Prevalence of iodine deficiency among school children and access to iodized salt in Zambia

This study, which covered all the ten provinces of Zambia, aimed at assessing the Iodine Deficiency prevalence, and access to adequately iodised salt in the country. It was carried out in 2011 and entailed determining the urinary iodine concentration (UIC) among 1, 283 school children from 30 selected schools and the amount of iodine in 875 salt samples collected from the households of the children. The iodine concentration was also determined in salt samples collected from 365 salt traders near the selected schools. Each of the salt traders was requested to complete a questionnaire. In addition, a questionnaire was administered to 75 teachers from the selected schools. The Urinary Iodine Concentration (UIC) was assayed by the Sandell-Kolthoff reaction, after digesting the urine with Ammonium Persulfate at 100oC. The iodine concentration in the salt was determined using the quantitative titrimetric method. The data for the UIC and salt iodine plus data from questionnaires were analysed using Excel and Statistical Package for Social Sciences version 15 (SPSS 15). The median urinary iodine concentration (MUIC) was 248.5μg/l and the Interquartile Range (IQR) was 145 – 380 μg/L. These results indicated that Iodine Deficiency was not of public health concern among children in Zambia at the time of this study. However, the proportion of households with access to adequately iodised salt (15-40 ppm iodine) was 53%, which is below the recommended target of 90% or more household coverage. Results from questionnaires indicated that the challenges faced by the Zambian Government in attaining Universal Salt Iodisation (USI) include: (i) lack of sustainability of local salt iodisation in local salt producing areas, (ii) weak enforcement of the law on salt iodisation, (iii) poor packaging and storage of salt by traders and households, (iv) limited knowledge of the link between lack of iodine in salt and iodine deficiency, and (v) relatively high cost of imported iodised salt in local salt producing areas.Keywords: Iodized, Salt, Iodine Deficiency, Universal Salt Iodisation, Zambi

Preschool, executive functions and oral language as predictors of literacy and numeracy skills in first grade

Preschool is known to prepare children for formal school. Studies worldwide have shown that children who attend preschool perform better than those who do not attend preschool in early years. There is some evidence that preschool curriculums that incorporate executive functions yield better results in literacy and numeracy in early school. Studies have also shown that oral language skills predict literacy attainment in primary school years. It is not known however, whether preschool prepares children to perform better in literacy and numeracy skills in the first grade in Zambia. This study, therefore, sought to establish the predictive role of preschool, executive functions and oral language in literacy and numeracy in the first grade in Lusaka Zambia. Specifically, the study sought to establish the extent to which preschool prepares children for learning to read and numeracy in first grade when social economic status (SES) and intelligence are controlled. In addition, the study examined whether preschool is beneficial for the development of executive functions (EF) like working memory and inhibitory skills as well as whether preschool stimulates reading, writing and numeracy through executive functions. The study further assessed whether preschool may interfere with learning to read in first grade if children do not speak Nyanja at home and depend on school for learning to read as well as learning the language of instruction (Nyanja).The study utilised a quasi-experimental design as children with and without preschool were assessed within the school setting. Eighteen schools took part in the study. The target sample per school was twelve (12) pupils, giving a total of 216. Out of these, 45 per cent were boys and 55 per cent girls (98 without preschool and 118 with preschool). Children were tested individually at the start of Grade one (Phase I). Follow-up testing (Phase II) commenced approximately seven months after the initial testing was completed. Hundred and ninety seven (197) of the children in the original sample were tested in Phase II. The tests were administered in Nyanja (the language of instruction in first grade) in Lusaka.To assess early literacy skills, the Basic Skills Assessment Tool (BASAT) was used. In addition to word recognition and text comprehension, the BASAT includes tests to assess basic skills like letter knowledge, phonemic awareness and short-term memory. Executive function skills were assessed using the pencil taping test, the Stroop-like test and the BRIEF. Familiarity with language was tested by eliciting a narration from each child and the Peabody Picture Vocabulary Test measured receptive vocabulary. Pattern Reasoning (Kauffman Test Battery for Children) was utilised to measure general intelligence, while information processing was measured using the RAN. A variety of methods were used to analyse the data including, correlations, t-test, factorial anova and multi-level regression. Results revealed that pupils who went to preschool did not outperform pupils who did not go to preschool in first grade. On the contrary, they performed worse than those that never went to preschool. Children with preschool had a head start in alphabetic skills compared to children without preschool in the first grade but on all other literacy and numeracy tests, there were no effects in favour of children who went to preschool. In terms of executive functions, the study revealed that executive functions do predict literacy and numeracy skills. Specifically, working memory and inhibitory control predict literacy and numeracy skills over and above other executive functions. However, preschool did not promote executive functions. But, it was established that executive functions are better predictors of numeracy than literacy. The study further revealed that oral language is important for performance in literacy skills. The study revealed that linguistic diversity may explain delays of children who attend preschool in the first grade. Children are taught in English in preschool but in a local language, Nyanja when they proceed to first grade. This theory is in line with the finding that children with the most confusing language situation, the non Nyanja speakers, were lowest performers. Non Nyanja speakers speak another language at home, learnt English in preschool and need to learn a third language, Nyanja, in first grade. The study recommends that the Zambian Government should assess the quality of preschools to ensure that the curriculum has preparatory activities for literacy and numeracy skills, alphabet knowledge, phonological awareness, counting and rhyming. It is also recommended that executive function stimulating activities be part of preschool. In addition, schools should use the same language in preschool and first grade

