 in the better eye with available correction. The major cause of blindness was cataract (47.2% with posterior segment disease being the next main cause (18.8%. 113 eyes had received cataract surgery with 30.1% having a poor outcome (VA <6/60 following surgery. Cataract surgical coverage showed that men (72% received more surgery than women (65%. DISCUSSION: The results from the RAAB survey in Zambia were very similar to the results from a similar survey in Malawi, where the main cause of blindness was cataract but posterior segment disease was also a significant contributor. Blindness in this part of Zambia is mainly avoidable and there is a need for comprehensive eye care services that can address both cataract and posterior segment disease in the population if the aim of VISION 2020 is to be achieved. Services should focus on quality and gender equity of cataract surgery.

  13. Child Labour or School Attendance? Evidence from Zambia

    DEFF Research Database (Denmark)

    Jensen, Peter; Nielsen, Helena Skyt

    1996-01-01

    In this paper, we investigate what affects school attendance and child labour in an LDC, using data for Zambia. Since the data come from a household survey with information on all household members, it allows us to take account of unobserved household effects by introducing household specific...... effects in a logit model. The empirical analysis suggests that both economic and sociological variables are important determinants for the choice between school attendance and child labour. In particular, we find some support for the hypothesis that poverty forces households to keep their children away...

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

    Science.gov (United States)

    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.

  15. Factors Influencing Poverty Alleviation amongst Microfinance Adopting Households in Zambia

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    Mavhungu Abel Mafukata

    2016-01-01

    Full Text Available The main objective of this paper is to investigate the factors having the most influence on the alleviation of poverty amongst the households adopting microfinance in Zambia. Ninety nine (n=99 respondents were randomly and purposively selected from amongst 340 microfinance adopters of the so-called Micro Bankers Trust programme operating a microfinance business in the Makululu Compound of Kabwe, Zambia. Socio-demographic primary data were collected through face-to-face interviews based on a semi-structured questionnaire instrument. The data were entered into an excel spreadsheet for analysis. The descriptive data were thereafter exported and fitted to an empirical model. The descriptive results revealed that the majority of the respondents were married, unemployed, fairly educated younger women from larger-sized poor households who drew their household income mainly from microfinance activities. The majority of the respondents thought microfinance had improved their well-being in some crucial areas. The results of the empirical model found that some respondents were indeed alleviated from poverty through microfinance. Conclusion drawn in this paper is that microfinance does alleviate poverty of the poor.

  16. Factors Influencing Poverty Alleviation amongst Microfinance Adopting Households in Zambia

    Directory of Open Access Journals (Sweden)

    Mavhungu Abel Mafukata

    2014-04-01

    Full Text Available The main objective of this paper is to explore the factors having the most significance on the probability of the adopters of microfinance moving out of poverty in Zambia. Ninety nine (n=99 respondents were randomly and purposively selected from amongst 340 microfinance adopters of the so-called Micro Bankers Trust programme operating a microfinance business in the Makululu Compound of Kabwe, Zambia. Primary data were collected through face-to-face interviews based on a semi-structured questionnaire. The data were entered into an excel spreadsheet for analysis. The descriptive data were thereafter exported and fitted to an empirical model. The descriptive results revealed that the majority of the respondents were married, unemployed, fairly educated younger women from larger-sized poor households who drew their household income mainly from microfinance activities. The majority of the respondents thought microfinance had improved their well-being in some crucial areas. The results of the empirical model found that some respondents indeed had improved their probabilities to move out of poverty. Conclusion drawn in this paper is that microfinance does alleviate poverty of the poor. 

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

    Science.gov (United States)

    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.

  18. Persistence of lindane and endosulfan under field conditions in Zambia

    International Nuclear Information System (INIS)

    Mwangala, F.S.; Mundia, P.M.; Nondo, J.C.; Banda, R.; Mangoye, C.

    1997-01-01

    The persistence of lindane and endosulfan was studied under field conditions in Zambia in 1992 to 1994. Both pesticides dissipated rapidly under field conditions. About 29% and 73% of initial concentration was lost during the first 30 and 60 days after treatment, respectively in 1992. After 180 days, about 11% of the initial concentration was recovered from the soil. In 1993, 40% of initial residues were lost during the first 30 days. At 180 days after spraying, slightly more residues (25% of the initial values) were recovered at this time than in 1992. This indicated a change in the longer term behaviour of lindane in the soil since the calculated half-lives of lindane, covering the shorter term behaviour, were 55-80 days in 1992 and ∼ 17 days in 1993. In 1994, losses of α-Endosulfan and β-Endosulfan were 40% and 37% respectively during the initial 30 days after treatment. A further 25% of α-Endosulfan and 33% of β-Endosulfan were lost during the following 30 days. These data allow estimates of the half-lives of α- and β-Endosulfan (40 and 38 days) under the field conditions pertaining in Zambia at the time of the trials showing that this compound has only moderate persistence and unlikely to cause long term environmental problems. (author). 7 refs, 8 tabs

  19. Improving Allocation And Management Of The Health Workforce In Zambia.

    Science.gov (United States)

    Walsh, Fiona J; Musonda, Mutinta; Mwila, Jere; Prust, Margaret Lippitt; Vosburg, Kathryn Bradford; Fink, Günther; Berman, Peter; Rockers, Peter C

    2017-05-01

    Building a health workforce in low-income countries requires a focused investment of time and resources, and ministries of health need tools to create staffing plans and prioritize spending on staff for overburdened health facilities. In Zambia a demand-based workload model was developed to calculate the number of health workers required to meet demands for essential health services and inform a rational and optimized strategy for deploying new public-sector staff members to the country's health facilities. Between 2009 and 2011 Zambia applied this optimized deployment policy, allocating new health workers to areas with the greatest demand for services. The country increased its health worker staffing in districts with fewer than one health worker per 1,000 people by 25.2 percent, adding 949 health workers to facilities that faced severe staffing shortages. At facilities that had had low staffing levels, adding a skilled provider was associated with an additional 103 outpatient consultations per quarter. Policy makers in resource-limited countries should consider using strategic approaches to identifying and deploying a rational distribution of health workers to provide the greatest coverage of health services to their populations. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Reprint of "Modelling the influence of temperature and rainfall on malaria incidence in four endemic provinces of Zambia using semiparametric Poisson regression".

    Science.gov (United States)

    Shimaponda-Mataa, Nzooma M; Tembo-Mwase, Enala; Gebreslasie, Michael; Achia, Thomas N O; Mukaratirwa, Samson

    2017-11-01

    Although malaria morbidity and mortality are greatly reduced globally owing to great control efforts, the disease remains the main contributor. In Zambia, all provinces are malaria endemic. However, the transmission intensities vary mainly depending on environmental factors as they interact with the vectors. Generally in Africa, possibly due to the varying perspectives and methods used, there is variation on the relative importance of malaria risk determinants. In Zambia, the role climatic factors play on malaria case rates has not been determined in combination of space and time using robust methods in modelling. This is critical considering the reversal in malaria reduction after the year 2010 and the variation by transmission zones. Using a geoadditive or structured additive semiparametric Poisson regression model, we determined the influence of climatic factors on malaria incidence in four endemic provinces of Zambia. We demonstrate a strong positive association between malaria incidence and precipitation as well as minimum temperature. The risk of malaria was 95% lower in Lusaka (ARR=0.05, 95% CI=0.04-0.06) and 68% lower in the Western Province (ARR=0.31, 95% CI=0.25-0.41) compared to Luapula Province. North-western Province did not vary from Luapula Province. The effects of geographical region are clearly demonstrated by the unique behaviour and effects of minimum and maximum temperatures in the four provinces. Environmental factors such as landscape in urbanised places may also be playing a role. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Contribution of market value chain to the control of African swine fever in Zambia.

    Science.gov (United States)

    Siamupa, C; Saasa, N; Phiri, A M

    2018-01-01

    African swine fever (ASF) is a worldwide disease of pigs endemic in most sub-Saharan African countries. Zambia has been experiencing outbreaks of ASF for many years because the disease is endemic in the eastern part of the country, with incursion into the central part of Lusaka Province. The latest outbreaks of ASF in Lusaka occurred in 2013 with substantial pig mortalities, loss in trade, and cost of control measures and compensation of affected farmers. The aims of the study were to identify market value chain-related factors that were associated with ASF outbreaks and assess why these outbreaks are becoming frequent despite control measures being put in place. Using a mixed-method design, participants involved in the value chain were purposively sampled. Some pig farmers were included using a respondent-driven technique. Farmers came from Lusaka, Chilanga, Kafue, and Chongwe districts. Other participants included district veterinary officers, veterinary assistants, police officers, and veterinary staff manning veterinary checkpoints, abattoir and processing plant managers, meat inspectors, market chairpersons, and traders. Semi-structured questionnaires, in-depth interviews, and direct observations were used to collect data to come up with narrations, tables, and flow charts. In assessing the contribution of the value chain in ASF, aspects of ASF screening, market availability and procedures, knowledge on ASF transmission, occurrence of ASF outbreak, and regulation of pig movement were investigated. Despite government ASF control measures being applied, the following were noted: (1) low awareness levels of ASF transmission among pig farmers and traders; (2) only 50% of farmers had their animals screened for ASF before sale; (3) all the markets did not have the pork inspected; (4) laxity in enforcing livestock movement control because of inadequate police and veterinary staff manning checkpoints; (5) lack of enforcement of meat inspection and food safety

  2. The Kazanga festival : ethnicity as cultural mediation and transformation in central western Zambia

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.

    1994-01-01

    This paper explores the cultural dynamics of ethnicity in the context of a postcolonial African State, Zambia. The opening sections define ethnicity and pinpoint its central dilemma: while unmistakably constructed and thus selectively empowering the brokers coordinating the construction process,

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

    Science.gov (United States)

    Ridge, Anna L; Bero, Lisa A; Hill, Suzanne R

    2010-12-16

    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. 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. 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. The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical practice. A better understanding of the supply system and of the pattern

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

    Directory of Open Access Journals (Sweden)

    Kabuba N

    2016-08-01

    Full Text Available Norma Kabuba,1,2 J Anitha Menon,1 Donald R Franklin Jr,3 Robert K Heaton,3 Knut A Hestad2,4,5 1Department of Psychology, The University of Zambia, Lusaka, Zambia; 2Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; 3Department of Psychiatry, University of California, San Diego, CA, USA; 4Department of Research, Innlandet Hospital Trust, Hamar, Norway; 5Department of Public Health, Hedmark University of Applied Sciences, Elverum, Norway Abstract: 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 ƞ2=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

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

    Directory of Open Access Journals (Sweden)

    Hill Suzanne R

    2010-12-01

    Full Text Available Abstract 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

  6. Perspectives on sex education in relation to sexual health of teenagers in Zambia

    OpenAIRE

    Simalimbu, Brenda

    2016-01-01

    This research explores the perspectives on sex education in relation to sexual health of teenagers in Zambia. The research aimed at exploring the perspectives of various stakeholders (teenagers, parents, teachers, pastors and traditional counsellors) on the role of sex education to promote the sexual health of young people in Zambia. The study is guided by the theoretical perspectives of the sociology of childhood, which consider childhood as a social construct and children as ...

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

    OpenAIRE

    Emmanuel Rudatsikira; Seter Siziya; Adamson Sinjani Muula

    2012-01-01

    Abstract: Background: Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying. Methods: The 2004 Zambia Gl...

  8. The State of Girl-Child’s Education in Zambia : The Case of Chongwe District

    OpenAIRE

    Mwanza, Peggy

    2015-01-01

    This paper discusses the importance of education with specific reference to Girl-Child’s education, and gender inequality1 and inequity2 in education in Zambia, focusing on one of the rural areas, Chongwe District. Many International Conferences are suggesting that educating girls is one of the ways of achieving gender equality in education thereby helping in achieving Education for All in primary and secondary schooling. In Zambia, with many economic and social problems, this is a particular...

  9. Knowledge and perceptions of couples' voluntary counseling and testing in urban Rwanda and Zambia: a cross-sectional household survey.

    Directory of Open Access Journals (Sweden)

    April L Kelley

    2011-05-01

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

  10. Rural electrification in Zambia: A policy and institutional analysis

    International Nuclear Information System (INIS)

    Haanyika, Charles M.

    2008-01-01

    Zambia is well endowed with hydropower and other energy resources, which could facilitate production of electricity for both urban and rural areas of the country. The country has an installed electricity generation capacity of 1786 MW and undeveloped hydropower potential of over 6000 MW. In the last few years, demand has been growing and it is anticipated to outstrip supply in 2008. The load growth is attributed to increased mining activities and development of the industrial base. The country is also endowed with abundant natural resources such as arable land, water, minerals and wildlife. With the available resource base, electricity along with other social and economic infrastructure such as roads and telecommunications could facilitate increased economic activities. In rural areas, electricity could be used for crop irrigation, agro-processing, small-scale mining and to facilitate tourism. However, rural electrification (RE) faces many challenges such as long distances from existing power stations to targeted rural areas, low population densities, high poverty levels and low skills availability. These and other factors have contributed to continued low levels of access to electricity in rural areas of the country. Measures so far undertaken to facilitate access to electricity in rural areas of Zambia include the adoption of a new National Energy Policy (NEP) in 1994. With regard to the electricity sector and RE in particular, the NEP was aimed at facilitating increased access by liberalising and restructuring the electricity market and promoting the use of low-cost technologies and decentralised renewable energies. To facilitate implementation of the new policy, the government established a legal and institutional framework by enacting new legislation, namely, the Electricity Act and the Energy Regulation Act in 1995. The Electricity Act provided for liberalisation and regulation of the electricity sector, while the Energy Regulation Act provided for the

  11. Successful multi-partner response to a cholera outbreak in Lusaka ...

    African Journals Online (AJOL)

    Successful multi-partner response to a cholera outbreak in Lusaka, Zambia 2016: a case control study. ... Univariate and multivariate analysis was performed using Epi-Info version 3.5.4 and Stata version 11.2. ... This odds ratio was adjusted for level education and gender to control and account for any confounding. Though ...

  12. Geophysical and geochemical characterisation of groundwater resources in Western Zambia

    DEFF Research Database (Denmark)

    Chongo, Mkhuzo; Banda, Kawawa Eddy; Bauer-Gottwein, Peter

    Zambia’s rural water supply system depends on groundwater resources to a large extent. However, groundwater resources are variable in both quantity and quality across the country and a national groundwater resources assessment and mapping program is presently not in place. In the Machile area...... in South-Western Zambia, groundwater quality problems are particularly acute. Saline groundwater occurrence is widespread and affects rural water supply, which is mainly based on shallow groundwater abstraction using hand pumps. This study has mapped groundwater quality variations in the Machile area using...... both ground-based and airborne geophysical methods as well as extensive water quality sampling. The occurrence of saline groundwater follows a clear spatial pattern and appears to be related to the palaeo Lake Makgadikgadi, whose northernmost extension reached into the Machile area. Because the lake...

  13. Identifying Factors for Worker Motivation in Zambia's Rural Health Facilities.

    Science.gov (United States)

    Cross, Samuel S; Baernholdt, Dr Marianne

    2017-01-01

    Within Zambia there is a shortage of health workers in rural areas. This study aims to identify motivating factors for retaining rural health workers. Sixty rural health workers completed surveys and 46 were interviewed. They rated the importance of six motivating factors and discussed these and other factors in interviews. An interview was conducted with a Government Human Resources Manager (HR Manager) to elicit contextual information. All six factors were identified as being very important motivators, as were two additional factors. Additional career training was identified by many as the most important factor. Comparison of results and the HR Manager interview revealed that workers lacked knowledge about opportunities and that the HR manager was aware of barriers to career development. The Zambian government might better motivate and retain rural health workers by offering them any combination of identified factors, and by addressing the barriers to career development.

  14. Child spacing and contraception among the poor in Zambia

    Directory of Open Access Journals (Sweden)

    Vijayan K Pillai

    2010-03-01

    Full Text Available Vijayan K Pillai1, Rashmi Gupta21School of Social Work, University of Texas at Arlington, Arlington, TX, USA; 2Department of Social Work, San Francisco State University, San Francisco, CA, USAAbstract: For decades, family planning programs have targeted women in developing countries. These programs bestow a great deal of autonomy on women with respect to fertility decision making. It is well known that a number of close relatives in multigenerational and extended family systems influence women’s fertility decisions with respect to child spacing and contraceptive use. One approach toward a systematic study of fertility decision making is to explicitly consider the husband’s influences on fertility decision making. This study examines the effects of a selected number of factors on the desired birth interval lengths. We interviewed husbands and wives separately from 165 randomly selected households from two poor neighborhoods in the city of Kitwe, Zambia. Three ordinal birth interval groups were obtained for both husbands and wives separately. The effect of selected factors on the likelihood of influencing the three groups was examined using ordinal logistic regression methods. Data from husbands and wives were analyzed separately. Qualitative methods such as semistructured interviews were used to gather extensive information on the various factors that husbands and wives perceive to influence their child spacing decisions. We found differences in accounts with respect to child spacing between husbands and wives, likely due to a lack of communication. A gender-sensitive approach is necessary to promote spacing methods among poor couples in Zambia.Keywords: child spacing, contraceptive use, correspondence analysis, couple decision making

  15. Decentralization in Zambia: resource allocation and district performance.

    Science.gov (United States)

    Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

    2003-12-01

    Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or

  16. Implementation research: reactive mass vaccination with single-dose oral cholera vaccine, Zambia.

    Science.gov (United States)

    Poncin, Marc; Zulu, Gideon; Voute, Caroline; Ferreras, Eva; Muleya, Clara Mbwili; Malama, Kennedy; Pezzoli, Lorenzo; Mufunda, Jacob; Robert, Hugues; Uzzeni, Florent; Luquero, Francisco J; Chizema, Elizabeth; Ciglenecki, Iza

    2018-02-01

    To describe the implementation and feasibility of an innovative mass vaccination strategy - based on single-dose oral cholera vaccine - to curb a cholera epidemic in a large urban setting. In April 2016, in the early stages of a cholera outbreak in Lusaka, Zambia, the health ministry collaborated with Médecins Sans Frontières and the World Health Organization in organizing a mass vaccination campaign, based on single-dose oral cholera vaccine. Over a period of 17 days, partners mobilized 1700 health ministry staff and community volunteers for community sensitization, social mobilization and vaccination activities in 10 townships. On each day, doses of vaccine were delivered to vaccination sites and administrative coverage was estimated. Overall, vaccination teams administered 424 100 doses of vaccine to an estimated target population of 578 043, resulting in an estimated administrative coverage of 73.4%. After the campaign, few cholera cases were reported and there was no evidence of the disease spreading within the vaccinated areas. The total cost of the campaign - 2.31 United States dollars (US$) per dose - included the relatively low cost of local delivery - US$ 0.41 per dose. We found that an early and large-scale targeted reactive campaign using a single-dose oral vaccine, organized in response to a cholera epidemic within a large city, to be feasible and appeared effective. While cholera vaccines remain in short supply, the maximization of the number of vaccines in response to a cholera epidemic, by the use of just one dose per member of an at-risk community, should be considered.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    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. 2010 Elsevier B.V. All rights

  1. Regulatory framework, strategy and radioactive waste management in Zambia

    International Nuclear Information System (INIS)

    Banda, S.

    2001-01-01

    Full text: Zambia is involved in the peaceful application in Nuclear Science and Technology which cover the agriculture, human health, industry, research and education sectors. In the execution of the projects various radioactive sources and radioisotopes are used. The data from the Radiation Protection Board show that there are 136 organizations and 971 Radiation workers benefit from the regulatory control and personnel Dosimetry service that is provided by the Board. The radiation user institutions are broken down as follows: medical (106), industrial (18), research (10) and (2) in teaching. The radioactive waste generated and spent sources are managed, in several ways depending on the type . In addition to radioactive waste generated by various application there are new developments concerning the management of spent sources mainly brought into control by the detection of illicit trade or trafficking activities by the Police, Drug Enforcement Commission, and the vigilant people of the community. The challenge for Zambia is to set-up a Radioactive Waste Management Facility preferably under the National Institute for Scientific and Industrial Research (NISIR). The RPB should legally designate NISIR for this function and assist to have the Government provide support that is required to have an operation and effective facility. One Radioactive Waste Interim Storage Shed at Kalulushi. This shed was put up by a copper mining conglomerate which now has been privatized. It is hoped that this facility can be licensed by Radiation Protection Board to be run by private enterprise for storage of prescribed spent radioactive sources and materials. This shed should be technically competent persons and should have good equipment for the purpose. The application in industry (NDT, mining, radiation sterilization, pipeline and construction, human health (nuclear medicine, radioimmunoassay and radiotherapy practices) and agriculture (use of P-32) required that a National Strategy

  2. Community narratives about women and HIV risk in 21 high-burden communities in Zambia and South Africa

    Directory of Open Access Journals (Sweden)

    Viljoen L

    2017-11-01

    Full Text Available Lario Viljoen,1 Rhoda Ndubani,2 Virginia Bond,2,3 Janet Seeley,3 Lindsey Reynolds,4,5 Graeme Hoddinott1 On behalf of the HPTN 071 (PopART Study Team 1Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 2Zambia AIDS-related Tuberculosis Project (Zambart, School of Medicine, Lusaka, Zambia; 3Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; 4Population Studies and Training Center, Brown University, Providence, RI, USA; 5Department of Sociology and Social Anthropology, Stellenbosch University, Stellenbosch, South Africa Abstract: Public health researchers repeatedly represent women as a group vulnerable to ill health. This has been particularly true in the field of HIV research, where women are disproportionately affected by HIV in terms of disease burden and the social effects of the epidemic. Although women have been the focus of many prevention and treatment programs, structural barriers to implementation of these targeted programs persist. In this article we explore how high HIV-burden communities in South Africa and Zambia engage with the concepts of “woman” and “HIV risk”. The data are drawn from participatory storytelling activities completed with 604 participants across 78 group discussions between December 2012 and May 2013. During discussions we found that participants made use of the core archetypal caricatures of “goodness,” “badness,” and “vulnerability” when describing women’s HIV risk. Community members shifted between these categories in their characterizations of women, as they acknowledged the multiple roles women play, internalized different stories about women, and sometimes shifted register in the same stories. Findings suggest that health implementers, in consultation with community members, should consider

  3. Farmer Perceptions of Conflict Related to Water in Zambia

    Directory of Open Access Journals (Sweden)

    Richard A. Marcantonio

    2018-01-01

    Full Text Available The relationship between climate change, water scarcity, and conflict is still debated. Much of the existing work relating resource scarcity to conflict has involved regional-scale analysis linking instances of violent outbreaks to environmental conditions. But how do individual farmers in Africa define conflict? Do they perceive that conflict will change as a function of water scarcity, and, if so, how? Here, we address these questions by surveying farmers in southern Zambia in 2015, where we asked respondents to define conflict, assessed their perceptions of past and future conflict, as well as perceptions of rainfall and water availability. We find that the majority of our respondents (75% think of conflict as misunderstandings or disagreements between people and that 91% of our sample has experienced past conflict, 70% expect to experience future conflict, and 58% expect to experience future physical violent conflict. When asked about the sources of conflict, respondents mainly mention land grabbing, crop damage by animals, and politics rather than water related issues. However, we find a significant relationship between perceptions of future rainfall decreasing and future physical violent conflict. These results imply that even though respondents do not think water scarcity is a direct source of conflict, the perception of decreased rain in the future is significantly related to the perception that future conflict and future physical violent conflict will occur.

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

    Science.gov (United States)

    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.

  5. Use of maternity waiting home in rural Zambia.

    Science.gov (United States)

    van Lonkhuijzen, Luc; Stegeman, Margreet; Nyirongo, Rebecca; van Roosmalen, Jos

    2003-04-01

    This study was conducted to assess the results from the use of a maternity waiting home, a health facility to which women with high risk pregnancies are referred during the last weeks of pregnancy in rural Zambia. It compared the risk status and pregnancy outcome in women staying as waiters with those women who give birth in hospital after direct admission (non-waiters). Forty seven per-cent of the non-waiters (n = 292) had no maternal risk factors and 85% had no antenatal risk factors as compared to 17% and 78% among the waiters (n = 218). Eighty six per cent of waiters had spontaneous vaginal vertex delivery as compared to 95% of non-waiters. Although the differences in risk status were statistically significant, no differences were found in birth weight and maternal and perinatal mortality. The similar obstetric outcome among waiters with more high risk pregnancies and non-waiters could be interpreted as a possible outcome of the maternity waiting home. When dependent on a proper functioning referral system, such waiting homes can reduce perinatal mortality.

  6. Proterozoic strata-bound uranium deposits of Zambia and Zaire

    International Nuclear Information System (INIS)

    Meneghel, L.

    1984-01-01

    The Katanga System, host to uranium and copper mineralisation, is several thousands of metres thick and rests unconformably on an older complex of crystalline rocks and metasediments and is locally covered by Karoo sandstones or Kalahari sands. The deposition of the Katanga System took place during the Late Proterozoic in a wide complex basin extending from Shaba province in Zaire through a large part of Zambia and into eastern Angola. The sediments were affected by different grades of metamorphism, tectonic events, and by thermal events associated with post-tectonic metamorphism. At the base of Katanga system there are 84 known copper deposits and 42 uranium occurrences. It is suggested that all the known uranium and copper occurrences are of an essentially syngenetic sedimentary origin. The mineralisation is found in the Lower Roan Formation near the base of the Katanga System occurring in rocks produced in similar environmental conditions and thus being stratigraphic controlled, however, their areal distribution is localised producing a regional metal zonation. Many of the uranium occurrences have a typical vein aspect. These transgressive relationships are not inconsistent with a syngenetic origin as evidenced by the vein morphology. (author)

  7. Climate Trends and Farmers' Perceptions of Climate Change in Zambia.

    Science.gov (United States)

    Mulenga, Brian P; Wineman, Ayala; Sitko, Nicholas J

    2017-02-01

    A number of studies use meteorological records to analyze climate trends and assess the impact of climate change on agricultural yields. While these provide quantitative evidence on climate trends and the likely effects thereof, they incorporate limited qualitative analysis of farmers' perceptions of climate change and/or variability. The present study builds on the quantitative methods used elsewhere to analyze climate trends, and in addition compares local narratives of climate change with evidence found in meteorological records in Zambia. Farmers offer remarkably consistent reports of a rainy season that is growing shorter and less predictable. For some climate parameters-notably, rising average temperature-there is a clear overlap between farmers' observations and patterns found in the meteorological records. However, the data do not support the perception that the rainy season used to begin earlier, and we generally do not detect a reported increase in the frequency of dry spells. Several explanations for these discrepancies are offered. Further, we provide policy recommendations to help farmers adapt to climate change/variability, as well as suggestions to shape future climate change policies, programs, and research in developing countries.

  8. Coal prospects in Botswana, Mozambique, Zambia, Zimbabwe and Namibia

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-12-01

    Increasing demand for coal in Asia is stimulating interest in the potentially large coal resources in Southern African countries such as Botswana, Mozambique, Zambia, Zimbabwe and Namibia. These countries have been slow to utilise their coal as local demand has been limited and the means to export coal has been inadequate. The governments in these regions are now recognising coal as a strategically important commodity, capable of earning foreign revenue but also adding value to the economy by generating much needed electricity. This report looks in turn at the role of coal in the energy economies of each of these countries. As in most emerging economies, the provision of a reliable and cost-effective supply of electricity to industries and people is essential for economic growth and the welfare of communities. Demand for Africa's mineral commodities such as diamonds and copper is driving a massive need for electricity and coal will play a major role. Not only does the mining industry need power, but with these growing industries come communities and commerce which are also in need of energy.

  9. Navigating through institutional identity in the context of a transformed United Church of Zambia University College in Zambia

    Directory of Open Access Journals (Sweden)

    Nelly Mwale

    2017-12-01

    Full Text Available The article investigated the rising trend that has not received attention in Zambian scholarship of institutions that started as theological institutions transforming or shifting from the provision of theology only to other disciplines to meet the growing demand for higher education. Using the United Church of Zambia University College (UCZUC as a case in point, the paper explored how the institution had experienced and repositioned itself in the context of transformation with reference to its identity and diversity from a descriptive case study perspective. Data was collected through document analyses and recorded interviews and informed by secularization of institutions’ theories. The study established that the institution had transformed into a university college and diversified its programmes from theology alone to other disciplines in order to broaden its scope of service in the area of education support to the nation. However, the integration of theology and other secular disciplines in the institution had not only transformed the institutional identity but also diversified the institution, and this required finding a balance between the two. Transformation had also initiated new marketing strategies to sell its products (programmes to the public. The paper argues that in the context of sustainability challenges associated with theological education, UCZUC presents a potential success story of theological institutions’ quest to maintain viability in modern times through striving for active and intentional integration of sacred and secular (theology with other disciplines as a contribution to higher education and society.

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

    Directory of Open Access Journals (Sweden)

    King Shimumbo Nalubamba

    2015-01-01

    Full Text Available 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.

  11. Unintended pregnancy among HIV positive couples receiving integrated HIV counseling, testing, and family planning services in Zambia.

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    John R. Koethe

    2013-01-01

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

  13. Disabling sexualities: Exploring the impact of the intersection of HIV, disability and gender on the sexualities of women in Zambia

    Directory of Open Access Journals (Sweden)

    Anna Wickenden

    2013-07-01

    Objective: The objective of this study was to explore how HIV, disability and gender shape the perspectives of HIV-positive women with disabilities regarding intimacy and gender roles. Methods: Twelve women in Lusaka, Zambia were recruited for in-depth semi-structured interviews to explore their experiences of having a disability and living with HIV. Interviews were conducted in English, Bemba, Nyanja and Zambian sign language. Descriptive and thematic analyses were conducted, followed by in-depth gender analyses of data relating to intimacy and gender roles. Results: Data analysis led to the identification of two main themes: the impact of HIV diagnosis on intimate relationships amongst the participants; and the disruption and renegotiation of gender roles. These findings demonstrate the loss of intimacy (often decided by the participants and changes in women’s gender roles (infrequently decided by them. Conclusions: The narrow approaches to sexuality and HIV that reinforce misconceptions and stereotypes need to change. In their place should be inclusive and disability and sex-positive approaches that are informed by the diverse realities of women’s lives. Further research is needed to develop stronger evidence of the impact of HIV and disability on gender roles and sexuality.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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. © The Author(s) 2014.

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

    Science.gov (United States)

    Ntengwe, F. W.

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

  17. CIDA funds AIDS counselling and care centre in Zambia.

    Science.gov (United States)

    Meehan, S T

    1993-12-01

    In its fight against the spread of AIDS, which is inextricably linked to the issues of international development, the Canadian International Development Agency (CIDA) has focused support on strengthening existing health care systems, helping vulnerable groups gain control over their lives and health, promoting AIDS prevention measures, and building links to other related health services. Funding includes 1) a grant to Hope House in Zambia (counseling and support for persons with AIDS); 2) a contribution to the Canadian Public Health Association's $11 million Southern Africa AIDS Training Programme (helps regional organizations working in AIDS prevention and support through education, training, hospital outreach, peer education for vulnerable groups, assistance to women's shelters, and networking); 3) support for Laval University's Laval Centre for International Cooperation in Health and Development (runs a $22 million program in French-speaking West Africa that operates in over 10 countries and focuses on epidemiological surveillance, information, education, and communication, control of sexually transmitted diseases [STDs], and management of national AIDS programs); 4) support for the University of Manitoba's $3 million program with the University of Nairobi to slow the spread of HIV (strengthens local health care capabilities for STD/HIV diagnosis, treatment, and counseling, with special emphasis on training and education); 5) support in the past for a study of proposed AIDS legislation and its potential impact on the human rights of PLWHIV/AIDS in Thailand; 6) a contribution to help equip the office of the National Movement for Street Children, Rio de Janeiro (focuses on preventing the spread of AIDS among child prostitutes); and 7) long-term financial support to the Interagency Coalition on AIDS and Development, a coalition of Canadian development nongovernmental organizations responding to AIDS in developing countries. An address to obtain a pamphlet giving

  18. Perspectives on literacy, gender and change: a case for Zambia.

    Science.gov (United States)

    Mwansa, D M

    1995-01-01

    This study examines illiterate participants' perceptions of literacy training that was conducted after 6-12 months of training in one urban Copperbelt province and one center in rural Luapula province in Zambia. Interviews were conducted among 29 female and 11 male participants and 15 male and 3 female officials. Analysis is based on interviews, observations, and written records. The researcher identified five broad areas of change: affective, attitudinal, pedagogic, economic, and sociopolitical. This study shows that literacy in rural areas is beneficial to people personally, to gender relations, and to socioeconomic development. The findings support the arguments advanced by Rockhill (1987), Bhola (1981), Freire (1970), and Nyerere (1978) about the need to reduce the fears and insecurities associated with being illiterate and the gain from developing people and not just production. The literacy training did not enrich people culturally nor did it alleviate poverty; it concentrated on integrating people into new modes of production. Affective changes included changes in self-esteem and feeling happier. Attitudinal changes included positive learning experiences about child care among both men and women. Nutrition and sanitation improved. Couples reported a greater effort at demonstrating polite behavior and respect toward each other. Literacy increased their status among friends and was accepted in steps, such as being proud of knowing how to write their name. Some participants changed their attitudes toward family planning, and clinic attendance increased. Literacy gave some more confidence and awareness of social relations. Literacy helped read seed and fertilizer labels. Lack of reading materials was a problem. Participants reported reading the Bible and magazines and writing letters. Participants tended to participate in church or literacy groups rather than political ones.

  19. 7 CFR 319.56-43 - Baby corn and baby carrots from Zambia.

    Science.gov (United States)

    2010-01-01

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

  20. International Uranium Resources Evaluation Project (IUREP) orientation phase mission summary report: Zambia

    International Nuclear Information System (INIS)

    1985-01-01

    A report has recently been published which describes the findings of the International Uranium Resources Evaluation Project (IUREP) mission to Zambia. The IUREP Orientation Phase mission to Zambia estimates that the Speculative Resources of that country fall within the range of 33 000 and 100 000 tonnes uranium. The majority of these resources are believed to exist in the Karoo sediments. Other potentially favourable geological environments are the Precambrian Katanga sediments, as well as intrusive rocks of different chemical compositions and surficial duricrusts. Previous unofficial estimates of Zambia's Reasonably Assured Resources (RAR) and Estimated Additional Resources (EAR) are considered to be still valid: the total RAR amount to 6 000 tonnes uranium, located in Karoo (4 000 tonnes) and Katanga (2 000 tonnes) sediments, while the EAR are believed to total 4 000 tonnes being found only in Karoo sediments. The mission recommends that approximately US$ 40 million be spent on uranium exploration in Zambia over 10 years. The largest part of this expenditure would be for drilling, while the remainder should be spent on airborne and ground surveys, as well as on interpretative work on previous airborne data, Landsat imageries, etc. (author)

  1. Socio-economic development of women in Zambia, an analysis of two women's organisations

    NARCIS (Netherlands)

    Touwen, Anne

    1990-01-01

    This report on the role of local nongovernmental organizations (NGOs) in the improvement of the socioeconomic position of women in Zambia is based on anthropological fieldwork carried out in 1988 and 1989, and a consultancy mission undertaken on behalf of the Organization of Dutch volunteers abroad

  2. Assessing the consequences of stigma for tuberculosis patients in urban Zambia

    NARCIS (Netherlands)

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

    2015-01-01

    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. To enhance

  3. Assessing the consequences of stigma for tuberculosis patients in urban zambia

    NARCIS (Netherlands)

    Cremers, A.L.; de Laat, M.M.; Kapata, N.; Gerrets, R.; Klipstein-Grobusch, K.; Grobusch, M.P.

