Zambia National Public Health Institute

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Anthrax outbreaks and epidemics in Zambia, 1990-2011: A review
(Health Press Zambia Bull., 2017) Siziya, S.
Anthrax is endemic in Zambia. A review was conducted for literature published on the epidemiology of anthrax in Zambia using google, google scholar and PubMed. A total of 7 publications were obtained using search words: anthrax, Zambia, epidemiology, outbreak and surveillance; and of these, 2 were full PubMed Central articles, 4 were abstracts without full articles and one was a citation. In Zambia in 1990, out of 220 human cases of anthrax, 19.1% died; between 1991 and 1998, 7.7% of 248 human cases died; between 1999 and 2007, out of 1790 human cases, 4.6% died; and in 2011, the case mortality rate was 1.2% out of 521 human cases. In Western province of Zambia, the overall cattle:human anthrax ratio was 1:1.47 and a reduction (Slope=0.738, 95% CI [-1.394, -0.083]) in the human case fatality rate was observed between 1999 and 2007. There is scanty information on anthrax in Zambia. The cattle:human anthrax infection ratio was lower than the expected ratio of 1:10 suggesting under-reporting of human cases or good outbreak/epidemic control. A reduction in the case fatality rate indicates good case management. An active surveillance of human cases of anthrax is recommended immediately there is an outbreak of bovine anthrax in order for people to start treatment early and avoid severe forms of anthrax.
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.
Antiretroviral therapy for all
(Health Press Zambia Bull., 2017) Michelo, K.; Whalen, K.
Zambia has attempted to create universal access to antiretroviral therapy. However, barriers still remain at the individual, institutional and national levels to access ART. The objective of the study was to determine factors related to accessibility to ART by PLHIV in Chikuni Parish in Southern province of Zambia. Out of a total of 1,067 Chikuni Home Based Care clients, 182 filled in the questionnaire: 173 adults, 7 youth aged 15-25 years and 2 children below the age of 15 years. In addition, two local partners implementing HIV and AIDS-related programs were interviewed. Purposive sampling was used to select participants. Out of 182 respondents, 125 (67%) described their condition as of by then to be very good, 44 (24%) as good, and 9 (5%) as not too good. Appointments to collect ARVs were not kept as reported by 43% of the respondents. About a quarter (24%) reported that there was a shortage of ARVs. About 1 in 10 (9%) of the respondents did not take the medication regularly. Access to ART was rated as by 54% of the respondents as good and 45% rated it as fair. Two thirds of the respondents found it hard to reach the facility for treatment; reasons being hospital too far from home, transport too expensive and sometimes transport was not available. On the services received, 56% of the respondents were dissatisfied with the attention and quality of care they received. Challenges of under staffing and self-stigma were some of the barriers to accessing ART. About 1 in 10 (9%) of the respondents did not take the medication regularly. Decentralizing model for ART delivery would improve access to ART.
Appropriateness of antipsychotic drugs prescribed for First episode psychosis by clinicians at Chainama Hills college hospital in Lusaka
(Health Press Zambia Bull., 2017) : Mwanza, J.; Paul, R.; Petlovani, P.; Ncheka, J. M.
Mental health disorders pose an increasing burden on societies all over the world. Notable one is Psychosis, a debilitating condition that presents as marked distortion in thinking and perception, whose first presentation of symptoms in a newly diagnosed patient requires accurate and evidence based drug treatment. Patients with first episode psychosis may present in a variety of clinical settings to providers who have a range of knowledge and skills. This study aimed to assess the appropriateness of antipsychotic drugs prescribed by clinicians in the management of first episode psychosis. A cross sectional study to assess appropriateness of antipsychotic drugs prescribed in the management of first episode psychosis using convenient sampling method and the NICE 2014 antipsychotic treatment guidelines as gold standard was conducted at Chainama hills college hospital in Lusaka. There were a total of 31 prescribers assessed for this study 38.7% psychiatrists and 61.3% clinical officer psychiatrists. The proportional difference of the two groups of prescribers assessed was not statistically significant, P-value = 0.21. Risperidone was the most frequently chosen antipsychotic with 58.1% of the respondents. Overall, there were 96.8% prescribers who did not prescribe anti psychotics in line with published guidelines. 3.2% of prescriber did prescribe in line with NICE 2014 guidelines. The front-line clinicians who encounter patients with first episode psychosis may have significant gaps in the initial and follow-up care of these patients. Given the preliminary nature of this study and the debate about the optimal care for first episode psychosis, further study with larger sample size is needed. If such gaps are confirmed additional educational interventions are required to align clinical management with published practice guidelines
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.
