Socio-economic disparities and predictors of fertility among adolescents aged 15 to 19 in Zambia: Evidence from the Zambia Demographic and Health Survey (2018).

Globally, 12 million girls aged 15-19 give birth each year, and Africa hosts 19% of youth aged 15-24. In Zambia, 29% of adolescents experience childbirth, with variations by age. Projections suggest a continued rise in these trends by 2030. Zambia came up with Adolescent Health Strategic Plan 2011-2015 among the specific policies being advocated for was Adolescent-Friendly Health Services (ADFHS) in order to mitigate among others adolescent fertility. The study aims to investigate socio-economic disparities and predictors of fertility in Zambian adolescents aged 15 to 19. The study used a cross-sectional study design utilized the 2018 Zambia Demographic Health Survey (ZDHS). The variable of interest in this study is "total number of children ever born" among adolescents aged 15 to 19 years. The explanatory variables that were used in the study were demographic, socio-economic, behavioral and community level factors. The Rao-Scott Chi-square test was used to test for association between categorical variables. Determinants of adolescent fertility were identified through a multilevel ordinal logistic regression conducted at a significance level of 5%. Analysis in the study was carried out using Stata version 14.2. A total of 3,000 adolescents were involved in the study, revealing that 75.88% had not given birth, 21.14% had one child, and 2.98% had at least two children. The findings revealed that education played a protective role, with adjusted odds ratios (AOR) of 0.47 (95% CI, 0.23-0.97), 0.21 (95% CI, 0.10-0.47), and 0.03 (95% CI, 0.00-0.54) for primary, secondary, and tertiary education, respectively. On the other hand, certain factors were associated with an elevated risk of fertility. These included the age of adolescents, educational attainment, marital status, wealth index, contraceptive use, exposure to family planning (FP) messages, being educated about FP at health facilities, and age at first sexual encounter. Among contextual factors, only community age at first birth was identified as a predictor of fertility, AOR, 1.59 (95% CI, 1.01-2.52). The study highlights sociodemographic disparities in adolescent fertility, emphasizing the need for targeted sexual reproductive health policies. Education protects against having more than one child, while marital status significantly influences fertility, particularly for married adolescents. The research provides valuable insights into the complex factors shaping adolescent fertility in Zambia, offering guidance for interventions and policies to support this vulnerable demographic.

Analysis of the proportion of university teaching hospital gastric cancer data included in the Zambia national cancer registry.

Background: The exact prevalence of gastric cancer in Zambia is unknown. The aim of this study was to determine the proportion of gastric cancer cases seen at the largest hospital in Zambia, whose records were included in the Zambia National Cancer Registry (ZNCR). Methods: We reviewed gastric cancer records between January 2015 and December 2017 from the University Teaching Hospital, Cancer Diseases Hospital and ZNCR. Statistical analysis was done using Stata version 15. Results: We reviewed 94 patient records (42 were females) with a mean age of 59 years (standard deviation, 14.9). Histologically, the majority of the cases were adenocarcinoma (84%). Of the reviewed records, only 39/94 (42%) had their data included in the ZNCR. Median time to from endoscopic diagnosis to histopathological confirmation was 11 days (inter-quartile range; 7-20). Median time from histological confirmation to the Cancer Diseases Hospital for therapy was 8 days (IQR 2-19). Overall median survival time for gastric cancer patients was 290 days (CI 95%, 112 - 1225). Conclusions: Data on gastric cancer reported in the ZNCR are an underestimate of the true disease burden and there is need to strengthen data collection strategies for gastric cancer in Zambia.

Oesophageal cancer cases recorded in the Zambia National Cancer Registry: a cross-sectional study.

