Southern Zambia Research Articles

Detection of Plasmodium falciparum Infection in Anopheles squamosus (Diptera: Culicidae) in an Area Targeted for Malaria Elimination, Southern Zambia.

Southern Zambia is the focus of strategies to create malaria-free zones. Interventions being rolled out include test and treat strategies and distribution of insecticide-treated bed nets that target vectors that host-seek indoors and late at night. In Macha, Choma District, collections of mosquitoes were made outdoors using barrier screens within homesteads or UV bulb light traps set next to goats, cattle, or chickens during the rainy season of 2015. Anopheline mosquitoes were identified to species using molecular methods and Plasmodium falciparum infectivity was determined by ELISA and real-time qPCR methods. More than 40% of specimens caught were identified as Anopheles squamosus Theobald, 1901 of which six were found harboring malaria parasites. A single sample, morphologically identified as Anopheles coustani Laveran, 1900, was also found to be infectious. All seven specimens were caught outdoors next to goat pens. Parasite-positive specimens as well as a subset of An. squamosus specimens from either the same study or archive collections from the same area underwent sequencing of the mitochondrial cytochrome oxidase subunit I gene. Maximum parsimony trees constructed from the aligned sequences indicated presence of at least two clades of An. squamosus with infectious specimens falling in each clade. The single infectious specimen identified morphologically as An. coustani could not be matched to reference sequences. This is the first report from Zambia of infections in An. squamosus, a species which is described in literature to display exophagic traits. The bionomic characteristics of this species needs to be studied further to fully evaluate the implications for indoor-targeted vector control.

Spatial and temporal changes in household structure locations using high-resolution satellite imagery for population assessment: an analysis in southern Zambia, 2006-2011.

Satellite imagery is increasingly available at high spatial resolution and can be used for various purposes in public health research and programme implementation. Comparing a census generated from two satellite images of the same region in rural southern Zambia obtained four and a half years apart identified patterns of household locations and change over time. The length of time that a satellite image-based census is accurate determines its utility. Households were enumerated manually from satellite images obtained in 2006 and 2011 of the same area. Spatial statistics were used to describe clustering, cluster detection, and spatial variation in the location of households. A total of 3821 household locations were enumerated in 2006 and 4256 in 2011, a net change of 435 houses (11.4% increase). Comparison of the images indicated that 971 (25.4%) structures were added and 536 (14.0%) removed. Further analysis suggested similar household clustering in the two images and no substantial difference in concentration of households across the study area. Cluster detection analysis identified a small area where significantly more household structures were removed than expected; however, the amount of change was of limited practical significance. These findings suggest that random sampling of households for study participation would not induce geographic bias if based on a 4.5-year-old image in this region. Application of spatial statistical methods provides insights into the population distribution changes between two time periods and can be helpful in assessing the accuracy of satellite imagery.

POTENTIAL CONTRIBUTION OF ADULT POPULATIONS TO THE MAINTENANCE OF SCHISTOSOMIASIS AND SOIL-TRANSMITTED HELMINTH INFECTIONS IN THE SIAVONGA AND MAZABUKA DISTRICTS OF ZAMBIA.

A majority of Zambian children live in impoverished communities that lack safe water and proper sanitation, exposing them to urogenital and intestinal helminths. Efforts to mitigate this plight have been implemented through mass drug administration aimed at deworming school-age and under-five children against schistosomiasis and soil-transmitted helminths. However, the disease status of adults living in the same communities as the treated children remains unknown. The aim of this study was to describe the potential contribution of infected adult populations to the transmission of these infections in southern Zambia. A cross-sectional study was conducted in April and May 2013 as part of baseline survey for a larger study in Mazabuka and Siavonga Districts. Stool and urine samples of 2829 adults from five catchment areas were collected and processed using Kato-Katz and urine filtration methods, respectively. Adults from Siavonga had a 13.9% combined prevalence of Schistosoma haematobium and S. mansoni, and 12.1% combined prevalence of Ascaris lumbricoides and hookworm. There was no S. mansoni in Mazabuka, and only a 5.3% prevalence of S. haematobium and 7.4% combined prevalence of A. lumbricoides and hookworm. Additionally, no Trichuris trichiura infections were observed in the two districts. Despite most of these infections being categorized as light intensity, heavy infection intensities were also found for all four parasite species. If this infected adult population is left untreated, the possibility of it acting as a reservoir of infections and ultimately transmitting the infections to treated children remains. Therefore, there is need to consider alternative treatment strategies that incorporate adults, thereby reducing the risk of contaminating the environment and perpetuating transmission to children.