    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.

  4. Econometric analysis of improved maize varieties and sustainable agricultural practices (SAPs) in Eastern Zambia

    NARCIS (Netherlands)

    Manda, J.

    2016-01-01

    Maize is the principle food staple in Zambia, providing both food and income for most of the rural populace. It is estimated that over 50% of the daily caloric intake is derived from maize; with an average consumption of over 85kg per year. Because of the importance of maize, a number of improved

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

    Science.gov (United States)

    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…

  6. Chiefs and the State in independent Zambia : exploring the Zambian national press

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.

    1987-01-01

    Zambia is among the few African countries where chiefs occupy an honorable position at the national level, and where a House of Chiefs is established, complementary to Parliament. This paper examines the relationship between chiefs and the central government on the basis of an analysis of newspaper

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

    Science.gov (United States)

    Chmurova, Lucia; Webb, Michael D

    2016-08-22

    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.

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

    Science.gov (United States)

    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…

  9. People know what they need. An interview with women activists in Zambia

    Czech Academy of Sciences Publication Activity Database

    Uhde, Zuzana; Tožička, T.

    2015-01-01

    Roč. 16, č. 2 (2015), s. 53-59 ISSN 1213-0028 Institutional support: RVO:68378025 Keywords : development * Zambia * gender equality Subject RIV: AO - Sociology, Demography http://dx.doi.org/10.13060/12130028.2015.16.2.220

  10. Callings, Work Role Fit, Psychological Meaningfulness and Work Engagement among Teachers in Zambia

    Science.gov (United States)

    Rothmann, Sebastiaan; Hamukang'andu, Lukondo

    2013-01-01

    Our aim in this study was to investigate the relationships among a calling orientation, work role fit, psychological meaningfulness and work engagement of teachers in Zambia. A quantitative approach was followed and a cross-sectional survey was used. The sample (n = 150) included 75 basic and 75 secondary school teachers in the Choma district of…

  11. Waiting too long : low use of maternal health services in Kalabo, Zambia

    NARCIS (Netherlands)

    Stekelenburg, J; Kyanamina, S; Mukelabai, M; Wolffers, [No Value; van Roosmalen, J

    OBJECTIVE To determine the level of use of maternal health services and to identify and assess factors that influence women's choices where to deliver in Kalabo District, Zambia. METHODS A cross-sectional descriptive study conducted between 1998 and 2000, with 332 women interviewed using

  12. Conceptualising Education Quality in Zambia: A Comparative Analysis across the Local, National and Global Discourses

    Science.gov (United States)

    Lee, Jeongmin; Zuilkowski, Stephanie Simmons

    2017-01-01

    Building on the Education for All movement, the 2030 Agenda for Sustainable Development re-emphasises quality education as a discrete goal. Contextualising the discussion surrounding this goal in Zambia, this study examines how education quality is conceptualised by educational stakeholders at local, national, and global levels. Triangulating…

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

    Science.gov (United States)

    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…

  14. The emergence and evolution of HIV counselling in Zambia: a 25-year history

    NARCIS (Netherlands)

    Simbaya, J.; Moyer, E.

    2013-01-01

    HIV-related counselling practices have evolved since emerging in Zambia in 1987. Whereas, initially, the goal of HIV counselling was to provide psychological support to the dying and their families, as knowledge about HIV grew, counselling objectives expanded to include behavioural change,

  15. 77 FR 48498 - Executive-Led Trade Mission to South Africa and Zambia

    Science.gov (United States)

    2012-08-14

    ... that are interested in doing business in Zambia and is therefore amending the mission statement for the... functioning basic water services and to a functioning basic sanitation facility by 2010. Today, 88% of..., Senior International Trade Specialist, Global Trade Programs. [FR Doc. 2012-19818 Filed 8-13-12; 8:45 am...

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

    Science.gov (United States)

    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…

  17. Assessment of Integrated Environmental Management in Public and Private Schools in the Copperbelt Province of Zambia

    Science.gov (United States)

    Makisa, Kaponda

    2016-01-01

    Copperbelt Province is one of the ten provinces of Zambia. It has public and private schools which have been faced with escalating levels of environmental problems due to growth in human population and economic growth. The environmental problems which are matters of concern in the schools include, unsound waste management, loss of vegetation…

  18. Condition and management of the rangelands in the western province of Zambia

    NARCIS (Netherlands)

    Baars, R.M.T.

    1996-01-01


    A land evaluation for extensive grazing was conducted to determine the potential carrying capacity (CC) of the Western Province of Zambia. A hierarchical land classification resulted in Land Regions (9), Land Systems (32), Land Units (124) and Land Facets (415). The vegetation was

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

    Science.gov (United States)

    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…

  20. Church mobilisation and HIV/AIDS treatment in Ghana and Zambia ...

    African Journals Online (AJOL)

    ... than 50 semi-structured interviews with a range of participants affiliated with HIV/AIDS organisations (e.g. church, secular, government, donor) in Zambia and Ghana. Keywords: Africa, aid policy, civil society, funding, national AIDS councils, political aspects, stigma. African Journal of AIDS Research 2010, 9(4): 407–418 ...

  1. Evaluation of portable water in five provinces of Zambia using a ...

    African Journals Online (AJOL)

    kabunga

    2013-01-11

    Jan 11, 2013 ... water which is hence a source of pollution (Khazai and. Riggi, 1999). ... capacity of the soil to absorb effluent from the tank has exceeded the limit ... It is the source of groundwater for major cities ... duals on the state of the water quality in Zambia. ...... main source of nitrate is from human excrement (pit lat-.

  2. determinants of intra-industry trade between zambia and it's trading

    African Journals Online (AJOL)

    Eyerusalem

    countries which are relatively similar and produce relatively similar products. IIT arises from the .... trade based on economies of scale, imperfect competition and product differentiation ... with liberalisation, such as the collapse of the manufacturing industries, the country's trade ... Zambia: Diagnostic Trade Integration. Study.

  3. Determinants of child nutritional status in the eastern province of Zambia

    NARCIS (Netherlands)

    Manda, Julius; Gardebroek, Koos; Khonje, Makaiko G.; Alene, Arega D.; Mutenje, Munyaradzi; Kassie, Menale

    2016-01-01

    Using household survey data from a sample of 810 households, this paper analyses the determinants of children’s nutritional status and evaluates the impacts of improved maize varieties on child malnutrition in eastern Zambia. The paper uses an endogenous switching regression technique, combined

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

    NARCIS (Netherlands)

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

    2016-01-01

    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

  5. Ethnoveterinary treatments for common cattle diseases in four districts of the Southern Province, Zambia.

    Science.gov (United States)

    Syakalima, Michelo; Simuunza, Martin; Zulu, Victor Chisha

    2018-02-01

    Ethno veterinary knowledge has rarely been recorded, and no or limited effort has been made to exploit this knowledge despite its widespread use in Zambia. This study documented the types of plants used to treat important animal diseases in rural Zambia as a way of initiating their sustained documentation and scientific validation. The study was done in selected districts of the Southern Zambia, Africa. The research was a participatory epidemiological study conducted in two phases. The first phase was a pre-study exploratory rapid rural appraisal conducted to familiarize the researchers with the study areas, and the second phase was a participatory rural appraisal to help gather the data. The frequency index was used to rank the commonly mentioned treatments. A number of diseases and traditional treatments were listed with the help of local veterinarians. Diseases included: Corridor disease (Theileriosis), foot and mouth disease, blackleg, bloody diarrhea, lumpy skin disease, fainting, mange, blindness, coughing, bloat, worms, cobra snakebite, hemorrhagic septicemia, and transmissible venereal tumors. The plant preparations were in most diseases given to the livestock orally (as a drench). Leaves, barks, and roots were generally used depending on the plant type. Ethno veterinary medicine is still widespread among the rural farmers in the province and in Zambia in general. Some medicines are commonly used across diseases probably because they have a wide spectrum of action. These medicines should, therefore, be validated for use in conventional livestock healthcare systems in the country to reduce the cost of treatments.

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

    Science.gov (United States)

    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…

  7. The distribution of sexually-transmitted Human Papillomaviruses in HIV positive and negative patients in Zambia, Africa

    Directory of Open Access Journals (Sweden)

    Hause Lara

    2007-07-01

    Full Text Available Abstract Background Human Papillomaviruses (HPV are double-stranded DNA viruses, considered to be the primary etiological agents in cervical intraepithelial neoplasias and cancers. Approximately 15–20 of the 40 mucosal HPVs confer a high-risk of progression of lesions to invasive cancer. In this study, we investigated the prevalence of sexually transmitted HPVs in Human Immunodeficiency Virus (HIV positive and negative patients in Zambia, Africa. The rate of high-risk HPV genotypes worldwide varies within each country. Thus, we sought to investigate the rates of HPV infection in sub-Saharan Africa and the potential role of HIV in affecting the HPV genotype distribution. Methods This retrospective cross-sectional study reports findings on the association and effects of HIV on HPV infections in an existing cohort of patients at University Teaching Hospital (UTH Lusaka, Zambia. The objective of this study was to assess HPV prevalence, genotype distribution and to identify co-factors that influence HPV infection. Polymerase chain reaction (PCR with two standard consensus primer sets (CpI/II and GP5+/6+ was used to test for the presence of HPV DNA. Primers specific for β-actin were used to monitor DNA quality. Vaginal lavage samples, collected between 1998-1999 from a total of 70 women, were part of a larger cohort that was also analyzed for HIV and human herpesvirus infection. Seventy of the samples yielded usable DNA. HIV status was determined by two rapid assays, Capillus and Determine. The incidence of HIV and HPV infections and HPV genotype distributions were calculated and statistical significance was determined by Chi-Squared test. Results We determined that most common HPV genotypes detected among these Zambian patients were types 16 and 18 (21.6% each, which is approximately three-fold greater than the rates for HPV16, and ten-fold greater than the rates for HPV18 in the United States. The worldwide prevalence of HPV16 is approximately 14

  8. Agriculture expansion, wood energy and woody encroachment in the Miombo woodlands: striving towards sustainability in Zambia.

    Science.gov (United States)

    Pelletier, J.

    2017-12-01

    Agricultural expansion is mostly done at the expense of forests and woodlands in the tropics. In Sub-Saharan Africa, forests are also critical as providers of wood energy for domestic consumption with a clear majority of households depending on firewood and charcoal as primary source of energy. Using Zambia as a case study, we look at the link between agricultural expansion, wood energy and the sustainability of forest resources. Zambia has been identified as having one of the highest rates of deforestation in the world, but there is large uncertainty in these estimates. The government of Zambia has identified charcoal production as one of the main of drivers of forest cover loss and is targeting this practice in their national strategy for reducing emissions from deforestation and forest degradation (REDD+). Other assessment however indicate that agricultural expansion is by far the main driver of deforestation and charcoal production is sustainable in Zambia. These competing evaluations call for a better understanding of the drivers of change. Using two national-scale vegetation surveys and remote sensing data, we compare and validate historical forest cover loss estimates to improve their accuracy. We attribute the change and their associated emissions to specific drivers of deforestation. The ecological properties of areas under change are compared to stable areas over time. Our results from national permanent plots indicate a woody encroachment process in Zambia, a potential ecological response to rising CO2 levels. We found that despite large emissions from deforestation, forests and woodlands have been acting as a carbon sink. This research addresses directly the potential feedbacks and responses to competing demands on forests coming from different sectors, including for agriculture and energy, to set the baseline on which to evaluate forest sustainability now and in the future given potentially new ecological conditions. It provides policy relevant

  9. Aspergillus section Flavi community structure in Zambia influences aflatoxin contamination of maize and groundnut.

    Science.gov (United States)

    Kachapulula, Paul W; Akello, Juliet; Bandyopadhyay, Ranajit; Cotty, Peter J

    2017-11-16

    Aflatoxins are cancer-causing, immuno-suppressive mycotoxins that frequently contaminate important staples in Zambia including maize and groundnut. Several species within Aspergillus section Flavi have been implicated as causal agents of aflatoxin contamination in Africa. However, Aspergillus populations associated with aflatoxin contamination in Zambia have not been adequately detailed. Most of Zambia's arable land is non-cultivated and Aspergillus communities in crops may originate in non-cultivated soil. However, relationships between Aspergillus populations on crops and those resident in non-cultivated soils have not been explored. Because characterization of similar fungal populations outside of Zambia have resulted in strategies to prevent aflatoxins, the current study sought to improve understanding of fungal communities in cultivated and non-cultivated soils and in crops. Crops (n=412) and soils from cultivated (n=160) and non-cultivated land (n=60) were assayed for Aspergillus section Flavi from 2012 to 2016. The L-strain morphotype of Aspergillus flavus and A. parasiticus were dominant on maize and groundnut (60% and 42% of Aspergillus section Flavi, respectively). Incidences of A. flavus L-morphotype were negatively correlated with aflatoxin in groundnut (log y=2.4990935-0.09966x, R 2 =0.79, P=0.001) but not in maize. Incidences of A. parasiticus partially explained groundnut aflatoxin concentrations in all agroecologies and maize aflatoxin in agroecology III (log y=0.1956034+0.510379x, R 2 =0.57, Pagroecologies across Zambia gives support for modifying fungal community structure to reduce the aflatoxin-producing potential. Published by Elsevier B.V.

  10. Aflatoxin contamination of groundnut and maize in Zambia: observed and potential concentrations.

    Science.gov (United States)

    Kachapulula, P W; Akello, J; Bandyopadhyay, R; Cotty, P J

    2017-06-01

    The aims of the study were to quantify aflatoxins, the potent carcinogens associated with stunting and immune suppression, in maize and groundnut across Zambia's three agroecologies and to determine the vulnerability to aflatoxin increases after purchase. Aflatoxin concentrations were determined for 334 maize and groundnut samples from 27 districts using lateral-flow immunochromatography. Seventeen per cent of crops from markets contained aflatoxin concentrations above allowable levels in Zambia (10 μg kg -1 ). Proportions of crops unsafe for human consumption differed significantly (P agroecologies with more contamination (38%) in the warmest (Agroecology I) and the least (8%) in cool, wet Agroecology III. Aflatoxin in groundnut (39 μg kg -1 ) and maize (16 μg kg -1 ) differed (P = 0·032). Poor storage (31°C, 100% RH, 1 week) increased aflatoxin in safe crops by over 1000-fold in both maize and groundnut. The L morphotype of Aspergillus flavus was negatively correlated with postharvest increases in groundnut. Aflatoxins are common in Zambia's food staples with proportions of unsafe crops dependent on agroecology. Fungal community structure influences contamination suggesting Zambia would benefit from biocontrol with atoxigenic A. flavus. Aflatoxin contamination across the three agroecologies of Zambia is detailed and the case for aflatoxin management with atoxigenic biocontrol agents provided. The first method for evaluating the potential for aflatoxin increase after purchase is presented. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Journal of Applied Microbiology published by John Wiley & Sons Ltd on behalf of The Society for Applied Microbiology.

  11. Enhancing global health and education in Malawi, Zambia, and the United States through an interprofessional global health exchange program.

    Science.gov (United States)

    Wilson, Lynda Law; Somerall, D'Ann; Theus, Lisa; Rankin, Sally; Ngoma, Catherine; Chimwaza, Angela

    2014-05-01

    This article describes participant outcomes of an interprofessional collaboration between health professionals and faculty in Malawi, Zambia, and the United States (US). One strategy critical for improving global health and addressing Millennium Development goals is promotion of interprofessional education and collaboration. Program participants included 25 health professionals from Malawi and Zambia, and 19 faculty/health professionals from Alabama and California. African Fellows participated in a 2 week workshop on Interprofessional Education in Alabama followed by 2 weeks working on individual goals with faculty collaborators/mentors. The US Fellows also spent 2 weeks visiting their counterparts in Malawi and Zambia to develop plans for sustainable partnerships. Program evaluations demonstrated participants' satisfaction with the program and indicated that the program promoted interprofessional and cross-cultural understanding; fostered development of long-term sustainable partnerships between health professionals and educators in Zambia and the US; and created increased awareness and use of resources for global health education. © 2014.

  12. Zambia's participation in past CTBTO activities and the upgrading of AS119 and N192: Experiences and the way forward

    International Nuclear Information System (INIS)

    Lombe, D.K.

    2002-01-01

    This presentation briefly describes the Zambian Seisimic Network (ZSN), Zambia's participation in past CTBTO activities and upgrading of AS119 and N192. It goes on to describe various experiences encountered and makes some suggestions for future considerations

  13. Sexual and reproductive health services for young people in Kenya and Zambia : Providers attitudes and young peoples needs and experiences

    OpenAIRE

    Warenius, Linnéa

    2008-01-01

    Background: Unintended pregnancy, abortion and STI, including HIV are common sexual and reproductive health problems among young people in Kenya and Zambia. Yet, the reproductive health services are underutilised. Nurses and midwives are key providers in the promotion young people s sexual and reproductive health in Kenya and Zambia. Aim: The overall aim was to describe and explore young people s sexual and reproductive health needs and experiences and to describe health ...

  14. cholera epidemiology in zambia from 2000 to 2010: implications for ...

    African Journals Online (AJOL)

    2013-10-10

    Oct 10, 2013 ... Zambian cholera data on the global health atlas to ensure consistency [6]. ... Management Committee (NEPPC&MC) meetings were also .... The inadequate water supply situation for Lusaka ... maintaining safe water chain at the household level through ... cost and logistics for administration needs to be.

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

    Science.gov (United States)

    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. Insecticide-treated nets mass distribution campaign: benefits and lessons in Zambia.

    Science.gov (United States)

    Masaninga, Freddie; Mukumbuta, Nawa; Ndhlovu, Ketty; Hamainza, Busiku; Wamulume, Pauline; Chanda, Emmanuel; Banda, John; Mwanza-Ingwe, Mercy; Miller, John M; Ameneshewa, Birkinesh; Mnzava, Abraham; Kawesha-Chizema, Elizabeth

    2018-04-24

    Zambia was an early adopter of insecticide-treated nets strategy in 2001, and policy for mass distribution with long-lasting insecticidal nets (LLINs) in 2005. Since then, the country has implemented mass distribution supplemented with routine delivery through antenatal care and under five clinics in health facilities. The national targets of universal (100%) coverage and 80% utilization of LLINs have not been attained. Free mass LLIN distribution campaign in Zambia offers important lessons to inform future campaigns in the African region. This study reviewed LLIN free mass distribution campaign information derived from Zambia's national and World Health Organization Global Malaria Programme annual reports and strategic plans published between 2001 and 2016. In 2014, a nationwide mass distribution campaign in Zambia delivered all the 6.0 million LLINs in 6 out of 10 provinces in 4 months between June and September before the onset of the rainy season. Compared with 235,800 LLINs and 2.9 million LLINs distributed on a rolling basis in 2008 and 2013, respectively, the 2014 mass campaign, which distributed 6 million LLINs represented the largest one-time-nationwide LLIN distribution in Zambia. The province (Luapula) with highest malaria transmission, mostly with rural settings recorded 98-100% sleeping spaces in homes covered with LLINs. The percentage of households owning at least 1 LLIN increased from 50.9% in 2006 to 77.7% in 2015. The 2014 mass campaign involved a coordinated response with substantial investments into macro (central) and micro (district) level planning, capacity building, tracking and logistics management supported by a new non-health sector partnership landscape. Coordination of LLIN distribution and logistics benefited from the mobile phone technology to transmit "real time" data on commodity tracking that facilitated timely delivery to districts. Free mass distribution of LLINs policy was adopted in 2005 in Zambia. Consistently implemented

  17. Life-forms and seasonal patterns in the pteridophytes in Zambia

    Directory of Open Access Journals (Sweden)

    Jan Kornaś

    2015-01-01

    Full Text Available 146 species of pteridophytes occurring in Zambia were classified into Raunkiaer's life-form classes. The hemicryptophytes are dominant and include the most widely distributed species. The phanerophytes (tree-ferns and lianas and the epiphytes are rather scarce and limited to or concentrated in the higher-rainfall areas in the northern part of the country. Simplified diagrams of periodicity were constructed for all Zambian pteridophyte species. Three major types of seasonal pattern of growth and dormancy were distinguished: the evergreen type, the poikilohydrous type, and the "summer-green" type. The first of them is connected with the local conditions of continuously wet non-zonal sites, while the two others clearly reflect the peculiarities of the zonal climate of Zambia.

  18. The influence of cultural practices on the HIV and AIDS pandemic in Zambia

    Directory of Open Access Journals (Sweden)

    Nolipher Moyo

    2011-05-01

    Full Text Available Culture plays a significant role in people’s lives in Zambia and in Africa as a whole. Consequently, there is a need to take Zambian or African culture seriously in order to look at the salient elements of cultural practices in rites of passage that influence the spread of HIV and AIDS. This article analyses four rites of passage associated with birth, puberty, marriage and death. There are numerous rites of passage in Zambian culture. Some of these rites help to curb the spread of HIV and AIDS, whilst others exacerbate the spread of the virus. Using the Reformed Church in Zambia Bible Study Method of Subgroups, discussions were held that allowed victims of cultural practices to tell their stories using the narrative model. This article sought to shed light on cultural practices that exacerbate HIV and AIDS and more importantly, provide culturally sensitive alternatives to these harmful practices.

  19. Schistosomiasis in Zambia: a systematic review of past and present experiences.

    Science.gov (United States)

    Kalinda, Chester; Chimbari, Moses J; Mukaratirwa, Samson

    2018-04-30

    The speedy rate of change in the environmental and socio-economics factors may increase the incidence, prevalence and risk of schistosomiasis infections in Zambia. However, available information does not provide a comprehensive understanding of the biogeography and distribution of the disease, ecology and population dynamics of intermediate host snails. The current study used an information-theoretical approach to understand the biogeography and prevalence schistosomiasis and identified knowledge gaps that would be useful to improve policy towards surveillance and eradication of intermediate hosts snails in Zambia. To summarise the existing knowledge and build on past and present experiences of schistosomiasis epidemiology for effective disease control in Zambia, a systematic search of literature for the period 2000-2017 was done on PubMed, Google Scholar and EBSCOhost. Using the key words: 'Schistosomiasis', 'Biomphalaria', 'Bulinus', 'Schistosoma mansoni', 'Schistosoma haematobium', and 'Zambia', in combination with Booleans terms 'AND' and 'OR', published reports/papers were obtained and reviewed independently for inclusion. Thirteen papers published in English that fulfilled the inclusion criteria were selected for the final review. The papers suggest that the risk of infection has increased over the years and this has been attributed to environmental, socio-economic and demographic factors. Furthermore, schistosomiasis is endemic in many parts of the country with infection due to Schistosoma haematobium being more prevalent than that due to S. mansoni. This review also found that S. haematobium was linked to genital lesions, thus increasing risks of contracting other diseases such as HIV and cervical cancer. For both S. haematobium and S. mansoni, environmental, socio-economic, and demographic factors were influential in the transmission and prevalence of the disease and highlight the need for detailed knowledge on ecological modelling and mapping the

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

    Science.gov (United States)

    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.

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

    OpenAIRE

    Mwape, Kabemba E.; Phiri, Isaac K.; Praet, Nicolas; Speybroeck, Niko; Muma, John B.; Dorny, Pierre; Gabri?l, 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-sam...

  2. Household lifestyle, energy related practices and perceptions of energy efficiency: Evidence from Kitwe, Zambia

    Directory of Open Access Journals (Sweden)

    Lilias Makashini

    2014-08-01

    Full Text Available Southern Africa is noted for not only constant power shortages but also poor access to electricity. In Zambia, for example, 75% of the population does not have access to electricity. This is partly because although Zambia has one of the lowest energy tariffs in Southern Africa, when compared with household monthly income, the resource is still reasonably unaffordable. Therefore, there is need to find innovative ways of reducing energy cost. Recent studies have indicated that there are patterns that show that there is a relationship between households' lifestyles and energy consumption. This means that understanding household lifestyles and how that impacts on energy use would be crucial in helping occupants to change their behaviours. This would result in the minimisation of energy consumption and thus a reduction in energy bills. However, there is a dearth of scholarly literature about households' lifestyles and their impacts on energy consumption in most developing countries including Zambia. This study investigates the perceptions of different lifestyles on household energy consumption and knowledge about energy efficiency in the city of Kitwe, the second largest city in Zambia. Motivation and barriers to energy efficiency have also been investigated. To achieve this, a mixed research approach was adopted. Firstly, a quantitative closed structured questionnaire instrument was used to collect data from 59 households in Kitwe. Secondly, mini-focus group discussions (average size of 5 ― brought about by the curiosity of residents and hence the contribution as families per household ― were undertaken in the informal settlement. The major findings are that households are generally motivated to implement energy saving strategies like covering pots when cooking, switching off lights in rooms that are not in use and that more information is needed as lack of knowledge and ‘landlord control' were identified as some of the barriers to energy

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

    Directory of Open Access Journals (Sweden)

    Paula A White

    Full Text Available 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.

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

    Science.gov (United States)

    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.

  5. Attitudes of basic school teachers towards inclusive education in the southern province of Zambia

    OpenAIRE

    Muleya, Edmond Moses

    2006-01-01

    Review of literature indicates that successful implementation of inclusion in regular schools is enhanced when regular class teachers have positive attitudes towards inclusion. This investigation explored teachers attitude toward including children with special education needs in the regular classroom. A questionnaire survey was administered to 300 teachers from 3 zones in three different districts in southern province of Zambia. In general it was found that teachers had negative attitudes t...

  6. Kanayaka: "The light is on": Understanding HIV and AIDS related Stigma in Urban and Rural Zambia

    OpenAIRE

    Bond, V; Levy, Chilikwela; Clay, S; Kafuma, T; Nyblade, L; Bettega, N

    2003-01-01

    The ZAMBART Project in partnership with Kara Counselling and Training Trust (KCTT) collaborated with the International Center for Research on Women (ICRW) to carry out community based research in Zambia over a period of two years (November 2001 to November 2003) in urban and rural sites, and used qualitative methods to investigate stigma associated with HIV and AIDS - its causes, forms and consequences and the social, economic and cultural factors that underlie it. This report describes the s...

  7. Insecticide resistance and role in malaria transmission of Anopheles funestus populations from Zambia and Zimbabwe.

    Science.gov (United States)

    Choi, Kwang S; Christian, Riann; Nardini, Luisa; Wood, Oliver R; Agubuzo, Eunice; Muleba, Mbanga; Munyati, Shungu; Makuwaza, Aramu; Koekemoer, Lizette L; Brooke, Basil D; Hunt, Richard H; Coetzee, Maureen

    2014-10-08

    Two mitochondrial DNA clades have been described in Anopheles funestus populations from southern Africa. Clade I is common across the continent while clade II is known only from Mozambique and Madagascar. The specific biological status of these clades is at present unknown. We investigated the possible role that each clade might play in the transmission of Plasmodium falciparum and the insecticide resistance status of An. funestus from Zimbabwe and Zambia. Mosquitoes were collected inside houses from Nchelenge District, Zambia and Honde Valley, Zimbabwe in 2013 and 2014. WHO susceptibility tests, synergist assays and resistance intensity tests were conducted on wild females and progeny of wild females. ELISA was used to detect Plasmodium falciparum circumsporozoite protein. Specimens were identified to species and mtDNA clades using standard molecular methods. The Zimbabwean samples were all clade I while the Zambian population comprised 80% clade I and 20% clade II in both years of collection. ELISA tests gave an overall infection rate of 2.3% and 2.1% in 2013, and 3.5% and 9.2% in 2014 for Zimbabwe and Zambia respectively. No significant difference was observed between the clades. All populations were resistant to pyrethroids and carbamates but susceptible to organochlorines and organophosphates. Synergist assays indicated that pyrethroid resistance is mediated by cytochrome P450 mono-oxygenases. Resistance intensity tests showed high survival rates after 8-hrs continuous exposure to pyrethroids but exposure to bendiocarb gave the same results as the susceptible control. This is the first record of An. funestus mtDNA clade II occurring in Zambia. No evidence was found to suggest that the clades are markers of biologically separate populations. The ability of An. funestus to withstand prolonged exposure to pyrethroids has serious implications for the use of these insecticides, either through LLINs or IRS, in southern Africa in general and resistance management

  8. Review of social issues for large-scale land investment in Zambia

    OpenAIRE

    Henley, Giles

    2017-01-01

    Given unsuccessful experiences to date in establishing large-scale investments for biofuels in Zambia, this paper explores the social constraints that may hinder future efforts to use the same models. The author reviews the legal framework that has guided the establishment of most agricultural investments to date (including investment in biofuels), and analyses some of the issues and social repercussions associated with them, through a review of existing case studies. He also explores through...

  9. Sustainability in Health Condition of the People Living in Rural Province of Zambia

    OpenAIRE

    Kon, Sayuri; Kubo, Harutaka

    2010-01-01

    In Zambia, located in southern part of Africa, drought is frequently happened in dry season but recently heavy rainfall seriously damages crops in rainy season. Life of the people depending on farming are liable to be greatly affected by environmental change, which decrease provision of food, furthermore it affects their nutritional and health conditions. We have conducted longitudinal body measurements for the people living in rural villages to reveal the variation of nutritional status whic...

  10. Long-run and Short-run Determinants of the Real Exchange Rate in Zambia

    OpenAIRE

    Mkenda, Beatrice Kalinda

    2001-01-01

    The paper analyses the main determinants of the real exchange rate in Zambia. It first gives a brief review of the Zambian economy and a review on real exchange rate studies. Then an illustrative model is presented. The study employs cointegration analysis in estimating the long-run determinants of the real exchange rates for imports and exports, and of the internal real exchange rate. The finding is that terms of trade, government consumption, and investment share all influence the real exch...

  11. Socio-economic gradients in prevalent tuberculosis in Zambia and the Western Cape of South Africa.

    Science.gov (United States)

    Yates, Tom A; Ayles, Helen; Leacy, Finbarr P; Schaap, A; Boccia, Delia; Beyers, Nulda; Godfrey-Faussett, Peter; Floyd, Sian

    2018-04-01

    To describe the associations between socio-economic position and prevalent tuberculosis in the 2010 ZAMSTAR Tuberculosis Prevalence Survey, one of the first large tuberculosis prevalence surveys in Southern Africa in the HIV era. The main analyses used data on 34 446 individuals in Zambia and 30 017 individuals in South Africa with evaluable tuberculosis culture results. Logistic regression was used to estimate adjusted odds ratios for prevalent TB by two measures of socio-economic position: household wealth, derived from data on assets using principal components analysis, and individual educational attainment. Mediation analysis was used to evaluate potential mechanisms for the observed social gradients. The quartile with highest household wealth index in Zambia and South Africa had, respectively, 0.55 (95% CI 0.33-0.92) times and 0.70 (95% CI 0.54-0.93) times the adjusted odds of prevalent TB of the bottom quartile. College or university-educated individuals in Zambia and South Africa had, respectively, 0.25 (95% CI 0.12-0.54) and 0.42 (95% CI 0.25-0.70) times the adjusted odds of prevalent TB of individuals who had received only primary education. We found little evidence that these associations were mediated via several key proximal risk factors for TB, including HIV status. These data suggest that social determinants of TB remain important even in the context of generalised HIV epidemics. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  12. Targeting indoor residual spraying for malaria using epidemiological data: a case study of the Zambia experience.

    Science.gov (United States)

    Pinchoff, Jessie; Larsen, David A; Renn, Silvia; Pollard, Derek; Fornadel, Christen; Maire, Mark; Sikaala, Chadwick; Sinyangwe, Chomba; Winters, Benjamin; Bridges, Daniel J; Winters, Anna M

    2016-01-06

    In Zambia and other sub-Saharan African countries affected by ongoing malaria transmission, indoor residual spraying (IRS) for malaria prevention has typically been implemented over large areas, e.g., district-wide, and targeted to peri-urban areas. However, there is a recent shift in some countries, including Zambia, towards the adoption of a more strategic and targeted IRS approach, in coordination with increased emphasis on universal coverage of long-lasting insecticidal nets (LLINs) and effective insecticide resistance management. A true targeted approach would deliver IRS to sub-district areas identified as high-risk, with the goal of maximizing the prevention of malaria cases and deaths. Together with the Government of the Republic of Zambia, a new methodology was developed applying geographic information systems and satellite imagery to support a targeted IRS campaign during the 2014 spray season using health management information system data. This case study focuses on the developed methodology while also highlighting the significant research gaps which must be filled to guide countries on the most effective strategy for IRS targeting in the context of universal LLIN coverage and evolving insecticide resistance.

  13. Environmental impact assessment of the charcoal production and utilization system in central Zambia

    International Nuclear Information System (INIS)

    Serenje, W.; Chidumayo, E.N.; Chipuwa, J.H.; Egneus, H.; Ellegaard, A.

    1994-01-01

    The present study is the outcome of the Zambia Charcoal Utilization Programme, which is based on cooperation that started in 1989 between the Department of Energy, Ministry of Energy and Water Development (then Ministry of Power, Transport and Communications) and the Stockholm Environmental Institute (SEI). The programme, which is funded by the Swedish International Development Authority (SIDA), consists of a number of studies focusing on different aspects of the wood and charcoal industry in Zambia. Selection of this energy system for detailed study was based on the fact that wood provides the largest contribution to total energy supply in Zambia, and the fact that wood is a renewable resource that could be exploited on a sustainable basis if properly managed. The studies therefore range from those that look at sustainability of the natural forests exploited for charcoal, to those that deal with transportation and health aspects of charcoal production and use. The present report focuses on the environmental and socio-economic effects of charcoal production and use. 72 refs., 20 figs., 38 tabs

  14. Patch-occupancy survey of elephant (Loxodonta africana surrounding Livingstone, Zambia

    Directory of Open Access Journals (Sweden)

    David A. Youldon

    2017-01-01

    Full Text Available Wild elephants represent the biggest human–wildlife conflict issue in Livingstone, Zambia. However, little is known about their movements. This survey investigated elephants’ habitat use outside a core protected and fenced zone that forms part of Mosi-oa-Tunya National Park, Zambia. Using ‘patch-occupancy’ methodology, indications of elephant presence (feeding behaviour, dung and tracks were surveyed. The survey aimed to assist proposed future monitoring exercises by defining the geographical extent that should be considered to improve accuracy in species abundance estimates. Results were supplemented using collected indications of elephant presence from prior monitoring exercises, and during this survey. Elephant presence was confirmed up to 8 km from the boundary of the protected core habitat, focussed in: (1 an unfenced zone of the national park, (2 along a road leading from the national park to the Dambwa Forest to the north and (3 along two rivers located to the west (Sinde River and east (Maramba River of the core area. Detection probability of elephant presence was high using these methods, and we recommend regular sampling to determine changes in habitat use by elephants, as humans continue to modify land-use patterns. Conservation implications: Identification of elephant ranging behaviour up to 8 km outside of the Mosi-oa-Tunya National Park in southern Zambia will assist in managing human– elephant conflict in the area, as well as in assessing this seasonal population’s abundance.

