Zambia National Public Health Institute

Phytoestrogens and early onset androginic alopecia: a study in ndola, zambia.

2018-01-01T00:00:00Z

Phytoestrogens and early onset androginic alopecia: a study in ndola, zambia. Mukumbwa, K. Androgenic alopecia is the most common type of hair loss experienced in males, presenting in genetically susceptible males with high free testosterone levels. Early onset androgenic alopecia refers to androgenic alopecia with an onset before thirty years. Phytoestrogens are plant derived substances that exhibit estrogen like properties in the body. The aim of the study was to determine the association between phytoestrogen containing foods and early onset androgenic alopecia. A retrograde case control study was conducted in Ndola, Zambia. The study was conducted from the 10th of September 2016 to the 22nd of January 2017.Control group comprised individuals with a positive familial susceptibility to androgenic alopecia, with no androgenic alopecia. Case group comprised individuals who had visible androgenic alopecia. A total of 194 individual participated in this study of which 97 were Cases and 97 Controls. The high intake of Soy foods was found to be significantly associated with decreased early onset androgenic alopecia (OR=3.5, 95% CI [1.862-6.546], other food however showed no significance.The study shows that individuals who develop early onset androgenic alopecia have a lower consumption of soya foods. The low consumption of soy foods is significantly associated with the presence of early onset androgenic alopecia. Other commonly consumed phytoestrogen containing foods in the study were not significantly associated with early onset androgenic alopecia. Switching to a high Soya diet may prevent early onset androgenic alopecia in genetically susceptible individuals. Further research is required into other environmental factors associated with early onset androgenic alopecia. The study determines the association between phytoestrogen containing foods and early onset androgenic alopecia in Ndola, Zambia.

Inva gene and antibiotic susceptibility of Salmonella Spp isolated from commercially processed broiler carcasses In Lusaka District, Zambia.

2018-01-01T00:00:00Z

Inva gene and antibiotic susceptibility of Salmonella Spp isolated from commercially processed broiler carcasses In Lusaka District, Zambia. 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. Poultry meat is considered to be one of the major vehicles of Salmonella infections in humans en implicated in outbreaks of Salmonellosis in humans.

Factors associated with the 2012 typhoid fever outbreak in Mufulira district, Zambia : A case control study

2018-01-01T00:00:00Z

Factors associated with the 2012 typhoid fever outbreak in Mufulira district, Zambia : A case control study 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 Typhoid fever is still a public health concern especially in Africa and Asia infecting millions of people while killing thousands.

Microbial translocation and its clinical significance

2018-01-01T00:00:00Z

Microbial translocation and its clinical significance Kaonga, P; Kaimoyo, E; Kelly, P. The literature was searched in PubMed Medline National Library of Medicine from 1990 to 2016 were used. The following words were used: ‘microbial translocation’ and ‘clinical significance,’ or ‘biomarkers,’ or ‘toll-like receptor,’ or ‘pathogen-associated molecular pattern.’ We found 3,300 published manuscripts using the above search. Of 3,300 manuscripts, we dropped 2087 and 723 manuscripts either they did not suit this review or were not in English; 490 manuscripts were selected for this review. From the literature, there is evidence that microbial translocation occurs in both animals and humans, but unlike in animals, its clinical significance remains questionable in humans. This could partly be explained by the current lack of a single acceptable sensitive and accurate biomarker to detect microbial translocation. Additionally, the extent to which microbial translocation in animals can be demonstrated cannot apply to humans for the sake of research without an underlying disease. In humans microbial translocation is associated with many conditions and microbial products may lead to systemic inflammation and immune activation. Although some of the microbial products or Pathogen-Associated Molecular Patterns (PAMPs) have been studied, their clinical importance is not well established, and the assays developed to measure PAMPs in blood have not been developed or validated for clinical use. However, a few molecules of microbial origin have been used as biomarkers of microbial translocation in many disease conditions. The innate immune system detects all PAMPs through cells such as macrophages, dendritic cells, and monocytes. Detection of PAMPs through pathogen recognition receptors such as Toll like receptors which result in the activation of the transcription factors, NK-κB, resulting in the production of pro-inflammatory cytokines. We provide a synthesis of the current understanding of the nature of microbial translocation, PAMP-receptor interaction and the health significance of microbial translocation in humans. This research article investigates the clinical significance of MT in humans in relation to its significance in contribution to several disease states.

Characteristics of patients with psychosis at Ndola Teaching Hospital Psychiatric Unit, Zambia

2017-01-01T00:00:00Z

Characteristics of patients with psychosis at Ndola Teaching Hospital Psychiatric Unit, Zambia 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. Description of patients with psychosis at Ndola Central Hospital Psychiatric Unit, Zambia.

