African women in science and development, bridging the gender gap

Science and technology play a fundamental role in driving social progress and economic growth in today's rapidly evolving world. Yet, despite considerable advancements, the gender gap in science remains a harsh reality, particularly for African women. This inequality directly impedes their invaluable perspectives and contributions to scientific advancements and innovations. Africa's development requires significant investment in science, technology, engineering, and mathematics (STEM) fields and leadership. This opinion piece delves into the gender disparity prevailing in STEM, emphasizes the challenges that African women experience, highlights the immense potential that African women possess, and finally advocates for immediate efforts to bridge this gap

Prevalence and antimicrobial resistance patterns of Enterococcus species isolated from laying hens in Lusaka and Copperbelt provinces of Zambia: a call for AMR surveillance in the poultry sector

BACKGROUND: The use of antimicrobials in layer poultry production for improved production, growth promotion, prophylaxis and treatment purposes has contributed to the development of antimicrobial resistance (AMR) in poultry. In Zambia, there is a paucity of information on the prevalence and AMR patterns of Enterococcus species isolated from laying hens. OBJECTIVES: This study investigated the prevalence and AMR patterns of enterococci isolated in layer hens in Lusaka and Copperbelt provinces of Zambia. METHODS: A cross-sectional study was conducted from September 2020 to April 2021. Three hundred and sixty-five pooled cloacal swab samples were collected from 77 layer poultry farms. Enterococci identification and confirmation were performed using Analytical Profile Index (API 20 STREP) and 16S rRNA sequencing, respectively. A panel of nine antibiotics was used for antibiotic susceptibility testing and interpreted according to the CLSI 2020 guidelines. Data were analysed using SPSS version 23 and WHONET 2020. RESULTS: A total of 308 (83%) single Enterococcus species isolates were obtained and showed resistance to tetracycline (80.5%), erythromycin (53.6%), quinupristin/dalfopristin (53.2%), ampicillin (36.72%), vancomycin (32.8%), linezolid (30.2%), ciprofloxacin (11.0%), nitrofurantoin (6.5%) and chloramphenicol (3.9%). The prevalence of enterococci resistant to at least one antibiotic was 99.4% (n = 306), of which 86% (n = 265) were MDR. CONCLUSIONS: This study found a high prevalence of antimicrobial-resistant enterococci. The presence of MDR requires urgent intervention and implementation of AMR surveillance strategies and antimicrobial stewardship programmes in layer poultry production in Zambia

Drivers of antimicrobial resistance in layer poultry farming: Evidence from high prevalence of multidrug-resistant Escherichia coli and enterococci in Zambia

Background and Aim: Inappropriate use of antimicrobials exacerbates antimicrobial resistance (AMR) in the poultry sector. Information on factors driving AMR in the layer poultry sector is scarce in Zambia. This study examined the drivers of AMR in the layer poultry sector in the Lusaka and Copperbelt Provinces of Zambia. Materials and Methods: This cross-sectional study employed a structured questionnaire in 77 layer poultry farms in the provinces of Lusaka and Copperbelt, Zambia, from September 2020 to April 2021. Data analysis was conducted using Stata version 16.1. Antimicrobial resistance was defined as the presence of multidrug resistance (MDR) isolates. Multivariable regression analysis was used to identify drivers of AMR. Results: In total, 365 samples were collected, from which 339 (92.9%) Escherichia coli and 308 (84.4%) Enterococcus spp. were isolated. Multidrug resistance was identified in 39% of the E. coli and 86% of the Enterococcus spp. The overall prevalence of AMR in layer poultry farms was 51.7% (95% confidence interval [CI]: 40.3%–63.5%). Large-scale farmers (Adjusted odds ratio [AOR] = 0.20, 95% CI: 0.04%–0.99%) than small-scale and farmers who were aware of AMR than those who were unaware (AOR = 0.26, 95% CI: 0.08%–0.86%) were less likely to experience AMR problems. Conclusion: This study found a high prevalence of AMR in layer poultry farming linked to the type of farm management practices and lack of AMR awareness. Evidence of high MDR in our study is of public health concern and requires urgent attention. Educational interventions must increase AMR awareness, especially among small- and medium-scale poultry farmers

