Pathology and Microbiology

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    Vitamin B12 and Folate deficiency in Megaloblastic Anaemia diagnosed morphologically at the University Teaching Hospital, Lusaka, Zambia
    (The International Journal of Multi-Disciplinary Research, 2018) Munsaka, Soddy Mweetwa; Ndhlovu, Jacob
    Background: Vitamin B12 and folate deficiency is a well-known health problem world-wide. Deficiencies of folic acid and vitamin B12 are known to cause megaloblastic anaemia, which is characterised by presence of abnormally large erythrocyte precursor cells, megaloblasts, in the bone marrow and macrocytic red cells in the peripheral blood. These megaloblasts arise because of impaired deoxyribonucleic acid (DNA) synthesis followed by ineffective erythropoiesis. However, vitamin B12 or folate levels have not been described in Zambia, whether normal levels or in relation to anaemia. The study aimed to determine vitamin B12 and folate levels in megaloblastic anaemia, diagnosed morphologically, in patients at the University Teaching. Methods: This was a cross sectional study which was undertaken at the University Teaching Hospital (UTH) in Lusaka, Zambia. Full blood count (FBC), Peripheral smears and ELISA were assessed on blood samples received from megaloblastic anaemia and non-anaemic patients. Vitamin B12 and folate concentrations were compared between groups using t-test. Results: The age range was between 18 – 54 years (Mean age-31 years). Among the 40 megaloblastic patients, 35% (14/40) were male and 65% (26/40) were female with a male to female ratio of 1:1.9. Full blood count and peripheral smear findings revealed that bicytopenia was present in 22.5% (9/40) and pancytopenia in 72.5% (29/40) patients. Furthermore, the megaloblastic anaemia participants had statistically significant lower median vitamin B12 concentration 175(150-333) pg/ml than non-anaemic control participants 299.5 (238-571) pg/ml p=0.0001. Megaloblastic anaemia participants also had a statistically significant lower folate concentration (12.32± 2.28 ng/ml) than non-anaemic control participants (19.28 ± 2.84 ng/ml) p=0.029. Of the megaloblastic anaemia patients, vitamin B12 deficiency was in 60% (24/40), pure folate deficiency in 30% (12/40) and combined deficiency was observed in 15% (6/40) patients. Conclusion: This study shows that majority of patients with megaloblastic anaemia, diagnosed morphologically at the University Teaching Hospital have a deficiency of vitamin B12 deficiency which further implicates vitamin B12 and folate in the disease process of megaloblastic anaemia.
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    Confirmation by necropsy of a high prevalence of porcine cysticercosis in a rural district of Madagascar.
    (The University of Zambia, 2023) Mananjara, Diana Edithe Andria; Rakotoarinoro, Mihajamanana; Rakotoarison, Valisoa. C.; Raliniaina, Modestine; Razafindraibe, Nivohanitra P.; Ravonirina, Claudia; Randriamparany, Tantely; Rasamoelina-Andriamanivo, Harentsoaniaina; Rakotozandrindrainy, Raphaël; Cardinale, Eric; Lightowlers, Marshall. W.; Donadeu, Meritxell; Mwape, Kabemba E.
    Neurocysticercosis is recognized as an important health issue in the Malagasy population. To date, investigations into prevalence of infection with the causative agent, Taenia solium, in the parasite's natural animal intermediate hosts, have relied on serological methods which have been found to be non-specific. We determined the prevalence of porcine cysticercosis among pigs from a contiguous area of the Betafo and Mandoto administrative districts, Vakinankaratra Region, Madagascar. One hundred and four slaughter-weight pigs were examined by detailed necropsy examination including slicing of the heart, tongue, masseter muscles, diaphragm and carcase musculature. Thirty-seven animals (35.6%) were found infected with T. solium, representing one of the highest rates of infection ever reported, worldwide. These findings highlight the importance of T. solium in Madagascar and support the need for increased efforts to prevent the parasite's transmission to reduce its burden on the health of the Malagasy population. Keywords cysticercosis Madagascar necropsy pig prevalence Taenia solium
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    Increasing early infant male circumcision uptake in Zambia: like father like son.
    (The University of Zambia, 2023) Weiss, Stephen M.; Rodriguez, Violeta J.; Cook, Ryan R.; Bowa, Kasonde; Zulu, Robert; Mweemba, Oliver; Kamboyi, Royd; Castro, Jose; Orrego, Victoria; Maria, Dunleavy; Maria, Dunleavy L; Alcaide, Deborah L. Jones
    Voluntary Medical Male Circumcision (VMMC) is an effective strategy for HIV prevention in areas with high prevalence of, and risk for, HIV. More than 361,000 male neonates are born each year in Zambia, many of whom could be eligible for Early-Infant Medical Circumcision (EIMC). Building on successful implementation strategies utilized in our Spear & Shield program, this pilot study, “Like Father, Like Son” (LFLS), evaluated the feasibility and acceptability of offering combined EIMC and VMMC services and couple-level behavioral interventions. A total of N = 702 pregnant women and their male partners (n = 351 couples) were recruited and enrolled. Couples were assessed twice pre-birth, 2 weeks post birth, and 6 months post birth. Expectant mothers were an average of 15.05 weeks pregnant (SD = 8.83). Thirty-nine pregnancies did not result in a live birth (11%), 14 couples withdrew from the study or were lost to follow-up prior to delivery (4%), and 148 babies were born female (42%), leaving 150 couples with a male infant in the analytic sample (43%). The LFLS study achieved significantly higher EIMC rates (35%) in comparison with previously observed EIMC study rates in Zambia (11%), and significantly higher than hypothetical comparison rates up to 30%. Relative to baseline rates, odds of VMMC among couples’ older sons increased by 31% at post-intervention and by 90% at two-weeks following birth. Overall, this pilot study found the LFLS intervention to be feasible, acceptable, and effective in doubling the rate of EIMC in comparison with a previous longitudinal study in Zambia. Future research should consider a family-centric approach to promotion of male circumcision for infants and adolescents. LFLS may be effective in promoting father-son “bonding” by MC status; a bond that may be a bridge to increase both EIMC and VMMC uptake in newborns and couples’ older sons and is a novel leverage point for promotion of this HIV prevention strategy.