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Objective To determine the prevalence and predictors of the uptake of four or more doses of sulfadoxine pyrimethamine (IPTp-SP 4+) in Zambia.Design A cross-sectional study using secondary data from the malaria in pregnancy survey (Malaria Indicator Survey) data set conducted from April to May 2018.Setting The primary survey was conducted at community level and covered all the 10 provinces of Zambia.Participants A total of 3686 women of reproductive age (15–45 years) who gave birth within the 5 years before the survey.Primary outcome Proportion of participants with four or more doses of IPTp-SP.Statistical analysis All analyses were conducted using RStudio statistical software V.4.2.1. Descriptive statistics were computed to summarise participant characteristics and IPTp-SP uptake. Univariate logistic regression was carried out to determine association between the explanatory and outcome variables. Explanatory variables with a p value less than 0.20 on univariate analysis were included in the multivariable logistic regression model and crude and adjusted ORs (aORs) along with their 95% CIs were computed (p

Abstract Background The food industry is increasingly becoming more scrutinized, given the frequency and intensity with which zoonotic diseases are being reported. Pathogen tracking has become more applicable with regards food safety. It is in this regard that the present study was formulated to track Listeria species. in freshly slaughtered cattle carcasses by utilizing standard and molecular biological techniques. Methods A cross-sectional study design was conducted from March to December 2020 with 200 samples being equally collected in the rainy and dry seasons. A total of 180 and 20 swabs were aseptically collected from carcasses and the environment respectively. Samples were first subjected to pre-enrichment in half-strength Fraser broth followed by enrichment in full strength Fraser broth and subsequent plating on Listeria agar. Listeria growth characteristics were identified up to species level based on their morphological and biochemical characteristics. Further, molecular detection and phylogenetic analysis was conducted. Quantitative proportionate survey data were analyzed using Stata Version 15 software to estimate crude prevalence taking into account complex design at abattoir level. Factors associated with contamination were characterized using logistic regression. Sequences were analyzed using, Genetyyx version 12 and phylogenetic Mega. Results Of the 200 samples, 19 were positive for Listeria species identified as L.innocua 14/19 (73.7%) and L. monocytogenes 5/19 (26.3%). All isolates were from freshly slaughtered carcasses, and none from environment. Siginificant differences in contamination levels were observed based on season: rainy season yielded 14 (73.6%) whilst the dry season 5 (26.3%). The L. monocytogenes strains showed a high degree of homogeneity on phylogenetic analysis and clustered based on abattoir. Seasonality was identified as a major determinant influencing contamination based on the final logistic regression model. Conclusion This study found evidence of L. monocytogenes contamination on traditionally raised beef carcasses across various abattoirs surveyed. The failure to find Listeria contamination on the abattoir environment may to a greater extent intimate cattle carccases as primary sources of contamination. However, a more comprerehnsive study incorporating different geographical regions is needed to conclusively ascertain these present findings.

Objective Since introduction of the programme in April 2021, COVID-19 vaccine uptake has been low at less than 20%. This study explored community members’ and health workers’ perspectives on the COVID-19 vaccine uptake and its influencing factors in Zambia.Study design A qualitative study employing focus group discussions (FGDs) and in-depth interviews (IDIs).Study setting Sixteen primary healthcare facilities selected from Lusaka, Copperbelt, Central and Southern provinces.Participants A total of 32 FGDs comprising local community members and 30 IDIs including health workers, traditional, religious and civic leaders (n=272). FGDs were separated based on age (youth and adults), sex (male and female) and place of residence (urban and rural).Results Both FGD and IDI participants agreed that vaccine uptake was low. Limited knowledge, access to information, myths and misconceptions, negative attitude, low-risk perception and supply in remote areas affected vaccine uptake. Overall, FGD participants expressed limited knowledge about the COVID-19 vaccine compared with health workers. Further, FGD participants from urban sites were more aware about the vaccine than those from rural areas. Health workers perceived the vaccine to be beneficial; the benefits included prevention of infection and limiting the severity of the disease. Moreover, FGD participants from urban sites expressed a negative attitude towards the vaccine. They believed the vaccine conferred no benefits. By contrast, participants from rural communities had mixed views; they needed more information about the vaccine benefits. Participants’ attitude seems to have been influenced by personal or family experience with the COVID-19 disease or vaccination; those who had experienced the disease had a more positive attitude. In contrast, most young people believed they were not at risk of the COVID-19 disease. Misinformation from social media influenced their attitude.Conclusion These results provide starting points for future policies and interventions for increasing COVID-19 vaccine uptake.

