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.

Epidemiology of human immunodeficiency virus in families in Lusaka Zambia.

Abstract: An investigation of members of households of patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) in Lusaka Zambia revealed a high rate of human immunodeficiency virus (HIV) infection in marital partners regardless of the sex of the index case. The study conducted in August 1985-June 1987 involved individuals in 244 households of index patients diagnosed with AIDS or ARC. 92 (61.3%) of the 150 male index cases and 57 (73.1%) of the 71 female index cases had an HIV-infected marital partner and the severity of HIV disease (AIDS or ARC) in the index partner was linearly associated with the severity of HIV disease in the spouse. 10 (25.6%) of 39 uninfected wives of HIV-positive men compared with only 1 (7.7%) of 13 uninfected husbands seroconverted during the 1st year of follow- up. 4 of the 11 spouses who seroconverted during this period reported sexual intercourse at a time when their HIV-infected partner had genital ulcers. Of the 264 children under 10 years of age from 154 households with an HIV-positive adult who were also evaluated as part of this study 39 (14.8%) were infected--26 had ARC and 13 had asymptomatic infection. Only 3 of the infected children were older than 5 years of age; the mean was 24.9 months. In all cases transmission in children was attributable to HIV infection in the mother. These findings suggest a need for more aggressive counseling to reduce the sexual transmission of HIV infection to uninfected partners. 46 of 52 discordantly infected couples followed for 1 year continued to have unprotected vaginal intercourse--a factor that certainly contributed to the high concordance of HIV infection among the couples in this study.

Underdevelopment and Class Formation in Ovamboland, 1845–1915

Abstract: The Ovambo and their Nkhumbi neighbours live in a flood plain, which is artificially divided by the present frontier between Angola and Namibia. From the mid-nineteenth century until World War I, they underwent a process of underdevelopment and class formation linked to the evolution of commercial relations with western societies. Between 1845 and 1885 the ivory trade temporarily enriched the Ovambo and widened the productive base of their economy through the introduction of fire-arms. At the same time, however, fire-arms became a necessity, and thus forged permanent links of dependence on western societies. Cattle replaced ivory as an export item after the elephants had been shot out, but pressure on the Ovambo's own cattle resources were largely avoided by systematic raiding in southern Angola. After the turn of the century natural disasters and effective Portuguese resistance to raiding made this solution inoperative, and led to a general impoverishment of Ovambo society. The social impact of this impoverishment was extremely uneven, for the kings and their followers passed it on to the more vulnerable members of society through a system of harsh and arbitrary taxation. A new stratum of men without cattle was thus forced to turn to migrant labour in Namibia and Angola. The colonial conquest of 1915 froze this situation into a permanent system of recurrent labour migration.

Leave no one behind: response to new evidence and guidelines for the management of cryptococcal meningitis in low-income and middle-income countries

Abstract: In 2018, WHO issued guidelines for the diagnosis, prevention, and management of HIV-related cryptococcal disease. Two strategies are recommended to reduce the high mortality associated with HIV-related cryptococcal meningitis in low-income and middle-income countries (LMICs): optimised combination therapies for confirmed meningitis cases and cryptococcal antigen screening programmes for ambulatory people living with HIV who access care. WHO's preferred therapy for the treatment of HIV-related cryptococcal meningitis in LMICs is 1 week of amphotericin B plus flucytosine, and the alternative therapy is 2 weeks of fluconazole plus flucytosine. In the ACTA trial, 1-week (short course) amphotericin B plus flucytosine resulted in a 10-week mortality of 24% (95% CI -16 to 32) and 2 weeks of fluconazole and flucytosine resulted in a 10-week mortality of 35% (95% CI -29 to 41). However, with widely used fluconazole monotherapy, mortality because of HIV-related cryptococcal meningitis is approximately 70% in many African LMIC settings. Therefore, the potential to transform the management of HIV-related cryptococcal meningitis in resource-limited settings is substantial. Sustainable access to essential medicines, including flucytosine and amphotericin B, in LMICs is paramount and the focus of this Personal View.

