Challenges of diabetes type two insulin dependent patients in Zambia. Patients perspective.

In the essay I will look at diabetes mellitus type two, the challenges patients go through and focusing on the patient’s perspective. As a nurse having worked in Zambia and in Norway, I will look at the settings of Zambia and the implications of the challenges in nursing .I will build on the information from research, journals, ,textbooks and internet sources and where I am not able to find information I will use my own experience and knowledge

Descri[ptive study of surrogate and clinical outcomes of anti-retroviral treatment in Selebi Phikwe, Botswana from June 2004 to June 2005

M.P.H., Faculty of Health Sciences, University of the Witwatersrand, 2011Background Few results are available concerning long-term clinical outcomes in ART treatment programs. The objective of this study was to describe clinical and laboratory outcomes for adult patients commenced on ART in Selebi Phikwe, Botswana from June 2004 to June 2005 within one year of commencement of ART. Methods Cross-sectional descriptive study of clinical and laboratory outcomes for 904 adult patients initiated on ART in Selebi Phikwe, Botswana, from June 2004 to June 2005. Data from ART services statistics was analyzed using descriptive statistical methods. Results Most patients had low a basal CD4 cellular count with a median count of 25 cells, which rose to 147 after 12 months of treatment. Of the 84 (9%) deaths, 75 (89%) had a basal CD4 count of less than 10 cells and 48 (57%) died within three months of commencing of ART Conclusion Good clinical and laboratory outcomes for patients on ART in resource limited are achievable. Mortality commonly occurs among patients with low CD4 counts and within three months of commencement of therapy

Risk-Taking Behaviors of First-Generation Sub-Saharan African-Born U.S. Resident Men

African-born residents of the United States have a higher incidence of HIV than African Americans. Factors such as lifestyle, habits, behavior practices, and activities may predispose African-born residents to behave sexually in ways that place them at risk of becoming infected with HIV. This study used a qualitative narrative approach to understand the lived experiences first generation Sub-Saharan African-born men who are U.S. residents to analyze the behaviors that expose them to HIV. To analyze data, the study used the health-belief model as the conceptual framework and NVivo for data analysis to assist in identifying, categorizing, and analyzing common themes and grouping unstructured data. The study used a purposive convenience sampling of 14 first generation Sub-Saharan African-born men who are U.S. residents residing in the states of Delaware, New Jersey, and Pennsylvania and discovered that they engage in sexual risk taking behaviors which include: having multiple sexual partners, preferring heterosexual relationships without a condom, have limited knowledge of HIV prevalence in the United States, and preferring to have sex with both African born females and American born women who are thought to be healthy. Their tendency to visit strip clubs, visit sex houses, and to abuse alcohol was also apparent in the study. Social change implications include adding new relevant knowledge in the understanding of how HIV spreads among Sub-Saharan African-born male U.S. residents by discovering the risk behaviors in which Sub-Saharan African men engage to expose themselves to contracting HIV disease. This knowledge can influence future health education efforts and target culture specific behaviors

Success factors for delivery of development aid in Zambia: the case of the pilot program for climate resilience (ppcr) project

ThesisStudies on the effectiveness of development aid have yielded different results in different localities, raising the need for addition studies that can explore and understand factors influencing project sustainability. The overall aim of this study was to examine factors affecting the effective use of development aid by focusing on the Pilot Programme for Climate Resilience (PPCR) project (2014-2017) in Zambia. This was undertaken in relation to the Programme overarching objective set out in the project document. The development objective of the project is to strengthen Zambia's institutional framework for climate resilience and improve the adaptive capacity of vulnerable communities in the Barotse Sub-basin of Western Province of Zambia. A mixed research design as adopted, collecting data from interviews and semi-structured survey questionnaires. Study participants included key project staff from five districts in Western Province. Purposive sampling was used to select staff of PPCR Project who participated in the study (n=35). Data was collected across six-month period (2018) revealed eight attributes as imperatives in the successful delivery of development aid as follows; (i) Institutional and political environment , (ii) Project coordination , (iii) Project design, (iv) Funds disbursement procedures, (v) Monitoring and evaluation system , (vi) Technical support and capacity building and (vii) Procurement processes. Data analysis involved the preparation of the collected data- editing and analyzed using content analysis and Microsoft excel package. The results of the study also revealed that Zambia’s weak disbursement profile, complex procurement processes and relatively weak outcome monitoring capacity contributes significantly towards the low performance of most development aid related Projects. The analysis of results provide support for the proposition that the concept of achieving success in administering aid resources has no single golden bullet but a multidimensional façade of variables which must all be deployed in sync in order to achieve the desired outcomes. Finally, the study also provides key insights for Project designers at concept stage to comprehend that an optimally designed Project model with a bias towards effectiveness, quality, satisfaction and timeliness is everything in successful Project Management. Keywords: Development aid, Project document, Climate Resilience, Adaptive Capacity, Critical success factors, Disbursement profile