Postnatal care utilization and local understandings of contagion among HIV-infected and uninfected women in rural, southern Zambia

ABSTRACTPostnatal care is essential for ensuring the optimal health of newborns and necessary for the prevention of maternal-to-child human immunodeficiency virus (HIV) transmission as well as the early diagnosis and treatment of HIV-infected infants. However, coverage of postnatal care is low in many rural areas of sub-Saharan Africa. We examined women’s experiences of accessing formal postnatal care for their HIV-exposed newborns, comparing reports of HIV-infected and uninfected women in an HIV-endemic area of rural southern Zambia. We conducted 24 qualitative in-depth interviews with recently delivered women in a rural region of southern Zambia, including 8 with women who were willing to disclose their HIV infection status and answer additional questions. Data were transcribed, coded and analyzed using thematic analysis techniques. HIV-infected women identified more disincentives and reported more negative experiences accessing postnatal care than HIV-uninfected women. A local notion of contagion holds that healthy infants may become sick with chibele, a fatal, febrile illness, if exposed to another infant who is taking “strong medicine”, such as antiretroviral drugs. Thus, HIV-uninfected women expressed objections to sharing clinics with women and infants who were presumed to be under treatment. Additionally, women reported receiving better treatment from staff at HIV clinics compared to general pediatric clinics. Due to these tensions, HIV-infected women were less likely to visit a clinic for newborn care if the clinic or waiting area was a common space used by HIV-uninfected women and their children. When integrating programs for HIV with maternal and child health care, these nuanced tensions between groups of patients must be recognized and resolved.

Assessment of the Ni-Cu-PGE sulphide potential of magmatic intrusions surrounding the Munali Ni-sulphide deposit, Zambia

The Munali Ni deposit and mine, southern Zambia, is an example of an economic magmatic Ni-Cu-PGE sulphide breccia deposit. Deposits such as Munali are typically hosted by mafic-ultramafic intrusion...

The Pratt Pouch Provides a Three-Fold Access Increase to Antiretroviral Medication for Births outside Health Facilities in Southern Zambia.

Introduction:Modern day antiretroviral therapy allows HIV+ pregnant women to lower the likelihood of viral transmission to their infants before, during, and after birth from 20-45% to less than 5%. In developing countries, where non-facility births may outnumber facility births, infant access to safe antiretroviral medication during the critical first three days after birth is often limited. A single-dose, polyethylene pouch (“Pratt Pouch”) addresses this challenge by allowing the medication to be distributed to mothers during antenatal care.Methods:The Pratt Pouch was introduced as part of a one year clinical feasibility study in two districts in Southern Province, Zambia. Participating nurses, community health workers, and pharmacists were trained before implementation. Success in achieving improved antiretroviral medication access was assessed via pre intervention and post intervention survey responses by HIV+ mothers.Results:Access to medication for HIV-exposed infants born outside of a health facility increased from 35% (17/51) before the introduction of the pouch to 94% (15/16) after (p<0.05). A non-significant increase in homebirth rates from 33% (pre intervention cohort) to 50% (post intervention cohort) was observed (p>0.05). Results remained below the national average homebirth rate of 52%. Users reported minimal spillage and a high level of satisfaction with the Pratt Pouch.Conclusion:The Pratt Pouch enhances access to infant antiretroviral medication in a rural, non-facility birth setting. Wide scale implementation could have a substantial global impact on HIV transmission rates from mother to child.

Indigenous practices of environmental sustainability in the Tonga community of southern Zambia.

Culture plays a significant role in conserving the environment. The purpose of this study was to explore the measures that have been employed by the Tonga people of southern Zambia to sustain their local biophysical environment. The research focussed on investigating the strategies which they use to conserve the soil, water, animals, medicinal and fruit plants, and rangeland. A qualitative research design was used in the study. The data were collected through interviews with elderly Tonga people and herbalists, and through observation and personal participation in the daily life of the Tongas. The study reveals that selective harvesting, totemism and taboos, organic farming, crop rotation and intercropping, sacredness of water sources and traditional authority are the main instruments of environmental conservation amongst the Tonga. The article concludes that governments, policymakers and environmentalists need to give the conservation strategies employed by indigenous people the prominence they deserve for environmental sustainability.

