Background and Purpose: It has been demonstrated that obesity is a condition which is associated ... more Background and Purpose: It has been demonstrated that obesity is a condition which is associated with a number of factors andstudies show that individuals who are overweight or obese run a greater risk of developing diabetes mellitus, hypertension, coronary heart disease, stroke, arthritis, and some forms of cancer. The objective of this study was to identify the factors that are associated with obesity among adults at Ndola Central Hospital (NCH), Zambia.Methods: All clients aged18 years and above who were coming for medical clinic at NCH in a period of 2 months (01/01/2016 to 28/022016.) were captured in the study. A case control study was conducted. Structured questionnaire was used to collect data and anthropometric measurements were done. Data entry and analysis were conducted using Epi Data version 3.1 and SPSS version 16.0, respectively. The Pearson’s Chi-square and the Fisher’s exact tests were used to establish associations. The cut off point for statistical significance was set at the 5% level. Results: A total of 80 individuals participated in this study. In this population 40 were obese and 40 had normal BMI. Among the obese, 26(65.0%) were aged 40+, while those who had normal BMI 22(55.0%) were <40 years old. It was also found that of the obese patients 32(80.0%) were females and only 8(20.0%) were males, while in the normal population 23(57.5%) were male and 17(42.5%) were female [Table2]. 26(81.2%) of obese patients who had their blood pressure measured were hypertensive (blood pressure ≥140/90 mmHg while only 9(27.3%) of the normal population were hypertensive. It was noticed that the majority 27(67.5%) of obese patients either did less than moderate exercise or no exercise at all, while the majority 23(57.5%) in normal population did exercise. Results also showed that 10(25%) of obese population used vegetable oil while 30(75.0%) used non vegetable oil.Conclusions: In conclusion, it was found that Hypertension was independently associated with obesity among adults attending medical clinic at NCH, other factors which were associated with obesity were Exercise, Type of cooking oil used and sex.
Background: Neonatal mortality has been a public health concern for a long time and remains relat... more Background: Neonatal mortality has been a public health concern for a long time and remains relatively unchanged especially in developing countries. In Zambia, 34% of all under-five deaths occur in the neonatal period. Methods: The study was designed as a comparison of cases and controls – new-born children who died before the age of 28 days and those who survived (treated) beyond 28 days respectively. Data was extracted from the 2014 and 2015 summary reports from the HMIS at Arthur Davison’s Children Hospital in Ndola Zambia. A multivariate logistic regression model was built through a back-wards step process to determine the factors associated with neonatal deaths.Results: A total of 1,534 records were extracted from the 2015 HMIS and 924 from the 2014 HMIS. Out of the total, 1,272 were treated whilst 262 died in 2015 and 726 were treated and 198 died in 2014. In 2015, infections caused less neonatal deaths than prematurity (AOR=0.29, CI 95% (0.21, 0.38)). In 2014, the sex of a child was significantly associated with surviving the first week of life; females were less likely to die than males (AOR= 0.62, CI 95 %( 0.44, 0.89)). Also in 2014, infections caused less neonatal deaths than prematurity (AOR=0.25, CI 95% (0.18, 0.36)).Conclusion and recommendations: This study revealed that factors associated with neonatal mortality include cause of death and sex. The sex of a neonate was significantly associated with surviving the first week of life. Further classification of cause of death would be beneficial in policy formulation.
A Caesarean section (C-section) is a procedure in surgery done to deliver a baby when vaginal del... more A Caesarean section (C-section) is a procedure in surgery done to deliver a baby when vaginal deliveryendangers the baby's or mother's life or health. No studies on prevalence or indications of C-section have been conducted at Ndola Central Hospital (NCH) in Zambia. Hence a retrospective study was undertaken aimed at determining the prevalence and indications for C-sections at NCH between January and December, 2013. The major goal was to contribute to the reduction of maternal and neonatal mortality at NCH. Following ethical approval from Tropical Diseases Research Centre (TDRC) Ethical Committee, data collection was performed from June to July, 2016. Data was extracted from maternity in-patient and theatre register records of 358 systematically randomly selected clients. Data was entered and analyzed using SPSS. Proportions of various variables were compared using the Chi-square test and only results yielding p value of less than 0.05 were considered to be of statistical significance. Findings were that 74 clients had caesarean sections and 284 clients delivered by spontaneous vaginal delivery (SVD). The overall prevalence of Caesarian section at NCH during period under review among 358 clients admitted was 20.7%. The most common indications were foetal and maternal distress (14.9%), prolonged labour (10.8%), cephalopelvic disproportion (8.1%), pregnancy induced hypertension (6.8%), malpresentation or breech presentation (6.8%), antepartum haemorrhage (4.1%), multi-gestation (4.1%) foetal and maternal distress together with pregnancy induced hypertension (4.1%). The observed rate is higher than the recommended rate by World Health Organization. Hence need to strengthen antenatal monitoring of indications for C-section and improve access to antenatal services.
