A Comparative Study of Septic Complications in HIVInfected and HIV-Uninfected Women Undergoing Caesarean Section at the University Teaching Hospital, Lusaka, Zambia

Background: There is evidence in support of the benefit of caesarean section for the prevention of mother to child transmission of HIV (PMTCT). Information on the extent of complications and maternal mortality associated with caesarean section in HIV infected women in low resourcesettings is lacking though some studies have reported increased risk of maternal complications associated with caesarean section in HIV infected women (particularly sepsis).Objective: This study was designed to determine the incidence of post caesarean maternal complications, particularly those due to sepsis, at the University Teaching Hospital (UTH) and compare complications in HIV infected and HIV uninfected women.Design and setting: A prospective cohort study documenting complications in women undergoing caesarean section at UTH in Lusaka. All consecutivepatients undergoing caesarean section at UTH in September 2010 and with a known HIV status were recruited. Consenting participants were followed up for six (6) weeks after the caesarean section. All complications were documented.Results: Fifty eight (19.4%) HIV positive and 241 (80.6%) HIV negative women were followed up. Overall, 27 (9%) women had sepsis (6 were HIV positive and 21 were HIV negative; 10.3 vs. 8.7% respectively). Theunadjusted odds ratio for sepsis in HIV positive vs. HIV negative women was 1.21 (95% CI 0.40-3.15). Adjusting for potential confounders (age, emergency or elective caesarean section, type of skin preparation, use of preeoperative antibiotics, blood loss, duration of operation) did not significantly alter the odds ratio (OR 1.39, 95% CI 0.5-3.6).Conclusion: Sepsis complicated 9% of caesarean sections at UTH though this complication was not independently associated with HIV status. Further studies are needed to address which factors contribute to postcaesareancomplications

Transversal directional filters for channel combining

A new concept for the design of power combiners based on matched directional filters is presented. The directional filters consist of individual balanced sections composed of hybrids and single resonators. Each of the sections corresponds to a pole of an all-pass function composed of the sum of S11 and S12 of the desired filter transfer function. A simple synthesis method is presented. The filter combiner has the advantage of ease of tunability because each pole is associated with a single resonator. Furthermore, no cross couplings are required to realize finite frequency transmission zeros

Southern Africa Consortium for Research Excellence (SACORE): successes and challenges

Copyright © Mandala et al. Open access article distributed under the terms of CC BY.Published Online November 13, 2014 http://dx.doi.org/10.1016/S2214-109X(14)70321-

Enhanced Library Services Through Social Media in the Age of Covid-19 Pandemic: An Anecdote of Academic Libraries in Zambia

The purpose of this study was to investigate the potential of using social media as a tool for promoting value addition and the enhancement of library services in the age of COVID-19 pandemic in two academic libraries in Zambia. Despite the growing mass of literature on social media usage in academic libraries globally, there is a dearth of research in Zambia on this emerging subject. The study used a survey method and the research instrument was an online questionnaire involving 22 academic librarians drawn from two public universities in Zambia, namely; the University of Zambia and Mulungushi University. Findings show that the use of social media for service delivery was nonexistent. Facebook and WhatsApp were the most prominent apps used for social networking among librarians. 86.3% of the respondents were of the view that the adoption of social media needed a cautious approach. 90% of the respondents had positive perceptions of the usefulness of social media in the era of the COVID-19 pandemic. Nonetheless, inadequate social media literacy skills, hesitancy among library staff, and poor technological infrastructure were perceived to be hindrances. The study advocates for social media literacy and the provision of a robust technological infrastructural base anchored on strong social media policies. This study provides library practitioners and students of Library and Information Science (LIS) with suggestions for how librarians, can use social media to improve audience engagement, create a community of users, and enhance the library\u27s profile

Viral Diversity and Diversification of Major Non-Structural Genes vif, vpr, vpu, tat exon 1 and rev exon 1 during Primary HIV-1 Subtype C Infection