Geology and potential hydrocarbon play system of Lower Karoo Group in the Maamba Coalfield Basin, southern Zambia

This study attempts to augment geology and potential hydrocarbon play system database not only in the Maamba Coalfield basin of southern Zambia but in other similar continental non-marine Karoo rift basins in the region as well. Geological analyses were conducted through extensive outcrops and exposures and subsurface boreholes. Six (6) major lithofacies (diamictites, conglomerates, sandstones, siltstones, coal and mudstones) represents Lower Karoo Group sequence. Four (4) mudstone core samples were prepared for thin section petrography. In addition, six (6) samples of sandstones obtained from outcrops, exposures and cores were impregnated with blue epoxy before thin sectioning in order to facilitate easy recognition of porosity. Quantification of framework grain composition and porosity was achieved by point counting a total of 300 points per thin section. The identification of diagenetic constituents and pore types was made possible by the use of scanning electron microscopy (SEM). Rock-Eval pyrolysis analyses utilised 35 core samples of mudstones and coal.According to results of the analyses, three (3) deposition settings which include; alluvial, fluvial-lacustrine and lacustrine setting are envisaged. . Fluvial-lacustrine deposits are host to mudstones and coal source rocks and sandstone reservoir rocks. Mudstones and coal source rocks gave the total organic carbon (TOC) that is well above the recommended thresholds of 0.5 wt % and 2.5 wt % of gas and oil generation respectively. The hydrogen index (HI) values are mostly below 200 mg HC/g TOC, indicating fair quantities of type III kerogen. The thermal maturity readings measured by temperature Tmax range from 440 to 485 °C in agreement with calculated vitrinite reflectance (Rocalc) range of 0.76–1.57% indicating mature to post mature stages. This maturation is attributed to the burial temperatures and near-surface heat flows by faults. Production Index (PI) values are less than 0.1 suggesting some hydrocarbon expulsion possibly gases and gas condensates. Sandstones are moderate to poor sorted sublitharenites. Total porosity in sandstones range between 0 and 6.3%, averaging 2.5%, and is mainly secondary porosity resulting from dissolution of labile minerals and fracture. Deposition and diagenetic related controls influenced much of the reservoir quality in sandstones. Lacustrine mudstones are the potential seal rocks. The major Structural traps are faults (e.g. normal and reverse faults) and the stratigraphic traps are sandstones.In this study, our area of focus is in the north and central part of Maamba Coalfield Basin where coal mining and exploration activities are currently taking place. The southernmost part of the basin is under developed such that the hydrocarbon play system potential is still unknown. However, recent coal exploration drilling has revealed the presence of source rocks at depth overlain by extensive overburden seal rocks. Based on the play concept analysis, it is possible to find more encouraging results from this area.

Livestock Husbandry and Smallholder Response to Shocks in Southern Zambia

This study aims to provide information on smallholder farmer access to livestock inputs and services and their husbandry practices in normal and shock years. A combination of qualitative techniques (community mapping with cards; scoring; etc) and a set of carefully designed semi-structured questionnaires were used to elicit information about the underlying livelihoods. The survey areas were purposively selected bearing in mind the geographical variations in levels of vulnerability and the intra-district variations in production potential and market access. Inter-household variations within each sampled community were taken care of by categorizing the households into three poverty groups (non-poor, poor and extremely poor) and implementing a sampling strategy that ensured adequate representation of each. The results suggest a strong need to improve not only public service delivery to the livestock sector but also to devise a multi-faceted system for enhancing productivity and market participation. This is especially critical during shock times.

Optimal Population-Level Infection Detection Strategies for Malaria Control and Elimination in a Spatial Model of Malaria Transmission.

