Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care ...Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.展开更多
Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and ...Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.展开更多
Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affectin...Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.展开更多
Breast milk offers essential nutrients crucial for the development of the preterm immune system, thus reducing the incidence of infection and mortality often associated with prematurity. In the absence of breast milk,...Breast milk offers essential nutrients crucial for the development of the preterm immune system, thus reducing the incidence of infection and mortality often associated with prematurity. In the absence of breast milk, the preferred option is donated breast milk, the best alternative for hospitalized neonates whose mothers have insufficient breast milk or are unavailable. In Zambia, donor breast milk is unavailable. Instead, the protocol recommends the administration of formula milk. However, the use of formula milk in preterm babies is associated with an increased risk of necrotizing enterocolitis and sepsis. Zambia needs to establish a donor milk bank, hence the need to understand the perception of mothers towards donated breast milk. A qualitative descriptive case study utilized 10 focus group discussions with in-depth interviews, purposively selected using a variation strategy. Data was thematically analysed. Participants demonstrated potential acceptance to donor breast milk utilization, as more nutritional compared to formula despite lack of awareness. Concerns related to safety, quality, fear of disease transmission and discomfort feeding from a different bloodline were identified as hinderance to possible utilisation. These perceptions underscore the importance of educational initiatives aimed at dispelling myths and misconceptions surrounding donor breast milk and establishing donor breast milk programs. Therefore, the study recommends educational initiatives tailored to raise awareness to mothers about donor breast milk.展开更多
Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, mo...Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.展开更多
Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity ...Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.展开更多
<strong>Background</strong>: Mealie Meal is one of the by-products of maize from dry milling. It constitutes more significant part of the daily diet of growing population of the Lusaka District of Zambia. ...<strong>Background</strong>: Mealie Meal is one of the by-products of maize from dry milling. It constitutes more significant part of the daily diet of growing population of the Lusaka District of Zambia. However, reported cases of a cholera outbreak in October 2017-May 2018 were attributed to water contamination in the households of Lusaka. Hitherto there is no previous study or documented data for gastroenteritis caused by microbial contamination from food stores. <strong>Aim</strong>: The main objective of the study was to carry out species identification of Mealie meal spoilage organisms and pathogenic bacteria from selected food stores in Lusaka district from September 2019-March 2020. Crosssectional survey was conducted for food spoilage organisms and pathogenic bacteria of packaged maize meal flour from a selected food store. The number of packaged Mealie meal samples from selected food stores included in the study was 143 samples. Samples were obtained by a simple stratified random selection from food stores in Lusaka District. Thus Mealie Meal samples bought from Street food vendors were 96 (67%), Shops—30 (21%), Malls—17 (11.9%). Subsequently isolation by spread and pour plate methods, and species identification of microbial contamination by Cell Culture processes coupled to microbial morphological and biochemical characterization was performed. Microsoft Office Excel (version 2007) Spreadsheet was employed for the categorical data analysis and summarized graphical presentation of data. Laboratory findings revealed: Spoilage organisms—<em>Aspergillum</em> species, <em>Mucor</em> Species, <em>Candida</em> Species, <em>Clostridium</em> Species and <em>Bacillus</em> Species;Pathogenic Bacteria Species—<em>Clostridium perfringens</em>, <em>Staphylococcus aureus</em>, <em>Clostridium tetani</em>, <em>Bacillus</em>, <em>Escherichia coli</em>, <em>Pseudomonas aeruginosa</em> and <em>Yesinia pestis</em>. It can be established from the laboratory results earlier mentioned that the food poisoning outbreak could evolve from food stores in Lusaka district apart from water contamination.展开更多
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron...<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>展开更多
Introduction: Clinical supervision plays a significant role in the acquisition of psychomotor skills by student midwives during training leading to the provision of high quality midwifery care. However, the acquisitio...Introduction: Clinical supervision plays a significant role in the acquisition of psychomotor skills by student midwives during training leading to the provision of high quality midwifery care. However, the acquisition of the psychomotor skills required for successful practice and learning can only be acquired if student midwives are supported and guided by clinical supervisors in their learning environments. Main Objective: The main objective of the study was to determine factors influencing clinical supervision of Student Midwives in Lusaka Urban District. Methodology: A cross-sectional study design that employed both quantitative and qualitative methods was used. The study population comprised 124 Nurses and Midwives working in Lusaka urban District. Self-administered questionnaires were used to collect data from the Nurses and midwives and a focus group discussion guide was used to guide discussions with the student midwives at Lusaka College of Nursing and Midwifery and a total of three focus group discussions were conducted. Quantitative data were entered into by Statistical Package Social Sciences (SPSS) version 22 for windows. Chi-square test was used to test associations among variables. The confidence interval was set at 95% with a significance level of 0.05. Qualitative data were analysed using content analysis to classify words into themes and categories by looking for repeated ideas or patterns of thoughts. Results: The findings showed that a high percentage of the clinical supervisors (89.5%) had