Obstetrical outcome in gestational diabetes mellitus: a retrospective study

Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcomes. Majority of the maternal complications associated with GDM have been decreasing nowadays, however the relative risk of development of perinatal complications remain higher in women with hyper glycaemia.Methods: This retrospective study was conducted among 286 delivered pregnant women. The pregnant women were diagnosed as GDM by DIPSI diagnostic criterion. The study was performed to find the association of various risk factors with GDM occurrence and to assess the obstetrical outcome in the GDM and normoglycaemic women.Results: Out of the 286 women, the proportion of women affected with GDM was 20.6%. The onset of GDM was more common among women between 25-30year (62.7%). GDM onset is increased when they had previous history of GDM and family history of diabetes.  The obstetric complications were less common among GDM women (23.72%). GDM women had increased rate of caesarean delivery (69.5%) and induction of labour (42.4%). The neonatal complications were more common among GDM neonates (57.62%). The proportion of occurrence of congenital anomalies and macrosomia (>3.5kg) was similar among both groups.Conclusions: Risk factors associated with GDM onset such as previous history of GDM and family history of diabetes are significant risk factors. Advanced age, increasing parity and occurrence of abortions were not associated with GDM onset.  With good glycaemic control the obstetrical complications and macrosomia are preventable. Rate of Induction of labour, caesarean delivery and neonatal morbidity remains higher among GDM women

Determinants of HIV Testing Among Sexually Active Young People in Zambia

This study used data from the 2013 Zambia Demographic Health Survey (ZDHS) based on a nationally representative sample carried out by Central Statistical Office of Zambia. This paper analyzed a special module designed to collect information on the extent of the uptake of HIV testing by sexually active young people in Zambia. The analysis of this paper is based on 1879 young women aged 15-19 and 2747 aged 20-24 years respectively. Their male counterparts were 1675 aged 15-19 and 2005 aged 20-24 years. Overall 84% of females and 57% of males reported having tested for HIV. Regression analysis further showed that age, place of residence, work status, educational level, consistency of condom use and number of sex partners were significantly related to the uptake of HIV testing for both female and male participants. Young sexually active people should be availed affordable educational opportunities which in turn will hopefully accord them to viable economic opportunities. The media exposure to the young men and women should preach consistent condom use as well as a reduction in their sexual partners.Key Words: HIV testing; Sexually active; Condom use; Prevalenc

Domestic Violence and Sexual Health among Young Women in Zambia

This paper aims at describing the prevalence and correlates of domestic violence, and evaluating their associations with key health outcomes among Zambian young females aged 15–24 years.Data from the 2007 Zambia Demographic Health Survey was utilized. The survey was carried out by Central Statistical Office with the technical assistance from Macro International through MEASURE DHS programme. The 2007 ZDHS is based on a nationally representative sample of 7146 ever married women of 15-49 age group covering 320 Standard Enumeration Areas (clusters). In this paper, the data analysis was only restricted to young women aged 15-24.The results show that among the various forms of violence against women, 22% of the women faced sexual violence, followed by emotional violence (21%) and physical violence (16%). The results further revealed  that age, religion, educational level, working status, condom use during last sex and had any STDs in the last 12 months, had genital sores/ulcers in the last 12 months were the most prominent factors significantly explaining variation in the prevalence of physical, emotional and sexual violence. Domestic violence is a complex societal scourge which is unlikely to be attributed to one single determinant.Keywords: Domestic Violenc