Mass campaigns with antimalarial drugs are potentially a powerful tool for local elimination of malaria, yet current diagnostic technologies are insufficiently sensitive to identify all individuals who harbor infections. At the same time, overtreatment of uninfected individuals increases the risk of accelerating emergence of drug resistance and losing community acceptance. Local heterogeneity in transmission intensity may allow campaign strategies that respond to index cases to successfully target subpatent infections while simultaneously limiting overtreatment. While selective targeting of hotspots of transmission has been proposed as a strategy for malaria control, such targeting has not been tested in the context of malaria elimination. Using household locations, demographics, and prevalence data from a survey of four health facility catchment areas in southern Zambia and an agent-based model of malaria transmission and immunity acquisition, a transmission intensity was fit to each household based on neighborhood age-dependent malaria prevalence. A set of individual infection trajectories was constructed for every household in each catchment area, accounting for heterogeneous exposure and immunity. Various campaign strategies—mass drug administration, mass screen and treat, focal mass drug administration, snowball reactive case detection, pooled sampling, and a hypothetical serological diagnostic—were simulated and evaluated for performance at finding infections, minimizing overtreatment, reducing clinical case counts, and interrupting transmission. For malaria control, presumptive treatment leads to substantial overtreatment without additional morbidity reduction under all but the highest transmission conditions. Compared with untargeted approaches, selective targeting of hotspots with drug campaigns is an ineffective tool for elimination due to limited sensitivity of available field diagnostics. Serological diagnosis is potentially an effective tool for malaria elimination but requires higher coverage to achieve similar results to mass distribution of presumptive treatment.

Implementation and Operational Research: Integration of PMTCT and Antenatal Services Improves Combination Antiretroviral Therapy Uptake for HIV-Positive Pregnant Women in Southern Zambia: A Prototype for Option B+?

Early initiation of combination antiretroviral therapy (cART) for HIV-positive pregnant women can decrease vertical transmission to less than 5%. Programmatic barriers to early cART include decentralized care, disease-stage assessment delays, and loss to follow-up. Our intervention had 3 components: integrated HIV and antenatal services in 1 location with 1 provider, laboratory courier to expedite CD4 counts, and community-based follow-up of women-infant pairs to improve prevention of mother-to-child transmission attendance. Preintervention HIV-positive pregnant women were referred to HIV clinics for disease-stage assessment and cART initiation for advanced disease (CD4 count <350 cells/μL or WHO stage >2). We used a quasi-experimental design with preintervention/postintervention evaluations at 6 government antenatal clinics (ANCs) in Southern Province, Zambia. Retrospective clinical data were collected from clinic registers during a 7-month baseline period. Postintervention data were collected from all antiretroviral therapy-naive, HIV-positive pregnant women and their infants presenting to ANC from December 2011 to June 2013. Data from 510 baseline women-infant pairs were analyzed and 624 pregnant women were enrolled during the intervention period. The proportion of HIV-positive pregnant women receiving CD4 counts increased from 50.6% to 77.2% [relative risk (RR) = 1.81; 95% confidence interval (CI): 1.57 to 2.08; P < 0.01]. The proportion of cART-eligible pregnant women initiated on cART increased from 27.5% to 71.5% (RR = 2.25; 95% CI: 1.78 to 2.83; P < 0.01). The proportion of eligible HIV-exposed infants with documented 6-week HIV PCR test increased from 41.9% to 55.8% (RR = 1.33; 95% CI: 1.18 to 1.51; P < 0.01). Integration of HIV care into ANC and community-based support improved uptake of CD4 counts, proportion of cART-eligible women initiated on cART, and infants tested.

Integration of PMTCT and Antenatal Services Improves Combination Antiretroviral Therapy Uptake for HIV-Positive Pregnant Women in Southern Zambia: A Prototype for Option B+?

Background: Early initiation of combination anti-retroviral therapy (cART) for HIV-positive pregnant women can decrease vertical transmission to less than 5%. Programmatic barriers to early cART include decentralized care disease stage assessment delays and loss-to-follow-up. Intervention: Our intervention had 3 components: integrated HIV and antenatal services in one location with one provider; lab courier to expedite CD4 counts; and community-based follow-up of women-infant pairs to improve PMTCT attendance. Pre-intervention HIV-positive pregnant women were referred to HIV clinics for disease stage assessment and cART initiation for advanced disease (CD4 2). Methods: We employed a quasi-experimental design with pre / post-intervention evaluations at 6 government antenatal clinics (ANC) in Southern Province Zambia. Retrospective clinical data were collected from clinic registers during a 7-month baseline period. Post-intervention data were collected from all ART-naive HIV-positive pregnant women and their infants presenting to ANC from December 2011-June 2013. Results: Data from 510 baseline women-infant pairs were analyzed and 624 pregnant women were enrolled during the intervention period. Proportion of HIV-positive pregnant women receiving CD4 counts increased from 50.6% to 77.2% (RR=1.81 95% CI: 1.57-2.08; p<0.01). Proportion of cART-eligible pregnant women initiated on cART increased from 27.5% to 71.5% (RR=2.25 95% CI: 1.78-2.83; p<0.01). Proportion of eligible HIV-exposed infants with documented 6-week HIV PCR test increased from 41.9% to 55.8% (RR=1.33 95% CI: 1.18-1.51; p<0.01). Conclusion: Integration of HIV care into ANC and community-based support improved uptake of CD4 counts proportion of cART-eligible women initiated on cART and infants tested. Copyright © 2015 Wolters Kluwer Health Inc. Unauthorized reproduction of this article is prohibited.