IntroductionZika virus (ZIKV) is a flavivirus that causes disease with similar but milder symptom... more IntroductionZika virus (ZIKV) is a flavivirus that causes disease with similar but milder symptoms to dengue fever. Clinical pictures range from asymptomatic cases to an influenza-like syndrome associated with fever, headache, malaise and cutaneous rash (1). Other less frequent symptoms and signs of ZIKV include myalgia, headache, retro-orbital pain, oedema and vomiting (2). Its natural transmission cycle in Africa involves primarily mosquitoes (Aedes species) and monkeys. While serological and entomological Zika virus infection have been reported in different areas in Africa including Burkina Faso, Ivory Coast, Egypt, Central African Republic, Mozambique, Nigeria, Uganda and Senegal, entomological and virological surveillance for arboviruses have been conducted since 1972 in Senegal and revealed presence of Zika virus (3). The virus was first identified in 1947 in rhesus monkey serum from Zika forest in Uganda (4). However ZIKV antibodies have been detected in humans across Africa, and Asia (5, 6). In Cameroon, the infection with Zika virus spread to neighbouring Nigeria resulting in an epidemic with symptoms including jaundice (7), an indicator for potential global spread (8).Despite the widespread distribution of Zika virus, there have been very few reported human cases until the Yap outbreak in 2007 (9). In particular, there is no documented information on Zika virus infection in Western province of Zambia. Following a risk assessment for Yellow fever in Western province of Zambia resulting from a re-classification of the province by World Health Organization as a low-risk area for Yellow fever, a study was undertaken using data collected from the Yellow fever survey to determine the prevalence and correlates for Zika virus infection in Western province of Zambia.MethodsWestern Province has a common border with Angola. The geography of the province is dominated by the Barotse Floodplain of the Zambezi river. This floodplain is inundated from December to June; this is important to agriculture as it provides natural irrigation for the grasslands. Much of the province is covered by sand believed to come from the Kalahari Desert, grasslands and woodlands.Western Province had seven districts with a total of 1,902 Standard Enumeration Areas (SEAs). Fishing and cattle rearing were the main occupation in the province. The population of the province was 881,524 according to national census of 2010 (10).Western province borders with Angola and had seven districts divided into 1,902 SEAs. The population stood at 881,524 with a population density of 7.0 (10). Crop and livestock production as well as fishing were the main economic activities.Sample sizesThe sample size calculation was based on the assumption that the seroprevalence for Yellow fever was 7% based on the study conducted by Robinson (11). A Statcal program in Epi Info v6.04 was used to estimate the sample size. The sample size was equally allocated to North-Western and Western provinces and powered to avoid chance findings, that is, 1,800 participants from each province.SamplingA multi-stage sampling technique was used for participants in both districts. Firstly, wards were randomly selected from each constituency. In the second stage of sampling, standard enumeration areas (SEAs) proportional to the ward size were systematically sampled. All survey participants aged nine months or older in a selected household were eligible to be enrolled in the study.Ethical approvalThe study protocol was reviewed and approved by the Tropical Diseases Research Centre Research Ethics Committee, and permission to conduct the study was obtained from the Ministry of Health, Zambia. Informed consent was obtained from survey participants after the interviewer had explained the benefits and risks of participating in the study. Entry forms were viewed only by those approved to be part of the survey.Data collectionA detailed semi structured questionnaire was used to collect information. …
IntroductionDengue fever caused by dengue virus of genus Flavivirus and family Flaviviridae is a ... more IntroductionDengue fever caused by dengue virus of genus Flavivirus and family Flaviviridae is a leading cause of morbidity and mortality in the tropics and subtropics posing a risk to one third of the world's population living in these areas (1, 2). The virus is transmitted to humans through the bite of a mosquito, primarily Aedes Aegypti and Aedes albopictus (2). Until the middle of the 20th century, dengue was relatively minor, geographically restricted disease (3-4). Pandemic Dengue begun in Southeast Asia in the mid 1940's after the second World War and has intensified in the last 15 years, (5) and has become endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, South-east Asia and the Western Pacific with the American, South- east Asia and the Western Pacific regions affected most seriously (6-8). Based on data submitted by WHO member states mostly affected by dengue indicates cases exceeding 1.2 million in 2008 and 2.3 million in 2010 (9). In Africa, documentation indicates dengue epidemics occurring as far back as 1927 (10) and increasing activity since 1980 (11). Angola and Kenya continued to experience dengue outbreaks in 2013 (12).The factors associated with Dengue fever may not be well understood but documentation cites an association with demographic and societal changes over the past 50 years (13, 14). Factors including sex, age, urbanization and mobility of people have been associated with increased dengue fever. The difference in incidence of dengue fever in relation to sex is attributed exposure to the vector (mosquito) (15). Most studies indicate risk of dengue fever increasing with age, urbanization and travel (9, 16-20). Older children and adults are more disposed to dengue fever (6). WHO documents that the increased mobility of people has contributed to the increase in the number of epidemics and circulating viruses (9). Persons with chronic diseases including diabetes and asthma are likely to encounter complicated disease which is life threatening (21). Once infected with dengue, IgG antibodies and detectable after 10 to 14 days of onset and one acquires life time immunity to the specific serotype. Infection with another serotype also increases chances of severity (22). This paper describes the