Retrospective analysis of laboratory diagnostic data to assess the seasonal and proportional distribution of major tick-borne diseases in cattle from selected smallholder farms, Zambia

The incidence and severity of frogeye leaf spot of soybean (Glycine max (L.) Merr.) was studied in agroecological region II of Zambia during the 1997/98 crop growing season. A survey was conducted on farmers' fields on SCSI Kaleya, Magoye and Hernon-147 cultivars. Disease incidence and severity was assessed by monitoring disease increments at two weeks interval (beginning of January to April) from nine fields, three from each province. Soybean cultivars were evaluated for yield losses resulting from frogeye leaf spot. Field plots of each cultivar were either sprayed twice with benomyl (benlate) or not sprayed at all. The results showed that the incidence of frogeye leaf spot was highest in Southern province (5.1), followed by Lusaka province (4.9) while Central province had the lowest disease incidence (1.8). Values for area under disease progress curve (AUDPC) were significantly greater (P < 0.05) for Lusaka and Southern provinces than for Central province. Yields in benomyl protected plots ranged from 1444 kg ha-1 to 2320 kg ha-1 and were significantly different among the cultivars. Average yields of non protected plants were reduced by 30.5% for Kaleya, 35.6% for Hernon-147 and 37.2% for SCS1. Incidence and severity increased with time and varied depending on weather parameters and susceptibility of cultivars to the disease. Yield losses due to frogeye leaf spot occurred through a reduction in seed size. Differences in weather conditions and amount of inocula are believed to contribute to the observed variation in incidence and severity of the disease at different locations.

Aims: This study explored learning and assessment of Civic Education from the pupils’ standpoint. Study Design: Employed a qualitative research paradigm, in particular a descriptive research design. Place and Duration: The study was conducted in selected rural secondary schools of Central, Lusaka and Southern provinces of Zambia, between April 2022 and April 2023. Methodology: It targeted 300 learners from 30 secondary schools in Central, Lusaka and Southern provinces. Schools and participants were systematically selected. Data was collected using a questionnaire with open-ended questions, analysed descriptively and thematically. Results: Findings show that teachers employ teacher-centered methods and neglect learner-centered methods which are ideal in teaching and learning Civic Education in schools. Findings also revealed that most learners like answering section A (multiple choice), followed by section B (one word or short phrased answers), with section C (essay writing) being the least. All participants contended that teachers could not prepare learners for section C during both formative and summative assessment. Conclusion: The Examinations Council of Zambia (ECZ) should train all teachers of Civic Education as examiners so that they acquire knowledge, build and sharpen their assessment skills; and ECZ should consider including continuous assessment in Civic Education as part of grade 12 national examination to allow learners interact with the community through research projects when they are in grade 11.

Despite the enormous potential that indigenous chickens (Gallus gallus domesticus) have for sustaining livelihoods, their production and marketing has been mostly neglected resulting in the sub-sector being highly underdeveloped with poor linkages between producers and consumers. The main objective of this study was to map and analyze the value chain for indigenous chickens in Lusaka and Central Provinces of Zambia. The study also analyzes the value added and the associated costs in the chain. Findings show that although almost all (99 percent) of smallholder households keep indigenous poultry, productivity and production is very low leading to low and unplanned sales. Low production is due to high mortality of indigenous chickens mainly as a result of limited producer knowledge of methods of disease prevention and breeding practices. The absence of processing along the value chain means that chickens are sold live (in open markets) and consequently cannot be retailed through formal channels like supermarkets leading to exclusion of potential middle and high income consumers. Although the value chain for indigenous chicken shows positive gross margins for all the players along the chain, there is need to address the various constraints affecting the value chain in order to improve the operation of the chain and hence lead to increased incomes for the value chain actors and at the same time ensuring cheap delivery of indigenous chicken in a more convenient form and in formal outlets.