Mountains of Maize, Persistent Poverty

The past two years are a tribute to Zambian farmers; they have responded admirably to government efforts to promote maize production. But ironically, rural poverty remains stubbornly high despite the fact that the government has spent over 2% of the nation’s gross domestic product in supporting maize production and subsidizing inputs for farmers. Why is it that maize production has increased so impressively without making a serious dent in rural poverty? And what are the lessons for the new government?maize, poverty, Zambia, Agricultural and Food Policy, Food Security and Poverty,

Non-physician anaesthesia providers’ perspectives on task sharing practices in Zambia and Somaliland: a qualitative study

Introduction: The 68th World Health Assembly, in 2015, called for surgical and anaesthesia services strengthening. Acknowledging the healthcare staff shortages, they referred to task sharing, among others, as a more effective use of the healthcare workforce. While task sharing has been increasingly proposed as an important strategy to increase the reach and safety of anaesthesia as well as a means of supporting the workforce in low-resource settings, most data on task sharing relate to non-anaesthetic healthcare contexts. The aim of this study was to understand anaesthetic task sharing as currently experienced and/or envisaged by non-physician anaesthesia providers in Zambia and Somaliland. Methods: An exploratory qualitative research methodology was used. Participants were recruited initially via contacts of the research team, then through snowballing using a purposive sampling strategy. There were 13 participants: 7 from Somaliland and 6 from Zambia. Semistructured interviews took place synchronously, then were recorded, anonymised, transcribed and analysed thematically. Triangulation and respondents’ validation were used to maximise data validity. Results: Four major themes were identified in relation to task sharing practices: (1) participants recognised variable components of task sharing in their practice; (2) access to task sharing depends both on sources and resources; (3) implicit barriers may inhibit task sharing practices; (4) there is an appetite among participants for amelioration of current task sharing practices. Conclusions: Empowering task sharing practices can be achieved only by understanding how these practices work, by identifying gaps and areas of improvement, and by addressing them. The findings from this exploratory study could help the global community understand how anaesthetic task sharing in low-resource settings works and inspire further research on the field. This could inform future modelling of workforce planning strategies in low-resource settings to maximise the effectiveness and professional well-being of the workforce

Lecturers experiences, challenges and prospects on continuing professional development.

University of Zambia, to establish factors that influence lecturers to engage in Continuing Professional Development (CPD) as well as factors inhibiting their participation in CPD. To establish these factors, open-ended questionnaires were used in conducting the study by means of a descriptive survey. Data were analysed qualitatively using emerging themes from the respondents’ answers and descriptive statistics were also utilised. The findings show that University lecturers are motivated to engage in CPD to update their current qualifications and as a way of showing professional competence. Among factors inhibiting lecturers from taking up CPD was lack of funds, to engage in some CPD activities and time constraints

The Politics of Maize in Zambia: Who holds the Keys to Change the Status Quo?

As both the national staple food and primary smallholder crop, maize occupies a central position in Zambia’s agricultural political economy. Despite the government’s large subsidies, maize productivity levels remain way below global averages, maize commercialisation in the smallholder sector remains highly concentrated, maize meal prices are highly volatile, and rural poverty remains high. This study uses a political economy framework to better understand the policy-making process, power structures and dynamics involved in the maize sector in order to get a better understanding of who holds the keys to change, and how to influence agricultural policy changes. Net-Map procedure was used to map the linkages of key players in order to determine critical nodes of policy change. The Executive (Cabinet/State House) was found to wield the most power in commanding the other actors in the sector. However, powerful lobby groups with links to the Executive have often opposed changes to the sector to maintain large rents to their constituency with disregard to the negative effects on the whole sector. In addition, a “Command Triangle” which holds the keys for sustainable policy changes in the maize sector was identified. This command triangle consists of the President, Minister of Finance and Minister of Agriculture. Hence, in order to bring about long-lasting changes to maize marketing policies in Zambia, there is a need for strong collective action within the command triangle, as it possesses the most influence

Differences among rice cultivars in their adaptation to low ionic strength solution with toxic level of aluminum that mimics tropical acid soil conditions