A Cluster Randomised Trial on the Impact of Integrating Early Infant HIV Diagnosis with the Expanded Programme on Immunization on Immunization and HIV Testing Rates in Rural Health Facilities in Southern Zambia

BackgroundWe assessed the integration of early infant HIV diagnosis with the expanded programme for immunization in a rural Zambian setting with the aim of determining whether infant and postpartum maternal HIV testing rates would increase without harming immunization uptake.MethodsIn an unblinded, location stratified, cluster randomised controlled trial, 60 facilities in Zambia’s Southern Province were equally allocated to a control group, Simple Intervention group that received a sensitization meeting and the resupply of HIV testing commodities in the event of a stock-out, and a Comprehensive Intervention group that received the Simple Intervention as well as on-site operational support to facilitate the integration of HIV testing services with EPI.FindingsThe average change in number of first dose diphtheria, pertussis, and tetanus vaccine (DPT1) provided per month, per facility was approximately 0.86 doses higher [90% confidence interval (CI) -1.40, 3.12] in Comprehensive Intervention facilities compared to the combined average change in the Simple Intervention and control facilities. The interventions resulted in a 16.6% [90% CI: -7%, 46%, P-value = 0.26] and 10% [90% CI: -10%, 36%, P-value = 0.43] greater change in average monthly infant DBS testing compared to control for the Simple and Comprehensive facilities respectively. We also found 15.76 (90% CI: 7.12, 24.41, P-value < 0.01) and 10.93 (90% CI: 1.52, 20.33, P-value = 0.06) additional total maternal re-tests over baseline for the Simple and Comprehensive Facilities respectively.ConclusionsThis study provides strong evidence to support Zambia’s policy of integration of HIV testing and EPI services. Actions in line with the interventions, including HIV testing material supply reinforcement, can increase HIV testing rates without harming immunization uptake. In response, Zambia’s Ministry of Health issued a memo to remind health facilities to provide HIV testing at under-five clinics and to include under-five HIV testing as part of district performance assessments.Trial RegistrationClinicalTrials.gov Registration Number: NCT02479659

Molecular analysis of selected paramphistome isolates from cattle in southern Africa.

Paramphistomes are parasites of domestic and wild ruminants, the effects of which in animal health remain underestimated. Very few studies in Africa have been done using molecular techniques to resolve situations associated with taxonomical groupings and epidemiology of these parasites. In this study, the genetic variability of nine representative paramphistome isolates collected from southern African countries, namely Botswana, South Africa, Zambia and Zimbabwe, was assessed using both morphological and internal transcribed spacer 2 (ITS2) rDNA sequence data. Morphological characterization and identification were carried out using median sagittal sections of the paramphistomes. DNA of the individual paramphistomes was isolated, the ITS2 rDNA was amplified, purified and sequenced. The sequences were submitted to GenBank, which assigned them the following accession numbers: KP639631, KP639630, KP639632, KP639633, KP639634, KP639635, KP639636, KP639637 and KP639638. These sequences were used for phylogenetic analysis using MEGA 6. Morphological characterization revealed three species of paramphistomes belonging to three different sub-families: one Stephanopharynx compactus isolate, a member of the Stephanopharyngidae sub-family; one Carmyerius dollfusi isolate, a member of the Gastrothylacidae sub-family; and seven Calicophoron microbothrium isolates belonging to the Paramphistomidae sub-family. ITS2 sequence analysis using BlastN results indicated that this is the first report of S. compactus (KP639630) and C. dollfusi (KP639636). Phylogenetic reconstruction of the paramphistome isolates revealed three separate clades representing the three species. However, the clade with all the C. microbothrium isolates was the only one that was supported by a higher bootstrap value of 92%, although there was no differentiation of the isolates according to geographical locations. The low divergence values on the ITS2 sequences of the C. microbothrium isolates indicate that ITS rDNA sequences can be used as a molecular tool to infer knowledge for resolving taxonomic groupings.