Characteristics of patients with psychosis at Ndola Teaching Hospital Psychiatric Unit, Zambia
(Health Press Zambia Bull., 2017) Lukonde, E.; Siziya, S.
Description of patients with psychosis is important in deciding on the best treatment to be offered to them. The objective of the study was to describe patients with psychosis at Ndola Central Hospital Psychiatric Unit, Zambia. Of the 699 patients who were seen and diagnosed with psychosis in a period of 12 months (01/01/14 to 31/12/14), records of 248 patients were considered in the study. However, 233 (94.0%) of 248 records were reviewed. Most of the patients were single (47.2%), of male gender (64.8%), unemployed (73.5%), attained secondary or higher level of education (70.3%) and from families made up of 5 or more members. Among males, 90.8% consumed alcohol compared to 33.3% of females (p<0.001). In relation to drug abuse, 54.3% of males smoked cannabis while none of the females smoked it. Among females, 28.0% of them were on HAART compared to 0.7% of males. Overall, alcohol use was very common (76.7%), followed by cannabis abuse (35.2%); then familial psychosis (27.6%) and lastly antiretroviral drug use (10.3%). Further studies are needed to establish associations between the common factors found in the current study and psychosis.
Cholera epidemic — Lusaka, Zambia, October 2017–May 2018.
(Morbidity and Mortality Weekly Report, 2018) Sinyange, N and others
On October 6, 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, from stool specimens from two patients with acute watery diarrhea.The two patients had gone to a clinic in Lusaka, the capital city, on October 4. Cholera cases increased rapidly, from several hundred cases in early December 2017 to approximately 2,000 by early January 2018 (Figure). In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples. In late December 2017, a number of water-related preventive actions were initiated, including increasing chlorine levels throughout the city’s water distribution system and placing emergency tanks of chlorinated water in the most affected neighborhoods; cholera cases declined sharply in January 2018. During January 10–February 14, 2018, approximately 2 million doses of oral cholera vaccine were administered to Lusaka residents aged ≥1 year. However, in mid-March, heavy flooding and widespread water shortages occurred, leading to a resurgence of cholera. As of May 12, 2018, the outbreak had affected seven of the 10 provinces in Zambia, with 5,905 suspected cases and a case fatality rate (CFR) of 1.9%. Among the suspected cases, 5,414 (91.7%), including 98 deaths (CFR =1.8%), occurred in Lusaka residents.
Cutaneous anthrax outbreak in Chama District, Muchinga province, Zambia, 2016 as history repeats itself
(Medical Journal of Zambia, 2017) Mwambi, P.; Mufunda, J.; Mwaba, P.; Kasese - Chanda, N.; Mumba, C.M.; Kalumbi, T.; Chaula, M.; Mweemba, N.; Hang’ombe, M.B.; Higashi, H.; Akamatsu, R.; Mazaba, M.L.
An outbreak of anthrax has been confirmed in Chama district in Zambia affecting close to 80 persons. A previous outbreak in the same area was confirmed in 2011 with 521 humans affected and 6 human and over 80 hippos dead. To understand the disease situation and provide technical support the Ministry of Health in collaboration with the World Health Organization (WHO) in Zambia and Center for Zoonoses control University of Zambia investigated the outbreak in various villages. The index case, a 22-year-old male presented at Pondo rural health centre with eschar invariably accompanied by oedema on the cheek with onset 22nd September 2016. More patients mostly below20 years of age from five RHCs were seen thereafter with varied lesions papules, vesicles and eschars and treated with ciprofloxacin. Most patients were associated with eating hippo meat. Various interventions were put in place to control the outbreak including case detection, case management, contact tracing and community awareness. Field investigations observed dead carcasses of Hippo and Buffalo. Bacillus anthracis was isolated from humans, buffalo, hippo and the environment confirming the outbreak link to Anthrax infection suggesting the need to strengthen surveillance, diagnosis, community sensitization and treatment of affected persons for effective disease control. The rapid response by the Ministry of Health, WHO Zambia, Center for Zoonosis Control, and ZAWA necessitated by the availability of financial resources provided by MOH and WHO Zambia contributed significantly to the timely containment of the outbreak and avoidance of any fatalities.