Background and Aim: Listeria monocytogenes in ready-to-eat (RTE) foods remains consistently under-reported globally. Nevertheless, several independent studies conducted to investigate have elucidated the prevalence and antibiotic resistance profiles of L. monocytogenes in RTE-associated foods and their antibiotic resistance profiles. Given the rapid increase in consumption of RTE foods of both animal and plant origin, it is imperative to know the prevalence deductive data focusing on how much of L. monocytogenes is present in RTE foods, which is critical for food safety managers and retailers to assess the possible risk posed to end-users. In addition, valuable insight and another angle to the depth of the problem, we conducted a systematic review and meta-analysis to synthesize available data regarding the prevalence of L. monocytogenes in RTE foods and antibiotic resistance profiles. Materials and Methods: We conducted a meta-analysis study of L. monocytogenes and antibiotic resistance to clinically relevant antibiotics to determine the extent of L. monocytogenes contamination in RTE foods and antibiotic resistance profiles. The primary search terms, also known as keywords used, were restricted to peer-reviewed and review articles, and databases, including Google Scholars, Science-Direct, and Scopus, were searched. The inclusion of articles meeting eligibility criteria published between 2010 and 2020 after title, abstract, and full article screening. Data analysis was performed at multiple stages using quantitative meta-analysis reviews. Results: L. monocytogenes pooled proportion/prevalence was highest in chicken products determined at (22%) followed by various but uncategorized RTE foods at 21%. Regarding antibiotic resistance, profiling's highest pooled prevalence resistance was observed in penicillin at 80% resistance, followed by cephalosporin at 47%. Conclusion: Within its limitations, this study has attempted to provide insight into the pooled proportion/prevalence of L. monocytogenes in RTE foods and the antibiotic resistance profile at the global level. Determining the proportion/ prevalence of L. monocytogenes in RTE foods across the globe and antibiotic resistance profile is essential for providing quality food and reducing public health problems due to unsuccessful treatment of foodborne illness. This study provides insight into the pooled prevalence of L. monocytogenes in RTE foods and the antibiotic resistance profile. The results of this study partly endeavored to help appropriate authorities strengthen their preventive measures on specific RTE foods that are most likely to be contaminated with L. monocytogenes and antibiotic resistance profiles.

Introduction Little is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health effects as well as the associated risk factors is scant. This study aims to determine the short, intermediate and long-term health effects of COVID-19 on the survivors and the associated risk factors.Methods and analysis We propose conducting a 24-month prospective quantitative study in 10 health facilities (2 specialist, 3 regional, 2 mission and 3 subdistrict hospitals) from Lusaka and Southern Province of Zambia. Health facilities will be those which served as COVID-19 treatment centres during the third wave (June–August 2021). Study participants will comprise a randomly selected cohort of 450 COVID-19 survivors who had mild or no symptoms (80%) and severe cases (20%). Using a questionnaire, respondent demographic, clinical and laboratory data will be collected at baseline and at a 3-month interval for 18 months using a questionnaire. Respondents’ medical records will be reviewed and data collected using a checklist. Descriptive statistics will be computed to summarise respondents’ characteristics and clinical outcomes. Bivariate analysis (Χ2 and t-test) will be conducted to test the association between respondent characteristics and clinical outcomes. Multivariate logistic regression analysis will be run to determine the risk factors for short, intermediate and long-term health effects; adjusted ORs will be computed to test the strength of the association (p