Escherichia coli Antimicrobial Susceptibility Reduction amongst HIV-Infected Individuals at the University Teaching Hospital, Lusaka, Zambia

Increased antimicrobial resistance among Human Immunodeficiency Virus (HIV)-infected individuals to commonly used antibiotics in the treatment of gastroenteritis is a public health concern, especially in resource-limited settings. We set out to compare the antimicrobial susceptibility pattern of Escherichia coli (E. coli) isolates from HIV-infected and HIV-uninfected individuals at a tertiary hospital in Lusaka, Zambia. An analytical cross-sectional study was conducted at the University Teaching Hospital from May 2019 to August 2019. Stool samples were screened, and 79 HIV-infected individuals matched by age and sex with 84 HIV-uninfected individuals that presented with E. coli associated gastroenteritis were studied. Demographics were collected from the Laboratory Information System (LIS) and stool samples were collected in a sterile leak-proof container. Samples were cultured and only those where E. coli was isolated were included in the study and tested for antimicrobial susceptibility by the Kirby–Bauer disk diffusion technique. HIV-positive individuals were 3 times (adjusted odds ratio (AOR) = 3.17; 95% CI (1.51, 6.66); p < 0.001) more likely to be resistant to quinolones compared with their HIV-negative counterparts. Similarly, HIV-positive individuals were almost 4 times (AOR = 3.97, 95% CI (1.37, 11.46); p = 0.011) more likely to have multidrug-resistant E. coli compared with those who were HIV-negative. HIV infection was associated with reduced E. coli susceptibility to commonly used antibiotics, and most cases showed resistance

Knowledge, attitude and practices towards infection prevention and control among undergraduate pharmacy students in Zambia : findings and implications

Background: Infection prevention and control (IPC) measures are critical in preventing the risk of acquiring and transmitting nosocomial infections. In Zambia, there is little information concerning IPC practices among pharmacy students who are exposed to potentially infectious areas both in public and private healthcare settings. Therefore, this study assessed the knowledge, attitude and practices of undergraduate pharmacy students towards infection prevention and control at the University of Zambia. Materials and methods: This cross-sectional study was conducted among 290 undergraduate pharmacy students at the University of Zambia using a structured questionnaire from August 2022 to October 2022. Data analysis was performed using SPSS version 25.0 and statistical significance was set at a 95% confidence level. Results: Of the 290 participants, 166(57.2%) were female and the majority were aged between 18 and 23 years. Overall, 252(86.9%) had good knowledge, 167(57.6%) had positive attitudes, and 248(85.5%) had good practices towards IPC measures. These results indicate lower attitude scores compared to knowledge and practices. Having good knowledge of IPC was associated with being a Christian by religion compared to other religions (OR= 5.314, 95% CI: 1.141-24.745). There was no association between sociodemographics and attitude and practice concerning IPC. Conclusion: This study found that pharmacy students had good knowledge, positive attitudes, and good practices towards IPC measures. Consequently, more emphasis is needed to improve the student’s knowledge, attitudes, and practices towards IPC, especially in areas where gaps were identified. Additionally, there is a need to improve curricula on IPC measures in the training of pharmacy programs

Drug-resistant Acinetobacter species isolated at the University Teaching Hospital, Lusaka, Zambia

