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.

Excellent adherence to antiretrovirals in HIV+ Zambian children is compromised by disrupted routine, HIV nondisclosure, and paradoxical income effects.

Abstract: Introduction A better understanding of pediatric antiretroviral therapy (ART) adherence in sub-Saharan Africa is necessary to develop interventions to sustain high levels of adherence. Methodology/Principal Findings Adherence among 96 HIV-infected Zambian children (median age 6, interquartile range [IQR] 2,9) initiating fixed-dose combination ART was measured prospectively (median 23 months; IQR 20,26) with caregiver report, clinic and unannounced home-based pill counts, and medication event monitoring systems (MEMS). HIV-1 RNA was determined at 48 weeks. Child and caregiver characteristics, socio-demographic status, and treatment-related factors were assessed as predictors of adherence. Median adherence was 97.4% (IQR 96.1,98.4%) by visual analog scale, 94.8% (IQR 86,100%) by caregiver-reported last missed dose, 96.9% (IQR 94.5,98.2%) by clinic pill count, 93.4% (IQR 90.2,96.7%) by unannounced home-based pill count, and 94.8% (IQR 87.8,97.7%) by MEMS. At 48 weeks, 72.6% of children had HIV-1 RNA <50 copies/ml. Agreement among adherence measures was poor; only MEMS was significantly associated with viral suppression (p = 0.013). Predictors of poor adherence included changing residence, school attendance, lack of HIV disclosure to children aged nine to 15 years, and increasing household income. Conclusions/Significance Adherence among children taking fixed-dose combination ART in sub-Saharan Africa is high and sustained over two years. However, certain groups are at risk for treatment failure, including children with disrupted routines, no knowledge of their HIV diagnosis among older children, and relatively high household income, possibly reflecting greater social support in the setting of greater poverty.

Dynamics of greenhouse gases (CO2, CH4, N2O) along the Zambezi River and major tributaries, and their importance in the riverine carbon budget

Abstract: . Spanning over 3000 km in length and with a catchment of approximately 1.4 million km2, the Zambezi River is the fourth largest river in Africa and the largest flowing into the Indian Ocean from the African continent. We present data on greenhouse gas (GHG: carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O)) concentrations and fluxes, as well as data that allow for characterization of sources and dynamics of carbon pools collected along the Zambezi River, reservoirs and several of its tributaries during 2012 and 2013 and over two climatic seasons (dry and wet) to constrain the interannual variability, seasonality and spatial heterogeneity along the aquatic continuum. All GHG concentrations showed high spatial variability (coefficient of variation: 1.01 for CO2, 2.65 for CH4 and 0.21 for N2O). Overall, there was no unidirectional pattern along the river stretch (i.e., decrease or increase towards the ocean), as the spatial heterogeneity of GHGs appeared to be determined mainly by the connectivity with floodplains and wetlands as well as the presence of man-made structures (reservoirs) and natural barriers (waterfalls, rapids). Highest CO2 and CH4 concentrations in the main channel were found downstream of extensive floodplains/wetlands. Undersaturated CO2 conditions, in contrast, were characteristic of the surface waters of the two large reservoirs along the Zambezi mainstem. N2O concentrations showed the opposite pattern, being lowest downstream of the floodplains and highest in reservoirs. Among tributaries, highest concentrations of both CO2 and CH4 were measured in the Shire River, whereas low values were characteristic of more turbid systems such as the Luangwa and Mazoe rivers. The interannual variability in the Zambezi River was relatively large for both CO2 and CH4, and significantly higher concentrations (up to 2-fold) were measured during wet seasons compared to the dry season. Interannual variability of N2O was less pronounced, but higher values were generally found during the dry season. Overall, both concentrations and fluxes of CO2 and CH4 were well below the median/average values for tropical rivers, streams and reservoirs reported previously in the literature and used for global extrapolations. A first-order mass balance suggests that carbon (C) transport to the ocean represents the major component (59%) of the budget (largely in the form of dissolved inorganic carbon, DIC), while 38% of the total C yield is annually emitted into the atmosphere, mostly as CO2 (98%), and 3% is removed by sedimentation in reservoirs.

Intimate partner violence among pregnant women in Rwanda

Abstract: Background Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV) against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women.

Covid-19 deaths in Africa: prospective systematic postmortem surveillance study.

Abstract: Objective To directly measure the fatal impact of coronavirus disease 2019 (covid-19) in an urban African population. Design Prospective systematic postmortem surveillance study. Setting Zambia’s largest tertiary care referral hospital. Participants Deceased people of all ages at the University Teaching Hospital morgue in Lusaka, Zambia, enrolled within 48 hours of death. Main outcome measure Postmortem nasopharyngeal swabs were tested via reverse transcriptase quantitative polymerase chain reaction (PCR) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Deaths were stratified by covis-19 status, location, age, sex, and underlying risk factors. Results 372 participants were enrolled between June and September 2020; PCR results were available for 364 (97.8%). SARS-CoV-2 was detected in 58/364 (15.9%) according to the recommended cycle threshold value of Conclusions Contrary to expectations, deaths with covid-19 were common in Lusaka. Most occurred in the community, where testing capacity is lacking. However, few people who died at facilities were tested, despite presenting with typical symptoms of covid-19. Therefore, cases of covid-19 were under-reported because testing was rarely done not because covid-19 was rare. If these data are generalizable, the impact of covid-19 in Africa has been vastly underestimated.