  15. The Local Social and Environmental Impacts of Smallholder-Based Biofuel Investments in Zambia

    Directory of Open Access Journals (Sweden)

    Laura German

    2011-12-01

    Full Text Available High oil prices, recent commitments by industrialized countries to enhance the use of renewable energy, and efforts by developing countries to stimulate foreign investment as a pathway to development have fueled high levels of interest in the biofuel sector throughout much of sub-Saharan Africa. Zambia is no exception. A large, land-locked country with high pump prices and vast tracts of land considered by many to be "degraded" or "underutilized," investor interest in the sector has remained high despite uncertainties associated with unproven feedstocks and market fluctuations. While investment in multiple feedstock and production models may be observed, one of the primary investments has been in jatropha outgrower schemes in which small-scale farmers grow feedstock on contract with domestic and foreign investors. We assess the history and evolution of the largest such scheme in Zambia, as well as the social and environmental impacts in two districts with large numbers of outgrowers. Findings suggest that, although such a production model may hold promise for enhancing rural livelihood benefits from the emerging biofuel sector, to date, small-scale farmers have borne the brunt of the risk and uncertainty that are the trademarks of this emerging industry. We conclude with a discussion of options to minimize forest conversion and protect farmers against high-risk investments, while harnessing the potential of this business model for enhancing rural livelihoods in Zambia and elsewhere.

  16. Information and communication: a library's local response to HIV/AIDS in Zambia.

    Science.gov (United States)

    Kanyengo, Christine Wamunyima

    2010-03-01

    To document and describe the University of Zambia Medical library's responses to the fight against HIV/AIDS in Zambia. The methodology adopted was a case study approach combined with an analysis of the literature such as annual reports and official documents. This was augmented by personal reflections of the author having worked at the Medical Library. The University of Zambia Medical library has over the years instituted and implemented HIV/AIDS information provision programmes that include the provision of information in various formats -- print or electronic and, in addition, capacity building in HIV/AIDS information literacy skills. A library's social responsibility calls for it to be part of national responses to crises that arise in society. As HIV/AIDS has affected every aspect of Zambian society prevention, treatment, care and support there is an understanding that the library's role should be using the critical and strategic resource at its disposal - information -- as part of their contribution to the fight against HIV/AIDS. In this context, libraries should source, collect, organize and disseminate information on HIV/AIDS in a way that is easily accessible to researchers, HIV/AIDS programme implementation agencies and the ordinary public.

  17. A quick needs assessment of key stakeholder groups on the role of family medicine in Zambia

    Directory of Open Access Journals (Sweden)

    J Sanders

    2017-10-01

    Full Text Available Background. Zambia is a nation of nine million people, and has too few physicians to meet the country’s health needs. Following the strategy of other sub-Saharan countries, Zambia has developed a training programme in family medicine to help improve the medical competencies of its physician workforce. A needs assessment was undertaken to better understand the landscape into which Zambian family medicine is being placed. Methods. In 2014, a nine-question survey in Likert-scale format was developed, validated, and then delivered to four stakeholder groups: (i practicing clinical physicians, (ii the general public, (iii the University of Zambia’s School of Medicine’s academic faculty and (iv medical students. The needs assessment was delivered through several different mechanisms: via web-based service, to respondents’ email addresses; in paper form, to population samples of convenience; and verbally, through face-to-face encounters. Results. The number of stakeholders from each group who responded to the needs assessment were: clinical physicians, 27; general public, 15; academic faculty, 14; and medical students, 31. Five of the nine survey statements achieved super-majority consensus, with >66% of stakeholders in each group agreeing. Two additional statements achieved a simple-majority consensus with >50% agreement within each stakeholder group. Conclusion. This survey suggests that there is a broad-based a priori understanding of family medicine in Zambia, and general agreement that its presence would be valuable to Zambia’s healthcare system.

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

    Directory of Open Access Journals (Sweden)

    Hang'ombe Bernard M

    2012-01-01

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

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

    Science.gov (United States)

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

    1996-07-01

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

  20. Associations of advertisement-promotion-sponsorship-related factors with current cigarette smoking among in-school adolescents in Zambia.

    Science.gov (United States)

    Zulu, Richard; Siziya, Seter; Muula, Adamson S; Rudatsikira, Emmanuel

    2009-01-01

    Tobacco use is the leading cause of noncommunicable disease morbidity and mortality. Most smokers initiate the smoking habit as adolescents or young adults. Survey data from the 2007 Lusaka (Zambia) Global Youth Tobacco Survey were used to estimate the prevalence of current cigarette smoking and assess whether exposure to pro-tobacco media and perception of the potential harm of secondhand smoke are associated with adolescents' smoking. Logistic regression analysis was used to estimate the associations. Altogether, 2378 students, of whom 56.8% were females, participated in the study. Overall, 10.5% of the students (9.3% among males and 12.1% among females) smoked cigarettes in the 30 days prior to the survey. Students who favored banning smoking in public places were 33% (OR = 0.67; 95% CI [0.47, 0.96]) less likely to smoke cigarettes compared to those who were not in favor of the ban. Seeing actors smoking in TV shows, videos or movies was positively associated with smoking (OR = 1.90; 95% CI [1.26, 2.88]). However, possessing an item with a cigarette brand logo on it, seeing advertisements of cigarettes on billboards and being ever offered a free cigarette by a cigarette sales representative were negatively associated with smoking (OR=0.39, 95% CI [0.26, 0.58]; OR=0.63, 95% CI [0.43, 0.92]; and OR=0.43, 95% CI [0.29, 0.65], respectively). Findings from this study indicate that TV advertisement-promotion-sponsorship was positively associated with smoking, while it was the opposite with other forms of advertisement; there is a need for further studies.

  1. Point-of-Care Virologic Testing to Improve Outcomes of HIV-Infected Children in Zambia: A Clinical Trial Protocol.

    Science.gov (United States)

    Chibwesha, Carla J; Ford, Catherine E; Mollan, Katie R; Stringer, Jeffrey S A

    2016-08-01

    In the absence of early infant diagnosis (EID) and immediate antiretroviral therapy (ART), some 50% of untreated HIV-infected infants die before age 2. Conventional EID requires sophisticated instruments that are typically placed in centralized or reference laboratories. In low-resource settings, centralized systems often lead to result turnaround times of several months, long delays in diagnosis, and adverse outcomes for HIV-infected children. Our clinical trial tests the effectiveness of a new point-of-care (POC) diagnostic technology to identify HIV-infected infants and start providing them life-saving ART as soon as possible. The study uses a randomized, controlled design to test whether the Alere q platform for HIV DNA polymerase chain reaction (PCR) testing improves outcomes of HIV-infected children in Zambia. We aim to enroll 2867 HIV-exposed infants aged 4-12 weeks and to follow those who are HIV infected for 12 months as they receive HIV care at 6 public health facilities in Lusaka. The trial's primary endpoint is the proportion of HIV-infected infants in each study arm who start ART and remain alive, in care, and virally suppressed 12 months after their diagnostic blood draw. Our trial will provide evidence for the incremental benefit of implementing a POC EID strategy in low-resource settings where only off-site PCR services are currently available. The results will be useful in guiding future decisions regarding investments in POC virologic testing as part of overall pediatric AIDS mitigation strategies in sub-Saharan Africa. clinicaltrials.gov NCT02682810.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

    There is emerging evidence that esophageal cancer occurs in younger adults in sub-Saharan Africa than in Europe or North America. The burden of human immunodeficiency virus (HIV) is also high in this region. We postulated that HIV and human papillomavirus (HPV) infections might contribute to esophageal squamous cell carcinoma (OSCC) risk. This was a 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

  3. Assessment of renal function in routine care of people living with HIV on ART in a resource-limited setting in urban Zambia.

    Science.gov (United States)

    Deckert, Andreas; Neuhann, Florian; Klose, Christina; Bruckner, Thomas; Beiersmann, Claudia; Haloka, John; Nsofwa, Mannie; Banda, Greg; Brune, Maik; Reutter, Helmut; Rothenbacher, Dietrich; Zeier, Martin

    2017-01-01

    Data on renal impairment in sub-Saharan Africa (SSA) remains scarce, determination of renal function is not part of routine assessments. We evaluated renal function and blood pressure in a cohort of people living with HIV (PLWH) on antiretroviral treatment (ART) in the Renal Care Zambia project (ReCaZa). Using routine data from an HIV outpatient clinic from 2011-2013, we retrospectively estimated the glomerular filtration rate (eGFR, CKD-Epi formula) of PLWH on ART in Lusaka, Zambia. Data were included if adults had had at least one serum creatinine recorded and had been on ART for a minimum of three months. We investigated the differences in eGFR between ART subgroups with and without tenofovir disproxil fumarate (TDF), and applied multivariable linear models to associate ART and eGFR, adjusted for eGFR before ART initiation. Among 1118 PLWH (63,3% female, mean age 41.8 years, 83% ever on TDF; median duration 1461 [range 98 to 4342] days) on ART, 28.3% had an eGFR ART had an initial eGFR lower 60ml/min. Nineteen percent had first-time hypertensive readings at their last visit. The multivariable models suggest that physicians acted according to guidelines and replaced TDF-containing ART if patients developed moderate/severe renal impairment. Assessment of renal function in SSA remains a challenge. The vast majority of PLWH benefit from long-term ART, including improved renal function. However, approximately 5% of PLWH on ART may have clinically relevant decreased eGFR, and 27% hypertension. While a routine renal assessment might not be feasible, strategies to identify patients at risk are warranted. Targeted monitoring prior and during ART is recommended, however, should not delay ART access.

  4. Tourism as a Poverty Reduction Tool: The Case of Mukuni Village in the Southern Province of Zambia

    Directory of Open Access Journals (Sweden)

    Miroslav Horák

    2014-01-01

    Full Text Available Globally, tourism is becoming one of the cornerstones of national economic growth and as a means of poverty alleviation, especially in the tourist attractions in rural areas. This article assesses the levels of utilization of tourism potentials in Zambia, in general, and the Mukuni village in the Southern province in Zambia, in particular, with reference to poverty reduction. The world famous Victoria Falls is situated in the Southern province and therefore this area is the most visited places in Zambia and attracts more tourists throughout the whole year. The main income of the local people, which includes the Tonga tribe comes from tourism. Even though tourism has brought positive results, including the realization of some local development projects and prosperity to the people, it has also brought some negative effects such as sociocultural change, pollution and waste in the tourist destination areas in Zambia.For the Mukuni people and Zambia as a whole to fully exploit tourism potentials, stricter laws protecting the destruction of the environment and the preservation culture of the indigenous people should be enforced in the tourist destination areas. The government should use the levy from tourism to provide better infrastructure, create job opportunities and create wealth within the tourist areas for sustainable tourism development and poverty reduction.

  5. Industrial Pollution Prevention Programme (IPPP) Progress report Visit to Environmental Council of Zambia (ECZ) 20.09.-01.10.98

    OpenAIRE

    Aanes, K.

    1998-01-01

    A visit to ECZ was paid by Mr. Karl Jan Aanes, NIVA, with the intention to assess to capacity of the chosen laboratories in Zambia to analyse water samples in the Water Quality Survey Programme. Along with the visting of laboratories a field trip was carried out to collect water samples from the upper part of Kafue and the main tributaries from mine sites. Parallel samples were taken and analysed both at laboratories in Zambia and at NIVA to conduct a preliminary intercalibration between the ...

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

    Science.gov (United States)

    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

  7. Using intersectionality to explore experiences of disability and HIV among women and men in Zambia.

    Science.gov (United States)

    Yoshida, Karen; Hanass-Hancock, Jill; Nixon, Stephanie; Bond, Virginia

    2014-01-01

    Little is known about the experiences of people with disabilities (PWD) who live with HIV. Existing research largely assumes a "double burden" approach, which views HIV as doubling the load for people already burdened by disability. Intersectionality (a dynamic process of converging systems of relationships) offers an alternative approach for understanding differences in experience. This study uses an intersectional approach to explore the experiences of PWD in Zambia who have become HIV-positive. We conducted semi-structured, in depth interviews with 21 PWD who live with HIV in Zambia (12 women, 9 men). Participants had various impairments (visual, hearing, mobility, intellectual). Interviews were conducted to meet participants' accessibility preferences. Our intersectional analysis demonstrates the dynamic and situational emergent meanings and consequences for PWD who are living with HIV related to: (1) meanings of HIV and disability linked with time and trajectory; (2) oppression and negotiation related to accessing health services and (3) social roles and relationships. Three case studies illustrate these circumstances. Intersectionality offers a complementary approach for examining the complex interrelationship among HIV, disability, gender and time among PWD living with HIV. Findings illustrate directions for improved services and policies for this important group. Rehabilitation services need to take a cross-disability (multiple disabilities) approach working with people living with HIV and disability. Rehabilitation, as illustrated by a CBR approach, needs to include services that will facilitate not only health, but education, jobs and housing for people living with HIV and disability. Rehabilitation needs to make more direct connections with Zambia social service sector to help address the fluctuating experience of living with HIV and disability.

  8. Adapting the emergency first aid responder course for Zambia through curriculum mapping and blueprinting.

    Science.gov (United States)

    Pigoga, Jennifer L; Cunningham, Charmaine; Kafwamfwa, Muhumpu; Wallis, Lee A

    2017-12-10

    Community members are often the first to witness and respond to medical and traumatic emergencies, making them an essential first link to emergency care systems. The Emergency First Aid Responder (EFAR) programme is short course originally developed to help South Africans manage emergencies at the community level, pending arrival of formal care providers. EFAR was implemented in two rural regions of Zambia in 2015, but no changes were originally made to tailor the course to the new setting. We undertook this study to identify potential refinements in the original EFAR curriculum, and to adapt it to the local context in Zambia. The EFAR curriculum was mapped against available chief complaint data. An expert group used information from the map, in tandem with personal knowledge, to rank each course topic for potential impact on patient outcomes and frequency of use in practice. Individual blueprints were compiled to generate a refined EFAR curriculum, the time breakdown of which reflects the relative weight of each topic. This study was conducted based on data collected in Kasama, a rural region of Zambia's Northern Province. An expert group of five physicians practising emergency medicine was selected; all reviewers have expertise in the Zambian context, EFAR programme and/or curriculum development. The range of emergencies that Zambian EFARs encounter indicates that the course must be broad in scope. The refined curriculum covers 54 topics (seven new) and 25 practical skills (five new). Practical and didactic time devoted to general patient care and scene management increased significantly, while time devoted to most other clinical, presentation-based categories (eg, trauma care) decreased. Discrepancies between original and refined curricula highlight a mismatch between the external curriculum and local context. Even with limited data and resources, curriculum mapping and blueprinting are possible means of resolving these contextual issues. © Article author

  9. The economic impact of HIV/AIDS on the education sector in Zambia.

    Science.gov (United States)

    Grassly, Nicholas C; Desai, Kamal; Pegurri, Elisabetta; Sikazwe, Alfred; Malambo, Irene; Siamatowe, Clement; Bundy, Don

    2003-05-02

    To estimate and project the economic impact of HIV/AIDS on the supply of education in Zambia. An analysis of the financial implications of HIV/AIDS for the Ministry of Education (MoE) and donors funding education in Zambia. A mathematical model was used to project the number of primary school teachers and their HIV status under current plans for teacher training and recruitment. Cost data were compiled from the MoE, the Teacher Education Department, teacher training colleges and the donor consortium BESSIP (Basic Education Sub-Sector Investment Programme). Multivariate sensitivity analyses were performed. The impact of HIV/AIDS on the supply of primary education imply costs to the MoE and BESSIP estimated at US$1.3-3.1 million in 1999, and projected at $10.6-41.3 million over the period 1999-2010. These costs include salaries paid to teachers absent as a result of HIV-associated illness (71%), additional training of teachers to cope with AIDS-related attrition (22%) and funeral costs contractually met by the MoE (7%). They do not include the additional costs of an active care and prevention response by the MoE, or the burden of ensuring enrolment of AIDS orphans. The annual cost of HIV/AIDS is a relatively small fraction of the overall MoE budget (2.5% in 1999) but has substantial implications for resource allocation to some functions. Expenditure on teacher training will need to increase by 26% if Education for All targets are to be met in the face of AIDS. HIV/AIDS has significant implications for resource allocation in the education sector in Zambia.

  10. Early alcohol use and problem drinking among students in Zambia and Uganda

    Directory of Open Access Journals (Sweden)

    Monica H. Swahn

    2011-09-01

    Full Text Available Excessive alcohol use is a serious public health concern worldwide, but less attention has been given to the prevalence, risk and protective factors, and consequences of early alcohol use in low-income, developing countries. The purpose of this study was to determine the associations between early alcohol use, before age 13, and problem drinking among adolescents in Uganda and Zambia. Data from students in Zambia (n=2257; 2004 and Uganda (n=3215; 2003 were obtained from the cross-sectional Global School-Based Student Health Survey (GSHS. The self-administered questionnaires were completed by students primarily 13 to 16 years of age. Multiple statistical models were computed using logistic regression analyses to test the associations between early alcohol initiation and problem drinking, while controlling for possible confounding factors (e.g., current alcohol use, bullying victimization, sadness, lack of friends, missing school, lack of parental monitoring, and drug use. Results show that early alcohol initiation was associated with problem drinking in both Zambia (AOR=1.28; 95% CI:1.02-1.61 and Uganda (AOR=1.48; 95% CI: 1.11- 1.98 among youth after controlling for demographic characteristics, risky behaviors, and other possible confounders.The study shows that there is a significant association between alcohol initiation before 13 years of age and problem drinking among youth in these two countries. These findings underscore the need for interventions and strict alcohol controls as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth.

  11. Diabetes mellitus, hypertension and albuminuria in rural Zambia: a hospital-based survey.

    Science.gov (United States)

    Rasmussen, Jon B; Thomsen, Jakúp A; Rossing, Peter; Parkinson, Shelagh; Christensen, Dirk L; Bygbjerg, Ib C

    2013-09-01

    To assess albuminuria in rural Zambia among patients with diabetes mellitus only (DM group), hypertension only (HTN group) and patients with combined DM and HTN (DM/HTN group). A cross-sectional survey was conducted at St. Francis Hospital in the Eastern province of Zambia. Albumin-creatinine ratio in one urine sample was used to assess albuminuria. Other information obtained included age, sex, body mass index (BMI), waist circumference (WC), blood pressure (BP), glycosylated haemoglobin (HbA1c ), random capillary glucose, time since diagnosis, medication and family history of DM or HTN. A total of 193 participants were included (DM group: n = 33; HTN group: n = 92; DM/HTN group: n = 68). The participants in the DM group used insulin more frequently as diabetes medication than the DM/HTN group (P < 0.05). Furthermore, the DM group was younger and had lower BMI, WC and BP than the two other groups. In the DM group, HTN group and DM/HTN group, microalbuminuria was found in 12.1%, 19.6% and 29.4% (P = 0.11), and macroalbuminuria was found in 0.0%, 3.3% and 13.2% (P = 0.014), respectively. The urine albumin (P = 0.014) and albumin-creatinine ratio (P = 0.0006) differed between the three groups. This hospital-based survey in rural Zambia found a lower frequency of albuminuria among the participants than in previous studies of patients with DM or HTN in urban sub-Saharan Africa. © 2013 John Wiley & Sons Ltd.

  12. Foreign capital flows, exports and growth in Zambia. A Vecm Approach

    Directory of Open Access Journals (Sweden)

    Kunofiwa Tsaurai

    2015-10-01

    Full Text Available This study investigates the causality between FDI net inflows, exports and GDP using Vector Error Correction Model (VECM approach. The words foreign capital flows and FDI are used interchangeably in this study. The findings from the VECM estimation technique is six fold: (1 the study revealed a long run causality relationship running from exports and GDP towards FDI, (2 the study showed a non–significant long run causality relationship running from FDI and exports towards GDP and (3 the existence of a weak long run causality relationship running from FDI and GDP towards exports in Zambia. The study also found out that no short run causality relationship that runs from FDI and exports towards GDP, short run causality running from FDI and GDP towards exports does not exist and there is no short run causality relationship running from exports and GDP towards FDI. Contrary to the theory which says that FDI brings along with it a whole lot of advantages (FDI technological diffusion and spill over effects, the current study found that the impact of FDI in Zambia is not significant in the long run. This is possibly because certain host country locational characteristics that ensures that Zambia can benefit from FDI inflows are not in place or they might be in place but still not yet reached a certain minimum threshold levels. This might be an interesting area for further research. On the backdrop of the findings of this study, the author recommends that the Zambian authorities should formulate and implement export promotion strategies and economic growth enhancement initiatives in order to be able to attract more FDI.

  13. Operational scale entomological intervention for malaria control: strategies, achievements and challenges in Zambia

    Directory of Open Access Journals (Sweden)

    Chanda Emmanuel

    2013-01-01

    Full Text Available Abstract Background While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. Case description All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS, data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Discussion and evaluation Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO encourages the adoption of the integrated vector management (IVM strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. Conclusions The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system.

  14. Prevalence of Cryptosporidium spp. and Giardia duodenalis in pigs in Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Joyce Siwila

    2012-02-01

    Full Text Available This study was aimed at determining the prevalence of Cryptosporidium spp. and Giardia duodenalis in pigs which were being raised in intensive management systems. Faecal samples were collected from pigs of all age groups from three different piggery units. Samples were collected directly from the rectum for piglets and weaners and from the floor within 2 min – 5 min of excretion for sows and boars. At the time of collection, faecal consistency was noted as being normal, pasty or diarrhoeic. Samples were analysed further using the Merifluor® Cryptosporidium/Giardia immunofluorescence assay. All piggeries had at least one pig infected with either parasite. From a total 217 samples collected, 96 (44.2%; confidence interval [CI] = 37.6% – 50.9% were positive for Cryptosporidium spp., whilst 26 (12%; CI = 7.6% – 16.3% had G. duodenalis parasites. Of all the pigs, 6.9% (15/217 harboured both parasites. With regard to Cryptosporidium spp. infection, statistically significant differences were observed amongst the three units (p = 0.001, whereas no significant differences were observed for G. duodenalis infection (p = 0.13. Prevalence was higher in weaners as compared to other pig classes for both parasites, with significant differences being observed for G. duodenalis infection (p = 0.013. There was, however, no difference in infection between male and female pigs for both parasites. Furthermore, most infections were asymptomatic. From the study results it was clear that Cryptosporidium spp. and G. duodenalis infections were prevalent amongst pigs in the piggeries evaluated and, as such, may act as a source of infection for persons who come into contact with them.

  15. Foregrounding possibilities and backgrounding exploitation in transnational medical research projects in Lusaka, Zambia

    DEFF Research Database (Denmark)

    Bruun, Birgitte

    2016-01-01

    Today medical research funded by resourceful commercial companies and philanthropic organizations increasingly takes place in much less resourceful settings across the globe. Recent academic studies of this trend have observed how global inequalities have shaped the movements of this research...

  16. EDRXF measurements of heavy elements in soil samples from some potentially polluted sites in zambia

    International Nuclear Information System (INIS)

    Hayumbu, P.; Phiri, L.K.; Mambo, A.; Sokotela, S.B.

    2001-01-01

    A survey of heavy element levels in top soils collected around four industrial plants and along four highway stretches demonstrated that there was significant pollution only around an abandoned Pb/Zn mine. Sample collection in a rectangular grid encompassing each source sought to depict the spatial extent of pollution. Ascertaining levels of heavy elements in potentially polluted soils in urban areas of Zambia and along major highways was deemed desirable because it is common practice to grow maize and vegetables in lots adjacent to accessible industrial sites and highways. Pb is a heavy element of interest for all sampled sites whose distribution at the abandoned mine ranged from 13 to 2028 ppm

  17. School effects on non-verbal intelligence and nutritional status in rural Zambia

    OpenAIRE

    Hein, Sascha; Tan, Mei; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

    2015-01-01

    This study uses hierarchical linear modeling (HLM) to examine the school factors (i.e., related to school organization and teacher and student body) associated with non-verbal intelligence (NI) and nutritional status (i.e., body mass index; BMI) of 4204 3rd to 7th graders in rural areas of Southern Province, Zambia. Results showed that 23.5% and 7.7% of the NI and BMI variance, respectively, were conditioned by differences between schools. The set of 14 school factors accounted for 58.8% and ...

  18. Effects of endosulfan on a maize agro-ecosystem in Zambia

    International Nuclear Information System (INIS)

    Deedat, Y.D.; Maimbo, G.C.; Phiri, A.S.

    1997-01-01

    The effect of endosulfan on non-target fauna in a maize agro-ecosystem was studied in Zambia in 1994 and 1995. Endosulfan was well tolerated by a number of beneficial arthropods such as spiders, coccinelids, carabids and ants. Springtails were significantly reduced. However the effect was only transient and lasted for at most eight weeks. While endosulfan was effective against the target pest (stalk borers) it appeared to have no real effect on the soil inhabiting microorganisms. (author). 6 refs, 6 tabs

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

    Directory of Open Access Journals (Sweden)

    Bloch Paul

    2010-11-01

    Full Text Available Abstract 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

  20. The relevance and impact of Ethical Consciousness on Environmental Management in Zambia: A philosophical critique

    International Nuclear Information System (INIS)

    Mweshi, John

    2004-01-01

    This dissertation is informed by the need for adequate ethical consciousness in view of the perceived need for public responsibility, cooperation and participation in ensuring sound environmental management. It investigates and critiques the extent to which an adequate range of ethical principles has been incorporated in Zambia's attempts to address environmental issues.The investigation focused on the role of government policy, education system and the mass media in promoting responsible environmental management and practices by raising environmental ethical consciousness. The study confirmed the preponderance of economic utilitarianism with regard to environmental issues. (author)

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

    Directory of Open Access Journals (Sweden)

    Emmanuel Rudatsikira

    2012-01-01

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

  2. Returns to Schooling in Less Developed Countries: New Evidence from Zambia

    DEFF Research Database (Denmark)

    Nielsen, Helena Skyt; Westergård-Nielsen, Niels Chr.

    2001-01-01

    In our analysis of returns to schooling in Zambia, we look at the rural and urban population separately, and estimate the returns to schooling in each region based on a selection model in two stages. For urban areas we find that the returns to primary schooling are nil whereas the returns to scho...... to schooling beyond primary school are higher. For rural areas we find that the returns to primary schooling are positive and no different from the returns to education beyond primary school. Udgivelsesdato: JAN...

  3. Cannabis use and its socio-demographic correlates among in-school adolescents in Zambia.

    Science.gov (United States)

    Siziya, Seter; Muula, Adamson S; Besa, Chola; Babaniyi, Olusegun; Songolo, Peter; Kankiza, Njinga; Rudatsikira, Emmanuel

    2013-02-15

    Cannabis dependence in adolescents predicts increased risks of using other illicit drugs, poor academic performance and reporting psychotic symptoms. The prevalence of cannabis use was estimated two decades ago in Zambia among secondary school students. There are no recent estimates of the extent of the problem; further, correlates for its use have not been documented in Zambia. The objective of study was to estimate the current prevalence of cannabis use and its socio-demographic correlates among in-school adolescents. We conducted secondary analysis of data that was obtained from the 2004 Zambia Global School-Based Health Survey. Logistic regression analysis was conducted to identify the socio-demographic factors associated with cannabis use. A total of 2,257 adolescents participated in the survey of which 53.9% were females. The overall prevalence of self reported ever-used cannabis was 37.2% (34.5% among males and 39.5% among females). In multivariate analysis, males were 8% (AOR = 0.92; 95% CI [0.89, 0.95]) less likely to have ever smoked cannabis. Compared to adolescents aged 16 years or older, adolescents aged 14 years were 45% (AOR = 1.45; 95% CI [1.37, 1.55]) more likely, and those aged 15 years were 44% (AOR = 0.56; 95% CI [0.53, 0.60]) less likely to report to have ever smoked cannabis. Other factors that were significantly associated with cannabis use were history of having engaged in sexual intercourse (AOR = 2.55; 95% CI [2.46, 2.64]), alcohol use (AOR = 4.38; 95% CI [4.24, 4.53]), and having been bullied (AOR = 1.77; 95% CI [1.71, 1.83]). Adolescents who reported being supervised by parents during free time were less likely to have smoked cannabis (AOR = 0.92; 95% CI [0.88, 0.95]). The use of cannabis is prevalent among Zambian in-school adolescents. Efforts to prevent adolescents' psychoactive drug use in Zambia should be designed considering the significant factors associated with drug use in the current study.

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

    Science.gov (United States)

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

    2012-01-01

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

  5. Implementing antiretroviral therapy programs in resource-constrained settings: lessons from Monze, Zambia.

    Science.gov (United States)

    Adedimeji, Adebola; Malokota, Oliver; Manafa, Ogenna

    2011-05-01

    We describe the impact of an antiretroviral therapy program on human resource utilization and service delivery in a rural hospital in Monze, Zambia, using qualitative data. We assess project impact on staff capacity utilization, service delivery, and community perception of care. Increased workload resulted in fatigue, low staff morale, and exacerbated critical manpower shortages, but also an increase in users of antiretroviral therapy, improvement in hospital infrastructure and funding, and an overall community satisfaction with service delivery. Integrating HAART programs within existing hospital units and services may be a good alternative to increase overall efficiency.

  6. Should I stay or should I go? Rural youth employment in Uganda and Zambia

    DEFF Research Database (Denmark)

    Kristensen, Søren Bech Pilgaard; Birch-Thomsen, Torben

    2013-01-01

    areas. Quantitative and qualitative data are drawn on to analyse the role of exogenous and endogenous support for young entrepreneurs. The findings indicate that agriculture plays a major role as a source of livelihood for rural youth and, in combination with other economic activities, provides a more......, a significant proportion of the youth, especially young men, migrate to urban areas, whereas in Zambia, almost all the young people have chosen to remain in the rural area, where they consider their prospects of success to be greater than if they were to migrate elsewhere....

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

    Science.gov (United States)

    Tuba, Mary; Sandoy, Ingvild F; Bloch, Paul; Byskov, Jens

    2010-11-01

    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. 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. 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. Poor status of the AFR

  8. Determinants of self-perceived risk of HIV infection: population-based observations in Zambia

    OpenAIRE

    Mwangala, Sheila Monde

    2008-01-01

    Background Perception of risk of HIV infection has been suggested to be an important area of study as it can be an assumed to be an indicator of one’s understanding of susceptibility to HIV infection and a precursor to behavioral change, which could determine future decision making regarding risk taking. Studies that have examined perception of HIV risk and its determinants still remain limited. Zambia is among the worst affected countries by the HIV pandemic in the sub-Sahara African r...

  9. Open Pit Water Control Safety A Case Of Nchanga Open Pit Mine Zambia

    OpenAIRE

    Silwamba C; Chileshe P R K

    2015-01-01

    Abstract Mining in Chingola Zambia started underground in 1931 and was catastrophically flooded and closed. The present Nchanga Underground Mine NUG started in 1937. The Nchanga Open Pit NOP mine started in 1955 situated to the west of NUG and partially overlying it. Open pit water control safety operations in the Nchanga-Chingola area have successfully enabled the safe extraction of millions of tonnes of copper ore annually over the past 60 years from NUG mining as well as the NOP. At the st...

  10. 'Then give him to the crocodiles' : violence, State formation, and cultural discontinuity in west central Zambia, 1600-2000

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.

    2003-01-01

    The purpose of this chapter is to explore the extent to which violence can be said to underlie any form of Stae formation in precolonial Africa. This is done by examining the role of violence in State formation in west central Zambia from the 17th century onwards. The chapter shows that State

  11. Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors.

    Science.gov (United States)

    Qiao, Shan; Zhang, Yao; Li, Xiaoming; Menon, J Anitha

    2018-01-01

    It was estimated that 1.2 million people live with HIV/AIDS in Zambia by 2015. Zambia has developed and implemented diverse programs to reduce the prevalence in the country. HIV-testing is a critical step in HIV treatment and prevention, especially among all the key populations. However, there is no systematic review so far to demonstrate the trend of HIV-testing studies in Zambia since 1990s or synthesis the key factors that associated with HIV-testing practices in the country. Therefore, this study conducted a systematic review to search all English literature published prior to November 2016 in six electronic databases and retrieved 32 articles that meet our inclusion criteria. The results indicated that higher education was a common facilitator of HIV testing, while misconception of HIV testing and the fear of negative consequences were the major barriers for using the testing services. Other factors, such as demographic characteristics, marital dynamics, partner relationship, and relationship with the health care services, also greatly affects the participants' decision making. The findings indicated that 1) individualized strategies and comprehensive services are needed for diverse key population; 2) capacity building for healthcare providers is critical for effectively implementing the task-shifting strategy; 3) HIV testing services need to adapt to the social context of Zambia where HIV-related stigma and discrimination is still persistent and overwhelming; and 4) family-based education and intervention should involving improving gender equity.

  12. Prevalence and burden of gastrointestinal helminths in wild and domestic guineafowls (Numida meleagris in the Southern Province of Zambia

    Directory of Open Access Journals (Sweden)

    King Shimumbo Nalubamba

    2015-08-01

    Conclusions: Syngamus trachea, Streptocara pectinifera and Acuaria spiralis are reported for the first time in domestic poultry in Zambia. This study represents the first comparative study of helminths in domestic and wild guineafowls at an interface area and adds to the knowledge base in a discipline where a dearth currently exists.

  13. 7 CFR 319.56-48 - Conditions governing the entry of baby squash and baby courgettes from Zambia.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Conditions governing the entry of baby squash and baby... Fruits and Vegetables § 319.56-48 Conditions governing the entry of baby squash and baby courgettes from Zambia. Baby squash (Curcurbita maxima Duchesne) and baby courgettes (C. pepo. L.) measuring 10 to 25...

  14. Communities of Change, Multi Stakeholder Processes, Lobby & Advocacy : More than 100 years of experience on HBC in Malawi & Zambia!

    NARCIS (Netherlands)

    Vugt, van S.M.; Sloot, H.

    2011-01-01

    This training of four days focussed on two areas of capacity development of the home-based care (HBC) alliance in Malawi and Zambia: 1. Communities of Change (CoC) concept and practice linked to the Multi Stakeholder Process (MSP), and 2. Lobby & Advocacy (L&A). Since June 2010 Cordaid

  15. A longitudinal study of the impact of corporate social responsibility on firm performance in SMEs in Zambia

    NARCIS (Netherlands)

    Choongo, Progress

    2017-01-01

    The aim of this study is to investigate the impact of corporate social responsibility on firm performance using a longitudinal design in small and medium-sized enterprises (SMEs). The reported study was conducted in a Sub-Saharan African developing country, Zambia. Data were collected from 153

  16. School effects on non-verbal intelligence and nutritional status in rural Zambia.

    Science.gov (United States)

    Hein, Sascha; Tan, Mei; Reich, Jodi; Thuma, Philip E; Grigorenko, Elena L

    2016-02-01

    This study uses hierarchical linear modeling (HLM) to examine the school factors (i.e., related to school organization and teacher and student body) associated with non-verbal intelligence (NI) and nutritional status (i.e., body mass index; BMI) of 4204 3 rd to 7 th graders in rural areas of Southern Province, Zambia. Results showed that 23.5% and 7.7% of the NI and BMI variance, respectively, were conditioned by differences between schools. The set of 14 school factors accounted for 58.8% and 75.9% of the between-school differences in NI and BMI, respectively. Grade-specific HLM yielded higher between-school variation of NI (41%) and BMI (14.6%) for students in grade 3 compared to grades 4 to 7. School factors showed a differential pattern of associations with NI and BMI across grades. The distance to a health post and teacher's teaching experience were the strongest predictors of NI (particularly in grades 4, 6 and 7); the presence of a preschool was linked to lower BMI in grades 4 to 6. Implications for improving access and quality of education in rural Zambia are discussed.

