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We retrospectively analyzed spatial factors for coronavirus disease 2019 (COVID-19)-associated community deaths i.e., brought-in-dead (BID) in Lusaka, Zambia, between March and July 2020. A total of 127 cases of BID with geocoordinate data of their houses were identified during the study period. Median interquartile range (IQR) of the age of these cases was 49 (34-70) years old, and 47 cases (37.0%) were elderly individuals over 60 years old. Seventy-five cases (75%) of BID were identified in July 2020, when the total number of cases and deaths was largest in Zambia. Among those whose information regarding their underlying medical condition was available, hypertension was most common (22.9%, 8/35). Among Lusaka's 94 townships, the numbers (median, IQR) of cases were significantly larger in those characterized as unplanned residential areas compared to planned areas (1.0, 0.0-4.0 vs 0.0, 0.0-1.0;p=0.030). The proportion of individuals who require more than 30 minutes to obtain water was correlated with a larger number of BID cases per 105 population in each township (rho=0.28, p=0.006). The number of BID cases was larger in unplanned residential areas, which highlighted the importance of targeted public health interventions specifically to those areas to reduce the total number of COVID-19 associated community deaths in Lusaka. Brought-in-dead surveillance might be beneficial in monitoring epidemic conditions of COVID-19 in such high-risk areas. Furthermore, inadequate access to water, sanitation, and hygiene (WASH) might be associated with such distinct geographical distributions of COVID-19 associated community deaths in Lusaka, Zambia.Copyright © Amos Hamukale et al.
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Background: Coronavirus disease 2019 (COVID-19) is a worldwide public health concern for healthcare workers. About 80% of cases appear to be asymptomatic, and about 3% may experience hospitalisation and later die. Less than 20% of studies have looked at the positivity rate of asymptomatic individuals. Objective: This study investigated the COVID-19 positivity rates among asymptomatic individuals during the second COVID-19 wave at one of Zambia's largest testing centre. Methods: This was a retrospective cross-sectional study conducted on routine surveillance and laboratory data at the Tropical Diseases Research Centre COVID-19 laboratory in Ndola, Zambia, from 01 December 2020 to 31 March 2021. The study population was made up of persons that had tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as a requirement for travel. Microsoft Excel was used to come up with an epidemiological curve of daily COVID-19 positive cases; proportions for gender were described using frequencies and percentages. Results: A total of 11 144 asymptomatic individuals tested for SARS-CoV-2 were sampled for the study and 1781 (16.0%) returned positive results. The median age among those tested was 36 years (interquartile range: 29-46). Testing for COVID-19 peaked in the month of January 2021 (37.4%) and declined in March 2021 (21.0%). The epidemiological curve showed a combination of continuous and propagated point-source transmission. Conclusion: The positivity rate of 16.0% among asymptomatic individuals was high and could imply continued community transmission, especially during January 2021 and February 2021. We recommend heightened testing for SARS-CoV-2 among asymptomatic individuals. What this study adds: This study adds critical knowledge to the transmission of COVID-19 among asymptomatic travellers who are usually a key population in driving community infection. This knowledge is critical in instituting evidence-based interventions in the screening and management of travellers, and its control.