Somali Resistance to Colonial Rule and the Development of Somali Political Activity in Kenya, 1893-1960

Abstract: This article investigates the relationship between different phases of Somali political activity in Kenya. A clear contrast emerges between the focus, the aims and the methods adopted by the Somali pastoralists along the northern frontier and those adopted by the Isaq and Herti Somali traders in Nairobi and Isiolo. The attitude of the former towards the Colonial Government was essentially negative. Yet, while they tended to be resisters par excellence and fought against the Government on a large number of occasions between 1893 and 1916, this article shows that their resistance was much more limited than has generally been supposed and that they were never united on a clan basis in their resistance. In fact intra-clan rivalries seriously undermined the effectiveness of their activities Moreover, certain weaker Somali segments actively cooperated with the Government in order to obtain military and political support for their positions which were threatened by stronger groups.On the other hand, Isaq and Herti traders attempted to manipulate the political institution in order to obtain additional privileges within the system. Their agitation had positive goals, for they campaigned to gain Asiatic status. They put pressure on the central organs of Government and hired lawyers to plead their case. They wrote numerous petitions and memorials to governors of the colony, to Secretaries of State and even to two British kings. They formed well-organized political associations and had contacts in British Somaliland and England. Yet, by a curious irony, it seems that the Somali Exemption Ordinance of 1919, which represented the closest they came to achieving non-native status, was not passed as a result of their campaigns. In fact, their later agitation achieved nothing; it seems to have represented a futile effort to counter the gradual erosion of privileges obtained at an earlier date.One of the main characteristics of the Isaq and Herti agitation was its essentially sectarian character. In fighting to obtain Asiatic status they emphasized traits that isolated them from other Somali groups, and they even ended by denying that they were Somali. As such, there was a considerable disparity between their aims and those of the Somali Youth League which emerged in 1946 as the main vehicle of mass Somali nationalism, uniting the Somali pastoralists and traders in one group.

Assessing the accuracy of adherence and sexual behaviour data in the MDP301 vaginal microbicides trial using a mixed methods and triangulation model

Abstract: Background: Accurate data on adherence and sexual behaviour are crucial in microbicide (and other HIV-related) research. In the absence of a ‘‘gold standard’’ the collection of such data relies largely on participant self-reporting. The Microbicides Development Programme has developed a mixed method/triangulation model for generating more accurate data on adherence and sexual behaviour. Methodology/Principal Findings: Data were collected from a random subsample of 725 women using structured case record form (CRF) interviews, coital diaries (CD) and in-depth interviews (IDI). Returned used and unused gel applicators were counted and additional data collected through focus group discussions and ethnography. The model is described in detail in a companion paper [1]. When CRF, CD and IDI are compared there is some inconsistency with regard to reporting of sexual behaviour, gel or condom use in more than half. Inaccuracies are least prevalent in the IDI and most prevalent in the CRF, where participants tend to under-report frequency of sex and gel and condom use. Women reported more sex, gel and condom use than their partners. IDI data on adherence match the applicator-return data more closely than the CRF. The main reasons for inaccuracies are participants forgetting, interviewer error, desirability bias, problems with the definition and delineation of key concepts (e.g. ‘‘sex act’’). Most inaccuracies were unintentional and could be rectified during data collection. Conclusions/Significance: The CRF – the main source of self-report data on behaviour and adherence in many studies – was the least accurate with regard to measuring sexual behaviour, gel and condom use. This has important implications for the use of structured questionnaires for the collection of data on sexual behaviour and adherence. Integrating in-depth interviews and triangulation into clinical trials could increase the richness and accuracy of behavioural and adherence data. Citation: Pool R, Montgomery CM, Morar NS, Mweemba O, Ssali A, et al. (2010) Assessing the Accuracy of Adherence and Sexual Behaviour Data in the MDP301