  17. Atovaquone and proguanil versus pyrimethamine/sulfadoxine for the treatment of acute falciparum malaria in Zambia.

    Science.gov (United States)

    Mulenga, M; Sukwa, T Y; Canfield, C J; Hutchinson, D B

    1999-05-01

    Atovaquone and proguanil hydrochloride are blood schizonticides that demonstrate in vitro synergy against drug-resistant strains of Plasmodium falciparum. When coadministered, they may therefore be effective for the treatment of malaria in regions where there is known or suspected drug resistance. In an open-label, randomized, parallel-group, clinical trial conducted in Zambia, 163 patients (age range, 14 to 54 years) with acute P falciparum malaria were randomly assigned to receive treatment with atovaquone and proguanil hydrochloride (1000 and 400 mg, respectively, administered orally at 24-hour intervals for 3 doses; n = 82) or pyrimethamine/sulfadoxine (75/1500 mg administered orally as a single dose; n = 81). Efficacy was assessed by cure rate (the percentage of patients in whom parasitemia was eliminated and did not recur during 28 days of follow-up), parasite clearance time (PCT), and fever clearance time (FCT). Safety was determined by sequential clinical and laboratory assessments over 28 days. Cure rates did not differ significantly between patients treated with atovaquone and proguanil (100%) and those treated with pyrimethamine/sulfadoxine (98.8%). Patients in the atovaquone and proguanil group had a significantly shorter FCT than patients in the pyrimethamine/sulfadoxine group (mean, 30.4 vs 44.9 hours; P proguanil was equally effective and as well tolerated as pyrimethamine/sulfadoxine for the treatment of acute, uncomplicated, drug-resistant falciparum malaria in Zambia.

  18. Strengthening and expanding the capacity of health worker education in Zambia.

    Science.gov (United States)

    Michelo, Charles; Zulu, Joseph Mumba; Simuyemba, Moses; Andrews, Benjamin; Katubulushi, Max; Chi, Benjamin; Njelesani, Evariste; Vwalika, Bellington; Bowa, Kasonde; Maimbolwa, Margaret; Chipeta, James; Goma, Fastone; Nzala, Selestine; Banda, Sekelani; Mudenda, John; Ahmed, Yusuf; Hachambwa, Lotti; Wilson, Craig; Vermund, Sten; Mulla, Yakub

    2017-01-01

    Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment. This was achieved by leveraging of existing and new partnerships with other universities and differentiating the old Master in Public Health into specialized curriculum. Furthermore, the MEPI program improved the capacity and quality of training by facilitating installation and integration of new technology such as the eGranary digital library, E-learning methods and clinical skills laboratory into the Schools. This technology enabled easy access to relevant data or information, quicker turn around of experiments and enhanced data recording, display and analysis features for experiments. The program also facilitated transforming of the academic environment into a more conducive work place through strengthening the Staff Development program and support towards research activities. These activities stimulated work motivation and interest in research by faculty. Meanwhile, these processes were inhibited by the inability to upload all courses on to Moodle as well as inadequate operating procedures and feedback mechanisms for the Moodle. Expansion and improvement in training processes for health care workers requires targeted investment within medical institutions and strengthening local and international partnerships.

  19. Factors Influencing the Identification of Sustainable Opportunities by SMEs: Empirical Evidence from Zambia

    Directory of Open Access Journals (Sweden)

    Progress Choongo

    2016-01-01

    Full Text Available This study uses the model of Patzelt and Shepherd (2011 to examine the factors influencing the identification of sustainable opportunities among SMEs in a developing country, Zambia. The factors under investigation include knowledge of the natural/social environment, perception of threats to the natural/social environment, altruism towards others and entrepreneurial knowledge. We interviewed 220 owner-managers in the trading and service sector who supply goods and services to the mining industry in Zambia. We found that altruism towards others was partially supported by our empirical results while the positive effects of knowledge of the natural/social environment and perception of threats to the natural/social environment on the identification of sustainable opportunities were not supported. Contrary to our expectations, entrepreneurial knowledge does not positively moderate the relationship between explanatory variables and the identification of sustainable opportunities. In sum, we found only limited empirical support for the model of Patzelt and Shepherd (2011 concerning the identification of sustainable opportunities. Our findings contribute to literature on entrepreneurship and sustainable opportunity identification by showing what factors influence the identification of sustainable opportunities. This can help us to create awareness among entrepreneurs regarding the effects of entrepreneurial activities on the environment and society; consequently, stimulating entrepreneurs to identify sustainable opportunities.

  20. Marketing of breast-milk substitutes in Zambia: evaluation of compliance to the international regulatory code.

    Science.gov (United States)

    Funduluka, P; Bosomprah, S; Chilengi, R; Mugode, R H; Bwembya, P A; Mudenda, B

    2018-03-01

    We sought to assess the level of non-compliance with the International Code of Marketing breast-milk substitutes (BMS) and/or Statutory Instrument (SI) Number 48 of 2006 of the Laws of Zambia in two suburbs, Kalingalinga and Chelstone, in Zambia. This was a cross sectional survey. Shop owners (80), health workers (8) and mothers (214) were interviewed. BMS labels and advertisements (62) were observed. The primary outcome was mean non-compliance defined as the number of article violations divided by the total 'obtainable' violations. The score ranges from 0 to 1 with 0 representing no violations in all the articles and one representing violations in all the articles. A total of 62 BMS were assessed. The mean non-compliance score by manufacturers in terms of violations in labelling of BMS was 0.33 (SD = 0.28; 95% CI: 0.26, 0.40). These violations were mainly due to labels containing pictures or graphics representing an infant. 80 shops were also assessed with mean non-compliance score in respect of violations in tie-in-sales, special display, and contact with mothers at the shop estimated as 0.14 (SD = 0.14; 95% CI: 0.11, 0.18). Non-compliance with the Code and/or the local SI is high after 10 years of domesticating the Code.

  1. Challenges experienced by mothers caring for children with cerebral palsy in Zambia

    Directory of Open Access Journals (Sweden)

    Carol Singogo

    2015-11-01

    Full Text Available Background: Mothers caring for children with disability experience a number of challenges. Aim: The aim of the study was to explore the challenges that mothers who cared for children with cerebral palsy (CP living in Zambia experienced. Methods: During a qualitative study the experiences of 16 conveniently sampled mothers of children with CP, from the Ndola district in Zambia, were explored by means of interviews. The responses were thematically analysed. All the necessary ethical considerations were upheld. Results: Mothers experienced social isolation and marital problems, as well as negative attitudes from family, friends, community members and health care professionals. The physical environment created access challenges because of a lack of sidewalks, ramps, functioning lifts and small indoor spaces. Conclusion: Mothers of children with CP feel socially isolated owing to a lack of support from family, community members, and health care providers. This social isolation was exacerbated by attitudes of others towards the mothers; it was felt that mothers were responsible for their children’s condition. Mothers also experienced marital problems as a result of having a child with CP.

  2. Safety and security of radiation sources and radioactive materials: A case of Zambia - least developed country

    International Nuclear Information System (INIS)

    Banda, S.C.

    1998-01-01

    In Zambia, which is current (1998) classified as a Least Developed Country has applications of nuclear science and technology that cover the medical, industrial, education and research. However, the application is mainly in medical and industry. Through the responsibility of radiation source is within the mandate of the Radiation Protection Board. The aspects involving security fall on different stake holders some that have no technical knowledge on what radiation is about. The stake holders in this category include customs clearing and forwarding agents, state security/defence agencies and the operators. Such a situation demands a national system that should be instituted to meet the safety and security requirements but takes into account the involvement of the diverse stake holders. In addition such system should avoid unnecessary exposure, ensure safety of radioactive materials and sources, detect illicit trade and maintain integrity of such materials or sources. This paper will provide the status on issue in Zambia and the challenges that exist to ensure further development in application of Nuclear Science and Technology (S and T) in the country takes into account the safety and security requirements that avoid deliberate and accidental loss of radiation sources and radioactive materials. The Government has a responsibility to ensure that effective system is established and operated to protect radiation sources and radioactive materials from theft, sabotage and ensure safety. (author)

  3. Is green economy achievable through championing green growth? A local government experience from Zambia

    Directory of Open Access Journals (Sweden)

    Phiri Rodgers

    2016-03-01

    Full Text Available The need to enhance environmental sustainability, sustainable development and growth that takes into account the well-being of the people and nature because of the increased production and consumption of goods and services is the major driver to the introduction of green economy in Zambia and countries in southern Africa. This article examines the extent to which local government in Zambia has embraced green growth and green economy and critically analyses the concept of green economy and green growth. This study is based on a review of planning and policy documents, a household questionnaire survey and interviews with various institutions, planners and rural development organisations. A number of policies implemented at the local government level were analysed and reflected upon irrespective of whether they contain the components of green growth and green economy and the extent to which they contribute to attaining green economy. The article argues that the need for economic diversification is important as far as green economy is concerned. The article recommends the need to invest in research and development in order to find more carbon-free economic activities. The conclusion is that local government is key to achieving green growth and green economy, because it is involved at all levels, from policy formulation to implementation.

  4. Underutilisation of routinely collected data in the HIV programme in Zambia: a review of quantitatively analysed peer-reviewed articles.

    Science.gov (United States)

    Munthali, Tendai; Musonda, Patrick; Mee, Paul; Gumede, Sehlulekile; Schaap, Ab; Mwinga, Alwyn; Phiri, Caroline; Kapata, Nathan; Michelo, Charles; Todd, Jim

    2017-06-13

    The extent to which routinely collected HIV data from Zambia has been used in peer-reviewed published articles remains unexplored. This paper is an analysis of peer-reviewed articles that utilised routinely collected HIV data from Zambia within six programme areas from 2004 to 2014. Articles on HIV, published in English, listed in the Directory of open access journals, African Journals Online, Google scholar, and PubMed were reviewed. Only articles from peer-reviewed journals, that utilised routinely collected data and included quantitative data analysis methods were included. Multi-country studies involving Zambia and another country, where the specific results for Zambia were not reported, as well as clinical trials and intervention studies that did not take place under routine care conditions were excluded, although community trials which referred patients to the routine clinics were included. Independent extraction was conducted using a predesigned data collection form. Pooled analysis was not possible due to diversity in topics reviewed. A total of 69 articles were extracted for review. Of these, 7 were excluded. From the 62 articles reviewed, 39 focused on HIV treatment and retention in care, 15 addressed prevention of mother-to-child transmission, 4 assessed social behavioural change, and 4 reported on voluntary counselling and testing. In our search, no articles were found on condom programming or voluntary male medical circumcision. The most common outcome measures reported were CD4+ count, clinical failure or mortality. The population analysed was children in 13 articles, women in 16 articles, and both adult men and women in 33 articles. During the 10 year period of review, only 62 articles were published analysing routinely collected HIV data in Zambia. Serious consideration needs to be made to maximise the utility of routinely collected data, and to benefit from the funds and efforts to collect these data. This could be achieved with government support

  5. Increased uptake of intermittent preventive treatment for malaria in pregnant women in Zambia (2006–2012: Potential determinants and highlight of lessons learnt

    Directory of Open Access Journals (Sweden)

    Freddie Masaninga

    2016-07-01

    Conclusions: Zambia has increased IPTp uptake through ANC for all women. The malaria control program has contributed to increasing access to health services and reducing demographic and socioeconomic disparities.

  6. A cost-effectiveness analysis of artemether lumefantrine for treatment of uncomplicated malaria in Zambia

    Directory of Open Access Journals (Sweden)

    Hawela Moonga

    2007-02-01

    Full Text Available Abstract Background Malaria remains a leading cause of morbidity, mortality and non-fatal disability in Zambia, especially among children, pregnant women and the poor. Data gathered by the National Malaria Control Centre has shown that recently observed widespread treatment failure of SP and chloroquine precipitated a surge in malaria-related morbidity and mortality. As a result, the Government has recently replaced chloroquine and SP with combination therapy as first-line treatment for malaria. Despite the acclaimed therapeutic advantages of ACTs over monotherapies with SP and CQ, the cost of ACTs is much greater, raising concerns about affordability in many poor countries such as Zambia. This study evaluates the cost-effectiveness analysis of artemether-lumefantrine, a version of ACTs adopted in Zambia in mid 2004. Methods Using data gathered from patients presenting at public health facilities with suspected malaria, the costs and effects of using ACTs versus SP as first-line treatment for malaria were estimated. The study was conducted in six district sites. Treatment success and reduction in demand for second line treatment constituted the main effectiveness outcomes. The study gathered data on the efficacy of, and compliance to, AL and SP treatment from a random sample of patients. Costs are based on estimated drug, labour, operational and capital inputs. Drug costs were based on dosages and unit prices provided by the Ministry of Health and the manufacturer (Norvatis. Findings The results suggest that AL produces successful treatment at less cost than SP, implying that AL is more cost-effective. While it is acknowledged that implementing national ACT program will require considerable resources, the study demonstrates that the health gains (treatment success from every dollar spent are significantly greater if AL is used rather than SP. The incremental cost-effectiveness ratio is estimated to be US$4.10. When the costs of second line

  7. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis

    Directory of Open Access Journals (Sweden)

    Simbaya Joseph

    2010-09-01

    Full Text Available Abstract Background Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Methods Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural, to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Results Clinical staff (doctors, nurses and nurse-midwives, and clinical officers numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART and prevention of mother to child transmission (PMTCT per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. Conclusions This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of

  8. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis

    LENUS (Irish Health Repository)

    Walsh, Aisling

    2010-09-17

    Abstract Background Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV\\/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Methods Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Results Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses\\/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. Conclusions This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV\\/AIDS service delivery has been on the back of sustained non

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

    Directory of Open Access Journals (Sweden)

    Peter A Lindsey

    Full Text Available 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

  10. Place of Delivery Associated With Postnatal Care Utilization Among Childbearing Women in Zambia

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    Charles Chungu

    2018-04-01

    Full Text Available ObjectivePostnatal care (PNC utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia.MethodsData from the 2013/14 Zambia Demographic and Health Survey for women, aged 15–49 years, who reported giving birth in the 2 years preceding the survey was used. The data comprised of sociodemographic and other obstetric data, which were cleaned, recoded, and analyzed using STATA version 13 (Stata Corporation, College Station, TX, USA. Multivariate logistic regression was used to examine the association of place of delivery and other background variables.ResultsWomen who delivered in a health facility were more likely to utilize PNC in the first 48 h compared to those who did not deliver in a health facility: government hospital (AOR 7.24, 95% CI 4.92–11.84, government health center/clinic (AOR 7.15 95% CI 4.79–10.66, other public sector (AOR 23.2 95% CI 3.69–145.91, private hospital/clinic (AOR 10.08 95% CI 3.35–30.35, and Mission hospital/clinic (AOR 8.56 95% CI 4.71–15.53. Additionally, women who were attended to by a skilled personnel during delivery of the baby were more likely to utilize PNC (AOR 2.30, 95% CI 1.57–3.37. Women from rural areas were less likely to utilize PNC in the first 48 h (AOR 0.70, 95% CI 0.53–0.90.ConclusionPlace of delivery was found to be linked with PNC utilization in this population although access to health care is still driven by inequity-related dynamics and imbalances. Given that inequity stresses are heaviest in the rural and poor groups, interventions should aim to reach this group.SignificanceThe study results will help program managers to increase access to health facility delivery and direct interventional efforts toward the affected subpopulations

  11. Place of Delivery Associated With Postnatal Care Utilization Among Childbearing Women in Zambia.

    Science.gov (United States)

    Chungu, Charles; Makasa, Mpundu; Chola, Mumbi; Jacobs, Choolwe Nkwemu

    2018-01-01

    Postnatal care (PNC) utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia. Data from the 2013/14 Zambia Demographic and Health Survey for women, aged 15-49 years, who reported giving birth in the 2 years preceding the survey was used. The data comprised of sociodemographic and other obstetric data, which were cleaned, recoded, and analyzed using STATA version 13 (Stata Corporation, College Station, TX, USA). Multivariate logistic regression was used to examine the association of place of delivery and other background variables. Women who delivered in a health facility were more likely to utilize PNC in the first 48 h compared to those who did not deliver in a health facility: government hospital (AOR 7.24, 95% CI 4.92-11.84), government health center/clinic (AOR 7.15 95% CI 4.79-10.66), other public sector (AOR 23.2 95% CI 3.69-145.91), private hospital/clinic (AOR 10.08 95% CI 3.35-30.35), and Mission hospital/clinic (AOR 8.56 95% CI 4.71-15.53). Additionally, women who were attended to by a skilled personnel during delivery of the baby were more likely to utilize PNC (AOR 2.30, 95% CI 1.57-3.37). Women from rural areas were less likely to utilize PNC in the first 48 h (AOR 0.70, 95% CI 0.53-0.90). Place of delivery was found to be linked with PNC utilization in this population although access to health care is still driven by inequity-related dynamics and imbalances. Given that inequity stresses are heaviest in the rural and poor groups, interventions should aim to reach this group. The study results will help program managers to increase access to health facility delivery and direct interventional efforts toward the affected subpopulations, such as the young and rural women. Furthermore, results will help

  12. Task sharing in Zambia: HIV service scale-up compounds the human resource crisis.

    Science.gov (United States)

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

    2010-09-17

    Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of sustained non-HIV workload levels, increasing HIV workload and stagnant

  13. Foot-and-mouth disease control in Zambia: A review of the current situation

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    Yona Sinkala

    2012-06-01

    Full Text Available Zambia has been experiencing low livestock productivity as well as trade restrictions owing to the occurrence of foot-and-mouth disease (FMD and contagious bovine pleura pneumonia (CBPP. Foot-and-mouth disease was first recorded in Zambia in 1933 in the Western Province and since then the country has experienced repeated outbreaks. Bearing in mind the pressure that may be existing on the many risk factors for FMD including climate change, there is need to review our knowledge on FMD control. We present the spatial distribution of the FMD outbreaks that have been recorded in Zambia in the last twenty years, and the effect of the vaccinations and movement control that have been applied. We propose further strain characterisation of previous FMD outbreaks, including full sequence of VP1 gene and the 5’UTR site. The data will be geo-coded and populated with risk factor attributes. We also present preliminary findings of the buffalo and cattle probang sampling that was conducted in Lochnivar and Kafue National Park. We further probang sampled 25 buffalo at each interface area in Sioma Ngwezi, Lukusuzi and Lower Zambezi national parks. Villages in close proximity to the buffalo populations as well as those not in close proximity will be multistage cluster sampled for comparison. The data will be geo-coded and populated with risk factor and foot-and-mouth disease virus (FMDV characterisation attributes. Data collected using a pre-tested structured questionnaire will be geo-coded and populated with identified risk factors and stored in a database and will be spatially modelled to determine their effect on FMD occurrence and control measures. New outbreaks of FMD that may occur will be investigated to find out if there are new strains involved, species affected and predisposing risk factors. The authors conclude that impacts of FMD on livelihoods if appropriate control measures are not put in place are far more devastating especially at community level

  14. Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

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    N. Mlenzana

    2012-12-01

    Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction

  15. "My mother told me that I should not": a qualitative study exploring the restrictions placed on adolescent girls living with HIV in Zambia.

    Science.gov (United States)

    Mackworth-Young, Constance Rs; Bond, Virginia; Wringe, Alison; Konayuma, Katongo; Clay, Sue; Chiiya, Chipo; Chonta, Mutale; Sievwright, Kirsty; Stangl, Anne L

    2017-12-01

    Adolescent girls in sub-Saharan Africa are disproportionately affected by HIV due to a range of social and structural factors. As they transition to adulthood, they are recipients of increasing blame for HIV infection and 'improper' sex, as well as increasing scrutiny, restrictions and surveillance. This study used a qualitative and participatory approach to explore the messaging and restrictions imposed on adolescent girls living with HIV in Zambia. Thirty-four in-depth interviews and four participatory workshops were carried out with 24 adolescent girls aged 15 to 19 years old living with HIV in Lusaka, Zambia. Key themes explored included experiences living with HIV, finding out about HIV status, disclosure, experiences with antiretroviral treatment, and support needs. Data were organized, coded and analysed using a grounded theory approach to thematic analysis. This analysis uses data on participants' experiences of living with HIV and their interactions with their parents, guardians and healthcare providers. Family and healthcare providers, partly in a quest to protect both the health of adolescent girls living with HIV and also to protect them from blaming discourse, imposed restrictions on their behaviour around three main topics: don't disclose your HIV status, don't have sex, and don't miss your medicines. These restrictions were often delivered using tactics of fear, and usually disconnected from other options. Participants responded to these messages in several ways, including internalizing the messages, changing their behaviour either to comply with or resist the restrictions, by remaining silent and anxious when restrictions were broken, and developing concerns around their own health and sexual and reproductive aspirations. Participants also sometimes experiencing stigma when restrictions could not be maintained. Restrictive messages were delivered to adolescent girls living with HIV through the broader social discourses of stigma, religion, and

  16. Enhancing knowledge retention in higher education: A case of the University of Zambia

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    Sitali Wamundila

    2011-08-01

    Full Text Available The purpose of this study was to investigate how knowledge retention may be enhanced at the University of Zambia (UNZA. A quantitative case study design employing a triangulation of data collection methods was used. Data were collected using interviews and questionnaires. Purposive sampling was used to determine participants for the interviews whilst stratified random sampling was employed to select the respondents for the questionnaire. The quantitative and qualitative data that was analysed using SPSS® indicates that UNZA lacked certain knowledge retention practices that might enable it to retain operational relevant knowledge. In view of the findings, the study recommends the adoption of a knowledge retention framework that could be embedded in UNZA’s knowledge management policy.

  17. The Agency's Technical Co-operation programme with Zambia, 1982-1992. Country programme summaries

    International Nuclear Information System (INIS)

    1992-01-01

    The country programme summary reported here is one in the series of such studies being undertaken of the Agency's TC programme with Member States. With $5.5 million of Agency support received, Zambia ranks 33rd among all recipients of technical assistance in the period 1958 through 1991. More than half of the assistance during the past ten years has been provided in the form of equipment (61%), followed by expert services (25%) and training (14%). Almost all of the resources made available came from the Technical Assistance and Co-operation Fund (93%), with only very small shares provided through extrabudgetary contributions (4%) and assistance in kind (3%). With regard to project disbursements during the past ten years, by sector, the largest areas have been agriculture (33%) and general atomic energy development (23%), followed by industry and hydrology (19%), nuclear raw materials (13%) and nuclear safety (6%)

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

    Science.gov (United States)

    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.

  19. Intestinal helminths and protozoa in children in pre-schools in Kafue district, Zambia

    DEFF Research Database (Denmark)

    Siwila, J.; Phiri, I. G. K.; Enemark, Heidi L.

    2010-01-01

    Intestinal parasitic infections are among the most widespread of human infections in developing countries, and children are the most vulnerable. The aim of this study was to determine the prevalence of the protozoa Cryptosporidium and Giardia, as well as prevalence and intensity of intestinal...... helminths in children attending pre-school or day-care centres in Kafue District, Zambia. Single stool samples were collected from 403 children from 10 pre-schools and Were subjected to duplicate Kato-Katz thick smears to identify and quantify helminths. A commercial immunofluorescence kit was used...... to identify Cryptosporidium- and Giardia-positive samples. The overall prevalence of helminth infection was 17.9%. Ascaris lumbricoides was found in 12.0%, hookworm in 8.3%, Taenia spp. in 0.9%, Hymenolepis nano in 0.6% and Schistosoma mansoni in 0.3%. The overall prevalence of Cryptosporidium and Giardia...

  20. Field and office instructions in stream gauging for the Hydrological Survey of Zambia

    Science.gov (United States)

    Bidwell, L.E.

    1971-01-01

    The importance of water to the basic needs of man is self- evident and needs no particular emphasis. The importance of water to a developing economy cannot be overemphasized. A few decades ago, hydrology was a division of hydraulic engineering and was a tool for project survey, plan, and design. Today hydrology still remains an important part of planning and management of water use projects, but it is imperative that surface and ground-water basic data networks be designed and operated from the standpoint of both present and future water needs. Water problems are ever increasing and ever changing and preparation for the future water demands of Zambia requires knowledge of the hydrology of the country instead of the examination of piecemeal samples for each water use project. The hydrologic survey of Zambia needs to be under the guidance of competent and imaginative hydrologists solidly trained in all elements of basic data collection and analysis and not in the hands of water project planners. Hydrology is a science which requires the highest order of teamwork and the hydrologist will need the help and advice of many employees within the organization to operate the network, provide adequate research, and examine the water needs of the country. It must be thoroughly understood that communication is essential between the hydrological survey and water project planners from both the government and private sectors. It is very important to define the aims and duties of the Hydrological Branch of the Water Affairs Department in a clear cut "Statement of Policy". Personal copies of the statement should be made available to all professional employees and technicians. The reasons for the existence of the Branch may be self-apparent to heads of the organization, but to all other employees the reasons may be vague and unknown. Every member of the technical and administrative staff would benefit by an understanding of the purpose of his work. Nebulous ideas of the function of a

  1. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

    2014-01-01

    of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban-rural residence. RESULTS: There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth......BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... areas of three districts in Kenya, Tanzania and Zambia. METHODS: A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place...

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

    Science.gov (United States)

    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 Basic Schools (NEBS) project, this article examines whether and to what extent school-based health and nutrition education can contribute directly to improving the health and nutrition behaviors of school children. Initial results suggest that gains in awareness, knowledge and behavior can be achieved among children and their families with an actively implemented classroom program backed by teacher training and parent involvement, even in the absence of school-based nutrition and health services.

  3. Data for developing allometric models and evaluating carbon stocks of the Zambezi Teak Forests in Zambia.

    Science.gov (United States)

    Ngoma, Justine; Moors, Eddy; Kruijt, Bart; Speer, James H; Vinya, Royd; Chidumayo, Emmanuel N; Leemans, Rik

    2018-04-01

    This paper presents data on carbon stocks of tropical tree species along a rainfall gradient. The data was generated from the Sesheke, Namwala, and Kabompo sites in Zambia. Though above-ground data was generated for all these three sites, we uprooted trees to determine below-ground biomass from the Sesheke site only. The vegetation was assessed in all three sites. The data includes tree diameter at breast height (DBH), total tree height, wood density, wood dry weight and root dry weight for large (≥ 5 cm DBH) and small (importance-value indices of various species for large and small trees are also determined. Below and above-ground carbon stocks of the surveyed tree species are presented per site. This data were used by Ngoma et al. (2018) [1] to develop above and below-ground biomass models and the reader is referred to this study for additional information, interpretation, and reflection on applying this data.

  4. Sediment Metal Contamination in the Kafue River of Zambia and Ecological Risk Assessment.

    Science.gov (United States)

    M'kandawire, Ethel; Choongo, Kennedy; Yabe, John; Mwase, Maxwell; Saasa, Ngonda; Nakayama, Shouta M M; Bortey-Sam, Nesta; Blindauer, Claudia A

    2017-07-01

    Zambia's Kafue River receives wastes from various sources, resulting in metal pollution. This study determined the degree of contamination of 13 metals (Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Cd, Hg and Pb) in Kafue River sediment and the associated ecological risks at six sites in three different seasons. The level of contamination for most metals showed significant site and seasonal differences. The contamination factor and pollution load index indicated that concentrations of most metals particularly copper (Cu), cobalt (Co), manganese (Mn) and arsenic (As) were very high at sites within the Copperbelt mining area. The geoaccumulation index showed an absence of anthropogenic enrichment with Cd and Hg at all the study sites and extreme anthropogenic enrichment with Cu at sites in the Copperbelt mining area. Potential ecological risk showed that Cu and As were likely to cause adverse biological effects to aquatic organisms in the Copperbelt mining region of the Kafue River.

  5. Investigating groundwater salinity in the Machile-Zambezi Basin (Zambia) with hydrogeophysical methods

    DEFF Research Database (Denmark)

    Chongo, Mkhuzo; A. Nyambe, Imasiku; Larsen, Flemming

    resources worldwide. This thesis presents the application of geo-electrical and electromagnetic methods for the investigation of groundwater salinity in the Machile-Zambezi Basin in south western Zambia, southern central Africa. Aerial and ground based transient electromagnetic measurenments were used...... use of direct current and transient electromagnetic data in one optimization. The result from the regional mapping with transient electromagnetic measurenments showed a spatial distribution of electrical resistivity that indicated block faulting in the Machile-Zambezi Basin. Saline groundwater...... parameters. This was for a coupled flow and solute transport model setup for the Kasaya transect under the forcing of evapotranspiration. Performance of the coupled hydrogeophysical inversion was better with the inclusion of direct current data in comparison to the use of transient electromagnetic data alone...

  6. Risk assessment for yellow fever in western and North-Western provinces of Zambia

    Directory of Open Access Journals (Sweden)

    Olusegun A Babaniyi

    2015-01-01

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

  7. Poverty and perceived stress: Evidence from two unconditional cash transfer programs in Zambia.

    Science.gov (United States)

    Hjelm, Lisa; Handa, Sudhanshu; de Hoop, Jacobus; Palermo, Tia

    2017-03-01

    Poverty is a chronic stressor that can lead to poor physical and mental health. This study examines whether two similar government poverty alleviation programs reduced the levels of perceived stress and poverty among poor households in Zambia. Secondary data from two cluster randomized controlled trials were used to evaluate the impacts of two unconditional cash transfer programs in Zambia. Participants were interviewed at baseline and followed over 36 months. Perceived stress among female caregivers was assessed using the Cohen Perceived Stress Scale (PSS). Poverty indicators assessed included per capita expenditure, household food security, and (nonproductive) asset ownership. Fixed effects and ordinary least squares regressions were run, controlling for age, education, marital status, household demographics, location, and poverty status at baseline. Cash transfers did not reduce perceived stress but improved economic security (per capita consumption expenditure, food insecurity, and asset ownership). Among these poverty indicators, only food insecurity was associated with perceived stress. Age and education showed no consistent association with stress, whereas death of a household member was associated with higher stress levels. In this setting, perceived stress was not reduced by a positive income shock but was correlated with food insecurity and household deaths, suggesting that food security is an important stressor in this context. Although the program did reduce food insecurity, the size of the reduction was not enough to generate a statistically significant change in stress levels. The measure used in this study appears not to be correlated with characteristics to which it has been linked in other settings, and thus, further research is needed to examine whether this widely used perceived stress measure appropriately captures the concept of perceived stress in this population. Copyright © 2017 UNICEF. Published by Elsevier Ltd.. All rights reserved.

  8. Fuel biomass and combustion factors associated with fires in savanna ecosystems of South Africa and Zambia

    Science.gov (United States)

    Shea, Ronald W.; Shea, Barbara W.; Kauffman, J. Boone; Ward, Darold E.; Haskins, Craig I.; Scholes, Mary C.

    1996-10-01

    Fires are dominant factors in shaping the structure and composition of vegetation in African savanna ecosystems. Emissions such as CO2, NOx, CH4, and other compounds originating from these fires are suspected to contribute substantially to changes in global biogeochemical processes. Limited quantitative data exist detailing characteristics of biomass, burning conditions, and the postfire environment in African savannas. Fourteen test sites, differentiated by distinct burn frequency histories and land-use patterns, were established and burned during August and September 1992 in savanna parklands of South Africa and savanna woodlands of Zambia. Vegetation physiognomy, available fuel loads, the levels of biomass consumed by fire, environmental conditions, and fire behavior are described. In the South African sites, total aboveground fuel loads ranged from 2218 to 5492 kg ha-1 where fire return intervals were 1-4 years and exceeded 7000 kg ha-1 at a site subjected to 38 years of fire exclusion. However, fireline intensity was only 1419 kW m-1 at the fire exclusion site, while ranging from 480 to 6130 kW m-1 among the frequent fire sites. In Zambia, total aboveground fuel loads ranged from 3164 kg ha-1 in a hydromorphic grassland to 7343 kg ha-1 in a fallow shifting cultivation site. Dormant grass and litter constituted 70-98% of the total fuel load among all sites. Although downed woody debris was a relatively minor fuel component at most sites, it constituted 43-57% of the total fuel load in the fire exclusion and shifting cultivation sites. Fire line intensity ranged between 1734 and 4061 kW m-1 among all Zambian sites. Mean grass consumption generally exceeded 95%, while downed woody debris consumption ranged from 3 to 73% at all sites. In tropical savannas and savanna woodlands of southern Africa, differences in environmental conditions, land- use patterns, and fire regimes influence vegetation characteristics and thus influence fire behavior and biomass

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

    Directory of Open Access Journals (Sweden)

    Kapanda Paul

    2009-05-01

    Full Text Available Abstract Background The human resource shortage in Zambia is placing a heavy burden on the few health care workers available at health facilities. The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. Methods Quantitative and qualitative data were collected by means of semistructured interviews from all active lay counsellors in each of the facilities and a facility manager or counselling supervisor overseeing counseling and testing services and clients. At each of the 10 selected facilities, all counselling and testing record books for the month of May 2007 were examined and any recordkeeping errors were tallied by cadre. Qualitative data were collected through focus group discussions with health care workers at each facility. Results Lay counsellors provide counselling and testing services of quality and relieve the workload of overstretched health care workers. Facility managers recognize and appreciate the services provided by lay counsellors. Lay counsellors provide up to 70% of counselling and testing services at health facilities. The data review revealed lower error rates for lay counsellors, compared to health care workers, in completing the counselling and testing registers. Conclusion Community volunteers, with approved training and ongoing supervision, can play a major role at health facilities to provide counselling and testing services of quality, and relieve the burden on already overstretched health care workers.

  10. A retrospective study and predictive modelling of Newcastle Disease trends among rural poultry of eastern Zambia.

    Science.gov (United States)

    Mubamba, C; Ramsay, G; Abolnik, C; Dautu, G; Gummow, B

    2016-10-01

    Newcastle Disease (ND) is a highly infectious disease of poultry that seriously impacts on food security and livelihoods of livestock farmers and communities in tropical regions of the world. ND is a constant problem in the eastern province of Zambia which has more than 740 000 rural poultry. Very few studies give a situational analysis of the disease that can be used for disease control planning in the region. With this background in mind, a retrospective epidemiological study was conducted using Newcastle Disease data submitted to the eastern province headquarters for the period from 1989 to 2014. The study found that Newcastle Disease cases in eastern Zambia followed a seasonal and cyclic pattern with peaks in the hot dry season (Overall Seasonal Index 1.1) as well as cycles every three years with an estimated provincial incidence range of 0.16 to 1.7% per year. Annual trends were compared with major intervention policies implemented by the Zambian government, which often received donor support from the international community during the study period. Aid delivered through government programmes appeared to have no major impact on ND trends between 1989 and 2014 and reasons for this are discussed. There were apparent spatial shifts in districts with outbreaks over time which could be as a result of veterinary interventions chasing outbreaks rather than implementing uniform control. Data was also fitted to a predictive time series model for ND which could be used to plan for future ND control. Time series modelling showed an increasing trend in ND annual incidence over 25 years if existing interventions continue. A different approach to controlling the disease is needed if this trend is to be halted. Conversely, the positive trend may be a function of improved reporting by farmers as a result of more awareness of the disease. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Assessing the Impact of Leveraging Traditional Leadership on Access to Sanitation in Rural Zambia.