not been trained in clinical supervision and most respondents had moderate knowledge on clinical supervision of students. Majority of the respondents (63%) exhibited inadequate supervision skills. The attitudes of all the supervisors towards supervision were positive. A large percentage of respondents (73%) were competent in clinical supervision. However the learning environment considered to be poor by most respondents (61%). The study revealed a significant association between clinical supervision and the respondents’ knowledge on clinical supervision (p-value of 0.00). Conclusion: The current study showed that clinical supervision was untrained and had inadequate supervision skills and the learning environment was poor. There is need therefore to train clinical supervisors and improve the students’ learning environment in order to enhance teaching and learning. The study offers a valuable insight into the factors influencing students’ midwives learning in clinical learning environment.展开更多
Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregna...Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregnancy, labour and delivery. Although caesarean section is a life saving procedure, it is associated with a number of risks or problems in the postoperative period. The aim of the study was to understand the Midwives’ perspective on the care of postpartum mothers who had cesarean section at the University Teaching Hospital—Women and Newborn in Lusaka District. Methods: A descriptive cross sectional survey was conducted at the University Teaching Hospital—Women and Newborn in Lusaka. 51 Midwives working in postnatal wards were consecutively selected to participate in the study. Data was collected using a self administered questionnaire with a 4 point Likert scale and also some closed and open ended questions. SPSS version 20 statistical package was used to analyse data, expressed as descriptive summary measures. Results: All the 51 Midwives were female and they scored themselves highly on a 4 point Likert scale as always performing all the immediate post-operative care on the postpartum mothers who had a caesarean section while the score was much lower during the subsequent post-operative period. Staffing levels and medical-surgical materials were found to be low and affect care of Postpartum mothers (P-0.050). The majority (94.2%) of the Midwives also indicated that C-section mothers were not given any form of written materials or standardized instructions to take home as reference material during the Information, Education Communication sessions on discharge (P-0.001) and home/domiciliary visits to postpartum mothers who had C-sections on postpartum were not being undertaken. Conclusion: There was need to improve the care rendered to the postpartum women who had complicated labour and delivery including caesarean sections in order to promote good health and to prevent postpartum complications.展开更多
Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely ...Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of radiation machines. Furthermore, there is a need to develop guidelines for follow-up in case of any disease outbreak to avoid interference with patients’ treatment schedules and appointments for reviews.展开更多
Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and ...Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and 55%. Commonly encountered psychological issues include and are not limited to fear, anxiety, and emotional distress. Many sources of emotional distress in patients with cancer during the COVID-19 pandemic have been reported to include poorly controlled symptoms arising from a lack of access to symptom control services and treatment. Social distress is associated with social isolation, separation from family and loss of employment. Cancer patients and society have been reported to experience anxiety, despair, and stress due to the COVID-19 restrictions on community movement and hospital appointment rescheduling. The objective of this study was to explore psychosocial distress and social burdens experienced by cancer patients during the COVID-19 pandemic. Methods: A descriptive phenomenological design was employed to describe “lived experiences of patients with Cancer” during the COVID-19 Pandemic. A total of 20 participants with Cancer and COVID-19 positive were purposefully selected and interviewed. Thematic analysis was utilized for data analysis by the use of themes generated from participants’ responses. Findings: Five major themes emerged: fear, self-isolation compliance, anxiety, low income and emotional distress. The findings of the study indicated that participants experienced fear, emotional distress and anxiety when diagnosed with COVID-19. Conclusion: The experiences of psychosocial distress and social burdens were a result of a lack of psychosocial support by both caregivers and health care workers. This study recommends appropriate health education concerning psychosocial support for cancer patients and the need to have appropriate clinical protocols and materials in allaying anxiety and fear in cancer patients during the COVID-19 pandemic.展开更多
Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sou...Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sought to establish the prevalence and social demographic factors associated with Secondary Traumatic Stress, Burnout and Compassion Satisfaction among Nurses working at selected Teaching Hospitals in Lusaka, Zambia. Methods: A correlational design employing a self-administered questionnaire adapted from version five of the Professional Quality of Life scale was used to collect data from 250 nurses drawn using proportional stratified sampling method. The resulting data were analyzed using version 23 of the Statistical Package for Social Sciences (SPSS). Hierarchical multiple linear regression analysis was used to identify predictors of Secondary Traumatic Stress and Burnout. Findings: Whilst the majority of respondents reported average levels of Secondary Traumatic Stress and Burnout, about a quarter reported high Secondary Traumatic Stress and Burnout scores at 23% and 26% respectively. Only 81 (32.4%) scored high on Compassion Satisfaction. Social demographic factors including;working in the main Intensive Care Unit, and being married accounted for the greatest variance in Secondary Traumatic Stress (R<sup>2</sup> = 0.237, p Conclusion: Findings of the current study signify a need to institute measures to help nurses cope with the deleterious psychological effects of constant engagement with those in distress and to foster Compassion Satisfaction.展开更多
Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “...Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.展开更多
Introduction: To achieve viral suppression and reduce vertical transmission of HIV, more than eighty percent of pregnant or breastfeeding women in Zambia have been started on combined ART using the Test and Treat mode...Introduction: To achieve viral suppression and reduce vertical transmission of HIV, more than eighty percent of pregnant or breastfeeding women in Zambia have been started on combined ART using the Test and Treat model. However, Chawama First Level Hospital in Lusaka had records which showed that 32 percent of pregnant or breastfeeding women were non-adherent to combined anti-retroviral therapy (cART). Method: A mixed-method study was conducted to establish predictors of non-adherence to cART by women in the Test and Treat model of care. For the quantitative component, 92 consenting Pregnant and breastfeeding women were randomly drawn from ART defaulter register and a semi-structured questionnaire was administered. Multiple logistic regression was conducted to improve predictive power and control for confounders. Quantitative Results: The mean age was 28years. The study established that housewives were 84 percent less likely to be non-adherent [AOR 0.16;95% CI 0.12, 0.36] compared to women who were formally employed with a statistically significant P-value of 0.04. Pregnant or breastfeeding women who were several months away from home were 84.9 percent more likely to be non-adherent [AOR 15.11;95% CI 13.9, 16.4] compared to women who had travelled away from home for several days. The associated P-value was 0.03. The study also established that pregnant and breastfeeding women who were counselled in individually enclosed units were 91 percent less likely to be non-adherent compared to those who were counselled in an open space as a group [AOR 0.09;95% CI 0.02, 0.53] with an associated P-value of 0.01. Conclusion: The study established that predictors of non-adherence to cART among pregnant and breastfeeding women were: being a working-class client;being away from home or usual clinic for several months;being counselled in open spaces, and negative staff attitude. Therefore, researcher can conclusively say that predictors of non-adherence to cART can be solved by training and re-training of health workers in Patient-Centred Care Model for effective patient engagement. Women should be counselled in private rooms. Furthermore, an improvement in patient’s tracking system by the use of smart-care-cards for pregnant and breastfeeding women countrywide can reduce patient’s non-adherence to cART.展开更多
Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide h...Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.展开更多
Background: Vaginal stenosis is an important adverse effect of brachytherapy for cervicalcancer. This study aimed to determine attitudes and practices contributing to vaginal stenosis following brachytherapy at the Ca...Background: Vaginal stenosis is an important adverse effect of brachytherapy for cervicalcancer. This study aimed to determine attitudes and practices contributing to vaginal stenosis following brachytherapy at the Cancer Diseases Hospital in Lusaka—Zambia. Methods: An analytical cross-sectional study design was employed, where 163 respondents were randomly selected after meeting inclusion criteria. A researcher-administered questionnaire was used to collect data and SPSS version 25 was used for data analysis. Results: Out of the 163 women enrolled in this study, 42.3% had developed vaginal stenosis while 57.7% did not with age range 15 - 60+ years. 76% exhibited good practices to measures against vaginal stenosis while majority (93.9%) of the respondents demonstrated poor attitudes towards measures to prevent the condition. Women with poor practices versus good practices (OR = 1.07, CI = 0.52 - 2.21, p = 0.855), poor attitudes versus good attitudes (aOR = 1.28, CI = 0.29 - 5.71, p = 0.746) and those employed versus unemployed (aOR = 1.76, CI = 0.73 - 4.27, p = 0.210) had increased odds of vaginal stenosis. However, these increasing effects were not significant at 5% level of significance. Although length of brachytherapy showed no significant effect independently, the odds of having vaginal stenosis were over 2 times higher for women who had been on brachytherapy between 6 and 12 months compared to those on brachytherapy for less than 6 months (OR = 2.45, CI = 1.03 - 5.82, p = 0.042). Conclusions: Failure to practice recommended measures and poor attitudes towards therapy contributes to vaginal stenosis. Efforts should be channeled towards overcoming religious, traditional, cultural and personal impediments contributing to vaginal stenosis in women with cervical cancer receiving brachytherapy.展开更多
Background: Pharmacovigilance of biological medicines is crucial because it ensures that medicines meet the World Health Organization (WHO) standards. In Zambia, there is little information on healthcare professionals...Background: Pharmacovigilance of biological medicines is crucial because it ensures that medicines meet the World Health Organization (WHO) standards. In Zambia, there is little information on healthcare professionals’ familiarity, knowledge and practices on the pharmacovigilance of biological and biosimilar medicines. Therefore, this study investigated the familiarity, knowledge, and practices related to the pharmacovigilance (PV) of biological and biosimilar medicines at selected hospitals in Lusaka, Zambia. Methods: The study was an analytical questionnaire-based cross-sectional study conducted among healthcare professionals (HCPs) at the Adult hospital, Cancer Diseases hospital, Paediatrics hospital and Women and New Born Hospital in Lusaka. Data were collected over four weeks in May and June 2021 and subsequently analysed using IBM SPSS version 21. The statistical significance was set at a 95% confidence interval. Results: Of 245 participants, only 115 (48.9%) of the HCPs were familiar with biological medicines to a basic understanding. Regarding the term biosimilars, most of the HCPs (40.9%) never heard of this word. The mean score for knowledge regarding the PV considerations of biological medicines was 4.1 out of 8 questions. Most HCPs used non-proprietary names (44.2%) when prescribing, dispensing, or administering biological medicines. Additionally, more than half (57.3%) of HCPs did not record batch numbers when dispensing or administering biological medicines. Conclusion: Healthcare professionals were more familiar with the term biological medicines than biosimilars. Healthcare professionals generally scored poorly when their knowledge regarding the PV considerations of biological medicines was assessed. Thus, there is a need to provide adequate training and continuous professional development among healthcare professionals on the pharmacovigilance of biological and biosimilar medicines.展开更多