The Prevalence of Intraventricular Haemorrhage and Associated Risk Factors in Preterm Neonates in the Neonatal Intensive Care Unit at the University Teaching Hospital, Lusaka, Zambia

Objectives: The study was undertaken with the aims of determining the prevalence and most frequent grade of IVH as well as associated risk factors in preterm neonates with birth weight 1.5kg or less admitted to the neonatal intensive care unit at the UTH in Lusaka, ZambiaDesign: This was a cross sectional study where 298 preterm neonates meeting the study's inclusion criteria had cranial ultrasound done in the first three days of life and on the seventh postnatal day. Data on the risk factors was obtained from the neonatal referral form, maternal records and direct interview with the neonate's mother.Main outcomes and Measures: The main outcomes were the prevalence of IVH and the most frequent grade of IVH. The variable any-IVH generated at the time of analysis was used in determining the prevalence of IVH and also as the dependent variable in multivariate logistic regression. Any-IVH was the highest grade of IVH obtained on either the first 3 days or day 7 on cranial ultrasound.Results: In this study, the prevalence of intraventricular haemorrhage in preterm infants with birth weight 1.5kg and less was 34.2% in the first seven days of postnatal life. Grade 1 (mild) IVH was the most frequent (54.9%) followed by severe IVH (grade 3 and 4) at 27.5%. The case fatality rate was 85.7% for those with grade 4 in the first three days of life. Grade 2 was the least prevalent at 17.7%. Risk factors significantly associated with IVH were birth weight [p=0.04, OR= 0.25(0.06-0.98) 95% C.I.] and gestational age [p=0.02, OR= 0.82 (0.69-0.97) 95%C.I.]Conclusions: The study found a similar or even lower overall prevalence to that reported in studies in Africa and globally, while the frequency of severe IVH was relatively very high with a high case fatality rate (85.7%) in the first seven days of postnatal life in respect of grade 4 IVH. Risk factors significantly associated with IVH were birth weight and gestational age while the former was also significantly associated with severe IVH as in otherstudies internationally

Determination of dichlorvos residue levels in vegetables sold in Lusaka, Zambia

Introduction: Small scale and large scale farmers around Lusaka, the capital city of Zambia grow vegetables using intensive agriculture methods to satisfy the ever increasing demand. To ensure maximum yield they apply various types of pesticides to control pests and diseases that attack these vegetables. Organophosphate pesticides are widely used in agriculture for the control of various insect pests mainly in developing countries. The purpose of the study was to determine the residual levels of the most commonly used organophosphate, 2, 2-Dichlorovinyl dimethyl phosphate, in three commonestvegetables supplied at various markets around Lusaka. Methods: Samples of 9 bunches of rape, 14 bunches lettuce and 15 rolls cabbage were randomly picked from several study sites around Lusaka. The vegetables were chopped into small pieces which were chemically treated to get methanol extracts. The extracts were then dissolved in an appropriate solvent and using Shimadzu High Performance Liquid Chromatography-Ultra-violet detector (HPLC-UV) levels of 2, 2-Dichlorovinyl dimethyl phosphate were determined. Results: The analysis showed that the average levels of dichlorvos were significantly above the maximum accepted limit as set by Zambian Food and Drugs Act on vegetables. Conclusion: Locally grown vegetables from around Lusaka have higher than maximum acceptable limits. This may have implications on human health as the cumulative effect of organophosphates in human body has potential to cause long term health problems.Pan African Medical Journal 2016; 2

