The role of traditional leaders in ending early child marriages for education: experiences from Kalonga Gawa Undi chiefdom of Katete district, Zambia.

ArticleThis paper explores the role of traditional leaders on ending early child marriages for education as panacea to the implementation of the ‘National Strategy on Ending Child Marriages in Zambia 2016 – 2021’. The Chewa Chiefdom of Zambia was used as a reference point on the role traditional leaders can play in implementing government policies. The article focused on how traditional leaders through their chiefdom structures discouraged early child marriages and supported girls and boys to continue with their education. A case study research design which was qualitative in nature was employed. Data was collected using face-to-face interviews, and observation of various practices among the Chewa people of Zambia. The interviews and observations covered historical information on traditions and cultural practices; including measures the chiefdom had put in place to ensure that all young girls and boys in the chiefdom have access to education. The article revealed that, in a quest to end early marriages and promote child education, Kalonga Gawa Undi had put in place several measures. These included; awareness campaigns, collaborating with support groups, and revising some traditional practices such as the times when Chinamwali and Nyau initiation ceremonies were expected to take place so that they do not disturb school going children. Respondents reported that, the measures positively reduced cases of early marriages and increased the number of children accessing education. Despite this improvement, lack of financial support remains a major constraint to ending early marriages and promoting child education in the Chewa kingdom. The article recommended among other things that, chiefdoms should have partnerships with stakeholders such as NGOs and government in supporting children’s education and discouraging early child marriages. In addition, more publicity was needed through various media; leaflets, posters, billboards in Chewa language and community dramaSel

An observational postmarketing safety registry of patients in the UK, Germany, and Switzerland, who have been prescribed Sativex® (THC:CBD, nabiximols) oromucosal spray

Tilden Etges, Kari Karolia, Thomas Grint, Adam Taylor, Heather Lauder, Brian Daka, Stephen Wright GW Pharmaceuticals, Cambridge, UK Abstract: The global exposure of Sativex® (Δ9-tetrahydrocannabinol [THC]:cannabidiol [CBD], nabiximols) is estimated to be above 45,000 patient-years since it was given marketing approval for treating treatment-resistant spasticity in multiple sclerosis (MS). An observational registry to collect safety data from patients receiving THC:CBD was set up following its approval in the UK, Germany, and Switzerland, with the aim of determining its long-term safety in clinical practice. Twice a year, the Registry was opened to prescribing physicians to voluntarily report data on patients’ use of THC:CBD, clinically significant adverse events (AEs), and special interest events. The Registry contains data from 941 patients with 2,213.98 patient-years of exposure. Within this cohort, 60% were reported as continuing treatment, while 83% were reported as benefiting from the treatment. Thirty-two percent of patients stopped treatment, with approximately one third citing lack of effectiveness and one quarter citing AEs. Psychiatric AEs of clinical significance were reported in 6% of the patients, 6% reported falls requiring medical attention, and suicidality was reported in 2%. Driving ability was reported to have worsened in 2% of patients, but improved in 7%. AEs were more common during the first month of treatment. The most common treatment-related AEs included dizziness (2.3%) and fatigue (1.7%). There were no signals to indicate abuse, diversion, or dependence. The long-term risk profile from the Registry is consistent with the known (labeled) safety profile of THC:CBD, and therefore supports it being a well-tolerated and beneficial medication for the treatment of MS spasticity. No evidence of new long-term safety concerns has emerged. Keywords: cannabidiol, tetrahydrocannabinol, non-interventional, multiple sclerosis, spasticity, risk management plan&nbsp

Seroprevalence of Bovine Brucellosis in Selected Districts of Zambia

Brucellosis is an infectious zoonosis that has huge economic and public health implications globally. The disease is prevalent in humans, livestock and wildlife in Sub-Saharan Africa. A cross-sectional study was conducted between 6 May 2017 and 31 July 2020 during which 1712 sera from 175 cattle herds in five districts from Southern, Western and Eastern Provinces of Zambia were collected and screened against brucellosis. The Rose Bengal Test (RBT) and competitive Enzyme-linked Immuno Assay (c-ELISA) were used in serial testing for the detection of antibodies against Brucella species. A total of 127 animals from 37 herds tested positive, giving overall individual animal and herd-level seroprevalences of 7.53% (95% CI: 6.28–8.78%) and 21.14% (95% CI: 15.0–27.2%), respectively. Namwala district had the highest herd seroprevalence (33.9%, 95% CI: 21.6–46.1%), while Lundazi did not record any seropositivity. Comparably, Southern Province had the highest individual animal (8.97%, 95% CI: 7–11%) and herd-level (28.5%, 95% CI: 20.3–36.7%) seroprevalences, although this was not statistically significant. Within Southern Province, higher seropositivity was observed in Namwala district (OR: 8.55; CI: 2.66–27.44), among female animals (OR: 2.48; CI: 1.38–4.46) and in those aged 11 years and above (OR: 2.67; CI: 1.34–5.34) as well as in gravid cows (OR: 4.34; CI: 2.08–8.92). Seropositivity was also observed among some animals with hygromas (OR: 6.5; CI: 0.45–94.08) and those with a history of abortion (OR: 1.13; CI: 0.18–7.28) although the findings were not statistically significant. Brucella seroprevalence among traditional cattle in Zambia remains high. Control programs against bovine brucellosis must be introduced to reduce its impact on human health and animal production