BACKGROUND: Spatio-temporal variations in malaria burden are currently complex and costly to measure, but are important for decision-making. We measured the spatio-temporal variation of clinical malaria incidence at a fine scale in a cohort of children under five in an endemic area in rural Chikhwawa, Malawi, determined associated factors, and monitored adult mosquito abundance. METHODS: We followed-up 285 children aged 6-48 months with recorded geolocations, who were sampled in a rolling malaria indicator survey, for one year (2015-2016). Guardians were requested to take the children to a nearby health facility whenever ill, where health facility personnel were trained to record malaria test results and temperature on the child's sick-visit card; artemisinin-based combination therapy was provided if indicated. The cards were collected and replaced 2-monthly. Adult mosquitoes were collected from 2-monthly household surveys using a Suna trap. The head/thorax of adult Anopheles females were tested for presence of Plasmodium DNA. Binomial logistic regression and geospatial modelling were performed to determine predictors of and to spatially predict clinical malaria incidence, respectively. RESULTS: Two hundred eighty two children, with complete results, and 267.8 child-years follow-up time were included in the analysis. The incidence rate of clinical malaria was 1.2 cases per child-year at risk; 57.1% of the children had at least one clinical malaria case during follow-up. Geographical groups of households where children experienced repeated malaria infections overlapped with high mosquito densities and high entomological inoculation rate locations. CONCLUSIONS: Repeated malaria infections within household groups account for the majority of cases and signify uneven distribution of malaria risk within a small geographical area

Dual-active-ingredient, insecticidal nets for preventing malaria: a systematic review protocol

Background: Malaria is caused by the Plasmodium parasite and is a highly transmissible disease representing a significant global public health burden. The provision of insecticide-treated mosquito nets (ITNs) has contributed to the reduction of malaria across endemic countries. However, the detection of insecticide resistance in many mosquito vector species potentially threatens the long-term effectiveness of ITNs. A novel method to reduce the impact of insecticide resistance is to treat mosquito nets with multiple active ingredients. Methods and analysis: This review will comprehensively search the literature (both published and unpublished) for any studies investigating the effectiveness of mosquito nets treated with multiple active ingredients, known henceforth as dual-active-ingredient (DAI) ITNs. The DAI ITNs of interest include those treated with a pyrethroid and non-pyrethroid insecticide (review question 1) or with a pyrethroid and an insect growth regulator (review question 2). Studies will be screened to meet the inclusion criteria by a minimum of two authors, followed by assessment of risk of bias (using appropriate risk of bias tools for randomised and non-randomised studies) and extraction of relevant information using structured forms by two independent authors. Meta-analyses will be carried out where possible for epidemiological outcomes and subgrouping will be considered. Certainty in the evidence will be established with GRADE assessments. Ethics and dissemination: A full review report will be submitted to the Vector Control and Insecticide Resistance Unit, Global Malaria Program, WHO. A version of this report will be submitted for publication in an open access peer-reviewed journal. The report will inform the development of WHO recommendations regarding the use of DAI ITNs for the prevention of malaria. This systematic review does not require ethics approval as it is a review of primary studies.Timothy Barker, Jennifer Stone, Sabira Hasanoff, Jennifer Stevenson, Carrie Price, Alinune Kabaghe, Zachary Mun

Procjena mikrostrukture alatnog čelika za hladni rad nakon pretaljivanja pulsirajućim laserom

The aim of this study is the investigation of micro-structural behaviour of a Mat. No. 1.2379 (EN-X160CrMoV121; AISI D2) cold work tool steel after remelting with a precise pulsed Nd:YAG laser. The investigated steel is one of the most hard to weld tool steels, due to large amount of alloying elements. The analysis was done on single spots remelted with specific laser pulse shape and parameters, assuring crack-less solidification. Re-solidifi ed areas were investigated with microscopy, hardness measurements, X-ray spectroscopy and diffraction method. Laser treatment causes rapid solidification leading into a formation of a fine dendritic microstructures containing high amount of retained austenite causing a significant decrease of hardness.Namjena ove studije je ispitivanje ponašanja mikro strukture alatnoga čelika za rad na hladno Mat. No.1.2379 (ENX160CrMoV121; AISI D2) po pretaljivanju s preciznim pulsiranim Nd:YAG laserom. Zbog velike količine legirnih elemenata istraživani materijal spada u grupu vrlo teško zavarljivih alatnih čelika. Analiza je provedena na pojedinim pretaljenim točkama korištenjem specifi čnog oblika i parametara laserskog impulsa koji osiguravaju skrućivanje bez pukotina. Pretaljena područja su ispitivana mikroskopom, mjerenjem mikro tvrdoće, rendgenskom spektroskopijom i defrakcijskom metodom. Tretman laserom uzrokvao je brzo skrućivanje koja dovodi do formiranja fi ne dendritičke strukture s velikim udjelom zaostalog austenita što uzrokuje bitno smanjivanje tvrdoće