Background: Each year around 1.5 million women living with Human immuno deficiency Virus (HIV) become pregnant, and without antiretroviral drugs there is a chance that their child will become infected. Following the i...Background: Each year around 1.5 million women living with Human immuno deficiency Virus (HIV) become pregnant, and without antiretroviral drugs there is a chance that their child will become infected. Following the introduction of Routine Human immuno deficiency Virus testing policy in Zambia, the Human immuno deficiency Virus test is offered to all pregnant women unless they decline. However, more pregnant women are declining to be tested. Objective: The main objective of this study was to investigate factors that influence acceptability of routine HIV testing by pregnant women in Lusaka district urban clinics. Materials and Methods: A cross sectional study using a quantitative approach was conducted in Lusaka District clinics. The sample size was 366 ante natal pregnant women who were selected by simple random sampling, selected from three (3) selected research setting. The study population included pregnant women aged 15 to 49 years, coming for ante natal visit for the first time, before being tested for HIV, were eligible and agreed to participate in the study. A pretested semi structured interview schedule was used to collect data. Data were entered and analysed with Statistical Package for Social Sciences (SPSS) version 20 program. Chi-square was used to test for significant associations and Binary Logistic regression modelling was carried out to predict the outcome. A 5% level of significance (p value) 0.05 confidence interval was set. Results: Study findings revealed that majority 85.6% (317) of respondents indicated willingness to undergo routine HIV testing in pregnancy though 77.3% perceived it a compulsory test. Binary logistic regression revealed that maternal age, educational level and information education and communication (IEC) contributed significantly to the model. The odds revealed that acceptability of routine HIV testing by older pregnant women (37 - 49 years) were 8 times (OR = 7.67, p = 0.003) higher than the younger ones. The odds of acceptability by respondents with tertiary education were 141 times (OR-141.23, p-0.0001), likely to accept HIV testing than those with primary or no education. And the odds also revealed that acceptability by women who cited adequate IEC (OR-2.6, p-0.024) were 3 times higher than those who cited inadequate IEC. Conclusion: The study showed that majority of the pregnant women was willing to undergo Routine HIV testing however a percentage regarded the test as a mandatory test without any choice of denial. Therefore there is need to address some factors that are likely to affect the routine HIV testing and impede the success of implementation of the PMTCT programme in the country which goes beyond testing for HIV alone. Recommendations: Ministry of Health needs to provide health education messages in different tribes. MOH should also intensify male involvement in HIV Testing and Counselling. LDHO should consider training more community health care givers as Voluntary Counselling and Testing providers. The District should organize regular refresher courses and presentations on Routine HIV testing to health workers and Ministry of Health should consider conducting a country wide study.展开更多
<strong>Background: </strong>Management of stroke patients requires a multidisciplinary approach. Literature presents unequivocal evidence of improved outcomes when patients are treated in a stroke unit by...<strong>Background: </strong>Management of stroke patients requires a multidisciplinary approach. Literature presents unequivocal evidence of improved outcomes when patients are treated in a stroke unit by multi-disciplinary teams made up of medical doctors, nurses, physiotherapists and occupational therapists. Among the multidisciplinary team members, physiotherapists and nurses are the largest professional workforce working with both stroke patients and survivors. This study, therefore, aims at investigating the role of nurses and physiotherapists in the management of stroke patients at the Adult University Teaching Hospital. <strong>Methodology:</strong> This study shall utilize a convergent parallel mixed method design where both quantitative and qualitative data will be collected at the same time resulting in two data sets which will eventually be merged at the point of discussion. The quantitative component shall utilize an analytical cross-sectional approach while the qualitative component shall use a qualitative case study approach. The study will be conducted at the Adult University Teaching Hospital in Lusaka. Data will be collected from all the 287 nurses and 37 physiotherapists working in the Emergency Department, Medical Wards, Adult Intensive Care Unit and the Department of Physiotherapy. Quantitative data will be analyzed using Statistical Package for social sciences. Descriptive statistics shall be computed on the role of nurses and physiotherapists in stroke care. In addition, chi-square and fisher’s exact tests will be used in the test for associations between variables while binary logistic regression will be used in identifying predictors of the various roles played by nurses and physiotherapists in the management of stroke patients. Qualitative data will be analyzed using thematic analysis in order to generate new concepts and a substantive model of care for stroke patients. <strong>Conclusion: </strong>Despite research evidence of improved outcomes when stroke patients are managed by a multi-disciplinary team, data on the role of different members of the multidisciplinary care team in stroke management is almost non-existent from the Zambia context. It is therefore hoped that information obtained from this study will be used as a basis for recommending the streamlined role of the nurse and physiotherapist in both acute care and rehabilitation.展开更多
文摘Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.
