Self-medication among medical students at the Copperbelt University, Zambia: A cross-sectional study.

BACKGROUND: Self-medication is a common practice and cause for concern globally. There is a paucity of information regarding students' self‑medication in Zambia. Therefore, this study aimed at determining the self‑medication practices among the medical students at Copperbelt University. METHODS: A descriptive cross-sectional study was conducted among 334 students. Data was collected using a semi-structured questionnaire, entered in excel, cleaned, and exported to SPSS version 21 for statistical analysis. Univariate analysis using Chi-Square or Fishers Exact test was performed. Independent predictors of self-medication practices were determined using logistic regression. Adjusted Odds ratios (AOR) and their 95% confidence intervals are reported. RESULTS: A total of 334 medical students, with slightly more females (50.3%, n = 168), participated in the study. Of these 61.1% (n = 204) reported self-medicating. Reasons for self-medicating were the presence of long queues at health facilities and lack of time to visit the hospital. Only the year of study was independently associated with self-medicating with those in their 4th year of study being more likely to self-medicate [AOR:3.43, 95% CI: 1.52-7.73]. CONCLUSION: Students should be educated on the consequences of self-medication practices especially the rational use of antibiotics

Literature review – assessing groundwater recharge estimates under conventional tillage and conservation agriculture

The purpose of this review is to identify studies from across the world that evaluated the impact of conservation agriculture (CA) on potential groundwater recharge in comparison to conventional tillage (CT), taking into consideration the techniques that have been used in measuring the soil or groundwater fluxes. In this review, we quantify case studies in which direct and indirect methods have been used to calculate a direct or proxy value of groundwater recharge under the different agricultural treatments of CA and CT. This review revealed that CA systems have the potential to improve infiltration or deep drainage and therefore potential recharge to the groundwater as evidenced by 54% of the case studies, including all studies (n=5) in the SADC region, however significant proportion of studies, mainly from the Americas and Europe, also reported either reduced potential recharge or no significant difference under different treatments. A majority of these studies used infiltration rates as a proxy. This review demonstrates that consideration on the methods used in estimating infiltration rates is important when evaluating the impact of agricultural systems on groundwater recharge in different climate zones. Issues such as the infiltration measurement technique used, timing of the measurements within the season, rainfall intensity, and soil type, are some of the parameters that must be carefully stated in studies to allow the infiltration rates within and across treatments to be comparable. The review revealed a gap in the literature for studies that used direct methods of recharge estimation to evaluate the impact of CA vs CT treatments. Unsaturated zone techniques provide only estimates of potential recharge based on drainage rates below the root zone and in some cases, drainage is diverted laterally and does not reach the water table. Use of direct methods that allow collection of data from the saturated zone such as groundwater level fluctuations in monitoring boreholes and environmental tracers such as Cl and stable isotopes of water, would be greatly beneficial to further our understanding of groundwater recharge processes beneath CA and CT systems. However, direct observations are more challenging to acquire and do have limitations

Genetic determinants of the pharmacokinetic variability of rifampin in Malawian adults with pulmonary tuberculosis

D.J.S. was supported by a Wellcome Trust Clinical PhD Fellowship (086757/Z/08/A to D.J.S.). A.D.M. was supported by a National Institute for Health Research Integrated Clinical Academic Training Fellowship and a Wellcome Trust Clinical PhD Fellowship (105/392/B/14/Z). The Malawi Liverpool Wellcome Trust Clinical Research Programme is supported by a strategic award from the Wellcome Trust.Variable exposure to antituberculosis (TB) drugs, partially driven by genetic factors, may be associated with poor clinical outcomes. Previous studies have suggested an influence of the SLCO1B1 locus on the plasma area under the concentration-time curve (AUC) of rifampin. We evaluated the contribution of single nucleotide polymorphisms (SNPs) in SLCO1B1 and other candidate genes (AADAC and CES-1) to interindividual pharmacokinetic variability in Malawi. A total of 174 adults with pulmonary TB underwent sampling of plasma rifampin concentrations at 2 and 6 h postdose. Data from a prior cohort of 47 intensively sampled, similar patients from the same setting were available to support population pharmacokinetic model development in NONMEM v7.2, using a two-stage strategy to improve information during the absorption phase. In contrast to recent studies in South Africa and Uganda, SNPs in SLCO1B1 did not explain variability in AUC0-∞ of rifampin. No pharmacokinetic associations were identified with AADAC or CES-1 SNPs, which were rare in the Malawian population. Pharmacogenetic determinants of rifampin exposure may vary between African populations. SLCO1B1 and other novel candidate genes, as well as nongenetic sources of interindividual variability, should be further explored in geographically diverse, adequately powered cohorts.Publisher PDFPeer reviewe

Determinants of self-reported correct knowledge about tuberculosis transmission among men and women in Malawi: evidence from a nationwide household survey

Abstract: Background: Correct knowledge about transmission of tuberculosis (TB) can influence better health-seeking behaviors, and in turn, it can aid TB prevention in society. Therefore, this study aimed to examine the prevalence and predictors of self-reported correct knowledge about TB transmission among adults in Malawi. Methods: We conducted a secondary analysis of the data obtained from the Malawi Demographic and Health Survey, 2015/16 (MDHS 2015/16). Questions regarding self-reported TB transmission were computed to evaluate the correct knowledge about TB transmission. The factors associated with the correct knowledge about Tb were assessed using univariate and multivariable logistic regression. Results: Overall, the prevalence of correct knowledge about TB transmission in the general population of Malawian adults was 61.5%. Specifically, the prevalence of correct knowledge about TB transmission was 63.6 and 60.8% in men and women, respectively. Those aged 35–44 years, having secondary or high education, belonging to the richest household, being exposed to mass media, being in professional/technical/managerial, having knowledge that “TB can be cured”, and those living in urban areas were significantly associated with correct knowledge about TB transmission. Conclusions: The findings of this study show that if appropriate strategies for TB communication and education to address the rural masses, young individuals, poor individuals, and individuals in the agriculture sector are put it place, can enhance TB prevention in Malawi