Dental caries on permanent dentition in primary school children — Ndola, Zambia, 2017
(Health Press Zambia Bull., 2018) Simushi, N.; Nyerembe, S.A.; Sasi, R.; Siziya, S.
Dental caries is a major oral health problem affecting 60-90% of children in developing countries . This study aimed to determine the prevalence of caries and associated factors in permanent dentition among primary school children. A cross sectional study was conducted using a modified 2007 WHO questionnaire and a 1997 WHO oral health survey clinical examination tool. Ethical approval and permission to conduct the study were obtained from relevant authorities. The Chi-squared test was used to determine associations, with the level of significance set at the 5%. A total of 365 children were enrolled of which 48.5% were males. The age range was 5-17 years. The overall prevalence of caries in permanent teeth was 47(12.9%). Geographical location (p=0.022) and family income (p= 0.014) were significantly associated with caries, although only family income was statistically significant (odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.46 - 0.92) in a multivariate analysis. The lower left first molar (9.0%) was the most often affected. None of the children had a tooth with a filled cavity. Less than half, 177 (48.5%), brushed their teeth for 2 or more minutes daily and only 71 (19.5%) had been for a dental check-up. Promotion of regular dental check-ups in schools and application of fissure sealants to children at high risk of developing caries is recommended.
Description of cases of parasuicides reported at University Teaching Hospital, Lusaka. Zambia: preliminary findings
(Health Press Zambia Bull., 2017) Paul, R.; Panchal, S.; Zimba, K.
Parasuicide has become a public health problem of importance. A sample size of 207 case records of patients was estimated considering a prevalence of 16+5% obtained in the project area, z=1.96 and margin of error of 5%. The case records were conveniently sampled. A total of 141 (68.1%) out of 207 records were reviewed of which 53.2% were for males. About a third of the cases were in the age group 20-24 years (35.0%), employed (33.1%) and students (28.8%). Most of the cases were married (47.9%), lived with their families (95.0%) and attained secondary level of education (79.9%). The most common reasons for parasuicide were domestic dispute, alcohol-related and psychiatric condition in that order. The most common methods used in parasuicide were organophosphate poisoning, drug overdose and acid poisoning. The common reasons and methods for parasuicide obtained in the current study may be considered in the care of parasuicides. Further studies should be conducted to establish factors associated with parasuicide.
Determinants of fetal mortality in Zambia.
(Health Press Zambia Bull., 2018) Nyirenda, H.T.; Nyirenda, H. B. C.; Mulenga, D.
A pregnancy that does not terminate into a live birth is a public health concern. The aim of the paper was to determine factors associated with fetal deaths in Zambia. This paper uses data from the 2013/2014 Zambia Demographic Health Survey (ZDHS) and used a cross sectional study design. The study was purely quantitative and was conducted through structured interviews. A representative sample of 18,052 households was drawn and interviewed women in the reproductive age group 15-49. The results showed that only 5.3% women in Zambia had a fetal death. The multivariate logistic regression findings indicate that the odds of having a fetal death was 1.46 (CI: 1.20-1.79) higher for women whose health care was decided by their partner; increasing maternal age increased the odds of having a fetal death by 1.02 (CI: 1.01-1.03) and the odds of having a fetal death was lower for women who had children or a child alive. Evaluating factors associated with fetal death makes it possible to recognize that interventions in some social, economic, demographic and maternal factors is key in the reduction and prevention of adverse birth outcomes such as fetal deaths.
Does circumcision influence risky sexual behaviour among circumcised sexually active men in Zambia?
(Zambia National Public Health Institute, 2017) Mapoma, C.C.; Bwalya, B.B.