association if any of factors including age, sex, education and travel with dengue fever in North-Western province of Zambia.MethodsNorth-Western province borders with Angola on the western side and Democratic Republic of Congo (DRC) (see Figure 1) on the northern side with 6 districts divided into 1,178 Standard Enumeration Areas (SEAs). The 2010 census reveals a population of 706,462 with population density of 5.6. The main economic activity was pineapple growing, with fast growing mining activities in one of the districts, Solwezi (23). Central Statistical Office (CSO) (24) reported in 2007 that 53.2% of the population slept under a net in the past night in North-Western province (24).Study population, Sample size, inclusion/exclusion criteria and samplingThis assessment was carried out among individuals aged nine months or older. The sample size calculation was based on the assumption that the sero-prevalence was 7% based on the study on Yellow fever conducted by Robinson, 1950 (25). For persons aged 5 years or older the following parameters were considered in estimating the sample size, a prevalence of 7%, desired precision or confidence interval (d) of +3%, and a design effect (DE) of 2 and an 80% response rate. The study aimed to recruit 700 male and 700 female participants in each province. A total of 12 households in each of the 30 clusters, assuming an average of 4 persons aged 5 years or older in each household, were to be recruited in the survey. The total number of persons that would be recruited from each province was 1,806, totaling 3,612 from both provinces.The sero-prevalence of children below five years was about half that for older children, and in estimating the sample size for persons aged below 5 years, the following parameters were considered: a prevalence of 3. …
IntroductionZambia is undergoing rapid developmental changes particularly in infrastructure. The ... more IntroductionZambia is undergoing rapid developmental changes particularly in infrastructure. The opening up of new mines in recent years in North-Western province means that mining has become a major occupation for the province. This has resulted in population movement especially from the 'traditional' Copperbelt province, creating a sudden increase in the total population of the province with resultant challenges for the health sector. Sudden population increase has resulted in over-crowding making a suitable environment for disease spread including the arboviruses.Among the emerging infectious diseases, the arboviral diseases group has particularly warranted attention in the global health landscape with its potential for epidemics and its unprecedented spread (1). Despite the significance and increasing public health impact on individuals worldwide, arboviruses remain poorly understood and controlled. While increasingly well characterised in industrialised countries, the epidemiology of the these viruses is a major challenge to developing countries and surveillance often is usually in the form of reports during outbreaks due to the poor population-based surveillance systems (2). The majority of the surveillance systems were designed to detect known pathogens (61.5%), while 19.9% were for both known and unknown pathogens and only a small proportion were designed to detect unknown pathogens (3).The diagnosis of Zika virus infection is based on detection of specific antibodies (4) or virus isolation from animals or mosquitoes which is time consuming; however, rapid diagnostic methods have been developed for the African and Asian strains (5). Several serological surveys have been carried out in Africa and notable among these is the Portuguese Guinea survey which demonstrated frequent antibodies to group B viruses particularly Yellow Fever, Zika and Wesselbrons; a finding similar to previous surveys in the same region (6). Based on serological analyses, flaviviruses were classified into eight antigenic complexes; however, many viruses including the prototype of the group Yellow Fever and many new viruses could not be affiliated to any complex partly due to extensive geographical distribution, diversity of arthropod vector or vertebrate hosts and also confusion in virus nomenclature (7).No information on Zika virus infection has been reported in Zambia. The objective of the study was, thus, to determine the prevalence and correlates for Zika virus infection in North-Western province of Zambia in order to contribute to the body of knowledge on the epidemiology of Zika virus infection in Zambia.MethodsNorth-Western Province borders with Angola in the West and Democratic Republic of Congo (DRC) in the North. North-Western Province was one of Zambia's nine provinces at the time of the survey before the creation of the tenth province. It covers an area of 125,826 km2 and had a population of 695,599 (8).A total of 1,178 Standard Enumeration Areas (SEAs) were demarcated in North-Western province in the eight districts of the province. North-Western province is located in Agro-ecological zone III which is suitable for cultivating rice, cassava, pineapples and bananas (9).Sample sizeThe data was obtained from a survey on Yellow fever. The sample size calculation was based on the assumption that the sero-prevalence for Yellow fever was 7% based on the study conducted by Robinson (10). A Statcal program in Epi Info v6.04 was used to estimate the sample size. After adjusting for 80% response rate, a sample size of 3600 was obtained. The sample size was equally divided into the two provinces and powered to avoid chance findings, that is, 1,800 participants from each province.SamplingA multi-stage sampling technique was used for participants in all districts. Firstly, wards were randomly selected from each constituency. In the second stage of sampling, standard enumeration areas (SEAs) proportional to the ward size were systematically sampled. …
International journal of child and adolescent health, 2015