Geographic location represents an ecological measure of HIV status and is a strong predictor of HIV prevalence. Given the complex nature of location effects, there is limited understanding of their impact on policies to reduce HIV prevalence. Participants were 3949 and 10 874 respondents from two consecutive Zambia Demographic and Health Surveys from 2001/2007 (mean age for men and women: 30.3 and 27.7 years, HIV prevalence 14.3% in 2001/2002; 30.3 and 28.0 years, HIV prevalence of 14.7% in 2007). A Bayesian geo-additive mixed model based on Markov Chain Monte Carlo techniques was used to map the change in the spatial distribution of HIV/AIDS prevalence at the provincial level during the 6-year period, accounting for important risk factors. Overall HIV/AIDS prevalence changed little over the 6-year period, but the mapping of residual spatial effects at the provincial level suggested different regional patterns. A pronounced change in odds ratios in Lusaka and Copperbelt provinces in 2001/2002 and in Lusaka and Central provinces in 2007 was observed following adjustment for spatial autocorrelation. Western province went from a lower prevalence area in 2001 (13.4%) to a higher prevalence area in 2007 (17.3%). Southern province went from the highest prevalence area in 2001 (17.3%) to a lower prevalence area in 2007 (15.9%). Findings from two consecutive surveys corroborate the Zambian government's effort to achieve Millennium Developing Goal (MDG) 6. The novel finding of increased prevalence in Western province warrants further investigation. Spatially adjusted provincial-level HIV/AIDS prevalence maps are a useful tool for informing policies to achieve MDG 6 in Zambia.

Background: In Zambia, Computed Tomography (CT) has been available since 1994 as part of the healthcare delivery pathway. Radiographers undertake CT examinations of the body to diagnose diseases, injuries and to plan for radiotherapy.&#x0D; Objective: The aim of this study was to audit CT services in Zambia.&#x0D; Methodology: The study used a convergent parallel design in which quantitative and qualitative data were collected concurrently using an online questionnaire. Quantitative data were analysed using descriptive statistics, whilst qualitative data were analysed by themes.&#x0D; Results: Out of the 23 facilities, a total of 22 responded. Results indicated that Western and Central provinces did not have CT scanners. Most CT facilities are in the Lusaka province. 59% (N=13) and 41% (N=9) were from the public and private sectors, respectively. In public hospitals, 46% (N=6) of CT scanners were functional with service contracts and 89% (N=8) were functional in the private hospitals with service contracts. 61.5 % (N=8) of public hospitals had maintenance schedules while 89% (N=8) of private hospitals had maintenance schedules. A total of 7 facilities reported having radiographers with a qualification in CT. 12 out of 22 facilities indicated having a radiologist with average patient waiting times for CT reports being 76 hours and 24 hours in public and private facilities, respectively.&#x0D; Conclusion: This audit revealed an unequal distribution of CT scanners characterised by poor maintenance and lack of service contracts, especially in public hospitals. The audit also revealed longer waiting times for CT reports in public than in private hospitals.&#x0D;

Rabies has been present in Zambia since the early years of the 20th century. It is a significant public health problem in Zambia. Domestic dogs accounted for 69.7% (1348/1935) of the samples received for rabies diagnosis for the period 1985-2004. Of the 1069 positive cases confirmed by the fluorescent antibody test, 747 (69.9%) were from domestic dogs, 139 (13.0%) from cattle and 98 (9.2%) from humans. Wildlife samples accounted for 4.5% (87/1935) of the samples tested with the jackal (Canis adustus) being the predominant species. Cases of rabies were highest in Lusaka Province followed by the Copperbelt, Southern and Central Provinces. The monthly distribution of canine rabies showed an average of 2.93 (95% CI 2.59-3.29) dog positive cases per month. The study confirms that rabies is endemic in Zambia and that the domestic dog is the principal maintenance host. The epidemiology and control measures currently used in Zambia are herein discussed highlighting their limitations and successes. Based on the findings obtained from this study we advocate for strengthening the delivery of public health services and that steps must taken to reduce the incidence of rabies in Zambia.

This study uses longitudinal household data collected in 2001, 2004, and 2008 to identify factors that influence Zambian smallholder farmers' participation in livestock markets. Although livestock ownership increased during the study period, not all provinces experienced the upward trend. While livestock populations increased in Southern and Central Provinces, they remained stagnant in Eastern, North western and Lusaka Provinces and reduced in Western Province. Not only has herd size remained stagnant over the years, but the level of participation of smallholder farmers in the livestock markets has also remained largely the same. Crop commercialization and participation in off-farm activities reduces the likelihood of participation in cattle markets but not in the markets for small livestock.