Low circumcision and high rates of heterosexual acquired HIV infections are among factors that have “influenced” Zambia to adopt, encourage and spearhead Voluntary Medical Male Circumcision (VMMC) as a preventive tool against HIV infection. Circumcision has been portrayed as the single most important “panacea” or “magic bullet” to HIV prevention in some circles of the Zambian society and many African countries. In this respect, this study aimed at answering two questions: Does circumcision influence risky sexual behaviour among circumcised men in Zambia? And; how do socio-economic and demographic characteristics influence such behaviour? Data for men age 15–59 years interviewed during the 2013–14 Zambia Demographic and Health Survey was used. A total of 14773 men were included in the sample. Logistic regression - the odds ratio - was used to assess the association between circumcision on one hand and socio-economic and demographic characteristics as well as risky sexual behaviours on the other hand. Men aged 35-45 and 45-54 were likely to report being circumcised comparatively (OR=0.691, p<0.001; OR=0.761, p<0.047). Men aged 45-54 were more likely to engage in risky sexual behaviour (OR=0.397, p<0.0001). Being married/living with a partner and being formerly married were highly associated with risky sexual behaviour (OR=0.0004, p<0.0001). In terms of wealth quintile, being in the rich bracket is highly associated with engaging in risky sexual behaviour (OR=1.396, p<0.026). Other sexual characteristics such as having two or more non-marital sexual partners was also highly associated with circumcision (OR=0.085, p<0.014). However, paying for sex, taking alcohol before sex and using a condom at last sexual intercourse with non-cohabiting sexual partner were not associated with circumcision status (OR=0.906, p<0.42; OR=0.846, p<0.138 and OR=0.906, p<0.420). There is strong evidence suggesting that men who are circumcised are also having two or more extra non-cohabiting sexual partners. Proponents of VMMC require to up their messages to ensure complete adherence to safe sexual messages, behaviour and practice if transmission of HIV and other STIs is to be halted and reversed.
The epidemiology of liver disease as we celebrate world liver day
(Medical Journal of Zambia, 2018) Mazyanga, M. L.
Exactly a year after the official launch of ZThe Health Press –Zambia (THP – Z) THP- extends its heartiest congratulations to the World Health Organisation (WHO) on the occasion of the Organisation’s 70th Anniversary for the many meaningful successful years of its existence. Every year on 7th April the WHO takes time to create awareness on issues of international public health concern. In the last 7 decades, the WHO has made efforts in spearheading eradication or elimination of specific diseases; Small pox is history now, others such as polio, measles, rubella, neonatal tetanus, Eliminate Lymphatic Filariasis are some among many others targeted for either eradication or elimination. One of the founding principles of the world Health organisation is “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” The 2018 theme “Universal health coverage (UHC): everyone, everywhere” stands on this principle. According to the WHO more than half the world’s population does not receive the essential health services they need
Epidemiology of tuberculosis in the context of HIV and AIDS in Sinazongwe district of Zambia:
(Zambia National Public Health Institute, 2017) Mtalimanja, J. L.; Simuunza, M.; Malama, S.; Muma, J.B.
TB cure and completion rates have remained poor for Sinazongwe district in the past five years. Mortality, treatment failure and defaulter rates among TB patients have also been increasing in the same period. The reasons for the observed poor treatment outcomes are not well understood but could be attributed to high HIV co-infection among TB patients in the district. This study was aimed at determining the prevalence of HIV/AIDS among TB patients and asses the association between the common TB treatment outcomes. A retrospective study of 484 TB patients’ clinical files drawn from a total of 2,137 files was conducted at Sinazongwe Zonal Health Centre. HIV was more prevalent among female TB patients at 61.5% compared to their male counterparts, 54%. TB/HIV co-infection were higher for patients with extra pulmonary TB compared to patients with pulmonary TB (p= 0.002).HIV prevalence among TB patients in Sinazongwe district was high and there was no evidence of declining trend observed across the reference period. HIV did not only fuel the number of new TB infections but was also, in part, responsible for reducing TB cure rate and increasing mortality rate among TB patients registered in the routine TB program.
Factors associated with the 2012 typhoid fever outbreak in Mufulira district, Zambia : A case control study
(Health Press Zambia Bull., 2018) Syapiila, M. P.