Factors Associated with Sustained Use of Long-Lasting Insecticide-Treated Nets Following a Reduction in Malaria Transmission in Southern Zambia.

Understanding factors influencing sustained use of long-lasting insecticide-treated nets (LLIN) in areas of declining malaria transmission is critical to sustaining control and may facilitate elimination. From 2008 to 2013, 655 households in Choma District, Zambia, were randomly selected and residents were administered a questionnaire and malaria rapid diagnostic test. Mosquitoes were collected concurrently by light trap. In a multilevel model, children and adolescents of 5-17 years of age were 55% less likely to sleep under LLIN than adults (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.35, 0.58). LLIN use was 80% higher during the rainy season (OR = 1.8; CI = 1.5, 2.2) and residents of households with three or more nets were over twice as likely to use a LLIN (OR = 2.1; CI = 1.4, 3.1). For every increase in 0.5 km from the nearest health center, the odds of LLIN use decreased 9% (OR = 0.9; CI = 0.88, 0.98). In a second multilevel model, the odds of LLIN use were more than twice high if more than five mosquitoes (anopheline and culicine) were captured in the house compared with households with no mosquitoes captured (OR = 2.1; CI = 1.1, 3.9). LLIN use can be sustained in low-transmission settings with continued education and distributions, and may be partially driven by the presence of nuisance mosquitoes.

Skin, thermal and umbilical cord care practices for neonates in southern, rural Zambia: a qualitative study.

BackgroundIn Choma District, southern Zambia, the neonatal mortality rate is approximately 40 per 1000 live births and, although the rate is decreasing, many deliveries take place outside of formal facilities. Understanding local practices during the postnatal period is essential for optimizing newborn care programs.MethodsWe conducted 36 in-depth interviews, five focus groups and eight observational sessions with recently-delivered women, traditional birth attendants, and clinic and hospital staff from three sites, focusing on skin, thermal and cord care practices for newborns in the home.ResultsNewborns were generally kept warm by application of hats and layers of clothing. While thermal protection is provided for preterm and small newborns, the practice of nighttime bathing with cold water was common. The vernix was considered important for the preterm newborn but dangerous for HIV-exposed infants. Mothers applied various substances to the skin and umbilical cord, with special practices for preterm infants. Applied substances included petroleum jelly, commercial baby lotion, cooking oil and breastmilk. The most common substances applied to the umbilical cord were powders made of roots, burnt gourds or ash. To ward off malevolent spirits, similar powders were reportedly placed directly into dermal incisions, especially in ill children.ConclusionsThermal care for newborns is commonly practiced but co-exists with harmful practices. Locally appropriate behavior change interventions should aim to promote chlorhexidine in place of commonly-reported application of harmful substances to the skin and umbilical cord, reduce bathing of newborns at night, and address the immediate bathing of HIV-infected newborns.

Inferring the links between breeding and wintering grounds in a Palearctic– African migratory bird, the Great Reed Warbler, using mitochondrial DNA data

Understanding spatial connections between breeding and wintering populations is critical for developing sound conservation plans in migratory animals. However, for long-distance migratory songbird species wintering in sub-Saharan Africa, many of which are in a state of population decline, information on migratory connectivity is especially lacking. We used mitochondrial DNA data from wintering populations of the Great Reed Warbler (Acrocephalus arundinaceus) in western (Nigeria), southern (Botswana and Zambia) and eastern (Kenya) Africa, as well as from several Eurasian breeding populations, to compare genetic differentiation and haplotype sharing between non-breeding and breeding populations. We found that the population in Nigeria had the best genetic match to breeding populations in West and Central Europe. In contrast, Botswana matched with West, Central and East Europe, and Zambia with Central and East Europe and the Middle East. Finally, Kenya showed the most distinct connectivity pattern of the four analysed populations and matched with East Europe and, in particular, to the Middle East. Our results indicate clear but weak migratory connectivity in Great Reed Warblers, a pattern that should be considered in conservation strategies of Palearctic–African migratory passerines.

A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness.