文摘Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.
文摘Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.
文摘Breast milk offers essential nutrients crucial for the development of the preterm immune system, thus reducing the incidence of infection and mortality often associated with prematurity. In the absence of breast milk, the preferred option is donated breast milk, the best alternative for hospitalized neonates whose mothers have insufficient breast milk or are unavailable. In Zambia, donor breast milk is unavailable. Instead, the protocol recommends the administration of formula milk. However, the use of formula milk in preterm babies is associated with an increased risk of necrotizing enterocolitis and sepsis. Zambia needs to establish a donor milk bank, hence the need to understand the perception of mothers towards donated breast milk. A qualitative descriptive case study utilized 10 focus group discussions with in-depth interviews, purposively selected using a variation strategy. Data was thematically analysed. Participants demonstrated potential acceptance to donor breast milk utilization, as more nutritional compared to formula despite lack of awareness. Concerns related to safety, quality, fear of disease transmission and discomfort feeding from a different bloodline were identified as hinderance to possible utilisation. These perceptions underscore the importance of educational initiatives aimed at dispelling myths and misconceptions surrounding donor breast milk and establishing donor breast milk programs. Therefore, the study recommends educational initiatives tailored to raise awareness to mothers about donor breast milk.
文摘Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.
文摘Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.
文摘<strong>Background</strong>: Mealie Meal is one of the by-products of maize from dry milling. It constitutes more significant part of the daily diet of growing population of the Lusaka District of Zambia. However, reported cases of a cholera outbreak in October 2017-May 2018 were attributed to water contamination in the households of Lusaka. Hitherto there is no previous study or documented data for gastroenteritis caused by microbial contamination from food stores. <strong>Aim</strong>: The main objective of the study was to carry out species identification of Mealie meal spoilage organisms and pathogenic bacteria from selected food stores in Lusaka district from September 2019-March 2020. Crosssectional survey was conducted for food spoilage organisms and pathogenic bacteria of packaged maize meal flour from a selected food store. The number of packaged Mealie meal samples from selected food stores included in the study was 143 samples. Samples were obtained by a simple stratified random selection from food stores in Lusaka District. Thus Mealie Meal samples bought from Street food vendors were 96 (67%), Shops—30 (21%), Malls—17 (11.9%). Subsequently isolation by spread and pour plate methods, and species identification of microbial contamination by Cell Culture processes coupled to microbial morphological and biochemical characterization was performed. Microsoft Office Excel (version 2007) Spreadsheet was employed for the categorical data analysis and summarized graphical presentation of data. Laboratory findings revealed: Spoilage organisms—<em>Aspergillum</em> species, <em>Mucor</em> Species, <em>Candida</em> Species, <em>Clostridium</em> Species and <em>Bacillus</em> Species;Pathogenic Bacteria Species—<em>Clostridium perfringens</em>, <em>Staphylococcus aureus</em>, <em>Clostridium tetani</em>, <em>Bacillus</em>, <em>Escherichia coli</em>, <em>Pseudomonas aeruginosa</em> and <em>Yesinia pestis</em>. It can be established from the laboratory results earlier mentioned that the food poisoning outbreak could evolve from food stores in Lusaka district apart from water contamination.
文摘<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>
文摘Introduction: Clinical supervision plays a significant role in the acquisition of psychomotor skills by student midwives during training leading to the provision of high quality midwifery care. However, the acquisition of the psychomotor skills required for successful practice and learning can only be acquired if student midwives are supported and guided by clinical supervisors in their learning environments. Main Objective: The main objective of the study was to determine factors influencing clinical supervision of Student Midwives in Lusaka Urban District. Methodology: A cross-sectional study design that employed both quantitative and qualitative methods was used. The study population comprised 124 Nurses and Midwives working in Lusaka urban District. Self-administered questionnaires were used to collect data from the Nurses and midwives and a focus group discussion guide was used to guide discussions with the student midwives at Lusaka College of Nursing and Midwifery and a total of three focus group discussions were conducted. Quantitative data were entered into by Statistical Package Social Sciences (SPSS) version 22 for windows. Chi-square test was used to test associations among variables. The confidence interval was set at 95% with a significance level of 0.05. Qualitative data were analysed using content analysis to classify words into themes and categories by looking for repeated ideas or patterns of thoughts. Results: The findings showed that a high percentage of the clinical supervisors (89.5%) had not been trained in clinical supervision and most respondents had moderate knowledge on clinical supervision of students. Majority of the respondents (63%) exhibited inadequate supervision skills. The attitudes of all the supervisors towards supervision were positive. A large percentage of respondents (73%) were competent in clinical supervision. However the learning environment considered to be poor by most respondents (61%). The study revealed a significant association between clinical supervision and the respondents’ knowledge on clinical supervision (p-value of 0.00). Conclusion: The current study showed that clinical supervision was untrained and had inadequate supervision skills and the learning environment was poor. There is need therefore to train clinical supervisors and improve the students’ learning environment in order to enhance teaching and learning. The study offers a valuable insight into the factors influencing students’ midwives learning in clinical learning environment.