Acinetobacter species have emerged as one of the leading causative agents of Hospital-Acquired Infections (HAIs). Acinetobacter baumannii, the most commonly isolated clinical subspecies among the Acinetobacter species, is known to cause a wide range of HAIs, with an increased risk of mortality ranging from 8% to 40% in hospitalized patients. This study aimed to evaluate the clinical significance of Acinetobacter species isolated from admitted patients, ward environmental surfaces and instruments at the University Teaching Hospital, (UTH) in Lusaka, Zambia.This was a facility-based cross-sectional study that involved collecting clinical samples (cerebrospinal fluid, sputum, pus swabs, blood culture, urine, synovial fluid, pericardial fluid, and pleural fluid) that were submitted to the Microbiology Laboratory at UTH as part of the routine diagnosis and patient care between July and December 2021. Environmental specimens were also collected from surfaces and equipment in contact with patients, such as beds, beddings, suction machines, ventilators, ward gowns and endotracheal tubes.Sixty Acinetobacter isolates were recovered, 40 (66.7%) from clinical specimens and 20 (33.3%) from environmental samples, respectively. Among the clinical isolates, the admission ward had the highest (21.7%; 95% CI: 10.9–32.4) while the main ICU had the least (1.7%; 95% CI: 0.0–5.0%); for environmental samples, the highest isolation was from taps (25%) and sinks (20%). Among the sixty Acinetobacter isolates, A. baumannii was the most prevalent subspecies (n = 43). Highest resistance was observed to tetracycline (98%; 95% CI: 94–100) and co-trimoxazole (70%; 95% CI: 58–82) while the lowest resistance was seen in imipenem (17%; 95% CI: 7.3–28.3), tobramycin (20%; 95%CI: 11.7–36) and cefotaxime (22%; 95% CI: 24–22). The AdeB gene (efflux pump) was detected in 82.5% of the clinical isolates. The frequency of clinical isolates that showed resistance to at least three classes of antibiotics (aminoglycosides, fluoroquinolones and sulphonamides) translated into being Multidrug-resistant (MDR) and Extensive drug resistance (XDR) in the clinical isolates was 75% (30/40) and 52.5% (21/30), respectively. These findings intimate the clinical significance of HAI Acinetobacter infections and need for continuous AMR surveillance to inform treatment guidelines and regular infection prevention processes

Antimicrobial susceptibility and genomic profiling of Salmonella enterica from bloodstream infections at a tertiary referral hospital in Lusaka, Zambia, 2018-2019

OBJECTIVES: This study investigated antimicrobial susceptibility and genomic profiling of S. enterica isolated from bloodstream infections at a tertiary referral hospital in Lusaka, Zambia, 2018–2019. METHOD: This was a prospective hospital-based study involving routine blood culture samples submitted to the microbiology laboratory at the University Teaching Hospital. Identification of S. enterica and determination of antimicrobial susceptibility profiles was achieved through conventional and automated methods. Whole-genome sequencing (WGS) was conducted, and the sequence data outputs were processed for species identification, serotype determination, multilocus sequence typing (MLST) profile determination, identification of antimicrobial resistance determinants, and phylogeny. RESULTS: Seventy-six Salmonella enterica were isolated and 64 isolates underwent WGS. Salmonella Typhi (72%) was the most prevalent serotype. Notable was the occurrence of invasive non-typhoidal Salmonella Typhimurium ST313 (3%), resistance to cephalosporins (4%) and ciprofloxacin (5%), multidrug resistance (46%), and reduced susceptibility to ciprofloxacin (30%) and imipenem (3%). Phylogenetic cluster analysis showed multiple Salmonella serovars with a wide range of genetic diversity. CONCLUSION: The genetic diversity of Salmonella Typhi, high prevalence of multidrug resistance, and the emergence of ciprofloxacin and cephalosporin resistance warrants improved hygiene and water and sanitation provision, continued surveillance to apprise antibiograms and inform policy, and the introduction of the typhoid conjugate vaccine

Nosocomial infections and associated risk factors at two tertiary healthcare facilities in Lusaka and Copperbelt Provinces, Zambia