BackgroundA mass test and treat campaign (MTAT) using rapid diagnostic tests (RDTs) and artemether-lumefantrine (AL) was conducted in Southern Zambia in 2012 and 2013 to reduce the parasite reservoir and progress towards malaria elimination. Through this intervention, community health workers (CHWs) tested all household members with rapid diagnostic tests (RDTs) and provided treatment to those that tested positive.MethodsA qualitative study was undertaken to understand CHW and community perceptions regarding the MTAT campaign. A total of eight focus groups and 33 in-depth and key informant interviews were conducted with CHWs, community members and health centre staff that participated in the MTAT.ResultsInterviews and focus groups with CHWs and community members revealed that increased knowledge of malaria prevention, the ability to reach people who live far from health centres, and the ability of the MTAT campaign to reduce the malaria burden were the greatest perceived benefits of the campaign. Conversely, the primary potential barriers to effectiveness included refusals to be tested, limited adherence to drug regimens, and inadequate commodity supply. Study respondents generally agreed that MTAT services were scalable outside of the study area but would require greater involvement from district and provincial medical staff.ConclusionsThese findings highlight the importance of increased community sensitization as part of mass treatment campaigns for improving campaign coverage and acceptance. Further, they suggest that communication channels between the Ministry of Health, National Malaria Control Centre and Medical Stores Limited may need to be improved so as to ensure there is consistent supply and management of commodities. Continued capacity building of CHWs and health facility supervisors is critical for a more effective programme and sustained progress towards malaria elimination.

Prevalence and species distribution of caprine trypanosomosis in Sinazongwe and Kalomo districts of Zambia

African animal trypanosomosis is one of the key livestock diseases hindering full exploitation of livestock production potential covering 37 countries across sub-Saharan Africa. Many studies have been carried out to investigate the prevalence of the disease in cattle and humans in many tropical African countries but very little attention has been directed towards generating the disease prevalence rates in goats. The current study was conducted between December 2013 and January 2014 to establish the prevalence of caprine trypanosomosis in Sinazongwe and Kalomo districts, southern Zambia. It involved 422 goats which were first examined by palpation for possible enlargement of superficial lymph nodes. Blood samples were then collected from the goats and subjected to laboratory diagnosis using the microscope and Loop Mediated Isothermal Amplification (LAMP). None of the examined goats displayed enlargement of superficial lymph nodes. On microscopy only one goat was found to be positive. The results of investigation using the LAMP method showed that 100 goats were infected with trypanosomes giving an overall prevalence rate of 23.7%. The prevalence of infection in Sinazongwe was 22.4% (n=183) while in Kalomo it was 24.7% (n=239); and the difference between the two districts was statistically significant at 95% CL (x2=4.4, df=1, p<0.05). Trypanosoma brucei, Trypanasoma vivax and Trypanasoma congolense were detected in 82.0%, 31.0% and 23.0% of the infected goats, respectively. Mixed infections were detected among 33.0% of the positive samples. The high prevalence rate of trypanosomes detected in the study area confirms the earlier reports that trypanosomosis is re-emerging in the areas previously aerial sprayed by Government. The detection of trypanosomes in naturally infected goats outlines the important role goats play in the epidemiology of African animal trypanosomosis.

The verification of seasonal precipitation forecasts for early warning in Zambia and Malawi

Abstract. We assess the probabilistic seasonal precipitation forecasts issued by Regional Climate Outlook Forum (RCOF) for the area of two southern African countries, Malawi and Zambia from 2002 to 2013. The forecasts, issued in August, are of rainy season rainfall accumulations in three categories (above normal, normal, and below normal), for early season (October–December) and late season (January–March). As observations we used in-situ observations and interpolated precipitation products from Global Precipitation Climatology Project (GPCP), Global Precipitation Climatology Centre (GPCC), and Climate Prediction Centre (CPC) Merged Analysis of Precipitation (CMAP). Differences between results from different data products are smaller than confidence intervals calculated by bootstrap. We focus on below normal forecasts as they were deemed to be the most important for society. The well-known decomposition of Brier score into three terms (Reliability, Resolution, and Uncertainty) shows that the forecasts are rather reliable or well-calibrated, but have a very low resolution; that is, they are not able to discriminate different events. The forecasts also lack sharpness as forecasts for one category are rarely higher than 40 % or less than 25 %. However, these results might be unnecessarily pessimistic, because seasonal forecasts have gone through much development during the period when the forecasts verified in this paper were issued, and forecasts using current methodology might have performed better.