文摘Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregnancy, labour and delivery. Although caesarean section is a life saving procedure, it is associated with a number of risks or problems in the postoperative period. The aim of the study was to understand the Midwives’ perspective on the care of postpartum mothers who had cesarean section at the University Teaching Hospital—Women and Newborn in Lusaka District. Methods: A descriptive cross sectional survey was conducted at the University Teaching Hospital—Women and Newborn in Lusaka. 51 Midwives working in postnatal wards were consecutively selected to participate in the study. Data was collected using a self administered questionnaire with a 4 point Likert scale and also some closed and open ended questions. SPSS version 20 statistical package was used to analyse data, expressed as descriptive summary measures. Results: All the 51 Midwives were female and they scored themselves highly on a 4 point Likert scale as always performing all the immediate post-operative care on the postpartum mothers who had a caesarean section while the score was much lower during the subsequent post-operative period. Staffing levels and medical-surgical materials were found to be low and affect care of Postpartum mothers (P-0.050). The majority (94.2%) of the Midwives also indicated that C-section mothers were not given any form of written materials or standardized instructions to take home as reference material during the Information, Education Communication sessions on discharge (P-0.001) and home/domiciliary visits to postpartum mothers who had C-sections on postpartum were not being undertaken. Conclusion: There was need to improve the care rendered to the postpartum women who had complicated labour and delivery including caesarean sections in order to promote good health and to prevent postpartum complications.
文摘Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of radiation machines. Furthermore, there is a need to develop guidelines for follow-up in case of any disease outbreak to avoid interference with patients’ treatment schedules and appointments for reviews.
文摘Background: Cancer diagnosis has been reported in some studies to have a significant psychosocial impact on both the patients and their caregivers. The estimated prevalence of psychosocial distress is between 35% and 55%. Commonly encountered psychological issues include and are not limited to fear, anxiety, and emotional distress. Many sources of emotional distress in patients with cancer during the COVID-19 pandemic have been reported to include poorly controlled symptoms arising from a lack of access to symptom control services and treatment. Social distress is associated with social isolation, separation from family and loss of employment. Cancer patients and society have been reported to experience anxiety, despair, and stress due to the COVID-19 restrictions on community movement and hospital appointment rescheduling. The objective of this study was to explore psychosocial distress and social burdens experienced by cancer patients during the COVID-19 pandemic. Methods: A descriptive phenomenological design was employed to describe “lived experiences of patients with Cancer” during the COVID-19 Pandemic. A total of 20 participants with Cancer and COVID-19 positive were purposefully selected and interviewed. Thematic analysis was utilized for data analysis by the use of themes generated from participants’ responses. Findings: Five major themes emerged: fear, self-isolation compliance, anxiety, low income and emotional distress. The findings of the study indicated that participants experienced fear, emotional distress and anxiety when diagnosed with COVID-19. Conclusion: The experiences of psychosocial distress and social burdens were a result of a lack of psychosocial support by both caregivers and health care workers. This study recommends appropriate health education concerning psychosocial support for cancer patients and the need to have appropriate clinical protocols and materials in allaying anxiety and fear in cancer patients during the COVID-19 pandemic.
文摘Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sought to establish the prevalence and social demographic factors associated with Secondary Traumatic Stress, Burnout and Compassion Satisfaction among Nurses working at selected Teaching Hospitals in Lusaka, Zambia. Methods: A correlational design employing a self-administered questionnaire adapted from version five of the Professional Quality of Life scale was used to collect data from 250 nurses drawn using proportional stratified sampling method. The resulting data were analyzed using version 23 of the Statistical Package for Social Sciences (SPSS). Hierarchical multiple linear regression analysis was used to identify predictors of Secondary Traumatic Stress and Burnout. Findings: Whilst the majority of respondents reported average levels of Secondary Traumatic Stress and Burnout, about a quarter reported high Secondary Traumatic Stress and Burnout scores at 23% and 26% respectively. Only 81 (32.4%) scored high on Compassion Satisfaction. Social demographic factors including;working in the main Intensive Care Unit, and being married accounted for the greatest variance in Secondary Traumatic Stress (R<sup>2</sup> = 0.237, p Conclusion: Findings of the current study signify a need to institute measures to help nurses cope with the deleterious psychological effects of constant engagement with those in distress and to foster Compassion Satisfaction.