Typhoid fever is still a public health concern especially in Africa and Asia infecting millions of people while killing thousands. In the year 2012, Zambia recorded a number of typhoid fever outbreaks. The most affected being Mufulira district in the Copperbelt province. As risk factors for typhoid fever may differ from one area to another, determination of risk factors for typhoid fever outbreak is critical in the formulation of rational setting-specific control and preventive measures. We investigated factors that were associated with the typhoid fever outbreak in 2012 in Mufulira district, Zambia. A case control study was done to determine factors associated with typhoid fever infection in Mupambe. All 42 cases meeting the inclusion criteria where invited to take part in the study while controls where selected by simple random selection from eligible members of each selected household. To select households for controls, every third household was picked by systematic random selection from the total of 450 household. Individual association of possible risk factors and typhoid fever infection where first analysed using logistic regression. Risk factors with the p value of less than 0.2 were then examined using multivariate logistic regression. The final model was assessed using Pearson’s Chi-square diagnostics. A total of 36 cases and 138 controls participated in this study. Age, younger than 23 years (aOR: 4.64, 95%CI: 1.84, 11.71), eating food from street vendors more than 7 times /week (aOR: 3.83; 95%CI: 1.40, 10.50), eating vegetable salads more than 2 times /week (aOR: 4.82; 95%CI: 1.63, 14.22) and drinking untreated water (aOR: 4.56, 95%CI: 1.73, 12.14) were significantly associated with typhoid fever. Eating of unsafe food and personal hygiene were factors responsible for the typhoid fever outbreak, suggesting that sensitising the community on good hygiene practices and general cleanliness could prevent further recurrences. Hygiene, Outbreak, Risk factors, Typhoid, Zambia
Full immunisation coverage of under five children and its correlates among women in Lubuto, Ndola, Zambia.
(Health Press Zambia Bull., 2018) Chofwe, M.; Kwangu, M.
Child morbidity and mortality in most developing countries is mainly due to vaccine-preventable diseases and Zambia is not an exception according to WHO. Although numerous interventions have been made to increase immunisation coverage, full,immunisation coverage in Zambia remains relatively low at 68%. This study examines the predictors of full childhood immunisation. A cross-sectional study of a representative sample of 364 women with children under the age of five years from households of diverse socio-economic levels in a peri-urban locality in Ndola, Zambia, was performed. Only 44.8% of subjects were found to be fully immunised. Children aged 1-12 months were less likely to be fully immunised than younger or older children: 30.7% compared with 56.5% for children aged <1month, 50.0% for those aged 13-24 months, and 55.6% for children aged 25-60 months. Contrary to other studies, distance from health centre, and maternal education were not found to predict the outcome of the immunisation status of a child. Immunisation coverage in Lubuto, Ndola, was much lower than found in other surveys done in the region. The differences found in immunisation coverage by marital status and age of the child should be considered by programme and policy makers if better rates of immunisation are to be achieved. In addition to this, younger mothers should be targeted.
Hopeful: Towards the tail end of the Zambia cholera 2017/2018 outbreak?
(Medical Journal of Zambia, 2018) Mazaba, M. L.
Early October 2017, cholera broke out in two sub-districts of Lusaka District. In the 4th week of the outbreak, the response team was excited to see a drastic drop in the number of cases. But the following week, the numbers of cases increased again. The epi curve showed exponential growth until week 14 of the outbreak (epi week 1 in 2018), when weekly incidence peaked at 709 cases/100,000 population. Incidence then fell rapidly for 4 weeks. Since January, incidence has fallen, to a weekly rate of 0.9/100,000 population in epi week 20 (Ministry of Health, unpublished situation report). In the current issue of The Health Press, we reprint an article from the 18 May 2018 issue of the MMWR, ‘Cholera Epidemic — Lusaka, Zambia, October 2017– May 2018’ that will give readers insight into the outbreak situation between 6 October 2017 and 5 May 2018 and the public health response then ongoing that ultimately ended the outbreak.
Increasing problem of alcohol abuse among the Zambian population in the psychiatric setting
(Health Press Zambia Bull., 2017) Paul, R.; Ncheka, J.; Hammerstein, N.