Family Domestic Violence: Impact on Children in Lusaka, Zambia

Aim: To explore the experiences of children exposed to domestic violence in Lusaka District, Zambia. Study Design: A qualitative exploratory approach was adopted for this study. Place and Duration of the Study: The study took place in Lusaka district over a period of 8 months. The study population included domestic violence survivor children and their parents. The study sample consisted of fifty-two participants divided into thirty children (boys and girls), sixteen parents or guardians, and six key informants. Data was collected using detailed interviews with children and key informants, while focus group discussions were conducted with the parents or guardians. Results: The findings of the study revealed that children were exposed to different forms of domestic violence including physical abuse, emotional (verbal) abuse, and economic abuse. The children were both witnesses and victims of domestic violence. The study also revealed that exposure to violence had negative effects on the children such as physical injury, fear and anxiety, loss of confidence and self-esteem, academic under performance, guilt and shame, and poor relationships with peers and parents. Conclusion and Recommendations: Domestic violence is still prevalent in Lusaka District and has negative long-term effects on children who witness it and are victimised by it. Interventions are necessary to address the size, nature, and complexity of the problem. It is recommended that professionals who have regular contact with families and children, including teachers, child care workers, health and mental health care providers, law enforcement officers, child welfare workers, and court officials should receive ongoing training on domestic violence and its impact on children, and necessary interventions to combat it

Bride Price (Lobola) and Gender-based Violence among Married Women in Lusaka

Background: This study investigated the influence of lobola, a payment made for marriage, on gender-based violence among married women in Lusaka’s Kamanga compound. Specifically, the study sought to establish how married women and men perceived lobola in relation to gender-based violence in marriage. Method: The study used the qualitative research method. Participants in the study included eighteen married women and men. In addition, in-depth interviews using a semi-structured interview guide were conducted with five key informants. Results: The findings from the study suggest that paying lobola translated into buying a wife and as such, a wife became a husband’s property. Lobola gave the man or husband powers to treat his wife as he wished, including subjecting her to sexual and other forms of abuse. This seems to take away a wife’s rights to make decisions on matters that affected her own life such as being restricted in her movements, in choosing what to wear, and depriving her of a claim over her children among others. Conclusion: The study recommends that the Ministries of Justice and Gender and the Local Government should look deeply into the issue of paying lobola and correct the practice by deterring or reprimanding those who do adhere to its significance. Civil society should also lobby government to enact appropriate laws and policies to deal with patriarchy and help married women to enjoy their rights as human beings

Gender Differentials in Consistent Condom Use among Young People in Zambia

The aim of this paper is to determine socio-economic and demographic factors that influence gender differentials in consistent use of condoms among young people in Zambia. Data for this paper were collected from a household questionnaire that was administered to sexually active youth (N=3554) between the ages of 15-24 during the 2013 Demographic Health survey. Cross tabulation and chi-square results revealed a relationship between age, gender, place of location, socio-economic background, employment status, level of education media exposure, alcohol consumption and perceived risk of contracting HIV with the consistent use of condoms. For females, regression analyses revealed that wealth status, work status, educational level and drinking alcohol were positively associated with reporting consistent use of condoms. For males, age, work status, educational level, perceived risk of contracting HIV and drinking alcohol are associated with increased likelihood of reporting consistent condom use within the last 6 months.Key Words: Gender Differentials, Condom use, Youth, Zambi

Dating Violence Experienced by Students at the University of Zambia

Dating violence is a complex problem determined by multiple factors. Poverty, cultural and social environmental factors are a major contributor to the gender based violence. The aim of this study was to examine the nature and extent of dating violence experienced by students at the University of Zambia. Eighteen students (nine males and nine females) aged fifteen to thirty years were recruited from the University of Zambia hostels. In-depth interviews with semi-structured interviews were used for data collection. This study has found that various forms of dating violence exists at the University of Zambia. The study further found risk factors that were associated with dating violence such as consumption of alcohol and/or use of entertaining substances, as well as being involved in aggressive activities such as fighting or insulting; other factors included; poverty, experiencing of inter-parental violence and prior experience with violence. The psychological and emotional implications were that some students became depressed and stressed, insecure, ideated suicide, feared sex, distrusted people and were worried and uneasy. Under physiological and health outcomes, some students contracted STDs and HIV, body injuries, became pregnant, and others lost or terminated their pregnancy. Furthermore, social implications were that some students became aggressive, went into self-isolation, and began living recklessly. Physical abuse, verbal abuse, sexual abuse and psychological or emotional abuse where the most common types of dating abuse found at the University of Zambia. Conclusively, In addition to awareness against gender based violence, youth friendly corners should be considered during the treatment of gender based violence in universities

