Medicine

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Acceptance and utilization of condoms in the prevention of HIV/AIDS amongst christian men in Mwinilunga.
(2014-06-30) Lupili, Hellen Mulenga.
The title of this study is Acceptance and Utilization of Condoms in the Prevention of HIV/AIDS amongst Christian men in Mwinilunga. The main objective is to determine the factors that influence the acceptance and utilization of condoms in the prevention of HIV/AIDS among Christian men in Mwinilunga. The specific objectives are to determine the level of acceptance of condoms among Christian men, determine the level of utilization of condoms among Christian men, determine the factors that influence the acceptance and utilization of condoms and make recommendations to all the concerned parties on how to increase condom use among Christian men in order to prevent HIV/AIDS. The study was conducted between 23rd August and 1st October, 2004.The findings of the study revealed that the majority of the respondents were aged between 25-34 years (50%). The majority of the respondents were married 66%, 40% were Lunda and belonged to New Convenant Church. This could be attributed to the fact that marriage is universal in Zambia and people marry at any age sometimes as early as 16 years; and the study was conducted in a predominantly Lunda speaking area. Apart from that, the study also found that the majority of the respondents 23(46%) had attained college level of education and were in formal employment 23 (46%). This could be attributed to some cultural practices where families may opt to marry off their daughters instead of sending them to school therefore it is not surprising that the same son who was empowered with the education would easily find formal employment.
An assessment of IEC given to HIV and AIDS patients in medical clinic at UTH.
(2014-02-17) Hamwiibu, Vine.
The purpose of this research was to assess the Information, Education and Communication (IEC) given to HIV/AIDS patients in University Teaching Hospital (UTH) and was carried out to determine whether patients are given IEC during their subsequent visits to the hospital The objectives of the study were to assess the content of IEC given to HIV and AIDS patients during the pre-testing counselling session and subsequent visits, determine the frequency at which HIV and AIDS patients received IEC and to determine factors influencing adherence to IEC. A descriptive study was conducted in September, 2007. The study was done on patients attending reviews in the Medical Clinic, particularly, those who are HIV positive. A total number of 50 HIV/AIDS patients were selected using simple random sampling method, while the study site was selected using purposive sampling technique. Data was collected by use of a structured interview schedule from 23rd September to 3rd October, 2007. When interviewed on what patients were taught on HIV and AIDS and how frequently did they receive IEC on HIV issues during the subsequent reviews, 54% had inadequate IEC and 58% had received IEC only once on the initial visit to the clinic.
Assessment of nursing care given to critically ill patients at kitwe central hospital.
(2013-11-20) Chirwa, Mabvuto.
The main objective of the study was to determine the nursing care given to critically ill patients at Kitwe Central Hospital. The study hypotheses were that nurses do not give quality nursing care to critically ill patients due to inadequate knowledge on critical care nursing and inadequate surgical and medical supplies. Non availability of protocols or guidelines on critical care nursing and the increased numbers of critically ill patients may also contribute to sub standard nursing care on the critically ill patients. The study was conducted at Kitwe Central Hospital. The hospital and the wards were conveniently selected while the respondents were purposefully selected. The study involved 50 respondents who were nurses working in low cost medical and surgical wards. A self administered questionnaire and participatory observation were used. Data were collected, sorted, coded and entered manually on the data master sheet. The study revealed that non availability of required medical-surgical supplies influenced the nursing care; 88% of the medical-surgical supplies were available in surgical department while 73% were available in medical department. The other factor which influenced the nursing care was non utilization of the available protocols on critical care. Only 70% of the participants knew that the protocols were available even when all the wards had all the necessary protocols. The numbers of critically ill patients also influenced the nursing care. It was observed that 54% of participants who gave substandard care were from medical wards while 46% were from surgical wards due to the difference in numbers of critically ill patients. The major recommendations for the study are that the Ministry of Health should support the health institutions in delivering of quality health care through funding of workshops/ seminars and departmental presentation on critical care nursing. The Ministry of Health should also improve supply of medical-surgical supplies and funding to nursing schools in order to train more nurses and improve the staffing levels in the hospitals.
