Tobacco smoking prevalence among in-school adolescents aged 13-15 years: baseline for evaluation of the implementation of the FCTC in Lusaka district, Zambia

Background: Tobacco use is a major public health concern worldwide. Zambia has been controlling tobacco use in terms of legislative interventions, and acceding to the World Health organization (WHO) Framework Convention on Tobacco Control (FCTC). The study was aimed to determine the baseline prevalence of current smoking to be used in the evaluation of the implementation of the WHO FCTC. Methods: Survey data from the 2002 and 2007 Global Youth Tobacco Surveys (GYTS) were used to estimate the prevalence of tobacco use. The standard protocol for GYTS was used in the surveys, and only data for students aged 13 to 15 years was used in the analysis. Data were analyzed using SUDAAN (Research Triangle institute), and SPSS (version 11.5) software packages. Weighted analysis was used to produce estimates together with their 95% confidence intervals (CI). Results: The current cigarette smokers were 9.2% in 2002 and 6.8% in 2007 (p>0.05), with an overall rate of 7.4% (95%CI [7.1, 7.7]). No significant difference in current cigarette smoking rates was observed between sexes. However, compared to students of age 15 years, those of ages 13 and 14 years were less likely to be current smokers (AOR=0.82, 95%CI [0.77, 0.88]) for 13 years, and AOR=0.90, 95%CI [0.85, 0.96] for 14 years). Conclusion: The results of this study show that Lusaka district is in the first stage of the tobacco epidemic. There is urgent need, guided by the WHO FCTC, for effective interventions to be put in place before the epidemic becomes unmanageable

A case study of government innovative programmes for increasing access to qualified health personnel in selected rural districts of Zambia

Objective: To document the experiences and lessons learnt from implementing innovative programmes that aim at increasing access to qualified health workers in Gwembe and Chibombo districts by Ministry of Health and participation of health workers.Methods: Qualitative analysis of the participation and satisfaction rates in retention and recruitment incentives for health workers in Gwembe and Chibombo Districts was conducted. Further document review of the current strategies implemented by the government was conducted with regards to them addressing the problems identified by the health workers based on a criterion that was developed. The study used primary and secondary data.Results: The findings indicated that there was high desire by the health workers to leave their current rural job postings and this was mainly due to issues related to their living and working conditions rather than the participation or satisfaction in the existing retention andrecruitment schemes. There was substantial turnover in the health workforces in both districts over the five-year period from 2005-2009, with annual losses ranging from 2 percent to 16 percent of the professional health workforce in each district. These losses were dues to death, retirement and redirection. Overall, there was also very little evidence and the quality of much of what existed was weak hence the difficult to ascertain if these interventions were contributing to an increase in access to qualified health workers in rural areas.Conclusion: To retain staff in the rural areas remains a challenge because of the high desire to leave exhibited by health workers. Bundled interventions therefore coupled with strong national leadership, governance and information systemsare key in ensuring skilled, motivated and supported health workers at the right place and time. In addition, a strong monitoring and evaluation system should be establised to provide evidence and lessons to ascertain which interventions are or are not working and inform further policy decisions on health workforce

Perceptions and Beliefs of University and College Students Towards Male Circumcision in Lusaka

Background: Data from a range of observational epidemiological studies, conducted since the mid 1980s, showed that circumcised men have a lower prevalence of HIV than those who are uncircumcised. Furthermore recent randomized controlled trials conducted in Uganda, Kenya and South Africa have presented a myriad of data pointing to a 60 – 70% protection against HIV transmission. This evidence supports the notion that there are substantial health benefits from scaling-up male circumcision in Zambia,  due to the country's high HIV prevalence and low rates of male  circumcision.Study Objective: To gain insights into the perceptions and beliefs about Male circumcision among University and college students in Lusaka,  Zambia. The study was purely qualitative, was conducted with an iterative approach.Results: Manifest content of the study findings suggests that there is a remarkable and consistent trend in the way that Medical Male Circumcision is perceived amongst college and university student. They present virtuallyuniversal knowledge about the procedure, its practice, where it should be conducted, the facts about circumcision and what the prevailing untruths are about the procedure. The female respondents approve of male circumcision for males of all ages. They were quite conservative in their speech where to express themselves adequately they would have to be coerced for example, into explicitly referring to the male sex organ as a penis.Conclusions: The results from this particular study suggest that most young male adults are willing to go for circumcision and for the correct reasons as stipulated in the clearing house on “Basic facts about  Circumcision”. In their opinion the main aspect which may limit scale upof circumcision would be lack of services as near to the prospective clients as possible and lack of sufficient information about male circumcision in various sections of society. The female students have grasped the opportunity and have become partners in their counterpart's health seeking behavior. They are aware that there are indirect benefits for them when their male partners have undergone circumcisio

Work-related Musculoskeletal Disorders: Prevalence, contributing factors and coping strategies among Physiotherapy personnel in Lusaka, Kitwe and Ndola districts, Zambia