Bullying victimization is a serious problem among in-school adolescents. Because of limited repor... more Bullying victimization is a serious problem among in-school adolescents. Because of limited reports on bullying among adolescents in Benin, a study was conducted to determine the prevalence and correlates for bullying victimization among school-going adolescents in Benin. Secondary analysis of data was conducted using the 2009 Benin Global School-based Health Survey (GSHS) data. Logistic regression analyses were done to estimate associations between selected explanatory variables and the outcome (bullying victimization). Out of 2,690 in-school adolescents, 49.3% were of age 16 years or older, 66.9% were males and 40.1% reported having been bullied at least once in the previous 30 days to the survey (39.2% among boys versus 42.0% among girls). Male adolescents were 11% (adjusted odds ratio (AOR) = 0.89; 95% confidence interval (CI) 0.88–0.90) less likely to be bullied compared to female adolescents. Participants who drank alcohol were 45% more likely to be bullied than those who did not drink alcohol (AOR=1.45; 95% CI 1.43-1.47). Adolescents who smoked cigarettes were 24% (AOR = 1.24; 95% CI 1.21–1.28) more likely to be bullied compared to non-smokers. Those who reported being involved in physical fighting were 77% more likely to be bullied than those who were not involved in physical fighting (AOR=1.77; 95% CI 1.75-1.79). Adolescents who had parental supervision were 10% (AOR=0.90; 95% CI 0.89, 0.91) less likely to be bullied than those who did not have parental supervision. Efforts to prevent and control bullying should take into consideration the factors identified in this study
Lymphatic filariasis (LF), also commonly known as elephantiasis, is a neglected tropical disease ... more Lymphatic filariasis (LF), also commonly known as elephantiasis, is a neglected tropical disease (NTD) caused by filarial parasites. The disease is transmitted by a bite from infected mosquitoes. The bites of these infected mosquitoes deposit filarial parasites, Wuchereria or Brugia whose predilection site is the lymphatic system. The damage to the lymph system causes swelling in the legs, arms, and genitalia. A mapping survey conducted between 2003 and 2010 determined LF that LF was endemic in Zambia in 96 out of 116 districts. Elimination of LF is known to be possible by stopping the spread of the infection through large-scale preventive chemotherapy. Therefore, mass drug administration (MDA) with diethylcarbamazine citrate (DEC) (6 mg/kg) and Albendazole (400 mg) for Zambia has been conducted and implemented in all endemic districts with five effective rounds. Post-MDA pre-transmission assessment survey (pre-TAS) was conducted between 2021 and 2022 in 80 districts to determine th...
Background: Cigarette smoking intention is a strong predictor of cigarette smoking initiation. Th... more Background: Cigarette smoking intention is a strong predictor of cigarette smoking initiation. There is limited data on predictors of cigarette smoking intentions among adolescents in developing countries. Objective: To determine factors associated with cigarettes smoking intentions among never-smoked adolescents. Methods: The study utilized the Zambia 2011 Global Youth Tobacco Survey dataset on adolescents. Results: Being in grade nine compared to grade seven (AOR 0.43, 95%CI 0.23-0.82). Having a smoking father (AOR 2.38, 95%CI 1.25-453) mother (AOR 11.77, 95%CI 4.16-33.33), or both parents (AOR 7.05, 95%CI 2.91-17.10) showed significantly higher chance of having smoking intentions than having non-smoker parents. Also, having some (AOR 1.97, 95%CI 1.12-3.47), most (AOR 5.37, 95%CI 2.82-10.25), or all (AOR 3.75, 95%CI 1.64-8.56) smoker close friend was significantly associated with smoking intention compared to having none-smoker friends. Being around others who smoked in out-door p...
IntroductionYellow fever (YF) is estimated to affect about 200,000 people annually in the tropics... more IntroductionYellow fever (YF) is estimated to affect about 200,000 people annually in the tropics of Africa and South America (1) and 30,000 deaths occur worldwide (2). The majority of persons infected with YF suffer from a self-limiting febrile illness. In persons who develop symptoms, symptoms occur 3-6 days after being infected and include fever, chills, severe headache, back pain, general body aches, nausea, vomiting, fatigue and weakness to severe liver disease with bleeding. Most persons who develop symptoms improve after the initial presentation of symptoms. About 15% of cases progress to a more severe form of the disease that is characterized by high fever, jaundice, bleeding, and eventually shock and failure of multiple organs (3). There is no specific treatment for yellow fever; care is based on symptoms. Steps to prevent yellow fever virus infection include using insect repellent, wearing protective clothing, and getting vaccinated (3).Transmission of YF in Africa has bee...
IntroductionThere is growing recognition of sexual violence (within or outside marriage) as a maj... more IntroductionThere is growing recognition of sexual violence (within or outside marriage) as a major public health problem as well as a serious human rights issue (1).Sexual violence such as forced sexual intercourse (forced sex) is associated with multiple reproductive and sexual health risks (2-5) and other adverse effects such as suicidality (6). In a Nepalese study women described backache, headache, lower abdominal pain, vaginal bleeding and thoughts of suicide as negative physical and psychological health consequences following forced sex within marriage (7).Other gynaecological and reproductive health problems associated with forced sex include transmission of HIV and other sexually transmitted infections (STIs), unwanted pregnancy, infection, decreased sexual desire, genital irritation, pain during sexual intercourse, chronic pelvic pain, and urinary tract infections (8-11).In a study conducted at alcohol serving venues in South Africa, Sikkema et al (12) reported that post- ...
Background Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improvin... more Background Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia. Methods We performed a cross-sectional study using secondary clinical data collected in 2015 using two validated World Health Organisation/Ministry of Health reporting forms. We reviewed demographics and VMMC surgical details from 391 randomly sampled adult males aged ≥18 years at Ndola Teaching Hospital, a specialised VMMC fixed site in Zambia. Non-parametric tests (Fisher’s exact test or Chi-square depending on assumptions being met) and logistic regression were conducted to determine the relationships between associated factors and VMMC AE. Results The overall VMMC AE prevalence was 3.1% (95% CI 1.60%– 5.30%) and most AEs occurred postoperat...