The attitude and utilisation of voluntary counselling and testing for HIV by married men in Gwembe district.
(2015-04-28) Mbewe, Misheck.
The study was aimed at determining the attitude and utilization of voluntary counselling and testing services by married men in Gwembe District and with a view to encourage married men to go for voluntary counselling and testing in order to prevent HIV/AIDS and promote behaviour change. Literature from various scholars, globally, regionally and nationally was reviewed on the attitude and utilization of HIV voluntary counselling and testing by married men and other related literature. A pilot study was conducted in Lukonde ward of Gwembe District and it consisted of one tenth of the total sample for the main study. For the main study, a descriptive study design for both qualitative and quantitative dimensions was used. The study population was married men. A convenient sampling method was used to select the sample population. The study was conducted in Jongola/Khoma and Chibuwe wards in Gwembe District. Data was collected using a structured interview schedule from fifty (50) respondents and later analysed manually by use of data master sheet and a scientific calculator and it has been presented in tables, cross-tabulations, pie charts and bar charts. The research findings revealed that majority (88%) of respondents had high knowledge on HIV/AIDS and VCT and (12%) had low knowledge. However, majority (76%) of the respondents had negative attitude towards HIV voluntary counselling and testing. Twenty four percent (24%) of the respondents had positive attitude towards the service.
Caregivers experiences in caring for children with hydrocepalus attending physiotherapy at the University teaching hospital D-block and CBI, Lusaka
(2014-08-25) Maifwani, Jack
The purpose of this study was to evaluate the caregivers' experiences in caring for children with hydrocephalus attending physiotherapy at UTH-block and CBI.A quasi experimental, cross sectional descriptive study was undertaken. Data was collected from 25 respondents, using a semi structured interview guide with open ended questions and a semi structured questionnaire. Data was analyzed using the statistical package for social sciences, descriptive and inferential statistics were used for the analysis of data. The results showed that most caregivers experienced profound sadness and rage; their care giving may be driven by empathy and love. Results showed that 68% reviewed to have experienced sadness on conditions of their children and 12% shock. On psychological impact 52% were emotionally drained, 24% stressed, 12% depressed, 4% optimism. On activities that caregivers found to do to their children, 52% expressed exercising the child, 24% bathing the child, 16% found feeding the child more enjoyable and 8% changing nappies.The results also show that 44% were moderately affected, 40% severely and 16% not at all affected by the child's condition.
Community perceptions towards people with mental illness in Lusaka urban district.
(2014-04-26) Kasaro, Mutinta F H.
In Zambia like in many other countries, the concept of mental illness is stigmatised in various ways. Poor community sensitisation about mental illness has resulted in negative community perceptions towards people with mental illness. The objective of the study was to explore community perceptions towards people with mental illness in Lusaka Urban District.A cross sectional study using semi-structured questionnaire was conducted. A total of 50 respondents aged 18 years and above were interviewed. Participants were selected using simple random sampling method. Despite the often assumed negative perception leading to stigma, the results revealed that 70 percent of the respondents had positive perceptions towards people with mental illness. Ninety percent of the respondents had adequate knowledge about mental illness, and majority of the respondents stated that they had quality health services. However, most of the respondents stated that mentally ill people were only treated at the referral hospital. Positive community perception towards people with mental illness is important to improving and promoting the mental health of all Zambians.
