Prevalence and correlates for hypertension among full-time UNZA academic staff

Objectives: To determine the prevalence and factors associated with hypertension among full-time UNZA academic staff.Design: Cross-sectional study.Main outcome measure: Raised blood pressure.Results: A total of 100 full time employed University of Zambia staff was enrolled into the study of which 25% were females. Altogether 22% of the participants smoked cigarettes, and 63% of them consumed alcohol. Overall, 40% of the participants were hypertensive. Age wassignificantly associated with hypertension. On each birthday, participants were 16% (OR=1.16, 95% CI [1.09, 1.23]) more likely to be hypertensive.Conclusions: The prevalence of hypertension was high and interventions must be put in place to curtail this high rate of hypertension among academic staff of the University of Zambia

Contribution of Non-Timber Forest Products to Rural Household Income in Zambia

Non-timber forest products (NTFPs) play an important role in supporting rural livelihoods and food security in Zambia. NTFP-dependent households are poorer, have younger household heads with lower levels of education, and are located closer to district towns than other rural households are. NTFPs are a particularly important source of income in Luapula, Northwestern and Western provinces. • Income from woodfuel represented the greatest share of income for households that participated in NTFPs, and it was the most commonly reported business activity, with 68% of NTFP households reporting income from charcoal and firewood. NTFPs contribute an average of 32% to total household income among participants, with the poorest being more dependent on these sources. • Given the widespread demand for woodfuel and other forest products, it is likely that rural households will continue to engage in the extraction and trade of NTFPs as a business activity. However, charcoal production, if left unchecked, could compromise the integrity of forests and adversely affect the availability of other NTFPs. In order to reduce households’ reliance on charcoal/firewood as an income source, outreach efforts could promote other NTFPs such as wild honey, ants, and mushrooms as business activities. Mushrooms, ants, and caterpillars may particularly be important activities for female-headed households, as more female-headed households derived income from these sources.NON-TIMBER FOREST, ZAMBIA, Agricultural and Food Policy, Consumer/Household Economics,

This is My Story: participatory performance for HIV and AIDS education at the University of Malawi

University students represent a subset of young men and women at risk for HIV in high prevalence settings. Innovative programs are needed to raise awareness on the unique issues around HIV and AIDS in the university campus, while training student leaders for peer-based education. The Process and Collaboration for Empowerment and Discussion (PACED) method engages artists and people living with HIV and AIDS (PLWHA) to create a performance that encourages community dialog about HIV and AIDS and empowers PLWHA. 'This is My Story' was a program at the University of Malawi, Chancellor College, which adapted the PACED approach for university students. A qualitative evaluation conducted 1 year later among students and PLWHA participants and audience members demonstrated retention of the following themes: (i) trust in a relationship and how it affects women,(ii) equality for PLWHA and (iii) life after HIV and AIDS. All of the PLWHA and 90.9% of student participants reported a greater sense of empowerment. Of the audience members, 82.1% discussed the performance with friends and family. We thus present the PACED approach as a valuable tool in HIV and AIDS education and prevention among university students in Malawi

Factors associated with high cholesterol levels in Lusaka, Zambia: a community-based study

Background: High cholesterol level is a risk factor for cardiovascular disease. The objective of the study was to estimate the prevalence and correlates for high cholesterol levels in Lusaka district, Zambia.Methods: A modified World Health Organization STEPwise approach to surveillance method was used to collect data among adults. Odds ratios and their 95% confidence intervals were used to estimate magnitudes of associations.Results: A total of 1928 individuals participated in the survey. Overall, 15.8% (12.8% among male and 17.3% among female, p=0.013) respondents had high cholesterol levels. Compared to males aged 45 years or older, males of age 25-34 years were 44% less likely to have raised cholesterol levels. Males with body mass index (BMI) <18.5 and 25.0-29.9 were 87% less and 2.49 times more likely to have raised cholesterol, respectively, compared to males with BMI of 30 or more. Meanwhile, females aged 25-34 years were 22% less likely to have raised cholesterol compared to females aged 45 years or older. Compared to females with BMI of 30 or more, females with BMI of 18.5-24.9 and 25.0-29.9 were 33% less and 57% more likely, respectively, to have raised cholesterol levels.Conclusion: A series of surveys to determine changes in total and LDL cholesterol are needed to estimate changes in the health level of the residents in Lusaka. These results could be used in the formulation of an action plan to prevent and control high cholesterol and its consequences among Zambian urban residents

Determinants of fetal mortality in Zambia.