Background and Purpose: It has been demonstrated that obesity is a condition which is associated ... more Background and Purpose: It has been demonstrated that obesity is a condition which is associated with a number of factors andstudies show that individuals who are overweight or obese run a greater risk of developing diabetes mellitus, hypertension, coronary heart disease, stroke, arthritis, and some forms of cancer. The objective of this study was to identify the factors that are associated with obesity among adults at Ndola Central Hospital (NCH), Zambia.Methods: All clients aged18 years and above who were coming for medical clinic at NCH in a period of 2 months (01/01/2016 to 28/022016.) were captured in the study. A case control study was conducted. Structured questionnaire was used to collect data and anthropometric measurements were done. Data entry and analysis were conducted using Epi Data version 3.1 and SPSS version 16.0, respectively. The Pearson’s Chi-square and the Fisher’s exact tests were used to establish associations. The cut off point for statistical significance was set at the 5% level. Results: A total of 80 individuals participated in this study. In this population 40 were obese and 40 had normal BMI. Among the obese, 26(65.0%) were aged 40+, while those who had normal BMI 22(55.0%) were <40 years old. It was also found that of the obese patients 32(80.0%) were females and only 8(20.0%) were males, while in the normal population 23(57.5%) were male and 17(42.5%) were female [Table2]. 26(81.2%) of obese patients who had their blood pressure measured were hypertensive (blood pressure ≥140/90 mmHg while only 9(27.3%) of the normal population were hypertensive. It was noticed that the majority 27(67.5%) of obese patients either did less than moderate exercise or no exercise at all, while the majority 23(57.5%) in normal population did exercise. Results also showed that 10(25%) of obese population used vegetable oil while 30(75.0%) used non vegetable oil.Conclusions: In conclusion, it was found that Hypertension was independently associated with obesity among adults attending medical clinic at NCH, other factors which were associated with obesity were Exercise, Type of cooking oil used and sex.
Background: Neonatal mortality has been a public health concern for a long time and remains relat... more Background: Neonatal mortality has been a public health concern for a long time and remains relatively unchanged especially in developing countries. In Zambia, 34% of all under-five deaths occur in the neonatal period. Methods: The study was designed as a comparison of cases and controls – new-born children who died before the age of 28 days and those who survived (treated) beyond 28 days respectively. Data was extracted from the 2014 and 2015 summary reports from the HMIS at Arthur Davison’s Children Hospital in Ndola Zambia. A multivariate logistic regression model was built through a back-wards step process to determine the factors associated with neonatal deaths.Results: A total of 1,534 records were extracted from the 2015 HMIS and 924 from the 2014 HMIS. Out of the total, 1,272 were treated whilst 262 died in 2015 and 726 were treated and 198 died in 2014. In 2015, infections caused less neonatal deaths than prematurity (AOR=0.29, CI 95% (0.21, 0.38)). In 2014, the sex of a child was significantly associated with surviving the first week of life; females were less likely to die than males (AOR= 0.62, CI 95 %( 0.44, 0.89)). Also in 2014, infections caused less neonatal deaths than prematurity (AOR=0.25, CI 95% (0.18, 0.36)).Conclusion and recommendations: This study revealed that factors associated with neonatal mortality include cause of death and sex. The sex of a neonate was significantly associated with surviving the first week of life. Further classification of cause of death would be beneficial in policy formulation.
A Caesarean section (C-section) is a procedure in surgery done to deliver a baby when vaginal del... more A Caesarean section (C-section) is a procedure in surgery done to deliver a baby when vaginal deliveryendangers the baby's or mother's life or health. No studies on prevalence or indications of C-section have been conducted at Ndola Central Hospital (NCH) in Zambia. Hence a retrospective study was undertaken aimed at determining the prevalence and indications for C-sections at NCH between January and December, 2013. The major goal was to contribute to the reduction of maternal and neonatal mortality at NCH. Following ethical approval from Tropical Diseases Research Centre (TDRC) Ethical Committee, data collection was performed from June to July, 2016. Data was extracted from maternity in-patient and theatre register records of 358 systematically randomly selected clients. Data was entered and analyzed using SPSS. Proportions of various variables were compared using the Chi-square test and only results yielding p value of less than 0.05 were considered to be of statistical significance. Findings were that 74 clients had caesarean sections and 284 clients delivered by spontaneous vaginal delivery (SVD). The overall prevalence of Caesarian section at NCH during period under review among 358 clients admitted was 20.7%. The most common indications were foetal and maternal distress (14.9%), prolonged labour (10.8%), cephalopelvic disproportion (8.1%), pregnancy induced hypertension (6.8%), malpresentation or breech presentation (6.8%), antepartum haemorrhage (4.1%), multi-gestation (4.1%) foetal and maternal distress together with pregnancy induced hypertension (4.1%). The observed rate is higher than the recommended rate by World Health Organization. Hence need to strengthen antenatal monitoring of indications for C-section and improve access to antenatal services.