Objective To explore the health professionals’ and community members’ perspectives on the factors influencing transmission of the novel COVID-19 in Zambia.Design An exploratory qualitative study using in-depth interviews as data collection technique.Setting Four primary healthcare facilities and local communities of Lusaka city and Chirundu international border town under Lusaka province, Zambia.Participants Purposive sampling of 60 study participants comprising health professionals (n=15) and community members (n=45). Health staff were health inspectors and surveillance officers. Community members included public market traders, civic and religious leaders, immigration officers, bus and international truck drivers.Results Both health professionals and community members were aware of the COVID-19 pandemic, the preventive and control measures. Nevertheless, stark differences were observed on the two groups’ perspectives on COVID-19 and the factors influencing its transmission. Most health staff expressed high personal risk and susceptibility to the disease and a positive attitude towards the prevention and control measures. Conversely, myths and misconceptions influenced most community members’ perspectives on the disease and their attitude towards the COVID-19 guidelines. Participants were unanimous on the low levels of adherence to the COVID-19 preventive and control measures in the community. Reasons for non-adherence included limited information on COVID-19, negative attitude towards COVID-19 guidelines, social movement and travel patterns, networks and interactions, living and work conditions, water and sanitation facilities, and observation of behaviours of important role models such as politicians and other community leaders. These factors were perceived to increase the risk of COVID-19 transmission.Conclusion These findings highlight important factors influencing transmission of COVID-19 in Zambia. Future interventions should focus on providing information to mitigate myths and misconceptions, increasing people’s risk perception to the disease, and improving attitude towards the prevention and control interventions and mitigating structural and socioeconomic barriers.

Abstract Background Zambia was an early adopter of insecticide-treated nets strategy in 2001, and policy for mass distribution with long-lasting insecticidal nets (LLINs) in 2005. Since then, the country has implemented mass distribution supplemented with routine delivery through antenatal care and under five clinics in health facilities. The national targets of universal (100%) coverage and 80% utilization of LLINs have not been attained. Free mass LLIN distribution campaign in Zambia offers important lessons to inform future campaigns in the African region. Methods This study reviewed LLIN free mass distribution campaign information derived from Zambia’s national and World Health Organization Global Malaria Programme annual reports and strategic plans published between 2001 and 2016. Results In 2014, a nationwide mass distribution campaign in Zambia delivered all the 6.0 million LLINs in 6 out of 10 provinces in 4 months between June and September before the onset of the rainy season. Compared with 235,800 LLINs and 2.9 million LLINs distributed on a rolling basis in 2008 and 2013, respectively, the 2014 mass campaign, which distributed 6 million LLINs represented the largest one-time-nationwide LLIN distribution in Zambia. The province (Luapula) with highest malaria transmission, mostly with rural settings recorded 98–100% sleeping spaces in homes covered with LLINs. The percentage of households owning at least 1 LLIN increased from 50.9% in 2006 to 77.7% in 2015. The 2014 mass campaign involved a coordinated response with substantial investments into macro (central) and micro (district) level planning, capacity building, tracking and logistics management supported by a new non-health sector partnership landscape. Coordination of LLIN distribution and logistics benefited from the mobile phone technology to transmit “real time” data on commodity tracking that facilitated timely delivery to districts. Conclusion Free mass distribution of LLINs policy was adopted in 2005 in Zambia. Consistently implemented, has not only contributed to increased coverage of LLINs, but has also produced the added value and lessons of strengthening joint planning, strategic coordination, partnerships with non-health sector institutions and community engagement with traditional leaders at community. Furthermore, the mass distribution, through improving coverage has indirect added (spin-off) value or impact on other arthropod-borne diseases, in addition to malaria.