Background: In Zambia, Computed Tomography (CT) has been available since 1994 as part of the healthcare delivery pathway. Radiographers undertake CT examinations of the body to diagnose diseases, injuries and to plan for radiotherapy.&#x0D; Objective: The aim of this study was to audit CT services in Zambia.&#x0D; Methodology: The study used a convergent parallel design in which quantitative and qualitative data were collected concurrently using an online questionnaire. Quantitative data were analysed using descriptive statistics, whilst qualitative data were analysed by themes.&#x0D; Results: Out of the 23 facilities, a total of 22 responded. Results indicated that Western and Central provinces did not have CT scanners. Most CT facilities are in the Lusaka province. 59% (N=13) and 41% (N=9) were from the public and private sectors, respectively. In public hospitals, 46% (N=6) of CT scanners were functional with service contracts and 89% (N=8) were functional in the private hospitals with service contracts. 61.5 % (N=8) of public hospitals had maintenance schedules while 89% (N=8) of private hospitals had maintenance schedules. A total of 7 facilities reported having radiographers with a qualification in CT. 12 out of 22 facilities indicated having a radiologist with average patient waiting times for CT reports being 76 hours and 24 hours in public and private facilities, respectively.&#x0D; Conclusion: This audit revealed an unequal distribution of CT scanners characterised by poor maintenance and lack of service contracts, especially in public hospitals. The audit also revealed longer waiting times for CT reports in public than in private hospitals.

A cross-sectional study was conducted between January 2007 and February 2008 to estimate seroprevalence of brucellosis and identify risk factors associated with Brucella infections in commercial cattle in three districts of Lusaka province (Chongwe, Luangwa, and Kafue; n = 849) and in one rural district from the Central province (n = 48). A total of 897 serum samples were randomly collected from 55 farms along with animal-level data such as sex, age, and parity. Sera were screened for presence of anti-Brucella antibodies using the Rose Bengal test, and positive samples were confirmed using competitive enzyme-linked immunosorbent assay. At the animal level, seroprevalence was estimated at 7.9% (95% CI = 4.4-11.4%) in the Lusaka province and 18.7% (95% CI = 7.5-29.9%) for Chibombo district. Brucellosis seroprevalence varied according to district, with Chongwe district recording the highest compared to other districts. Seroprevalence also varied according to sex with bulls (n = 96) having higher seroprevalence (12.5%; 95% CI = 3.8-21.1%) compared to females (8.1%; 95% CI = 4.6-11.6). Similarly, seroprevalence varied according to age groups, with the age category 1-4 years recording the highest (10.7%). The study recorded relatively low Brucella seroprevalence in commercial farms in Lusaka, compared to the traditional small-scale farms. We suggest that testing and stamping out of infected animals is likely to improve the situation and significantly reduce the public health risk associated with Brucella infections in animals.

BackgroundInvolving all relevant healthcare providers in tuberculosis (TB) management through public-private mix (PPM) approaches is a vital element in the World Health Organization's (WHO) Stop TB Strategy. The control of TB in Zambia is mainly done in the public health sector, despite the high overall incidence rates.AimWe conducted a survey to determine the extent of private-sector capacity, participation, practices and adherence to national guidelines in the control of TB.SettingThis survey was done in the year 2012 in 157 facilities in three provinces of Zambia where approximately 85% of the country's private health facilities are found.MethodsWe used a structured questionnaire to interview the heads of private health facilities to assess the participation of the private health sector in TB diagnosis, management and prevention activities.ResultsOut of 157 facilities surveyed, 40.5% were from the Copperbelt, 4.4% from Central province and 55.1% from Lusaka province. Only 23.8% of the facilities were able to provide full diagnosis and management of TB patients. Although 47.4% of the facilities reported that they do notify their cases to the National TB control programme, the majority (62.7%) of these facilities did not show evidence of notifications.ConclusionOur results show that the majority of the facilities that diagnose and manage TB in the private sector do not report their TB activities to the National TB Control Programme (NTP). There is a need for the NTP to improve collaboration with the private sector with respect to TB control activities and PPM for Directly Observed Treatment, Short Course (DOTS).