    Science.gov (United States)

    Tiwari, Amy; Russpatrick, Scott; Hoehne, Alexandra; Matimelo, Selma M; Mazimba, Sharon; Nkhata, Ilenga; Osbert, Nicolas; Soloka, Geoffrey; Winters, Anna; Winters, Benjamin; Larsen, David A

    2017-11-01

    Open defecation is practiced by more than one billion people throughout the world and leads to significant public health issues including infectious disease transmission and stunted growth in children. Zambia implemented community-led total sanitation (CLTS) as an intervention to eliminate open defecation in rural areas. To support CLTS and the attainment of open defecation free communities, chiefs were considered key agents of change and were empowered to drive CLTS and improve sanitation for their chiefdom. Chiefs were provided with data on access to sanitation in the chiefdom during chiefdom orientations prior to the initiation of CLTS within each community and encouraged to make goals of universal sanitation access within the community. Using a survival regression, we found that where chiefs were orientated and mobilized in CLTS, the probability that a village would achieve 100% coverage of adequate sanitation increased by 23% (hazard ratio = 1.263, 95% confidence interval = 1.080-1.478, P = 0.003). Using an interrupted time series, we found a 30% increase in the number of individuals with access to adequate sanitation following chiefdom orientations (95% confidence interval = 28.8-32.0%). The mobilization and support of chiefs greatly improved the uptake of CLTS, and empowering them with increased CLTS knowledge and authority of the program in their chiefdom allowed chiefs to closely monitor village sanitation progress and follow-up with their headmen/headwomen. These key agents of change are important facilitators of public health goals such as the elimination of open defecation in Zambia by 2020.

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

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    Kigozi Fred

    2010-08-01

    Full Text Available Abstract Background Mental illnesses are increasingly recognised as a leading cause of disability worldwide, yet many countries lack a mental health policy or have an outdated, inappropriate policy. This paper explores the development of appropriate mental health policies and their effective implementation. It reports comparative findings on the processes for developing and implementing mental health policies in Ghana, South Africa, Uganda and Zambia as part of the Mental Health and Poverty Project. Methods The study countries and respondents were purposively selected to represent different levels of mental health policy and system development to allow comparative analysis of the factors underlying the different forms of mental health policy development and implementation. Data were collected using semi-structured interviews and document analysis. Data analysis was guided by conceptual framework that was developed for this purpose. A framework approach to analysis was used, incorporating themes that emerged from the data and from the conceptual framework. Results Mental health policies in Ghana, South Africa, Uganda and Zambia are weak, in draft form or non-existent. Mental health remained low on the policy agenda due to stigma and a lack of information, as well as low prioritisation by donors, low political priority and grassroots demand. Progress with mental health policy development varied and respondents noted a lack of consultation and insufficient evidence to inform policy development. Furthermore, policies were poorly implemented, due to factors including insufficient dissemination and operationalisation of policies and a lack of resources. Conclusions Mental health policy processes in all four countries were inadequate, leading to either weak or non-existent policies, with an impact on mental health services. Recommendations are provided to strengthen mental health policy processes in these and other African countries.

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

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    Ferrinho Paulo

    2012-09-01

    Full Text Available Abstract 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.

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

    Science.gov (United States)

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

    2014-10-01

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

  15. Practices of traditional beef farmers in their production and marketing of cattle in Zambia.

    Science.gov (United States)

    Mumba, Chisoni; Häsler, Barbara; Muma, John B; Munyeme, Musso; Sitali, Doreen Chilolo; Skjerve, Eystein; Rich, Karl M

    2018-01-01

    Understanding the practices of traditional cattle farmers in developing countries is an important factor in the development of appropriate, pro-poor disease control policies, and in formulating regional-specific production incentives that can improve productivity. This paper describes the production, husbandry practices, economics, and constraints of traditional cattle farming in Zambia. A cross-sectional study design was used to obtain data from traditional cattle farmers (n = 699) using a structured questionnaire. Data analyses were carried out using SPSS and STATA statistical packages. The results revealed that the majority [65% (95% CI: 59.3-71.1)] of farmers practised a transhumant cattle herding system under communal grazing. In these transhumant herding systems, animal husbandry and management systems were found to be of poor quality, in terms of supplementary feeding, vaccination coverage, deworming, uptake of veterinary services, usage of artificial insemination, and dip tanks all being low or absent. East Coast Fever was the most common disease, affecting 60% (95% CI: 56.4-63.7) of farmers. Cattle sales were low, as farmers only sold a median of two cattle per household per year. Crop farming was found to be the main source of farm income (47%) in agro-pastoralist communities, followed by cattle farming (28%) and other sources (25%). The median cost of production in the surveyed provinces was reported at US$316, while that of revenue from cattle and cattle products sales was estimated at US$885 per herd per year. This translates to an estimated gross margin of US$569, representing 64.3% of revenue.There is considerable diversity in disease distribution, animal husbandry practices, economics, and challenges in traditional cattle production in different locations of Zambia. Therefore, to improve the productivity of the traditional cattle sub-sector, policy makers and stakeholders in the beef value chain must develop fit-for-purpose policies and

  16. Seasonality, Blood Feeding Behavior, and Transmission of Plasmodium Falciparum by Anopheles Arabiensis after an Extended Drought In Southern Zambia

    Science.gov (United States)

    Thuma, Philip E.; Mharakurwa, Sungano; Norris, Douglas E.

    2014-01-01

    Transmission of Plasmodium falciparum is hyperendemic in southern Zambia. However, no data on the entomologic aspects of malaria transmission have been published from Zambia in more than 25 years. We evaluated seasonal malaria transmission by Anopheles arabiensis and An. funestus s.s. and characterized the blood feeding behavior of An. arabiensis in two village areas. Transmission during the 2004–2005 rainy season was nearly zero because of widespread drought. During 2005–2006, the estimated entomologic inoculation rate values were 1.6 and 18.3 infective bites per person per transmission season in each of the two village areas, respectively. Finally, with a human blood index of 0.923, An. arabiensis was substantially more anthropophilic in our study area than comparable samples of indoor-resting An. arabiensis throughout Africa and was the primary vector responsible for transmission of P. falciparum. PMID:17297034

  17. Prevalence of undiagnosed hypoxemia in adults and children in an under-resourced district hospital in Zambia

    OpenAIRE

    Foran, Mark; Ahn, Roy; Novik, Joseph; Tyer-Viola, Lynda; Chilufya, Kennedy; Katamba, Kasseba; Burke, Thomas

    2010-01-01

    Background: In adequately resourced clinical environments, diagnosis of hypoxemia via pulse oximetry is routine. Unfortunately, pulse oximetry is rarely utilized in under-resourced hospitals in developing countries. Aim: The prevalence of undiagnosed hypoxemia among adults and children with illnesses other than pneumonia in these environments remains poorly described. Methods: This cross-sectional analysis of the prevalence of hypoxemia was conducted in Kapiri Mposhi, Zambia, at the 60-bed Di...

  18. Diabetes mellitus in Zambia and the Western Cape province of South Africa: Prevalence, risk factors, diagnosis and management.

    Science.gov (United States)

    Bailey, Sarah Lou; Ayles, Helen; Beyers, Nulda; Godfrey-Faussett, Peter; Muyoyeta, Monde; du Toit, Elizabeth; Yudkin, John S; Floyd, Sian

    2016-08-01

    To determine the prevalence of and risk factors for diabetes mellitus and examine its diagnosis and management in the study communities. This is a population-based cross-sectional study among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Diabetes is defined as a random blood glucose concentration (RBG)⩾11.1mmol/L, or RBGdiabetes diagnosis. For individuals with a prior diagnosis of diabetes, RBGprevalence of diabetes was 3.5% and 7.2% respectively. The highest risk groups identified were those of older age and those with obesity. Of those identified to have diabetes, 34.5% in Zambia and 12.7% in WC were previously unaware of their diagnosis. Among Zambian participants with diabetes, this proportion was lower among individuals with better education or with higher household socio-economic position. Of all those with previously diagnosed diabetes, 66.0% in Zambia and 59.4% in WC were not on any diabetes treatment, and 34.4% in Zambia and 32.7% in WC had a RBG concentration beyond the recommended level, ⩾7.8mmol/L. The diabetes risk factor profile for our study communities is similar to that seen in high-income populations. A high proportion of individuals with diabetes are not on diabetes treatment and of those on treatment a high proportion have high glycaemic concentrations. Such data may assist in healthcare planning to ensure timely diagnosis and management of diabetes. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

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

    OpenAIRE

    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 ...

  20. RESPONSIVENESS OF SPATIAL PRICE VOLATILITY TO INCREASED GOVERNMENT PARTICIPATION IN MAIZE GRAIN AND MAIZE MEAL MARKETING IN ZAMBIA

    OpenAIRE

    Syampaku, E.M; Mafimisebi, Taiwo Ejiola

    2014-01-01

    The study analyzed the responsiveness of maize grain and maize meal spatial price volatilities to increased government participation in maize grain marketing in Zambia using descriptive statistics and vector auto-regression (VAR). This was achieved by comparing spatial price volatility means and spatial price means for the period under increased government participation with respective means for periods under limited government participation. Also, spatial price volatilities were regressed ag...

  1. Taenia solium from a community perspective: Preliminary costing data in the Katete and Sinda districts in Eastern Zambia.

    Science.gov (United States)

    Hobbs, Emma C; Mwape, Kabemba E; Devleesschauwer, Brecht; Gabriël, Sarah; Chembensofu, Mwelwa; Mambwe, Moses; Phiri, Isaac K; Masuku, Maxwell; Zulu, Gideon; Colston, Angela; Willingham, Arve Lee; Berkvens, Dirk; Dorny, Pierre; Bottieau, Emmanuel; Speybroeck, Niko

    2018-02-15

    The tapeworm Taenia solium is endemic in Zambia, however its socioeconomic cost is unknown. During a large-scale interventional study conducted in Zambia, baseline economic costs of human and porcine T. solium infections were measured. Questionnaire surveys were conducted within three neighbourhoods in Zambia's Eastern province in 2015 and 2016. A human health questionnaire, capturing costs of clinical symptoms commonly attributable to human cysticercosis and taeniasis, was conducted in randomly selected households (n = 267). All pig-keeping households were administered a pig socioeconomic questionnaire (n = 271) that captured pig demographic data, costs of pig-keeping, and economic losses from porcine cysticercosis. Of all respondents 62% had reportedly experienced at least one of the surveyed symptoms. Seizure-like episodes were reported by 12%, severe chronic headaches by 36%, and vision problems by 23% of respondents. These complaints resulted in 147 health care consultations and 17 hospitalizations in the five years preceding the study, and an estimated productivity loss of 608 working days per year. Of all pigs 69% were bought within villages. Nearly all adult pigs were sold to local traders, and tongue palpation for detection of cysticerci was commonly performed. Reportedly, 95% of pig owners could not sell tongue-positive pigs, while infected pigs fetched only 45% of the normal sale value. These preliminary costing data indicate that human and porcine T. solium infections substantially impact endemic areas of Eastern Zambia. A full socioeconomic burden assessment may enable improved T. solium management in sub-Saharan Africa. Copyright © 2018 Ross University School of Veterinary Medicine. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    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. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  3. Estimated mortality on HIV treatment among active patients and patients lost to follow-up in 4 provinces of Zambia: Findings from a multistage sampling-based survey.

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    Charles B Holmes

    2018-01-01

    Full Text Available Survival represents the single most important indicator of successful HIV treatment. Routine monitoring fails to capture most deaths. As a result, both regional assessments of the impact of HIV services and identification of hotspots for improvement efforts are limited. We sought to assess true mortality on treatment, characterize the extent under-reporting of mortality in routine health information systems in Zambia, and identify drivers of mortality across sites and over time using a multistage, regionally representative sampling approach.We enumerated all HIV infected adults on antiretroviral therapy (ART who visited any one of 64 facilities across 4 provinces in Zambia during the 24-month period from 1 August 2013 to 31 July 2015. We identified a probability sample of patients who were lost to follow-up through selecting facilities probability proportional to size and then a simple random sample of lost patients. Outcomes among patients lost to follow-up were incorporated into survival analysis and multivariate regression through probability weights. Of 165,464 individuals (64% female, median age 39 years (IQR 33-46, median CD4 201 cells/mm3 (IQR 111-312, the 2-year cumulative incidence of mortality increased from 1.9% (95% CI 1.7%-2.0% to a corrected rate of 7.0% (95% CI 5.7%-8.4% (all ART users and from 2.1% (95% CI 1.8%-2.4% to 8.3% (95% CI 6.1%-10.7% (new ART users. Revised provincial mortality rates ranged from 3-9 times higher than naïve rates for new ART users and were lowest in Lusaka Province (4.6 per 100 person-years and highest in Western Province (8.7 per 100 person-years after correction. Corrected mortality rates varied markedly by clinic, with an IQR of 3.5 to 7.5 deaths per 100 person-years and a high of 13.4 deaths per 100 person-years among new ART users, even after adjustment for clinical (e.g., pretherapy CD4 and contextual (e.g., province and clinic size factors. Mortality rates (all ART users were highest year 1 after

  4. To assess control measures for tobacco consumption in Zambia between 2014 and 2017. What are the gaps?

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    Davies Kalunga

    2018-03-01

    Full Text Available Background Cigarette smoking is a leading cause of global morbidity and mortality, in developing countries interest in smoking prevalence has been growing since 1999. Many factors are known to influence smoking prevalence and trends in prevalence, from individual level factors such as education level, to country-level factors such as national economic development and implementation of tobacco control policies, therefore there is need to assess the control measures for tobacco smoking in Zambia between 2014 and 2017and determine the gaps in policy implementation in tobacco consumption in Zambia. Methods This was a retrospective study using policy documents from central statistical office. Results The following gaps were identified in which there was no legislation: concerning Institutions and mechanisms to provide for a funding mechanism, Public education requiring mass public education campaigns to change public attitudes regarding tobacco and tobacco control, Advertising, promotion and sponsorship as a comprehensive ban involves a ban on all forms of direct and indirect advertisements, promotion and sponsorship, Price and tax measures as an effective means of reducing tobacco consumption, especially among young people. Monitoring- No known data or no recent data or data that are not both recent and representative (WHO report on the global tobacco epidemic, 2017. Conclusions The absence of legislation in these areas of institutions and mechanisms, public education, advertising, promotion and sponsorship and the price and tax measures have far reaching consequences in tobacco control in Zambia.

  5. Expanding contraceptive choice in the developing world: lessons from the Lao People's Democratic Republic and the Republic of Zambia.

    Science.gov (United States)

    d'Arcangues, Catherine M; Ba-Thike, Katherine; Say, Lale

    2013-12-01

    Women need different forms of contraception over their lifetime. In the developed world, they have access to some 20 different methods. In developing countries, only a few options are available. This paper focuses on four under-used methods: intrauterine devices, implants, emergency contraception and female condoms. It examines reasons for their low uptake, strategies used for their adoption, and challenges in sustaining these efforts, in two countries: Laos and Zambia. In-country documentation and reports from international partners were reviewed; questionnaires were sent and interviews carried out with ministry officials, senior providers, and local representatives of international organisations and international non-governmental organisations. In Laos, the family planning programme is relatively young; its challenges include ensuring the sustainability of services and supplies, improving the quality of IEC to dispel misconceptions surrounding contraception, and developing novel distribution systems to reach rural populations. Zambia has a much older programme, which lost ground in the face of competing health priorities. Its challenges include strengthening the supply chain management, coordinating the multiple groups of providers and ensuring the sustainability of services in rural areas. The contrast offered by Laos and Zambia illustrates the importance of regular evaluation to identify priority areas for improving contraceptive delivery.

  6. Foot and mouth disease in Zambia: Spatial and temporal distributions of outbreaks, assessment of clusters and implications for control

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    Yona Sinkala

    2014-04-01

    Full Text Available Zambia has been experiencing low livestock productivity as well as trade restrictions owing to the occurrence of foot and mouth disease (FMD, but little is known about the epidemiology of the disease in these endemic settings. The fundamental questions relate to the spatio-temporal distribution of FMD cases and what determines their occurrence. A retrospective review of FMD cases in Zambia from 1981 to 2012 was conducted using geographical information systems and the SaTScan software package. Information was collected from peer-reviewed journal articles, conference proceedings, laboratory reports, unpublished scientific reports and grey literature. A space–time permutation probability model using a varying time window of one year was used to scan for areas with high infection rates. The spatial scan statistic detected a significant purely spatial cluster around the Mbala–Isoka area between 2009 and 2012, with secondary clusters in Sesheke–Kazungula in 2007 and 2008, the Kafue flats in 2004 and 2005 and Livingstone in 2012. This study provides evidence of the existence of statistically significant FMD clusters and an increase in occurrence in Zambia between 2004 and 2012. The identified clusters agree with areas known to be at high risk of FMD. The FMD virus transmission dynamics and the heterogeneous variability in risk within these locations may need further investigation.

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

    Science.gov (United States)

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

    2016-01-01

    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

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

    Science.gov (United States)

    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.

  9. Experiences with and expectations of maternity waiting homes in Luapula Province, Zambia: a mixed-methods, cross-sectional study with women, community groups and stakeholders.

    Science.gov (United States)

    Chibuye, Peggy S; Bazant, Eva S; Wallon, Michelle; Rao, Namratha; Fruhauf, Timothee

    2018-01-25

    Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. To examine the experiences with maternity homes, formative research was undertaken in four districts of Luapula Province to assess women's and community's needs, use patterns, collaboration between maternity homes, facilities and communities, and promising practices and models in Central and Lusaka Provinces. A cross-sectional, mixed-methods design was used. In Luapula Province, qualitative data were collected through 21 focus group discussions with 210 pregnant women, mothers, elderly women, and Safe Motherhood Action Groups (SMAGs) and 79 interviews with health workers, traditional leaders, couples and partner agency staff. Health facility assessment tools, service abstraction forms and registers from 17 facilities supplied quantitative data. Additional qualitative data were collected from 26 SMAGs and 10 health workers in Central and Lusaka Provinces to contextualise findings. Qualitative transcripts were analysed thematically using Atlas-ti. Quantitative data were analysed descriptively using Stata. Women who used maternity homes recognized the advantages of facility-based births. However, women and community groups requested better infrastructure, services, food, security, privacy, and transportation. SMAGs led the construction of maternity homes and advocated the benefits to women and communities in collaboration with health workers, but management responsibilities of the homes remained unassigned to SMAGs or staff. Community norms often influenced women's decisions to use maternity homes. Successful maternity homes in Central Province also relied on SMAGs for financial support, but the sustainability of these

  10. Transitioning couple's voluntary HIV counseling and testing (CVCT from stand-alone weekend services into routine antenatal and VCT services in government clinics in Zambia's two largest cities.

    Directory of Open Access Journals (Sweden)

    Mubiana Inambao

    Full Text Available Most HIV infections in Africa are acquired by married/cohabiting adults and WHO recommends couple's voluntary HIV counseling and testing (CVCT for prevention. The handover from NGO-sponsored weekend CVCT to government-sponsored services in routine weekday antenatal care (ANC and individual voluntary testing and counseling (VCT services in Zambia's two largest cities from 2009-2015 is described.Government clinic counselors were trained to provide CVCT, and along with community health workers they promoted CVCT services in their clinic and surrounding areas. When client volume exceeded the capacity of on-duty staff in ANC and VCT, non-governmental organization (NGO subsidies were offered for overtime pay.Implementation of routine CVCT services varied greatly by clinic and city. The 12 highest volume clinics were examined further, while 13 clinics had CVCT numbers that were too low to warrant further investigation. In Lusaka, the proportion of pregnant women whose partners were tested rose from 2.6% in 2009 to a peak of 26.2% in 2012 and 24.8% in 2015. Corresponding reports in Ndola were 2.0% in 2009, 17.0% in 2012 and 14.5% in 2015. Obstacles to CVCT included: limited space and staffing, competing priorities, record keeping not adapted for couples, and few resources for promotion and increasing male involvement. Conflicting training models for 'partner testing' with men and women separately vs. CVCT with joint post-test counseling led to confusion in reporting to district health authorities.A focused and sustained effort will be required to reach a meaningful number of couples with CVCT to prevent heterosexual and perinatal HIV transmission. Establishing targets and timelines, funding for dedicated and appropriately trained staff, adoption of standardized data recording instruments with couple-level indicators, and expansion of community and clinic-based promotions using proven models are recommended.

  11. Modeling the impact of integrating HIV and outpatient health services on patient waiting times in an urban health clinic in Zambia.

    Directory of Open Access Journals (Sweden)

    Sarang Deo

    Full Text Available Rapid scale up of HIV treatment programs in sub-Saharan Africa has refueled the long-standing health policy debate regarding the merits and drawbacks of vertical and integrated system. Recent pilots of integrating outpatient and HIV services have shown an improvement in some patient outcomes but deterioration in waiting times, which can lead to worse health outcomes in the long run.A pilot intervention involving integration of outpatient and HIV services in an urban primary care facility in Lusaka, Zambia was studied. Data on waiting time of patients during two seven-day periods before and six months after the integration were collected using a time and motion study. Statistical tests were conducted to investigate whether the two observation periods differed in operational details such as staffing, patient arrival rates, mix of patients etc. A discrete event simulation model was constructed to facilitate a fair comparison of waiting times before and after integration. The simulation model was also used to develop alternative configurations of integration and to estimate the resulting waiting times.Comparison of raw data showed that waiting times increased by 32% and 36% after integration for OPD and ART patients respectively (p<0.01. Using simulation modeling, we found that a large portion of this increase could be explained by changes in operational conditions before and after integration such as reduced staff availability (p<0.01 and longer breaks between consecutive patients (p<0.05. Controlling for these differences, integration of services, per se, would have resulted in a significant decrease in waiting times for OPD and a moderate decrease for HIV services.Integrating health services has the potential of reducing waiting times due to more efficient use of resources. However, one needs to ensure that other operational factors such as staff availability are not adversely affected due to integration.

  12. Barriers and facilitators to the implementation of antenatal syphilis screening and treatment for the prevention of congenital syphilis in the Democratic Republic of Congo and Zambia: results of qualitative formative research.

    Science.gov (United States)

    Nkamba, Dalau; Mwenechanya, Musaku; Kilonga, Arlette Mavila; Cafferata, Maria Luisa; Berrueta, Amanda Mabel; Mazzoni, Agustina; Althabe, Fernando; Garcia-Elorrio, Ezequiel; Tshefu, Antoniette K; Chomba, Elwyn; Buekens, Pierre M; Belizan, Maria

    2017-08-14

    The impact of untreated syphilis during pregnancy on neonatal health remains a major public health threat worldwide. Given the high prevalence of syphilis during pregnancy in Zambia and Democratic Republic of Congo (DRC), the Preventive Congenital Syphilis Trial (PCS Trial), a cluster randomized trial, was proposed to increase same-day screening and treatment of syphilis during antenatal care visits. To design an accepted and feasible intervention, we conducted a qualitative  formative research. Our objective was to identify context-specific  barriers and facilitators to the implementation of antenatal screening and treatment during pregnancy. Qualitative research included in-depth semi-structured interviews with clinic administrators, group interviews with health care providers, and focus groups with pregnant women in primary care clinics (PCCs) in Kinshasa (DRC) and Lusaka (Zambia). A total of 112 individuals participated in the interviews and focus groups. Barriers for the implementation of syphilis testing and treatment were identified at the a) system level: fragmentation of the health system, existence of ANC guidelines in conflict with proposed intervention, poor accessibility of clinics (geographical and functional), staff and product shortages at the PCCs; b) healthcare providers' level: lack of knowledge and training about evolving best practices, reservations regarding same-day screening and treatment; c) Pregnant women level: late enrollment in ANC, lack of knowledge about consequences and treatment of syphilis, and stigma. Based on these results, we developed recommendations for the design of the PCS Trial intervention. This research allowed us to identify barriers and facilitators to improve the feasibility and acceptability of a behavioral intervention. Formative research is a critical step in designing appropriate and effective interventions by closing the "know-do gap".

  13. HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial.

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    Michael M Chanda

    2017-11-01

    Full Text Available HIV self-testing (HIVST may play a role in addressing gaps in HIV testing coverage and as an entry point for HIV prevention services. We conducted a cluster randomized trial of 2 HIVST distribution mechanisms compared to the standard of care among female sex workers (FSWs in Zambia.Trained peer educators in Kapiri Mposhi, Chirundu, and Livingstone, Zambia, each recruited 6 FSW participants. Peer educator-FSW groups were randomized to 1 of 3 arms: (1 delivery (direct distribution of an oral HIVST from the peer educator, (2 coupon (a coupon for collection of an oral HIVST from a health clinic/pharmacy, or (3 standard-of-care HIV testing. Participants in the 2 HIVST arms received 2 kits: 1 at baseline and 1 at 10 weeks. The primary outcome was any self-reported HIV testing in the past month at the 1- and 4-month visits, as HIVST can replace other types of HIV testing. Secondary outcomes included linkage to care, HIVST use in the HIVST arms, and adverse events. Participants completed questionnaires at 1 and 4 months following peer educator interventions. In all, 965 participants were enrolled between September 16 and October 12, 2016 (delivery, N = 316; coupon, N = 329; standard of care, N = 320; 20% had never tested for HIV. Overall HIV testing at 1 month was 94.9% in the delivery arm, 84.4% in the coupon arm, and 88.5% in the standard-of-care arm (delivery versus standard of care risk ratio [RR] = 1.07, 95% CI 0.99-1.15, P = 0.10; coupon versus standard of care RR = 0.95, 95% CI 0.86-1.05, P = 0.29; delivery versus coupon RR = 1.13, 95% CI 1.04-1.22, P = 0.005. Four-month rates were 84.1% for the delivery arm, 79.8% for the coupon arm, and 75.1% for the standard-of-care arm (delivery versus standard of care RR = 1.11, 95% CI 0.98-1.27, P = 0.11; coupon versus standard of care RR = 1.06, 95% CI 0.92-1.22, P = 0.42; delivery versus coupon RR = 1.05, 95% CI 0.94-1.18, P = 0.40. At 1 month, the majority of HIV tests were self-tests (88.4%. HIV self

  14. HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial.

    Science.gov (United States)

    Chanda, Michael M; Ortblad, Katrina F; Mwale, Magdalene; Chongo, Steven; Kanchele, Catherine; Kamungoma, Nyambe; Fullem, Andrew; Dunn, Caitlin; Barresi, Leah G; Harling, Guy; Bärnighausen, Till; Oldenburg, Catherine E

    2017-11-01

    HIV self-testing (HIVST) may play a role in addressing gaps in HIV testing coverage and as an entry point for HIV prevention services. We conducted a cluster randomized trial of 2 HIVST distribution mechanisms compared to the standard of care among female sex workers (FSWs) in Zambia. Trained peer educators in Kapiri Mposhi, Chirundu, and Livingstone, Zambia, each recruited 6 FSW participants. Peer educator-FSW groups were randomized to 1 of 3 arms: (1) delivery (direct distribution of an oral HIVST from the peer educator), (2) coupon (a coupon for collection of an oral HIVST from a health clinic/pharmacy), or (3) standard-of-care HIV testing. Participants in the 2 HIVST arms received 2 kits: 1 at baseline and 1 at 10 weeks. The primary outcome was any self-reported HIV testing in the past month at the 1- and 4-month visits, as HIVST can replace other types of HIV testing. Secondary outcomes included linkage to care, HIVST use in the HIVST arms, and adverse events. Participants completed questionnaires at 1 and 4 months following peer educator interventions. In all, 965 participants were enrolled between September 16 and October 12, 2016 (delivery, N = 316; coupon, N = 329; standard of care, N = 320); 20% had never tested for HIV. Overall HIV testing at 1 month was 94.9% in the delivery arm, 84.4% in the coupon arm, and 88.5% in the standard-of-care arm (delivery versus standard of care risk ratio [RR] = 1.07, 95% CI 0.99-1.15, P = 0.10; coupon versus standard of care RR = 0.95, 95% CI 0.86-1.05, P = 0.29; delivery versus coupon RR = 1.13, 95% CI 1.04-1.22, P = 0.005). Four-month rates were 84.1% for the delivery arm, 79.8% for the coupon arm, and 75.1% for the standard-of-care arm (delivery versus standard of care RR = 1.11, 95% CI 0.98-1.27, P = 0.11; coupon versus standard of care RR = 1.06, 95% CI 0.92-1.22, P = 0.42; delivery versus coupon RR = 1.05, 95% CI 0.94-1.18, P = 0.40). At 1 month, the majority of HIV tests were self-tests (88.4%). HIV self-test use

  15. Infants and young children feeding practices and nutritional status in two districts of Zambia.

    Science.gov (United States)

    Katepa-Bwalya, Mary; Mukonka, Victor; Kankasa, Chipepo; Masaninga, Freddie; Babaniyi, Olusegun; Siziya, Seter

    2015-01-01

    Appropriate feeding is important in improving nutrition and child survival. Documentation of knowledge of caregiver on infant feeding is scanty in Zambia. The aim of this study was to describe feeding practices and nutritional status among infants and young children (IYC) in two districts in Zambia: Kafue and Mazabuka. A cross-sectional study was conducted between January and March 2006 using both quantitative and qualitative methods. A questionnaire was administered to caregiver of children aged under24 months. Lengths and weights of all children were measured. Focused group discussions were conducted in selected communities to assess parents or guardian knowledge, attitude and practice related to infant feeding. A total of 634 caregivers (361 from Kafue and 273 from Mazabuka) participated in the study. About 311/618 (54.0%) of the caregiver knew the definition and recommended duration of exclusive breastfeeding (EBF) and when to introduce complementary feeds. Two hundred and fifty-one (81.2%) out of 310 respondents had acquired this knowledge from the health workers. Only 145/481 (30.1%) of the respondents practiced exclusive breastfeeding up to six months with 56/626 (8.9%) of the mothers giving prelacteal feeds. Although 596/629 (94.8%) of the respondents reported that the child does not need anything other than breast milk in the first three days of life, only 318/630 (50.5%) of them considered colostrum to be good. Complementary feeds were introduced early before six months of age and were usually not of adequate quality and quantity. Three hundred and ninety-one (64%) out of 603 caregivers knew that there would be no harm to the child if exclusively breastfed up to six months. Most of the children's nutritional status was normal with 25/594 (4.2%) severely stunted, 10/596 (1.7%) severely underweight and 3/594 (0.5%) severely wasted. The caregiver in the communities knew about the recommended feeding practices, but this knowledge did not translate into good

  16. Open Pit Water Control Safety A Case Of Nchanga Open Pit Mine Zambia

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    Silwamba C

    2015-08-01

    Full Text Available Abstract Mining in Chingola Zambia started underground in 1931 and was catastrophically flooded and closed. The present Nchanga Underground Mine NUG started in 1937. The Nchanga Open Pit NOP mine started in 1955 situated to the west of NUG and partially overlying it. Open pit water control safety operations in the Nchanga-Chingola area have successfully enabled the safe extraction of millions of tonnes of copper ore annually over the past 60 years from NUG mining as well as the NOP. At the start Nchanga mining license surface already had NUG and many watershed divides with the Nchanga and Chingola streams being the main streams feeding into Zambias second largest river Kafue river and 42 of the year was characterised by heavy rains ranging between 800mm to 1300mm per annum. In this paper the presence of very significant amounts of seasonal rain and subsurface water in the mining area was identified as both a curse and a blessing. An excess in seasonal rain and subsurface water would disrupt both open pit and underground mining operations. In order for NOP to be operated successfully stable and free from flooding coping water management tactics were adopted from 1955 to 2015 including 1. Underground mine pump chamber pumping system 2. Piezometer instrumented boreholes 3. Underground mine 1500-ft sub-haulage east borehole dewatering beneath the open pit 4. Nchanga and Chingola stream diversionary tunnel and open drains 5. Nchanga stream causeway and embankment dam in the Matero School Golf Club area 6. Pit perimeter borehole pumping 7. Outer and inner pit perimeter drains and bund walls 8. In-pit ramp side drains 9. In-pit sub-horizontal borehole geo-drains and water and 10. Pit bottom sump pumps. Application of grout curtains along the Vistula River Poland was noted as a possibility in the right circumstances although it had never been used at Nchanga Open Pit. An additional conclusion was that forward health safety and environmental end

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

    Science.gov (United States)

    Robinson, Peter B.

    In southern Africa, gross disparities in access to water are symptomatic of the overall uneven pattern of development. Despite post-independence egalitarian rhetoric, in countries such as Zambia and Zimbabwe inappropriate models (piped house connections in the urban areas, high technology irrigation schemes in the agricultural sector), combined with weak macro-economies and poorly formulated sectoral policies have actually exacerbated the disparities. Zero or very low tariffs have played a major role in this. Although justified as being consistent with water's special status, inadequate tariffs in fact serve to undermine any programme of making water accessible to all. This has led to a narrowing of development options, resulting in exclusivist rather than inclusivist development, and stagnation rather than dynamism. A major part of the explanation for perpetuation of such unsatisfactory outcomes is the existence of political interest groups who benefit from the status quo. The first case study in the paper involves urban water consumers in Zambia, where those with piped water connections seek to continue the culture of low tariffs which is by now deeply embedded. The result is that the water supply authorities (in this case the newly formed, but still politically constrained 'commercialised utilities') are unable even to maintain adequate supplies to the piped customers, let alone extend service to the peri-urban dwellers, 56% of whom do not have access to safe water. The paper outlines some modest, workable principles to achieve universal, affordable access to water in the urban areas, albeit through a mix of service delivery mechanisms. In a second case study of rural productive water in Zimbabwe, the reasons for only 2% of the rural subsistence farming households being involved in formal small-scale irrigation schemes 20 years after independence are explored. Again, a major part of the explanation lies in government pursuing a water delivery model which is not

  18. Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study.

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

    2015-09-11

    Despite the policy change stopping traditional birth attendants (TBAs) from conducting deliveries at home and encouraging all women to give birth at the clinic under skilled care, many women still give birth at home and TBAs are essential providers of obstetric care in rural Zambia. The main reasons for pregnant women's preference for TBAs are not well understood. This qualitative study aimed to identify reasons motivating women to giving birth at home and seek the help of TBAs. This knowledge is important for the design of public health interventions focusing on promoting facility-based skilled birth attendance in Zambia. We conducted ten focus group discussions (n = 100) with women of reproductive age (15-45 years) in five health centre catchment areas with the lowest institutional delivery rates in the district. In addition, a total of 30 in-depth interviews were conducted comprising 5 TBAs, 4 headmen, 4 husbands, 4 mothers, 4 neighbourhood health committee (NHC) members, 4 community health workers (CHWs) and 5 nurses. Perspectives on TBAs, the decision-making process regarding home delivery and use of TBAs, and reasons for preference of TBAs and their services were explored. Our findings show that women's lack of decision- making autonomy regarding child birth, dependence on the husband and other family members for the final decision, and various physical and socioeconomic barriers including long distances, lack of money for transport and the requirement to bring baby clothes and food while staying at the clinic, prevented them from delivering at a clinic. In addition, socio-cultural norms regarding childbirth, negative attitude towards the quality of services provided at the clinic, made most women deliver at home. Moreover, most women had a positive attitude towards TBAs and perceived them to be respectful, skilled, friendly, trustworthy, and available when they needed them. Our findings suggest a need to empower women with decision-making skills

  19. Practical Field Survey Approach with Handle Device for Lead Contamination Assessment in Kabwe, Zambia

    Science.gov (United States)

    Nakamura, S.; Hirose, K.; Takeda, T.; Uchida, Y.; Nakata, H.; Nakayama, S.; Ishizuka, M.; Yabe, J.; Ito, M.; Igarashi, T.

