Knowledge, attitude, and practices on disposal methods of expired and unused medicines among students in public academic institutions in Lusaka, Zambia

Background: Unsafe disposal of unused and expired household medicines is a public health problem and mostly occur because of a lack of knowledge towards suitable medicine disposal methods. Thus, we aimed to assess the knowledge, attitude, and practices on the disposal methods of unused and expired medicines among students in public academic institutions in Lusaka, Zambia.Methods: This was a cross-sectional study in which 385 students from three higher learning academic institutions were interviewed face to face using a structured questionnaire from 10th May to 24th June 2019. The cleaned data was then transferred to statistical package for social science (SPSS) version 25.0 for analysis.Results: The mean age of the participants was 23 (SD±2.9). Out of the 385 participants, 215 (55.8%) did not know much about medical waste and 345 (89.6%) of them did not have any previous information regarding proper and safe disposal of unused and expired medicine. However, 351 (91.4%) of the participants appropriately responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. Throwing unused and expired medicine in household garbage/bin was the most frequently used disposal practice followed by flushing them in toilet/sink as responded by 231 (60.0%) and 128 (33.3%) of participants respectively. Only 17 (4.42%) reported returning unused and expired medicines to the nearest pharmacy.  Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that unsafe disposal of unused and expired medicines is a public health problem and proposed the need to introduce drug take-back programs in the communities. 

Understanding matrix-assisted continuous co-crystallization using a data mining approach in Quality by Design (QbD)

YesThe present study demonstrates the application of decision tree algorithms to the co-crystallization process. Fifty four (54) batches of carbamazepine-salicylic acid co-crystals embedded in poly(ethylene oxide) were manufactured via hot melt extrusion and characterized by powder X-ray diffraction, differnetial scanning calorimetry, and near-infrared spectroscopy. This dataset was then applied in WEKA, which is an open-sourced machine learning software to study the effect of processing temperature, screw speed, screw configuration, and poly(ethylene oxide) concentration on the percentage of co-crystal conversion. The decision trees obtained provided statistically meaningful and easy-to-interpret rules, demonstrating the potential to use the method to make rational decisions during the development of co-crystallization processes.Commonwealth Scholarship Commission in the UK (ZMCS-2018-783) and Engineering and Physical Sciences Research Council (EPSRC EP/J003360/1 and EP/L027011/1

Substandard and falsified medical product recalls in Zambia from 2018 to 2021 and implications on the quality surveillance systems

BACKGROUND: Substandard and falsified (SF) medical products are removed from circulation through a process called 'product recall' by medicines regulatory agencies. In Zambia, the Zambia Medicines Regulatory Authority (ZAMRA) is responsible for recalling SF medical products from the Zambian market through passive and active surveillance methods. This study aimed to describe the prevalence of recalls of SF medical products and to analyse the frequently recalled therapeutic categories, dosage forms, categories of defects that led to the recalls and their sources with respect to the country of the marketing authorisation holder (MAH) or manufacturer. METHODS: We conducted a descriptive cross-sectional review of the product recalls issued by ZAMRA between January 2018 and December 2021. A search for all medical product alerts and recalls issued by ZAMRA was carried out by reviewing the internal post-marketing surveillance database kept at ZAMRA headquarters. Data were extracted using a structured Excel database and analysed using Microsoft Excel. RESULTS: A total of 119 alerts were received during the review period, of which 83 (69.7%) were product recalls. Oral solid dosage forms were the most recalled dosage form (53%). Furthermore, the number of recalls increased in 2020 (44.6%) and 2021 (22.9%), with the majority (20.5%) of the recalled products being substandard products classified as antiseptics and disinfectants and were attributed to the high demand during the COVID-19 pandemic. Manufacturing laboratory control issues were the reason for product recall in almost half (47.4%) of the cases. Most of the products recalled originated from India (38.6%), followed by Zambia (25.3%). Only one suspected falsified product was recalled between 2018 and 2021. A total of 66 recalls of the 83 products were initiated by ZAMRA, with only 17 voluntarily by foreign MAHs. No product recall was initiated by the local representatives of foreign manufacturers or MAH. CONCLUSION: The majority of the pharmaceutical product recalls in Zambia were substandard products. Manufacturing laboratory control issues lead to most recalls and require investigation of the root causes, preventive action, and strict compliance with the good manufacturing practices guidelines by manufacturers