The study aimed to estimate the burden of ticks and tick-borne diseases (TBDs) among rural cattle-keeping households of the Eastern Cape province of South Africa using Productivity Adjusted Life Years (PALYs). We modified Disability Adjusted Life Year (DALY) equations for humans to PALYs to estimate the societal burden of tick-borne animal diseases. Whilst the World Health Organization has indicated the adaptability of DALYs to assess burden of animal diseases, nothing has been done in this regard. This could be due to several reasons including that the assessment of animal disease burden is often less of a priority compared to human diseases, particularly in low- and middle-income countries where resources may be limited. As a result, less funding and attention may be given to developing and implementing PALYs for animal diseases. Furthermore, technical and conceptual challenges may be associated with applying DALYs equations to animal diseases, such as determining appropriate measures of productivity loss for different types and categories of animals and diseases. This motivated our study, which is focused on modelling the burden of ticks and TBDs in cattle (cows, oxen and bulls) reared in resource-poor settings. We formulated a PALYs approach for cattle populations by adapting the DALYs approach to assess the burden of ticks and TBDs for cattle populations in 20 villages in the Eastern Cape province of South Africa. PALYs is a measurement used to assess the burden of disease in cattle populations, quantifying the years of life lost due to premature mortality and disability. It encompasses years of life lost due to premature mortality (YLL) and years lost due to disability (YLD) caused by health conditions. PALYs provide a comprehensive perspective on the effective number of years lost due to disability and premature death in cattle populations. The PALYs model involves several parameters that are examined to understand their impact on the model's behavior. To illustrate this, we used a structured questionnaire to collect data on parameters that feed into PALY equations. We coded and entered data from questionnaires directly into Statistical Package of Social Sciences (IBM SPSS Version 20) and entered the estimated values of PALY parameters to calculate PALYs equations, which were to estimate the societal disease burden of ticks and TBDs in cattle. PALYs calculations were done in three categories; PALYs without discounting and age weighting, PALYs with only discounting, and PALYs with discounting and age weighting in a practical example to study how these parameters influence the outcomes of the PALYs model. Our results revealed that the years of productivity lost by a cow, bull, and ox that suffered from ticks and TBDs could be estimated at various disability weights. Approximately 26%, 23% and 35% of the productivity years of a cow, ox and bull, respectively, reared by resource-poor livestock owners are lost due to the burden of ticks and TBDs in the Eastern Cape province of South Africa. However, introducing tick control measures reduces the loss to approximately 3%, 2% and 3% of their lifespan productivity, an indication that tick control will save approximately 23%, 21% and 32% of years of the productive life of cows, oxen and bulls, respectively. Therefore, it is evident that using ticks and TBD prevention measures at an early age of cattle will improve cattle productivity and hence the socioeconomic welfare of resource-poor rural farming communities in the Eastern Cape province of South Africa. The findings generated from the PALYs approach are helpful in projections for the future burden of any livestock disease. They may be used as a basis in policy formulation and decision-making by various stakeholders, and hence a priority in animal health economics. We recommend that a classification of livestock diseases of national economic importance should consider both the societal burden (non-monetary) and economic impact instead of the common practice of only considering the economic (monetary) impact. Adding a societal burden measure to existing economic measures provides a holistic understanding of the impact of a disease on society especially in resource-limited settings where the livestock value goes beyond monetary value.

To assess the current situation of access to information by health staff at selected central, provincial, district hospitals and health centres in Zambia. Government and non-governmental institutions were visited in the Lusaka Urban District and nine rural districts in the North-Western, Western and Central Provinces of Zambia in 2001. Thirty interviews were held with provincial and district health directors, medical doctors, nurses and clinical officers in district hospitals and rural and urban health centres. In 2006, a follow-up visit was undertaken to the health centres in the Lusaka Urban District in Lusaka Province and the Sesheke District in the Western Province. There is limited access to health information for health workers in Zambia. In hospitals and health centres, where there is access, it is usually provided in an ad hoc manner without a central policy from the government. In all the places visited, there was also an overwhelming expressed need for different types of information relating to the professional or personal needs of health care workers. The study found that access to information was very poor. There were some excellent examples of local initiatives showing that, even under difficult financial and infrastructural circumstances, it was feasible to improve health workers' access to information by using low technology, information access initiatives. These existing local initiatives deserve to be scaled up, while new initiatives should be adopted to improve access to information in a much more structured way. Of paramount importance is the formulation and implementation of an information policy that will guarantee the provision of health information to Zambian health workers.