Community perspectives towards mandatoty testing for HIV in Macha
(2012-08-15) Sitali, Doreen Chilolo
Zambia's national HIV policy does not support mandatory testing of individuals on public health grounds. However, due to the low uptake of voluntary counseling and testing which is only 20% of the population, there have been recent proposals by the Ministry of Health to introduce mandatory HIV testing for individuals attending health facilities. This proposal has triggered various views from various backgrounds in society. The aim of this study was to explore community perspectives on mandatory testing. The study also'acted as a model through which the community was involved in decision making for public policy which is an important aspect of community involvement that enhances policy formulation and helps to avoid social engineering.The study was a cross-sectional descriptive design. The study used both qualitative and quantitative approaches. Multistage sampling was used to select households for interviews. Adults above 18 years, of age were interviewed from the selected households using a structured interview questionnaire. The questionnaire was translated into the local language to enhance understanding of the subject. Purposive sampling was instituted to select key informants for in-depth interviews. The study was undertaken within the Diffusion of Innovation Theory. The theory enhances understanding of the factors that influence ccJmmunities to embrace new ideas or practices.Quantitative data was analyzed using SPSS version 16 for windows. Preliminary analyses were done followed by cross tabulations to measure associations between variables. Logistic regression was applied to determine independent predictors for supporting mandatory HIV testing. In-depth interviews were translated and transcribed into computer files; common themes were identified, after which data was categorized using the Nvivo statistical package. Interpretation of qualitative data was done manually.A total of 809 respondents and 12 (twelve) key informants participated in the study. The age range for the cohort was 18-80 years, with mean age of 35.8 years. Of the whole study population, 42.8% were males while 57.2% were females. The study found that the majority of respondents (61.9%)) had never heard about mandatory HIV testing before. Despite this scenario, the majority (80.3%) of respondents and all the key informants supported the policy. Furthermore; most (89.5%) respondents indicated that they would accept to be tested without consent if they were to be hospitalized. Support for the policy was on the premise that the community has realized the importance of HIV testing as an entry point to HIV care, treatment, and support. Concerning issues of stigma and discrimination it was found that the majority of respondents (76.2%) felt that this is likely to reduce if mandator^^ HIV testing is introduced. In -depth interviews revealed that stigma and discrimination in the community had tremendously reduced due to increased awareness of HIV disease and the introduction of ARV's.The study established that while 52.6% of the cohort thought that mandatory testing is not a violation of human rights, 47.4% felt so. The majority of respondents (71.8%) indicated that they still valued their right to privacy and autonomy, although they were ready to forego the same for the sake of knowing their status. Prior knowledge about the policy and relative advantage were found to be very significant independent predictors for supporting mandatory HIV testing. It was found that those who had heard about the policy before were 1.5 times more likely to support the policy than those who had not (p value 0.044). On the other hand, those who thought that the policy will offer more benefits than risks were ten times more likely to support the policy than those who thought otherwise (p value 0.001). The study established that the cornmunity was in support of mandatory HIV testing policy. It was also established that the commun|ty had realized the vital role that testing plays in accessing HIV care and treatoient and was more willing to be tested. However, issues of human rights are still debatable and need to be explored more in the light of the new policy. Furthermore, it has been established that the community had began to respond more favorably to testing using other strategies such as mobile VCT which need to be strengthened. It was also evident from the study that the poor response to VCT is not exclusively due to fear of being tested but largely due to the African culture of not wanting to be screened when one is not sick. This therefore explains why there was an increased response to mobile VCT.lt is therefore evident that strengthening mobile VCT and increasing access to testing centers can significantly increase uptake of testing in the communities. Sensitization of communities is also key in increasing awareness and changing attitudes towards HIV testing and reducing stigma and discrimination.
A descriptive study of the attitudes and practices of health personnel towards clients with STD/HIV.
(2013-09-25) Chipungu, Anne Mulenga Makanta.