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Intro: COVID-19 vaccines are safe and effective at reducing risk of severe COVID-19 among pregnant women, a group at higher risk of severe disease. However, vaccine uptake has been slow among people in Zambia. We sought to describe vaccine uptake among pregnant women in Zambia. Method(s): We conducted serial cross-sectional surveys among pregnant women attending first antenatal care visits in one rural and two urban districts of Zambia from December 2021 through June 2022. Ten health facilities per district were randomly selected and a convenience sample of 20 women per facility per month were recruited. Consenting participants were administered an electronic questionnaire asking about offers and receipt of COVID-19 vaccines. Finding(s): In total, 3,652 women were recruited from December 2021 to June 2022, and 82.4% had not received a COVID-19 vaccine. Vaccine coverage among participants rose from 10.5% in December 2021 to 28.7% in June 2022 (p<0.01). During the same period, the proportion of women who reported being offered a vaccine rose significantly from 22.4% to 52.5% (p<0.01), with a non-significant increase in the proportion of women who were unvaccinated but willing to accept a vaccine (58.0% to 65.8%, p=0.59). Among 785 women who were unvaccinated and not willing to accept a vaccine, 42.3% were concerned about the safety of vaccination during pregnancy. Conclusion(s): Vaccine coverage among pregnant women in Zambia remains low and safety concerns during pregnancy are high. Door-to-door vaccination campaigns and individual vaccination consultations at all healthcare encounters may increase the number of women being offered a vaccine. Focused safety messaging for pregnant women may help to alleviate fears and increase COVID-19 vaccine uptake.Copyright © 2023
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Background: Following acute COVID-19, some (~10-20%) individuals continue to experience a persistent variety of symptoms often referred to as long COVID- 19. However, evidence on long COVID-19 is limited from countries in Africa. We sought to describe the clinical presentation and factors associated with long COVID-19 in Zambia. Method(s): We conducted a cross-sectional analysis of routinely collected clinical information from patients receiving care in Zambia following SARS-CoV- 2 infection. Data were collected from 13 'post-acute COVID-19' (PAC-19) clinics established across Zambia to care for people following their acute infection. Long COVID-19 was defined as experiencing persistent symptoms >=4 weeks after initial diagnosis. Comorbidities detected at the time of SARS-CoV-2 infection were considered newly diagnosed. Severe illness was defined as acute COVID-19 that required supplemental oxygen therapy. We analyzed data from the first visit to the PAC-19 clinics and developed logistic regression models to assess factors associated with long COVID-19 at first visit to a PAC-19 clinic. Result(s): In total, 1,238 persons (< 1%) had >=1 visit to a PAC-19 clinic from August 2020 to April 2022 (out of ~319,500 confirmed cases in Zambia). Eight hundred twenty-three (66%) persons had been hospitalized for acute COVID-19 and the median length of stay was 8 days (interquartile range [IQR]: 4-16 days). Of these 1,238 persons, 641 (52%) were female while 403 (33%) had long COVID-19. The median age in persons with long COVID-19 was 54 years (IQR: 44-63) compared to 50 years (IQR: 37-61) in those without (p< 0.001). Cough (22%), fatigue (21%), and shortness of breath (15%) were frequently reported symptoms among persons with long COVID-19, while 4% had forgetfulness. Having severe illness (adjusted odds ratio [aOR] 2.8) and hospitalization for acute COVID-19 with length of stay >=15 days (aOR 13) were associated with having long COVID-19 (Table 1). Conclusion(s): Long COVID-19 was common among people attending PAC-19 clinics in Zambia, yet few persons with COVID-19 had attended a PAC-19 clinic. Those with severe illness were more likely to experience long COVID-19, which is consistent with other studies of long COVID-19. Given the burden of COVID-19 in Zambia, systems to care for patients with long COVID-19 might be needed in the future. Scaling up PAC-19 services and integrating into routine clinical care could improve access and further aid in understanding long COVID-19 in Zambia. (Table Presented).
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Background: Confirmed COVID-19 case counts underestimate SARS-CoV-2 infections, particularly in countries with limited testing capacity. Pregnant women attending antenatal care (ANC) clinics have served as healthy population surrogates to monitor diseases like HIV and malaria. We measured SARS-CoV-2 seroprevalence among women attending ANC clinics to assess infection trends over time in Zambia. Method(s): We conducted repeated cross-sectional surveys among pregnant women aged 15-49 years attending their first ANC visits in 3 districts of Zambia during September 2021-September 2022. Up to 200 women per district were enrolled each month, completing a standardized questionnaire. Dried blood spot samples were collected for serologic testing for prior infection using the Tetracore FlexImmArrayTM SARS-CoV-2 Human IgG Antibody Test and HIV testing according to national guidelines. We calculated odds ratios (ORs) for SARS-CoV-2 seroprevalence by demographic characteristics, adjusting for the district. Result(s): A total of 5,351 women were enrolled at 29 study sites between September 2021 and September 2022. Participants' median age was 25 years (interquartile range: 21-30), 530 (9.9%) tested positive for HIV, and 101 (1.9%) reported a prior positive COVID-19 test. Overall, SARS-CoV-2 seroprevalence was 67%, and rose from 49% in September 2021 to 85% in September 2022 (Figure 1). The greatest increase in seroprevalence occurred during the 4th wave caused by the Omicron variant (48% in December 2021 to 63% in January 2022). Seroprevalence was significantly higher among women living in urban districts (Chipata and Lusaka) compared to rural Chongwe District (Chipata OR: 1.2, 95% confidence interval [CI]: 1.1-1.4;Lusaka OR: 1.7, 95% CI: 1.5-2.0). The age group was not significantly associated with seroprevalence after adjusting for the district (aOR: 1.1, 95% CI: 1.0-1.2). Seroprevalence was significantly lower among women living with HIV than women living without HIV (aOR: 0.8, 95% CI: 0.6-0.9). Conclusion(s): Overall, two-thirds of women in the three surveyed districts in Zambia had evidence of SARS-CoV-2 exposure, rising to 85% after the Omicron variant spread throughout the country. ANC clinics have a potential role in ongoing SARS-CoV-2 serosurveillance and can continue to provide insights into SARS-CoV-2 infection dynamics. Furthermore, they provide a platform for focused SARS-CoV-2 prevention messaging and COVID-19 management in pregnant women at higher risk of severe disease. (Figure Presented).
