Overweight and Obesity in Kaoma and Kasama Rural Districts of Zambia: Prevalence and Correlates in 2008-2009 Population Based Surveys

Background: Overweight and obesity (overweight/obesity) is associated with hypertension. Low- and middleincome countries are experiencing an obesity epidemic. There is growing evidence that the epidemic is on the increase in urban settings of developing countries. However, there is scanty information on the magnitude of this epidemic and its correlates in rural settings. The objective of the current study was to establish levels of overweight/obesity and its correlates in rural areas of Zambia. Designing interventions based on the correlates for overweight/obesity to reduce its prevalence may in turn lead to a reduction in the prevalence of hypertension. Methods: Cross sectional studies using a modified WHO Stepwise questionnaire were conducted. Logistic regression analyses were used to determine factors that were associated with overweight/obesity. Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) and their 95% confidence intervals are reported. Results: Totals of 895 participants from Kaoma and 1198 from Kasama took part in the study. Altogether, 7.6% of the participants were overweight and 2.5% were obese, with a combined prevalence of overweight/obesity of 10.1%. Factors that were independently associated with overweight/obesity were sex, education, vegetable consumption, smoking and hypertension. Female participants were 78% (AOR=1.78, 95% CI [1.46, 2.17]) more like to be overweight/ obese compared to males. Participants with secondary or higher education level were 2.04 (95% CI [1.56, 2.67]) times more likely to be overweight/obese compared to participants with lower levels of education. Participants who consumed vegetables 5 to 7 days in a week were 35% (AOR=1.35, 95% CI [1.06, 1.72]) more likely to be overweight/ obese compared to participants who ate vegetables less than 5 days in a week. Non smokers were 2.06 (95% CI [1.42, 2.98]) times more likely to be overweight/obese than smokers. Participants who were non hypertensive were 30% (AOR=0.70, 95% CI [0.59, 0.82]) less likely to be overweight/obese compared to participants who were hypertensive. Conclusions: Prevalence of overweight/obesity was low and this is the time to start instituting interventions to control the obesity epidemic in rural districts of Zambia

Cannabis Use and its Socio-demographic Correlates among in-School Adolescents in Zambia

Background 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. Methods 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. Results 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]). Conclusions 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

Prevalence and Correlates for Smoking among Persons Aged 25 Years or Older in Two Rural Districts of Zambia

Smoking is a major risk factor for lung cancer and is the most widely recognized modifiable risk factor for this disease. No studies have been conducted on correlates for smoking in rural areas of Zambia where smoking rates may be higher than in urban settings. A cross sectional study was conducted to determine the prevalence of smoking and its correlates in two rural districts of Zambia, namely Kaoma and Kasama. A multivariate logistic regression analysis was used to determine independent correlates for smoking. In total, 895 participants from Kaoma and 1198 participants from Kasama took part in the survey. Of the 886 participants in Kaoma and 1,195 from Kasama with recorded gender, 40.3% and 42.8% were males, respectively. Sex, body mass index and alcohol consumption were independently associated with smoking in both districts. Male participants were more likely to smoke than females (AOR=2.38; 95% CI [1.92, 2.95] in Kaoma and AOR = 2.62; 95% CI [2.13, 3.22] in Kasama). Participants who were lean were more likely to smoke than those who were overweight or obese (AOR=2.85, 95% CI [1.76, 4.60] in Kaoma, and AOR=2.36, 95% CI [1.59, 3.50] in Kasama). Other factors associated with smoking were alcohol use, low education (in Kaoma district) and older age (45 years or older). The findings reveal that smoking is prevalent among rural residents in Kaoma and Kasama, Zambia. Smoking is positively associated with older age, male gender, alcohol use, low BMI. Effective preventive strategies are needed to halt the growing trend of smoking

Prevalence and Correlates for Smoking among Persons Aged 25 Years or Older in Two Rural Districts of Zambia

Smoking is a major risk factor for lung cancer and is the most widely recognized modifiable risk factor for this disease. No studies have been conducted on correlates for smoking in rural areas of Zambia where smoking rates may be higher than in urban settings. A cross sectional study was conducted to determine the prevalence of smoking and its correlates in two rural districts of Zambia, namely Kaoma and Kasama. A multivariate logistic regression analysis was used to determine independent correlates for smoking. In total, 895 participants from Kaoma and 1198 participants from Kasama took part in the survey. Of the 886 participants in Kaoma and 1,195 from Kasama with recorded gender, 40.3% and 42.8% were males, respectively. Sex, body mass index and alcohol consumption were independently associated with smoking in both districts. Male participants were more likely to smoke than females (AOR=2.38; 95% CI [1.92, 2.95] in Kaoma and AOR = 2.62; 95% CI [2.13, 3.22] in Kasama). Participants who were lean were more likely to smoke than those who were overweight or obese (AOR=2.85, 95% CI [1.76, 4.60] in Kaoma, and AOR=2.36, 95% CI [1.59, 3.50] in Kasama). Other factors associated with smoking were alcohol use, low education (in Kaoma district) and older age (45 years or older). The findings reveal that smoking is prevalent among rural residents in Kaoma and Kasama, Zambia. Smoking is positively associated with older age, male gender, alcohol use, low BMI. Effective preventive strategies are needed to halt the growing trend of smoking

13C-sucrose breath test for the non-invasive assessment of environmental enteropathy in Zambian adults

Objectives: Environmental enteropathy (EE) is a subclinical disorder highly prevalent in tropical and disadvantaged populations and is thought to play a role in growth faltering in children, poor responses to oral vaccines, and micronutrient deficiencies. This study aims to evaluate the potential of a non-invasive breath test based on stable isotopes for evaluation of impaired digestion and absorption of sucrose in EE. Methods: We optimized a 13C-sucrose breath test (13C-SBT) in 19 young adults in Glasgow, United Kingdom. In a further experiment (in 18 adults) we validated the 13C-SBT using Reducose, an intestinal glucosidase inhibitor. We then compared the 13C-SBT to intestinal mucosal morphometry, immunostaining for sucrose-isomaltase (SI) expression, and SI activity in 24 Zambian adults with EE. Results: Fully labeled sucrose (0.3 mg/kg) provided clear breath enrichment signals over 2–3 h in both British and Zambian adults, more than fivefold higher than naturally enriched sucrose. Reducose dramatically impaired 13C-sucrose digestion, reducing 4 h 13CO2 breath recovery by > 50%. Duodenal biopsies in Zambian adults confirmed the presence of EE, and SI immunostaining was present in 16/24 adults. The kinetics of 13CO2 evolution were consistently faster in participants with detectable SI immunostaining. Although sucrase activity was strongly correlated with villus height (r = 0.72; P < 0.05) after adjustment for age, sex and body mass index, there were no correlations between 13C-SBT and villus height or measured sucrase activity in pinch biopsies. Conclusion: A 13C-SBT was developed which was easy to perform, generated clear enrichment of 13CO2 in breath samples, and clearly reports sucrase activity. Further work is needed to validate it and understand its applications in evaluating EE

Novel therapies for malnutrition enteropathy in Zambian and Zimbabwean children with severe acute malnutrition: a multi-arm phase II trial

Primary endpoint dataset contains sex, study site (Zambia/Zimbabwe), presence/grade of oedema, weight-for-length Z (WLZ) score, treatment allocation, primary endpoint composite score pre and post-treatment, HIV status, and presence of diarrhoea at baseline. Treatment is coded as A (colostrum), B(NAG), C(teduglutide), D(budesonide), or E(standard care). Secondary endpoints are in a separate database which includes all variables (in pg/ml) as continuous variables