    2017-12-01

    International joint research project for assessing lead soil contamination in Kabwe, Zambia was started by Zambian and Japanese scientists in 2008. Various scientific data and results have been obtained up to now. Data sharing among researchers and government officials is necessary for understanding current situation of lead contamination in Kabwe comprehensively. As lead contamination affects on local communities seriously, local community participation is important to solve the environmental issue in near future. This study, therefore, aims to develop GIS Data Integration System (GDIS as followed) consisted of GIS Data Sharing System (GDSS as followed) as web-GIS, FIELDNAUT as Android App for field survey and opensource SNS instance named Mastodon. GDIS will provide local communities to participate easily and support researchers to collect and understand about everyday situation and visualize lead contamination status in Kabwe, Zambia. GDIS is developed with opensource programs. GDSS was simply designed and developed on one desktop PC (Hirose et al., 2015) although common web-GIS requires many servers (Suresh et al., 2015). FIELDNAUT was developed in 2016. FIELDNAUT provides researchers plotting their locations on satellite images and thematic maps, filming and texting with their locations, and compiling and sharing data through GDSS. Mastodon will be used as a new FIELDNAUT communication function between local communities and researchers. It is an independent SNS instance, and the closed and secure communication system will be able to be developed. With this function, local communities will share photos and texts about their daily lives and situation around Kabwe by FIELDNAUT, and those data will be collected into GDSS. Researchers provide their results as hazard maps to local communities through FIELDNAUT. GDIS consisted of GDSS, FIELDNAUT and Mastodon encourages local community participation and let local communities be interested in their environmental issues

  20. Determination Of Optimal Stope Strike Length On Steep Orebodies Through Laser Scanning At Lubambe Copper Zambia

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    Kalume H

    2017-08-01

    Full Text Available Lubambe Copper Mine is located in Chililabombwe Zambia and is a joint copper mining venture with three partners that include African Rainbow Minerals 40 Vale 40 and the Government of Zambia 20. The current mining method utilises Longitudinal Room and Pillar Mining LRP on 70m long panels strike length. However these long panels have resulted in unprecedented levels of dilution mainly from the collapse of hanging wall laminated ore shale OS2 leading to reduced recoveries. Observations made underground show high variability in geological and geotechnical conditions of the rock mass with factors such as weathering on joints lamina spaced joints and stress changes induced by mining all contributing to weakening and early collapse of the hanging wall. Therefore a study was undertaken to establish the optimal stope strike length of steep ore bodies at Lubambe. The exercise involved the use of Faro Laser Scanner every four stope rings blasted with time when the scan was performed noted. The spatial coherence of lasers makes them ideal measuring tools in situations where measurements need to be taken in inaccessible areas. Recent advances in laser scanning coupled with the exponential increase in processing power have greatly improved the methods used to estimate stope tonnages extracted from massive inaccessible stopes. The collected data was then used to construct digital three dimensional models of the stope contents. Sections were cut every metre with deformations taken and analysed with respect to time. Deformation rates from the hanging wall was reducing from 0.14thr to 0.07thr between rings 1 to 8. This reduction was as a result of slot blasting that involved drilling and blasting a number of holes at the same time. Between rings 8 to 25 deformation was constant averaging 0.28thr and between rings 26 and 28 a sharp increase in deformation rate was experienced from as low as 0.16thr to 6.33thr. This sharp increase defines the optimal stope length

  1. From chloroquine to artemether-lumefantrine: the process of drug policy change in Zambia

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    Snow Robert W

    2008-01-01

    Full Text Available Abstract Background Following the recognition that morbidity and mortality due to malaria had dramatically increased in the last three decades, in 2002 the government of Zambia reviewed its efforts to prevent and treat malaria. Convincing evidence of the failing efficacy of chloroquine resulted in the initiation of a process that eventually led to the development and implementation of a new national drug policy based on artemisinin-based combination therapy (ACT. Methods All published and unpublished documented evidence dealing with the antimalarial drug policy change was reviewed. These data were supplemented by the authors' observations of the policy change process. The information has been structured to capture the timing of events, the challenges encountered, and the resolutions reached in order to achieve implementation of the new treatment policy. Results A decision was made to change national drug policy to artemether-lumefantrine (AL in the first quarter of 2002, with a formal announcement made in October 2002. During this period, efforts were undertaken to identify funding for the procurement of AL and to develop new malaria treatment guidelines, training materials, and plans for implementation of the policy. In order to avoid a delay in implementation, the policy change decision required a formal adoption within existing legislation. Starting with donated drug, a phased deployment of AL began in January 2003 with initial use in seven districts followed by scaling up to 28 districts in the second half of 2003 and then to all 72 districts countrywide in early 2004. Conclusion Drug policy changes are not without difficulties and demand a sustained international financing strategy for them to succeed. The Zambian experience demonstrates the need for a harmonized national consensus among many stakeholders and a political commitment to ensure that new policies are translated into practice quickly. To guarantee effective policies requires

  2. Taenia solium Infections in a rural area of Eastern Zambia-a community based study.

    Science.gov (United States)

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

    2012-01-01

    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. 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. This study has recorded high taeniosis and cysticercosis prevalences and identified the need for further studies on transmission

  3. Taenia solium Infections in a rural area of Eastern Zambia-a community based study.

    Directory of Open Access Journals (Sweden)

    Kabemba E Mwape

    Full Text Available 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

  4. Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia.

    Science.gov (United States)

    Kayeyi, Nkomba; Sandøy, Ingvild F; Fylkesnes, Knut

    2009-08-25

    Investigations of the association between socio-economic position indicators and HIV in East, Central and Southern Africa have chiefly focused on factors that pertain to individual-level characteristics. This study investigated the effect of neighbourhood educational attainment on HIV prevalence among young women in selected urban and rural areas in Zambia. This study re-analysed data from a cross-sectional population survey conducted in Zambia in 2003. The analyses were restricted to women aged 15-24 years (n = 1295). Stratified random cluster sampling was used to select 10 urban and 10 rural clusters. A measure for neighbourhood-level educational attainment was constructed by aggregating individual-level years-in-school. Multi-level mixed effects regression models were run to examine the neighbourhood-level educational effect on HIV prevalence after adjusting for individual-level underlying variables (education, currently a student, marital status) and selected proximate determinants (ever given birth, sexual activity, lifetime sexual partners). HIV prevalence among young women aged 15-24 years was 12.5% in the urban and 6.8% in the rural clusters. Neighbourhood educational attainment was found to be a strong determinant of HIV infection in both urban and rural population, i.e. HIV prevalence decreased substantially by increasing level of neighbourhood education. The likelihood of infection in low vs. high educational attainment of neighbourhoods was 3.4 times among rural women and 1.8 times higher among the urban women after adjusting for age and other individual-level underlying variables, including education. However, the association was not significant for urban young women after this adjustment. After adjusting for level of education in the neighbourhood, the effect of the individual-level education differed by residence, i.e. a strong protective effect among urban women whereas tending to be a risk factor among rural women. The findings suggested structural

  5. Population-level scale-up of cervical cancer prevention services in a low-resource setting: development, implementation, and evaluation of the cervical cancer prevention program in Zambia.

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    Groesbeck P Parham

    Full Text Available Very few efforts have been undertaken to scale-up low-cost approaches to cervical cancer prevention in low-resource countries.In a public sector cervical cancer prevention program in Zambia, nurses provided visual-inspection with acetic acid (VIA and cryotherapy in clinics co-housed with HIV/AIDS programs, and referred women with complex lesions for histopathologic evaluation. Low-cost technological adaptations were deployed for improving VIA detection, facilitating expert physician opinion, and ensuring quality assurance. Key process and outcome indicators were derived by analyzing electronic medical records to evaluate program expansion efforts.Between 2006-2013, screening services were expanded from 2 to 12 clinics in Lusaka, the most-populous province in Zambia, through which 102,942 women were screened. The majority (71.7% were in the target age-range of 25-49 years; 28% were HIV-positive. Out of 101,867 with evaluable data, 20,419 (20% were VIA positive, of whom 11,508 (56.4% were treated with cryotherapy, and 8,911 (43.6% were referred for histopathologic evaluation. Most women (87%, 86,301 of 98,961 evaluable received same-day services (including 5% undergoing same-visit cryotherapy and 82% screening VIA-negative. The proportion of women with cervical intraepithelial neoplasia grade 2 and worse (CIN2+ among those referred for histopathologic evaluation was 44.1% (1,735/3,938 with histopathology results. Detection rates for CIN2+ and invasive cervical cancer were 17 and 7 per 1,000 women screened, respectively. Women with HIV were more likely to screen positive, to be referred for histopathologic evaluation, and to have cervical precancer and cancer than HIV-negative women.We creatively disrupted the 'no screening' status quo prevailing in Zambia and addressed the heavy burden of cervical disease among previously unscreened women by establishing and scaling-up public-sector screening and treatment services at a population level. Key

  6. Population-level scale-up of cervical cancer prevention services in a low-resource setting: development, implementation, and evaluation of the cervical cancer prevention program in Zambia.

    Science.gov (United States)

    Parham, Groesbeck P; Mwanahamuntu, Mulindi H; Kapambwe, Sharon; Muwonge, Richard; Bateman, Allen C; Blevins, Meridith; Chibwesha, Carla J; Pfaendler, Krista S; Mudenda, Victor; Shibemba, Aaron L; Chisele, Samson; Mkumba, Gracilia; Vwalika, Bellington; Hicks, Michael L; Vermund, Sten H; Chi, Benjamin H; Stringer, Jeffrey S A; Sankaranarayanan, Rengaswamy; Sahasrabuddhe, Vikrant V

    2015-01-01

    Very few efforts have been undertaken to scale-up low-cost approaches to cervical cancer prevention in low-resource countries. In a public sector cervical cancer prevention program in Zambia, nurses provided visual-inspection with acetic acid (VIA) and cryotherapy in clinics co-housed with HIV/AIDS programs, and referred women with complex lesions for histopathologic evaluation. Low-cost technological adaptations were deployed for improving VIA detection, facilitating expert physician opinion, and ensuring quality assurance. Key process and outcome indicators were derived by analyzing electronic medical records to evaluate program expansion efforts. Between 2006-2013, screening services were expanded from 2 to 12 clinics in Lusaka, the most-populous province in Zambia, through which 102,942 women were screened. The majority (71.7%) were in the target age-range of 25-49 years; 28% were HIV-positive. Out of 101,867 with evaluable data, 20,419 (20%) were VIA positive, of whom 11,508 (56.4%) were treated with cryotherapy, and 8,911 (43.6%) were referred for histopathologic evaluation. Most women (87%, 86,301 of 98,961 evaluable) received same-day services (including 5% undergoing same-visit cryotherapy and 82% screening VIA-negative). The proportion of women with cervical intraepithelial neoplasia grade 2 and worse (CIN2+) among those referred for histopathologic evaluation was 44.1% (1,735/3,938 with histopathology results). Detection rates for CIN2+ and invasive cervical cancer were 17 and 7 per 1,000 women screened, respectively. Women with HIV were more likely to screen positive, to be referred for histopathologic evaluation, and to have cervical precancer and cancer than HIV-negative women. We creatively disrupted the 'no screening' status quo prevailing in Zambia and addressed the heavy burden of cervical disease among previously unscreened women by establishing and scaling-up public-sector screening and treatment services at a population level. Key determinants

  7. Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia.

    Science.gov (United States)

    Oldenburg, Catherine E; Ortblad, Katrina F; Chanda, Michael M; Mwanda, Kalasa; Nicodemus, Wendy; Sikaundi, Rebecca; Fullem, Andrew; Barresi, Leah G; Harling, Guy; Bärnighausen, Till

    2017-04-20

    HIV testing and knowledge of status are starting points for HIV treatment and prevention interventions. Among female sex workers (FSWs), HIV testing and status knowledge remain far from universal. HIV self-testing (HIVST) is an alternative to existing testing services for FSWs, but little evidence exists how it can be effectively and safely implemented. Here, we describe the rationale and design of a cluster randomised trial designed to inform implementation and scale-up of HIVST programmes for FSWs in Zambia. The Zambian Peer Educators for HIV Self-Testing (ZEST) study is a 3-arm cluster randomised trial taking place in 3 towns in Zambia. Participants (N=900) are eligible if they are women who have exchanged sex for money or goods in the previous 1 month, are HIV negative or status unknown, have not tested for HIV in the previous 3 months, and are at least 18 years old. Participants are recruited by peer educators working in their communities. Participants are randomised to 1 of 3 arms: (1) direct distribution (in which they receive an HIVST from the peer educator directly); (2) fixed distribution (in which they receive a coupon with which to collect the HIVST from a drug store or health post) or (3) standard of care (referral to existing HIV testing services only, without any offer of HIVST). Participants are followed at 1 and 4 months following distribution of the first HIVST. The primary end point is HIV testing in the past month measured at the 1-month and 4-month visits. This study was approved by the Institutional Review Boards at the Harvard T.H. Chan School of Public Health in Boston, USA and ERES Converge in Lusaka, Zambia. The findings of this trial will be presented at local, regional and international meetings and submitted to peer-reviewed journals for publication. Pre-results; NCT02827240. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Effects of hand-hoe tilled conservation farming on soil quality and carbon stocks under on-farm conditions in Zambia

    DEFF Research Database (Denmark)

    Martinsen, V; Shitumbanuma, V; Mulder, J

    2017-01-01

    Conservation farming (CF) has been promoted in Zambia since the 1980s. Despite long-term practice of CF in Zambia, its effect on soil fertility, including the storage of soil organic matter (SOM), on smallholder farms are inconclusive. Here, we assess the effect of CF as compared to conventional....... Overall, our results show small differences in the soil quality parameters between the CF and conventional practices at smallholder farms after maximum 12 years since adoption of CF....... tillage on soil quality parameters on smallholder farms in the Eastern province (EP, 20 sites, two to six years of CF) and Central province (CP, 20 sites, four to twelve years of CF) in Zambia. Soils under CF (minimum tillage hoe basins, crop rotation and residue retention) were compared with adjacent...

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

    Science.gov (United States)

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

    2011-01-01

    Background Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings HIV-infected patients aged ≥18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings. PMID:22205933

  10. Knowledge and use of modern family planning methods by rural women in Zambia

    Directory of Open Access Journals (Sweden)

    C. Mubita-Ngoma

    2010-09-01

    Full Text Available The main aim of the study was to determine knowledge and use of modem contractive methods among reproductive age group rural women in Zambia. The study is a descriptive cross-sectional study of 105 randomly selected rural women. Data was collected using semi-structured interview schedule and analyzed using EPI Info version 6 statistical packages. The findings revealed that 63% of the respondents were within the age group 21-35 years, 65% were married and 64% were peasant farmers. 90% of the respondents had heard about modem contraceptives and their main source of information was the Health worker (62%. 76% of the respondents stated that modem contraceptive methods could be obtained from public health facilities. 56% of the respondents were currently using modem contraceptive methods and 46% were not using modem contraceptive methods. Reasons for non use of contraceptive methods were religious beliefs (50%, partner disapproval (30% and side effects (20%. The results showed a relationship between educational level and use of contraceptives (Chi-square 7.83, df = 3, P < 0.05 and spouse approval or support of contractive methods and use of contraceptive (Chisquare 5.9, df = 2, P < 0.05. Therefore, efforts to promote modem contraceptive use among the rural women should be intensified to overcome barriers to contraceptive use and should involve men.

  11. The Importance of Animal Source Foods for Nutrient Sufficiency in the Developing World: The Zambia Scenario.

    Science.gov (United States)

    Zhang, Zhiying; Goldsmith, Peter D; Winter-Nelson, Alex

    2016-05-05

    There have been successful interventions fortifying staple foods to mobilize micronutrients as well as agricultural efforts to raise yields of staple foods to increase food availability. Zambia serves as an interesting case study because since 1961 there has been a notable decline in the availability of animal source foods (ASFs) and pulses and a significant increase in the supply of cassava and vegetable oils. The shift in food availability was partly attributed to the agricultural success in high-yielding and drought-resistant varieties that made cassava and oil crops more affordable and readily available. In this research, we explore another policy strategy that involves ASF as a mechanism to help remedy micronutrient inadequacies in a population. A scenario modeling analysis compares the changes in the nutrient profile of the Zambian diet through adding either staple plant source foods (PSFs) or ASFs. The scenarios under study involve the addition of (1) 18 fl oz of whole cow's milk; (2) 60 g of beef, 30 g of chicken, and 5 g of beef liver; (3) milk plus meat; or (4) 83 g of maize flour, 123 g of cassava, and other staple PSF, that is, isocaloric to the "milk + meat" group. The findings alert program planners and policy makers to the value of increasing the availability, accessibility, and utilization of ASF to simultaneously address multiple nutrient deficiencies, as well as the nutrition challenges that remain when expanding the availability of plant-based staples. © The Author(s) 2016.

  12. Early Childhood Education, Child Development and School Readiness: Evidence from Zambia

    Directory of Open Access Journals (Sweden)

    Stephanie Simmons Zuilkowski

    2012-12-01

    Full Text Available While early childhood education has received increasing attention in the developing world in recent years, relatively little evidence is available from sub-Saharan Africa on its effects on child development and subsequent school enrolment. We use a prospective case-control design to evaluate the developmental impact of a community-based early childhood center in an urban area in Zambia. Comparing 40 children attending the center to 40 children not attending the center from the same community, we find that center attendance was associated with significantly better performance in an assessment of task orientation, and was also weakly associated with increased letter familiarity. We also observed higher performance among center students on tests of receptive language and pencil-related fine motor skills. These associations were, however, smaller and not statistically significant. We conducted a follow-up one year after the initial assessment, when children were seven years old and should have been in first grade. At follow-up, 27% of non-attendees were not yet enrolled in primary school, compared to just 11% of center students, suggesting that participation in early education encourages a timely transition into first grade.

  13. Balancing risk, interpersonal intimacy and agency: perspectives from marginalised women in Zambia.

    Science.gov (United States)

    Davis, Lwendo Moonzwe; Kostick, Kristin Marie

    2018-05-15

    Women are most exposed to sexual health risks within their marital relationships, primarily due to the sexually risky behaviours of their spouses. Studies show that expanding agency is critical for women to mitigate both physical and sexual health risks and is linked to increased psycho-social well-being and economic independence. Drawing on qualitative and quantitative primary data collected from a peri-urban community in Zambia, this paper explores how women exert agency in a community where few educational and economic opportunities and substantial food insecurity exacerbate women's risk for HIV within their marital relationships. It also examines how expressions of agency within marital unions can reduce HIV risk exposure and lead to socio-economic benefits. However, expressions of agency can also create physical, psycho-social and sexual health risks, particularly when spouses do not support independent decision-making and actions that women consider necessary to support the household and maintain intimacy. Findings highlight the importance of community involvement and addressing harmful socio-cultural norms to foster the realisation of women's agency.

  14. Willingness to Pay for a Maternity Waiting Home Stay in Zambia

    Science.gov (United States)

    White, Emily E.; Biemba, Godfrey; Mataka, Kaluba; Scott, Nancy

    2016-01-01

    Introduction Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability. Methods We conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context. Results The maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use. Discussion While Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households. PMID:28419708

  15. The state of HIV sector local governance in Malawi and Zambia: Evidence from five districts

    Directory of Open Access Journals (Sweden)

    Justin Steyn

    2014-07-01

    Full Text Available This paper encapsulates the outputs of a Swiss Agency for Development Cooperation (SDC funded project that aimed to improve the levels of HIV governance at the district level in Malawi and Zambia by encouraging public participation in an effort to more effective use of local resources. The methodology for this project, developed by the Institute for Democracy in Africa (Idasa and SDC, included a barometer which assessed perceptions of district HIV governance among key stakeholders. Perceptions were gathered on governance principles of effectiveness, efficiency, rule of law, accountability, participation and equity. The stakeholders ranged from administrators, political representatives, community-based organisations and the private sector on the supply side and citizens on the demand or beneficiary side. The findings of the research indicate specific sector governance issues that may be generalised to governance. Communication and transparency appear to be major issues underpinning the bottlenecks and shortcomings in the HIV sector governance at the district level. Information gaps have given rise to accountability deficits and coordination deficiencies. Addressing these matters would make more effective use of resources and lessen dependence on external funding sources.

  16. Assessing care-givers' satisfaction with child immunisation services in Zambia: Evidence from a national survey.

    Science.gov (United States)

    Chama-Chiliba, Chitalu Miriam; Masiye, Felix; Mphuka, Chrispin

    2017-10-09

    The main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants. This study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5. We used an ordered logistic regression model to analyse the significance of perceived quality of vaccination services, immunisation delivery mode and a range of individual characteristics in predicting care-giver satisfaction. Findings show that one in five care givers were unsatisfied with the vaccination services that they had received, with rural populations showing a significantly higher level of satisfaction. Poor quality of care, defined by long waiting times, poor quality of communication between health staff and care givers, long distance to vaccination sites, mode of delivery, and personal characteristics were among major factors driving care-giver satisfaction ratings. We also find that receiving a vaccination at outreach mode of delivery was associated with higher odds of greater satisfaction compared to on-facility vaccination services. The odds of satisfaction were lower for respondents living further away from a health facility, which emphasizes the importance of access in seeking vaccination services. These findings suggest that major improvements in quality of vaccination and service organisation will be needed to increase client satisfaction and service utilisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. HIV testing and tolerance to gender based violence: a cross-sectional study in Zambia.

    Directory of Open Access Journals (Sweden)

    Sara Gari

    Full Text Available 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.

  18. eC3--a modern telecommunications matrix for cervical cancer prevention in Zambia.

    Science.gov (United States)

    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

    2010-07-01

    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. 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. 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. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

  20. First detection of Rickettsia conorii ssp. caspia in Rhipicephalus sanguineus in Zambia.

    Science.gov (United States)

    Chitimia-Dobler, Lidia; Dobler, Gerhard; Schaper, Sabine; Küpper, Thomas; Kattner, Simone; Wölfel, Silke

    2017-11-01

    Ticks are important vectors for Rickettsia spp. of the spotted fever group all around the world. Rickettsia conorii is the etiological agent of boutonneuse fever in the Mediterranean region and Africa. Tick identification was based on morphological features and further characterized using the 16S rRNA gene. The ticks were individually tested using pan-Rickettsia real-time-PCR for screening, and 23S-5S intergenic spacer region, 16S rDNA, gltA, sca4, ompB, and ompA genes were used to analyze the Rickettsia positive samples. Rickettsia conorii ssp. caspia was detected in tick collected in Zambia for the first time, thus demonstrating the possibility of the occurrence of human disease, namely Astrakhan fever, due to this Rickettsia ssp. in this region of Africa. The prevalence of R. conorii ssp. caspia was 0.06% (one positive tick out of 1465 tested ticks) and 0.07% (one positive tick out of 1254 tested Rh. sanguineus).

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

    Science.gov (United States)

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

    Science.gov (United States)

    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 (pintervention 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

  3. Bovine Tuberculosis and Brucellosis in Traditionally Managed Livestock in Selected Districts of Southern Province of Zambia

    Directory of Open Access Journals (Sweden)

    J. B. Muma

    2013-01-01

    Full Text Available A study was performed in 2008 to estimate the prevalence of tuberculosis and brucellosis in traditionally reared cattle of Southern Province in Zambia in four districts. The single comparative intradermal tuberculin test (SCITT was used to identify TB reactors, and the Rose Bengal test (RBT, followed by confirmation with competitive enzyme-linked immunosorbent assay (c-ELISA, was used to test for brucellosis. A total of 459 animals were tested for tuberculosis and 395 for brucellosis. The overall prevalence of BTB based on the 4 mm and 3 mm cutoff criteria was 4.8% (95% CI: 2.6–7.0% and 6.3% (95% CI: 3.8–8.8%, respectively. Change in skin thickness on SCITT was influenced by initial skin-fold thickness at the inoculation site, where animals with thinner skin had a tendency to give a larger tuberculin response. Brucellosis seroprevalence was estimated at 20.7% (95% CI: 17.0–24.4%. Comparison between results from RBT and c-ELISA showed good agreement (84.1% and revealed subjectivity in RBT test results. Differences in brucellosis and tuberculosis prevalence across districts were attributed to type of husbandry practices and ecological factors. High prevalence of tuberculosis and brucellosis suggests that control control programmes are necessary for improved cattle productivity and reduced public health risk.

  4. Understanding local water conflict and cooperation: The case of Namwala District, Zambia

    Science.gov (United States)

    Funder, Mikkel; Mweemba, Carol; Nyambe, Imasiku; van Koppen, Barbara; Ravnborg, Helle Munk

    Understanding the nature of water conflict and cooperation is a crucial element in water governance within Integrated Water Resources Management (IWRM). Much of the recent attention to the issue has however focused on transboundary aspects, while we know rather less about the nature and dynamics of local water conflict and cooperation. Drawing on the work of the collaborative Competing for Water Research Programme, this article presents selected findings from a quantitative and qualitative mapping and exploration of water conflict and cooperation events in Namwala District of Zambia. It is found that local water competition situations often involve both conflictive and cooperative events in a dynamic succession of each other, but also that the majority of events are conflictive, and that they primarily take place between different types of water uses, and less frequently among the same types of uses. There is a distinct tendency for both conflictive and cooperative events to originate in the dry season, and many events are associated with water infrastructure development, particularly boreholes. The study found that most conflictive and cooperative events took place within individual communities, and only to a lesser extent between two or more communities or between districts. While third parties are involved in some events, these are primarily local village institutions such as Headmen. The article concludes by discussing the implications of these findings for local water governance, including the need to ensure that the very localized nature of such conflict and cooperation events is taken into consideration in the institutional development of IWRM.

  5. The Lufilian arc and Irumide belt of Zambia: Results of a geotraverse across their intersection

    Science.gov (United States)

    Daly, M. C.; Chakraborty, S. K.; Kasolo, P.; Musiwa, M.; Mumba, P.; Naidu, B.; Namateba, C.; Ngambi, O.; Coward, M. P.

    The Kibaran aged Irumide belt and the Pan African aged Lufilian arc intersect in central Zambia. The Irumide belt is a thrust belt comprising northwesterly verging structures in the north, upright structures in the central zone and southeasterly verging structures in the south. Tectonic transport, as deduced from regional stretching lineations, changes across the central upright zone. To the north of this zone, movement is to the northwest; to the south of the zone, movement is to the southeast. This divergence of structures about a central upright zone is recognized throughout the belt. The Lufilian arc comprises a northeasterly verging thrust belt involving large basement thrust sheets forming domal culimations throughoutregion. These thrusts climb up-section towards the northeast and have telescoped the Katangan stratigraphy. In the Copperbelt area of the arc, the Irumide and Lufilian structures are separated by a marked unconformity. However in the Mubalashi area, south of the Copperbelt, there is aa coincidence of strike of Lufilian and Irumide structures which, in the past, has made their separation difficult. The structures can be separated on the basis of stretching lineations associated with the deformation. In the ENE striking Lufilian structures stretching lineations are seen to be sub-horizontal, suggesting a lateral ramp relationship to the main Lufilian deformation. Similar striking Irumide structures have a steeply plunging down dip lineation. The intersection of these two belts represents the junction of two different tectonic systems operating in Africa during the Late Proterozoic.

  6. Insights and efforts to control rabies in Zambia: Evaluation of determinants and barriers to dog vaccination in Nyimba district.

    Directory of Open Access Journals (Sweden)

    Carolyn Patricia Mulipukwa

    2017-10-01

    Full Text Available The current rabies control strategy in Zambia is based on dog vaccination, dog population control and dog movement restrictions. In Nyimba district of Zambia, dog vaccination coverage is low but the incidence of dog bites is high which places the community at risk of rabies infection. The renewed global interest eliminating rabies in developing countries has spurred interest to identify determinants and barriers of dog vaccination in an effort to reduce the overall disease burden.A mixed methods cross sectional design was used in the study. This consisted of three parts: Evaluation of medical records regarding dog bite injuries, implementation and analysis of a household survey and in-depth review of key informant interviews. Data was collected into a Microsoft Excel database and subsequently transferred to STATA for descriptive, inferential and thematic analysis.Dog vaccination coverage overall was 8.7% (57/655, with 3.4% (22/655 in urban areas, 1.8% (12/655 in peri-urban and 3.5 (23/655 in the rural regions. Financially stable households were more likely to have their dogs vaccinated. Only 10.3% (31/300 of the respondents had vaccinated their dogs and these had a reliable source of income as 6% (18/300 were peasant farmers, 2% (6/300 were dependants whose guardians were financially stable and 2.3% (7/300 were in steady employment. Important barriers to dog vaccination included cost, limited awareness of vaccination program and access.Current rabies control strategies in Nyimba district, Zambia, appear quite limited. Improvements in the regional dog vaccination program may provide benefits. Enhancement of educational efforts targeting behavioural factors may also prove useful. Finally, the cost of dog vaccination can be reduced with scaled up production of a local vaccine.

  7. The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey

    Directory of Open Access Journals (Sweden)

    Rehnberg Clas

    2005-12-01

    Full Text Available Abstract Background Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. Aims and objectives This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. Methods A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. Findings The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed.

  8. Mixed crop-livestock production systems of smallholder farmers in sub-humid and semi-arid areas of Zambia

    International Nuclear Information System (INIS)

    Lungu, J.C.N.

    2002-01-01

    Livestock production activities among small-scale farmers of semi-arid (Agro-ecological zone 1) and sub-humid (Agro-ecological zone 2) areas of Zambia are integrated with crop production activities in what is termed as crop/livestock farming system. This is a closed system in which production of one enterprise depends on the other. In Zambia, crop production depends on draught animals for tillage of cropping area, animal manure for fertilisation of crops while livestock depend on crop residues for dry season feeding. Good quality grass is generally available in adequate amounts to support reasonable level of livestock productivity during the rainy season. But livestock rely on low quantity and poor quality, highly fibrous perennial grass from veld and fibrous crop residues during the dry season. These resources are inadequate to support optimum livestock productivity activities. Poor nutrition results in low rates of reproduction and production as well as increased susceptibility to diseases. With the increasing human population cropping land is expanding, leading to increased production of crop residues. This has however, reduced the grazing land available for ruminant production. In Zambia large quantities of crop residues (stovers, husks and straws, legume tops and hulls, sugar cane tops, cassava leaves, potato vines, etc.) are left in the field where they are wasted each year because small-scale farmers lack the knowledge on how best to use them. There is a need to find ways to reverse this situation by adapting known and workable technologies to local conditions and by introducing new approaches for improving the use of crop residues and poor quality fibrous feeds. Efforts should also be made to enlarge feed resource base. The technologies should be simple and effective. In the presence of a dynamic market system, livestock production in a crop/livestock system could be intensified and made profitable for small-scale farmers. (author)

  9. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

    Science.gov (United States)

    Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

    2017-01-05

    Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. The Epidemiology of African Swine Fever in "Nonendemic" Regions of Zambia (1989-2015): Implications for Disease Prevention and Control.

    Science.gov (United States)

    Simulundu, Edgar; Lubaba, Caesar H; van Heerden, Juanita; Kajihara, Masahiro; Mataa, Liywalii; Chambaro, Herman Moses; Sinkala, Yona; Munjita, Samuel Munalula; Munang'andu, Hetron Mweemba; Nalubamba, King Shimumbo; Samui, Kenny; Pandey, Girja Shanker; Takada, Ayato; Mweene, Aaron S

    2017-08-23

    African swine fever (ASF) is a highly contagious and deadly viral hemorrhagic disease of swine. In Zambia, ASF was first reported in 1912 in Eastern Province and is currently believed to be endemic in that province only. Strict quarantine measures implemented at the Luangwa River Bridge, the only surface outlet from Eastern Province, appeared to be successful in restricting the disease. However, in 1989, an outbreak occurred for the first time outside the endemic province. Sporadic outbreaks have since occurred almost throughout the country. These events have brought into acute focus our limited understanding of the epidemiology of ASF in Zambia. Here, we review the epidemiology of the disease in areas considered nonendemic from 1989 to 2015. Comprehensive sequence analysis conducted on genetic data of ASF viruses (ASFVs) detected in domestic pigs revealed that p72 genotypes I, II, VIII and XIV have been involved in causing ASF outbreaks in swine during the study period. With the exception of the 1989 outbreak, we found no concrete evidence of dissemination of ASFVs from Eastern Province to other parts of the country. Our analyses revealed a complex epidemiology of the disease with a possibility of sylvatic cycle involvement. Trade and/or movement of pigs and their products, both within and across international borders, appear to have been the major factor in ASFV dissemination. Since ASFVs with the potential to cause countrywide and possibly regional outbreaks, could emerge from "nonendemic regions", the current ASF control policy in Zambia requires a dramatic shift to ensure a more sustainable pig industry.

  11. Insights and efforts to control rabies in Zambia: Evaluation of determinants and barriers to dog vaccination in Nyimba district.

    Science.gov (United States)

    Mulipukwa, Carolyn Patricia; Mudenda, Boyd; Mbewe, Allan Rabson

    2017-10-01

    The current rabies control strategy in Zambia is based on dog vaccination, dog population control and dog movement restrictions. In Nyimba district of Zambia, dog vaccination coverage is low but the incidence of dog bites is high which places the community at risk of rabies infection. The renewed global interest eliminating rabies in developing countries has spurred interest to identify determinants and barriers of dog vaccination in an effort to reduce the overall disease burden. A mixed methods cross sectional design was used in the study. This consisted of three parts: Evaluation of medical records regarding dog bite injuries, implementation and analysis of a household survey and in-depth review of key informant interviews. Data was collected into a Microsoft Excel database and subsequently transferred to STATA for descriptive, inferential and thematic analysis. Dog vaccination coverage overall was 8.7% (57/655), with 3.4% (22/655) in urban areas, 1.8% (12/655) in peri-urban and 3.5 (23/655) in the rural regions. Financially stable households were more likely to have their dogs vaccinated. Only 10.3% (31/300) of the respondents had vaccinated their dogs and these had a reliable source of income as 6% (18/300) were peasant farmers, 2% (6/300) were dependants whose guardians were financially stable and 2.3% (7/300) were in steady employment. Important barriers to dog vaccination included cost, limited awareness of vaccination program and access. Current rabies control strategies in Nyimba district, Zambia, appear quite limited. Improvements in the regional dog vaccination program may provide benefits. Enhancement of educational efforts targeting behavioural factors may also prove useful. Finally, the cost of dog vaccination can be reduced with scaled up production of a local vaccine.

  12. Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia.

    Science.gov (United States)

    Walubita, Mulima; Sikateyo, Bornwell; Zulu, Joseph M

    2018-05-02

    Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Schroder Kate

    2010-06-01

    Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health

  15. The Public-Private Sector Wage Gap in Zambia in the 1990s: A Quantile Regression Approach

    DEFF Research Database (Denmark)

    Nielsen, Helena Skyt; Rosholm, Michael

    2001-01-01

    of economic transition, because items as privatization and deregulation were on the political agenda. The focus is placed on the public-private sector wage gap, and the results show that this gap was relatively favorable for the low-skilled and less favorable for the high-skilled. This picture was further......We investigate the determinants of wages in Zambia and based on the quantile regression approach, we analyze how their effects differ at different points in the wage distribution and over time. We use three cross-sections of Zambian household data from the early nineties, which was a period...

  16. The effect of lindane on non-target fauna in a maize agro-ecosystem in Zambia

    International Nuclear Information System (INIS)

    Deedat, Y.D.; Chanda, S.; Chivundu, A.M.; Kalembe, G.; Mecha, C.D.