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Background: Throughout the COVID-19 pandemic, it was evident that many SARS-CoV-2 infections occurred at mass gathering events. In many LMICs and LICs, places of worship serve as a venue for mass gatherings, and therefore a potential source of large-scale transmission events. Mass gatherings at places of worship also serve as an opportunity to distribute Ag-RDTs to a significant proportion of the community at regular intervals, disrupting transmission within the event and potentially impacting community spread of SARS-CoV-2. Method(s): We used an agent-based community assessment model, Propelling Action for Testing and Treatment, to estimate how various strategies of asymptomatic Ag-RDT self-testing of a fixed percentage of persons attending large religious gatherings (10%, 20%, 40%, 100%), in addition to the general underlying level of ongoing symptomatic testing in the population, would impact community transmission of SARS-CoV-2 in 3 contexts (Brazil, Georgia, Zambia). These testing strategies were analyzed with bi-weekly and weekly asymptomatic self-testing in a population with varying levels of vaccine efficacy (low/high), vaccine coverage (10%, 50%, 80%), and reproductive numbers (0.9, 1.2, 1.5, and 2.0) to simulate varying stages of the COVID-19 pandemic. We then performed an economical evaluation of the results from the model to understand the impact and cost-effectiveness of each self-testing strategy at places of worship. Result(s): In each of the epidemic conditions modeled, testing of symptomatic persons at weekly and biweekly frequencies can avert 2%-16% of Brazilian community infections and 31%-45% of infections occurring in places of worship in Brazil. The same is true in Georgia (1%-6% of total infections and 28%-45% place of worship-related infections) and Zambia (2%-21% of total infections and 29%-45% of place of worship related infections) despite differences in the proportion of populations regularly attending places of worship in the 3 countries. Asymptomatic self-testing in 100% of places of worship in a country result in the greatest percent of infections averted and consistently lands on the cost-effectiveness frontier yet requires a budget 520- 1550x greater than that of symptomatic testing alone. Conclusion(s): Testing of symptomatic persons attending regular religious gatherings have a significant impact on the spread of SARS-CoV-2 in places of worship and can significantly reduce community spread in contexts where population level attendance at religious gatherings is high. Cost-effectiveness analysis from Brazil, Georgia and Zambia modelling results with infections averted within places of worship and total community infections averted assuming a total cost per self-test of $2.50 USD.
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LMS use and the academic performance of undergraduate students In our first Refereed Article Odekeye, Fakokunde, Metu and Adewusi investigated the perception of undergraduate students on the use of a Learning Management System (LMS) in the learning process. researchers employed a descriptive survey design and administered an online questionnaire among undergraduate students at Osun State University. Using digital tools for social engagement in remote learning The authors note that digital tools have evolved into a way of life, and as a result, they have become a growing area of interest for academics who research teaching and learning. The section closes with two studies that present use cases that may be of interest to readers on resource availability and creative use of digital tools to enhance teaching and learning in resource strained contexts. Reflections on teaching and learning post COVID-19 In this article Tiyamike Ngonda reflects on teaching and learning at two universities in Africa, considering evidence from the literature on the challenges of transition to online teaching and learning and the affordances of the learner management systems they adopted.