Knowledge, Attitudes, and Practices of Poultry Farmers on Antimicrobial Use and Resistance in Kitwe, Zambia: Implications on Antimicrobial Stewardship

The inappropriate antimicrobial usage (AMU) in chicken production has led to an increase in the prevalence of antimicrobial resistance (AMR). In Zambia, there is little information documented regarding the knowledge, attitude, and practices of poultry farmers on AMU and AMR. Therefore, this study assessed the knowledge, attitude and practices regarding AMU and AMR among poultry farmers in Kitwe, Zambia. Methods: This was a cross-sectional study conducted among 106 poultry farmers from November to December 2021 using a structured questionnaire. Data analysis was done using IBM Statistical Package for Social Sciences (SPSS) version 26. Results: Overall, of the 106 participants, 90.6% knew what antimicrobials were, but only 29.2% were aware of AMR. The study showed that 46.2% of the participants had low knowledge, 71.7% had negative attitudes, and 61.3% had poor practices regarding AMR. The prevalence of antibiotic use in poultry production was 83%. The most used antimicrobials were tetracycline (84%) and gentamicin (35.2%). The commonly reported reason for the use of antimicrobials was for the treatment (93.2%) and prevention (89.8%) of diseases. Further, 76.9% of the administered antimicrobials were usually done without veterinarian consultation or prescription. Conclusion: The study shows that there was high AMU in poultry farms in Kitwe. However, there was low knowledge, negative attitude, and poor practices towards AMU and AMR. Therefore, there is a need for educational and sensitisation programmes regarding AMU and AMR among poultry farmers in Kitwe, Zambia. Alongside this, antimicrobial stewardship and surveillance systems should be strengthened in the livestock production sector. This will ensure food safety and public health

Familiarity, Knowledge and Practices of Healthcare Professionals Regarding the Pharmacovigilance of Biological Medicines in Lusaka, Zambia: A Multi-Facility Cross-Sectional Study.

Background: Pharmacovigilance of biological medicines is crucial because it ensures that medicines meet the World Health Organization (WHO) standards. In Zambia, there is little information on healthcare professionals’ familiarity, knowledge and practices on the pharmacovigilance of biological and biosimilar medicines. Therefore, this study investigated the familiarity, knowledge, and practices related to the pharmacovigilance (PV) of biological and biosimilar medicines at selected hospitals in Lusaka, Zambia. Methods: The study was an analytical questionnaire-based cross-sectional study conducted among healthcare professionals (HCPs) at the Adult hospital, Cancer Diseases hospital, Paediatrics hospital and Women and New Born Hospital in Lusaka. Data were collected over four weeks in May and June 2021 and subsequently analysed using IBM SPSS version 21. The statistical significance was set at a 95% confidence interval. Results: Of 245 participants, only 115 (48.9%) of the HCPs were familiar with biological medicines to a basic understanding. Regarding the term biosimilars, most of the HCPs (40.9%) never heard of this word. The mean score for knowledge regarding the PV considerations of biological medicines was 4.1 out of 8 questions. Most HCPs used non-proprietary names (44.2%) when prescribing, dispensing, or administering biological medicines. Additionally, more than half (57.3%) of HCPs did not record batch numbers when dispensing or administering biological medicines. Conclusion: Healthcare professionals were more familiar with the term biological medicines than biosimilars. Healthcare professionals generally scored poorly when their knowledge regarding the PV considerations of biological medicines was assessed. Thus, there is a need to provide adequate training and continuous professional development among healthcare professionals on the pharmacovigilance of biological and biosimilar medicines

Knowledge, Attitudes, and Practices towards Antibiotic Use and Antimicrobial Resistance among Pharmacy Students at the University of Zambia: Implications for Antimicrobial Stewardship Programmes.

