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.

Clinical and ultrasonographic features of abdominal tuberculosis in HIV positive adults in Zambia.

Abstract: The diagnosis of abdominal tuberculosis (TB) is difficult, especially so in health care facilities in developing countries where laparoscopy and colonoscopy are rarely available There is little information on abdominal TB in HIV infection We estimated the prevalence and clinical features of abdominal (excluding genitourinary) TB in HIV infected adults attending the University Teaching Hospital, Zambia We screened 5,609 medical inpatients, and those with fever, weight loss, and clinical features suggestive of abdominal pathology were evaluated further A clinical algorithm was used to specify definitive investigations including laparoscopy or colonoscopy, with culture of biopsies and other samples Of 140 HIV seropositive patients with these features, 31 patients underwent full evaluation and 22 (71%) had definite or probable abdominal TB The commonest presenting abdominal features were ascites and persistent tenderness The commonest ultrasound findings were ascites, para-aortic lymphadenopathy (over 1 cm in size), and hepatomegaly Abdominal TB was associated with CD4 cell counts over a wide range though 76% had CD4 counts <100 cells/μL The clinical manifestations of abdominal TB in our HIV-infected patients resembled the well-established pattern in HIV-uninfected adults Patients with fever, weight loss, abdominal tenderness, abdominal lymphadenopathy, ascites and/or hepatomegaly in Zambia have a high probability of abdominal TB, irrespective of CD4 cell count

HIV infection and domestic smoke exposure, but not human papillomavirus, are risk factors for esophageal squamous cell carcinoma in Zambia: a case-control study.

Abstract: There is emerging evidence that esophageal cancer occurs in younger adults in sub-Saharan Africa than in Europe or North America. The burden of human immunodeficiency virus (HIV) is also high in this region. We postulated that HIV and human papillomavirus (HPV) infections might contribute to esophageal squamous cell carcinoma (OSCC) risk. This was a case–control study based at the University Teaching Hospital in Lusaka, Zambia. Cases were patients with confirmed OSCC and controls had completely normal upper endoscopic evaluations. A total of 222 patients were included to analyze the influence of HIV infection; of these, 100 patients were used to analyze the influence of HPV infection, alcohol, smoking, and exposure to wood smoke. The presence of HIV infection was determined using antibody kits, and HPV infection was detected by polymerase chain reaction. HIV infection on its own conferred increased risk of developing OSCC (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.0–5.1; P = 0.03). The OR was stronger when only people under 60 years were included (OR 4.3; 95% CI 1.5–13.2; P = 0.003). Cooking with charcoal or firewood, and cigarette smoking, both increased the odds of developing OSCC ([OR 3.5; 95% CI 1.4–9.3; P = 0.004] and [OR 9.1; 95% CI 3.0–30.4; P < 0.001], respectively). There was no significant difference in HPV detection or alcohol intake between cases and controls. We conclude that HIV infection and exposure to domestic and cigarette smoke are risk factors for OSCC, and HPV immunization unlikely to reduce OSCC incidence in Zambia.

Prevalence and patterns of antimicrobial resistance among Escherichia coli isolated from Zambian dairy cattle across different production systems

Abstract: This study focused on the use of antibiotics on small, medium and commercial-sized dairy farms in the central region of Zambia and its relationship to antibiotic resistance in Escherichia coli. A stratified random sample of 104 farms was studied, representing approximately 20% of all dairy farms in the region. On each farm, faecal samples were collected from a random sample of animals and a standardised questionnaire on the usage of antibiotics was completed. An E. coli isolate was obtained from 98.67% (371/376) of the sampled animals and tested for resistance to six classes of antibiotics. The estimated prevalence of resistance across the different farming systems was: tetracycline (10.61; 95%CI: 7.40–13.82), ampicillin (6.02; 95%CI: 3.31–8.73), sulfamethoxazole/ trimethoprim (4.49; 95%CI: 2.42–6.56), cefpodoxime (1.91; 95%CI: 0.46–3.36), gentamicin (0.89; 95%CI: 0.06–1.84) and ciprofloxacin (0%). Univariate analyses indicated certain diseases, exotic breeds, location, farm size and certain management practices as risk factors for detection of resistance, whereas multivariate analyses showed an association with lumpy skin disease and a protective effect for older animals (>25 months). This study has provided novel insights into the drivers of antibiotic use and their association with antibiotic resistance in an under-studied region of Southern Africa.

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

Abstract: Over the last decades, studies in sub-Saharan Africa have indicated that epilepsy is a highly prevalent neurological disorder. Causes may be varied with infections of the central nervous system playing an important role. Neurocysticercosis (NCC) has recently been recognised as an emerging public health problem and a growing concern throughout sub-Saharan Africa and has been estimated to be responsible for 30–50% of acquired epilepsy. NCC is closely linked with porcine cysticercosis and human taeniosis, the former reaching a prevalence of almost 50% in some pig populations. In this review, we first summarize prevalence data on epilepsy and highlight some special aspects of the disorder within sub-Saharan Africa. We then focus on the prevalence of NCC, clinical signs and symptoms and diagnostic criteria for NCC with special reference to sub-Saharan Africa. This is followed by a section on the latest developments regarding serodiagnosis of cysticercosis and a section on care management of people infected with NCC. NCC clearly represents a major risk factor of epilepsy, thus detecting and treating NCC may help cure epilepsy in millions of people in sub-Saharan Africa.