Uptake of prevention and control measures of plague: a post-plague outbreaks case-study of Sinda District,Zambia

THESIS MSCZambia’s recent plague outbreaks in 2001 and 2007 were of great public health concern because of the potential to cause devastating social, environmental and economic effects in the country. Plague is a virulent vector-borne zoonotic disease caused by Yersinia pestis and has potential to infect humans and cause fatalities in 50 to 100 percent of cases if left untreated. The disease is known to have had reduced the world population in the 14th century from an estimated 450 million down to near 350 million. Consequently, plague remains a global public health threat. As an active plague foci, Sinda District remains under alert for subsequent outbreaks. Effective efforts on prevention and control of plague requires targeted approaches designed on the basis of adequate information on determinants of the uptake of plague prevention and control measures (PCM). This study, therefore, was conducted on the premise of understanding factors that determine uptake of PCM. The study involved a cross-sectional survey design where two villages (Nyanje and Nsato) where purposively selected before the selection of 178 households using multistage sampling. From each household, a respondent (head of household or knowledgeable elderly person) was interviewed. Additionally, two key informants’ interviews and one focus group discussion supplemented information. The significance of explanatory variables influencing the uptake of PCM was determined using multiple logistic regression analysis in Statistical Package for Social Sciences (SPSS) with statistical significance set at P≤ 0.05. The study population comprised mainly of female (61 percent). Majority (52 percent) are indigenous to the study area. With only 43 percent having attained only primary education, most of the study participants depend on faming and trading (43 and 50 percent respectively) for their livelihoods. Multiple logistic regression showed significant associations between literacy; sources of livelihoods; knowledge and perceptions (about plague and measures); source of information about plague outbreaks and the uptake of PCM. Participants who attained at least primary level of education are 79 percent likely to take up PCM than those who have never been to school. It is further established that farming as a source of income reduces odds of taking up PCM by 1 percent compared to 84 percent likelihood of taking up PCM when trading is a source of income. The odds of taking up PCM are positive with knowledge about plague and radio as source of information about outbreaks. However, demographic characteristics are not associated with uptake of PCM. The study has established that socio-economic factors such as education, source of livelihoods, source of information and perceptions about plague outbreaks are key determinants of the uptake of PCM. This in particular recommends design of strategies that will cogitate the significant effect of these key determinants

Examining environmental sustainability of practices of selected supermarkets through ISO 14001 in Lusaka district, Zambia

Rapid increase in the number of Supermarkets in sub-Saharan Africa, and Zambia in particular, has been viewed as an indication of positive developmental growth. However, as with any other industry, the food retail industry produces waste and contributes to environmental degradation. The extent to which this industry has affected the environment has not been well ascertained, and the overall image that emerges from literature is that very few studies have been undertaken to assess the environmental impacts associated with Supermarkets. The study was inspired by the lack of sustainability education and the low levels of compliance by Supermarkets to both local and international environmental regulatory standards leading to poor environmental sustainability practices in Zambia. The object of this study, therefore, was to examine the environmental sustainability practices of selected Supermarkets in Zambia’s Lusaka District through ISO 14001 and to determine whether or not sufficient effort was made to improve sustainability. ISO 14001 is an internationally agreed standard that sets out requirements for an Environmental Management System (EMS). This standard identifies and establishes environmental impacts associated with business operations and suggests effective operational controls to manage the identified impacts. A qualitative descriptive survey was used, which utilized a structured interview schedule and an ISO Checklist tool as primary data collection instruments. Purposive sampling design, involving expert purposive sampling and homogenous purposive sampling techniques, were employed to select ten supermarkets and an additional fifty members of the general public. The obtained results were analyzed using thematic analysis approach. The study revealed that there were a number of environmental concerns associated with Supermarkets’ daily business operations, among which were solid waste generation leading to environmental pollution and littering. There were no policy guidelines that regulated the general operations of supermarkets regarding environmental protection as observed from the disparities in the measures supermarkets were engaged in to promote environmental sustainability. This explained the reason why there was very little understanding of the concept of environmental sustainability among members of the public and Supermarket management teams in particular. Only eight percent of Supermarkets were engaged in recycling as a means to promote environmental sustainability. These findings point to a need for policy development to promote best practices and standards that will guide business operations among supermarkets as well as guide training and education to improve sustainability education among all sectors of the economy and among members of the general public. The study recommends that there should be strict policy guidance that regulates business operations in supermarkets in order to promote sustainable business operations. All Supermarkets should also have operational Environmental Management Systems that address environmental problems associated with their daily business operations