Alcohol abuse is related to the development of cancer, neuropsychiatric disorders, cardiovascular diseases and cirrhosis of the liver among others. Level of alcohol abuse varies in different subpopulations and is hypothesized to be high in psychiatry patients. The objective of the study was to determine proportions of patients with history of alcohol abuse and alcohol related disorders in the Psychiatry ward of the University Teaching Hospital (UTH) in Lusaka, Zambia. All diagnoses made in the Psychiatry ward between January 2012 and October 2015 were reviewed for frequency of alcohol related disorders. Additionally, randomly selected files in 2016 were examined for history of alcohol abuse. The Chi-squared test was used to compare proportions, while trends were established using simple linear regression. The cut off point for statistical significance was set at 5%. Totals of 6212 (3629 male and 2583 female) and 109 (79 male and 30 female) records were reviewed for alcohol related disorders and alcohol abuse, respectively. More males (75.9%) than females (23.3%) had a history of alcohol abuse (p<0.001). No significant linear trends were observed in the proportion of alcohol related disorders for both gender between 2012 and 2015 (males: slope = 3.980; 95% CI [-1.213, 9.173]; females: slope = 1.101; 95% CI [-1.479, 3.682]). Overall, rates of alcohol related disorders increased linearly from 9.3% in 2012 to 18.7% in 2015 (slope = 2.920; 95% CI [0.099, 5.741]). Proportions of alcohol abuse and alcohol related disorders are high among patients in the Psychiatry ward of the University Teaching Hospital (UTH) in Lusaka, Zambia. Generally, the rate of alcohol related disorders is on an increase. Interventions are needed to reduce rates of alcohol abuse and subsequently alcohol related disorders. Rehabilitation centers are needed to provide affected patients with appropriate support.
Inva gene and antibiotic susceptibility of Salmonella Spp isolated from commercially processed broiler carcasses In Lusaka District, Zambia.
(Medical Journal of Zambia, 2018) Shamaila, T. M.; Ndashe, K.; Kasase, C.; Mubanga, M.; Moonga, L.; Mwansa, J.; Hang’ombe, B. M.
Poultry meat is considered to be one of the major vehicles of Salmonella infections in humans en implicated in outbreaks of Salmonellosis in humans. The potential for mass outbreaks of Salmonellosis is likely to be linked to the high consumption of poultry meat and the increasing antibiotic resistance of Salmonella spp poses a huge challenge to treatment of the foodborne infection. Determination of virulence genes such as InvA is important as they play a vital role in the establishment and invasion of Salmonella spp in the gastrointestinal tract of the host and therefore is means of detection of the virulence of the pathogen and it is the international standard in the detection of Salmonella spp using molecular techniques. This was a cross-sectional study where two abattoirs were sampled conveniently in Lusaka district. A total of 100 swabs were collected from the 2 abattoirs and submitted to the University of Zambia, School of Veterinary Medicine, Paraclinical Sciences laboratory were isolation and identification bacteria was conducted. Presumptive Salmonella colonies were further analysed through conducting biochemical tests, molecular detection of the virulence gene invA through polymerase chain reaction and antibiotic susceptibility testing.The study revealed that 2% of commercially broiler carcasses were contaminated with Salmonella spp. The isolates further showed resistance to two antibiotics, gentamicin and tetracycline after antimicrobial susceptibility testing. The presence of Salmonella spp with a virulence gene (InvA) in commercially processed broilers is a public health concern mostly in sensitive population and multi-drug resistance of the pathogen presents challenge in treatment options of Salmonellosis.
Keep our future generation alive: Reinforcing routine HIV testing and treatment among children in Zambia
(Health Press Zambia Bull., 2017) Savory, T.; Chitala, M.; Lumpa, M.; Mwanza, M.
Only 3% of children visiting clinics are tested for HIV, despite Ministry of Health recommendations to test and treat ALL children. If unidentified and left untreated, 75% of HIV positive children die by the age of 5 years. Reinforcement of routine HIV testing and treatment of children will increase testing up to 90 - 95%, and importantly reduce mortality by 52%. Adding Integrated Primary School Screening will reach 5-10 year olds who were not previously tested.

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