    1997-01-01

    The effect of lindane on non-target fauna in a maize agro-ecosystem was studied in Zambia in 1992 and 1993. While lindane was effective against the stalk borers, a target pest, it also affected other non-target fauna. Ants, spiders and springtails were significantly reduced. However the effect was only transient and lasted for approximately two months. Lindane appeared to have no real effect on aerial non-target fauna or on soil inhabiting microorganisms. (author). 8 refs, 6 tabs

  17. Below and above-ground carbon distribution along a rainfall gradient. A case of the Zambezi teak forests, Zambia

    Science.gov (United States)

    Ngoma, Justine; Moors, Eddy; Kruijt, Bart; Speer, James H.; Vinya, Royd; Chidumayo, Emmanuel N.; Leemans, Rik

    2018-02-01

    Understanding carbon (C) stocks or biomass in forests is important to examine how forests mitigate climate change. To estimate biomass in stems, branches and roots takes intensive fieldwork to uproot, cut and weigh the mass of each component. Different models or equations are also required. Our research focussed on the dry tropical Zambezi teak forests and we studied their structure at three sites following a rainfall gradient in Zambia. We sampled 3558 trees at 42 plots covering a combined area of 15ha. Using data from destructive tree samples, we developed mixed-species biomass models to estimate above ground biomass for small (forests, thereby adversely affecting their mitigating role in climate change.

  18. Listening to the community: Using formative research to strengthen maternity waiting homes in Zambia.

    Science.gov (United States)

    Scott, Nancy A; Vian, Taryn; Kaiser, Jeanette L; Ngoma, Thandiwe; Mataka, Kaluba; Henry, Elizabeth G; Biemba, Godfrey; Nambao, Mary; Hamer, Davidson H

    2018-01-01

    The WHO recommends maternity waiting homes (MWH) as one intervention to improve maternal and newborn health. However, persistent structural, cultural and financial barriers in their design and implementation have resulted in mixed success in both their uptake and utilization. Guidance is needed on how to design a MWH intervention that is acceptable and sustainable. Using formative research and guided by a sustainability framework for health programs, we systematically collected data from key stakeholders and potential users in order to design a MWH intervention in Zambia that could overcome multi-dimensional barriers to accessing facility delivery, be acceptable to the community and be financially and operationally sustainable. We used a concurrent triangulation study design and mixed methods. We used free listing to gather input from a total of 167 randomly sampled women who were pregnant or had a child under the age of two (n = 59), men with a child under the age of two (n = 53), and community elders (n = 55) living in the catchment areas of four rural health facilities in Zambia. We conducted 17 focus group discussions (n = 135) among a purposive sample of pregnant women (n = 33), mothers-in-law (n = 32), traditional birth attendants or community maternal health promoters (n = 38), and men with a child under two (n = 32). We administered 38 semi-structured interviews with key informants who were identified by free list respondents as having a stake in the condition and use of MWHs. Lastly, we projected fixed and variable recurrent costs for operating a MWH. Respondents most frequently mentioned distance, roads, transport, and the quality of MWHs and health facilities as the major problems facing pregnant women in their communities. They also cited inadequate advanced planning for delivery and the lack of access to delivery supplies and baby clothes as other problems. Respondents identified the main problems of MWHs specifically as over-crowding, poor

  19. Prevalence and species distribution of caprine trypanosomosis in Sinazongwe and Kalomo districts of Zambia.

    Science.gov (United States)

    Nyimba, P H; Komba, E V G; Sugimoto, C; Namangala, B

    2015-06-15

    African animal trypanosomosis is one of the key livestock diseases hindering full exploitation of livestock production potential covering 37 countries across sub-Saharan Africa. Many studies have been carried out to investigate the prevalence of the disease in cattle and humans in many tropical African countries but very little attention has been directed towards generating the disease prevalence rates in goats. The current study was conducted between December 2013 and January 2014 to establish the prevalence of caprine trypanosomosis in Sinazongwe and Kalomo districts, southern Zambia. It involved 422 goats which were first examined by palpation for possible enlargement of superficial lymph nodes. Blood samples were then collected from the goats and subjected to laboratory diagnosis using the microscope and Loop Mediated Isothermal Amplification (LAMP). None of the examined goats displayed enlargement of superficial lymph nodes. On microscopy only one goat was found to be positive. The results of investigation using the LAMP method showed that 100 goats were infected with trypanosomes giving an overall prevalence rate of 23.7%. The prevalence of infection in Sinazongwe was 22.4% (n=183) while in Kalomo it was 24.7% (n=239); and the difference between the two districts was statistically significant at 95% CL (x(2)=4.4, df=1, pgoats, respectively. Mixed infections were detected among 33.0% of the positive samples. The high prevalence rate of trypanosomes detected in the study area confirms the earlier reports that trypanosomosis is re-emerging in the areas previously aerial sprayed by Government. The detection of trypanosomes in naturally infected goats outlines the important role goats play in the epidemiology of African animal trypanosomosis. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Siziya Seter

    2010-09-01

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

  1. The social and economic impact of epilepsy in Zambia: a cross-sectional study.

    Science.gov (United States)

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

    2007-01-01

    Among the 40 million people with epilepsy worldwide, 80% reside in low-income regions where human and technological resources for care are extremely limited. Qualitative and experiential reports indicate that people with epilepsy in Africa are also disadvantaged socially and economically, but few quantitative systematic data are available. We sought to assess the social and economic effect of living with epilepsy in sub-Saharan Africa. We did a cross-sectional study of people with epilepsy concurrently matched for age, sex, and site of care to individuals with a non-stigmatised chronic medical condition. Verbally administered questionnaires provided comparison data for demographic characteristics, education, employment status, housing and environment quality, food security, healthcare use, personal safety, and perceived stigma. People with epilepsy had higher mean perceived stigma scores (1.8 vs 0.4; pvs 9.4 years; pvs 9.1 years; pvs 9.6 years; p=0.42). Housing and environmental quality were poorer for people with epilepsy, who had little access to water, were unlikely to have electricity in their home (19%vs 51%; pvs 15%; p=0.0007). Personal safety for people with epilepsy was also more problematic; rape rates were 20% among women with epilepsy vs 3% in the control group (p=0.004). People with epilepsy in Zambia have substantially poorer social and economic status than do their peers with non-stigmatised chronic medical conditions. Suboptimum housing quality differentially exposes these individuals to the risk of burns and drowning during a seizure. Vulnerability to physical violence is extreme, especially for women with epilepsy.

  2. Identification of Risk Factors Associated with Transmission of Plague Disease in Eastern Zambia.

    Science.gov (United States)

    Nyirenda, Stanley S; Hang'ombe, Bernard M; Machang'u, Robert; Mwanza, Jackson; Kilonzo, Bukheti S

    2017-09-01

    Plague is a fatal, primarily rodent-flea-borne zoonotic disease caused by Yersinia pestis . The identification of risk factors of plague was investigated through questionnaire interview and conducting focus group discussion (FGD) in Sinda and Nyimba districts of eastern Zambia. A total of 104 questionnaires were administered to individual respondents and 20 groups consisting of 181 discussants, which comprised FGD team in this study. The study revealed that trapping, transportation, and preparation of rodents for food exposed the community to rodent and their fleas suggesting that plague may have occurred primarily by either flea bites or contact with infected wild rodents. The study also revealed that most people in communities consumed rodents as part of their regular diet; therefore, contact with small wild mammals was a common practice. The mode of transportation of freshly trapped rodents, in particular, carcasses risked human to flea bites. Questionnaire respondents (75%) and FGD discussants (55%) indicated that trappers preferred to carry rodent carcasses in small bags, whereas 55.8% and 20% respectively, reported hunters carrying carcasses in their pockets. Carrying of carcass skewers on trappers' shoulders was reported by 38.4% and 20% of individual respondents and FGD, respectively. All these activities were exposing humans to rodents and their fleas, the natural reservoirs and vectors of plague, respectively. This study also showed that there is a statistically significant (χ 2 = 4.6878, P < 0.05), between digging of rodents from their burrows and the presence of fleas on the hunter's bodies or clothes, which exposes humans to potentially flea bites in an enzootic cycle.

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

    Science.gov (United States)

    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. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Gastroenterology training in a resource-limited setting: Zambia, Southern Africa.

    Science.gov (United States)

    Asombang, Akwi W; Turner-Moss, Eleanor; Seetharam, Anil; Kelly, Paul

    2013-07-07

    To evaluate need for and efficacy of a structured gastroenterology didactic session in expanding awareness and understanding of digestive disorders. A four-day symposium was developed with didactic sessions (days 1, 2) and practical endoscopy (days 3, 4). Didactic sessions included case presentations highlighting pathophysiology and management. One nurse and four practicing gastroenterologists from the United Kingdom led lectures and supervised workshops with audience participation. Practical endoscopy focused on diagnostic and therapeutic procedures and their application to diagnosis and treatment of ailments of the gastrointestinal tract. Pre- and post-workshop questionnaires were distributed to participants during didactic sessions. A pre-workshop questionnaire gauged expectations and identified objectives to be met at the symposium. Post-workshop questionnaires were administered to assess efficacy of each session. Participants graded sessions from 1 (poor) to 5 (excellent) on quality of case presentations, knowledge, clarity and mode of presentation. We assessed if time allotted to each topic was sufficient, value of sessions, impact on practice and interest in future symposiums. There were 46 attendees on day 1: 41% undergraduates, 41% residents, 11% consultants and 4% unspecified. Day 2 (a Saturday) had 24 participants: 17% undergraduates, 71% residents, 9% consultants, 4% unspecified. Primary pre-workshop symposium expectation was to gain knowledge in: general gastroenterology (55.5%), practical endoscopy (13.8%), pediatric gastroenterology (5%), epidemiology of gastrointestinal disorders specific to Zambia (6%), and interaction with international speakers (6%). The post-symposium questionnaire was answered by 19 participants, of whom 95% felt specific aims were met; all would attend future conferences and recommend to others. The beneficial effect of a structured symposium in developing countries warrants further attention as a mechanism to improve disease

  5. Moving malaria in pregnancy programs from neglect to priority: experience from Malawi, Senegal, and Zambia

    Science.gov (United States)

    Roman, Elaine; Wallon, Michelle; Brieger, William; Dickerson, Aimee; Rawlins, Barbara; Agarwal, Koki

    2014-01-01

    Background: Pregnant women and infants are particularly vulnerable to malaria. National malaria in pregnancy (MIP) programs in Malawi, Senegal, and Zambia were reviewed to identify promising strategies that have helped these countries achieve relatively high coverage of MIP interventions as well as ongoing challenges that have inhibited further progress. Methods: We used a systematic case study methodology to assess health system strengths and challenges in the 3 countries, including desk reviews of available reports and literature and key informant interviews with national stakeholders. Data were collected between 2009 and 2011 and analyzed across 8 MIP health systems components: (1) integration of programs and services, (2) policy, (3) commodities, (4) quality assurance, (5) capacity building, (6) community involvement, (7) monitoring and evaluation, and (8) financing. Within each program area, we ranked degree of scale up across 4 stages and synthesized the findings in a MIP table of analysis to reveal common themes related to better practices, remaining bottlenecks, and opportunities to accelerate MIP coverage, strengthen MIP programs, and improve results. Findings: Each of the 3 countries has malaria policies in place that reflect current MIP guidance from the World Health Organization. The 3 countries successfully integrated MIP interventions into a platform of antenatal care services, but coordination at the national level was disjointed. All 3 countries recognized the importance of having a MIP focal person to ensure collaboration and planning at the national level, but only Malawi had appointed one. Commodity stockouts were frequent due to problems at all levels of the logistics system, from quantification to distribution. Lack of support for quality assurance and weak monitoring and evaluation mechanisms across all 3 countries affected optimal coverage. Conclusions: MIP programs should address all 8 interconnected MIP health systems areas holistically, in

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

    Directory of Open Access Journals (Sweden)

    Kasonde Joseph M

    2012-10-01

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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Kabemba E Mwape

    Full Text Available 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 (reinfected 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.

  9. Managing the vitamin A program portfolio: a case study of Zambia, 2013-2042.

    Science.gov (United States)

    Fiedler, John L; Lividini, Keith

    2014-03-01

    Micronutrient deficiencies continue to constitute a major burden of disease, particularly in Africa and South Asia. Programs to address micronutrient deficiencies have been increasing in number, type, and scale in recent years, creating an ever-growing need to understand their combined coverage levels, costs, and impacts so as to more effectively combat deficiencies, avoid putting individuals at risk for excess intakes, and ensure the efficient use of public health resources. To analyze combinations of the two current programs--sugar fortification and Child Health Week (CHW)--together with four prospective programs--vegetable oil fortification, wheat flour fortification, maize meal fortification, and biofortified vitamin A maize--to identify Zambia's optimal vitamin A portfolio. Combining program cost estimates and 30-year Zambian food demand projections, together with the Zambian 2005 Living Conditions Monitoring Survey, the annual costs, coverage, impact, and cost-effectiveness of 62 Zambian portfolios were modeled for the period from 2013 to 2042. Optimal portfolios are identified for each of five alternative criteria: average cost-effectiveness, incremental cost-effectiveness, coverage maximization, health impact maximization, and affordability. The most likely scenario is identified to be one that starts with the current portfolio and takes into account all five criteria. Starting with CHW and sugar fortification, it phases in vitamin A maize, oil, wheat flour, and maize meal (in that order) to eventually include all six individual interventions. Combining cost and Household Consumption and Expenditure Survey (HCES) data provides a powerful evidence-generating tool with which to understand how individual micronutrient programs interact and to quantify the tradeoffs involved in selecting alternative program portfolios.

  10. Plasmodium falciparum HRP2 ELISA for analysis of dried blood spot samples in rural Zambia.

    Science.gov (United States)

    Gibson, Lauren E; Markwalter, Christine F; Kimmel, Danielle W; Mudenda, Lwiindi; Mbambara, Saidon; Thuma, Philip E; Wright, David W

    2017-08-23

    Dried blood spots are commonly used for sample collection in clinical and non-clinical settings. This method is simple, and biomolecules in the samples remain stable for months at room temperature. In the field, blood samples for the study and diagnosis of malaria are often collected on dried blood spot cards, so development of a biomarker extraction and analysis method is needed. A simple extraction procedure for the malarial biomarker Plasmodium falciparum histidine-rich protein 2 (HRP2) from dried blood spots was optimized to achieve maximum extraction efficiency. This method was used to assess the stability of HRP2 in dried blood spots. Furthermore, 328 patient samples made available from rural Zambia were analysed for HRP2 using the developed method. These samples were collected at the initial administration of artemisinin-based combination therapy and at several points following treatment. An average extraction efficiency of 70% HRP2 with a low picomolar detection limit was achieved. In specific storage conditions HRP2 was found to be stable in dried blood spots for at least 6 months. Analysis of patient samples showed the method to have a sensitivity of 94% and a specificity of 89% when compared with microscopy, and trends in HRP2 clearance after treatment were observed. The dried blood spot ELISA for HRP2 was found to be sensitive, specific and accurate. The method was effectively used to assess biomarker clearance characteristics in patient samples, which prove it to be ideal for gaining further insight into the disease and epidemiological applications.

  11. Exploring a Third Space for Sustainable Educational Development—HIV/AIDS Prevention, Zambia

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    Ellen Carm

    2018-03-01

    Full Text Available This study was conducted in Zambia from 2002 to 2008, a country greatly affected by the HIV (Human Immunodeficiency Virus/AIDS (Acquired Immune Deficiency Syndrome epidemic. The global, national, as well as local discourses on spread and mitigation were clustered around scientific knowledge and the local context and cultural traditions. The education sector struggled with implementing the national HIV/AIDS education strategy but by a broader stakeholder involvement, and a close collaboration between the educational sector and tribal chiefs and their traditional internal structures, a localized approach emerged. The overall objective of the paper is to illustrate how a multi-voiced strategy can bring about sustainable change, illustrated by this study. The study used qualitative constructivist and grounded theoretical approaches, and applied the third generation of cultural and historical activity theory (CHAT as an analytical tool. Bernstein’s concept, symbolic control, contributes to a broader understanding of the underlying processes and outcomes of the study. The findings revealed that the strategically monitored multi-voiced participation of local stakeholders created a learning space where both scientific and indigenous knowledge were blended, and thereby creating solutions to preventive action meeting the local needs. The study exemplifies these processes by identifying contradictions between the various levels and activity systems involved, by listing some of their characteristics, manifestations and finally their negotiated solutions. These solutions, or the third space interventions, the outcome of the multi-voiced participation, is in the paper used to explore a theoretical framework for an ethical and decolonized development strategy; a precondition for sustained local development.

  12. Tuberculosis among older adults in Zambia: burden and characteristics among a neglected group.

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    Coffman, Jenna; Chanda-Kapata, Pascalina; Marais, Ben J; Kapata, Nathan; Zumla, Alimuddin; Negin, Joel

    2017-10-12

    The 2010 Global Burden of Disease estimates show that 57% of all TB deaths globally occurred among adults older than 50 years of age. Few studies document the TB burden among older adults in Southern Africa. We focused on adults older than 55 years to assess the relative TB burden and associated demographic factors. A cross sectional nationally representative TB prevalence survey conducted of Zambian residents aged 15 years and above from 66 clusters across all the 10 provinces of Zambia. Evaluation included testing for TB as well as an in-depth questionnaire. We compared survey data for those aged 55 and older to those aged 15-54 years. Survey results were also compared with 2013 routinely collected programmatic notification data to generate future hypotheses regarding active and passive case finding. Among older adults with TB, 30/ 54 (55.6%) were male, 3/27 (11.1%) were HIV infected and 35/54 (64.8%) lived in rural areas. TB prevalence was higher in those aged ≥55 (0.7%) than in the 15-54 age group (0.5%). Males had higher rates of TB across both age groups with 0.7% (15-54) and 1.0% (≥55) compared with females 0.4% (15-54) and 0.6% (≥55). In rural areas, the prevalence of TB was significantly higher among older than younger adults (0.7% vs 0.3%), while the HIV infection rate was among TB patients was lower (11.1% vs 30.8%). The prevalence survey detected TB in 54/7484 (0.7%) of older adults compared to 3619/723,000 (0.5%) reported in 2013 programmatic data. High TB rates among older adults in TB endemic areas justify consideration of active TB case finding and prevention strategies.

  13. Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia.

    Science.gov (United States)

    Heemelaar, Steffie; Habets, Nicole; Makukula, Ziche; van Roosmalen, Jos; van den Akker, Thomas

    2015-03-01

    To assess coverage of repeat HIV testing among women who delivered in a Zambian hospital. HIV testing of pregnant women and repeat testing every 3 months during pregnancy and breastfeeding is the recommended policy in areas of high HIV prevalence. A prospective implementation study in a second-level hospital in rural Zambia. Included were all pregnant women who delivered in hospital during May and June 2012. Data regarding antenatal visits and HIV testing were collected by two investigators using a standardised form. Of 401 women who delivered in hospital, sufficient antenatal data could be retrieved for 322 (80.3%) women. Of these 322 women, 301 (93.5%) had attended antenatal care (ANC) at least once. At the time of discharge after delivery in hospital, 171 (53.1%) had an unclear HIV status because their negative test result was more than 3 months ago or of an unknown date, or because they had not been tested at all during pregnancy or delivery. An updated HIV status was present for 151 (46.9%) women: 25 (7.8%) were HIV positive and 126 (39.1%) had tested negative within the last 3 months. In this last group, 79 (24.5%) had been tested twice or more during pregnancy. During the study period, none of the women was tested during admission for delivery. Despite high ANC coverage, opportunities for repeat HIV testing were missed in almost half of all women who delivered in this hospital in a high-prevalence HIV setting. © 2014 John Wiley & Sons Ltd.

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

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    Felix Masiye

    Full Text Available 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.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.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.Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of

  15. Global tobacco control and economic norms: an analysis of normative commitments in Kenya, Malawi and Zambia.

    Science.gov (United States)

    Lencucha, Raphael; Reddy, Srikanth K; Labonte, Ronald; Drope, Jeffrey; Magati, Peter; Goma, Fastone; Zulu, Richard; Makoka, Donald

    2018-04-01

    Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments implement and strengthen tobacco control measures. Given that economic arguments in favor of tobacco production remain a prominent barrier to tobacco control efforts, there is a continued need to examine how economic sectors frame and mobilize their policy commitments to tobacco production. This study explores the proposition that divergence of international norms fosters policy divergence within governments. This study was conducted in three African countries: Kenya, Malawi, and Zambia. These countries represent a continuum of tobacco control policy, whereby Kenya is one of the most advanced countries in Africa in this respect, whereas Malawi is one of the few countries that is not a party to the FCTC and has implemented few measures. We conducted 55 key informant interviews (Zambia = 23; Kenya = 17; Malawi = 15). Data analysis involved deductive coding of interview transcripts and notes to identify reference to international norms (i.e. commitments, agreements, institutions), coupled with an inductive analysis that sought to interpret the meaning participants ascribe to these norms. Our analysis suggests that commitments to tobacco control have yet to penetrate non-health sectors, who perceive tobacco control as largely in conflict with international economic norms. The reasons for this perceived conflict seems to include: (1) an entrenched and narrow conceptualization of economic development norms, (2) the power of economic interests to shape policy discourses, and (3) a structural divide between sectors in

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

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    J. Muma

    2012-06-01

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

  17. Negotiation of Legitimacy of Witch-Finders in Lusaka

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    Mildnerová Kateřina

    2017-12-01

    Full Text Available The article aims at legal and illegal activities of Lusaka´s traditional healers within the system of traditional medicine which is primarily anchored in the constitution of traditional healers´ associations. It primarily focuses on witch-finders, whose social status, professional position and authority is constantly negotiated within the formal and informal sector of traditional medicine. Since the late 1990s, the quest for services of traditional healers specialised in witch-finding has gained popularity, particularly amongst the impoverished Lusaka compound-dwellers. Due to the increasing public violence against those denoted as witches, the activities of witch-finders were officially banned by the Witchcraft Act in 1995 and this profession is not officially recognised by the Constitution of Traditional Health Practitioners Association of Zambia (THAPAZ. In spite of the prohibition, there remain many witch-finders in Lusaka who practise witch-finding secretly, in order not to commit an offence they do not openly denounce the name of an alleged witch. Their authority and credibility is threatened by many “official” as well as “unofficial” competitors in the city and it must be constantly reaffirmed and negotiated by introducing innovations. The ability to keep clients and to gain a good reputation thus depends on the originality of their diagnostic and therapeutic procedures. At the same time witch-finders must counter diverse obstacles and uncertainties resulting from their illegal status within the sector of traditional medicine. The author analyses tactics that Lusaka´s witch-finders have developed and employed to negotiate their social status, credibility and authority visà-vis the competition from the “official” traditional healers.

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

    NARCIS (Netherlands)

    Mbagaya, Catherine Vuhya

    2010-01-01

    Child maltreatment is a global phenomenon affecting a significant number of the world’s children. The purpose of this study was to compare the prevalence of self-reported childhood maltreatment among university students in Kenya, Zambia, and The Netherlands. We also sought to compare the

  19. Costing commodity and human resource needs for integrated community case management in thie differing community health strategies of Ethiopia, Kenya and Zambia.

    Science.gov (United States)

    Nefdt, Rory; Ribaira, Eric; Diallo, Khassoum

    2014-10-01

    To ensure correct and appropriate funding is available, there is a need to estimate resource needs for improved planning and implementation of integrated Community Case Management (iCCM). To compare and estimate costs for commodity and human resource needs for iCCM, based on treatment coverage rates, bottlenecks and national targets in Ethiopia, Kenya and Zambia from 2014 to 2016. Resource needs were estimated using Ministry of Health (MoH) targets fronm 2014 to 2016 for implementation of case management of pneumonia, diarrhea and malaria through iCCM based on epidemiological, demographic, economic, intervention coverage and other health system parameters. Bottleneck analysis adjusted cost estimates against system barriers. Ethiopia, Kenya and Zambia were chosen to compare differences in iCCM costs in different programmatic implementation landscapes. Coverage treatment rates through iCCM are lowest in Ethiopia, followed by Kenya and Zambia, but Ethiopia had the greatest increases between 2009 and 2012. Deployment of health extension workers (HEWs) in Ethiopia is more advanced compared to Kenya and Zambia, which have fewer equivalent cadres (called commu- nity health workers (CHWs)) covering a smaller proportion of the population. Between 2014 and 2016, the propor- tion of treatments through iCCM compared to health centres are set to increase from 30% to 81% in Ethiopia, 1% to 18% in Kenya and 3% to 22% in Zambia. The total estimated cost of iCCM for these three years are USD 75,531,376 for Ethiopia, USD 19,839,780 for Kenya and USD 33,667,742 for Zambia. Projected per capita expen- diture for 2016 is USD 0.28 for Ethiopia, USD 0.20 in Kenya and USD 0.98 in Zambia. Commodity costs for pneumonia and diarrhea were a small fraction of the total iCCM budget for all three countries (less than 3%), while around 80% of the costs related to human resources. Analysis of coverage, demography and epidemiology data improves estimates of fimding requirements for iCCM. Bottleneck

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    K. Chishimba

    2016-01-01

    Full Text Available 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.

  2. Prevalence of mental illness among inmates at Mukobeko maximum security prison in Zambia: A cross-sectional study

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    Mweene T Mweene

    2016-01-01

    Full Text Available Objectives: The objective of this study is to determine the prevalence and sociodemographic correlates for mental illness among inmates at Mukobeko Maximum Security Prison, Zambia. Materials and Methods: A cross sectional study was conducted to assess psychiatric disturbance using a Self-Reported Questionnaire (SRQ20. A cut off point of 7/8 was used. The Chi-square test and Fishers′ exact test were used to determine associations at the 5% significance level, and magnitude of association was estimated using the odds ratio and its 95% confidence interval. Results: Of the 394 inmates in prison, 29.2% had a current mental illness. Gender status was significantly associated with mental illness. Male participants were 35% (odds ratio = 0.65, 95% confidence interval [0.51, 0.82] less likely to have mental illness compared to female participants. Conclusions: The prevalence of mental illness is high in Mukobeko Maximum Security Prison in Zambia. Gender-specific interventions should be designed to reduce the level of mental illness in this prison.

  3. A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

    Science.gov (United States)

    Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

    2015-07-01

    The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

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

    Science.gov (United States)

    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.

  5. Impacts of Public-Private Partnership on Local Livelihoods and Natural Resource Dynamics: Perceptions from Eastern Zambia

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    Muleba Nshimbi

    2014-06-01

    Full Text Available This study evaluated the long-term implications of a Public-Private Partnership (PPP on livelihoods and natural resource (NR dynamics under a market-oriented approach to conservation. Drawing examples from the Luangwa Valley in eastern Zambia, the study sought to answer questions on two closely interrelated aspects. These included the contribution of PPP to sustainable livelihoods in and around Protected Areas (PAs and its impacts on natural resources in Game Management Areas (GMAs. Quantitative data were collected from PPP participating and non-PPP households using standardized structured interviews, while qualitative data were obtained from three chiefdoms using semi-structured interviews and focus group discussions. Taking the case of Community Markets for Conservation (COMACO in eastern Zambia, results of this study showed that PPP contributed to sustainable livelihoods and overall natural resources management through varied ways. These include promotion of conservation farming, agroforestry, poacher transformation (individuals who have given up poaching due to PPP interventions and provision of markets for the produce of participating households. Further, impacts of PPP on soil fertility, crop, and honey yields were statistically significant (p ˂ 0.05. A combination of increased crop productivity and household incomes has seen a 40-fold increase in poacher transformation. The results of this study suggest that PPPs, if well-structured, have the potential to address both livelihoods and enterprise needs with an ultimate benefit of promoting both sustainable livelihoods and natural resources management around PAs in tropical Africa.

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

    Science.gov (United States)

    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.

  7. Liver fibrosis in treatment-naïve HIV-infected and HIV/HBV co-infected patients: Zambia and Switzerland compared.

    Science.gov (United States)

    Wandeler, Gilles; Mulenga, Lloyd; Vinikoor, Michael J; Kovari, Helen; Battegay, Manuel; Calmy, Alexandra; Cavassini, Matthias; Bernasconi, Enos; Schmid, Patrick; Bolton-Moore, Carolyn; Sinkala, Edford; Chi, Benjamin H; Egger, Matthias; Rauch, Andri

    2016-10-01

    To examine the association between hepatitis B virus (HBV) infection and liver fibrosis in HIV-infected patients in Zambia and Switzerland. HIV-infected adults starting antiretroviral therapy in two clinics in Zambia and Switzerland were included. Liver fibrosis was evaluated using the aspartate aminotransferase-to-platelet-ratio index (APRI), with a ratio >1.5 defining significant fibrosis and a ratio >2.0 indicating cirrhosis. The association between hepatitis B surface antigen (HBsAg) positivity, HBV replication, and liver fibrosis was examined using logistic regression. In Zambia, 96 (13.0%) of 739 patients were HBsAg-positive compared to 93 (4.5%) of 2058 in Switzerland. HBsAg-positive patients were more likely to have significant liver fibrosis than HBsAg-negative ones: the adjusted odds ratio (aOR) was 3.25 (95% confidence interval (CI) 1.44-7.33) in Zambia and 2.50 (95% CI 1.19-5.25) in Switzerland. Patients with a high HBV viral load (≥20000 IU/ml) were more likely to have significant liver fibrosis compared to HBsAg-negative patients or patients with an undetectable viral load: aOR 3.85 (95% CI 1.29-11.44) in Zambia and 4.20 (95% CI 1.64-10.76) in Switzerland. In both settings, male sex was a strong risk factor for significant liver fibrosis. Despite the differences in HBV natural history between Sub-Saharan Africa and Europe, the degree of liver fibrosis and the association with important risk factors were similar. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  8. Can HIV/AIDS be fought by targeting youths in Zambia? Analysis of the Knowledge, Attitudes and Sexual Behaviour among youths aged 15 – 24 years.

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    Bupe Bwalya Bwalya

    2015-12-01

    Full Text Available Background: Although people of any age are susceptible to HIV, youths aged 15 – 24 face disproportionate risk of contracting it because of challenges that they face with regard to correct HIV and AIDS related knowledge, attitudes and practices. This study was aimed at determining whether HIV and AIDS can be fought by targeting interventions at youths aged 15 – 24 years by assessing their current knowledge, attitudes and sexual behaviours in Zambia.  Methods: The study utilised secondary data from a self-weighting nationally representative sample of the 2009 Zambia Sexual Behaviour Survey. Results: Generally correct comprehensive knowledge is very low among youths (43 percent. This is in spite having good command of general and full general knowledge and the ABCs of HIV and AIDS prevention. Attitudes towards PLHIV, Condom use and HIV counselling and testing were negative. About one third (58 percent of youths in Zambia have a history of early sexual debut (sex before age 15 with more females (64 percent than males (51 percent having hard sex. Male youths were more likely to have used a condom with most recent sexual partner as compared to females (AOR=0.265, 95%CI: 0.160, 0.438; p<0.001. Youths in rural areas had reduced odds of using a condom during their first sexual intercourse compared with those in urban areas (AOR=0.530, 95%CI: 0.387, 0.726; p<0.001. Conclusions: Therefore, it can be seen lack of comprehensive correct knowledge, gender disparities, poor educational levels, youth’s age and place of residence are some of the contributing factors that may hinder the fight against HIV/AIDS among youths in Zambia.Key words: Youths; HIV/AIDS; Knowledge; Attitudes; Behaviour, Zambia

  9. Tuberculosis caseload in children with severe acute malnutrition related with high hospital based mortality in Lusaka, Zambia.

    Science.gov (United States)

    Munthali, Tendai; Chabala, Chishala; Chama, Elson; Mugode, Raider; Kapata, Nathan; Musonda, Patrick; Michelo, Charles

    2017-06-12

    Tuberculosis and severe acute malnutrition (SAM) in children pose a major treatment and care challenge in high HIV burden countries in Africa. We investigated the prevalence of Tuberculosis notifications among hospitalised under-five children with severe acute malnutrition. A retrospective review of medical records for all children aged 0-59 months admitted to the University Teaching Hospital from 2009 to 2013 was performed. Descriptive statistics were employed to estimate TB caseload. Logistic regression was used to identify predictors of the TB caseload. A total of (n = 9540) under-five children with SAM were admitted over the period reviewed. The median age was 16 months (IQR 11-24) and the proportion diagnosed with TB was 1.58% (95% CI 1.3, 1.8) representing 151 cases. Of these, only 37 (25%) were bacteriologically confirmed cases. The HIV seroprevalence of children with SAM and TB was 46.5%. Children with SAM and TB were 40% more likely to die than children with SAM and without TB. Tuberculosis contributes to mortality among children with SAM in high TB and HIV prevalence settings. The under detection of cases and association of TB with HIV infection in malnutrition opens up opportunities to innovate integrative case finding approaches beyond just HIV counselling and testing within existing mother and child health service areas to include TB screening and prevention interventions, as these are critical primary care elements.

  10. Water system hardware and management rehabilitation: Qualitative evidence from Ghana, Kenya, and Zambia.

    Science.gov (United States)

    Klug, Tori; Shields, Katherine F; Cronk, Ryan; Kelly, Emma; Behnke, Nikki; Lee, Kristen; Bartram, Jamie

    2017-05-01

    Sufficient, safe, continuously available drinking water is important for human health and development, yet one in three handpumps in sub-Saharan Africa are non-functional at any given time. Community management, coupled with access to external technical expertise and spare parts, is a widely promoted model for rural water supply management. However, there is limited evidence describing how community management can address common hardware and management failures of rural water systems in sub-Saharan Africa. We identified hardware and management rehabilitation pathways using qualitative data from 267 interviews and 57 focus group discussions in Ghana, Kenya, and Zambia. Study participants were water committee members, community members, and local leaders in 18 communities (six in each study country) with water systems managed by a water committee and supported by World Vision (WV), an international non-governmental organization (NGO). Government, WV or private sector employees engaged in supporting the water systems were also interviewed. Inductive analysis was used to allow for pathways to emerge from the data, based on the perspectives and experiences of study participants. Four hardware rehabilitation pathways were identified, based on the types of support used in rehabilitation. Types of support were differentiated as community or external. External support includes financial and/or technical support from government or WV employees. Community actor understanding of who to contact when a hardware breakdown occurs and easy access to technical experts were consistent reasons for rapid rehabilitation for all hardware rehabilitation pathways. Three management rehabilitation pathways were identified. All require the involvement of community leaders and were best carried out when the action was participatory. The rehabilitation pathways show how available resources can be leveraged to restore hardware breakdowns and management failures for rural water systems in sub

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

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    Theodore J.D. Knight-Jones

    2016-07-01

    Full Text Available 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

  12. Use of Mutation Breeding Technique in Improving Finger Millet in Northern Zambia

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    Msikita, R.N.

    2002-01-01

    Many breeders have observed that induced mutation increases genetic variability, and the expose to mutagenic agents increases mutation frequency. Studies have indicated the effect in height reduction, increased yield components,disease resistance, in crop like rice and wheat. A study was conducted in finger millet in thr Northern part of Zambia (Region III), a high rainfall area, aiming at improving finger length, number of fingers till ring capacity in order to increase the yield. the seed of Nyika variety, popular to farmers due to its medium maturity, palm shaped fingers (six fingers on average), and light brown grain. Three quantities of seed were irradiated at 15Kr, 20Kr and 30Kr doses. A dose of 15Kr of gamma rays irradiation continued to create good genetic change in the exposed material. These observations clearly suggest that 15Kr dose of gamma rays is the optimum one to expose/irradiate finger millet to create desired genetic changes. The results of 2000/2001 were not significantly different. However, FMM 165 had better yields (3193 Kg) than FMM 175 in Misamfu, while FMM 175 yielded better (3272 Kg) in Chinsali. During 2001/2002 both FMMs performed well in the national finger number of 10 per head. There were also highly significant differences among finger lengths.FMM 165 had finger length of 10.3 cm. Concerning grain yield FMM 165 and FMM 175 had 3802 and 3864 Kg/ha, respectively, which were above the overall mean 3864 Kg/ha. Grain yield correlated positively with finger number with an r-value of 0.19 and finger length r-value of 0.22 although it was not significant at 1% or 5%. Meanwhile in the advance trial there were significant differences among genotypes in finger number. Both FMMs had 9 fingers above the overall mean of 8.8. In the finger length there were highly significant differences. FMM 175 had a length of 11.5 cm while FMM 165 had 10.4 cm. There were highly significant differences among the genotypes in yield. FMM 165 (4636 Kg) and FMM 175

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

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    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

  14. Characterisation of the wildlife reservoir community for human and animal trypanosomiasis in the Luangwa Valley, Zambia.

