Risk factors associated with zoonotic tuberculosis at the animal-human interface in a tuberculosis-endemic sub-Saharan country.

We aimed to assess the proportion of tuberculosis in humans and tuberculosis (TB)-associated abattoir condemnations from the animal sector, as well as determine risk factors of zoonotic tuberculosis at the animal-human interface in Zambia. The study involved 255 presumptive TB patients and 156 cattle carcasses and was conducted from April 2020 to December 2021. Univariable and multivariable logistic regressions were performed for risk factor analysis for zoonotic TB. The overall proportion of bovine tuberculosis in traditional cattle and the proportion of tuberculosis among presumptive TB patients were 39.7% and 10.2%, respectively. Consumption of raw milk (adjusted odds ratio (AOR)=2.72, 95% confidence interval (CI): 1.73-4.28) and history of previous contact with a TB patient (AOR=1.86, 95% CI: 1.17-2.95) were risk factors for zoonotic TB at the animal-human interface of Zambia. Therefore, community campaigns and sensitization on zoonotic TB transmission are recommended.

Prevalence and correlates of voluntary medical male circumcision adverse events among adult males in the Copperbelt Province of Zambia: A cross-sectional study.

BACKGROUND: Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia. METHODS: We performed a cross-sectional study using secondary clinical data collected in 2015 using two validated World Health Organisation/Ministry of Health reporting forms. We reviewed demographics and VMMC surgical details from 391 randomly sampled adult males aged ≥18 years at Ndola Teaching Hospital, a specialised VMMC fixed site in Zambia. Non-parametric tests (Fisher's exact test or Chi-square depending on assumptions being met) and logistic regression were conducted to determine the relationships between associated factors and VMMC AE. RESULTS: The overall VMMC AE prevalence was 3.1% (95% CI 1.60%- 5.30%) and most AEs occurred postoperatively. In decreasing order, the commonly reported VMMC AE included; bleeding (47.1%), swelling (29.4%), haematoma (17.6%), and delayed wound healing (5.9%). There was an inversely proportional relationship between VMMC volume (as measured by the number of surgeries conducted per VMMC provider) and AEs. Compared to the highest VMMC volume of 63.2% (247/391) as reference, as VMMC volume reduced to 35.0% (137/391) and then 1.8% (7/391), the likelihood of AEs increased by five times (aOR 5.08; 95% CI 1.33-19.49; p = 0.018) and then sixteen times (aOR 16.13; 95% CI 1.42-183.30; p = 0.025) respectively. CONCLUSIONS: Our study found a low prevalence of VMMC AEs in Ndola city, Copperbelt Province of Zambia guaranteeing the safety of the VMMC program. We recommend more surgically proficient staff to continue rendering this service. There is a need to explore other high priority national/regional areas of VMMC program safety/quality, such as adherence to follow-up visits.