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Introduction: In 2007, the Cancer Disease Hospital (CDH) was opened as the national referral center for patients diagnosed with cancer in Zambia. Since inception of the CDH, there has been no systematic analysis of the disease burden and implication on healthcare delivery with regards to pancreatic cancer. There are limited studies describing patterns of pancreatic cancer in a native African population. Data suggest African-Americans have a higher incidence and poorer prognosis of pancreatic cancer than non-African Americans.Objective: Our aim is to describe the demographic features (age, gender) of pancreatic cancer using the Cancer Disease Hospital (CDH) data base in a native African population and compare with the African-American cohort using the Surveillance, Epidemiology End Results (SEER) Program database.Methods: This was a retrospective study of patients diagnosed with pancreatic cancer at the CDH in Zambia, Southern Africa between 2007 and 2014. We entered the term “pancreatic cancer” into the CDH database, extracted patient medical records numbers, and manually located the records for review. From each chart we extracted: age, gender, geographic origin, ethnicity, clinical features at presentations, location of tumor, stage at diagnosis and treatment. Data collection tool and master code sheet created a priori were used. Data was analyzed using statistical analysis software (SAS). Descriptive statistics including means, medians as well as frequency distributions and crosstabulations were used. SEER database was used to compare subjects between Zambia and USA. Groups were compared using Chi-square tests and Wilcoxon Signed Rank test. Ap-value less than 0.05 was used as the level of significance.Results: Thirty-eight charts were identified in the CDH dataset, of which 27 were included in final analysis and 11 excluded (5 non-pancreatic cancer diagnosis, 6 not manually located). The mean age of diagnosis was 55.7 years in the native African population, compared to 66.7 years for the African-Americans in the SEER database, p < 0.0001. There were 63.0% males (CDH) compared to 48.1% (SEER), p=0.121. Further review of the CDH database revealed that the most common presenting symptom was abdominal pain (52.6%), mode of diagnosis surgical (83%, missing 3), histopathology adenocarcinoma (86%, missing 6), location head of pancreas (83%, missing 9) and stage 4 at diagnosis (100%, missing 3).Conclusion: Pancreatic cancer occurs at a younger age in Zambians when compared to the African American, USApopulation. There is no statistically significant difference in sex presentation between Zambian and USAblack population.

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Immunisation is a proven cost effective strategy in promoting child health and one of the greatest medical achievements of our time. Along with advocacy, social mobilisation, and other important aspects of immunisation programmes, communication should be an inherent part of the programmes. Effective communication activities complement immunisation technical components. This paper provides an overview of the existing communication component in the Expanded Program on Immunisation (EPI) training in Zambia and critically analyses the need for a humane touch in the communication process so as to reach the target audience effectively. Interpersonal Communication (IPC) in Zambia has been shown to be effective. We recommend continuous multi modal communication with deliberate emphasis on IPC including attention to care givers or parental concerns.Key words: Immunisation, Interpersonal Communication, Five key questions on vaccines

Objectives: The objective of the study was to evaluate the effectiveness of the training initiative to identify the challenges of immunisation at the district level in Zambia. The secondary objective was to assess the immediate impact of the training on the perceived competence of trainees who attended the Mid Level Management (MLM) course on immunisation.Methods: A needs assessment of the EPI programme in Zambia was conducted. Participants were assessed on their ability, competence, knowledge and skills in areas such as understanding the Reach Every District (RED) strategy, vaccine management, cold chain management, and immunisation monitoring. Based on these assessments, 12 areas were identified as of particular relevance, and the World Health Organisation MLM course manual was adapted to reflect them. Two groups of 25 participants were assessed at two different time points with an interval of six months.Results: There was a significant increase (p