Prevalence and correlates for tobacco smoking among persons aged 25 years or older in Lusaka urban district

Zambia must act now to curtail the epidemic. The association between smoking and body mass index should further be explored so that an intervention can be designed that addresses both smoking and nutrition

Combined prevalence of impaired glucose level or diabetes and its correlates in Lusaka urban district, Zambia: a population based survey

<p>Abstract</p> <p>Background</p> <p>Developing countries are undergoing an epidemiological transition, from Communicable or Infectious to 'Non-Communicable' diseases (NCDs), such that cardiovascular disease, chronic respiratory diseases, cancer, and diabetes were responsible for 60% of all deaths globally in 2005, with more than 75% of these deaths occurring in developing countries. A survey was conducted to determine among other objectives the prevalence of diabetes and its association with physical fitness and biological factors.</p> <p>Methods</p> <p>A cross sectional study utilizing a modified World Health Organization's STEPwise approach to surveillance of NCDs was conducted in Lusaka district, Zambia. A multi-stage cluster sampling technique was used to select study participants of age 25 years or older. All eligible members of a household that was selected were invited to participate in the study. Unadjusted odds ratios (OR), and adjusted odds ratios (AOR) together with their 95% Confidence Intervals (CI) were obtained using Complex samples logistic regression</p> <p>Results</p> <p>A total of 1928 individuals participated in the survey, of which 33.0% were males. About half of the participants were of age 25-34 years (53.2%), and about a third of the respondents had attained secondary level of education (35.8%). The combined prevalence for impaired glucose level or diabetes was 4.0%. Age and mild hypertension were significantly associated with impaired levels of glucose or diabetes. Compared to participants in the age group 25-34 years, older participants were more likely to have impaired glucose level or diabetes (AOR = 2.49 (95%CI [1.35, 2.92]) for 35-44 years age group, and AOR = 3.80 (95%CI [2.00, 7.23]) for 45 + years age group). Mild hypertension was associated with impaired glucose level or diabetes (AOR = 2.57) (95%CI [1.44, 4.57])).</p> <p>Conclusions</p> <p>The prevalence of diabetes in Lusaka district has not reached an alarming level and it is now that interventions targeting the younger age group 25-34 years should be put in place to curtail the spread of diabetes.</p

Baseline mapping of neglected tropical diseases in Africa: the accelerated WHO/AFRO mapping project

Mapping is a prerequisite for effective implementation of interventions against neglected tropical diseases (NTDs). Before the accelerated World Health Organization (WHO)/Regional Office for Africa (AFRO) NTD Mapping Project was initiated in 2014, mapping efforts in many countries were frequently carried out in an ad hoc and nonstandardized fashion. In 2013, there were at least 2,200 different districts (of the 4,851 districts in the WHO African region) that still required mapping, and in many of these districts, more than one disease needed to be mapped. During its 3-year duration from January 2014 through the end of 2016, the project carried out mapping surveys for one or more NTDs in at least 2,500 districts in 37 African countries. At the end of 2016, most (90%) of the 4,851 districts had completed the WHO-required mapping surveys for the five targeted Preventive Chemotherapy (PC)-NTDs, and the impact of this accelerated WHO/AFRO NTD Mapping Project proved to be much greater than just the detailed mapping results themselves. Indeed, the AFRO Mapping Project dramatically energized and empowered national NTD programs, attracted donor support for expanding these programs, and developed both a robust NTD mapping database and data portal. By clarifying the prevalence and burden of NTDs, the project provided not only the metrics and technical framework for guiding and tracking program implementation and success but also the research opportunities for developing improved diagnostic and epidemiologic sampling tools for all 5 PC-NTDs-lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma

Developing an integrated implementation plan for control and elimination of NTDs: Nationwide mapping surveys for lymphatic filariasis, schistosomiasis and soil-transmitted helminthiasis in Zambia

