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.

Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries

Abstract: Oligohydramnios is a condition of abnormally low amniotic fluid volume that has been associated with poor pregnancy outcomes. To date, the prevalence of this condition and its outcomes has not been well described in low and low-middle income countries (LMIC) where ultrasound use to diagnose this condition in pregnancy is limited. As part of a prospective trial of ultrasound at antenatal care in LMICs, we sought to evaluate the incidence of and the adverse maternal, fetal and neonatal outcomes associated with oligohydramnios. We included data in this report from all pregnant women in community settings in Guatemala, Pakistan, Zambia and the Democratic Republic of Congo (DRC) who received a third trimester ultrasound as part of the First Look Study, a randomized trial to assess the value of ultrasound at antenatal care. Using these data, we conducted a planned secondary analysis to compare pregnancy outcomes of women with to those without oligohydramnios. Oligohydramnios was defined as measurement of an Amniotic Fluid Index less than 5 cm in at least one ultrasound in the third trimester. The outcomes assessed included maternal morbidity and fetal and neonatal mortality, preterm birth and low-birthweight. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models using general estimating equations to account for the correlation of outcomes within cluster. Of 12,940 women enrolled in the clusters in Guatemala, Pakistan, Zambia and the DRC in the First Look Study who had a third trimester ultrasound examination, 87 women were diagnosed with oligohydramnios, equivalent to 0.7% of those studied. Prevalence of detected oligohydramnios varied among study sites; from the lowest of 0.2% in Zambia and the DRC to the highest of 1.5% in Pakistan. Women diagnosed with oligohydramnios had higher rates of hemorrhage, fetal malposition, and cesarean delivery than women without oligohydramnios. We also found unfavorable fetal and neonatal outcomes associated with oligohydramnios including stillbirths (OR 5.16, 95%CI 2.07, 12.85), neonatal deaths < 28 days (OR 3.18, 95% CI 1.18, 8.57), low birth weight (OR 2.10, 95% CI 1.44, 3.07) and preterm births (OR 2.73, 95%CI 1.76, 4.23). The mean birth weight was 162 g less (95% CI -288.6, − 35.9) with oligohydramnios. Oligohydramnos was associated with worse neonatal, fetal and maternal outcomes in LMIC. Further research is needed to assess effective interventions to diagnose and ultimately to reduce poor outcomes in these settings. NCT01990625.

On tracing seismic rays with specified end points in layers of constant velocity and plane interfaces

Abstract: A polygonal ray path connects the seismic source and detector positions when the intervening medium consists solely of constant velocity layers with plane interfaces which may have arbitrary orientation. The coordinates of the ray vertices satisfy a system of coupled equations resulting from the requirement that Fermat's principle be satisfied along the ray path. Solving the system of equations is equivalent to tracing the ray numerically. A notable feature of this approach is that a ray which is critically refracted over a segment of its path requires no special handling.

Weight conservation in Zambian children: A non-verbal approach.

Abstract: Pour la premiere fois, selon l'A., l'etude de la conservation a ete realisee avec une methode non-verbale sur des enfants de culture non-europeenne. Les resultats qui ont ete obtenus avec cette methode dans un groupe controle d'enfants d'origine et d'education europeennes sont comparables a ceux qui ont ete trouves en Suisse et aux Etats-Unis avec la methode genevoise classique. On peut done s'appuyer avec une certaine confiance sur ce fait pour analyser les resultats obtenus par la methode non-verbale avec 200 eleves d'ecole primaire de Zambie et les comparer aux donnees d'une etude australienne sur des enfants aborigenes dans laquelle la methode classique a ete utilisee. La moitie environ des enfants zambiens atteignent l'adolescence sans reussir les epreuves de conservation du poids; l'A. degage les implications et les causes possibles d'un tel fait, et specialement l'influence des facteurs de milieu: par exemple, la langue qui est utilisee comme vehicule d'education, egalement la qualite du m...

Moving on From HAND: Why We Need New Criteria for Cognitive Impairment in Persons Living With Human Immunodeficiency Virus and a Proposed Way Forward.

Abstract: Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) criteria are frequently used to describe cognitive impairment in persons living with HIV (PLWH) across diverse populations globally. These criteria typically find 20-60% of PLWH meet criteria for HAND, which does not tally with clinical observations in the modern era that cognitive disorders present relatively infrequently. Most with HAND have asymptomatic neurocognitive impairment; however, the significance of low cognitive test performance without symptoms is uncertain. Methods underlying HAND criteria carry a false-positive rate that can exceed 20%. Comorbidities, education, and complex socioeconomic factors can influence cognitive test performance, further increasing the potential for misclassification. We propose a new framework to characterize cognitive impairment in PLWH that requires a clinical history and acknowledges the multifactorial nature of low cognitive test performance. This framework is intended to be applicable across diverse populations globally, be more aligned with clinical observations, and more closely represent HIV brain pathology.

Comparison of absorption rates of glucose and maltose in man in vivo.

Abstract: SUMMARY 1. Using a double-lumen tube perfusion technique in vivo, the absorption rates of glucose from a glucose (200 mm011-~) and from a maltose (100 mmol 1-I) solution were measured in the proximal jejunum of six Zambian African adults. 2. In all of the subjects the rate of glucose absorption from the maltose solution was greater than that from the glucose solution. The difference between the mean rates was approximately 15% and is significant (P