The study sought to determine the attitudes of health personnel towards clients with STD/HIV. A sample of sixty (60) subjects comprising of 31 (51.7%) males and 29(48%) females was selected randomly. The respondents were drawn from three health centers of Lusaka, namely University Teaching Hospital (U.T.H.), Kabwata Clinic and University of Zambia Clinic. Data was collected between 25th to 30th August, 1995. A self devised questionnaire was used and this was complimented by a Focus Group discussion. The method was convenient and cheap considering the time limit, in which the study had to be completed. Before data could be collected, a letter to the Ethical Committee was sought and permission was granted. The study revealed that attitudes of the respondents towards clients with STD/HIV varied. The majority of respondents showed a positive attitude which was closely related to educational status attained. Respondents 7(100%) with University status showed a positive attitude. The results of the study showed that to a certain extent the negative attitude of health workers did contribute to the increase in STD because some health workers did not maintain confidentiality. The study also revealed that clients with STD/HIV are at times discriminated. The majority of respondents felt that the only way to change this practice was through education while some respondents thought an extra allowance would change the attitudes of health personnel. Based on the study results the researcher concluded that it is very important for health workers to develop positive attitudes if the fight against STD/HIV has to succeed.
Determining adolescents perception of voluntary counselling and testing of HIV at Libala and David kaunda high schools in Lusaka urban.
(2015-05-11) Kabinga, Marjorie C.
This study was carried out in order to determine adolescents' perception towards HIV voluntary counseling and testing in Lusaka urban with an aim of encouraging the adolescents to go for voluntary counseling and testing in order to prevent HIV spread and promote behavior change. The literature reviewed was from studies done in Zambia, Africa and other countries around the world on knowledge, attitudes and practices of adolescents towards HIV VCT and other related literature. The study sites were two high schools in Lusaka urban that is, Libala and David Kaunda. Both schools are co-education and they were selected using purposive sampling technique. The study was conducted from June 2002 to January 2003. The sample consisted of sixty (60) respondents and these were selected using simple random sampling technique. Data was collected by use of a self-administered questionnaire from 9th to 23rd September over a period of two weeks. The findings revealed that 88% of adolescents had high knowledge of HIV/AIDS and voluntary counselling and testing while 12% had medium knowledge. Fifty-three (53%) percent of the respondents had a negative perception towards HIV VCT and 54% of these were aged 15-20 years. The findings also revealed that only 10% of the respondents had received voluntary counselling and had done an HIV test.
Determining how accurate clients interpret health messages communicated by health education posters.
(2013-08-23) Chintu, Mwate K Nampemba.
The purpose of the study was to determine how accurate clients interpret health education messages communicated by health education posters displayed in most health institutions, organisations and/or public places. It was hoped that the findings would help health educators to critically analyze how they utilize the posters when conducting health education and help health workers especially those involved in developing educational aids to improve available posters and the ones to be developed by taking into consideration this aspect of their job. The areas pertinent to the study include literature review on background to the concept of health education in traditional Zambia, development of modern health education, concept and philosophy of education and perception and communication.The sample which was drawn from four health centres in Lusaka consisted of sixty (60) males and females aged between twenty (20) to forty (40) years of age. It was assumed that age group has been exposed to experiences that are likely to influence the accuracy with which they will interpret health messages communicated by health education posters. An interview schedule in conjunction with three health education posters were used to collect data. Four health centres in Lusaka urban were selected for sampling. The probability sampling procedure approach was selected as an appropriate method. The interviews took place during the end of the rain season in March to avoid inconveniences caused by the rains which would discourage most clients from attending the health centres. Various problems related to collection of data were minimized through co-operation with officers in charge and the clients themselves. The findings revealed than an average, respondents had a fair idea on health education. However, the majority did not interpret accurately the messages conveyed by the three (3) health education posters which were used in the study. These findings imply that there is need to look into nursing practices, administration, education and research that will improve on the quality of methods used in health education especially in the use of health education posters.
Determining knowledge, attitude and practice of men towards postnatal care services in mazabuka district of Zambia.
(2014-06-11) Lungu, Rabecca.