IntroductionZika virus (ZIKV) is a flavivirus that causes disease with similar but milder symptom... more IntroductionZika virus (ZIKV) is a flavivirus that causes disease with similar but milder symptoms to dengue fever. Clinical pictures range from asymptomatic cases to an influenza-like syndrome associated with fever, headache, malaise and cutaneous rash (1). Other less frequent symptoms and signs of ZIKV include myalgia, headache, retro-orbital pain, oedema and vomiting (2). Its natural transmission cycle in Africa involves primarily mosquitoes (Aedes species) and monkeys. While serological and entomological Zika virus infection have been reported in different areas in Africa including Burkina Faso, Ivory Coast, Egypt, Central African Republic, Mozambique, Nigeria, Uganda and Senegal, entomological and virological surveillance for arboviruses have been conducted since 1972 in Senegal and revealed presence of Zika virus (3). The virus was first identified in 1947 in rhesus monkey serum from Zika forest in Uganda (4). However ZIKV antibodies have been detected in humans across Africa, and Asia (5, 6). In Cameroon, the infection with Zika virus spread to neighbouring Nigeria resulting in an epidemic with symptoms including jaundice (7), an indicator for potential global spread (8).Despite the widespread distribution of Zika virus, there have been very few reported human cases until the Yap outbreak in 2007 (9). In particular, there is no documented information on Zika virus infection in Western province of Zambia. Following a risk assessment for Yellow fever in Western province of Zambia resulting from a re-classification of the province by World Health Organization as a low-risk area for Yellow fever, a study was undertaken using data collected from the Yellow fever survey to determine the prevalence and correlates for Zika virus infection in Western province of Zambia.MethodsWestern Province has a common border with Angola. The geography of the province is dominated by the Barotse Floodplain of the Zambezi river. This floodplain is inundated from December to June; this is important to agriculture as it provides natural irrigation for the grasslands. Much of the province is covered by sand believed to come from the Kalahari Desert, grasslands and woodlands.Western Province had seven districts with a total of 1,902 Standard Enumeration Areas (SEAs). Fishing and cattle rearing were the main occupation in the province. The population of the province was 881,524 according to national census of 2010 (10).Western province borders with Angola and had seven districts divided into 1,902 SEAs. The population stood at 881,524 with a population density of 7.0 (10). Crop and livestock production as well as fishing were the main economic activities.Sample sizesThe sample size calculation was based on the assumption that the seroprevalence for Yellow fever was 7% based on the study conducted by Robinson (11). A Statcal program in Epi Info v6.04 was used to estimate the sample size. The sample size was equally allocated to North-Western and Western provinces and powered to avoid chance findings, that is, 1,800 participants from each province.SamplingA multi-stage sampling technique was used for participants in both districts. Firstly, wards were randomly selected from each constituency. In the second stage of sampling, standard enumeration areas (SEAs) proportional to the ward size were systematically sampled. All survey participants aged nine months or older in a selected household were eligible to be enrolled in the study.Ethical approvalThe study protocol was reviewed and approved by the Tropical Diseases Research Centre Research Ethics Committee, and permission to conduct the study was obtained from the Ministry of Health, Zambia. Informed consent was obtained from survey participants after the interviewer had explained the benefits and risks of participating in the study. Entry forms were viewed only by those approved to be part of the survey.Data collectionA detailed semi structured questionnaire was used to collect information. …
IntroductionDengue fever caused by dengue virus of genus Flavivirus and family Flaviviridae is a ... more IntroductionDengue fever caused by dengue virus of genus Flavivirus and family Flaviviridae is a leading cause of morbidity and mortality in the tropics and subtropics posing a risk to one third of the world's population living in these areas (1, 2). The virus is transmitted to humans through the bite of a mosquito, primarily Aedes Aegypti and Aedes albopictus (2). Until the middle of the 20th century, dengue was relatively minor, geographically restricted disease (3-4). Pandemic Dengue begun in Southeast Asia in the mid 1940's after the second World War and has intensified in the last 15 years, (5) and has become endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, South-east Asia and the Western Pacific with the American, South- east Asia and the Western Pacific regions affected most seriously (6-8). Based on data submitted by WHO member states mostly affected by dengue indicates cases exceeding 1.2 million in 2008 and 2.3 million in 2010 (9). In Africa, documentation indicates dengue epidemics occurring as far back as 1927 (10) and increasing activity since 1980 (11). Angola and Kenya continued to experience dengue outbreaks in 2013 (12).The factors associated with Dengue fever may not be well understood but documentation cites an association with demographic and societal changes over the past 50 years (13, 14). Factors including sex, age, urbanization and mobility of people have been associated with increased dengue fever. The difference in incidence of dengue fever in relation to sex is attributed exposure to the vector (mosquito) (15). Most studies indicate risk of dengue fever increasing with age, urbanization and travel (9, 16-20). Older children and adults are more disposed to dengue fever (6). WHO documents that the increased mobility of people has contributed to the increase in the number of epidemics and circulating viruses (9). Persons with chronic diseases including diabetes and asthma are likely to encounter complicated disease which is life threatening (21). Once infected with dengue, IgG antibodies and detectable after 10 to 14 days of onset and one acquires life time immunity to the specific serotype. Infection with another serotype also increases chances of severity (22). This paper describes the association if any of