Introduction: the aim of this study was to determine what proportion of patients with confirmed esophageal cancer at the largest hospital in the country were recorded in the Zambia National Cancer Registry (ZNCR). Methods: we reviewed esophageal cancer records at the University Teaching Hospital (UTH) and ZNCR, between 2015 and 2017. Using Stata version 15, data were summarised and the Kruskal-Wallis was used to compute comparisons, Kaplan-Meier curves for survival estimates and Cox regression for associated factors. Results: included in the final analysis were records for 222 patients with confirmed esophageal cancer and of these 51/222 (41%) were appearing in the ZNCR. The mean age of the patients was 56.2 years (SD, 13.0) and only 2/222 (1%) were confirmed alive at the time of data analysis. The median time from endoscopic diagnosis to histological confirmation was 12.5 days (IQR 7.5 - 21.5) and arrival at the Cancer Diseases Hospital (CDH) for treatment was 20 days (IQR 10 - 34). The overall median survival time in the study was 259 days (CI 95%; 151 - 501). Age, sex, time to diagnosis, histological classification and grade of tumour did not show any evidence of predicting survival in both the univariate and multivariable cox regression model (p>0.05). Conclusion: a significant proportion of esophageal cancer cases seen at UTH were not included in the national registry suggesting that official figures for the prevalence of esophageal cancer in Zambia are underestimated. There is an urgent need to improve the collection of data on esophageal cancer in Zambia.

Personal protective equipment availability and accessibility among nurses and midwives in selected urban general hospitals in Lusaka, Zambia: a cross-sectional study.

Introduction: the World Health Organization (WHO) declared COVID-19 a pandemic in January 2020, which has spread to many countries, including Zambia. Zambia has had challenges in providing personal protective equipment (PPEs) to nurses and midwives. The study's objective was to assess the availability and accessibility of PPEs among nurses and midwives caring for women in the general hospitals in Lusaka, Zambia. Methods: a cross-sectional analytical study design was conducted at five general hospitals in Lusaka on 162 nurses and midwives between February and April 2021, selected by purposive sampling of study sites and simple random sampling to select the participants. Data was collected using a semi-structured self-administered questionnaire and analyzed in STATA version 13. Chi-square and Fisher's exact test were used to test associations between the independent variables and the outcome, and a multivariable logistic regression was used to investigate the predictors of accessing PPEs. Results: out of the 162 who participated in the study, 48.8% were nurses, while 51.2% were midwives. Only 10% (16/160) of the participants reported having enough PPEs at work. Age, marital status, PPE use, employment duration, and protection confidence were associated with accessibility (P<0.05). Conclusion: overall, there was an inadequate provision of PPEs in the health facilities putting the nurses and midwives at a high risk of acquiring COVID-19. Policymakers need a deliberate move to make the availability and accessibility of PPEs a reality during the pandemic.

Gender disparities and associated factors to intention to getting a second dose of COVID-19 AstraZeneca vaccine among adult populations in selected facilities of Lusaka, Zambia.

As COVID-19 vaccines are becoming more available, there is also a growing need to understand the population receiving the doses, existing inequalities and the intention to getting the second vaccine dose among the populations that receive the vaccines. We evaluated gender inequalities and intention to uptake of the second dose of COVID-19 AstraZeneca vaccine among adult populations in selected urban facilities of Lusaka, Zambia. A cross-sectional study design was conducted between May and June 2021 among adults who received AstraZeneca vaccine from three selected urban facilities of Lusaka, Zambia. Phone-based interviews were conducted 6 weeks after the first dose of the vaccine. Descriptive analysis and mixed-effect logistic regression were done using STATA version 16.2. Of the 1321 adults who had received AstraZeneca vaccine, 868 respondents completed the questionnaire. About, 47% (408/868) were females and 53% (460/868) were males. Median age in the study was 40 years. Majority of males were educated (54%) and employed (57%). Furthermore, majority of females that got the first dose of AstraZeneca reported experiencing side effects (76.98%) compared to males (64.24%). Among study participants, 93.7% intended to receive the AstraZeneca vaccine, of whom 46.7% (380/814) were females and 52.9% (434/814) were males. Majority of participants that did not intend to get a second dose were not married (55.56%). Only age (AOR, 1.05; 95% CI, 1.02-1.08) predicted intention to getting a second dose of AstraZeneca vaccine. We found important gender-dependent differences in the side effects reported by females that received the first dose of Astra Zeneca. Finding that intention to get the second dose of the vaccine increased with age suggests a need for enhancing COVID-19 vaccination programmes targeting young people and a need for further research to identify specific adverse effects of COVID-19 Astra Zeneca vaccines.