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Background: Despite widespread vaccination and increasing population immunity from previous infections, community transmission of COVID-19 continues, and testing may continue to be an important component of our response particularly with the proliferation of new variants of concern. Strategic deployment of SARS-CoV-2 antigen-detection rapid diagnostic (AgRDT) self-tests to settings with increased transmission potential can reduce the viral burden within the specific settings, such as in K-12 schools, and may have spillover benefits for broader community transmission. Method(s): Using a previously developed agent-based simulation model, parameterized to three distinct country archetypes (Brazil, Georgia, Zambia), we analyzed 11 different self-testing strategies within the school-going population at three testing frequencies under 24 different epidemic conditions (Rt, vaccination coverage/effectiveness), comprising a total of 696 scenarios per country. Strategies included symptomatic testing, and in addition, asymptomatic testing at 5, 20, 40 or 100% of schools, or asymptomatic contact testing. These were all targeted to either only teachers or teachers and students. Then, with the cost to offer a COVID-19 self-test in schools at USD 2.50, we performed an economic analysis with all scenarios to identify the most costeffective strategies by country. Result(s): Routine asymptomatic testing of teachers and students at 100% of schools reduced the greatest number of infections across contexts, but at the greatest cost. However, with respect to both the reduction in infections and total cost, symptomatic testing of all teachers and students appears to be the most efficient strategy. Symptomatic testing can prevent up to 69.3%, 64.5%, and 75.5% of school infections in Brazil, Georgia, and Zambia, across all epidemic conditions. Additionally, it can prevent up to 77,200, 80,900, 107,800 symptomatic days per 100,000 teachers and students in each country, respectively, over the course of a 90-day epidemic wave. The incremental cost-effectiveness ratios for strategies that consistently appeared on the costeffectiveness frontier across countries and epidemic conditions are shown in Figure 1 for an Rt of 1.2. Conclusion(s): If financial resources are limited, symptomatic testing of teachers and students has the potential to be cost-effective while reducing a substantial number of infections and the amount of time lost from the classroom, making it a feasible strategy for implementation in a variety of settings.
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Background: Since 2017 global guidelines have recommended "same-day initiation" (SDI) of antiretroviral treatment (ART) for patients considered ready for treatment on the day of HIV diagnosis. Many countries have incorporated a SDI option into national guidelines, but SDI uptake is not well documented. We estimated average time to ART initiation at 12 public healthcare facilities in Malawi, five in South Africa, and 12 in Zambia. Methods: We sequentially enrolled patients eligible to start ART between January 2018 and June 2019 and reviewed their medical records from the point of HIV diagnosis or first HIV-related interaction with the clinic to the earlier date of treatment initiation or 6 months. We estimated the proportion of patients initiating ART on the same day or within 7, 14, 30, or 180 days of baseline. Results: We enrolled 826 patients in Malawi, 534 in South Africa, and 1,984 in Zambia. Overall, 88% of patients in Malawi, 57% in South Africa, and 91% in Zambia were offered and accepted SDI. In Malawi, most who did not receive SDI had not initiated ART ≤6 months. In South Africa, an additional 13% initiated ≤1 week, but 21% had no record of initiation ≤6 months. Among those who did initiate within 6 months in Zambia, most started ≤1 week. There were no major differences by sex. WHO Stage III/IV and tuberculosis symptoms were associated with delays in ART initiation. Conclusions: As of 2020, SDI of ART was widespread, if not nearly universal, in Malawi and Zambia but considerably less common in South Africa. Limitations of the study include pre-COVID-19 data that do not reflect pandemic adaptations and potentially missing data for Zambia. South Africa may be able to increase overall ART coverage by reducing numbers of patients who do not initiate ≤6 months. Registration: Clinicaltrials.gov ( NCT04468399; NCT04170374; NCT04470011).
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Mobile money has been known to be a successful venture around the world especially so, for African countries due to the many limitations that traditional banks have like operations, expensive transaction costs and cumbersome process to open account to mention but a few. The presence of mobile money has not only allowed the unbanked population to have accounts but has also alleviated poverty for many rural communities. Zambia has seen an increase of mobile money accounts and COVID-19 has exacerbated this increase. Therefore, this paper sought to determine data mining algorithm best predicts mobile money transaction growth. This paper was quantitative in nature and used aggregated monthly mobile money data (from Zambian mobile network operators) from 2013 to 2020 as its sample which was collected from Bank of Zambia and Zambia Information Communications and Technology Authority. The paper further used WEKA data mining tool for data analysis following the Cross-Industrial Standard Process for data mining guidelines. The performance from best to least is K-nearest neighbour, random forest, support vector machines, multilayer perceptron and linear regression. The predictions from data mining techniques can be deployed to predict growth of mobile money and hence be used in financial inclusion policy formulation and other strategies that can further improve service delivery by mobile network operators.