factors including age, sex, education and travel with dengue fever in North-Western province of Zambia.MethodsNorth-Western province borders with Angola on the western side and Democratic Republic of Congo (DRC) (see Figure 1) on the northern side with 6 districts divided into 1,178 Standard Enumeration Areas (SEAs). The 2010 census reveals a population of 706,462 with population density of 5.6. The main economic activity was pineapple growing, with fast growing mining activities in one of the districts, Solwezi (23). Central Statistical Office (CSO) (24) reported in 2007 that 53.2% of the population slept under a net in the past night in North-Western province (24).Study population, Sample size, inclusion/exclusion criteria and samplingThis assessment was carried out among individuals aged nine months or older. The sample size calculation was based on the assumption that the sero-prevalence was 7% based on the study on Yellow fever conducted by Robinson, 1950 (25). For persons aged 5 years or older the following parameters were considered in estimating the sample size, a prevalence of 7%, desired precision or confidence interval (d) of +3%, and a design effect (DE) of 2 and an 80% response rate. The study aimed to recruit 700 male and 700 female participants in each province. A total of 12 households in each of the 30 clusters, assuming an average of 4 persons aged 5 years or older in each household, were to be recruited in the survey. The total number of persons that would be recruited from each province was 1,806, totaling 3,612 from both provinces.The sero-prevalence of children below five years was about half that for older children, and in estimating the sample size for persons aged below 5 years, the following parameters were considered: a prevalence of 3. …
IntroductionZambia is undergoing rapid developmental changes particularly in infrastructure. The ... more IntroductionZambia is undergoing rapid developmental changes particularly in infrastructure. The opening up of new mines in recent years in North-Western province means that mining has become a major occupation for the province. This has resulted in population movement especially from the 'traditional' Copperbelt province, creating a sudden increase in the total population of the province with resultant challenges for the health sector. Sudden population increase has resulted in over-crowding making a suitable environment for disease spread including the arboviruses.Among the emerging infectious diseases, the arboviral diseases group has particularly warranted attention in the global health landscape with its potential for epidemics and its unprecedented spread (1). Despite the significance and increasing public health impact on individuals worldwide, arboviruses remain poorly understood and controlled. While increasingly well characterised in industrialised countries, the epidemiology of the these viruses is a major challenge to developing countries and surveillance often is usually in the form of reports during outbreaks due to the poor population-based surveillance systems (2). The majority of the surveillance systems were designed to detect known pathogens (61.5%), while 19.9% were for both known and unknown pathogens and only a small proportion were designed to detect unknown pathogens (3).The diagnosis of Zika virus infection is based on detection of specific antibodies (4) or virus isolation from animals or mosquitoes which is time consuming; however, rapid diagnostic methods have been developed for the African and Asian strains (5). Several serological surveys have been carried out in Africa and notable among these is the Portuguese Guinea survey which demonstrated frequent antibodies to group B viruses particularly Yellow Fever, Zika and Wesselbrons; a finding similar to previous surveys in the same region (6). Based on serological analyses, flaviviruses were classified into eight antigenic complexes; however, many viruses including the prototype of the group Yellow Fever and many new viruses could not be affiliated to any complex partly due to extensive geographical distribution, diversity of arthropod vector or vertebrate hosts and also confusion in virus nomenclature (7).No information on Zika virus infection has been reported in Zambia. The objective of the study was, thus, to determine the prevalence and correlates for Zika virus infection in North-Western province of Zambia in order to contribute to the body of knowledge on the epidemiology of Zika virus infection in Zambia.MethodsNorth-Western Province borders with Angola in the West and Democratic Republic of Congo (DRC) in the North. North-Western Province was one of Zambia's nine provinces at the time of the survey before the creation of the tenth province. It covers an area of 125,826 km2 and had a population of 695,599 (8).A total of 1,178 Standard Enumeration Areas (SEAs) were demarcated in North-Western province in the eight districts of the province. North-Western province is located in Agro-ecological zone III which is suitable for cultivating rice, cassava, pineapples and bananas (9).Sample sizeThe data was obtained from a survey on Yellow fever. The sample size calculation was based on the assumption that the sero-prevalence for Yellow fever was 7% based on the study conducted by Robinson (10). A Statcal program in Epi Info v6.04 was used to estimate the sample size. After adjusting for 80% response rate, a sample size of 3600 was obtained. The sample size was equally divided into the two provinces and powered to avoid chance findings, that is, 1,800 participants from each province.SamplingA multi-stage sampling technique was used for participants in all districts. Firstly, wards were randomly selected from each constituency. In the second stage of sampling, standard enumeration areas (SEAs) proportional to the ward size were systematically sampled. …
International journal of child and adolescent health, 2015