Medical prescription pitfalls of acute upper respiratory infections in government health care facilities in Zambia

2017-01-01T00:00:00Z

Medical prescription pitfalls of acute upper respiratory infections in government health care facilities in Zambia Besa, C.; Siziya, S. Prescribing of medicines is one of the most important clinical task that is complex and consists of a mixture of sub-competences such as principles of clinical pharmacology, knowledge, skill, critical judgement among many others. Prescription errors, potentially serious and non-serious, have been reported in the United Kingdom hospitals among both junior and senior doctors. The aim of this study was to evaluate pitfalls in medical prescriptions of acute upper respiratory tract infection in Zambia. Medical/dental students attended government healthcare facilities and requested for medical prescriptions to enable them purchase medications for their acute upper respiratory tract infection or sore throat. A total of 80 (77.7%) students out of 103 participated in the survey. This study has demonstrated gross drug misuse as all the healthy medical and dental students who presented at government healthcare facilities with complaints of acute upper respiratory tract infection were given medical prescriptions. Only a small proportion of patient’s prescription had addresses indicated (16.7%) and not all (87.1%) had patients’ names written on the prescriptions. Only a small proportion of prescriptions (28.5%) had generic names indicated on the prescriptions. More than half of prescriptions in this study did not have prescribers’ names (54.7%), identification numbers (73.2%) and addresses or departments (71.7%). This study demonstrated over prescription and drug misuse. A large proportion of prescriptions had no identification of both patients and prescribers. Furthermore, only a small proportion of prescriptions were written using generic names making generic substitutions at pharmacy outlets a challenge. evaluating pitfalls in medical prescriptions of acute upper respiratory tract infection in Zambia.

Keep our future generation alive: Reinforcing routine HIV testing and treatment among children in Zambia

2017-01-01T00:00:00Z

Keep our future generation alive: Reinforcing routine HIV testing and treatment among children in Zambia 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. Only 3% of children visiting clinics are tested for HIV, despite Ministry of Health recommendations to test and treat ALL children.

The solidarity model: Zambia public health insurance scheme

2018-01-01T00:00:00Z

The solidarity model: Zambia public health insurance scheme Deka, B. The structure and financing system of health insurance is a key component of a nation’s health system. The Solidarity Model of public health financing is a concept widely utilized by many countries to reduce costs and increase efficiency and effectiveness in a nations health sector. Although various countries have different country-fitted health insurance scheme structures, the concept of a Solidarity Based Model of Health Insurance financing can be identified in many of them. By definition, the modern meaning of solidarity in health insurance refers to the equal treatment for all social groups (elderly, low- income, immigrants, disabled etc.) anchored on a contributory based system mandating that all working citizens must join the same contributory health financing fund [1]. Members of these schemes are usually nationals and residents who pay on average between 6-10% of their income to the scheme/fund which is widely accessible to the general population at various levels (different packages). The concept is meant to provide for sustainable health financing through the equitable and fair collection of contributions. The model is intended to expand coverage for vulnerable groups such as the chronically ill and elderly, and although there may be numerous arguments as to whether or not this must be supported is based on the moral fibre of the policy makers and general citizenry. The structure and financing system of health insurance is a key component of a nation’s health system.

Negligible therapeutic effects of enalapril in a 65-year-old black man of essential hypertension

2017-01-01T00:00:00Z

Negligible therapeutic effects of enalapril in a 65-year-old black man of essential hypertension Besa, C. This is a case report of negligible therapeutic effects of enalapril in a patient of essential hypertension for a period of 3 months. Negligible therapeutic effects of enalapril response in this patient was unexpected as patient claimed complete adherence to the treatment regimen and could possibly be attributed to counterfeit medication which is a recognised problem in some developing nations. Eventually, the patient developed dangerously high blood pressure with the systolic pressure above 200 mmHg. The patient was rescued with sublingual nifedipine and later maintained on monotherapy with another calcium channel blocker. This report has demonstrated that when physicians acquire adequate knowledge and skills in clinical pharmacology and therapeutics, they would be able to adjust drug treatment appropriately. In addition, this report has also highlighted the need to investigate factors that may influence poor response to medications. This document is a case report of negligible therapeutic effects of enalapril in a patient of essential hypertension for a period of 3 months.

Universal health coverage: A perspective of the WHO country office in zambia.

2018-01-01T00:00:00Z

Universal health coverage: A perspective of the WHO country office in zambia. Bakyaita, N.; Mweemba, N. This paper provides a perspective of the WHO Country Office on Universal Health Coverage following the commemoration of the World Health Day 2018 on 7 April under the theme “Universal Health Coverage: Everyone, Everywhere” and the slogan “Health For all”. The World Health Day theme put a spotlight on the significance of Universal Health Coverage in health system strengthening and its importance in achieving health for and its importance to the 2030 sustainable development agenda. It argues that UHCis technically feasible and attainable. It highlights the how Zambia has integrated UHC in its health development agenda, success so far, challenges and how it can accelerate actions to move towards UHC using the existing international and regional frameworks. The role of WHO in supporting the country in moving towards UHC including monitoring progress is illustrated. WHO Country Office on Universal Health Coverage in Zambia