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    Neil E Anderson

    2011-06-01

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

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

    Science.gov (United States)

    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.

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

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    Amadi Beatrice

    2010-09-01

    Full Text Available Abstract 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

  17. Issues in the Learning Context of Undergraduate Physiotherapy Programme at a Premier Medical School in Zambia

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    Christian C Ezeala

    2018-01-01

    Full Text Available Background: Students’ perceptions of their learning environments influence their approaches to learning and the learning outcomes, and reflect a programme’s effectiveness. In Africa, literature on the learning environments of medical and health sciences education is scanty, and the issues impinging on effective education are not well documented. The objective of this study was to determine learners’ perceptions of the issues in the learning environment of undergraduate physiotherapy education at the University of Zambia.Methods: Undergraduate physiotherapy students in years 2 to 5 were stratified according to level of study and randomly sampled. They were provided written information about the study, and consenting students were allowed to complete the DREEM questionnaire unassisted. Completed questionnaires were rated using a recommended guideline and their responses analysed quantitatively. Global, subscale, and item mean scores were calculated, and Cronbach’s alpha was determined as a measure of data reliability and internal consistency. The study was approved by ethics committees of two universities.Results: Ninety-three students participated in the study. The response rate was 88.4 %. All classes rated the learning environment as ‘more positive than negative,’ with a mean global score of 123.2/200 (61.6 %. Scores within subscales (55.7–70.4 % were comparable across the classes. Nine items scored below 2.0/4.0 indicating dissatisfaction. These included inadequate social support, teacher authoritarianism, and factual overload. Cronbach’s alpha for global scores was 0.896, and between 0.616 and 0.820 for subscale scores.Conclusion: Though total DREEM scores showed overall positive perception of the learning environment by the students, item analysis showed students’ dissatisfaction with several aspects. This analysis of undergraduate students’ perceptions of the Physiotherapy learning environment provided insight into the

  18. Mental distress in the general population in Zambia: Impact of HIV and social factors

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    Chipimo Peter J

    2009-08-01

    Full Text Available Abstract Background Population level data on mental health from Africa are limited, but available data indicate mental problems to represent a substantial public health problem. The negative impact of HIV on mental health suggests that this could particularly be the case in high prevalence populations. We examined the prevalence of mental distress, distribution patterns and the ways HIV might influence mental health among men and women in a general population. Methods The relationship between HIV infection and mental distress was explored using a sample of 4466 participants in a population-based HIV survey conducted in selected rural and urban communities in Zambia in 2003. The Self-reporting questionnaire-10 (SRQ-10 was used to assess global mental distress. Weights were assigned to the SRQ-10 responses based on DSM IV criteria for depression and a cut off point set at 7/20 for probable cases of mental distress. A structural equation modeling (SEM was established to assess the structural relationship between HIV infection and mental distress in the model, with maximum likelihood ratio as the method of estimation. Results The HIV prevalence was 13.6% vs. 18% in the rural and urban populations, respectively. The prevalence of mental distress was substantially higher among women than men and among groups with low educational attainment vs. high. The results of the SEM showed a close fit with the data. The final model revealed that self-rated health and self perceived HIV risk and worry of being HIV infected were important mediators between underlying factors, HIV infection and mental distress. The effect of HIV infection on mental distress was both direct and indirect, but was particularly strong through the indirect effects of health ratings and self perceived risk and worry of HIV infection. Conclusion These findings suggest a strong effect of HIV infection on mental distress. In this population where few knew their HIV status, this effect was

  19. Examining the association between livestock ownership typologies and child nutrition in the Luangwa Valley, Zambia.

    Science.gov (United States)

    Dumas, Sarah E; Kassa, Lea; Young, Sera L; Travis, Alexander J

    2018-01-01

    To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife "buffer zones" of Zambia's Luangwa Valley using a novel livestock typology approach. We conducted a cross-sectional study of 838 children aged 6-36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock. We used multilevel mixed-effects linear and logistic regression to examine the association between livestock typologies and four nutrition-related outcomes of interest. Results were compared with analyses using more common binary and count measures of livestock ownership. No measure of livestock ownership was significantly associated with children's odds of animal-source food consumption, child height-for-age z-score, or stunting odds. Livestock ownership Type 2 (having a small number of poultry) was surprisingly associated with decreased child dietary diversity (β = -0.477; p<0.01) relative to owning no livestock. Similarly, in comparison models, chicken ownership was negatively associated with dietary diversity (β = -0.320; p<0.01), but increasing numbers of chickens were positively associated with dietary diversity (β = 0.022; p<0.01). Notably, neither child dietary diversity nor animal-source food consumption was significantly associated with height, perhaps due to unusually high prevalences of morbidities. Our novel typologies methodology allowed for an efficient and a more in-depth examination of the differential impact of livestock ownership patterns compared to typical binary or count measures of livestock ownership. We found that these patterns were not positively associated with child nutrition outcomes in this context. Development and conservation programs focusing on livestock must carefully consider the complex, context-specific relationship between livestock

  20. Examining the association between livestock ownership typologies and child nutrition in the Luangwa Valley, Zambia.

    Directory of Open Access Journals (Sweden)

    Sarah E Dumas

    Full Text Available To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife "buffer zones" of Zambia's Luangwa Valley using a novel livestock typology approach.We conducted a cross-sectional study of 838 children aged 6-36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock. We used multilevel mixed-effects linear and logistic regression to examine the association between livestock typologies and four nutrition-related outcomes of interest. Results were compared with analyses using more common binary and count measures of livestock ownership.No measure of livestock ownership was significantly associated with children's odds of animal-source food consumption, child height-for-age z-score, or stunting odds. Livestock ownership Type 2 (having a small number of poultry was surprisingly associated with decreased child dietary diversity (β = -0.477; p<0.01 relative to owning no livestock. Similarly, in comparison models, chicken ownership was negatively associated with dietary diversity (β = -0.320; p<0.01, but increasing numbers of chickens were positively associated with dietary diversity (β = 0.022; p<0.01. Notably, neither child dietary diversity nor animal-source food consumption was significantly associated with height, perhaps due to unusually high prevalences of morbidities.Our novel typologies methodology allowed for an efficient and a more in-depth examination of the differential impact of livestock ownership patterns compared to typical binary or count measures of livestock ownership. We found that these patterns were not positively associated with child nutrition outcomes in this context. Development and conservation programs focusing on livestock must carefully consider the complex, context-specific relationship between

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

    Science.gov (United States)

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

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    Cohen Judith A

    2011-09-01

    Full Text Available Abstract 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

  3. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

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    Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

    2012-01-01

    Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

  4. From favours to entitlements: community voice and action and health service quality in Zambia.

    Science.gov (United States)

    Schaaf, Marta; Topp, Stephanie M; Ngulube, Moses

    2017-07-01

    Social accountability is increasingly invoked as a way of improving health services. This article presents a theory-driven qualitative study of the context, mechanisms and outcomes of a social accountability program, Citizen Voice and Action (CVA), implemented by World Vision (WV) in Zambia. Primary data were collected between November 2013 and January 2014. It included in-depth interviews and focus group discussions with program stakeholders. Secondary data were used iteratively-to inform the process for primary data collection, to guide primary data analysis and to contextualize findings from the primary data. CVA positively impacted the state, society, state-society relations and development coordination at the local level. Specifically, sustained improvements in some aspects of health system responsiveness, empowered citizens, the improved provision of public goods (health services) and increased consensus on development issues appeared to flow from CVA. The central challenge described by interviewees and FGD participants was the inability of CVA to address problems that required central level input. The mechanisms that generated these outcomes included productive state-society communication, enhanced trust, and state-society co-production of priorities and the provision of services. These mechanisms were activated in the context of existing structures for state-society interaction, willing political leaders, buy-in by traditional leaders, and WV's strong reputation and access to resources. Prospective observational research in multiple contexts would shed more light on the context, mechanisms and outcomes of CVA programs. In addition to findings that are intuitive and well supported in the literature we identified new areas that are promising areas for future research. These include (1) the context of organizational reputation by the organization(s) spearheading social accountability efforts; (2) the potential relationship between social accountability efforts

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

    Science.gov (United States)

    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

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

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    Mwanza Jason

    2011-04-01

    Full Text Available Abstract Background Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. Methods The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached. Results All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. Conclusions Six gaps which could

  7. Medication side effects among people with epilepsy taking phenobarbital in Zambia.

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    Elafros, Melissa A; Bui, Esther; Birbeck, Gretchen L

    2014-11-01

    Phenobarbital remains one of the most widely used antiepileptic drugs worldwide, yet there are limited data regarding side effects associated with its use in routine clinical care settings in low-income countries. Available data suggests that phenobarbital is as effective as other first-line drugs for treating tonic-clonic seizures, but side effect reports differ widely between high and low-income settings. A better understanding of phenobarbital side effect profile and severity in low-income settings is warranted given its role in efforts to decrease the epilepsy treatment gap. We used the Liverpool adverse events profile (LEAP) to assess side effects in consecutive patients with epilepsy on phenobarbital seeking care in rural Zambia. Data regarding age, gender, medication dose, and medication adherence were also collected. T-tests and Spearman's correlation coefficient were used to assess predictors of LEAP score and medication adherence. Thirty-five patients receiving a mean dose of 2.1mg/kg/day (SD: 2.78 mg/kg/day) of phenobarbital were assessed. All participants reported at least one side effect in the previous four weeks with a median of 6 symptoms (IQR: 4-8) and a mean side effects score of 28/76 (SD: 5.38). Over half reported sleepiness and dizziness. Memory problems and depression were also common (both 46%). Total LAEP score was not associated with age (p=0.88), gender (p=0.17), or phenobarbital dose (p=0.13). Medication adherence was not associated with side effects total score (p=0.56). Rural Zambian adults taking phenobarbital at doses recommended by the World Health Organization report a significant number of side effects. The most common side effects reported were similar to those reported in high-income countries. The significant burden of phenobarbital-associated side effects in this African cohort is in contrast to data from non-randomized clinical trials in China that reported phenobarbital to be well-tolerated with few side effects. Additional

  8. Uranium cycle and tectono-metamorphic evolution of the Lufilian Pan-African orogenic belt (Zambia)

    International Nuclear Information System (INIS)

    Eglinger, Aurelien

    2013-01-01

    Uranium is an incompatible and lithophile element, and thus more concentrated in silicate melt produced by the partial melting of the mantle related to continental crust formation. Uranium can be used as a geochemical tracer to discuss the generation and the evolution of continental crust. This thesis, focused on the Pan-African Lufilian belt in Zambia, combines structural geology, metamorphic petrology and thermos-barometry, fluid inclusions, geochemistry and geochronology in order to characterize the uranium cycle for this crustal segment. Silici-clastic and evaporitic sediments have been deposited within an intra-continental rift during the dislocation of the Rodinia super-continent during the early Neo-proterozoic. U-Pb ages on detrital zircon grains in these units indicate a dominant Paleo-proterozoic provenance. The same zircon grains show sub-chondritic εHf (between 0 and -15) and yield Hf model ages between ∼2.9 and 2.5 Ga. These data suggest that the continental crust was generated before the end of the Archean (< 2.5 Ga) associated with uranium extraction from the mantle. This old crust has been reworked by deformation and metamorphism during the Proterozoic. Uranium has been re-mobilized and reconcentrated during several orogenic cycles until the Pan-African orogeny. During this Pan-African cycle, U-Pb and REY (REE and Yttrium) signatures of uranium oxides indicate a first mineralizing event at ca. 650 Ma during the continental rifting. This event is related to late diagenesis hydrothermal processes at the basement/cover interface with the circulation of basinal brines linked to evaporites of the Roan. The second stage, dated at 530 Ma, is connected to metamorphic highly saline fluid circulations, synchronous to the metamorphic peak of the Lufilian orogeny (P=9±3 kbar; T=610±30 deg. C). These fluids are derived from the Roan evaporite dissolution. Some late uranium re-mobilizations are described during exhumation of metamorphic rocks and their

  9. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Directory of Open Access Journals (Sweden)

    Jane N Mutanga

    Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

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

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-05-25

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

  11. Health care needs assessment among adolescents in correctional institutions in Zambia: an ethical analysis.

    Science.gov (United States)

    Kumwenda, Maureen; Nzala, Selestine; Zulu, Joseph M

    2017-08-22

    While health care needs assessments have been conducted among juveniles or adolescents by researchers in developed countries, assessments using an ethics framework particularly in developing countries are lacking. We analysed the health care needs among adolescents at the Nakambala Correctional Institution in Zambia, using the Beauchamp and Childress ethics framework. The ethics approach facilitated analysis of moral injustices or dilemmas triggered by health care needs at the individual (adolescent) level. The research team utilized 35 in-depth interviews with juveniles, 6 key informant interviews and 2 focus group discussions to collect data. We analysed the data using thematic analysis. The use of three sources of data facilitated triangulation of data. Common health problems included HIV/AIDS, STIs, flu, diarrhoea, rashes, and malaria. Although there are some health promotion strategies at the Nakambala Approved School, the respondents classified the health care system as inadequate. The unfavourable social context which included clouded rooms and lack of adolescent health friendly services unfairly exposed adolescents to several health risks and behaviours thus undermining the ethics principle of social justice. In addition, the limited prioritisation of adolescent centres by the stakeholders and erratic funding also worsened injustices by weakening the health care system. Whereas the inadequate medical and drug supplies, shortage of health workers in the nearby health facilities and weak referral systems excluded the juveniles from enjoying maximum health benefits thus undermining adolescents' wellbeing or beneficence. Inadequate medical and drug supplies as well as non-availability of adolescent friendly health services at the nearest health facility did not only affect social justice and beneficence ethics principles but also threatened juveniles' privacy, liberty and confidentiality as well as autonomy with regard to health service utilisation

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

    Science.gov (United States)

    Nygren, David; Stoyanov, Cristina; Lewold, Clemens; Månsson, Fredrik; Miller, John; Kamanga, Aniset; Shiff, Clive J

    2014-06-13

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

  13. In-home HIV testing and nevirapine dosing by traditional birth attendants in rural Zambia: a feasibility study.

    Science.gov (United States)

    Brennan, Alana T; Thea, Donald M; Semrau, Katherine; Goggin, Caitlin; Scott, Nancy; Pilingana, Portipher; Botha, Belinda; Mazimba, Arthur; Hamomba, Leoda; Seidenberg, Phil

    2014-01-01

    Access to lifesaving prevention of mother-to-child transmission (PMTCT) services is problematic in rural Zambia. The simplest intervention used in Zambia has been 2-dose nevirapine (NVP) administration in the peripartum period, a regimen of 1 NVP tablet to the mother at the onset of labor and 1 dose in the form of syrup to the newborn within 4 to 72 hours after birth. This 2-dose regimen has been shown to reduce MTCT by nearly 50%. We set out to demonstrate that in-home HIV testing and NVP dosing by traditional birth attendants (TBAs) is feasible and acceptable by women in rural Zambia. This was a pilot program using TBAs to perform rapid saliva-based HIV testing and administer single-dose NVP in tablet form to the mother at the onset of labor and syrup to the infant after birth. A total of 280 pregnant women were consented and enrolled into the program, of whom 124 (44.3%) gave birth at home with the assistance of a trained TBA. Of those, 16 (12.9%) were known to be HIV positive, and 101 of the remaining 108 (93.5%) accepted a rapid HIV test. All these women tested HIV negative. In the subset of 16 mothers who were HIV positive, 13 (81.3%) took single-dose NVP administered by a TBA between 1 and 24 hours prior to birth and 100% of exposed newborns (16 of 16) received NVP syrup within 72 hours after birth, 80% of whom were dosed in the first 24 hours of life. With the substantial shortage of human resources in public health care throughout sub-Saharan Africa, it is extremely valuable to utilize lay health care workers to help extended services beyond the level of the facility. Given the high uptake of PMTCT services we believe that TBAs with proper training and support can successfully provide country-approved PMTCT. © 2013 by the American College of Nurse-Midwives.

  14. Determinants of Healthcare Utilisation and Out-of-Pocket Payments in the Context of Free Public Primary Healthcare in Zambia

    Directory of Open Access Journals (Sweden)

    Felix Masiye

    2016-12-01

    Full Text Available Background Access to appropriate and affordable healthcare is needed to achieve better health outcomes in Africa. However, access to healthcare remains low, especially among the poor. In Zambia, poor access exists despite the policy by the government to remove user fees in all primary healthcare facilities in the public sector. The paper has two main objectives: (i to examine the factors associated with healthcare choices among sick people, and (ii to assess the determinants of the magnitude of out-of-pocket (OOP payments related to a visit to a health provider. Methods This paper employs a multilevel multinomial logistic regression to model the determinants of an individual’s choice of healthcare options following an illness. Further, the study analyses the drivers of the magnitude of OOP expenditure related to a visit to a health provider using a two-part generalised linear model. The analysis is based on a nationally representative healthcare utilisation and expenditure survey that was conducted in 2014. Results Household per capita consumption expenditure is significantly associated with increased odds of seeking formal care (odds ratio [OR] = 1.12, P = .000. Living in a household in which the head has a higher level of education is associated with increased odds of seeking formal healthcare (OR = 1.54, P = .000 and (OR = 1.55, P = .01, for secondary and tertiary education, respectively. Rural residence is associated with reduced odds of seeking formal care (OR = 0.706, P = .002. The magnitude of OOP expenditure during a visit is significantly dependent on household economic wellbeing, distance from a health facility, among other factors. A 10% increase in per capita consumption expenditure was associated with a 0.2% increase in OOP health expenditure while every kilometre travelled was associated with a K0.51 increase in OOP health expenditure. Conclusion Despite the removal of user fees on public primary healthcare in Zambia, access to

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

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    Hadley Mary B

    2011-05-01

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

  16. Significant decline in lymphatic filariasis associated with nationwide scale-up of insecticide-treated nets in Zambia

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    M. Nsakashalo-Senkwe

    2017-11-01

    Full Text Available Lymphatic filariasis (LF is a mosquito-borne disease, broadly endemic in Zambia, and is targeted for elimination by mass drug administration (MDA of albendazole and diethylcarbamazine citrate (DEC to at-risk populations. Anopheline mosquitoes are primary vectors of LF in Africa, and it is possible that the significant scale-up of malaria vector control over the past decade may have also impacted LF transmission, and contributed to a decrease in prevalence in Zambia. We therefore aimed to examine the putative association between decreasing LF prevalence and increasing coverage of insecticide-treated mosquito nets (ITNs for malaria vector control, by comparing LF mapping data collected between 2003–2005 and 2009–2011 to LF sentinel site prevalence data collected between 2012 and 2014, before any anti-LF MDA was started. The coverage of ITNs for malaria was quantified and compared for each site in relation to the dynamics of LF. We found a significant decrease in LF prevalence from the years 2003–2005 (11.5% CI95 6.6; 16.4 to 2012–2014 (0.6% CI95 0.03; 1.1; at the same time, there was a significant scale-up of ITNs across the country from 0.2% (CI95 0.0; 0.3 to 76.1% (CI95 71.4; 80.7 respectively. The creation and comparison of two linear models demonstrated that the geographical and temporal variation in ITN coverage was a better predictor of LF prevalence than year alone. Whilst a causal relationship between LF prevalence and ITN coverage cannot be proved, we propose that the scale-up of ITNs has helped to control Anopheles mosquito populations, which have in turn impacted on LF transmission significantly before the scale-up of MDA. This putative synergy with vector control has helped to put Zambia on track to meet national and global goals of LF elimination by 2020.

  17. From idealism to realism : a social history of the Dutch in Zambia 1965-2013

    NARCIS (Netherlands)

    Hoek, A.L.

    2014-01-01

    After almost fifty years of Dutch-Zambian relationships, the Royal Netherlands Embassy in Lusaka closed its doors in 2013. Earlier, the development cooperation with this African country was ended. A lively Dutch community of entrepreneurs and (former) development workers stay behind. How do they and

  18. 'Between a rock and a hard place': applied anthropology and AIDS research on a commercial farm in Zambia.

    Science.gov (United States)

    Bond, V

    1997-01-01

    Fieldwork on a commercial farm in southern Zambia, which was aimed at designing an HIV prevention program for farm workers, gradually exposed the nature of sexual liaisons between young girls, coming to work on the farm from the surrounding villages, and older migrant men workers. Before completing fieldwork, the anthropologist voiced her concern about the implications of these liaisons for the spread of STDs and HIV with the local rural community, farm management and farm workers. The immediate outcome of her intercessions was the decision by management to sack under-age workers. Although some members of the local community, including local research assistants, and some managers and workers welcomed this decision, others were angered by it. Caught between interest groups and conflicting guidelines, the anthropologist, it is argued, was in a no-win situation, 'between a rock and a hard place'. The paper proposes that the application of anthropological ethics in AIDS research needs some re-evaluation.

  19. Democracy and consensus decision-making among the Bemba-speaking people of Zambia: An African theological perspective

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    Simon Muwowo

    2016-08-01

    Full Text Available This article contributes to a critical assessment of the concept of democracy and consensus decision-making of the Bemba matrilineal governance system as a basis for a democratic model of engagement in African politics from an African theological perspective. It is of the opinion that assessing the concept of democracy by consensus decision-making of the Bemba provides a dialogue between the African traditional governance systems as a viable form of political governance ideal for multi-ethnic countries such as Zambia. This is a pinnacle of the 21st century debate which elaborates the important task of African Christian Theology in the rehabilitation, or renovation process of politics of identity for an authentic governance system with authentic African flavour for African governance systems.

  20. Occurrence of Cryptosporidium and Giardia in domestic animals in peri-urban communities of Kafue district, Zambia

    DEFF Research Database (Denmark)

    Siwila, J.; Phiri, I. G. K.; Enemark, Heidi L.

    2013-01-01

    /148), goats (5.9%; 1/17), dogs (25.0%; 5/20) and ducks (6.7%; 2/30). Diarrhoea was not associated with either infection. Age was also not associated with either infection except in dogs where Giardia infection was only detected in animals aged less than six months (p=0.009). It is concluded from this study......Cryptosporidium spp. and Giardia duodenalis are important parasites infecting a wide range of domestic animals worldwide. The aim of the present study was to determine the occurrence of Cryptosporidium spp. and Giardia parasites in different domestic animals living in close contact with humans...... within rural/semiurban communities in Kafue district in Zambia. A single faecal sample per animal was collected from pigs, goats, dogs, ducks, chickens and pigeons and analysed by Merifluor Cryptosporidium/Giardia immunofluorescence antibody assay for the simultaneous detection of these parasites...

  1. Occurrence of Cryptosporidium and Giardia in domestic animals in peri-urban communities of Kafue district, Zambia

    DEFF Research Database (Denmark)

    Siwila, J.; Phiri, I. G. K.; Enemark, Heidi L.

    2013-01-01

    Cryptosporidium spp. and Giardia duodenalis are important parasites infecting a wide range of domestic animals worldwide. The aim of the present study was to determine the occurrence of Cryptosporidium spp. and Giardia parasites in different domestic animals living in close contact with humans...... within rural/semiurban communities in Kafue district in Zambia. A single faecal sample per animal was collected from pigs, goats, dogs, ducks, chickens and pigeons and analysed by Merifluor Cryptosporidium/Giardia immunofluorescence antibody assay for the simultaneous detection of these parasites....... The faecal consistency was noted and scored as non-diarrhoeic or diarrhoeic. A total of 236 samples were collected. Cryptosporidium spp. oocysts were detected in pigs (11.5%, 17/148), goats (5.9%; 1/17), ducks (10.0%; 3/30) and chickens (14.3%; 2/14) while Giardia cysts were detected in pigs (8.1%; 12...

  2. A Longitudinal Study of the Impact of Corporate Social Responsibility on Firm Performance in SMEs in Zambia

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    Progress Choongo

    2017-07-01

    Full Text Available The aim of this study is to investigate the impact of corporate social responsibility on firm performance using a longitudinal design in small and medium-sized enterprises (SMEs. The reported study was conducted in a Sub-Saharan African developing country, Zambia. Data were collected from 153 entrepreneurs in two surveys and changes in CSR and firm performance measures were analysed over a 12-month period using SmartPLS structural equation modelling. The findings show that the relationship between CSR and financial performance is significant. Further, the association between CSR and the two measures of firm performance (corporate reputation and employee commitment was only partially significant over time. We discuss the relevance of these results for entrepreneurs, researchers and policy makers in understanding the outcomes of sustainability practices in SMEs in developing countries, especially in Sub-Saharan Africa.

  3. Distance Education Examination Management in a Lowly Resourced North-Eastern Region of Zambia: A Phenomenological Approach

    Directory of Open Access Journals (Sweden)

    Francis Simui

    2017-09-01

    Full Text Available This paper focuses on the management of distance education examination in a lowly resourced North-Eastern region of Zambia. The study applies Hermeneutic Phenomenology approach to generate and make sense of the data. It is the lived experiences of 2 invigilators and 66 students purposively selected that the study draws its insights from. Meaning within the generated data is elicited using the Chaos theory. Emerging from this study is a multiplicity of ingredients needed to effectively manage distance education examinations in a chaotic environment. The need for visionary leadership with a shared understanding of institutional purpose, the need for motivated staff with creativity and innovation and the need for effective communication are all vital ingredients needed to manage examinations. In conclusion, we now know that amidst chaos lay opportunities for innovation and creativity in terms of new strategies for managing distance education. To this extent, chaos should be treasured and not censured.

  4. The Anatomy of Medium-Scale Farm Growth in Zambia: What Are the Implications for the Future of Smallholder Agriculture?

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    Nicholas Sitko

    2015-09-01

    Full Text Available Lost in the debates about the appropriate scale of production to promote agricultural growth in Africa is the rapid expansion of medium-scale farmers. Using Zambia as a case study, this article explores the causes and consequences of this middle-tier transformation on the future of small-scale agriculture. Combining political economic analysis with household survey data, this article examines the relationships between the growth in medium-scale farmers and changing conditions of land access, inequality, and alienation for small-scale farmers. Growth of medium-scale farmers is associated with high land inequality and rapid land alienation in high potential agricultural areas. This growth is shown to be partially driven by wage earner investment in land acquisition and is leading to substantial under-utilization of agricultural land. These processes are both limiting agricultural growth potential and foreclosing future options for an inclusive agricultural development strategy.

  5. List randomization for soliciting experience of intimate partner violence: Application to the evaluation of Zambia's unconditional child grant program.

    Science.gov (United States)

    Peterman, Amber; Palermo, Tia M; Handa, Sudhanshu; Seidenfeld, David

    2018-03-01

    Social scientists have increasingly invested in understanding how to improve data quality and measurement of sensitive topics in household surveys. We utilize the technique of list randomization to collect measures of physical intimate partner violence in an experimental impact evaluation of the Government of Zambia's Child Grant Program. The Child Grant Program is an unconditional cash transfer, which targeted female caregivers of children under the age of 5 in rural areas to receive the equivalent of US $24 as a bimonthly stipend. The implementation results show that the list randomization methodology functioned as planned, with approximately 15% of the sample identifying 12-month prevalence of physical intimate partner violence. According to this measure, after 4 years, the program had no measurable effect on partner violence. List randomization is a promising approach to incorporate sensitive measures into multitopic evaluations; however, more research is needed to improve upon methodology for application to measurement of violence. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Local perceptions, cultural beliefs and practices that shape umbilical cord care: a qualitative study in Southern Province, Zambia.

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    Julie M Herlihy

    Full Text Available 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.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.Umbilical cord care practices and beliefs were diverse. Dry cord care, as recommended by the World Health Organization at the time of the study, is not widely practiced in Southern Province, Zambia. A cultural health systems model that depicts all stakeholders is proposed as an approach for policy makers and program implementers to work synergistically with existing cultural beliefs and practices in order to maximize

  7. Utilization of focused antenatal care in Zambia: examining individual- and community-level factors using a multilevel analysis.

    Science.gov (United States)

    Chama-Chiliba, Chitalu M; Koch, Steven F

    2015-02-01

    We examine the individual- and community-level factors associated with the utilization of antenatal care, following the adoption of the focused antenatal care (FANC) approach in Zambia. Using the 2007 Zambia Demographic and Health Survey, linked with administrative and health facility census data, we specify two multilevel logistic models to assess the factors associated with (1) the inadequate use of antenatal care (ANC) (defined as three or fewer visits) and (2) the non-use of ANC in the first trimester of pregnancy. Although all women in the selected sample had at least one ANC visit, 40% did not have the minimum number required (four), whereas more than 80% of the initial check-ups did not occur in the first trimester. At the individual level, the woman's employment status, quality of ANC received and the husband's educational attainment are negatively associated, while parity, the household childcare burden and wealth are positively associated with inadequate utilization of ANC. Both individual- and community-level characteristics influence inadequate use and non-use of ANC in the first trimester; however, community-level factors are relatively stronger in rural areas. The results suggest that improving the content of care during ANC visits may foster adequate use of ANC and encourage early initiation of ANC visits. Furthermore, health promotion programmes need to further encourage male involvement in pregnant women's decision to seek ANC to encourage adequate use of services. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  8. The risk of pulmonary tuberculosis in underground copper miners in Zambia exposed to respirable silica: a cross-sectional study

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    Kingsley Ngosa

    2016-08-01

    Full Text Available Abstract Background Pulmonary tuberculosis (PTB among underground miners exposed to silica remains a global problem. Although well described in gold and coal mining, risk in other mining entities are not as well documented. This study aims to determine dust-related dose response risk for PTB among underground miners exposed to silica dust in Zambia's copper mines. Methods A cross sectional study of in-service miners (n = 357 was conducted at Occupational Health and Safety Institute (OHSI, Zambia. A systematic review of medical data over a 5-year period from assessments conducted by doctors at OHSI and statutory silica exposure data (n = 16678 from the Mine Safety Department (MSD were analysed. Lifetime cumulative exposure metrics were calculated. Multivariate logistic regression analysis was used to determine the association between PTB and lifetime exposure to silica, while adjusting for various confounders. Results The median respirable silica dust level was 0.3 mg/m3 (range 0.1–1.3. The overall prevalence of PTB was 9.5 % (n = 34. High cumulative respirable silica dust category showed a statistically significant association with PTB (OR = 6.4 (95 % CI 1. 8–23 and a significant trend of increasing disease prevalence with increasing cumulative respirable silica dust categories was observed (ptrend < 0.01. Smoking showed a statistically significant association with PTB with OR = 4.3 (95 % CI 1.9–9.9. Conclusions Our results demonstrate the association of increased risk for certified active TB with cumulative respirable dust in a dose related manner among this sample of copper miners. There is need to intensify dust control measures and incorporate anti-smoking interventions into TB prevention and control programmes in the mines.

  9. Monitoring the endangered population of the antelope Kobus leche smithemani (Artiodactyla: Bovidae, in the Bangweulu ecosystem, Zambia

    Directory of Open Access Journals (Sweden)

    Victor M. Siamudaala

    2012-12-01

    Full Text Available 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 250 000-15 000 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 15 000 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

  10. Energy SMEs in sub-Saharan Africa: Outcomes, barriers and prospects in Ghana, Senegal, Tanzania and Zambia

    Energy Technology Data Exchange (ETDEWEB)

    Haselip, J. A.; Desgain, D.; Mackenzie, G. A.

    2013-05-15

    This report presents the findings of research into the main outcomes of government and donor-backed efforts to promote small and medium-sized energy businesses (energy SMEs) in sub-Saharan Africa. The research follows an outcome analysis methodology. The focus is on four countries: Ghana, Senegal, Tanzania and Zambia and primarily on UNEP's AREED programme (2002-2012). This research focuses on the 'contributing factors' - a deliberately broader term that incorporates the internal 'success factors' - for energy SMEs, about which much has already been written. Indeed, the research findings presented in this report reaffirm most of what has been concluded in previous studies. These studies identified the lack of access to affordable finance as being the predominant, persistent, barrier to establishing and scaling up a commercially viable energy SME sector, emphasising the lack of strong policy support from governments, poor business skills capacity and the high cost of many RETs as related cause-and-effect barriers. While these issues continue to characterise, to a greater or lesser extent, the energy SMEs sectors in the countries studied for this research, it is more relevant to revisit the main assumption behind AREED and other donor-backed programmes designed to promote energy SMEs. The assumption is that the solution to the aforementioned barriers would be overcome by a 'demonstration effect' whereby successful energy SMEs, supported by donor-backed programmes, influence the commercial financial sector to invest in energy SMEs, thus triggering a virtuous circle of growth and profitability. Experiences drawn from a decade of AREED support across four of the project countries reveal both the presence (Ghana, Senegal) and absence, or weak presence, of this demonstration effect (Tanzania, Zambia). This is a central question, and one which was not the focus of previous research, presumably because the answer was not fully apparent prior to 2006 when the last

  11. The Socio-economic Impact of Stroke on Households in Livingstone District, Zambia: A Cross-sectional Study.

    Science.gov (United States)

    Mapulanga, M; Nzala, S; Mweemba, C

    2014-07-01

    Stroke is the leading cause of adult disability. Stroke, which affects mostly the productive age group, leaves about 65% of its victims disabled, leads to increased loss of manpower both at individual and national levels. Little is known about the socio-economic burden of the disease in terms of its impacts on the individual, family and community both directly and indirectly in Sub-Sahara Africa region and Zambia at large. The study was aimed at assessing the socio-economic impact of stroke households in Livingstone district, Zambia. A total of 50 households were randomly selected from the registers of Livingstone General Hospital. Self-administered questionnaires and focus group discussions were used to collect quantitative and qualitative data respectively. The data was analyzed using Statistical Package for Social Sciences version 16 (IBM Corporation) and content analysis. Chi-square test was used to make associations between variables. The social impacts on the victim were depression, difficult to get along with, resentfulness, apathy, needy, separation, divorce, general marital problems, neglect on the part of the victim and fear. The economic impacts were loss of employment, reduced business activity and loss of business on the part of the victim. Economic activities such as food provision, payment of school fees, accommodation were affected as a result of stroke and this led to financial insecurities in households with lost incomes in form of salaries and businesses. The activities forgone by stroke households were food provision, housing and education. The study also revealed an association between period of stroke and relationship changes (P < 0.001). Gender and family relationship changes were highly associated (P < 0.00), as more females than males experienced relationship changes. The results of the present study show that stroke has considerable socio-economic impact on households in Livingstone district, which can deter the victims' development as

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

    Science.gov (United States)

    Gillet, Rhonda M; Tobias, Phillip V

    2002-01-01

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

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

    Science.gov (United States)

    Sedlmayr, Richard; Fink, Günther; Miller, John M; Earle, Duncan; Steketee, Richard W

    2013-03-18

    Relatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP). The study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia's cotton sector, in December 2010. 39,963 (49%) were randomly selected