To assess the level of intra-patient diversity and evolution of HIV-1C non-structural genes in primary infection, viral quasispecies obtained by single genome amplification (SGA) at multiple sampling timepoints up to 500 days post-seroconversion (p/s) were analyzed. The mean intra-patient diversity was 0.11% (95% CI; 0.02 to 0.20) for vif, 0.23% (95% CI; 0.08 to 0.38) for vpr, 0.35% (95% CI; −0.05 to 0.75) for vpu, 0.18% (95% CI; 0.01 to 0.35) for tat exon 1 and 0.30% (95% CI; 0.02 to 0.58) for rev exon 1 during the time period 0 to 90 days p/s. The intra-patient diversity increased gradually in all non-structural genes over the first year of HIV-1 infection, which was evident from the vif mean intra-patient diversity of 0.46% (95% CI; 0.28 to 0.64), vpr 0.44% (95% CI; 0.24 to 0.64), vpu 0.84% (95% CI; 0.55 to 1.13), tat exon 1 0.35% (95% CI; 0.14 to 0.56 ) and rev exon 1 0.42% (95% CI; 0.18 to 0.66) during the time period of 181 to 500 days p/s. There was a statistically significant increase in viral diversity for vif (p = 0.013) and vpu (p = 0.002). No associations between levels of viral diversity within the non-structural genes and HIV-1 RNA load during primary infection were found. The study details the dynamics of the non-structural viral genes during the early stages of HIV-1C infection

The epidemiology of gonorrhoea, chlamydial infection and syphilis in four African cities.

OBJECTIVES: To compare the epidemiology of gonorrhoea, chlamydial infection and syphilis in four cities in sub-Saharan Africa; two with a high prevalence of HIV infection (Kisumu, Kenya and Ndola, Zambia), and two with a relatively low HIV prevalence (Cotonou, Benin and Yaoundé, Cameroon). DESIGN: Cross-sectional study, using standardized methods, including a standardized questionnaire and standardized laboratory tests, in four cities in sub-Saharan Africa. METHODS: In each city, a random sample of about 2000 adults aged 15-49 years was taken. Consenting men and women were interviewed about their socio-demographic characteristics and their sexual behaviour, and were tested for HIV, syphilis, herpes simplex virus type 2 (HSV-2), gonorrhoea, chlamydial infection, and (women only) Trichomonas vaginalis infection. Risk factor analyses were carried out for chlamydial infection and syphilis seroreactivity. RESULTS: The prevalence of gonorrhoea ranged between 0% in men in Kisumu and 2.7% in women in Yaoundé. Men and women in Yaoundé had the highest prevalence of chlamydial infection (5.9 and 9.4%, respectively). In the other cities, the prevalence of chlamydial infection ranged between 1.3% in women in Cotonou and 4.5% in women in Kisumu. In Ndola, the prevalence of syphilis seroreactivity was over 10% in both men and women; it was around 6% in Yaoundé, 3-4% in Kisumu, and 1-2% in Cotonou. Chlamydial infection was associated with rate of partner change for both men and women, and with young age for women. At the population level, the prevalence of chlamydial infection correlated well with reported rates of partner change. Positive syphilis serology was associated with rate of partner change and with HSV-2 infection. The latter association could be due to biological interaction between syphilis and HSV-2 or to residual confounding by sexual behaviour. At the population level, there was no correlation between prevalence of syphilis seroreactivity and reported rates of partner change. CONCLUSION: Differences in prevalence of chlamydial infection could be explained by differences in reported sexual behaviour, but the variations in prevalence of syphilis seroreactivity remained unexplained. More research is needed to better understand the epidemiology of sexually transmitted infections in Africa

Task-Shifting and Quality of HIV Testing Services: Experiences from a National Reference Hospital in Zambia.

BACKGROUND: With new testing technologies, task-shifting and rapid scale-up of HIV testing services in high HIV prevalence countries, assuring quality of HIV testing is paramount. This study aimed to explore various cadres of providers' experiences in providing HIV testing services and their understanding of elements that impact on quality of service in Zambia. METHODS: Sixteen in-depth interviews and two focus group discussions were conducted with HIV testing service providers including lay counselors, nurses and laboratory personnel at purposively selected HIV testing sites at a national reference hospital in Lusaka. Qualitative content analysis was adopted for data analysis. RESULTS: Lay counselors and nurses reported confidentiality and privacy to be greatly compromised due to limited space in both in- and out-patient settings. Difficulties in upholding consent were reported in provider-initiated testing in in-patient settings. The providers identified non-adherence to testing procedures, high workload and inadequate training and supervision as key elements impacting on quality of testing. Difficulties related to testing varied by sub-groups of providers: lay counselors, in finger pricking and obtaining adequate volumes of specimen; non-laboratory providers in general, in interpreting invalid, false-negative and false-positive results. The providers had been participating in a recently established national HIV quality assurance program, i.e. proficiency testing, but rarely received site supervisory visits. CONCLUSION: Task-shifting coupled with policy shifts in service provision has seriously challenged HIV testing quality, protection of confidentiality and the process of informed consent. Ways to better protect confidentiality and informed consent need careful attention. Training, supervision and quality assurance need strengthening tailored to the needs of the different cadres of providers