Factors associated with fetal deaths in ZambiaA pregnancy that does not terminate into a live birth is a public health concern. The aim of the paper was to determine factors associated with fetal deaths in Zambia. This paper uses data from the 2013/2014 Zambia Demographic Health Survey (ZDHS) and used a cross sectional study design. The study was purely quantitative and was conducted through structured interviews. A representative sample of 18,052 households was drawn and interviewed women in the reproductive age group 15-49. The results showed that only 5.3% women in Zambia had a fetal death. The multivariate logistic regression findings indicate that the odds of having a fetal death was 1.46 (CI: 1.20-1.79) higher for women whose health care was decided by their partner; increasing maternal age increased the odds of having a fetal death by 1.02 (CI: 1.01-1.03) and the odds of having a fetal death was lower for women who had children or a child alive. Evaluating factors associated with fetal death makes it possible to recognize that interventions in some social, economic, demographic and maternal factors is key in the reduction and prevention of adverse birth outcomes such as fetal deaths.Office of Global AIDS/US Department of Stat

HIV clinical stage progression of patients at 241 outpatient clinics in Democratic Republic of Congo: Disparities by gender, TB status and rurality

Background: HIV clinical care programs are increasingly cognizant of the importance of customizing services according to patients’ clinical stage progression (WHO\u27s four-tiered staging) and other risk assessments. Understanding factors associated with Persons Living with HIV (PLHIV) patients’ progression through the treatment cascade and clinical stages is essential for programs to provide patient-centered, evidence-based services. Methods and materials: To analyze patient characteristics associated with disease progression stages for PLHIV on antiretroviral therapy (ART), this quantitative study used data, from January 2014–June 2019, from 49,460 PLHIV on ART from 241 HIV/AIDS outpatient clinics in 23 health zones in Haut-Katanga and Kinshasa provinces, Democratic Republic of Congo. To assess bivariate and multivariate associations, we performed Chi-square and multinomial logistic regression. Results: Among PLHIV receiving ART, 4.4% were at stage 4, and 30.7% at stage 3. Those at the less severe stages 2 and 1 constituted 22.9% and 41.9%. After controlling for covariates, patients with no TB were significantly more likely than those with TB (p\u3c = .05) to be at stage 1, rather than 3 or 4 (adjusted odds ratio or AOR, 5.73; confidence interval or CI, 4.98–6.59). Other characteristics significantly associated with higher odds of being at stage 1 included being female (AOR, 1.35; CI, 1.29–1.42), and shorter duration on ART (vs. \u3e 40.37 months); for ART duration less than 3.23 months the AOR was 2.47, for 3.23–14.52 months duration the AOR was 2.60, and for 14.53–40.37 months duration the AOR was 1.77 (quartile cut points used). Compared to patients in urban health zones, those in rural (AOR, 0.32) and semi-rural health zones (AOR, 0.79) were less likely to be at stage 1. Conclusion: Significant and substantial variation in HIV clinical progression stage by geographic location and demographic characteristics existed, indicative of the need for targeted efforts to improve the effectiveness of HIV care. Patients with TB coinfection compared to those without coinfection had a much greater risk of being at stage 3 or 4, implying a need for customized approaches and clinical regimens for this high-risk population

Socioeconomic status and other factors associated with HIV status among OVC in Democratic Republic of Congo (DRC)

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa. Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC. Methods: For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents\u27 or guardians\u27 characteristics. We used the chi-square test to determine bivariate associations of the predictor variables with the dichotomous dependent variable, HIV positivity status. To analyze the association between these independent variables and the dichotomous dependent variable HIV status after controlling for other covariates, we performed firth\u27s logistic regression. Results: Of the OVC included in this study, 18% were orphans, and 10.9% were HIV+. The chi-square analysis showed that among parents/guardians that were HIV+, a significantly lower proportion of OVC (11.7%) were HIV+ rather than HIV- (26.3%). In contrast, for parents/guardians with HIV- status, 9.0% of OVC were HIV-negative, and 11.7% of OVC were OVC+. The firth\u27s logistic regression also showed the adjusted odds of HIV+ status were significantly lower for OVC with parents/guardians having HIV+ status themselves (AOR, 0.335; 95% CI, 0.171–0.656) compared with HIV-negative parents/guardians. The adjusted odds of HIV+ status were significantly lower for OVC with a monthly household income of \u3c $30 (AOR, 0.421; 95$30. Conclusions: Our results suggest that, with the exception of a few household and parent/guardian characteristics, the risk of HIV+ status is prevalent across all groups of OVC within this study, which is consistent with the existing body of evidence showing that OVC are in general vulnerable to HIV infection. With a notable proportion of children who are single or double orphans in DRC, HIV+ OVC constitute a high-risk group that merits customized HIV services. The findings of this study provide data-driven scientific evidence to guide such customization of HIV services