Evaluation of Dichlorvos levels in Cabbage,Rape and Lettuce sold on some parts of Lusaka,Zambia: Davies Mwazi Sinyangwe

Small scale and large scale farmers around Lusaka, the capital city of Zambia grow vegetables using intensive agriculture methods to satisfy the ever increasing demand. To ensure maximum yield farmers apply various types of pesticides to control pests and diseases that attack these vegetables. Organophosphate pesticides are widely used in agriculture for the control of various insect pests mainly in developing countries. The purpose of this study was to determine the residual levels of the most commonly used organophosphate, 2, 2-Dichlorovinyl dimethyl phosphate (Dichlorvos), in three common vegetables supplied at various study sites around Lusaka. Samples of rape, lettuce and cabbage were randomly picked from the study sites around Lusaka. The vegetables were chopped into small pieces which were chemically treated to get methanol extracts. The extracts were then dissolved in an appropriate solvent and using Shimadzu High Performance Liquid Chromatography-Ultra-violet detector, levels of dichlorvos were determined. The results of analysis showed that the levels of dichlorvos were significantly above the maximum accepted limit as set by Zambian Food and Drugs Act on vegetables. This higher than acceptable levels of dichlorvos may have implications on human health as the cumulative effect of organophosphates in human body has potential to cause long term health problems (Mackenzie Ross et al., 2010

Trends and factors associated with acute respiratory infection among under five children in Zambia: evidence from Zambia´s demographic and health surveys (1996-2014)

Introduction: acute respiratory infection (ARI) is one of the leading causes of morbidity and mortality among children under the age of five years globally accounting for 16% of deaths. In Zambia, ARI accounts for 30-40% of children's outpatient attendance and 20-30% of hospital admissions. We assessed trends and factors associated with ARI among under-five children in Zambia from 1996 to 2014. Methods: we analysed the Zambia demographic and health survey data for 1996, 2002, 2007 and 2014 of under five children and their mothers. We extracted data using a data extraction tool from the women's file. We analysed trends using chi square for trends. We conducted a complex survey multivariable logistic regression analysis, reported adjusted odds ratios (AOR) 95% confidence intervals (CI) and p-values. Results: we included a total of 6,854 and 2,389 (8%) had symptoms consistent with ARI. A 2% upward trend was noted between the 1996 and 2002 surveys but a sharp decline of 10% occurred in 2007. The chi2 trend test was significant p < 0.001. Children whose mothers had secondary or higher education were less likely to have ARI (AOR 0.30 95% CI 0.15-0.58) compared to those with no education. Underweight children had 1.50 times increased odds of having ARI (AOR 1.50 95% CI 1.25 - 1.68) compared with children who were not. Use of biomass fuels such as charcoal (AOR 2.67 95% CI 2.09 - 3.42) and wood (2.79 95% CI 2.45 -3.19) were associated with high odds for ARI compared to electricity. Conclusion: the prevalence of ARI has declined in Zambia from 1996 to 2014. Factors associated with occurrence of ARI included being a child under one year, underweight, use of biomass fuel such as charcoal and wood. Interventions to reduce the burden of ARI should be targeted at scaling up nutrition programs, as well as promoting use of cleaner fuels