Background: Antimicrobial resistance (AMR) is a global public health problem affecting healthcare systems. There is little information on undergraduate pharmacy students' knowledge, attitude, and practices regarding antibiotic use (AMU) and AMR in Zambia. This study assessed knowledge, attitude, and practices on AMU and AMR among undergraduate pharmacy students at the University of Zambia. Materials and Methods: This cross-sectional study was conducted among172 randomly selected participants using a structured questionnaire. Data were analysed using IBM Statistical Package for Social Sciences version 20. Results: Of the 172 total participants, 55.2% (n = 95) were male. Most participants were between 21 and 25 years old (n=110, 64 %). Most of the pharmacy students had good knowledge (n=155, 90% average score), positive attitude (n=145, 84% average score) but suboptimal practices (n=110, 64% average score) about AMU and AMR. Despite these good scores, the prevalence of self-medication using antibiotics was 41% (n=70).Conclusion: Undergraduate pharmacy students had good knowledge, and a positive attitude, but suboptimal practices towards AMU and AMR. A low-average practice score is of great concern and requires urgent attention. There is a need to improve the details of the undergraduate pharmacy curriculum regarding AMU, AMR and antimicrobial stewardship programmes

Biocompatibility of Biomaterials for Nanoencapsulation: Current Approaches.

Nanoencapsulation is an approach to circumvent shortcomings such as reduced bioavailability, undesirable side effects, frequent dosing and unpleasant organoleptic properties of conventional drug delivery systems. The process of nanoencapsulation involves the use of biomaterials such as surfactants and/or polymers, often in combination with charge inducers and/or ligands for targeting. The biomaterials selected for nanoencapsulation processes must be as biocompatible as possible. The type(s) of biomaterials used for different nanoencapsulation approaches are highlighted and their use and applicability with regard to haemo- and, histocompatibility, cytotoxicity, genotoxicity and carcinogenesis are discussed

Knowledge, attitude, and acceptance of COVID-19 vaccines among secondary school pupils in Zambia : implications for future educational and sensitisation programmes

The coronavirus disease 2019 (COVID-19) pandemic resulted in the closure of schools to slow the spread of the virus across populations, and vaccines administered to protect people from severe disease, including school children and adolescents. In Zambia, there is currently little information on the acceptance of COVID-19 vaccines among school-going children and adolescents despite their inclusion in the vaccination programme. This study assessed the knowledge, attitude, and acceptance of COVID-19 vaccines among secondary school pupils in Lusaka, Zambia. A cross-sectional study was conducted from August 2022 to October 2022. Of the 998 participants, 646 (64.7%) were female, and 127 (12.7%) would accept to be vaccinated. Those who were willing to be vaccinated had better knowledge (68.5% vs 56.3%) and a positive attitude (79.1% vs 33.7%) compared to those who were hesitant. Overall, the odds of vaccine acceptance were higher among pupils who had higher knowledge scores (AOR=11.75, 95% CI: 6.51-21.2), positive attitude scores (AOR=9.85, 95% CI: 4.35-22.2), and those who knew a friend or relative who had died from COVID-19 (AOR=3.27, 95% CI: 2.14-5.09). The low vaccine acceptance among pupils is of public health concern, emphasizing the need for heightened sensitisation programmes that promote vaccine acceptance among pupils in Zambia

COVID-19 vaccine acceptance and hesitancy among healthcare workers in Lusaka, Zambia; findings and implications for the future

The uptake of COVID-19 vaccines is critical to address the severe consequences of the disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant to re-ceive the COVID-19 vaccine, further enhancing hesitancy rates within countries. COVID-19 vaccine acceptance and hesitancy levels are currently unknown among HCWs in Zambia, which is a concern given the burden of infectious diseases in the country. Consequently, this study assessed COVID-19 vaccine acceptance and hesitancy among HCWs in Lusaka, Zambia. A cross-sectional study was conducted among 240 HCWs between August and September 2022 using a semi-structured ques-tionnaire. Multivariable analysis was used to determine key factors associated with vaccine hesi-tancy among HCWs. Of the 240 HCWs who participated, 54.2% were females. 72.1% of HCWs would accept to be vaccinated while 27.9% were hesitant. 93.3% of HCWs had positive attitudes towards COVID-19 vaccines, with medical doctors having the highest mean attitude score (82%). Encourag-ingly, HCWs with positive attitudes towards COVID-19 vaccines had reduced odds of being hesitant (AOR=0.02, 95% CI: 0.01-0.11,

Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia.

INTRODUCTION: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. MATERIALS AND METHODS: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely; Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. RESULTS: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. CONCLUSION: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future