Challenges and opportunities related to postgraduate evidence-based practice module using blended learning

The use of information and communications technology (ICT) has become integral to health professions education worldwide. The incorporation of online facilities and maintaining of the face-to-face element make blended learning the ‘best of both worlds’. Blogs can be used to create a relatively learner-centred environment that allows students to learn at their own pace. Though blended learning has been proved to be appropriate in higher learning institutions, it comes with challenges and opportunities. Our study intended to highlight the challenges and identify opportunities encountered by an evidencebased practice (EBP) postgraduate class who used the blended learning model of learning. An action-based research methodology was utilised in this study. This involved data gathering, action planning, action taking and action evaluation. Data were gathered through the use of a blog that was accessed by all participants. They made comments which were reflecting their perceptions on the model that was used for the course. The students gave consent to participate while permission from the physiotherapy head of department was also acquired. Deductive analysis was used for data analysis. The information from the blog was extracted and converted into text files. Coding and analysis into opportunities and challenges as expressed by the participants was performed. Theoretical saturation through every reviewer’s agreement and satisfaction about the information was included. The data consisted of 94 postings made of primary postings (22) and responses (72). All the authors acted as reviewers. Certainty was achieved by discussing any ambiguity in coding. Any necessary amendments were made. The participants reported to have experienced some challenges pertaining to blended learning. The blog that was used as a media between students and the facilitator was inefficient in some way. Some students could not access it when required and some resources in the blog were inaccessible. The wireless internet connection mainly used in this model was not reliable. However, there were opportunities experienced by the learners. These included easy interaction between the learners and the facilitator at any time. The model also reduced instructor dependence and made the learners more responsible of their work. The blog appeared as a resource base for skills development. Timely feedback involving solving the problems students encountered during the course improved the communication skills between the students and the facilitator. However, technology constraints involving the blog and the internet connection were overwhelming among the students while writing up the tasks allocated to them. Despite the fact that students faced some challenges, facilitators of blended learning such as the interaction between the students and the facilitator of the course were motivating to keep the course interesting. While students experienced some opportunities about blended learning, its future rests on averting the challenges associated with it more, especially in developing countries. If the challenges reported would be addressed in developing countries, blended learning can be effective in building students’ engagement and relieving of overcrowded classrooms in higher learning institutions

Genetic diversity of Mycobacterium tuberculosis isolated from tuberculosis patients in the Serengeti ecosystem in Tanzania

SummaryThis study was part of a larger cross-sectional survey that was evaluating tuberculosis (TB) infection in humans, livestock and wildlife in the Serengeti ecosystem in Tanzania. The study aimed at evaluating the genetic diversity of Mycobacterium tuberculosis isolates from TB patients attending health facilities in the Serengeti ecosystem. DNA was extracted from 214 sputum cultures obtained from consecutively enrolled newly diagnosed untreated TB patients aged ≥18 years. Spacer oligonucleotide typing (spoligotyping) and Mycobacterium Interspersed Repetitive Units and Variable Number Tandem Repeat (MIRU-VNTR) were used to genotype M. tuberculosis to establish the circulating lineages. Of the214 M. tuberculosis isolates genotyped, 55 (25.7%) belonged to the Central Asian (CAS) family, 52 (24.3%) were T family (an ill-defined family), 38 (17.8%) belonged to the Latin American Mediterranean (LAM) family, 25 (11.7%) to the East-African Indian (EAI) family, 25 (11.7%) comprised of different unassigned (‘Serengeti’) strain families, while 8 (3.7%) belonged to the Beijing family. A minority group that included Haarlem, X, U and S altogether accounted for 11 (5.2%) of all genotypes. MIRU-VNTR typing produced diverse patterns within and between families indicative of unlinked transmission chains. We conclude that, in the Serengeti ecosystem only a few successful families predominate namely CAS, T, LAM and EAI families. Other types found in lower prevalence are Beijing, Haarlem, X, S and MANU. The Haarlem, EAI_Somalia, LAM3 and S/convergent and X2 subfamilies found in this study were not reported in previous studies in Tanzania