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Background: Nosocomial infections are a serious public health problem affecting both developed and developing countries. They are caused mainly by multi-drug-resistant pathogens that limit treatment options, leading to high morbidity and mortality, longer hospital stays and increased costs of health care. This study aimed to evaluate nosocomial infections, risk factors and causative pathogens at two large teaching hospitals in Zambia. Material and methods: A yearlong hospital-based cross-sectional study was conducted from April 2020 to April 2021 at two large tertiary-level hospitals in Zambia. Hospitalised and out-patients with previous hospital contact were screened for nosocomial infections, followed by the collection of specimens (skin swabs, urine or sputum) for bacteriological culture and Polymerase Chain Reaction (PCR) amplification of 16S rRNA gene fragments. Nosocomial infections were defined according to the World Health Organization case definitions. Frequencies were estimated, and the association between the outcome variable (positive culture) and categorical predictor variables were analysed using the Chi-square test. Results: Eight hundred and forty-one clinical specimens (skin swabs, urine or sputum) were collected and analysed, 640 from the University Teaching Hospital in Lusaka and 201 from the Ndola Teaching Hospital in Ndola. Of these, 71.2% were from male, with only 28.8% from female patients. The median age was 50 years old. Catheter-associated urinary tract infections (57%) were the most common, followed by those from pressure sores (38.7%). The most frequently observed pathogens included Escherichia coli (17.8%), Pseudomonas aeruginosa (13.7%), Klebsiella pneumonia (5.6%) and Proteus vulgaris (5.5%). Conclusions: The hospital infection rate at the two urban tertiary hospitals was very high. Age over 65 years, male gender, presence of medical devices, presence of a wound, longer hospital stays, previous hospital contacts and low systolic blood pressure were associated with the risk of developing nosocomial infections. Despite improved infection control following the COVID-19 waves, nosocomial infections have remained a significant public health threat. © 2023 The Author(s)
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Objective: To assess the global epidemic of Coronavirus disease 2019 (COVID-19) in January 2023 and the risk of importation. Methods: According to the daily COVID-19 data publicly released by Johns Hopkins University, combined with the travel restrictions published by Sherpa, an epidemiological description method was used to provide a comprehensive and timely assessment of the global epidemic risk through a general overview, a comprehensive assessment of the epidemic trends in each continent and key countries, as well as a comprehensive analysis of the epidemic and travel requirements in 14 neighbouring countries. Results: Compared with the previous month, the number of confirmed cases and deaths respectively decreased by 40.37% and increased by 147.95% globally in January 2023. Daily new confirmed cases showed a decreasing trend, while deaths in all continents stayed stable except Asia in January. The time taken for every 50 million new confirmed cases and 500 thousand deaths globally has increased slightly. The number of deaths in Japan, America, China, and Australia increased rapidly. Zambia, Argentina, New Zealand and Mexico were the countries that showed a sharp rise in the number of deaths in January. Russia was the country with special concern among the 14 neighbouring countries. Conclusion: The global daily new confirmed cases and deaths showed a downward trend in January, but the epidemic situation was prominent in some regions and countries. It is necessary to continuously monitor countries with global focus and establish a communication mechanism with relevant agencies to exchange information and provide timely warnings.
