Knowledge, attitude and practice towards cervical cancer screening among women living with human immunodeficiency virus: Implication for prevention strategy uptake.

AIM: To explore the knowledge, attitude and practices of cervical cancer screening among HIV-infected women in public health facilities in Lusaka, Zambia. DESIGN: Cross-sectional study. METHODS: The study was conducted from 1st January 2020 to 28th February 2020. We used a structured questionnaire for data collection. The Structural Equation Modelling (SEM) was used to analyse relationships among latent variables (knowledge, attitude and practice). RESULTS: The overall knowledge, attitude, and practice scores of cervical cancer screening among women living with HIV were 6.86/11 (62.4%), 6.41/7 (91.6%) and 2.92/8 (36.5%), respectively. Overall, knowledge was positively and significantly associated with attitude (r = .53, p < .001) and practice (r = .38, p < 0.001). Additionally, attitude and practice were significantly associated (r = 0.29, p < .001). Our findings support the reinforcement of current public health interventional programmes to improve the knowledge about cervical cancer and screening uptake.

Factors associated with non-use of insecticide-treated bed nets among pregnant women in Zambia.

BACKGROUND: Despite the Zambian government's efforts to ensure 80% use of insecticide-treated nets (ITNs) among pregnant women, ITN use remains critically low. Only 49% of pregnant women reported sleeping under an ITN in 2018 in the country. This study aims to determine the prevalence of, and the factors associated with the non-use of ITNs among pregnant women in Zambia. METHODS: This study was a secondary analysis of the data collected during the 2018 Zambian Demographic and Health Survey. One thousand one hundred and thirty-eight (1 138) pregnant women were included in the study. The prevalence of the non-use of ITNs was computed and univariable and multivariable logistic regression models were fitted to determine the factors associated with the non-use of ITNs in the study population. RESULTS: The study found that 578 (50.8%) pregnant women reported not using an ITN the night before the survey. The results of the multivariable logistic regression indicated that, primary level education (OR = 2.13, 95% CI 1.23-3.68), ITN per household member (OR = 0.01, 95% CI 0.00-0.02), parity (OR = 0.83, 95% CI 0.70-0.99), moderate malaria prevalence provinces (OR = 0.34, 95% CI 0.23-0.50), high malaria prevalence provinces (OR = 0.26, 95% CI 0.18-0.39) and currently in a union (OR = 0.52, 95% CI 0.30-0.88) were significantly associated with the non-use of ITNs. CONCLUSION: This study showed a high prevalence of the non-use of ITNs among pregnant women in Zambia. Factors found to be associated with the non-use of ITNs in the study population are: ITN per household member, parity, education, marital status and malaria prevalence provinces. Addressing the identified factors will require intensification of ITN programming and other malaria preventive measures.

Determinants and neonatal outcomes of preeclampsia among women living with and without HIV at a tertiary hospital in Zambia: a review of medical records.

Introduction: pre-eclampsia, a pregnancy-specific condition that occurs after 20 weeks of gestation, is a significant public health problem. In the extant literature, there are still conflicting reports on whether Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) affect preeclampsia rates. We, therefore, explored the determinants and neonatal outcomes of preeclampsia among pregnant women living with and without HIV. Methods: we reviewed delivery registers and neonatal files from the 1st January 2018, to 30th of September 2019 for women who delivered at Women and Newborn Hospital. The logistic regression model estimated the odds of preeclampsia and described the neonatal outcomes. Results: the prevalence of preeclampsia was 7.7% (95% confidence intervals: 6.8 to 8.7). On ART, pregnant women with HIV infection were less likely to develop preeclampsia than those without HIV infection (aOR=0.50; 95% CI: 0.32 to 0.80). However, neonates born to women with preeclampsia were more likely to be admitted to kangaroo mother care than neonates born to normotensive women, regardless of the HIV-exposure status. Conclusion: overall, the prevalence of preeclampsia was 7.7%, but it was less common among HIV-infected pregnant women receiving ART. Neonates born from women with preeclampsia are at increased risk of adverse outcomes, including admission to kangaroo mother care. These findings underscore the need for healthcare workers to direct their efforts on early diagnosis and detection of preeclampsia in pregnant women to prevent poor outcomes.