Zambia National Public Health Institute

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Browsing Zambia National Public Health Institute by Author "Besa, C."

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    Antimicrobial susceptibility patterns and their correlate for urinary tract infection pathogens at Kitwe Central Hospital, Zambia.
    (Health Press Zambia Bull., 2017) Chisanga, J.; Mazaba, M.L.; Mufunda, J.; Besa, C.; Kapambwe-muchemwa, M.C.; Siziya, S.
    Inadequate data on antimicrobial susceptibility patterns in the Africa region and indeed in Zambia have led to ineffective empirical treatment before the culture and sensitivity results are made available. The purpose of this study was to determine the antimicrobial susceptibility patterns amongest the most common bacterial causes of UTIs amongest patients presenting at Kitwe Central Hospital (KCH), Zambia. A 5-year record review of data captured in the laboratory urine register from 2008 to 2013 was conducted. Demographic data, culture and antimicrobial susceptibility data were entered in Epi Info version 7 and analysed using SPSS version 17.0. Associations were determined using the Chi-squared test at the 5% significance level. A total of 1854 records were extracted from the laboratory register. The highest frequency of UTI (43.9%) was in the 15–29 years age group. The overall sensitivity patterns indicated that E.coli was mostly sensitive to ciprofloxacin (69.8%), Klebsiella species to ciprofloxacin (68.2%), Proteus species to cefotaxime (66.7%) and Staphylococcus saprophyticus to nitrofuratoin (63.7%). Sensitivity for E. coli to nalidixic acid was higher for males (58.6%) than females (39.5%). Sensitivity for E. coli to cefotaxime and norfloxacin varied with age (Chi-squared for trend=10.32, p=0.001). Our results have shown that UTI pathogens isolated at KCH were less than 70% sensitive to the recommended and used antibiotic. Studies to establish highly sensitive antibiotics to UTI pathogens are needed to effectively treat patients.
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    Bacteriological status of shallow well water and practices of users in Chipulukusu township, Ndola, Zambia
    (Medical Journal of Zambia, 2017) Bulaya, A.O.; Besa, C.; Tembo, M.; Siziya, S.
    In many countries in Africa piped water availability is limited and cannot meet the demands of the growing populations. Most rural areas in Africa resort to underground water which is readily available and is believed to be uncontaminated due to its filtering system as it drains back into the ground. However, it is not always the case due to many factors such as overcrowding, poorly constructed pit latrines and humans that contaminate water. A cross sectional study was conducted to determine bacteriological status of shallow well water and practices of users in Chipulukusu township in Ndola, Zambia. Data was collected using a structured questionnaire and water samples were examined for the presence of fecal coliforms. Data was entered in Epi Info version 7 and analyzed using SPSS version 16. A total of 58 (84.1%) out of 69 households participated in the study. Altogether, 53 (91.4%5) wells were unprotected. All respondents stored their water in wide mouth containers. From a total of 58 households, 34 (58.6%) treated their water with chlorine. The distance between the well and pit latrine for 57 (98.3%) out of 58 households was below 30 m. A total of 47 (81.0%) out of 58 wells contained fecal coliforms. The majority of the wells were contaminated with fecal coliform making water unsafe to use and increases the risk of water borne diseases. Boiling and chlorination will make water fit for drinking.
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    Medical prescription pitfalls of acute upper respiratory infections in government health care facilities in Zambia
    (Health Press Zambia Bull., 2017) Besa, C.; Siziya, S.
    Prescribing of medicines is one of the most important clinical task that is complex and consists of a mixture of sub-competences such as principles of clinical pharmacology, knowledge, skill, critical judgement among many others. Prescription errors, potentially serious and non-serious, have been reported in the United Kingdom hospitals among both junior and senior doctors. The aim of this study was to evaluate pitfalls in medical prescriptions of acute upper respiratory tract infection in Zambia. Medical/dental students attended government healthcare facilities and requested for medical prescriptions to enable them purchase medications for their acute upper respiratory tract infection or sore throat. A total of 80 (77.7%) students out of 103 participated in the survey. This study has demonstrated gross drug misuse as all the healthy medical and dental students who presented at government healthcare facilities with complaints of acute upper respiratory tract infection were given medical prescriptions. Only a small proportion of patient’s prescription had addresses indicated (16.7%) and not all (87.1%) had patients’ names written on the prescriptions. Only a small proportion of prescriptions (28.5%) had generic names indicated on the prescriptions. More than half of prescriptions in this study did not have prescribers’ names (54.7%), identification numbers (73.2%) and addresses or departments (71.7%). This study demonstrated over prescription and drug misuse. A large proportion of prescriptions had no identification of both patients and prescribers. Furthermore, only a small proportion of prescriptions were written using generic names making generic substitutions at pharmacy outlets a challenge.
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    Misdiagnosis of heart failure for Amlodipine adverse reaction
    (Health Press Zambia Bull., 2017) Besa, C.
    This is a case report of misdiagnosis of heart failure for amlodipine related adverse reaction. Amlodipine is a dihydropyridine calcium channel blocker frequently used in drug treatment of essential hypertension. Adverse reactions of calcium channel blockers are well documented yet the attending physician did not recognise ankle oedema as an adverse drug reaction of amlodipine. Instead, a differential diagnosis of heart was made. If the diagnosis of heart failure was maintained, this would have easily led to inappropriate use of multiple drugs and related problems such as non-adherence to treatment, duplication of treatment, additional adverse reactions and drug-drug interactions. This report has demonstrated poor understanding of the basic principles of clinical pharmacology and therapeutics (CPT) by the attending physician that could have threatened patient’s safety.
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    Negligible therapeutic effects of enalapril in a 65-year-old black man of essential hypertension
    (Health Press Zambia Bull, 2017) Besa, C.
    This is a case report of negligible therapeutic effects of enalapril in a patient of essential hypertension for a period of 3 months. Negligible therapeutic effects of enalapril response in this patient was unexpected as patient claimed complete adherence to the treatment regimen and could possibly be attributed to counterfeit medication which is a recognised problem in some developing nations. Eventually, the patient developed dangerously high blood pressure with the systolic pressure above 200 mmHg. The patient was rescued with sublingual nifedipine and later maintained on monotherapy with another calcium channel blocker. This report has demonstrated that when physicians acquire adequate knowledge and skills in clinical pharmacology and therapeutics, they would be able to adjust drug treatment appropriately. In addition, this report has also highlighted the need to investigate factors that may influence poor response to medications.