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This chapter presents case examples of eco-anxiety in Africa. The rural communities in Zambia are highly dependent on agriculture, which has already been much affected by the climate crisis. The chapter examines various reactions and coping methods, along with gaps where further research is needed. It analyzes eco-anxiety and the anxiety and hysteria brought about by COVID-19. It has shown that although humans and nature have lived symbiotically for centuries, anthropogenic activities were detrimental to this relationship. Therefore, for humans to enjoy their ancient relationship with nature, their destructive activities on nature needed to be minimized. However, there have been some exaggerations regarding the effects of climate change. Predictions of doom, extinction, and other alarming words were more responsible for eco-anxiety. Despite these alarms and actual danger, humans could adapt. As the world was coming to terms with climate change and eco-anxiety, COVID-19 emerged with even more devastation and threats to humanity. Unlike climate change, COVID-19 was sudden, fast, and fatal while restricting human activities, thereby affecting all aspects of life. It was therefore more anxiety-causing than climate change. Future research should focus on reducing alarmism, enhancing human adaptation to climate change, minimizing its effects, and preparing for pandemics. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The study sought to explore the motivating factors for and barriers to the uptake of the coronavirus disease 2019 (COVID-19) vaccine in Zambia and recommend possible ways of addressing the challenges. The study used a qualitative case study approach, employing online media platforms as sources of data. Thematic analysis was to identify topics from posts, with each topic further grouped into themes. Motivating factors to vaccine uptake include an increase in reported cases of COVID-19, accessibility, and availability of vaccines, vaccine certificates required to travel, and credible sources of information. Barriers to uptake include lack of information, concerns about the safety of the vaccine, mistrust in Western medicine, lack of belief in conventional medicine versus belief in God, confusing information about eligibility, and belief that public figures used in the campaigns were not receiving the vaccine. Some of the strategies to encourage vaccination included the involvement of local scientists, demand generation through media platforms, community sensitization, vaccine materials, and creating an enabling environment for community involvement. The social media interactions on the COVID-19 vaccine revealed several factors that impede the uptake of the vaccine and encourage uptake. However, stakeholders' involvement in scaling up vaccination programs was reported to be one of the effective strategies to increase vaccine uptake in Zambia.Copyright © 2022 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
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Africa is facing a new debt crisis, exacerbated by the COVID-19 pandemic. China, a major creditor nation, has demonstrated a willingness to negotiate debt relief measures with African states on both a bilateral and multilateral basis. An assessment of African agency in bilateral debt renegotiations remains a conundrum for China–Africa observers, however, due to the secretive nature of these talks. Given the power deficits that African states hold relative to China, this article, on the basis of the application of an analytical framework and a study of the Zambian case, argues that it would be more strategic for African officials to engage with the Chinese via multilateral channels when it comes to debt renegotiations. Additionally, in view of decreased Chinese lending and the concerns of Chinese creditors about their debt exposure in Africa, the article provides a brief look ahead at the future of Chinese lending to the continent. © 2023 The South African Institute of International Affairs.
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The purpose of this manuscript is to describe household dietary diversity (HDDS) in Lusaka, Zambia between households with and without a child with a disability living in the same communities. Cross-sectional data were collected in three low-income compounds in September 2021. Participants included households with a child with a disability enrolled in Kusamala+, a community-based program, (n = 444) and a convenience sample of adults living in the same area without a child with a disability (n = 1027). The HDDS tool asked about food groups consumed in the past 24 h by people in the household. The responses were summed (yes = 1, no = 0), range 0-12. Individual dietary diversity scores (IDDSs) were calculated for children (0-8 items). Analysis included descriptive statistics and linear regression. Mean HDDS for the households with a child with a disability was 4.8 (SD 2.1) vs. 6.1 (SD = 2.2) among households without a child with a disability (p < 0.001). The individual score for children (IDDS) for households with children with disabilities was 2.6 (SD = 1.4) vs. 3.7 (SD = 1.6) for households without a child with a disability. Households with a child with a disability had a significantly lower HDDS and IDDS in unadjusted and adjusted models (p < 0.001). National policy must assure the most vulnerable populations, and often hidden, receive focused financial and food support.