Effect of Age and Level of Education on Neurocognitive Impairment in HIV Positive Zambian Adults

Objective: Older age and lower education levels are known to be associated with worse neurocognitive (NC) performance in healthy adults, and individuals with HIV infection may experience accelerated brain/cognition aging. However, higher education may possibly protect against HIV-associated neurocognitive disorders (HAND). The aim of the current cross-sectional study was to assess the effect of age and education in an HIV-1 clade C infected adult population in urban Zambia. Method: Demographically corrected Zambian norms on a neuropsychological (NP) test battery were used to correct for normal age and education effects. The study assessed 286 HIV positive (+) males (37.1%) and females (62.9%) with a mean age of 41.35 (SD = 8.56) and mean years of education = 10.16 (SD = 2.18). A comprehensive NP test battery was used to assess cognitive domains frequently affected by HIV: attention/working memory, learning/and delayed recall, executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. Results: In younger HIV+ Zambians, higher education evidenced protective effects against NC impairments overall, and for the specific domains of executive functions, learning and speed of information processing. Impairment scores did not support accelerated overall brain aging although the restricted age range and relative youth of our total sample may have precluded detection of such tendencies. Conclusions: The present study raises the need to investigate factors that could be implicated in the poor neurocognitive performance among the younger, less educated HIV+ individuals in Zambia.Effect of Age and Level of Education on Neurocognitive Impairment in HIV Positive Zambian AdultspublishedVersio

Study of ABCB1 polymorphism (C3435T) in HIV-1-infected individuals from South India

Studies on P-glycoprotein expression and function have revealed that a single nucleotide polymorphism (SNP) in the human ABCB1 gene at 3435 (C > T) results in altered expression and function of P-glycoprotein [1, 2].There have been reports of lower nelfinavir and efavirenz (EFV) concentrations associated with TT genotypes (mutant) of ABCB1 C3435T polymorphism [3, 4].Frequency distribution of this polymorphism is known to vary across populations [3, 5, 6]. We report the genotype distribution of ABCB1 C3435T in 179 individuals (126 HIV-infected and 53 healthy) from South India. The polymorphism was correlated with plasma 12 h EFV and 2 h nevirapine (NVP) concentrations in 55 and 71 patients, respectively. Plasma EFV and NVP were estimated by HPLC [7, 8]. Genotyping was carried out by PCR-RFLP [9]

Perspectives on ART adherence among Zambian adults living with HIV: insights raised using HIV-related disability frameworks.

Anti-retroviral treatment (ART) has improved the survival of people living with HIV in Africa. Living with chronic HIV comes with new health and functional challenges and the need to manage ART adherence. The Sepo Study applied disability frameworks to better understand living with chronic HIV while using ART. The study followed 35 people (18 women, 17 men) living with HIV and on ART 6 months or longer in private and public health facilities in Lusaka, Zambia over 18-months (2012-2015). A total of 99 in-depth interviews were conducted. Conventional content analysis and NVIVOv10 were applied to analyse the data. Participants were adhering to ART at the times of the interviews and therefore less likely to report major challenges with adherence. Three main themes emerged from the data related to adherence. Firstly, ART was regarded as "giving life", which underscored adherence. Secondly, all participants described strategies for to managehealth and functional limitations, which they attributed as side-effects or chronicity. Thirdly, participants described experiences of uncertainty, including the efficacy of new regimens, potential loss of functioning, risk of new health problems, and death. Long-term ART managment in Africa needs to integrate rehabilitation approaches to address functional limitations, uncertainties, strengthen and support for adherence