Background: Insecticide Treated Nets are one of the backbones of malaria prevention in Africa where the vector mosquitos bite at night and prefer humans for feeding. Children who sleep under Insecticide Treated Nets though protected still get malaria infections. This study aimed to assess the risk factors of malaria infection among under-five children who sleep under insecticide-treated Treated Nets. Methodology: This was a secondary analysis of a cross-sectional survey the Malaria Indicator survey of 2021 in Zambia. Data was extracted from the database at the Ministry of Health and analysed in STATA version 14. Data was analysed in counts and frequencies, cross-tabulations and associations assessed using logistic regressing using complex data analysis. Results: A total of 1695 children aged below five years who had slept under an Insecticide Treated Net the night before the survey were included in the study, 50.9% were female while 49.1 were male. Over a third of them (23.9%) had a fever in the previous two weeks, over half 51.9% of them had anaemia and 28.8% of them had malaria infection tested using Rapid Diagnostic tests. There was a 3.46 (95%CI 2.67 - 4.49) increase in the odds of having malaria if the under-five child was anaemic (haemoglobin less than 11mg/dl). Other factors that are usually associated with malaria infection such as younger age group, low socio-economic status, residing in rural areas and having had a fever in the previous two weeks. Conclusion: In Zambia, about a third of under-five children who slept under insecticide-treated nets still had evidence of malaria infection. A significant risk factor for malaria infection among the under-five children who slept under ITNs was anaemia. Other known risk factors for malaria among under-five children such as age, rural residence, wealth status, province of residence and education of guardians were not statistically significant. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia is one of the major public health concerns in many developing countries including Zambia. Unless it is acute, the consequences of anaemia are not immediate but have long-term debilitating effects such as growth and intellectual retardation and as such it does not receive the necessary attention it deserves. This study set out to assess the prevalence and associated factors of anaemia in under-five children in Zambia. Methods: This study was a secondary analysis of the 2021 Malaria Indicator Survey. We extracted data from the datasets at the National Malaria Elimination Centre after obtaining permission from the Ministry of Health. The extracted data was analysed in STATA 14, summarised in frequencies, cross-tabulations between independent variables and the outcome and multivariable logistic regression was used to assess the associations between variables and anaemia. Findings: The prevalence of anaemia was found to be 53.8%. Anaemia was found to be associated more with children below one year compared to older children, children whose household heads had no or only have primary education compared to those with secondary or tertiary education and in the northern parts of the country such as Luapula and Northern provinces compared to the southern province. Further anaemia was more common in those with malaria than those without malaria and those with febrile illnesses than those without febrile illnesses. In addition, anaemia was less common in those who slept under insecticide-treated nets. Conclusion: Anaemia in Zambia has been found to be higher than the average in Southern Africa, it is associated with younger age groups, poverty conditions and where diseases like malaria and other febrile illnesses are more common than where they are not. The use of interventions like insecticidetreated nets is associated with reduced prevalence of anaemia. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are key public health issues in many high-income countries and have become a major public health concern affecting all ages, including adolescents in lowincome and middle-income countries. This study determined the prevalence of overweight and obesity and their associated factors among undergraduate students at colleges and universities in the Mongu district of the Western Province of Zambia. Methods: This was a cross-sectional study. Undergraduate students aged 18 to 26 years were sampled from two colleges and one university in Mongu. Data was collected electronically by trained research assistants using a structured questionnaire using Kobo Collect software. Data was analysed using Stata version 14 software. The analysis included descriptive statistics, using counts, frequencies, percentages, means and medians depending on the distribution of the data. Chisquared tests of association, bivariate, and multivariate logistic regression were done to test for association between overweight and independent variables. A p-value less than 0.05 was considered significant. Results: A total of 330 students were captured in the survey; over half of the respondents were female students 214 (64.85%), while 116 (35.15%) were male respondents. Body Mass Index (BMI) showed that 21 (6.8%) were underweight, 208 (63.0%) had normal weight, 76 (23.0%) were overweight, and 25 (7.6%) were obese. Factors associated with overweight and obesity included female sex a OR 1.68 (95%CI 1.02 - 2.76), age and alcohol intake. [ABSTRACT FROM AUTHOR]

Background: Prompt diagnosis and appropriate treatment of fever can prevent severe disease and mortality. Delayed diagnosis and treatment of infections contribute significantly to the high underfive mortality ratio especially in sub-Saharan Africa. This study assessed the prevalence and associated factors to prompt diagnosis and treatment of fever among under-five children in Zambia. Methods: The study used secondary data from the Malaria Indicator Survey of 2021. Descriptive statistics using measures of frequencies, medians and interquartile ranges were done, and crosstabulations and logistic regression were used to assess measures of association. The significance level was set at a P-value of 0.05 and a confidence level of 95%. The data was analysed in STATA 14. Results: A total of 3003 under-five children were included, 728 (19.5%) had a fever in the two weeks preceding the survey. The prevalence of prompt health-seeking behaviour was 57.3% which raises concerns that 42.7% of the children with fever did not have prompt treatment within the same of the next day of fever onset. Male sex aOR = 1.52 (95%CI 1.10 - 2.12) and the use of IRS aOR 1.8(1.30 - 2.50) were associated with increased odds of prompt health-seeking behaviour. Conclusion: This study found that the prevalence of fever among under-five children in Zambia was comparable to other sub-Saharan African countries. Health-seeking behaviour among children with fever was sub-optimal, as a considerable proportion did not seek treatment. Factors associated with health-seeking behaviour among children with fever included sex and staying in a house with indoor residual spraying. [ABSTRACT FROM AUTHOR]