The study was conducted with a purpose of determining knowledge, attitude and practice of men towards PNC services in Mazabuka district. This was to establish if men's involvement would improve the postnatal service utilization by women within the district. The hypothesis for the study was that the less the knowledge on postnatal care services, the poor the practice of utilisation the service and that; Men with positive attitude towards PNC services are more likely to utilise the services (practice). A non intervention descriptive cross section research design was used. Sampling was multi staged and later a purposive sampling method was applied to select fifty respondents as they came to the health facility for any service. Data was collected using a structured interview schedule on men over 17years regardless of their marital status, had a child before and residing in Mazabuka. Analysis of data was done manually on data master sheet and use of statistical package for social scientists version 16.0. Data was presented in the form of frequency tables, pie and bar charts. Cross tabulation tables were used to determine the relationship among variables. Results from the study revealed that 100% of the respondents had a positive attitude towards PNC services, 68% of the respondents had high knowledge and 82% had good practice. Majority (75%) of the respondents, who had good practice, had high levels of knowledge, 100% of the respondents with good practice and high knowledge had positive attitude. Respondents between 28-35 years and those with fewer children and with formal education had high knowledge. Distance to the health facility also had an influence on knowledge, attitude and practice. Health workers and spouses were the major sources of information on PNC services and 48.5% of those who sought PNC services said the treatment by health service provider was excellent. From these results, conclusions can be drawn that adequate knowledge and positive attitude are major contributors to good practice among men.
Disclosure of HIV status by caregivers of HIV infected children at the University Teaching Hospital pediatric ART clinic.
(2013-11-29) Inambao, Nalishebo.
The study sought to determine caregivers' knowledge of HIV infection, knowledge of HIV status disclosure, their attitude towards HIV status disclosure and level of HIV status disclosure among caregivers of HIV infected children attending ART clinic at the University Teaching Hospital. A descriptive cross sectional study design was used and an interview schedule was used to collect data from 50 caregivers. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16. Findings revealed that all, 50(100%) respondents were knowledgeable about HIV infection. Majority of the respondents 38 (76%) were knowledgeable about HIV status disclosure. All the 50 (100%) respondents had positive attitude towards HIV status disclosure. Slightly over half of the respondents 27 (54%) had disclosed HIV status to their infected children, out of which 11 (22%) respondents only disclosed HIV status partially. However, the knowledge level and attitude of the respondents were not related to HIV status disclosure as disclosure was only 54%.
Does the registered nursing curriculum prepare graduates for rural nursing?Nurses and their supervisors' views.
(2015-01-29) Kunsanama, Sandie K.
The main aim of the study was to determine factors that would better prepare the graduate nurse for rural nursing. At the same time conditions which make the nurse indifferent to rural areas were identified. Factors or situations which the supervisors and the nurses felt would better prepare the graduate nurses for rural nursing were investigated. The literature reviewed for the study indicated that graduate nurses need exposure to rural nursing during their training and more knowledge and practice in administration. The graduate nurse assumes administrative roles when sent to rural areas to which she only had little exposure while on training. Data were collected from nurses who had worked in rural areas in the previous five years and from the supervisors who were working in rural areas at the time of data collection. Two self-devised questionnaires were used to collect data. The study was descriptive in nature. Data were collected from fifty-five (55) registered nurse and thirty-five (35) nursing supervisors The findings of the study revealed that Registered Nurse Education Curriculum did not equip the graduate nurse to nurse effectively in rural areas. The finding further revealed that graduate nurses lacked administrative skills. The suggestions by the nurses and their supervisors as a means of strengthening the curriculum are presented in the study. The findings from three (3) responses in the nurses questionnaire and fourteen (14) responses from the supervisors questionnaire who indicated lack of exposure of trainee nurses to rural areas supported hypothesis number one which states that "student nurses' lack of exposure to rural areas during their training leads to nurses failure to adapt to rural nursing".