Background: Injuries at a work place comprise a substantial part of injury burden. Work-related musculoskeletal disorders (WRMDs) are common in the field of physiotherapy because the nature of job tasks is physically challenging and therapeutic procedures are often repetitive, labour intensive and involve direct contact with patients. The objective of the study was to determine the prevalence, contributing factors and coping strategies for WRMDs among physiotherapy personnel in Lusaka, Kitwe and Ndola districts of Zambia.Methods: Data was collected using a selfadministered semi structured questionnaire in a cross sectional study. Data were summarized using percents for categorical variables, mean (standard deviation) for continuous variables, and median (Q1, Q3) for skewed variables.Results: A total of 120 physiotherapists participated in the survey and of these 82 (68.3%) experienced WRMDs that lasted for more than 3 days in the previous 12 months to the survey. Most (40.7%) participants experienced work-related injuries within the first five years after graduation. The majority of the participants indicated that the following work factors contributed to WRMDs: treating a large number of patients per day (97.5%), repeatedly performing the same task (94.9%), performing manual therapy techniques (93.2%), working in the same position for long periods (92.1%), and lifting and transferring patients (88.6%).Conclusions: WRMDs are common among physiotherapy personnel in Lusaka, Kitwe and Ndola districts of Zambia. Outcomes underlines the importance of further research with larger sample sizes to examine factors associated with WRMDs among physiotherapy personnel in this country.&#160

The socio-economic impact of stroke on households in Livingstone district, Zambia- a cross sectional study

The World Health Organization (WHO) defines stroke as 'the neurological deficit of cerebral vascular cause that persists beyond twenty four hours or is interrupted by death within 24 hours'. In Livingstone, Zambia, more than 30% of stroke victims indicate socio-economic problems. The study aimed at assessing the socioeconomic impact of stroke in households in Livingstone district. A total of 50 households were conveniently selected from the Physiotherapy and Community Based Rehabilitation registers of Livingstone General Hospital. Self administered questionnaires and Focus group discussions were used to collect quantitative and qualitative data respectively. The data was analyzed using SPSS and content analysis. The social impacts on the victim were depression, difficult to get along with, resentfulness, apathy, needy, separation, divorce, general marital problems, neglect on the part of the victim and fear. In families, there was low moods and apathy in households. The study also revealed an association between period of stroke and relationship changes (p<0.001). Gender and family relationship changes were highly associated (p<0.001), as more females than males experienced relationship changes. The economic impacts were loss of employment, reduced business activity and loss of business on the part of the victim. Economic activities like food provision, payment of school fees, accommodation were affected as a result of stroke, and this led to financial insecurities in households. The study also showed that the incomes lost were mostly salaries, followed by businesses. Most of the victims experienced economic challenges after stroke with a few of them were receiving economic assistance. The activities forgone by stroke households were food provision, housing, and education in order to accommodate the stroke situation in the households. The results of the study show that stroke has considerable socioeconomic impact on households which can deter the victims' developmentKeywords: Stroke; household; socio-economic; impact; Livingston

A quick needs assessment of key stakeholder groups on the role of family medicine in Zambia

Background. Zambia is a nation of nine million people, and has too few physicians to meet the country’s health needs. Following the strategy of other sub- Saharan countries, Zambia has developed a training programme in family medicine to help improve the medical competencies of its physician workforce. A needs assessment was undertaken to better understand the landscape into which Zambian family medicine is being placed.Methods. In 2014, a nine-question survey in Likert-scale format was developed, validated, and then delivered to four stakeholder groups: (i) practicing clinical physicians, (ii) the general public, (iii) the University of Zambia’s School of Medicine’s academic faculty and (iv) medical students. The needs assessment was delivered through several different mechanisms: via web-based service, to respondents’ email addresses; in paper form, to population samples of convenience; and verbally, through face-to-face encounters.Results. The number of stakeholders from each group who responded to the needs assessment were: clinical physicians, 27; general public, 15; academic faculty, 14; and medical students, 31. Five of the nine survey statements achieved super-majority consensus, with >66% of stakeholders in each group agreeing. Two additional statements achieved a simple-majority consensus with >50% agreement within each stakeholder group.Conclusion. This survey suggests that there is a broad-based a priori understanding of family medicine in Zambia, and general agreement that its presence would be valuable to Zambia’s healthcare system

Evaluation of oral hygiene services in selected public health facilities in Lusaka district of Zambia

Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. This study was conducted in the public health centers and first level hospitals with dental units (DUs) in Lusaka district. Adequacy of dental equipment, instruments and materials required for scaling and polishing (S&P) and oral hygiene instructions (OHI) was evaluated. Challenges faced by the dental therapists (DTs) in the entire DUs were also evaluated. This was a mixed method study; quantitative data was collected using a structured questionnaire which contained a standard facility assessment check list. Qualitative data was collected by conducting in-depth interviews. The study results showed that the oral hygiene services offered by the selected DUs in Lusaka district were inadequate. A fully functional dental chair was available only in fifty percent of the DUs, only twenty percent of the facilities had fully functional ultrasonic scaling unit, none of the facilities had all the instruments for polishing. The DTs work under stressful conditions as sixty percent of the facilities were understaffed; the supply of dental instruments and materials was poor; delay in repairing faulty equipment; risk of exposure to air borne infections as most of the facilities have space and ventilation problems. Recommendations of this study point towards an urgent need to improve and coordinate the oral health care system