Subject(s)
Disabled Children , Adult , Child , Humans , Cross-Sectional Studies , Zambia/epidemiology , Diet , Poverty , Food SupplyABSTRACT
BACKGROUND: Antimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet its extent is not well evaluated, especially in low-middle income countries. It is challenging to promote policies without focusing on healthcare systems at a local level, therefore a baseline assessment of the AMR occurrence is a priority. This study aimed to look at published papers relating to the availability of AMR data in Zambia as a means of establishing an overview of the situation, to help inform future decisions. METHODS: PubMed, Cochrane Libraries, Medical Journal of Zambia and African Journals Online databases were searched from inception to April 2021 for articles published in English in accordance with the PRISMA guidelines. Retrieval and screening of article was done using a structured search protocol with strict inclusion/exclusion criteria. RESULTS: A total of 716 articles were retrieved, of which 25 articles met inclusion criteria for final analysis. AMR data was not available for six of the ten provinces of Zambia. Twenty-one different isolates from the human health, animal health and environmental health sectors were tested against 36 antimicrobial agents, across 13 classes of antibiotics. All the studies showed a degree of resistance to more than one class of antimicrobials. Majority of the studies focused on antibiotics, with only three studies (12%) highlighting antiretroviral resistance. Antitubercular drugs were addressed in only five studies (20%). No studies focused on antifungals. The most common organisms tested, across all three sectors, were Staphylococcus aureus, with a diverse range of resistance patterns found; followed by Escherichia coli with a high resistance rate found to cephalosporins (24-100%) and fluoroquinolones (20-100%). CONCLUSIONS: This review highlights three important findings. Firstly, AMR is understudied in Zambia. Secondly, the level of resistance to commonly prescribed antibiotics is significant across the human, animal, and environmental sectors. Thirdly, this review suggests that improved standardization of antimicrobial susceptibility testing in Zambia could help to better delineate AMR patterns, allow comparisons across different locations and tracking of AMR evolution over time.
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Drug Resistance, Bacterial , One Health , Animals , Humans , Zambia , Antitubercular Agents , Anti-Retroviral Agents , Escherichia coliABSTRACT
Background: Misuse of antimicrobials combined with poor infection prevention and control (IPC) can result in antimicrobial resistance (AMR). Health partnerships are ideally placed to enhance antimicrobial stewardship (AMS) through sharing up-to-date evidence and implementing best practice. Purpose(s): Brighton Lusaka Pharmacy Link (BLPL) was awarded a Commonwealth Partnerships for Antimicrobial Stewardships Scheme (CwPAMS) grant to implement AMS at University Teaching Hospital (UTH) (THET, 2020). Pharmacists-led AMS prescribing and monitoring activities aim to implement a robust data collection system and measure the impact of interventions reducing misuse and overuse of antibiotics while increasing knowledge about on IPC and AMS. Method(s): BLPL conducted a three-day workshop in Zambia for pharmacists, physicians, nurses and allied healthcare professionals at UTH to enhance AMS and point prevalence surveillance (PPS). IPC training was provided by the experienced Ndola IPC team. Train the trainer workshops enables UTH to disseminate AMS, PPS, IPC and data collection standards. Result(s): Proactive MDT committee to manage AMS and IPC activities at UTH was established Specialist AMS pharmacist appointed Two Global-PPS undertaken Modified antibiotic prescribing chart introduced and audited-UTH antimicrobial guidelines updated AMS modular training programme for health care accredited by UNZAforCPD recognition-34 IPC trainers trained Bare-below-the-elbow dress code (BBE) adopted nationally by HOPAZ WHO hand-rub production expanded Conclusion(s): This model of pharmacist-led AMS demonstrates sustainability in locally driven AMS knowledge and seeded national IPC capacity-building whilst instigating behavioural change pertinent during the COVID-19 pandemic.
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The study aims to understand the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic. The study adopts the PRISMA approach to screening the selection of journal articles and review papers according to the research aims and the inclusion criteria. The journal articles and review papers were extracted and stored in Microsoft Excel and Google Scholar, Academic. Microsoft, Semantic Scholar, Elsevier, and Emerald Insight databases searched relevant documents using formulated keywords. A statistical technique was applied using the M.S. Excel analysis tool (PivotTable and an independent t-Test) to analyze data and determine the differences between teachers and students. The review revealed the evidence that the majority of the studies were primarily focused on the individual developing countries and results from other developing countries were not considered. In addition, the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic were inadequate skills and training, inadequate Internet/Infrastructure, lack of supporting resources and lack of online student engagement and feedback. Finally, the independent t-test reveals there is no statistically significant difference in challenges in the transition to online teaching and learning during the COVID-19 pandemic. Both teachers and students encounter similar challenges. The systematic review raised concerns that higher learning needs to effectively implement long term strategies and support teachers and students in getting into online teaching and learning.
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To accelerate COVID-19 vaccination delivery, Zambia integrated COVID-19 vaccination into HIV treatment centers and used World AIDS Day 2021 to launch a national vaccination campaign. This campaign was associated with significantly increased vaccinations, demonstrating that HIV programs can be leveraged to increase COVID-19 vaccine uptake.