Effect of Bacteraemia and HIV infection on treatment outcome in children with severe acute malnutrition admitted to the University Teaching Hospital Malnutrition Ward, Lusaka, Zambia
(2013-01-09) Mwambazi-Mweene, Mwate
Background:Severe malnutrition remains a major cause of mortality in children less than 5 years at the University Teaching Hospital, with rates ranging between 30-40 % among patients admitted in the malnutrition ward. The effects of bacteraemia and HIV infection on outcome to treatment remain unknown. Objective:To establish the magnitude of bacteraemia and HIV infection in children with severe acute malnutrition (SAM) admitted to the Zambian University Teaching Hospital (UTH) malnutrition ward, describe the types of bacteria and antimicrobial sensitivity, and effect on treatment outcome. Method: Children admitted to the malnutrition ward at the UTH from August to December of 2009 were included in the study after acquiring informed consent. Data on nutritional status, social demographic factors and admission medical conditions were collected. In addition blood sample was collected from every child. Identification of positive culture yielding pathogenic bacterial strains were done using BACTEC machine, and completed with morphologic and biochemical tests. Antibiotic susceptibility tests were performed using Kirby-Bauer susceptibility testing method. Results: Data were collected from 441 children aged six to 59 months old, 55.3% (244/441) of whom were boys. Median age of the cohort was 17 months (inter quartile range, IQR 12-22). 68.9% (295/428) had edema at admission; 57.4% (247/430) had weight for height Z score < -3SD at admission. The majority, 67.3% (261/388) of the children presented with diarrhea. 38.9 % (162/420) tested HIV-positive; 21.4% (91/425) of the children had one or more bacteria isolated from their blood samples; 40.5% (174/430) of the children died. The predominant organisms isolated were Coagulase negative Staphylococcus (20.7%), E. coli (15.5%), Staphylococcus aureus (15.5%), Salmonella (12.1%,), Pseudomonas (8.6%), Diphteriods (6.9%) and Klebsiella pneumonia (6.9%). Crystalline Penicillin had 85.7% (12/14) resistance; ranging from 66.7% to S.Aureus to 100% to E.coli and klebsiella. Gentamycine had 23.6% (5/19) resistance; ranging from 0% to E.coli to 100% to Klebsiella; Ciprofloxacin had 27.9% (13/43); ranging from 0% to Salmonella, Klebsiella and Psuedomonas to 55.6% to E.Coli. HIV positive children had increased odds of mortality, adjusted 0R= 1.70 (95% CI 1.04-2.83, P=0.04). Children with bacteremia had increased odds of mortality compared to those with no bacteremia, adjusted OR=1.90 (95% CI 1.04-3.40, P=0.04). There was no interaction between bacteremia and HIV infection on outcome (P=0.77). Conclusion: SAM children admitted in UTH suffer from high prevalence of bacteremia on admission. This has increased their odds of death by almost two folds regardless of their admission nutritional status, diarrhea, age, sex, and HIV status. The baseline mortality and HIV prevalence in the malnutrition ward was higher than other similar studies. The drug resistance, to first line antibiotics mainly to penicillin, calls for an in-depth review of drug management.
Effect of party, maternal age and pre-eclampsia on birth weight .
(2012-11-28) Anim, Mamle
A case control study was carried out in Lusaka to find the effect of parity, maternal age, pre-eclampsia and its severity on birth weight. 100 pre-eclamptic cases were selected from University Teaching Hospital, department of Obstetrics and Gynaecology. 200 controls were selected from Chilenje Clinic, a peripheral Clinic in Lusaka. All samples were randomly selected. Average birth weight for this study was 3.233kg. This was the average birth weight for controls. From this study it was shown pre-eclampsia reduces the average birth weight of a child. Average birth weight for cases was 2.9521kg and that for controls was 3.2136kg. The difference was significant (P value>0.05). Average birth weight for mild pre-eclampsia cases was 2.978kg, for moderate was 3.016kg and severe was 2.850kg. These values were not significantly different. Average birth weight increased with maternal age but the differences were not statistically significant. Ideal maternal age for ideal average birth weight was the 20-29 year group. Birth weight increased with parity. The ideal parity for ideal average birth weight was Para 2 and Para 3.
Emotional support of a labouring woman.
(2014-06-11) Kwendakwape, Monica Mutale.