Alcohol Consumption in Lusaka Urban District, Zambia: A Population Based Survey, 2007

Alcohol use is an important preventable risk factor for several non-communicable diseases (NCDs) and injuries that is related to lifestyle choices. The objective of the study was to determine the prevalence of alcohol consumption and its correlates. A cross sectional study utilizing a WHO stepwise approach to surveillance of NCDs was conducted in Lusaka district, Zambia. Current alcohol consumption was defined as having consumed alcohol in the previous 30 days to the survey. Complex samples logistic regression was used to determine independent predictors. A total of 1928 individuals participated in the survey. A third of the participants were males and 53.2% were in the age group 25 to 34 years. Overall, 35.8% of the respondents had attained secondary level of education. The prevalence for current consumption of alcohol was 20.7% (37.9% of males and 12.2% of females). Sex was associated with alcohol consumption, with females being 68% (AOR = 0.32, 95%CI [0.20, 0.51]) less likely to consume alcohol compared to male respondents. Age, education, body mass index and sedentary were not independently associated with alcohol consumption. The high prevalence of alcohol use among Zambian adults indicates an urgent need for specific measures such as public awareness campaigns, policies, and regulations

Prevalence of hypertension and its correlates in Lusaka urban district of Zambia: a population based survey

<p>Abstract</p> <p>Background</p> <p>Hypertension is a leading cause for ill-health, premature mortality and disability. The objective of the study was to determine the prevalence and associated factors for hypertension in Lusaka, Zambia.</p> <p>Methods</p> <p>A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables.</p> <p>Results</p> <p>A total of 1928 individuals participated in the survey, of which 33.0% were males. About a third of the respondents had attained secondary level education (35.8%), and 20.6% of males and 48.6% of females were overweight or obese. The prevalence for hypertension was 34.8% (38.0% of males and 33.3% of females). In multivariate analysis, factors independently associated with hypertension were: age, sex, body mass index, alcohol consumption, sedentary lifestyle, and fasting blood glucose level.</p> <p>Conclusions</p> <p>Health education and structural interventions to promote healthier lifestyles should be encouraged taking into account the observed associations of the modifiable risk factors.</p

The Afrotropical breeding grounds of the Palearctic-African migratory painted lady butterflies (Vanessa cardui)

Migratory insects are key players in ecosystem functioning and services, but their spatiotemporal distributions are typically poorly known. Ecological niche modeling (ENM) may be used to predict species seasonal distributions, but the resulting hypotheses should eventually be validated by field data. The painted lady butterfly (Vanessa cardui) performs multigenerational migrations between Europe and Africa and has become a model species for insect movement ecology. While the annual migration cycle of this species is well understood for Europe and northernmost Africa, it is still unknown where most individuals spend the winter. Through ENM, we previously predicted suitable breeding grounds in the subhumid regions near the tropics between November and February. In this work, we assess the suitability of these predictions through i) extensive field surveys and ii) two-year monitoring in six countries: a large-scale monitoring scheme to study butterfly migration in Africa. We document new breeding locations, year-round phenological information, and hostplant use. Field observations were nearly always predicted with high probability by the previous ENM, and monitoring demonstrated the influence of the precipitation seasonality regime on migratory phenology. Using the updated dataset, we built a refined ENM for the Palearctic-African range of V. cardui. We confirm the relevance of the Afrotropical region and document the missing natural history pieces of the longest migratory cycle described in butterflies.This work was funded by the National Geographic Society (grant WW1-300R-18); by the British Ecological Society (grant LRB16/1015); by the Research and Conservation Projects of the Fundació Barcelona Zoo; by the grant PID2020-117739GA-I00/MCIN/AEI/10.13039/501100011033 of the Spanish Ministry of Science and Innovation and the Spanish State Research Agency to G.T.; by the grant LINKA20399 from the Spanish National Research Council iLink program to G.T., C.P.B., N.E.P., and R.V.; by fellowship FPU19/01593 of the program Formación de Profesorado Universitario (FPU) to A.G.-B.; by the Turkana Basin Institute, National Geographic Society, and Whitley Fund for Nature to D.J.M.; and by grant 2018-00738 of the New Frontiers in Research Fund (Government of Canada) to G.T. and C.P.B.Significance Abstract Results Field Surveys, Larval Hostplants, and Field-Based Model Validation Monitoring Results and Population Dynamics across Regions A Refined Model for the Afrotropical Region Discussion The Afrotropical Breeding Grounds of V. cardui: Multiple Generations Shift South Toward the Tropics Diversity and Phenology of Larval Hostplants in the Afrotropics The Ecological Relevance of Delimiting Spatiotemporal Distributions in Migratory Insects Conclusion Methods December-January Field Surveys and Year-Round Monitoring Spatiotemporal Ecological Niche Modeling Data, Materials, and Software Availability Acknowledgments Supporting Information Reference