Background: Nosocomial infections are a serious public health problem affecting both developed and developing countries. They are caused mainly by multi-drug-resistant pathogens that limit treatment options, leading to high morbidity and mortality, longer hospital stays and increased costs of health care. This study aimed to evaluate nosocomial infections, risk factors and causative pathogens at two large teaching hospitals in Zambia. Material and methods: A yearlong hospital-based cross-sectional study was conducted from April 2020 to April 2021 at two large tertiary-level hospitals in Zambia. Hospitalised and out-patients with previous hospital contact were screened for nosocomial infections, followed by the collection of specimens (skin swabs, urine or sputum) for bacteriological culture and Polymerase Chain Reaction (PCR) amplification of 16S rRNA gene fragments. Nosocomial infections were defined according to the World Health Organization case definitions. Frequencies were estimated, and the association between the outcome variable (positive culture) and categorical predictor variables were analysed using the Chi-square test. Results: Eight hundred and forty-one clinical specimens (skin swabs, urine or sputum) were collected and analysed, 640 from the University Teaching Hospital in Lusaka and 201 from the Ndola Teaching Hospital in Ndola. Of these, 71.2% were from male, with only 28.8% from female patients. The median age was 50 years old. Catheter-associated urinary tract infections (57%) were the most common, followed by those from pressure sores (38.7%). The most frequently observed pathogens included Escherichia coli (17.8%), Pseudomonas aeruginosa (13.7%), Klebsiella pneumonia (5.6%) and Proteus vulgaris (5.5%). Conclusions: The hospital infection rate at the two urban tertiary hospitals was very high. Age over 65 years, male gender, presence of medical devices, presence of a wound, longer hospital stays, previous hospital contacts and low systolic blood pressure were associated with the risk of developing nosocomial infections. Despite improved infection control following the COVID-19 waves, nosocomial infections have remained a significant public health threat

Awareness of Antimicrobial Resistance and Associated Factors among Layer Poultry Farmers in Zambia: Implications for Surveillance and Antimicrobial Stewardship Programs

Antimicrobial resistance (AMR) is a global public health problem affecting animal and human medicine. Poultry production is among the primary sources of income for many Zambians. However, the increased demand for poultry products has led to a subsequent increase in antimicrobial use. This study assessed the awareness of AMR and associated factors among layer poultry farmers in Zambia. A cross-sectional study was conducted among 77 participants from September 2020 to April 2021. Data was analysed using Stata version 16.1. The overall awareness of AMR among the farmers was 47% (n = 36). The usage of antibiotics in layer poultry production was high at 86% (n = 66). Most antibiotics were accessed from agrovets (31%, n = 24) and pharmacies (21%, n = 16) without prescriptions. Commercial farmers were more likely to be aware of AMR compared to medium-scale farmers (OR = 14.07, 95% CI: 2.09–94.70), as were farmers who used prescriptions to access antibiotics compared to those who did not (OR = 99.66, 95% CI: 7.14–1391.65), and farmers who did not treat market-ready birds with antibiotics compared to those who did (OR = 41.92, 95% CI: 1.26–1396.36). The awareness of AMR among some layer farmers was low. Therefore, policies that promote the rational use of antibiotics need to be implemented together with heightened surveillance activities aimed at curbing AMR

Antimicrobial Susceptibility Profiles and Molecular Characterisation of Staphylococcus aureus from Pigs and Workers at Farms and Abattoirs in Zambia

Pigs have been shown to be a reservoir for recently emerging livestock-associated Staphylococcus aureus (LA-SA), including methicillin resistant strains in many countries worldwide. However, there is sparse information about LA-SA strains circulating in Zambia. This study investigated the prevalence, phenotypic and genotypic characteristics of S. aureus from pigs and workers at farms and abattoirs handling pigs in Lusaka Province of Zambia. A total of 492 nasal pig swabs, 53 hand and 53 nasal human swabs were collected from farms and abattoirs in selected districts. Standard microbiological methods were used to isolate and determine antimicrobial susceptibility patterns of S. aureus. Polymerase Chain Reaction was used to confirm the species identity and detect antimicrobial resistance and virulence genes of isolates, whereas genetic diversity was evaluated using spa typing. Overall prevalence of S. aureus was 33.1%, 37.8% for pigs and 11.8% for humans. The isolates were resistant to several antibiotics with resistance ranging from 18% to 98% but were all susceptible to vancomycin. Typical LA-SA spa types were detected. The presence of plasmid mediated resistance genes such as tetM (12.8%), other resistance determinants and immune evasion cluster genes among the isolates is of great public health concern. Thus, continuous surveillance of S. aureus using a “One health” approach is warranted to monitor S.aureus infections and spread of antimicrobial resistance