The purpose of the study was to find out how much emotional support is given during labour and delivery to women who deliver in the University Teaching Hospital (U.T.H.), and to further find out whether or not the same women are satisfied with the care given. This was in order to bring attention to both care givers and the authority to the factors which contribute to inability to give quality care. The literature used in the study was obtained from text books and studies done in other countries, since no such studies were conducted in Zambia.The findings of the study revealed that most of these patients were satisfied with emotional support given during labour and delivery. Twenty one out of thirty (70%) respondents said that they were satisfied with the care given to them, in the first stage of labour. During delivery all those who passed through second stage twenty --five (83%) of the total number of respondents said that they were satisfied with the care given.The factors which dissatisfied the patients were: shouting at the patient, talking in hush voices, giving inappropriate re-assurance, unfriendly attitude, being left alone, no information about the condition of the baby, anticipated time of delivery and about the progress of labour. Inability of midwives to come when they were called by a woman in first stage of labour. The authorities are advised to give praise where it is due and critically analyse the bad behaviour and culprits should be warned about that.
Evaluating the effectiveness of patient counselling services in the delivery of pharmaceutical care to patients at uth.
(2015-10-05) Kalumba, Mukoma I.
The main objective of the study was to evaluate the effectiveness of patient counselling services in the delivery of pharmaceutical care to patients at UTH. The study was beneficial as it aimed at improving pharmaceutical care services and in particular patient counselling services for the betterment of health. The key variables of the study were patient counselling sessions, quality of pharmaceutical care being delivered through patient counselling, views of patients on counselling services, knowledge that patients are receiving from pharmacists, the major factors contributing to the prevailing standards of patient counselling services at UTH & medication counselling behaviour guidelines.The study adopted a Descriptive cross-sectional method of research as it aimed at quantifying the distribution of certain variables in a study population. The main data collection instrument was a structured questionnaire as it enhanced data collection to a larger group of people within the short time that was available to the researcher. The study revealed the following findings: 55% of the patient respondents had been counselled while 45% had not been counselled by the pharmacist on the medicines they had acquired. The majority of those not counselled were inpatients as there were no pharmacists on the wards. Regarding the quality of pharmaceutical care being delivered by pharmacists through patient counselling services, the study revealed that pharmacists arc generally delivering quality pharmaceutical care through patient counselling services.
Factors affecting accessibility of antenatal care services among pregnant teenagers:Evidence from three centres in Lusaka.
(2015-04-13) Kapeta, Benetiah Nansengo.
Despite antenatal care services being provided free and available every working day, pregnant teenagers rarely access the services which may be attributed to lack of recognition of signs of pregnancy and midwives attitude among others. Late accessibility of antenatal care compromises the quality of care the pregnant teenagers receives as it creates missed opportunities for interventions such as early identification of obstetric complications. It is for this reason that the study embarked on exploring factors affecting accessibility of antenatal care services among pregnant teenagers.A descriptive cross-sectional study was carried out on factors affecting accessibility of antenatal care services among pregnant teenagers in Lusaka. Semi-structured interviews were conducted with 50 participants. Participants were selected using purposive sampling method. Quantitative data were assigned numerals which were entered manually on the data master sheet. Both quantitative and qualitative data were categorised and coded, then analysed using the Statistical Package for Social Sciences (SPSS) version 16.0. The study was guided by the Health Belief Model.The results showed that factors that influenced accessibility of ANC services in a positive way were economic status, level of knowledge on ANC services and the perception of midwives attitude towards pregnant teenagers, while social support influenced accessibility in a negative way. Majority of respondents who lacked social support had more accessibility of ANC services. Increased accessibility of ANC services could be attributed to the fact that pregnant teenagers who lacked social support from their homes opted to obtain the support from health practitioners through early access to ANC services while those who had social support may have developed a passive attitude towards accessing ANC services.