Zambia, like most countries in Southern Africa, is non-endemic for onchocerciasis. However, this also means that, unlike many African countries experienced in community-directed delivery of medicines for helminthiasis, Zambia is relatively naive to preventive chemotherapy and associated delivery strategies, such as community-based mass drug administration (MDA). The current integrated approach the WHO is promoting for control of neglected tropical diseases (NTDs) targets conditions that are amenable to preventive chemotherapy using ivermectin (IVM) or diethylcarbamazine (DEC) with albendazole (ALB) for lymphatic filariasis (LF), ivermectin for onchocerciasis, praziquantel (PZQ) for schistosomiasis (SCH) and ALB or mebendazole (MBD) for soil-transmitted helminthiasis (STH) is recommended for Zambia. Recent advancements and external assistance to the country has supported the initiation of these programmes. In areas free of onchocerciasis, the WHO guidelines for helminth control advise intervention through community-directed MDA strategies using DEC and ALB for LF. The first plan recommended for SCH and STHs control is co-administration of PZQ and ALB through targeted large-scale distribution using a school-based treatment delivery system targeting all school-age children. Following several sporadic studies, Zambia is a developing country that has produced evidence of LF, SCH and STH, which are widespread and amenable to MDA and controlled on the same platform. Past and current information outlines that active transmission of these NTDs is ongoing and needs urgent intervention to control morbidity. In six chapters addressing specific topics, this PhD study will be in line with the WHO Global Programmes for the control of NTDs using an integrated strategy including capacity development for mapping and monitoring and evaluation as central to this project. The aim is to review the national policies on NTDs and construct solutions to address the main gaps and challenges as the country plan to scale up integrated interventions for control and elimination of specific NTDs based on the study findings. With evidence from nationwide mapping surveys for LF, SCH and STH in Zambia. A significant decrease in LF prevalence from the years 2003–2005 (11.5% CI95 6.6; 16.4) to 2012–2014 (0.6% CI95 0.03; 1.1); a significant scale-up of ITNs across the country from 0.2% (CI95 0.0; 0.3) to 76.1% (CI95 71.4; 80.7), respectively. ITN coverage was a better predictor of LF prevalence than a year alone with a significant Spearman’s correlation of -.462 at the 0.01 level (2-tailed), R²= 0.1878 (year alone) And 0.2837 (year and ITN coverage). Thirty-nine thousand nine hundred four children tested for SCH and STH in 1349 schools. The overall prevalence of schistosomiasis is 16.6 %, while STH was 22.0 %. The highest prevalence was reported in Lusaka (65.3 %) and Northwestern (41.9 %) for SCH and STH, respectively. Most participants were aged 10-12 years and had the highest prevalence of S. haematobium, followed by 13-15 years who had the highest prevalence of hookworm. Pearson Chi-Square test on age group indicated statistically significant difference at 4 degrees of freedom X²=372.766 (S. mansoni), X²=353.108, (hookworm) and X²=94.965 (A. lumbricoides) at p<0.0005. Univariate and multivariate analysis revealed a correlation on the independent environmental and climatic predictors with SCH and STH prevalence. The general information collected from this research will be used for policy development and provide direction for the National Neglected Tropical Diseases programme in line with the National Health Strategic Plan 2017- 2021 that focuses on primary health care and community health approaches. Currently, no nationwide MDA campaigns for SCH and STH is implemented, but LF MDAs have been going on since 2012/13 and have already reached the fifth round in one province. Therefore, the MoH NTD policy or strategic plan will be comprehensively revised to highlight the national NTD goals, strategic objectives, and key performance indicators for the next five years and beyond. The putative synergy of LF prevalence with vector control has provided evidence that helped to put Zambia on track to meet national and global goals of LF elimination by 2020. The distribution of SCH and STH is widespread, with varying risks of transmission. The maps produced will provide evidence on the areas targeted for interventions in Zambia