Bullying victimization is a serious problem among in-school adolescents. Because of limited repor... more Bullying victimization is a serious problem among in-school adolescents. Because of limited reports on bullying among adolescents in Benin, a study was conducted to determine the prevalence and correlates for bullying victimization among school-going adolescents in Benin. Secondary analysis of data was conducted using the 2009 Benin Global School-based Health Survey (GSHS) data. Logistic regression analyses were done to estimate associations between selected explanatory variables and the outcome (bullying victimization). Out of 2,690 in-school adolescents, 49.3% were of age 16 years or older, 66.9% were males and 40.1% reported having been bullied at least once in the previous 30 days to the survey (39.2% among boys versus 42.0% among girls). Male adolescents were 11% (adjusted odds ratio (AOR) = 0.89; 95% confidence interval (CI) 0.88–0.90) less likely to be bullied compared to female adolescents. Participants who drank alcohol were 45% more likely to be bullied than those who did not drink alcohol (AOR=1.45; 95% CI 1.43-1.47). Adolescents who smoked cigarettes were 24% (AOR = 1.24; 95% CI 1.21–1.28) more likely to be bullied compared to non-smokers. Those who reported being involved in physical fighting were 77% more likely to be bullied than those who were not involved in physical fighting (AOR=1.77; 95% CI 1.75-1.79). Adolescents who had parental supervision were 10% (AOR=0.90; 95% CI 0.89, 0.91) less likely to be bullied than those who did not have parental supervision. Efforts to prevent and control bullying should take into consideration the factors identified in this study
Lymphatic filariasis (LF), also commonly known as elephantiasis, is a neglected tropical disease ... more Lymphatic filariasis (LF), also commonly known as elephantiasis, is a neglected tropical disease (NTD) caused by filarial parasites. The disease is transmitted by a bite from infected mosquitoes. The bites of these infected mosquitoes deposit filarial parasites, Wuchereria or Brugia whose predilection site is the lymphatic system. The damage to the lymph system causes swelling in the legs, arms, and genitalia. A mapping survey conducted between 2003 and 2010 determined LF that LF was endemic in Zambia in 96 out of 116 districts. Elimination of LF is known to be possible by stopping the spread of the infection through large-scale preventive chemotherapy. Therefore, mass drug administration (MDA) with diethylcarbamazine citrate (DEC) (6 mg/kg) and Albendazole (400 mg) for Zambia has been conducted and implemented in all endemic districts with five effective rounds. Post-MDA pre-transmission assessment survey (pre-TAS) was conducted between 2021 and 2022 in 80 districts to determine th...
Background: Cigarette smoking intention is a strong predictor of cigarette smoking initiation. Th... more Background: Cigarette smoking intention is a strong predictor of cigarette smoking initiation. There is limited data on predictors of cigarette smoking intentions among adolescents in developing countries. Objective: To determine factors associated with cigarettes smoking intentions among never-smoked adolescents. Methods: The study utilized the Zambia 2011 Global Youth Tobacco Survey dataset on adolescents. Results: Being in grade nine compared to grade seven (AOR 0.43, 95%CI 0.23-0.82). Having a smoking father (AOR 2.38, 95%CI 1.25-453) mother (AOR 11.77, 95%CI 4.16-33.33), or both parents (AOR 7.05, 95%CI 2.91-17.10) showed significantly higher chance of having smoking intentions than having non-smoker parents. Also, having some (AOR 1.97, 95%CI 1.12-3.47), most (AOR 5.37, 95%CI 2.82-10.25), or all (AOR 3.75, 95%CI 1.64-8.56) smoker close friend was significantly associated with smoking intention compared to having none-smoker friends. Being around others who smoked in out-door p...
IntroductionYellow fever (YF) is estimated to affect about 200,000 people annually in the tropics... more IntroductionYellow fever (YF) is estimated to affect about 200,000 people annually in the tropics of Africa and South America (1) and 30,000 deaths occur worldwide (2). The majority of persons infected with YF suffer from a self-limiting febrile illness. In persons who develop symptoms, symptoms occur 3-6 days after being infected and include fever, chills, severe headache, back pain, general body aches, nausea, vomiting, fatigue and weakness to severe liver disease with bleeding. Most persons who develop symptoms improve after the initial presentation of symptoms. About 15% of cases progress to a more severe form of the disease that is characterized by high fever, jaundice, bleeding, and eventually shock and failure of multiple organs (3). There is no specific treatment for yellow fever; care is based on symptoms. Steps to prevent yellow fever virus infection include using insect repellent, wearing protective clothing, and getting vaccinated (3).Transmission of YF in Africa has bee...
IntroductionThere is growing recognition of sexual violence (within or outside marriage) as a maj... more IntroductionThere is growing recognition of sexual violence (within or outside marriage) as a major public health problem as well as a serious human rights issue (1).Sexual violence such as forced sexual intercourse (forced sex) is associated with multiple reproductive and sexual health risks (2-5) and other adverse effects such as suicidality (6). In a Nepalese study women described backache, headache, lower abdominal pain, vaginal bleeding and thoughts of suicide as negative physical and psychological health consequences following forced sex within marriage (7).Other gynaecological and reproductive health problems associated with forced sex include transmission of HIV and other sexually transmitted infections (STIs), unwanted pregnancy, infection, decreased sexual desire, genital irritation, pain during sexual intercourse, chronic pelvic pain, and urinary tract infections (8-11).In a study conducted at alcohol serving venues in South Africa, Sikkema et al (12) reported that post- ...
Background Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improvin... more Background Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia. Methods We performed a cross-sectional study using secondary clinical data collected in 2015 using two validated World Health Organisation/Ministry of Health reporting forms. We reviewed demographics and VMMC surgical details from 391 randomly sampled adult males aged ≥18 years at Ndola Teaching Hospital, a specialised VMMC fixed site in Zambia. Non-parametric tests (Fisher’s exact test or Chi-square depending on assumptions being met) and logistic regression were conducted to determine the relationships between associated factors and VMMC AE. Results The overall VMMC AE prevalence was 3.1% (95% CI 1.60%– 5.30%) and most AEs occurred postoperat...
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Papers by Seter Siziya