Life's Essential 8 and Life's Simple 7 in relation to coronary atherosclerosis : results from the population-based scapis project

Objective: To examine the associations between the American Heart Association scores ("Life's Essential 8" [LE8] and "Life's Simple 7" [LS7]) and 2 subclinical coronary atherosclerosis indicators: coronary computed tomographic angiography (CCTA)-stenosis and coronary artery calcium (CAC). Patients and Methods: We included a population-based sample, aged 50 to 64 years, recruited between 2013 and 2018 from the Swedish Cardiopulmonary Bioimage Study (n=24,819, 50.3% women). CCTA-stenosis was graded as no stenosis, stenosis (1%-49%) or severe stenosis (≥50%), whereas CAC was graded as 0, 1 to 99, 100 to 399, or ≥400 Agatston units. Multinomial logistic regression and receiver operating characteristic (ROC) curves were used to study the associations between cardiovascular health scores and subclinical coronary atherosclerosis. Results: Odds ratios (ORs) for CCTA-stenosis and severe CCTA-stenosis between the lowest (<50 points) vs the highest (≥80 points) LE8 group were 4.18 (95% CI, 3.56 to 4.91) and 11.17 (95% CI, 8.36 to 14.93), respectively. For corresponding CAC results, ORs were 3.36 (95% CI, 2.84 to 3.98), 7.72 (95% CI, 6.03 to 9.89), and 14.94 (95% CI, 10.47 to 21.31) for CAC scores of 1 to 99, 100 to 399, and ≥400, respectively. Area under ROC curves for predicting any stenosis were 0.642 (95% CI, 0.635 to 0.649) and 0.631 (95% CI, 0.624 to 0.638, P<.001) for LE8 and LS7, respectively. Conclusion: Our data indicate that LE8 showed a strong, graded, and inverse association with CCTA-stenosis and CAC score. The capacity to predict CCTA-stenosis was comparable between LE8 and LS7, although LE8 had slightly higher prediction capacity of any stenosis. This study provides novel evidence that the LE8 score may be a useful tool for monitoring cardiovascular health

Life's Essential 8 and carotid artery plaques : the Swedish cardiopulmonary bioimage study

Background: To quantify cardiovascular health (CVH), the American Heart Association (AHA) recently launched an updated construct of the "Life's Simple 7" (LS7) score, the "Life's Essential 8" (LE8) score. This study aims to analyse the association between both CVH scores and carotid artery plaques and to compare the predictive capacity of such scores for carotid plaques. Methods: Randomly recruited participants aged 50-64 years from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analysed. According to the AHA definitions, two CVH scores were calculated: i) the LE8 score (0, worst CVH; 100, best CVH) and two different versions of the LS7 score [(0-7) and (0-14), 0 indicating the worst CVH]. Ultrasound-diagnosed carotid plaques were classified as no plaque, unilateral, and bilateral plaques. Associations were studied by adjusted multinomial logistic regression models and adjusted (marginal) prevalences, while comparison between LE8 and LS7 scores was performed through receiver operating characteristic (ROC) curves. Results: After exclusions, 28,870 participants remained for analysis (50.3% women). The odds for bilateral carotid plaques were almost five times higher in the lowest LE8 (<50 points) group [OR: 4.93, (95% CI: 4.19-5.79); adjusted prevalence 40.5%, (95% CI: 37.9-43.2)] compared to the highest LE8 (& GE;80 points) group [adjusted prevalence 17.2%, (95% CI: 16.2-18.1)]. Also, the odds for unilateral carotid plaques were more than two times higher in the lowest LE8 group [OR: 2.14, (95% CI: 1.82-2.51); adjusted prevalence 31.5%, (95% CI: 28.9-34.2)] compared to the highest LE8 group [adjusted prevalence 29.4%, (95% CI: 28.3-30.5)]. The areas under ROC curves were similar between LE8 and LS7 (0-14) scores: for bilateral carotid plaques, 0.622 (95% CI: 0.614-0.630) vs. 0.621 (95% CI: 0.613-0.628), P = 0.578, respectively; and for any carotid plaque, 0.602 (95% CI: 0.596-0.609) vs. 0.600 (95% CI: 0.593-0.607), P = 0.194, respectively. Conclusion: The new LE8 score showed inverse and dose-response associations with carotid plaques, particularly bilateral plaques. The LE8 did not outperform the conventional LS7 score, which showed similar ability to predict carotid plaques, especially when scored as 0-14 points. We conclude that both the LE8 and LS7 may be useful in clinical practice for monitoring CVH status in the adult population