Improving paediatric asthma care in Zambia

Problem: In 2008, the prevalence of paediatric asthma in Zambia was unknown and the national treatment guideline was outdated. Approach: We created an international partnership between Zambian clinicians, the Zambian Government and a pharmaceutical company to address shortcomings in asthma treatment. We did two studies, one to estimate prevalence in the capital of Lusaka and one to assess attitudes and practices of patients. Based on the information obtained, we educated health workers and the public. The information from the studies was also used to modernize government policy for paediatric asthma management. Local setting: The health care system in Zambia is primarily focused on acute care delivery with a focus on infectious diseases. Comprehensive services for noncommunicable diseases are lacking. Asthma management relies on treatment of acute exacerbations instead of disease control. Relevant changes: Seven percent of children surveyed had asthma (255/3911). Of the 120 patients interviewed, most (82, 68%) used oral short-acting β-agonists for symptom control; almost half (59, 49%) did not think the symptoms were preventable and 43% (52/120) thought inhalers were addictive. These misconceptions informed broad-based educational programmes. We used a train-the-trainer model to educate health care workers and ran public awareness campaigns. Access to inhalers was increased and Zambian standard treatment guideline for paediatric asthma was revised to include steroid inhalers as control treatment. Lessons learnt: Joint activities were required to change paediatric asthma care in Zambia. Success will depend on local sustainability, and it may be necessary to shift resources to mirror the disease burden

Properties and sources of the remotely sensed and other environmental predictors used to model LF prevalence in Zambia.

1<p>Moderate Resolution Imaging Spectroradiometer (MODIS); available at <a href="https://lpdaac.usgs.gov/" target="_blank">https://lpdaac.usgs.gov/</a> (accessed February 2012).</p>2<p>Global Land Cover Network (GLCN); available at <a href="http://www.glcn.org/databases/lc_gc-africa_en.jsp" target="_blank">http://www.glcn.org/databases/lc_gc-africa_en.jsp</a> (accessed February 2012).</p>3<p>World Clim - Global Climate data, available at <a href="http://www.worldclim.org/" target="_blank">http://www.worldclim.org/</a> (accessed February 2012).</p>4<p>United States Geological Services (USGS) Digital Elevation Model (DEM) available at: <a href="http://eros.usgs.gov/" target="_blank">http://eros.usgs.gov/</a> (accessed February 2012).</p>5<p>Socioeconomic Data and Applications Center, available at <a href="http://sedac.ciesin.columbia.edu/data/set/wildareas-v2-human-influence-index-geographic" target="_blank">http://sedac.ciesin.columbia.edu/data/set/wildareas-v2-human-influence-index-geographic</a>. (accessed February 2012).</p

Maps of the MaxEnt predicted distributions of CFA prevalence categories.

<p>(A) The heatmap values represent the relative probabilities of presence of LF with at least 5%, CFA prevalence (model 1). (B) The heatmap represent the predicted relative probability of presence of LF with at least 15% CFA prevalence (model 2).</p

The use of Loop-mediated Isothermal Amplification (LAMP) to detect the re-emerging Human African Trypanosomiasis (HAT) in the Luangwa and Zambezi valleys

Background: Loop-mediated isothermal amplification (LAMP) is a novel strategy which amplifies DNA with high sensitivity and rapidity under isothermal conditions. In the present study, the performance of the repetitive insertion mobile element (RIME)-LAMP and human serum resistance-associated gene (SRA)-LAMP assays were evaluated using clinical specimens obtained from four male patients from Luangwa and Zambezi valleys in Zambia and Zimbabwe, respectively. Findings: The cases reported in this preliminary communication were all first diagnosed by microscopy, through passive surveillance, and confirmed by both RIME-LAMP and SRA-LAMP. A good correlation between microscopy and LAMP was observed and contributed to staging and successful treatment of patient. RIME-LAMP and SRA-LAMP complimented each other well in all the cases. Conclusions: Both RIME-LAMP and SRA-LAMP were able to detect Trypanosoma brucei rhodesiense DNA in patient blood and CSF and hence confirmed HAT in the parasitaemic patients. Our study indicates that the LAMP technique is a potential tool for HAT diagnosis, staging and may be useful for making therapeutic decisions. However, no statistically significant conclusion may be drawn due to the limited sample size used in the present study. It is thus imperative to conduct a detailed study to further evaluate the potential of LAMP as a bedside diagnostic test for HAT