文摘Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.
文摘Introduction: To achieve viral suppression and reduce vertical transmission of HIV, more than eighty percent of pregnant or breastfeeding women in Zambia have been started on combined ART using the Test and Treat model. However, Chawama First Level Hospital in Lusaka had records which showed that 32 percent of pregnant or breastfeeding women were non-adherent to combined anti-retroviral therapy (cART). Method: A mixed-method study was conducted to establish predictors of non-adherence to cART by women in the Test and Treat model of care. For the quantitative component, 92 consenting Pregnant and breastfeeding women were randomly drawn from ART defaulter register and a semi-structured questionnaire was administered. Multiple logistic regression was conducted to improve predictive power and control for confounders. Quantitative Results: The mean age was 28years. The study established that housewives were 84 percent less likely to be non-adherent [AOR 0.16;95% CI 0.12, 0.36] compared to women who were formally employed with a statistically significant P-value of 0.04. Pregnant or breastfeeding women who were several months away from home were 84.9 percent more likely to be non-adherent [AOR 15.11;95% CI 13.9, 16.4] compared to women who had travelled away from home for several days. The associated P-value was 0.03. The study also established that pregnant and breastfeeding women who were counselled in individually enclosed units were 91 percent less likely to be non-adherent compared to those who were counselled in an open space as a group [AOR 0.09;95% CI 0.02, 0.53] with an associated P-value of 0.01. Conclusion: The study established that predictors of non-adherence to cART among pregnant and breastfeeding women were: being a working-class client;being away from home or usual clinic for several months;being counselled in open spaces, and negative staff attitude. Therefore, researcher can conclusively say that predictors of non-adherence to cART can be solved by training and re-training of health workers in Patient-Centred Care Model for effective patient engagement. Women should be counselled in private rooms. Furthermore, an improvement in patient’s tracking system by the use of smart-care-cards for pregnant and breastfeeding women countrywide can reduce patient’s non-adherence to cART.
文摘Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.
文摘Background: Vaginal stenosis is an important adverse effect of brachytherapy for cervicalcancer. This study aimed to determine attitudes and practices contributing to vaginal stenosis following brachytherapy at the Cancer Diseases Hospital in Lusaka—Zambia. Methods: An analytical cross-sectional study design was employed, where 163 respondents were randomly selected after meeting inclusion criteria. A researcher-administered questionnaire was used to collect data and SPSS version 25 was used for data analysis. Results: Out of the 163 women enrolled in this study, 42.3% had developed vaginal stenosis while 57.7% did not with age range 15 - 60+ years. 76% exhibited good practices to measures against vaginal stenosis while majority (93.9%) of the respondents demonstrated poor attitudes towards measures to prevent the condition. Women with poor practices versus good practices (OR = 1.07, CI = 0.52 - 2.21, p = 0.855), poor attitudes versus good attitudes (aOR = 1.28, CI = 0.29 - 5.71, p = 0.746) and those employed versus unemployed (aOR = 1.76, CI = 0.73 - 4.27, p = 0.210) had increased odds of vaginal stenosis. However, these increasing effects were not significant at 5% level of significance. Although length of brachytherapy showed no significant effect independently, the odds of having vaginal stenosis were over 2 times higher for women who had been on brachytherapy between 6 and 12 months compared to those on brachytherapy for less than 6 months (OR = 2.45, CI = 1.03 - 5.82, p = 0.042). Conclusions: Failure to practice recommended measures and poor attitudes towards therapy contributes to vaginal stenosis. Efforts should be channeled towards overcoming religious, traditional, cultural and personal impediments contributing to vaginal stenosis in women with cervical cancer receiving brachytherapy.
文摘Background: Pharmacovigilance of biological medicines is crucial because it ensures that medicines meet the World Health Organization (WHO) standards. In Zambia, there is little information on healthcare professionals’ familiarity, knowledge and practices on the pharmacovigilance of biological and biosimilar medicines. Therefore, this study investigated the familiarity, knowledge, and practices related to the pharmacovigilance (PV) of biological and biosimilar medicines at selected hospitals in Lusaka, Zambia. Methods: The study was an analytical questionnaire-based cross-sectional study conducted among healthcare professionals (HCPs) at the Adult hospital, Cancer Diseases hospital, Paediatrics hospital and Women and New Born Hospital in Lusaka. Data were collected over four weeks in May and June 2021 and subsequently analysed using IBM SPSS version 21. The statistical significance was set at a 95% confidence interval. Results: Of 245 participants, only 115 (48.9%) of the HCPs were familiar with biological medicines to a basic understanding. Regarding the term biosimilars, most of the HCPs (40.9%) never heard of this word. The mean score for knowledge regarding the PV considerations of biological medicines was 4.1 out of 8 questions. Most HCPs used non-proprietary names (44.2%) when prescribing, dispensing, or administering biological medicines. Additionally, more than half (57.3%) of HCPs did not record batch numbers when dispensing or administering biological medicines. Conclusion: Healthcare professionals were more familiar with the term biological medicines than biosimilars. Healthcare professionals generally scored poorly when their knowledge regarding the PV considerations of biological medicines was assessed. Thus, there is a need to provide adequate training and continuous professional development among healthcare professionals on the pharmacovigilance of biological and biosimilar medicines.