Factors affecting Voluntary Blood donation in Zambia
(2012-08-03) Kongwa, Patricia Namukolo Mutumba
The study attempted to investigate those factors that affect voluntary blood donation - in relation to the supply of a safe and adequate blood to hospitals in Zambia. A'cross sectional survey of a systematic, randomly selected, secondary school students, was done using a self administered questionnaire. A self administered questionnaire was also used to inquire about the prescription and use of blood among doctors working in four major hospitals in Zambia. Discussions were held with blood bank staff in the four hospitals using the Focus Group Discussion model.In all,165 students, 16 prescribers and 14 blood bank staff, from Lusaka, Livingstone,Kitwe and Ndola cities were included.The outcome of the study showed that:The fear of the HIV test discourages people from voluntarily donating blood.The lack of a blood donor recruitment programme has had an adverse effect on voluntary donations. Lack of knowledge in communities on blood donation adversely affected voluntary blood donation. The supplies of blood to the hospitals were inadequate.
Factors associated with Elevated Plasma levels of Liprotein (a) in indegenous black Zambians with Diabetes Mellitus type 2 in the outpatient medical clinic at the University Teaching Hospital,Lusaka,Zambia
Sinyani, Angela
Introduction: Diabetes mellitus (DM) is an established risk factor for cardiovascular disease (CVD) and is considered to be a CVD equivalent. Lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular diseases. Since Diabetes Mellitus Type 2 (T2DM) patient numbers continue to rise, and since patients continue to present with cardiovascular disease-related complications, it is possible that some of these patients have high plasma levels of Lp(a). The aim of the study was to investigate the plasma levels of Lp(a) in T2DM patients and also to assess the factors that may be associated with the plasma levels of Lp(a) among indigenous black Zambians with T2DM. Materials and methods: We conducted a cross sectional study that enrolled 155 participants, 79 T2DM patients attending the outpatient medical clinic of the University Teaching Hospital and 76 community-based healthy individuals. A short questionnaire was used to record the social demographic characteristics and anthropometric measurements. 4ml of venous blood was collected from which all the analytes were measured. The factors that were assessed for association with Lp(a) included; social demographic characteristics, social economic status, duration of illness, dietary composition, physical fitness, BMI, fasting blood sugar (FBS), renal function, hepatic function, acute phase response, lipid profile, and glycaemic control. Therefore the variables that were measured were as follows; Age, sex, marital status, occupation, residence, dietary fat content, dietary carbohydrate source, dietary protein source, frequency of exercise, BMI, FBS, ALT, urea, creatinine, C-reactive protein, Triglycerides, total cholesterol, low density lipoprotein, high density lipoprotein, HbA1c and lipoprotein(a) respectively. The data were expressed as median (interquartile range). The Mann-Whitney U test was used to compare the median values between the two groups of the study participants (Diabetics and healthy individuals) for continuous variables, the Wilcoxon rank-sum test or Kruskal-Wallis test for the ordinal data whereas the Chi-squared test was used to compare the proportions for the nominal data. SPSS version 21(IBM) was used to perform a multiple linear regression analysis to identify the *9/et of variables that would best predict the plasma levels of Lp(a) Results: The median plasma levels of Lp(a) in the diabetics (20.0 (11.8-37.4)mg/dl) was significantly higher (p<0.001,) than the healthy individuals (13.6 (9.4-21.5)mg/dl). 17 % of the diabetics had plasma levels of Lp(a) higher than 30 mg/dl. Of all the independent variables assessed, the results showed that glycemic control (HbA1c), FBS (glucose) triglycerides and residence were significant (p<0.001, p=0.030, p=0.040, p= 0.004 respectively) predictors of plasma levels of Lp(a). The linear relationships showed that the plasma levels of Lp(a) had a positive relationship with HbA1c (r=5.220) and FBS (r=0.660) whereas the relationship with triglycerides (r= -4.794) and residence (r= -7.165) were inverse Conclusion: . The plasma levels of Lp(a) in the T2DM patients were significantly higher than the non-diabetic healthy individuals. Glycemic control (HbA1c) , triglycerides (TG), fasting blood glucose (FBS) and social economic status (medium density residence) were predictors of serum levels of Lp(a).

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