A two year study was conducted in the high tomato (Lycopersicon esculentum Mill.), production area of the country (Central and Lusaka Provinces). Tomatoes for the market are packed in wooden boxes, open metal basins and grass baskets. Approx. 5-10% and 20-30% of the fruits packed in wooden boxes, basins and baskets respectively got damaged in transit from site of production to the market. Damage of fruits in wooden boxes was mainly due to the transportation in vehicles of overipe fruits on bumpy roads. Regarding the other containers damage was caused by stacking the containers, on top of each other as well as having different types of produce on top. Most of the damaged fruits could not be sold as the tomato processing industry is not yet well developed.

BackgroundObstetric fistulas are common in low-resourced settings, but the factors associated with successful repair remain unclear in Zambia. We assessed the socio-demographics, fistula characteristics, and healthcare factors associated with successful obstetric fistula repair outcomes in Zambia.MethodsOur retrospective cohort study was based on the Zambia Fistula Foundation Treatment Network’s clinical database, including 1439 women who underwent obstetric fistula surgical repairs at hospitals in Zambia between 2017 and 2023. Tanahashi’s Health Services Coverage framework guided the selection of potential factors associated with successful obstetric fistula repair outcomes. We employed Multivariate Imputation by Chained Equations (MICE) before conducting logistic regression analyses. Univariable models, a multivariable model, and marginal probabilities were then fitted to examine the associations between successful obstetric fistula repair outcome, a fistula that is closed and dry, and relevant covariates.ResultsOur results showed an overall fistula repair success rate of 88.1%. Patients from the Northern and Muchinga provinces showed 51% (AOR = 0.49, 95% CI = 0.27, 0.90) lower odds of surgical repair success compared to those from Central and Lusaka provinces. Patients with a previous fistula repair had 47% lower odds of success (AOR = 0.53, 95% CI = 0.32, 0.87) than those without. Finally, surgeries rated intermediate in difficulty had 64% (AOR = 0.36, 95% CI = 0.18, 0.70), and those rated difficult had 90% (AOR = 0.10, 95% CI = 0.05, 0.21) lower odds of success than simple repairs.ConclusionWe identified geographic location, previous repair history, and surgical complexity as the factors associated with successful obstetric fistula repair outcomes.

ObjectivesTo describe the magnitude and severity of abortion-related complications in health facilities and calculate the incidence of abortion-related near-miss complications at the population level in three provinces in Zambia, a country where abortion is legal but stigmatized. Study designWe conducted a cross-sectional study in 35 district, provincial and tertiary hospitals over 5 months. All women hospitalized for abortion-related complications were eligible for inclusion. Cases of abortion-related near-miss, moderate and low morbidity were identified using adapted World Health Organization (WHO) near-miss and the prospective morbidity methodology criteria. Incidence was calculated by annualizing the number of near-misses and dividing by the population of women of reproductive age. We calculated the abortion-related near-miss rate, abortion-related near-miss ratio and the hospital mortality index. ResultsParticipating hospitals recorded 26,723 births during the study. Of admissions for post-abortion care, 2406 (42%) were eligible for inclusion. Near-misses constituted 16% of admitted complications and there were 14 abortion-related maternal deaths. The hospital mortality index was 3%; the abortion-related near-miss rate for the three provinces was 72 per 100,000 women, and the near-miss ratio was 450 per 100,000 live births. ConclusionsAbortion-related near-miss and mortality are challenges for the Zambian health system. Adapted to reflect health systems capabilities, the WHO near-miss criteria can be applied to routine hospital records to obtain useful data in low-income settings. Reducing avoidable maternal mortality and morbidity due to abortion requires efforts to de-stigmatize access to abortion provision, and expanded access to modern contraception. ImplicationsThe abortion-related near-miss rate is high in Zambia compared with other restrictive contexts. Our results suggest that near-miss is a promising indicator of unsafe abortion; can be measured using routine hospital data, conveniently defined using the WHO criteria; and can be incorporated into the frequently utilized prospective morbidity methodology.