Estimation of groundwater recharge due to conservation agriculture practice

A review of groundwater recharge studies in Sub-Saharan Africa demonstrates a strong relationship between rainfall and recharge, but with considerable uncertainty due to significant impact of land cover and in particular land clearing and agriculture. This research project focuses on impacts of conservation agriculture (CA) practice on groundwater recharge. Conservation agriculture is being encouraged by governments over conventional methods in the understanding that CA practices such as minimum tillage, retention of crop residue and crop diversity improves crop resilience under dry conditions. However, there has been little consideration of the direct impact of such practices on groundwater. In this study, we setup three experimental sites in Zambia, Zimbabwe and Malawi to quantify recharge patterns under CA in comparison to conventional farming practice. Each site will be instrumented with soil moisture monitoring probes, a weather station, monitoring boreholes and electrical-resistivity tomography (ERT) equipment. Environmental isotopes and tracers (such as CFCs and SF6) and water chemistry will also be analysed. The monitoring will help to elucidate processes in the unsaturated zone around the plant root zone through to groundwater. Ultimately, this will help understand groundwater dynamics and fractioning below surface of CA field

Changes of Alpha1-Antitrypsin Levels in Allergen-induced Nasal Inflammation

ObjectivesAlpha1-antitrypsin (AAT) is the main inhibitor of human neutrophil elastase, and plays a role in counteracting the tissue damage caused by elastase in local inflammatory conditions. The study evaluated the involvement of AAT in nasal allergic inflammation.MethodsForty subjects with mono-sensitization to Dermatophagoides pteronyssinus (Dpt) were enrolled. Twenty allergic rhinitis patients frequently complained of nasal symptoms such as rhinorrhea, stuffiness, sneezing, and showed positive responses to the nasal provocation test (NPT) with Dpt (Group I). The other 20 asymptomatic patients showed sensitization to Dpt but negative NPT (Group II). The levels of AAT, eosinophil cationic protein (ECP), and Dpt-specific IgA antibodies were measured in the nasal lavage fluids (NLFs), collected at baseline, 10 minutes, 30 minutes, 3 hours, and 6 hours after the NPT. Nasal mucosa AAT expression was evaluated with immunohistochemical staining from Group I and Group II.ResultsAt baseline, only the Dpt-specific IgA level was significantly increased in the NLFs of Group I compared with Group II, while ECP and AAT levels were not significantly different between two groups. After Dpt provocation, AAT, ECP, and Dpt-specific IgA levels were significantly increased in the NLFs of Group I during the early and late responses. The protein expression level of AAT was mostly found in the infiltrating inflammatory cells of the nasal mucosa, which was significantly increased in Group I compared to Group II.ConclusionThe increment of AAT showed a close relationship with the activation of eosinophils induced by allergen-specific IgA in the NLFs of patients with allergic rhinitis after allergen stimulation. These findings implicate AAT in allergen-induced nasal inflammation

Response of a multi-domain continental margin to compression: study from seismic reflection-refraction and numerical modelling in the Tagus Abyssal Plain

The effects of the Miocene through Present compression in the Tagus Abyssal Plain are mapped using the most up to date available to scientific community multi-channel seismic reflection and refraction data. Correlation of the rift basin fault pattern with the deep crustal structure is presented along seismic line IAM-5. Four structural domains were recognized. In the oceanic realm mild deformation concentrates in Domain I adjacent to the Tore-Madeira Rise. Domain 2 is characterized by the absence of shortening structures, except near the ocean-continent transition (OCT), implying that Miocene deformation did not propagate into the Abyssal Plain, In Domain 3 we distinguish three sub-domains: Sub-domain 3A which coincides with the OCT, Sub-domain 3B which is a highly deformed adjacent continental segment, and Sub-domain 3C. The Miocene tectonic inversion is mainly accommodated in Domain 3 by oceanwards directed thrusting at the ocean-continent transition and continentwards on the continental slope. Domain 4 corresponds to the non-rifted continental margin where only minor extensional and shortening deformation structures are observed. Finite element numerical models address the response of the various domains to the Miocene compression, emphasizing the long-wavelength differential vertical movements and the role of possible rheologic contrasts. The concentration of the Miocene deformation in the transitional zone (TC), which is the addition of Sub-domain 3A and part of 3B, is a result of two main factors: (1) focusing of compression in an already stressed region due to plate curvature and sediment loading; and (2) theological weakening. We estimate that the frictional strength in the TC is reduced in 30% relative to the surrounding regions. A model of compressive deformation propagation by means of horizontal impingement of the middle continental crust rift wedge and horizontal shearing on serpentinized mantle in the oceanic realm is presented. This model is consistent with both the geological interpretation of seismic data and the results of numerical modelling. (C) 2008 Elsevier B.V. All rights reserved.Instituto Nacional de Engenharia, Tecnologia e Inovacao(INETI); Landmark Graphics Corporation; Landmark University Grant Program; LATTEX/IDL [ISLF-5-32]; FEDERinfo:eu-repo/semantics/publishedVersio