文摘Background: Each year around 1.5 million women living with Human immuno deficiency Virus (HIV) become pregnant, and without antiretroviral drugs there is a chance that their child will become infected. Following the introduction of Routine Human immuno deficiency Virus testing policy in Zambia, the Human immuno deficiency Virus test is offered to all pregnant women unless they decline. However, more pregnant women are declining to be tested. Objective: The main objective of this study was to investigate factors that influence acceptability of routine HIV testing by pregnant women in Lusaka district urban clinics. Materials and Methods: A cross sectional study using a quantitative approach was conducted in Lusaka District clinics. The sample size was 366 ante natal pregnant women who were selected by simple random sampling, selected from three (3) selected research setting. The study population included pregnant women aged 15 to 49 years, coming for ante natal visit for the first time, before being tested for HIV, were eligible and agreed to participate in the study. A pretested semi structured interview schedule was used to collect data. Data were entered and analysed with Statistical Package for Social Sciences (SPSS) version 20 program. Chi-square was used to test for significant associations and Binary Logistic regression modelling was carried out to predict the outcome. A 5% level of significance (p value) 0.05 confidence interval was set. Results: Study findings revealed that majority 85.6% (317) of respondents indicated willingness to undergo routine HIV testing in pregnancy though 77.3% perceived it a compulsory test. Binary logistic regression revealed that maternal age, educational level and information education and communication (IEC) contributed significantly to the model. The odds revealed that acceptability of routine HIV testing by older pregnant women (37 - 49 years) were 8 times (OR = 7.67, p = 0.003) higher than the younger ones. The odds of acceptability by respondents with tertiary education were 141 times (OR-141.23, p-0.0001), likely to accept HIV testing than those with primary or no education. And the odds also revealed that acceptability by women who cited adequate IEC (OR-2.6, p-0.024) were 3 times higher than those who cited inadequate IEC. Conclusion: The study showed that majority of the pregnant women was willing to undergo Routine HIV testing however a percentage regarded the test as a mandatory test without any choice of denial. Therefore there is need to address some factors that are likely to affect the routine HIV testing and impede the success of implementation of the PMTCT programme in the country which goes beyond testing for HIV alone. Recommendations: Ministry of Health needs to provide health education messages in different tribes. MOH should also intensify male involvement in HIV Testing and Counselling. LDHO should consider training more community health care givers as Voluntary Counselling and Testing providers. The District should organize regular refresher courses and presentations on Routine HIV testing to health workers and Ministry of Health should consider conducting a country wide study.
文摘<strong>Background: </strong>Management of stroke patients requires a multidisciplinary approach. Literature presents unequivocal evidence of improved outcomes when patients are treated in a stroke unit by multi-disciplinary teams made up of medical doctors, nurses, physiotherapists and occupational therapists. Among the multidisciplinary team members, physiotherapists and nurses are the largest professional workforce working with both stroke patients and survivors. This study, therefore, aims at investigating the role of nurses and physiotherapists in the management of stroke patients at the Adult University Teaching Hospital. <strong>Methodology:</strong> This study shall utilize a convergent parallel mixed method design where both quantitative and qualitative data will be collected at the same time resulting in two data sets which will eventually be merged at the point of discussion. The quantitative component shall utilize an analytical cross-sectional approach while the qualitative component shall use a qualitative case study approach. The study will be conducted at the Adult University Teaching Hospital in Lusaka. Data will be collected from all the 287 nurses and 37 physiotherapists working in the Emergency Department, Medical Wards, Adult Intensive Care Unit and the Department of Physiotherapy. Quantitative data will be analyzed using Statistical Package for social sciences. Descriptive statistics shall be computed on the role of nurses and physiotherapists in stroke care. In addition, chi-square and fisher’s exact tests will be used in the test for associations between variables while binary logistic regression will be used in identifying predictors of the various roles played by nurses and physiotherapists in the management of stroke patients. Qualitative data will be analyzed using thematic analysis in order to generate new concepts and a substantive model of care for stroke patients. <strong>Conclusion: </strong>Despite research evidence of improved outcomes when stroke patients are managed by a multi-disciplinary team, data on the role of different members of the multidisciplinary care team in stroke management is almost non-existent from the Zambia context. It is therefore hoped that information obtained from this study will be used as a basis for recommending the streamlined role of the nurse and physiotherapist in both acute care and rehabilitation.
