University of Zambia

About: University of Zambia is a education organization based out in Lusaka, Lusaka, Zambia. It is known for research contribution in the topics: Population & Health care. The organization has 2593 authors who have published 4402 publications receiving 122411 citations. The organization is also known as: UNZA.

Mathematical modelling for health systems research: a systematic review of system dynamics and agent-based models

Abstract: Mathematical modelling has been a vital research tool for exploring complex systems, most recently to aid understanding of health system functioning and optimisation. System dynamics models (SDM) and agent-based models (ABM) are two popular complementary methods, used to simulate macro- and micro-level health system behaviour. This systematic review aims to collate, compare and summarise the application of both methods in this field and to identify common healthcare settings and problems that have been modelled using SDM and ABM. We searched MEDLINE, EMBASE, Cochrane Library, MathSciNet, ACM Digital Library, HMIC, Econlit and Global Health databases to identify literature for this review. We described papers meeting the inclusion criteria using descriptive statistics and narrative synthesis, and made comparisons between the identified SDM and ABM literature. We identified 28 papers using SDM methods and 11 papers using ABM methods, one of which used hybrid SDM-ABM to simulate health system behaviour. The majority of SDM, ABM and hybrid modelling papers simulated health systems based in high income countries. Emergency and acute care, and elderly care and long-term care services were the most frequently simulated health system settings, modelling the impact of health policies and interventions such as those targeting stretched and under resourced healthcare services, patient length of stay in healthcare facilities and undesirable patient outcomes. Future work should now turn to modelling health systems in low- and middle-income countries to aid our understanding of health system functioning in these settings and allow stakeholders and researchers to assess the impact of policies or interventions before implementation. Hybrid modelling of health systems is still relatively novel but with increasing software developments and a growing demand to account for both complex system feedback and heterogeneous behaviour exhibited by those who access or deliver healthcare, we expect a boost in their use to model health systems.

Detoxification of lead-bearing zinc plant leach residues from Kabwe, Zambia by coupled extraction-cementation method

Abstract: Zinc plant leach residues (ZPLRs) are hazardous solid wastes generated from zinc metal production owing to their substantial contents of lead (Pb), a toxic heavy metal. This study investigated the detoxification of historic ZPLRs from Kabwe, Zambia by removing Pb using a coupled extraction-cementation method in chloride media. For the coupled extraction-cementation method, micro-scale zero-valent iron (mZVI) was added during ZPLRs leaching in acidified chloride solution. Cemented Pb on the surface of mZVI was recovered easily from the leaching pulp by magnetic separation. Pb removal was evaluated in different solution compositions (NaCl:1–5.13 M, HCl: 0–0.1 M) with and without the addition of mZVI. The addition of mZVI during ZPLRs leaching (i.e., coupled extraction-cementation) increased Pb removal from 3% to 24%, 1.3% to 27.5%, 5.2% to 34.9%, and 6.5% to 55.8% when NaCl concentration was fixed at 0.86 M and HCl concentrations were 0 M, 0.01 M, 0.05 M and 0.1 M, respectively. When NaCl concentration was increased above 3.42 M and HCl maintained at 0.1 M HCl, Pb removal increased to 80%. Analysis of the Pb-loaded mZVI (magnetic fraction) by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) and X-ray photoelectron spectroscopy (XPS) revealed that Pb was recovered during leaching via cementation as Pb°. The toxicity characteristic leaching procedure (TCLP) and in vitro solubility and bioavailability research consortium gastric phase (SBRC-G) tests for Pb of ZPLRs before and after treatment decreased drastically from 11.3 to 3.5 mg/L (below 5 mg/L threshold) and 12 300 to 2 840 mg/Kg, respectively.

Assessing capacity and readiness to manage NCDs in primary care setting: Gaps and opportunities based on adapted WHO PEN tool in Zambia

Abstract: Introduction Sub-Saharan Africa is experiencing an epidemiological transition as the burden of NCDs overtake communicable diseases. However, it is unknown what capacity and gaps exist at primary care level to address the growing burden of NCDs. This study aimed to assess the Zambian health system’s capacity to address in NCDs, using an adapted WHO Essential Non Communicable Disease Interventions (WHO PEN) tool. Methodology This was a cross-sectional facility survey in the three districts conducted from September 2017 to October 2017. We defined facility readiness along five domains: basic equipment, essential services, diagnostic capacity, counseling services, and essential medicines. For each domain, we calculated an index as the mean score of items expressed as percentage. These indices were compared to an agreed cutoff at 70%, meaning that a facility index or district index below 70% off was considered as ‘not ready’ to manage NCDs at that level. All analysis were performed using Stata 15 MP. Results There appeared to be wide heterogeneity between facilities in respect of readiness to manage NCDs. Only 6 (including the three 1st level hospitals) out of the 46 facilities were deemed ready to manage NCDs. Only the first level hospitals scored a mean index higher than the 70% cut off; With regard to medications needed to manage NCDs, urban and rural health facilities were comparably equipped. However, there was evidence that calcium channel blockers (p = 0.013) and insulin (p = 0.022) were more likely to be available in urban and semi-urban health facilities compared to rural facilities. Conclusion Our study revealed gaps in primary health care capacity to manage NCDs in Zambia, with almost all health facilities failing to reach the minimum threshold. These results could be generalized to other similar districts in Zambia and the sub-region, where health systems remain focused on infectious rather than non-communicable Disease. These results should attract policy attention and potentially form the basis to review current approach to NCD care at the primary care level in Zambia and Sub-Saharan Africa.

Polyphenolic extracts from cowpea (Vigna unguiculata) protect colonic myofibroblasts (CCD18Co cells) from lipopolysaccharide (LPS)-induced inflammation – modulation of microRNA 126

Abstract: Cowpea (Vigna unguiculata) is a drought tolerant crop with several agronomic advantages over other legumes. This study evaluated varieties from four major cowpea phenotypes (black, red, light brown and white) containing different phenolic profiles for their anti-inflammatory property on non-malignant colonic myofibroblasts (CCD18Co) cells challenged with an endotoxin (lipopolysaccharide, LPS). Intracellular reactive oxygen species (ROS) assay on the LPS-stimulated cells revealed antioxidative potential of black and red cowpea varieties. Real-time qRT-PCR analysis in LPS-stimulated cells revealed down-regulation of proinflammatory cytokines (IL-8, TNF-α, VCAM-1), transcription factor NF-κB and modulation of microRNA-126 (specific post-transcriptional regulator of VCAM-1) by cowpea polyphenolics. The ability of cowpea polyphenols to modulate miR-126 signaling and its target gene VCAM-1 were studied in LPS-stimulated endothelial cells transfected with a specific inhibitor of miR-126, and treated with 10 mg GAE/L black cowpea extract where the extract in part reversed the effect of the miR-126 inhibitor. This suggests that cowpea may exert their anti-inflammatory activities at least in part through induction of miR-126 that then down-regulate VCAM-1 mRNA and protein expressions. Overall, Cowpea therefore is promising as an anti-inflammatory dietary component.